bluuebunny/crossref_metadata_2025_split huggingface dataset:
Content accuracy and readability of dietary advice available on webpages: A systematic review of the evidence
Authors: Fappa Evaggelia , Micheli Mary 
Published: November 2024

AbstractBackgroundConcerns have been raised regarding the quality of health information published on the World Wide Web, while studies accumulating similar evidence for nutrition‐related information are scarce. The present review aimed to systematically accumulate and discuss the findings of studies evaluating the content quality of websites publishing nutrition‐related information, based on the PRISMA statement.MethodsStudies that have assessed the accuracy and readability of dietary advice published on websites/webpages were evaluated. The SPIDER framework was used for the systematic search of studies, and those that evaluated websites/webpages that did not contain nutritional information, were videos or social media, referred to health professionals, or contained information on a specific theme (e.g., dietary supplements), were excluded.ResultsTwenty‐nine studies were included in this review, assessing information, published mainly in English, on 18 different diet‐related topics. Twenty of them classified websites and reported, also, results per category. Inconsistent information has been found on 16%–49.6% of websites, with this percentage rising to 54%–94% in the case of ‘weight loss’ information. Purely congruent with guidelines information was found on 18%–39.7% of websites. Commercial sites were inferior in terms of quality to the rest. The readability level was estimated as higher than the recommended in 9 out of 11 studies that assessed it.ConclusionsResults of the present systematic review indicate that inaccurate and hard‐to‐read dietary advice is found on many websites, regardless of the dietary topic.
Applying natural language processing to understand symptoms among older adult home healthcare patients with urinary incontinence
Authors: Scharp Danielle , Song Jiyoun , Hobensack Mollie , Palmer Mary Happel , Barcelona Veronica , Topaz Maxim 
Published: November 2024

AbstractIntroductionLittle is known about the range and frequency of symptoms among older adult home healthcare patients with urinary incontinence, as this information is predominantly contained in clinical notes. Natural language processing can uncover symptom information among older adults with urinary incontinence to promote holistic, equitable care.DesignWe conducted a secondary analysis of cross‐sectional data collected between January 1, 2015, and December 31, 2017, from the largest HHC agency in the Northeastern United States. We aimed to develop and test a natural language processing algorithm to extract symptom information from clinical notes for older adults with urinary incontinence and analyze differences in symptom documentation by race or ethnicity.MethodsSymptoms were identified through expert clinician‐driven Delphi survey rounds. We developed a natural language processing algorithm for symptom identification in clinical notes, examined symptom documentation frequencies, and analyzed differences in symptom documentation by race or ethnicity using chi‐squared tests and logistic regression models.ResultsIn total, 39,179 home healthcare episodes containing 1,098,419 clinical notes for 29,981 distinct patients were included. Nearly 40% of the sample represented racially or ethnically minoritized groups (i.e., 18% Black, 14% Hispanic, 7% Asian/Pacific Islander, 0.3% multi‐racial, and 0.2% Native American). Based on expert clinician‐driven Delphi survey rounds, the following symptoms were identified: anxiety, dizziness, constipation, syncope, tachycardia, urinary frequency/urgency, urinary hesitancy/retention, and vision impairment/blurred vision. The natural language processing algorithm achieved excellent performance (average precision of 0.92). Approximately 29% of home healthcare episodes had symptom information documented. Compared to home healthcare episodes for White patients, home healthcare episodes for Asian/Pacific Islander (odds ratio = 0.74, 95% confidence interval [0.67–0.80], p < 0.001), Black (odds ratio = 0.69, 95% confidence interval [0.64–0.73], p < 0.001), and Hispanic (odds ratio = 0.91, 95% confidence interval [0.85–0.97], p < 0.01) patients were less likely to have any symptoms documented in clinical notes.ConclusionWe found multidimensional symptoms and differences in symptom documentation among a diverse cohort of older adults with urinary incontinence, underscoring the need for comprehensive assessments by clinicians. Future research should apply natural language processing to other data sources and investigate symptom clusters to inform holistic care strategies for diverse populations.Clinical RelevanceKnowledge of symptoms of older adult home healthcare patients with urinary incontinence can facilitate comprehensive assessments, health equity, and improved outcomes.
Technological innovations of hidden champions: Evidence from patent data
Authors: Lampe Hannes W. , Block Jörn , Willeke Tom , Clauss Thomas , Steinmetz Holger 
Published: November 2024

AbstractThe hidden champion concept has received much interest in practice. As market leaders in niche markets, hidden champions represent the success of the (German) Mittelstand. Innovation is a key element of their strategy and their focus and niche market strategy are associated with specific technological capabilities. However, thus far, little quantitative empirical evidence exists about the innovation output of hidden champions. Drawing on a capability perspective and using patent data, the present study analyzes differences between hidden champions and comparable non‐hidden champion firms in their technological innovation. Our results show that hidden champions have a significantly larger technological innovation output but do not have a higher efficiency in their innovation creation compared to other firms from the same industry, size, and age. Moreover, the innovations produced by hidden champions show higher levels of technological depth and indicate lower levels of technological breadth. The sources of technological knowledge of hidden champions seem to be more inward oriented. Finally, innovations of hidden champions have similar technological impact, novelty and quality compared to those of other firms. Overall, our study supports many of the anecdotal beliefs about the innovation of hidden champions contributing to a better understanding of what makes hidden champions different from other Mittelstand firms. Practical implications for hidden champions and Mittelstand firms are discussed.
Performance of questionnaires to predict sleep‐disordered breathing in acute stroke patients
Authors: Dekkers Martijn Petrus Josephus , Horvath Christian Michael , Woerz Vanessa S. , Bernasconi Corrado , Duss Simone B. , Schmidt Markus H. , Manconi Mauro , Brill Anne‐Kathrin , Bassetti Claudio L. A. 
Published: November 2024

SummarySleep‐disordered breathing is common in stroke and may negatively affect its outcome. Screening for sleep‐disordered breathing in this setting is of interest but poorly studied. We aimed to evaluate the performance of eight obstructive sleep apnea screening questionnaires to predict sleep‐disordered breathing in acute stroke or transient ischaemic attack patients, and to assess the impact of stroke/transient ischaemic attack‐specific factors on sleep‐disordered breathing prediction. We analysed acute stroke/transient ischaemic attack patients (N = 195) from a prospective cohort (“Sleep Deficiency and Stroke Outcome study”). Assessments included anthropometrics, stroke‐specific parameters, sleep history, an in‐hospital respiratory polygraphy within the first week after stroke, and obstructive sleep apnea screening questionnaires (Berlin Questionnaire, Epworth Sleepiness Scale, STOP‐BANG, NoSAS, Sleep Apnea Clinical Score, No‐Apnea, Sleep Obstructive apnea score optimized for Stroke, SLEEP‐IN). In a binary classification task for respiratory event index ≥ 15 per hr, we evaluated the performance of the above‐mentioned questionnaires. We used logistic regression to identify predictors for sleep‐disordered breathing in this cohort. The areas under the curve for respiratory event index ≥ 15 per hr were: Berlin Questionnaire 0.60; STOP‐BANG 0.72; NoSAS 0.69; No‐Apnea 0.69; Sleep Apnea Clinical Score 0.75; Epworth Sleepiness Scale 0.50; Sleep Obstructive apnea score optimized for Stroke 0.58; and SLEEP‐IN 0.67. The No‐Apnea had the lowest false omission rate (0.13), a sensitivity of 0.97 and a specificity of 0.12. In multiple logistic regression analysis (respiratory event index ≥ 15 per hr), age, neck circumference, National Institutes of Health Stroke Scale at admission, prior stroke, cardioembolic stroke aetiology and observed apneas were associated with sleep‐disordered breathing. The logistic regression model performed similar (area under the curve 0.80) to Sleep Apnea Clinical Score (p = 0.402) and STOP‐BANG (p = 0.127), but outperformed the other questionnaires. Neither existing questionnaires nor our statistical model are sufficient to accurately diagnose sleep‐disordered breathing after stroke, thus requiring sleep study evaluation. The No‐Apnea questionnaire may help to identify patients amenable to sleep testing.
Dose‐exposure‐response of CARDALIS® (benazepril/spironolactone) on the classical and alternative arms of the renin‐angiotensin‐aldosterone system in healthy dogs
Authors: Manson Elizabeth , Ward Jessica L. , Merodio Maria , Guillot Emilie , Blondel Thomas , Allenspach Karin , Domenig Oliver , Mochel Jonathan P. 
Published: November 2024

AbstractBackgroundBenazepril exhibits a dose‐dependent effect on biomarkers of the circulating renin‐angiotensin‐aldosterone system (RAAS) in dogs.Hypothesis/ObjectivesTo characterize the dose‐exposure‐response relationship of a fixed‐dose combination product including benazepril and spironolactone (CARDALIS®) on RAAS biomarkers in dogs.AnimalsEighteen purpose‐bred healthy beagle dogs.MethodsThree groups of 6 dogs received different doses of CARDALIS® for 14 days following induction of RAAS activation by feeding a low‐sodium diet: (a) benazepril 0.25 mg/kg + spironolactone 2 mg/kg PO q24h (label dose); (b) benazepril 0.25 mg/kg + spironolactone 2 mg/kg PO q12h; or (c) benazepril 0.5 mg/kg + spironolactone 4 mg/kg PO q12h. Blood samples were collected at baseline and serial time intervals after CARDALIS® dosing to measure serum RAAS biomarkers and plasma concentrations of active drug metabolites. Time‐weighted averages for serum RAAS biomarkers after CARDALIS® dosing at steady state were compared between dosage groups using Wilcoxon rank‐sum testing.ResultsCompared to the label dose, the highest dose of CARDALIS® was associated with a 30% decrease in angiotensin II (P = .03), 94% increase in angiotensin 1‐7 (P = .03), 71% decrease in surrogate activity of ACE (P = .002), and 116% increase in circulating aldosterone (P = .02). CARDALIS® was well‐tolerated at all doses with no clinically relevant changes in renal values or serum electrolytes.Conclusions and Clinical ImportanceThe combined CARDALIS® product leads to dose‐dependent alterations of RAAS metabolites. These results could help inform clinical trials in dogs with heart disease.
Efficacy of Procaine, With and Without Epinephrine, Compared to Lidocaine in Local Anesthesia for Calves Before Thermocautery Disbudding
Authors: Adam Magdy , Jokela Annemari , Salla Kati , Aho Riikka , Raekallio Marja , Hänninen Laura , Hokkanen Ann‐Helena 
Published: November 2024

ABSTRACTWithin the European Union, the use of lidocaine in food‐producing animals is restricted due to concerns over human safety. This study compared the clinical effectiveness of procaine, with and without epinephrine, against lidocaine in pain alleviation during thermocautery disbudding in xylazine‐sedated calves. The efficacy of local blocks was assessed through needle pricks, and the behavioral reactions to disbudding were scored. Post‐disbudding pain was subjectively evaluated, and pressure pain threshold and tactile sensitivity around the horn bud were assessed at intervals. Blood was collected at intervals for plasma cortisol analysis. No significant differences were found between the groups in the needle prick test (p = 0.329) and the disbudding score (p = 0.855). Pain scores and quantitative sensory tests showed no significant differences between the lidocaine and procaine‐epinephrine groups. Conversely, tactile sensitivity and pain scores were significantly higher, and pressure pain thresholds were significantly lower with procaine alone than in other groups. Elevated cortisol concentrations were observed in all groups before disbudding compared to the baselines. The results suggest that procaine combined with epinephrine appears to be a safe and effective alternative to lidocaine for calf disbudding. Cortisol concentrations as an indicator of pain in xylazine‐sedated calves appear inadequate.
A participatory democracy with an intersectional approach
Authors: Castañeda Hernández Mireya 
Published: November 2024

AbstractThe article inserts the concept of intersectionality contributed by Afro‐descendant feminism to study whether affirmative action is open to other vulnerable groups besides gender in Mexico. An explanatory investigation of the concept of intersectionality correlated with multiple affirmative action is carried out, and a case study considers the decisions made by two electoral institutions in Mexico. Crenshaw's theories are confirmed, including a case study carried out in Mexico focused on decisions by electoral authorities that have promoted the establishment of multiple affirmative actions in electoral matters. A ruling by the Electoral Tribunal in which the discussion focused on the implementation of the intersectionality concept due to the application of multiple affirmative actions is also highlighted. Affirmative action must be understood in a broad vision open to different vulnerable groups, and the concept of intersectionality must be considered when there is more than one reason for vulnerability so that better protection can be provided.
Enhanced Biomechanical Stability in Proximal Humeral Fractures: Finite Element Analysis of a Novel Endosteal Anatomical Support Nail for Improved Fixation in Elderly Patients
Authors: Chen Jiawen , Wang Zhonghe , Li Changda , He Peiyu , Chen Zhongxuan , Sun Lijun , Cao Xiaoyan , Tian Na , Dong Xiang , Tang Peifu , Chen Hua 
Published: November 2024

ABSTRACTObjectivesIntramedullary nailing is preferred for treating elderly proximal humeral fractures, but secondary reductions are common, particularly in elderly and osteoporotic patients. This occurs due to the intramedullary nail fixation's insufficient anti‐varus and anti‐rotational capacities and high stress at the bone–implant interface. We aim to enhance the anti‐varus and anti‐rotational stability of the fixation structure while reducing the stresses on the bone and internal fixation through structural design.Materials and MethodsWe developed a novel endosteal anatomical support nail (EASN) that integrates an endosteal torus construct into the proximal portion of the angle‐stable proximal humerus nail. The endosteal torus construct includes endosteal anatomical support (EAS) with a flat plane that allows direct fixation of the humeral head fragments and is shaped to conform to the medial side of the medullary cavity of the proximal humerus. We conducted finite element analysis to assess the biomechanical stability of four constructs: EAS with a calcar screw (CS), EAS without CS, non‐EAS with CS, and non‐EAS without CS. This analysis determined the contribution of the EAS to the mechanical stability of the proximal humerus in two‐part PHF with medial column disruption. Specimens were subjected to loads simulating partial‐weight‐bearing (as in rising from a chair or using crutches) and full‐weight‐bearing (as in rising from bed). We evaluated the stiffness of the construct, displacement at the fracture site, von Mises stress, and stress distribution.ResultsUnder compressive or rotational loads, the EAS construct, with or without CS, was significantly stiffer than the non‐EAS construct. Displacement at the fracture site was significantly less with the EAS fixation than with the non‐EAS fixation. However, the stiffness and displacement at the fracture site of the EAS fixation without CS were comparable to those of the non‐EAS construct with CS. The EAS construct reduced the load on the nail and decreased the risk of implant failure. Both von Mises stress and stress distribution were significantly lower following fixation with the EAS constructs.ConclusionsThis study introduces a novel EAS concept to enhance the anti‐varus and anti‐rotational capabilities of the humeral head and distribute stress at the bone–implant interface in treating elderly PHFs. This strategy shows promise based on our limited analysis.
BcVQ11A‐BcWRKY23‐BcWRKY25 Module Is Involved in Thermotolerance by Regulating Phenylalanine Ammonia‐Lyase Activity in Non‐Heading Chinese Cabbage
Authors: Gao Zhanyuan , Wang Haiyan , Chen Xiaoshan , Ding Qiang , Li Entong , Shen Yunlou , Jiang Cheng , Li Ying , Zhang Changwei , Hou Xilin 
Published: November 2024

ABSTRACTHigh temperature can significantly affect the quality and yield of plants. However, there has been limited research investigating the thermotolerance of non‐heading Chinese cabbage (NHCC). This study, identified BcWRKY23 through transcriptome analysis in NHCC with varying levels of thermotolerance. Overexpression and silencing experiments demonstrated that BcWRKY23 positively regulates the thermotolerance of NHCC by activating its own expression under short‐term heat stress (HS). Additionally, BcWRKY23 was found to bind to the promoter of BcWRKY25 and activate its expression, which also enhanced thermotolerance. BcWRKY23 and BcWRKY25 enhanced the expression of HSR genes to improve thermotolerance. Furthermore, BcPAL1 was shown to be activated by BcWRKY23, while BcPAL2 was activated by both BcWRKY23 and BcWRKY25. Overexpression of BcPAL1 and BcPAL2 in NHCC significantly increased thermotolerance, accompanied by an enhancement of phenylalanine ammonia‐lyase (PAL) activity. Moreover, under long‐term HS, the significant accumulation of BcVQ11A was observed, and the interaction between BcVQ11A and BcWRKY23 as well as BcWRKY25 inhibited the activation of them to target genes, resulting in decreased PAL activity. This study proposes a HS response pathway involving BcVQ11A‐BcWRKY23‐BcWRKY25‐BcPAL1/BcPAL2, providing valuable insights into the molecular mechanisms underlying thermotolerance in plants.
Association between peripheral activated naive and double negative 2 B‐cell subsets and clinical parameters in lupus nephritis patients
Authors: Wangriatisak Kittikorn , de Vries Charlotte , Sharma Ravi Kumar , Huang Wenqi , Grönwall Caroline , Pisitkun Prapaporn , Gunnarsson Iva , Malmström Vivianne , Chootong Patchanee , Faustini Francesca 
Published: November 2024

AbstractAltered composition of B‐cell compartments is a known feature in patients with systemic lupus erythematosus (SLE). However, deep characterisation of B‐cell subsets and their relation to clinical manifestations and disease activity in patients is limited. In this study, we analysed peripheral B‐cell subsets phenotype in SLE (n = 35) and healthy controls (HCs, n = 15) by spectral flow cytometry. Disease activity was stratified as inactive (SLEDAI‐2 K score 0, n = 2), mild (SLEDAI‐2 K score 1–5, n = 12), moderate (SLEDAI‐2 K score 6–10, n = 6) or high (SLEDAI‐2 K > 10, n = 15). An elevated proportion of activated naive (aNAV), double negative 2 (DN2) and plasmablasts (PB) was observed in patients with high disease activity, compared to other groups of patients and HCs. An upregulation of BTLA was found on both aNAV and DN2 and shifted to lower levels with increasing disease activity. In lupus nephritis (LN) patients (n = 21), aNAV B‐cells were especially expanded and positively correlated with DN2 (r = 0.5, p = 0.019) and PB (r = 0.43, p = 0.048). Also, correlation was observed between DN2 and PB (r = 0.6, p = 0.003). Moreover, aNAV frequencies positively correlated with SLEDAI‐2 K score, and negatively with the complement fractions C3 and C4. Further, aNAV, DN2 and PB were more expanded in association with positive anti‐dsDNA antibodies, rather than other antibody specificities (anti‐Sm). These data suggest roles of extrafollicular B cells as key players in disease development of LN. Their association with presence of anti‐dsDNA antibodies may indicate their value as candidate biomarkers of kidney involvement in SLE.
Profiles of father involvement among unmarried Black fathers and child social–emotional functioning
Authors: Yoon Susan , Wang Jingyi , Chang Yujeong , Lee Joyce Y. , Nho Choong Rai , Chung Ick‐Joong , Schoppe‐Sullivan Sarah J. 
Published: November 2024

AbstractThis study examined patterns of father involvement among 2040 unmarried non‐Hispanic Black fathers (M = 25.27 years; SD = 6.51 years) with low income, and their associations with young children's (age 3 years; 50.34% girls) social–emotional functioning. Latent profile analysis revealed four father involvement profiles: high involvement (50.60%); nonresident, moderate involvement (18.09%); highly engaged, but low cognitive stimulation (25.49%); and nonresident, very low involvement (3.82%). Children of highly involved Black fathers exhibited optimal social–emotional functioning compared to children of fathers in the other profiles. Children of fathers in the highly engaged, but low cognitive stimulation profile showed poorer social–emotional functioning. Our findings showed that Black fathering is a diverse experience with much heterogeneity, suggesting the need for fatherhood programs responsive to different fathering profiles.
Discovering journals: A strategy for enhancing the introductory statistics course for undergraduate students
Authors: Setiawan Ezra Putranda 
Published: November 2024

AbstractUndergraduate students outside Statistics major frequently take only one class of Basic Statistics or Introductory Statistics during their studies. As a consequence, many of them have little knowledge about advanced statistical methods, such as logistic regression, nonparametric procedures, and multivariate analysis, although they might need to perform it in the future. We have developed a teaching strategy to introduce these topics to first‐year students who take the Introductory Statistics course by asking them to discovering scientific journals in groups and present them. A discussion feature in the Moodle e‐learning systems really helps us to carry out this strategy effectively. We discuss some benefits of this strategy as well as some pitfalls that can be occurred during its implementation.