bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multimodal fusion-powered English speaking robot
Authors: Pan Ruiying 
Published: November 2024

IntroductionSpeech recognition and multimodal learning are two critical areas in machine learning. Current multimodal speech recognition systems often encounter challenges such as high computational demands and model complexity.MethodsTo overcome these issues, we propose a novel framework-EnglishAL-Net, a Multimodal Fusion-powered English Speaking Robot. This framework leverages the ALBEF model, optimizing it for real-time speech and multimodal interaction, and incorporates a newly designed text and image editor to fuse visual and textual information. The robot processes dynamic spoken input through the integration of Neural Machine Translation (NMT), enhancing its ability to understand and respond to spoken language.Results and discussionIn the experimental section, we constructed a dataset containing various scenarios and oral instructions for testing. The results show that compared to traditional unimodal processing methods, our model significantly improves both language understanding accuracy and response time. This research not only enhances the performance of multimodal interaction in robots but also opens up new possibilities for applications of robotic technology in education, rescue, customer service, and other fields, holding significant theoretical and practical value.
Population pharmacokinetics of rilpivirine following oral administration and long-acting intramuscular injection in real-world people with HIV
Authors: Thoueille Paul , Saldanha Susana Alves , Schaller Fabian , Choong Eva , Veuve François , Munting Aline , Cavassini Matthias , Braun Dominique , Günthard Huldrych F. , Duran Ramirez Jessy J. , Surial Bernard , Furrer Hansjakob , Rauch Andri , Ustero Pilar , Calmy Alexandra , Stöckle Marcel , Di Benedetto Caroline , Bernasconi Enos , Schmid Patrick , Marzolini Catia , Girardin François R. , Buclin Thierry , Decosterd Laurent A. , Guidi Monia 
Published: November 2024

BackgroundThe pharmacokinetics of long-acting rilpivirine has mostly been studied in clinical trials, which do not fully address the uncertainties that arise in routine clinical situations.Aims and methodsOur population analysis aims to establish percentile curves for rilpivirine concentrations in people with HIV (PWH) followed-up in a routine clinical setting, while identifying patient-related factors that may influence rilpivirine exposure. A total of 238 PWH enrolled in our nationwide multicenter observational study contributed to 1038 concentrations (186 and 852 concentrations after oral and intramuscular injection, respectively).ResultsRilpivirine pharmacokinetics were best described by a two-compartment model with an oral to intramuscular relative bioavailability factor. A simple zero-order absorption process was retained for oral administration while a parallel first-order absorption was used for intramuscular administration, with 27.6% of the dose released via a fast absorption pathway and the remaining fraction via a slow absorption pathway. Our model estimated that long-acting rilpivirine reaches steady-state after 2.5 years and has an elimination half-life of 18 weeks, consistent with published estimates. In females, a 45.6% reduction in the proportion of the dose absorbed via the rapid absorption pathway was observed. However, this resulted in no more than 15% difference in trough concentrations (Ctrough) compared to males, which was not considered to be clinically relevant.ConclusionOverall, our model-based simulations showed that only approximately 50% of long-acting rilpivirine Ctrough would be above the 50 ng/mL threshold associated with optimal therapeutic response, while approximately 85% of Ctrough would be above the first quartile of concentrations observed in Phase III trials (32 ng/mL).
Towards p-11B medium configurations with high Pfus/PBrems ratios
Authors: Daponta C. , Moustaizis S. , Eliezer S. , Henis Z. , Lalousis P. , Nissim N. , Schweitzer Y. 
Published: November 2024

Aneutronic p-11B nuclear fusion is promising for clean energy production, as it produces three (3) alpha particles with 8.7 MeV total energy. However, the main difficulty for p-11B fusion ignition (Q = Pfus/PBrems≥ 1) concerns the nuclear cross section and thus, reactivity efficiency at higher than 200 keV medium temperatures. To overcome this difficulty, the present work emphasizes on the numerical investigation of medium schemes (configurations) with enhanced reactivity. The configurations refer to the addition of energetic protons in a low-density 11boron or proton–11boron medium (n = 1020 m−3), with (np/nB) &gt; 1 for Bremsstrahlung losses optimization and initial temperature in the range of 1 keV ≤ Tin≤ 400 keV. A self-consistent multi-fluid global particle and energy balance code, including collisions between all medium species (p, 11B, e, α), is used for the description of the temporal evolution of all fusion medium physical parameters and the evaluation of the optimum initial conditions for the obtainment of Q ≥ 1. The numerical simulation results show that the coupling between the 200 keV &lt; Ep,0≤ 750 keV energetic protons and the 1 keV ≤ Tin≤ 400 keV initial fusion medium leads to ignition, 1 ≤ Q &lt; 1.4, below Tin= 100 keV. In all the presented initial medium temperature cases, and especially, the lower (&lt;) than 100 keV, the ignition condition (Pfus/PBrems) &gt; 1 arises, as a consequence of the chain reactions and the related avalanche alpha heating effect.
Graft-derived cell free DNA: used for assessment of early graft status and its implications for long-term kidney function
Authors: Wei Liang , Zhao Yongheng , Deng Shaoping , Wu Shaoping , Wang Hailian , Luo Xiangwei , Yang Hongji 
Published: November 2024

BackgroundThe long-term graft survival is closely related to its early status, yet the indices for assessing the early graft status are complex and lack quantitative values. The aim of this study is to investigate the potential of GcfDNA as a comprehensive, non-invasive, convenient, and quantifiable indicator for evaluating early graft status.MethodsIn this study, 138 recipients who underwent primary kidney transplantation were enrolled. Peripheral blood samples, each 10 mL, were collected on days 1 and 7 post-transplantation. The quantification of both the graft cell-free DNA (GcfDNA) fraction (%) and GcfDNA concentration (copies per milliliter, cp/mL) was performed using droplet digital PCR (ddPCR).ResultsFor most recipients, both the GcfDNA fraction and concentration had a rapid decline at 7 days post-transplantation, reaching median values of approximately 0.7% and 53.5 cp/mL, respectively. No significant associations were found between GcfDNA values and other clinical parameters. On the seventh postoperative day, we observed a significant elevation in GcfDNA concentration among recipients with eGFR values &lt; 60 mL/min/1.73 m2. Additionally, notable increases were identified in both GcfDNA fraction and concentration variations within this specific subgroup. The findings of our study indicate a negative correlation between the concentration and fractional changes of GcfDNA on postoperative days 1 and 7, as well as the GcfDNA concentration on postoperative day 7, with eGFR within the 1–2 years post-transplantation period. The ROC curve of GcfDNA_Copies_Variation. day1-day 7 showed the highest AUC value AUC = 0.8006, with high sensitivity (90.14%) and specificity (77.61%), and PPV and NPV were 81.01% and 88.14%, respectively. Using four classical algorithm models, we found that the xgboost regression model achieved the best predictive performance (area under the curve (AUC) values = 0.862) for eGFR within 1–2 years post-transplantation, with high sensitivity (85.7%) and specificity (85%).ConclusionThe changes of GcfDNA levels in the early stage are closely related to kidney function within 1–2 years post-transplantation. As a comprehensive indicator of graft function, GcfDNA has great potential for clinical application.
A longitudinal study on the impact of perceived stress on academic engagement among deaf college students: the moderating effect of positive emotions
Authors: Chen Tianlin , Xu Kunjin , Luo Lan , Chen Yongfei 
Published: November 2024

IntroductionThis longitudinal study sought to examine the dynamic influence of perceived stress on academic engagement among deaf college students, as well as assess the moderating role of positive emotions in this relationship. Given the unique challenges faced by deaf students in educational environments, understanding these dynamics becomes crucial for developing effective support strategies.MethodsAcross a seven-month period, encompassing two semesters, 223 deaf college students were evaluated three times using the Perceived Stress Questionnaire, the Academic Engagement Questionnaire, and the Positive Emotions Questionnaire.ResultsThe results indicated that these students experienced high and variable levels of perceived stress, along with inadequate and similarly fluctuating levels of academic engagement. Their positive emotions were moderately low but relatively consistent. Perceived stress was found to be a negative predictor of academic engagement, while positive emotions positively predicted academic engagement. Furthermore, positive emotions acted as a moderating factor, alleviating the negative effects of perceived stress on academic engagement and serving as a protective mechanism for the academic engagement of deaf college students.DiscussionThis research sheds light on the impact of perceived stress on academic engagement in deaf college students, and reveals the underlying mechanisms, contributing precious empirical evidence to further our comprehension and enhance special education services.
The prevalence of anxiety symptoms/disorders in cancer patients: a meta-analysis
Authors: Amiri Sohrab 
Published: November 2024

ObjectiveCancer can have negative effects on mental health. The aim of this study was to investigate the prevalence of anxiety symptoms/disorders in cancer patients’ worldwide using meta-analysis.MethodsThe study population was cancer patients who had cancer at the time of the study. The outcome studied in this study was anxiety symptoms/disorders. PubMed and Scopus were searched based on the syntax of keywords, this search was limited to articles published in English until September 2021. For this meta-analysis, data on the prevalence of anxiety were first extracted for each of the eligible studies. The random-effects method was used for the pool of all studies. Subgroup analysis was performed based on sex, anxiety disorders, cancer site, and continents. Heterogeneity in the studies was also assessed.ResultAfter evaluating and screening the studies, eighty-four studies were included in the meta-analysis. Prevalence of anxiety symptoms/disorders in cancer patients showed that this prevalence is 23% (I2 = 99.59) in the 95% confidence interval between 22-25%. This prevalence was 20% (I2 = 96.06%) in the 95% confidence interval between 15-24% in men and this prevalence is 31% (I2 = 99.72%) in the 95% confidence interval between 28-34% in women. The highest prevalence of anxiety was in patients with ovarian, breast, and lung cancers.DiscussionIt showed a high prevalence of anxiety symptoms/disorders in cancer patients, in addition to therapeutic interventions for cancer, the necessary interventions should be made on the anxiety of these patients. Methodological limitation was the heterogeneity between the studies included in the meta-analysis. Some types of cancer sites could not be studied because the number of studies was small or the site of cancer was not identified.
Pathway analysis of clinical nurse educator’s intention to use virtual reality technology based on the UTAUT model
Authors: Mengying Li , Dongquan Fu , Lin Li , Yining Cao , Huijuan He , Siyu Zhou , Dan Yin 
Published: November 2024

PurposeThis study aims to investigate the willingness of clinical nurse educator to adopt virtual reality technology, while also examining the underlying mechanisms that influence this willingness through the lens of the Unified Theory of Acceptance and Use of Technology (UTAUT).MethodsA convenience sampling method was employed to select 225 clinical nurse educator, all of whom possess a professional qualification certificate as nurse practitioners, from a tertiary hospital in Wuhan City, Hubei Province. The study utilized an adapted UTAUT model theory-based design to develop several questionnaires: the performance expectancy questionnaire (11 items), the effort expectancy questionnaire (4 items), the social influence questionnaire (6 items), the facilitating conditions questionnaire (7 items), and the behavioral intention questionnaire (4 items). These instruments were designed to assess the clinical nurse educators’ willingness to adopt VR technology. Furthermore, a regression model was established to analyze the factors influencing this willingness, utilizing SPSS 26.0 for statistical analysis and validating the model through path analysis with AMOS 24.0, where a p-value of less than 0.05 was considered statistically significant.ResultsThe questionnaire demonstrated strong reliability and validity, yielding a total of 222 valid samples, comprising 209 females (94.14%) and 13 males (5.86%). Among the clinical nurse educators, 163 (73.42%) reported a willingness to use virtual reality technology, with scores of 4 or higher. Pearson correlation analysis revealed positive correlations between performance expectancy, effort expectancy, social influence, and facilitating conditions with behavioral intention (p &lt; 0.05). Furthermore, regression analysis indicated that performance expectancy, effort expectancy, social influence, and facilitating conditions had a positive impact on behavioral intention (p &lt; 0.05). The path model exhibited a good fit, and the results were consistent with the regression analysis, showing that the effects of performance expectancy, effort expectancy, and social influence on the behavioral intention to use virtual reality technology were 0.231, 0.150, 0.236, and 0.247, respectively.ConclusionClinical nurse educators exhibit a robust willingness to engage with VR technology. Moreover, improving factors such as performance expectancy, effort expectancy, social influence, and facilitating conditions can substantially enhance their readiness to adopt this technology.
Individual and community level determinants of minimum meal frequency among breastfeeding children aged 6–23 months in Ethiopia: a multilevel analysis of 2019 Ethiopian Demographic Health Survey data
Authors: Melak Dagnachew , Abeje Eyob Tilahun , Bayou Fekade Demeke , Getaneh Fekadeselassie Belege , Asmare Lakew , Endawkie Abel , Gedefie Alemu , Muche Amare , Mohammed Anissa , Ayres Aznamariam 
Published: November 2024

BackgroundMinimum meal frequency (MMF) is a vital indicator of whether a child’s energy needs are being met. Previous studies in Ethiopia on MMF have primarily focused on individual factors, often using basic logistic regression models with limited scope and small sample sizes. In contrast, this study aims to identify the key determinants of MMF among breastfed children aged 6–23 months in Ethiopia, examining both individual and community-level factors through multilevel logistic regression analysis, utilizing nationally representative data.MethodThe study utilized a community-based cross-sectional design with a sample of 1,245 6–23 month breastfed children in Ethiopia, using data from the 2019 Ethiopian Mini Demographic Health Survey. Mixed effect logistic regression was used to identify factors associated with MMF. Adjusted odds ratios (AOR) with 95% confidence intervals were used to assess variable associations, while Intra-cluster correlation (ICC), median odds ratio (MOR), and proportional change in variance (PCV) were employed to gauge random variation.ResultThe proportion of 6–23-month breastfeeding children with MMF was found to be 55.9% (95% CI: 53.2, 58.6). In mixed effect logistic regression; breastfeeding initiation time within days after birth [AOR = 0.44; 95%CI: (0.24, 0.80)], maternal primary educational level [AOR = 1.46; 95%CI: (1.03, 2.05)], maternal higher level education [AOR = 2.43; 95%CI: (1.22, 4.81)] and children from wealthiest household wealth index [AOR = 2.13; 95%CI: (1.04, 4.33)] were individual-level factors and children from city-based regions [AOR = 1.75; 95%CI: (1.10, 2.77)] was community level factors significantly associated with MMF. The final model indicates that 50.8% of the variation in MMF was explained by combined factors at both individual and community levels and also the variation across clusters remained statistically significant (ICC = 8.1% and variance = 0.29 with p &lt; 0.001).ConclusionMinimum meal frequency is a proxy for meeting energy requirements and it is a key indicator of infant and young child feeding (IYCF) practice. According to this study finding, the prevalence of MMF among 6–23-month children in Ethiopia was found to be low. The study also suggest that time of breastfeeding initiation, women’s educational level, household wealth index, and contextual region were factors significantly associated with MMF. It is recommended that IYCF strategies should be implemented widely through women’s education and empowerment and promoting early initiation of breast feeding to increase the proportion of children to be fed with MMF appropriate for their age.
Associations between smoking and coronary heart disease: mediating role of RDW
Authors: Ma Mingfeng , Wu Yue , He Xingmin , Zhang Miaomiao , Han Yanlin , Guo Renwei , Li Shaojie 
Published: November 2024

IntroductionPrevious studies have demonstrated that both smoking and coronary heart disease (CHD) are linked to red cell distribution width (RDW). However, the role of the RDW in the association between smoking and CHD remains unclear. This study investigates the role of RDW in the association between smoking and coronary heart disease.MethodsData from 13,080 adults aged 40–80 years were analyzed from the National Health and Nutrition Examination Survey (NHANES) conducted between 2006 and 2017. Statistical methods included regression analysis, restricted cubic spline curve (RCS), subgroup analysis, and mediation analysis.ResultsResults showed higher RDW levels in participants with smoking and/or CHD than in those without. Smoking status was positively associated with RDW and CHD even after adjusting for potential confounders. A nonlinear relationship between RDW and CHD was observed (P for nonlinear &lt;0.001). Subgroup analysis revealed that sex influenced the relationship between smoking and CHD (p = 0.0284). Mediation analysis showed that increased RDW levels mediated the association between smoking status and CHD (PM = 2.1959%, ACME = 0.000694, 95% CI = 0.000262–0.001259, p &lt; 0.001).DiscussionOur research showed that smoking, RDW, and CHD are interrelated, with RDW playing as a mediator, offering a novel perspective for the prevention and management of CHD.
Assessment of the quality of malaria surveillance and laboratory services for diagnosis in three districts of Gujarat state, India
Authors: Kaur Jaspreet , Baharia Rajendra , Dattani Mamta 
Published: November 2024

ObjectivesSurveillance is the backbone for the control of malaria and its elimination. In the state of Gujarat, situated in the western region of India, some of the districts reported a high annual blood examination rate (ABER) for malaria. Therefore, a study was conducted to identify the underlying reasons for the increase in the ABER for malaria.MethodsPlanned investigations were carried out in three of the state districts, scrutinizing records of malaria forms and other epidemiological data collected during health worker surveillance, assessment of laboratory services, and rapid fever surveys.ResultsThe rate of fever ranged from 8 to 57% in the primary health centers that were surveyed. Analysis of epidemiological data revealed that malaria parasite positivity was more from passive than active surveillance. Increased ABER was accounted for by multiple factors, including blood slides collected during the mass survey and contact smears, which were included in the ABER and not mentioned separately. Blood slides prepared for the migrant population were included in the ABER, but the migrant population was not counted while calculating the ABER.ConclusionThe ABER in villages surveyed varied from 1.6 to 78%, which is mainly due to indiscriminate preparation of blood slides, i.e., without fever symptoms. Addressing the key gaps identified in data recording may aid in channeling the limited resources efficiently, thereby progressing toward malaria elimination. Adequate surveillance activities, along with systematic data recording, will enable timely, informed decision-making for the effective allocation of resources, ultimately supporting malaria elimination efforts in the state.
Cellular senescence in acute human infectious disease: a systematic review
Authors: Miller William C. , Wallace Stephanie , Kamm William , Reardon Erin , Theis-Mahon Nicole , Yousefzadeh Matthew J. , Schmidt Elizabeth L. , Niedernhofer Laura J. , Puskarich Michael A. 
Published: November 2024

IntroductionAcute infectious disease represents a significant cause of mortality and morbidity in elderly individuals admitted to the hospital. In its extreme, it presents as sepsis, a systematic inflammatory and immunologic response responsible for self-injurious organ injury. As individuals age, a unique set of factors including immunosenescence predispose them to acquiring an infection and a worse clinical prognosis. This systematic review explores the relationship between cellular senescence, an age-related inflammatory phenomenon, with acute human infectious disease.MethodsEmbase via OVID, Scopus, Web of Science, Global Index Medicus, Cochrane Library via Wiley, and ClinicalTrials.gov were queried. Included studies must have compared at least one of the following measures of cellular senescence between patients with an infection and without an infection: cell cycle inhibition measured via levels of p16INK4a and/or p21CIP1, short telomere length, DNA damage via ɣH2AX, high senescence-associated β galactosidase activity, and inflammation via the detection of senescence associated secretory phenotype (SASP). Manuscripts were screened and data collected via two independent reviewers.ResultsA total of 15,828 studies were screened after duplicates were removed. One hundred and fifty-three full-text articles were assessed for eligibility and a total of 16 original articles were included in analysis. Of the 16 original articles included, 12 (75%) articles were centered on SARS-CoV-2, 2 (12.5%) articles utilized patients infected with Leishmania braziliensis, 1 (6.25%) with Plasmodium falciparum, and 1 (6.25%) with Hepatitis C.ConclusionCurrent literature demonstrates robust upregulation of markers of cellular senescence in the setting of acute SARS-CoV-2, P. falciparum, L. braziliensis, and hepatitis C virus, and that markers of senescence correlate with disease severity and persist for months after resolution. Limitations in the number and types of infectious organisms studied, low sample sizes, modest longitudinal sampling, and a lack of consistency in markers measured, the method of measurement, and the definition of normal values represent ongoing gaps in the literature.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=421473, Identifier CRD42023421473.