bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analysis of the association between non-alcoholic fatty liver disease and mortality in United States adults
Authors: Rong Fen , Mai Yiyi , Shou Lujia , Zhu Xinya , Li Meiyue , Zhu Liuchen , Sun Xiuli , Zhao Xinhua 
Published: November 2024

BackgroundNon-alcoholic Fatty Liver Disease (NAFLD) is a prevalent condition characterized by the accumulation of fat in the liver, often linked with increased risk for multi-systemic diseases. This study aims to investigate the relationship between NAFLD and mortality, particularly all-cause and cardiovascular mortality, among United States adults.MethodsData from the National Health and Nutrition Examination Survey (NHANES) were utilized, encompassing 80,312 participants from 2003–2004 to 2017–2018. After exclusions for incomplete data, potential other liver diseases, and significant alcohol consumption, the final analytical cohort included 32,698 participants. The Fatty Liver Index (FLI), a non-invasive diagnostic tool, was used to identify NAFLD. Covariates included demographic characteristics, lifestyle factors, and biochemical parameters. Survival analysis was conducted using a weighted Cox proportional hazards regression model to quantify the impact of NAFLD on mortality.ResultsThe study revealed that NAFLD was significantly associated with increased risks of all-cause and cardiovascular disease (CVD) mortality. The hazard ratios (HRs) from the survival analysis consistently indicated a higher risk among participants with NAFLD compared to those without. Subgroup analyses further confirmed the association, with notable exceptions in certain subgroups such as those with high school education and diabetes. Additionally, a nonlinear relationship between serum uric acid (SUA) levels and mortality risk was identified among NAFLD participants.ConclusionNon-alcoholic Fatty Liver Disease is a significant risk factor for all-cause and CVD mortality in US adults. The findings underscore the importance of early detection and intervention for NAFLD to mitigate its impact on public health. Further research is needed to explore the complex interactions between NAFLD, SUA levels, and mortality, particularly in high-risk subgroups.
Detecting and localizing cervical lesions in colposcopic images with deep semantic feature mining
Authors: Wang Li , Chen Ruiyun , Weng Jingjing , Li Huiping , Ying Shi , Zhang Jinghui , Yu Zehao , Peng Chengbin , Zheng Siming 
Published: November 2024

ObjectiveThis study aims to investigate the feasibility of employing artificial intelligence models for the detection and localization of cervical lesions by leveraging deep semantic features extracted from colposcopic images.MethodsThe study employed a segmentation-based deep learning architecture, utilizing a deep decoding network to integrate prior features and establish a semantic segmentation model capable of distinguishing normal and pathological changes. A two-stage decision model is proposed for deep semantic feature mining, which combines image segmentation and classification to categorize pathological changes present in the dataset. Furthermore, transfer learning was employed to create a feature extractor tailored to colposcopic imagery. Multi-scale data were bolstered by an attention mechanism to facilitate precise segmentation of lesion areas. The segmentation results were then coherently mapped back onto the original images, ensuring an integrated visualization of the findings.ResultsExperimental findings demonstrated that compared to algorithms solely based on image segmentation or classification, the proposed approach exhibited superior accuracy in distinguishing between normal and lesioned colposcopic images. Furthermore, it successfully implemented a fully automated pixel-based cervical lesion segmentation model, accurately delineating regions of suspicious lesions. The model achieved high sensitivity (96.38%), specificity (95.84%), precision (97.56%), and f1 score (96.96%), respectively. Notably, it accurately estimated lesion areas, providing valuable guidance to assisting physicians in lesion classification and localization judgment.ConclusionThe proposed approach demonstrates promising capabilities in identifying normal and cervical lesions, particularly excelling in lesion area segmentation. Its accuracy in guiding biopsy site selection and subsequent localization treatment is satisfactory, offering valuable support to healthcare professionals in disease assessment and management.
Bimodal intensity-modulated radiotherapy in combination with carbon ion therapy (C12) of mucosal melanomas - data of the last decade from Heidelberg University Hospital
Authors: Bauer Lukas , Paul Angela , Regnery Sebastian , Deng Maximilian Y. , Ellerbrock Malte , Mielke Thomas , Harrabi Semi B. , Seidensaal Katharina , Held Thomas , Herfarth Klaus , Debus Jürgen , Hassel Jessica C. , Uzun-Lang Kristin 
Published: November 2024

IntroductionDue to the rarity of mucosal melanomas, few recent studies can be found investigating the success and side effects of therapy for this entity with large numbers of patients. In this retrospective analysis, the efficacy and toxicity of combined intensity-modulated radiotherapy (IMRT) and carbon ion therapy (C12) of mucosal melanomas were analyzed to contribute to a better understanding of this rare disease.MethodsTwenty-two patients were included from 2013 to 2022 in the Department of Radiation Oncology at Heidelberg University Hospital. 19 patients received bimodal radiotherapy consisting of radiotherapy by IMRT and carbon ion therapy (C12). 3 patients received photon only IMRT. In addition to Overall Survival (OS), local control rate (LCR), locoregional control rate (LRCR) and progression-free survival (PFS), early and late toxicity of treatment was analyzed. Bimodal radiotherapy consisted of IMRT of the primary tumor region and cervical lymph nodes in a single dose of 2 Gy up to the dose of 50.0 Gy in the basic schedule after application of a C12 boost of the primary tumor region up to 24 Gy (RBE) in a single dose of 3 Gy (RBE) up to the total dose of 74.0 Gy (RBE) in 5-6 fractions/week. Photon only radiotherapy comprised IMRT up to total doses of 66-70,4 Gy in 5 fractions/week.ResultsAfter 2 years, overall survival, progression-free survival, local control and locoregional control were 46%, 41%, 77% and 77%, respectively. 4 out of 5 patients with local relapse showed in-field recurrence inside the C12 boost volume. The primary tumor in these patients was always located in the main nasal cavity and/or paranasal sinus. Leading acute toxicity was grade 2 mucositis (12 patients, 55%) followed by grade 1 radiation dermatitis (10 patients, 45%). The cumulative incidence of late grade 3 toxicities was 15%.DiscussionThe combination of IMRT with carbon ion therapy in the treatment of mucosal melanoma provides promising local control rates with mild acute toxicity despite unfavorable patient preselection. The unfavorable overall survival as well as progression-free survival rates indicate that concomitant systemic therapies should be the subject of future research.
Influence of neuropathological diagnosis on psychooncological distress in neurooncological patients - a retrospective cross-sectional analysis
Authors: Staub-Bartelt Franziska , Obermayr Sarah , Sabel Michael , Rapp Marion 
Published: November 2024

BackgroundGliomas, the most common primary brain tumours, are classified based on histology and molecular genetics. Glioblastomas (GBM) are highly aggressive and are graded as WHO grade 4, while astrocytoma and oligodendrogliomas fall under WHO grades 2-3 (4). Gliomas affect 6 per 100,000 people, with a higher incidence in men. GBM has the poorest prognosis, whereas grade 2 astrocytoma and oligodendrogliomas show better outcomes. Quality of life (QoL) is now a crucial therapeutic goal alongside survival. Despite the impact of gliomas on QoL, especially given their incurability and progressive neurological deficits, research specifically comparing QoL and psycho-oncological stress in GBM versus grade 2 gliomas (glioma_2) remains limited. This study aims to fill that gap using validated measurement methods.MethodsThis retrospective, single-centre study investigated differences in QoL among neuro-oncological patients using the Karnofsky Performance Score (KPS), Distress Thermometer (DT), Hospital Anxiety and Depression Scale (HADS), and EORTC-QLQ-C30-BN20. Data were collected before chemotherapy or radiotherapy to avoid therapy impact on QoL. Out of 2258 patients screened until June 30, 2022, 639 had glioblastoma or WHO grade 2 gliomas, with 223 meeting inclusion criteria for analysis.ResultsThe study included 161 GBM and 62 Glioma_2 patients, with 64% of all patients being male. The mean age was 58.11 years (SD ± 16.186). The DT did not show significant differences between GBM and glioma_2 glioma patients (median GBM:6 vs. 5 in glioma_2, p=0.480). However, the HADS-D indicates that GBM patients experience significantly more depression (median GBM 4.5 vs. 4 in glioma_2, p=0.033), though anxiety levels are similar in both groups (median GBM. 6 vs. 6 in glioma_2, p=0.867). The KPS (median GBM 70 vs. 90 in glioma_2, p&lt;0.001) and specific aspects of the EORTC-QLQ-C30-BN20 questionnaire demonstrate that GBM patients have notably greater physical impairments than glioma_2 patients at diagnosis. Overall, GBM patients report worse quality of life compared to glioma_2 patients (median GBM 50 vs. 67 in glioma_2, p&lt;0.001).ConclusionThis study showed that distress is present in glioma patients regardless of their histopathological grading, even though GBM patients show higher depression levels and more physical limitations. Targeted anxiety management and early depression screening are essential for all glioma patients. Early QoL screening and making QoL a therapeutic goal benefits patient care and society.
Association between reported ADHD symptom and motor development delay in preschool children
Authors: Cui Zhijun , Li Shijie , Liang Aimin , Huang Hongmei , Ni Xin 
Published: November 2024

ObjectiveTo explore whether the motor developmental level is associated with the attention deficit/hyperactivity disorder (ADHD) symptoms severity reported by parents in preschool children.MethodsPreschool children aged 4–6 years old with the chief complaint of reported inattention or hyperactivity by kindergarten teachers or parents were recruited in this study. All participants were consulted by at least one experienced developmental behavior pediatrician, according to DSM-V diagnostic criteria of ADHD. Their neuromotor developments were assessed by the Children's Neuropsychological and Behavior Scale and recorded as developmental quotient (DQ) score in gross motor, fine motor, and other domains. Regarding the evaluation of ADHD symptoms, parents of the 4-year-old group completed the Conners' Parent Symptom Questionnaire, while parents of the 5-year-old group completed The Vanderbilt ADHD Diagnostic Parent Rating Scale.ResultsA total of 137 preschool children aged 4–4.9 years (4-year-old group) and 252 were aged 5.0–5.9 years (5-year-old group) were included in the study. Children exhibiting ADHD symptoms were at a much higher risk of fine motor delays compared to gross motor delays, particularly among the younger age group. Correlation analysis and hierarchical regression showed that in the 4-year-old ADHD group, better gross motor development was associated with increased severity of parent-reported ADHD symptoms. In the 5-year-old ADHD group, poorer fine motor development was linked to higher ADHD symptom severity. For children who do not meet ADHD diagnostic criteria, no significant correlations were found between gross or fine motor developmental quotients (DQ) and the severity of ADHD symptoms.ConclusionsPreschool children exhibiting ADHD symptoms are at a notable high risk of fine motor delays. Motor development in preschool children who meet ADHD diagnostic criteria is related to the severity of their symptoms. It is important to monitor both fine and gross motor development in preschool children with ADHD.
Effects of unilateral and bilateral contrast training on the lower limb sports ability of college basketball players
Authors: Duan Tianyu , He Zongwei , Dai Jing , Xie Lin , Shi Yuer , Chen Lunxin , Song Junyi , Li Guoxing , Zhang Wenfeng 
Published: November 2024

Objective: The purpose of this study was to compare the impact of unilateral (U) and bilateral (B) contrast training on lower limb explosiveness, agility, and balance in college basketball athletes.Methods: Twenty male college basketball players were randomly assigned to either a unilateral group (U, n = 10) or a bilateral group (B, n = 10). Both groups underwent an 8week strength training program, with sessions held twice a week. The unilateral group performed six Bulgarian split squats and ten reverse lunge jump squats, while the bilateral group performed six barbell rear squats and ten double-leg vertical jumps. To comprehensively assess the training effects, the study utilized one-repetition maximum (1RM), countermovement jump (CMJ), 20m sprint, and single-leg hop tests to evaluate explosive power; the 505 and t-test to assess change-of-direction ability; and the Y-balance test (YBT) to evaluate dynamic balance. Paired sample t-tests were used to evaluate within-group changes, and a 2 (pre- and post-) × 2 (experimental and control groups) repeated measures analysis of variance (ANOVA) was used to assess between-group differences.Results: Within-group comparisons indicated that both unilateral and bilateral contrast training significantly improved all performance metrics. Between-group comparisons revealed that bilateral training was superior to unilateral training in improvements in 1RM and CMJ (p &gt; 0.05) (growth rate of 1RM: B: 8.4%, U: 5.15%; growth rate of CMJ: B: 15.63%, U: 6.74%). Unilateral training showed greater improvements in the 20m sprint, dominant leg single-leg hop, YBT left, and YBT right (p &gt; 0.05) (growth rate of 20m sprint: B: 5.43%, U: 10.41%; growth rate of advantage foot touch high: B: 4.56%, U: 9.35%; growth rate of YBT left: B: 3.77%, U: 8.53%; growth rate of YBT right: B: 4.72%, U: 13.8%). Unilateral training also significantly outperformed bilateral training in non-dominant leg single-leg hop, t-test, 505 left, and 505 right improvements (p &lt; 0.05).Conclusion: Unilateral contrast training may offer advantages for enhancing change-of-direction ability and explosive power in the non-dominant leg, and it may also provide benefits for improving short-distance sprinting ability, explosive power in the dominant leg, and dynamic balance. In contrast, bilateral contrast training appears to be more effective for enhancing bilateral explosive power and may be more advantageous for increasing maximal strength.
Anxiety and depression in first-year university students: the role of family and social support
Authors: Estrella-Proaño Andrea , Rivadeneira María F. , Alvarado Jéssica , Murtagh Matías , Guijarro Susana , Alomoto Lidia , Cañarejo Glenda 
Published: November 2024

BackgroundAdolescents and young are one of the population groups with the highest prevalence of anxiety and depression worldwide. Few studies address this problem in young university students. This study aimed to analyze the prevalence of anxiety and depression in first-year university students and its association with family functionality and social support.MethodsA cross-sectional study was carried out on 847 students from five cities in Ecuador, between 18 and 25 years of age, who were beginning their university career. Anxiety and depression symptoms were measured with the Hospital Anxiety and Depression Scale, family functionality with the FF-SIL Test, and social support with the Medical Outcomes Study Scale. The sociodemographic characteristics of the participants were also measured. Bivariate and multivariate data analyzes were performed using logistic regression.ResultsThe 19.7% of the students presented anxiety, while 24.7% presented depression. Female students, students with poor economic status, and married/in union students had a higher prevalence of anxiety and depression. Family dysfunction and lack of global social support were significantly associated with a higher prevalence of anxiety (OR 1.93 95% CI 1.20–3.10; OR 1.99 95% CI 1.19–3.33, respectively) and depression (OR 1.87 95% CI 1.16–3.01; OR 2.2 95% CI 1.35–2.57, respectively), regardless of the student’s economic situation.ConclusionSocial support and family functionality play an important role in the prevention of anxiety and depression in first-year university students. It is necessary to establish mental health policies and strategies in this underserved population group that strengthen social support and family functionality.
Serial multiple mediating role of coping style and anxiety in the relationship between life events and academic satisfaction in Chinese medical undergraduates
Authors: Yang Jiarun , Song Xuemei , Zhang Jili , Zheng Yunge , Chen Guangyu , Bu Tianyi , Zhou Jiawei , Tong Yuying , Yang Yanjie , Qiao Zhengxue 
Published: November 2024

ObjectivesAcademic satisfaction plays an important role in promoting the future careers of medical undergraduates. Therefore, it is of great significance to improve academic satisfaction by exploring its influencing factors. The purpose of this study was to investigate the serial multiple mediating role of life events, coping styles, anxiety, and academic satisfaction among Chinese medical students.MethodsIn this cross-sectional study, clinical medicine students from a medical university in Heilongjiang Province were surveyed using stratified random cluster sampling procedures. The questionnaires included the Adolescent Life Events Scale, the Simple Coping Style Questionnaire, the Self-rating Anxiety Scale, and the Academic Satisfaction Scale. Pearson’s correlation analysis and bootstrap analysis were used for statistical analysis.ResultsLife events were negatively related to positive coping styles and academic satisfaction and were positively related to anxiety symptoms. Positive coping styles were negatively associated with anxiety symptoms and positively associated with academic satisfaction. Anxiety symptoms were negatively associated with academic satisfaction. The serial multiple mediating role of positive coping style and anxiety in the relationship between life events and academic satisfaction was significant.ConclusionThe results showed that life events were sequentially associated with decreased positive coping styles and then increased anxiety, which resulted in reduced academic satisfaction among medical students.
Blind supratemporal retrobulbar block in cats: a feasibility cadaveric study and its efficacy in a group of subjects undergoing corneal or intraocular surgery
Authors: Lardone Elena , Crasta Manuela , Ostan Pier Carlo , Gherlinzoni Paola , Landi Alessandra , Franci Paolo 
Published: November 2024

IntroductionThe supratemporal retrobulbar block (RB) has not been comprehensively described in cats.Materials and methodsCadaveric study: a modified supratemporal retrobulbar injection of 0.1 ml/kg of iomeprole and saline (1:3) was executed using a Tuohy needle in recently deceased cats. Cadavers underwent computed tomography before and following injections. Injectate distribution within the intraconal space was evaluated. Extraconal injections were considered a failure. Clinical study: cats undergoing corneal/intraocular surgery were included. After intramuscular premedication with methadone 0.3 mg/kg, dexmedetomidine 3 mcg/kg and alfaxalone 2 mg/kg and induction with intravenous (IV) alfaxalone to effect, isoflurane anesthesia was maintained with a target end-expired fraction of 1.1%. Cats were randomly allocated in the retrobulbar group [RG, receiving a modified supratemporal RB with 0.1 ml/kg of a mixture of 2% lidocaine (5.5 ml) and 0.75% ropivacaine (2 ml)] or control group (CG). When heart rate or mean arterial pressure increased above 20% of the pre-incisional values, fentanyl (1 mcg/kg IV) was administered. Alfaxalone (0.5 mg/kg IV) was injected when anesthesia was deemed too light. After a total of 3 interventions regardless the type of drugs (fentanyl/alfaxalone), a constant rate infusion of fentanyl (5 mcg/kg/h IV) was started. Anesthetist interventions, quality of recovery (blindly assessed using a descriptive score scale), postoperative eye rubbing, complications were studied.ResultsIn the cadaveric study 8 eyes were included (success rate = 87%). The contrast agent spread was scored “moderate-to-large” or “large” in 85.7% of cases and a median 360° (180–360) distribution around the optic nerve was reported. In the clinical study 12 cats were included (6 in RG, 6 in CG). The median time to perform the RB was 35 s (20–50). Only the controls required anesthetist interventions [total amount of 6 (p = 0.0276): fentanyl (3/6) and alfaxalone (2/6)]. The RG had a significantly better recovery score (p = 0.0012) than CG. Only controls showed eye rubbing (3/6).ConclusionsThe modified supratemporal RB is an achievable and rapidly performed technique. In this study it reduced intraoperative drug administration and improved recovery quality in cats undergoing corneal or intraocular surgery.
Triple Validation of Calibrated Building Energy Models with Different Air Infiltration Values
Authors: Bastos Porsani Gabriela , Echeverría Trueba Juan Bautista , Fernández Bandera Carlos 
Published: November 2024

Model calibration refines design-stage inputs to align with real-world building performance. Accurate parameter selection, especially for highly sensitive variables like air leakage, is crucial. This study compared two building energy model calibration methods. The “classic” method adjusted indoor air capacitance, internal mass, and air infiltration, while a novel method focused on capacitance and internal mass, using empirical data for infiltration. The infiltration values were calculated using the decay equation and the EnergyPlus equations with site-specific coefficients. A triple validation assessed model performance in terms of temperature (CIBSE TM63), energy consumption (minimization), and indoor air quality (represented by CO2 levels in accordance with the ASTM D5157 Standard). Results demonstrated the novel method’s superiority across all three performance metrics. All calibrated models met the CIBSE TM63 criteria even during the validation period, which was five times longer than the training period. Compared to the classic method, models incorporating dynamic empirical infiltration showed a 29% and 26% improvement in MAE and RMSE, respectively, in temperature prediction. In energy consumption results, the novel method models presented a 31% reduction, and for CO2 level agreement, these models achieved a 130% higher R2 value than the classic model. In addition, the classic method’s infiltration values failed to meet ASTM D5157 requirements, suggesting reliance on unrealistic parameter values for accurate temperature representation. The incorporation of calculated air leakage data into the BEM allowed a more realistic estimation of capacitance and internal mass values, emphasizing the importance of accurate air infiltration modeling for overall model reliability.