bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pilot study of a real-time early agitation capture technology (REACT) for children with intellectual and developmental disabilities
Authors: Khan Nibraas , Plunk Abigale , Zheng Zhaobo , Adiani Deeksha , Staubitz John , Weitlauf Amy , Sarkar Nilanjan 
Published: October 2024

Objective Children and adolescents with intellectual and developmental disabilities (IDD), particularly those with autism spectrum disorder, are at increased risk of challenging behaviors such as self-injury, aggression, elopement, and property destruction. To mitigate these challenges, it is crucial to focus on early signs of distress that may lead to these behaviors. These early signs might not be visible to the human eye but could be detected by predictive machine learning (ML) models that utilizes real-time sensing. Current behavioral assessment practices lack such proactive predictive models. This study developed and pilot-tested real-time early agitation capture technology (REACT), a real-time multimodal ML model to detect early signs of distress, termed “agitations.” Integrating multimodal sensing, ML, and human expertise could make behavioral assessments for people with IDD safer and more efficient. Methods We leveraged wearable technology to collect behavioral and physiological data from three children with IDD aged 6 to 9 years. The effectiveness of the REACT system was measured using F1 score, assessing its usefulness at the time of agitation to 20s prior. Results The REACT system was able to detect agitations with an average F1 score of 78.69% at the time of agitation and 68.20% 20s prior. Conclusion The findings support the use of the REACT model for real-time, proactive detection of agitations in children with IDD. This approach not only improves the accuracy of detecting distress signals that are imperceptible to the human eye but also increases the window for timely intervention before behavioral escalation, thereby enhancing safety, well-being, and inclusion for this vulnerable population. We believe that such technological support system will enhance user autonomy, self-advocacy, and self-determination.
TUMamba: A novel tongue segment methods based on Mamba and U-Net
Authors: Jiang Fan , Zhong Yanmei , Yang Simin 
Published: October 2024

Background and Objective Current tongue segmentation methods often struggle with extracting global features and performing selective filtering, particularly in complex environments where background objects resemble the tongue. These challenges significantly reduce segmentation efficiency. To address these issues, this article proposes a novel model for tongue segmentation in complex environments, combining Mamba and U-Net. By leveraging Mamba’s global feature selection capabilities, this model assists U-Net in accurately excluding tongue-like objects from the background, thereby enhancing segmentation accuracy and efficiency. Methods To improved the segmentation accuracy of the U-Net backbone model, we incorporated the Mamba attention module along with a multi-stage feature fusion module. The Mamba attention module serially connects spatial and channel attention mechanisms at the U-Net ’s skip connections, selectively filtering the feature maps passed into the deep network. Additionally, the multi-stage feature fusion module integrates feature maps from different stages, further improving segmentation performance. Results Compared with state-of-the-art semantic segmentation and tongue segmentation models, our model improved the mean intersection over union by 1.17%. Ablation experiments further demonstrated that each module proposed in this study contributes to enhancing the model’s segmentation efficiency. Conclusion This study constructs a Tongue segmentation model based on U-Net and Mamba (TUMamba). The model effectively extracted global spatial and channel features using the Mamba attention module, captured local detail features through U-Net, and enhanced image features via multi-stage feature fusion. The results demonstrate that the model performs exceptionally well in tongue segmentation tasks, proving its value in handling complex environments.
Comparison of Hounsfield Unit, Vertebral Bone Quality, and Dual-Energy X-Ray Absorptiometry T-Score for Predicting Cage Subsidence After Posterior Lumbar Interbody Fusion
Authors: Wang Yunsheng , Zhang Jiali , Tong Tong , Miao Dechao , Wang Feng , Wang Linfeng 
Published: October 2024

Study design Retrospective cohort study. Objectives To compare Hounsfield unit (HU), vertebral bone quality (VBQ), and dual-energy X-ray absorptiometry (DEXA) T-score in predicting cage subsidence (CS) after posterior lumbar interbody fusion. Methods We retrospectively reviewed patients undergoing PLIF and measured L4 HU and VBQ. Baseline characteristics between CS and non-CS groups were compared. Multiple logistic regression analysis was used to identify risk factors for CS. Receiver operating characteristic (ROC) curves were used to explore the predictive value of variables for CS. Subgroup analysis was conducted for patients with available DEXA results. Results Eighty-four patients were analyzed. The subsidence group was older, with lower L4 HU (92.6 (35.4) vs 130.8 (47.8), P < 0.001) and higher VBQ (3.30 (0.64) vs 2.99 (0.63), P = 0.041) compared to the non-CS group. Low L4 HU (OR 0.979, P = 0.022) was an independent risk factor for subsidence, while VBQ was not. ROC analysis indicated that L4 HU (AUC = 0.733, P < 0.001) exhibited superior predictive performance compared to VBQ (AUC = 0.643, P = 0.032). Subgroup analysis in patients with DEXA showed that the femoral neck T-score (AUC = 0.67, P = 0.037) could differentiate CS, with L4 HU exhibiting the highest predictive ability (AUC = 0.778, P < 0.001), both outperforming VBQ (AUC = 0.645, P = 0.075). Conclusions Among the three BMD parameters, only low L4 HU could be an independent risk factor for CS. Preoperative HU is mandatory in patients at risk for osteoporosis when undergoing spine surgery.
Single versus dual fixation of distal femur fractures: A retrospective cohort study at a level one trauma centre in New Zealand
Authors: Miller Robyn , Zhang John , Powell Andrew , Chuang Tim 
Published: October 2024

Background The study compares single versus combination fixation of distal femur fractures. Method We retrospectively reviewed patients over 60 between January 2016 and December 2022. Union rate, ambulatory status and complication rate were primary outcomes. Secondary outcomes included quality of reduction, operative time and rate of blood transfusion. Results A total of 92 patients received single fixation, and 22 patients received combination fixation. There was no difference in rate or time of fracture union. Patients with dual fixation were allowed to weight bear on discharge significantly more than single fixation patients (50% vs. 18.9%, p = 0.003). Intramedullary nail fixation, as a single method or combined with lateral plating, was associated with earlier weight bearing. Immediate post-operative weight bearing significantly increased the likelihood of discharging to home or rehabilitation versus discharging to a transitional care facility ( p < 0.00001). There was no difference in the rate of blood transfusion, complication or mortality. Medial translation of the distal articular block was significantly lower with dual fixation (1.2% vs. 3.4%, p = 0.021). Operation time was longer with combination fixation (183 min vs. 134 min p < 0.001). Conclusion Combination fixation allows earlier weight bearing, at the cost of longer operation time.
Pharmacist knowledge, attitude, and practice regarding pharmacy code of practice and ethics in Iraq
Authors: Ibrahim Albaroodi Khansaa A 
Published: October 2024

Introduction: The Iraqi pharmacy code of practice and ethics enables pharmacists to resolve conflicts between the code and patient demands and satisfy their needs. This study evaluates pharmacists’ knowledge, attitude, and practice toward the pharmacy code of practice and ethics. Design and Methods: This cross-sectional study was conducted in three different provenances (Baghdad, Al-Diwaniya, and Wasit) from October 1st to December 31st, 2022. Results: Among 202 Iraqi pharmacists, the mean age was (30.4 ± 6.8) years old, and about (59%) of the participants were aware of the Iraqi Code of Practice and Ethics; similar results were found regarding their practice. About two-thirds of the participants agreed that modifying the Iraqi Pharmacy Code of Practice and Ethics will enable pharmacists to resolve the conflict between the code and patient demands, satisfy their needs, and raise healthcare standards. More than two-thirds of the participants thought that they don’t need training courses to give vaccines for addiction, smoking cessation, obesity, or sleeping problems. Conclusion: According to the study, more than half of the Iraqi pharmacists exhibited good knowledge, attitude, and practice regarding the pharmacy code of practice and ethics. However, it is recommended that Iraqi pharmacists engage in comprehensive training programs covering different aspects of healthcare, such as vaccination and smoking cessation, to further improve their contribution to the healthcare system.
Patient-Identified Treatment Goals for Psoriatic Disease: Results From a US Patient Survey
Authors: Armstrong April , Levit Noah A. , Schneider Beth , Seiden Richard , Shi Linyu , Kaplan Blair , Wu Jashin J. 
Published: October 2024

Background Despite advancements in the treatment landscape for psoriasis (PsO) and psoriatic arthritis (PsA), some patients may not achieve the desired disease improvement due to undertreatment. Understanding patient perspectives on treatment expectations can inform patient-centered decisions and enhance treatment satisfaction. Objective To describe patient-identified treatment goals and expectations for managing psoriatic disease. Methods A cross-sectional study was conducted using a survey through MyPsoriasisTeam, an online social community. The survey was available to its US-based patients aged ≥21 years with self-reported diagnoses of PsO and/or PsA. The study assessed patients’ treatment goals, satisfaction with treatment outcomes, and satisfaction with health care providers (HCPs). Responses were summarized using descriptive statistics. Results This analysis included 386 patients (PsO, n = 130; PsA with/without PsO, n = 256). Treatment goals varied by psoriatic disease type. The top 3 treatment goals for PsO were reduce itching (73.1%), reduction in size/thickness (68.5%), and reduction in the number of plaques (63.1), and for PsA, were reducing joint pain (77.7%), lessening fatigue (64.8%), and reducing joint stiffness (62.1%). Patient satisfaction with treatment outcomes was low (extremely/very satisfied: PsO, 7.5%/8.5% and PsA, 9.2%/20.2%). Overall, 73.1% with PsO were treated by a dermatologist, and a dermatologist or rheumatologist treated 74.6% with PsA. Overall, patient satisfaction with HCPs who treated their disease was lacking (PsO, 19.3% and 19.3%; PsA, 27.3% and 33.6% were extremely and very satisfied, respectively). Conclusion These findings suggest the need for enhanced communication between patients and HCPs to align treatment goals and expectations and to improve treatment satisfaction and disease management.
Digital Health Tools and Behavioral Strategies to Increase Engagement With Diabetes Self-Management Education and Support: Design and Feasibility of DM-BOOST
Authors: Amante Daniel J. , Shenette Lisa , Wainaina Stacey , Balakrishnan Kavitha , Bhatia Shina , Lee Jung Ae , Lemon Stephenie C. , McManus David , Harlan David M. , Malkani Samir , Gerber Ben S. 
Published: October 2024

Purpose The purpose of the study was to describe the development and feasibility of implementing the DM-BOOST program in support of an established diabetes self-management education and support (DSMES) program. Methods A patient panel of 4 adults with type 2 diabetes (T2DM) codesigned DM-BOOST. DM-BOOST is a patient-focused program that includes peer-written text messages about diabetes self-management behaviors and digital health training to improve patient portal use and initiate goal setting prior to a scheduled DSMES appointment. Adults with T2DM and A1C ≥8.0% participated in a 6-month feasibility pilot. Participants were randomly assigned (1:1) to receive either DM-BOOST or usual care. Outcomes included DSMES engagement (scheduled and attended DSMES appointments) and changes in diabetes self-efficacy and treatment satisfaction. Results Pilot participants (n = 60) were 60.0% female with mean age 45.5 years (SD 8.3) and A1C 10.1% (SD 1.8%). All DM-BOOST participants (30/30, 100%) had DSMES appointments scheduled compared to 86.7% of usual care (26/30). DM-BOOST participants had fewer DSMES appointment no-shows/cancellations (3/30, 10%) compared to usual care (10/26, 35%). There was greater improvement in diabetes self-efficacy in the DM-BOOST group compared to usual care and no difference in treatment satisfaction. Conclusions DM-BOOST, leveraging peer-written text messaging and digital health training, increased DSMES engagement. Implementation of DM-BOOST was determined to be feasible, with several system-level barriers identified, including obtaining provider referrals and scheduling appointments. An effectiveness trial of DM-BOOST is needed to evaluate the impact on clinical outcomes.
Deep brain stimulation of the motor thalamus relieves experimentally induced air hunger
Authors: Chapman Tom P. , Divanbeighi Zand Amir P. , Debrah Emmanuel , Petric Beth , Farrell Sarah M. , FitzGerald James J. , Moosavi Shakeeb H. , Green Alexander L. 
Published: October 2024

Research questionWe previously reported that deep brain stimulation (DBS) of the motor thalamus, in a patient with post-stroke tremor, relieved breathlessness associated with COPD. This raised the question of whether motor thalamus DBS mitigates the ascending dyspnoea signal. We therefore sought to conduct a fully powered cohort study of experimentally induced air hunger, an uncomfortable urge to breathe in patients with motor thalamus DBS “ON” and “OFF”.Methods16 patients (three females) with DBS of the ventral intermediate nucleus (VIM) as treatment for tremor underwent hypercapnic air hunger tests, with DBS ON and OFF. Patients rated air hunger on a visual analogue scale (VAS) every 15 s. Hypercapnia and ventilation were matched for ON and OFF states (end-tidal carbon dioxide tension mean±sd43±4 and 43±4 mmHg, respectively; ventilation 13.7 and 13.4 L·min−1, respectively). Participants’ ventilation was constrained to baseline levels by breathing from a 3-L inspiratory reservoir with fixed flow of fresh gas while targeting their resting breathing frequency to a metronome.ResultsOverall steady-state air hunger was 52±28%VAS for ON and 67±20%VAS for OFF (p=0.002; two-tailed paired t-test). The mean reduction in air hunger during VIM DBS was −14.4%VAS. DBS of the motor thalamus relieved air hunger in 13 patients, heightened air hunger in two and caused no change in one.ConclusionDBS of the motor thalamus for tremor relief also mitigates the air hunger component of dyspnoea. We posit that DBS of the motor thalamus heightens the gating control of the thalamus modulating the ascending air hunger signal. Extent of relief suggests that thalamic DBS may prove to be a viable therapy for intractable dyspnoea.
Genetic diagnosis and outcomes of intracytoplasmic sperm injection in South Chinese patients with congenital bilateral aplasia of the vas deferens
Authors: Hu Haishan , Zhou Qing , Ma Yanlin , Zhang Lingxiao 
Published: October 2024

Abstract
Background
Obstructive azoospermia commonly is caused by CBAVD(Congenital Bilateral Aplasia of the Vas Deferens), mainly due to the cystic fibrosis transmembrane conductance regulator (CFTR) and adhesion G protein-coupled receptor G2(ADGRG2) mutations. The genetic landscape for Chinese CBAVD patients is unclear, leading to debates over genetic screening, counseling, and assisted reproduction strategies. This study investigates the prevalence of CFTR and ADGRG2 mutations in a southern Chinese cohort of CBAVD patients and evaluates the impact of CFTR mutations on intracytoplasmic sperm injection (ICSI) outcomes.

Results
CFTR mutations were identified in 71.4% (30/42) of CBAVD patients, with a total of 36 CFTR mutation sites across 13 types identified, including two novel mutations. A novel ADGRG2 mutation was also detected. Betweenthe CFTR mutation-CBAVD group and the non-CBAVD OA group, a significant difference was observed only in the 2 Pronuclei(2PN) rate (79.5% vs 86.2%, P = 0.0065), while fertilization rates, pregnancy rates, miscarriage rates, and live birth rates showed no significant differences. Between the CFTR mutation-CBAVD group and the CBAVD group without CFTR mutation, there were no significant differences in fertilization rates, 2PN rates, pregnancy rates, miscarriage rates, or live birth rates.

Conclusion
Chinese CBAVD patients primarily exhibit mutations in the CFTR and ADGRG2 genes. Therefore, targeted gene testing for CFTR and ADGRG2 is more suitable compared to WES for CBAVD patients. Considering that the genetic factors of approximately 30% of CBAVD patients remain unknown, it is recommended to perform massive parallel sequencing for patients who test negative for CFTR and ADGRG2 gene screening. Despite these genetic factors, ICSI outcomes were not adversely affected, except for the 2PN rate. However, genetic counseling remains crucial for Chinese CBAVD patients before undergoing assisted reproduction.
Assisted peritoneal dialysis compared to in-centre hemodialysis – an observational study of outcomes from the Swedish Renal Registry
Authors: Rydell Helena , Segelmark Mårten , Clyne Naomi 
Published: October 2024

Abstract
Background
In-center hemodialysis (IHD) is the most common dialysis modality. Assisted peritoneal dialysis (assPD) is an option for frail and/or incapacitated patients. Both modalities can be used to alleviate uremic symptoms towards the end of life. There are few studies comparing these modalities. The primary aim is to compare hospital admissions between assPD and IHD. The secondary aim is to compare continuation of the dialysis modality and patient survival.

Methods
Patients > 65 years, registered in the Swedish Renal Registry (SRR) and starting dialysis 2010–2017 were eligible for inclusion. Patients starting on assPD were matched with patients starting on IHD according to sex, Charlson Index, age and date for start of dialysis. Data were collected from SRR and other registries.

Results
During the first year, patients on assPD and IHD had in median one (IQR 0–5.0; 0–4.0) hospitalization (p = 0.412). There was no significant difference after two years, in the annual number of days admitted to hospital, in hospitalizations with cardiovascular or infectious disease diagnoses or continuation of the dialysis modality, respectively. However, patients on assPD had a worse median survival (1.1 years IQR 0.6–2.1; IHD 3.1 years IQR 0.2–5.8; p < 0.001).

Conclusion
In this study patients starting assPD, often as a palliative treatment, showed no difference compared to IHD concerning the number of hospitalizations, number of days in hospital/year or continuation of the dialysis modality. Patients on assPD had a worse survival, which is likely due to residual confounding. Without that, patients on assPD would probably have lower number of hospitalizations. Despite limitations due to the retrospective observational design of the study, the results indicate that assPD is a feasible alternative to IHD when self-care dialysis is not possible and/or IHD too arduous.
Understanding the body image perception of pregnant women during their third trimester in a tertiary care setting in Southern India
Authors: Desai Ketaki , Poojari Deepalaxmi Paresh , Shwetha T.S. , Upadhyaya Rajani , Ramachandra Preetha 
Published: October 2024

Abstract
Background
Pregnancy is a known physiological phenomenon characterized by various changes in the body. The physical and physiological changes that occur during pregnancy may impact the body image which may lead to implications such as body image issues or poor eating habits among pregnant women. This study aimed to analyze the body image perception of pregnant women in their third trimester.

Methods
This cross-sectional survey which involved the administration of a Multidimensional Body Self-Relations Questionnaire (MBSRQ), was conducted among pregnant women between 28 and 40 weeks of gestation in a tertiary care setting in Southern India. Descriptive statistics were used to report the demographic characteristics of the respondents. A one-sample t-test was used to analyze the difference between the present sample scores and the published norms of MBSRQ. Univariate Logistic Regression was done to find the association between the demographic variables and subdomains of MBSRQ.

Results
The mean age of the respondents (n = 246) was 29.5 years, and the period of gestation was 33.4 weeks. With mean scores of subscales of MSRQ as reference values, a greater proportion of women had higher scores on appearance orientation (52.44%), health evaluation (56.91%), and illness orientation (55.28%). Respondents scored less on appearance evaluation (52.03%) and body areas satisfaction scale (50.41%). The study found that pre-pregnancy BMI, abdominal circumference, and weight gain during pregnancy were associated with appearance orientation, overweight preoccupation, and self-classified weight. Health evaluation was associated with weight gain and Instagram use, while moderate-intensity physical activity during pregnancy was associated with higher health orientation.

Conclusion
Although pregnant women in our setting during the third trimester were oriented towards their appearance and considered themselves healthy and fit, almost half of the respondents reported dissatisfaction with their changing bodies and appearance. Self-reported physical activity status, body mass index, weight gain, level of education, use of Instagram app, and type of family were factors found to affect pregnant body image perception. Hence, we conclude that body image perception is affected during pregnancy, and healthcare professionals should be aware of this, and the factors associated with it while addressing the health of pregnant women.

Clinical trial registration details
The study was registered under the Clinical Trials Registry- India: CTRI/2023/08/056524. https://ctri.nic.in/Clinicaltrials/rmaindet.php?trialid=89771&EncHid=39880.12369&modid=1&compid=19.