bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early Identification of Cognitive Impairment in Community Environments Through Modeling Subtle Inconsistencies in Questionnaire Responses: Machine Learning Model Development and Validation
Authors: Gao Hongxin , Schneider Stefan , Hernandez Raymond , Harris Jenny , Maupin Danny , Junghaenel Doerte U , Kapteyn Arie , Stone Arthur , Zelinski Elizabeth , Meijer Erik , Lee Pey-Jiuan , Orriens Bart , Jin Haomiao 
Published: September 2024

Background
The underdiagnosis of cognitive impairment hinders timely intervention of dementia. Health professionals working in the community play a critical role in the early detection of cognitive impairment, yet still face several challenges such as a lack of suitable tools, necessary training, and potential stigmatization.

Objective
This study explored a novel application integrating psychometric methods with data science techniques to model subtle inconsistencies in questionnaire response data for early identification of cognitive impairment in community environments.

Methods
This study analyzed questionnaire response data from participants aged 50 years and older in the Health and Retirement Study (waves 8-9, n=12,942). Predictors included low-quality response indices generated using the graded response model from four brief questionnaires (optimism, hopelessness, purpose in life, and life satisfaction) assessing aspects of overall well-being, a focus of health professionals in communities. The primary and supplemental predicted outcomes were current cognitive impairment derived from a validated criterion and dementia or mortality in the next ten years. Seven predictive models were trained, and the performance of these models was evaluated and compared.

Results
The multilayer perceptron exhibited the best performance in predicting current cognitive impairment. In the selected four questionnaires, the area under curve values for identifying current cognitive impairment ranged from 0.63 to 0.66 and was improved to 0.71 to 0.74 when combining the low-quality response indices with age and gender for prediction. We set the threshold for assessing cognitive impairment risk in the tool based on the ratio of underdiagnosis costs to overdiagnosis costs, and a ratio of 4 was used as the default choice. Furthermore, the tool outperformed the efficiency of age or health-based screening strategies for identifying individuals at high risk for cognitive impairment, particularly in the 50- to 59-year and 60- to 69-year age groups. The tool is available on a portal website for the public to access freely.

Conclusions
We developed a novel prediction tool that integrates psychometric methods with data science to facilitate “passive or backend” cognitive impairment assessments in community settings, aiming to promote early cognitive impairment detection. This tool simplifies the cognitive impairment assessment process, making it more adaptable and reducing burdens. Our approach also presents a new perspective for using questionnaire data: leveraging, rather than dismissing, low-quality data.
Relationships Among eHealth Literacy, Physical Literacy, and Physical Activity in Chinese University Students: Cross-Sectional Study
Authors: Jiang Shan , Ng Johan Y Y , Choi Siu Ming , Ha Amy S 
Published: September 2024

Background
eHealth literacy is critical for evaluating abilities in locating, accessing, and applying digital health information to enhance one’s understanding, skills, and attitudes toward a healthy lifestyle. Prior research indicates that enhancing eHealth literacy can improve health behaviors such as physical activity (PA). Physical literacy (PL) refers to the ability to develop sustainable PA habits, taking into account various aspects of an individual. Notably, university students have shown a decline in PA and possess low PL levels. However, the connection between eHealth literacy and PL in this demographic has not been extensively studied, and it remains uncertain whether PA acts as a mediator between eHealth literacy and PL.

Objective
This study examines the extent to which PA mediates the link between eHealth literacy and PL in Chinese university students and explores gender differences in these variables.

Methods
In February 2022, a cross-sectional survey was administered to 1210 students across 3 universities in China. The instruments used were the Perceived PL Instrument, the International Physical Activity Questionnaire, and the Chinese version of the eHealth Literacy Scale. Correlations between eHealth literacy, PA, and PL were analyzed using Pearson product-moment correlation and multiple linear regression, while mediation models helped elucidate the interactions among the 3 variables.

Results
The response rate for the study was 92.9% (1124/1210). In the mediation analysis, eHealth literacy showed a significant direct effect on PL, with a coefficient of 0.78 (β .75, SE 0.02; P<.001). Moderate to vigorous physical activity (MVPA) accounted for 2.16% of the total effect, suggesting that MVPA partially mediates the relationship between eHealth literacy and PL. Additionally, male students outperformed female students in terms of MVPA (t636=4.94; P<.001) and PL (t636=3.18; P<.001), but no significant differences were found in eHealth literacy (t636=1.23; P=.22).

Conclusions
The findings indicate that MVPA serves as a mediator in the link between eHealth literacy and PL among university students. Students with low eHealth literacy or limited PA are less likely to be physically literate. Thus, eHealth literacy plays a crucial role in enhancing PL and PA, especially when interventions targeting PL are implemented. Our results also suggest a need for targeted health education interventions aimed at improving MVPA and PL among female students, while also recognizing that eHealth literacy is comparable across genders at universities.
Definitions and Characteristics of Patient Digital Twins Being Developed for Clinical Use: Scoping Review
Authors: Drummond David , Gonsard Apolline 
Published: September 2024

Background
The concept of digital twins, widely adopted in industry, is entering health care. However, there is a lack of consensus on what constitutes the digital twin of a patient.

Objective
The objective of this scoping review was to analyze definitions and characteristics of patient digital twins being developed for clinical use, as reported in the scientific literature.

Methods
We searched PubMed, Scopus, Embase, IEEE, and Google Scholar for studies claiming digital twin development or evaluation until August 2023. Data on definitions, characteristics, and development phase were extracted. Unsupervised classification of claimed digital twins was performed.

Results
We identified 86 papers representing 80 unique claimed digital twins, with 98% (78/80) in preclinical phases. Among the 55 papers defining “digital twin,” 76% (42/55) described a digital replica, 42% (23/55) mentioned real-time updates, 24% (13/55) emphasized patient specificity, and 15% (8/55) included 2-way communication. Among claimed digital twins, 60% (48/80) represented specific organs (primarily heart: 15/48, 31%; bones or joints: 10/48, 21%; lung: 6/48, 12%; and arteries: 5/48, 10%); 14% (11/80) embodied biological systems such as the immune system; and 26% (21/80) corresponded to other products (prediction models, etc). The patient data used to develop and run the claimed digital twins encompassed medical imaging examinations (35/80, 44% of publications), clinical notes (15/80, 19% of publications), laboratory test results (13/80, 16% of publications), wearable device data (12/80, 15% of publications), and other modalities (32/80, 40% of publications). Regarding data flow between patients and their virtual counterparts, 16% (13/80) claimed that digital twins involved no flow from patient to digital twin, 73% (58/80) used 1-way flow from patient to digital twin, and 11% (9/80) enabled 2-way data flow between patient and digital twin. Based on these characteristics, unsupervised classification revealed 3 clusters: simulation patient digital twins in 54% (43/80) of publications, monitoring patient digital twins in 28% (22/80) of publications, and research-oriented models unlinked to specific patients in 19% (15/80) of publications. Simulation patient digital twins used computational modeling for personalized predictions and therapy evaluations, mostly for one-time assessments, and monitoring digital twins harnessed aggregated patient data for continuous risk or outcome forecasting and care optimization.

Conclusions
We propose defining a patient digital twin as “a viewable digital replica of a patient, organ, or biological system that contains multidimensional, patient-specific information and informs decisions” and to distinguish simulation and monitoring digital twins. These proposed definitions and subtypes offer a framework to guide research into realizing the potential of these personalized, integrative technologies to advance clinical care.
Sex Difference and Socioeconomic Inequity in Chinese People With Hypertension: National Cross-Sectional Survey Study
Authors: Zhang Xiaoyun , Wang Siyu , Yang Qianqian , Zheng Ruizhi , Wang Long , Lin Hong , Wang Shuangyuan , Li Mian , Wang Tiange , Zhao Zhiyun , Lu Jieli , Xu Min , Chen Yuhong , Zheng Jie , Dai Meng , Zhang Di , Wang Weiqing , Ning Guang , Bi Yufang , Xu Yu 
Published: September 2024

Abstract

Background
Sex differences in blood pressure (BP) levels and hypertension are important and the role of socioeconomic status (SES) in sex differences in hypertension remains unclear.

Objective
This study aimed to evaluate the impact of SES on sex differences of hypertension in a nationally representative survey study.

Methods
A total of 98,658 participants aged ≥18 years who have lived in their current residence for ≥6 months were recruited from 162 study sites across mainland China. Sex was self-reported. Individual-level SES included the highest level of education and annual household income. Area-level SES included economic development status, urban/rural residency, and north/south location. Outcomes included levels of systolic and diastolic BP, and hypertension. Linear and Cox regression models were used to examine the associations between sex (women vs men) and BP characteristics stratified by individual or combined SES indicators.

Results
Systolic and diastolic BP levels and the prevalence of hypertension were higher in men than in women. This sex difference was found across categories of SES with widened sex disparities in participants having more favorable SES. Significant multiplicative interaction effects of SES on the association of sex with BP characteristics were found. Women with improving SES were associated with lower BP and hypertension prevalence compared to men. For combined SES, a 9% (prevalence ratio 0.91, 95% CI 0.83-0.98) and a 30% lower probability (prevalence ratio 0.70, 95% CI 0.63-0.78) of having hypertension were found in women with an overall intermediate SES and high SES, respectively, compared to those with low SES, while no significant reduction was found in men.

Conclusions
There are significant sex differences in BP characteristics and SES has a potent impact on the disparities. Sex-specific public health policies to alleviate socioeconomic inequalities, especially in women are important for the prevention of hypertension.
Relationship Between Average Glucose Levels and HbA1c Differs Across Racial Groups: A Substudy of the GRADE Randomized Trial
Authors: Nathan David M. , Herman William H. , Larkin Mary E. , Krause-Steinrauf Heidi , Abou Assi Hiba , Ahmann Andrew J. , Brown-Friday Janet , Hsia Daniel S. , Harindhanavudhi Tasma , Johnson Mary , Arends Valerie L. , Butera Nicole M. , Rosin Samuel P. , Lachin John M. , Younes Naji ,   GRADE Study Research Group, Everett B.M. , Abdouch I. , Bahtiyar G. , Brantley P. , Broyles F.E. , Canaris G. , Copeland P. , Craine J.J. , Fein W.L. , Gliwa A. , Hope L. , Lee M.S. , Meiners R. , Meiners V. , O’Neal H. , Park J.E. , Sacerdote A. , Sledge E. , Soni L. , Steppel-Reznik J. , Turchin A. 
Published: September 2024

OBJECTIVE
To determine whether the relationship between average glucose (AG) levels and hemoglobin A1c (HbA1c) differs across racial/ethnic groups.

RESEARCH DESIGN AND METHODS
We performed a prospective substudy of GRADE, a comparative effectiveness randomized trial conducted in 36 centers in the U.S. A total of 1,454 of the 5,047 participants in the GRADE cohort, including 534 non-Hispanic White (NHW), 389 non-Hispanic Black (NHB), and 327 Hispanic White patients and 204 patients of other racial/ethnic backgrounds, were included in the substudy. Continuous glucose monitoring (CGM) performed for 10 days was used to calculate AG10. Immediately after CGM, HbA1c and glycated albumin were measured. Fasting plasma glucose (FPG) and glucose area under the curve (AUC) were derived from a 75-g oral glucose tolerance test.

RESULTS
The relationship between AG10 and HbA1c was significantly different for NHB compared with NHW patients and those of other racial/ethnic groups. HbA1c levels were 0.2–0.6 percentage points higher in NHB than in NHW patients for AG10 levels from 100 to 250 mg/dL. For an HbA1c of 7%, AG10 was 11 mg/dL higher for NHW than for NHB patients. Similar findings were observed across races for relationships of FPG and AUC with HbA1c and for glucose measurements with glycated albumin levels. Differences in the relationship between AG10 and HbA1c across racial groups remained after adjustments for any demographic or other differences between racial/ethnic subgroups.

CONCLUSIONS
The relationship between several measures of glucose with HbA1c and glycated albumin consistently differed across races. These findings should be considered in setting treatment goals and diagnostic levels.
Can pin-site inflammation be detected with thermographic imaging? A cross-sectional study from the USA and Denmark of patients treated with external fixators
Authors: Fridberg Marie , Rahbek Ole , Husum Hans-Christen , Anirejuoritse Bafor , Duch Kirsten , Iobst Christopher , Kold Søren 
Published: September 2024

Background and purpose: Patients with external fixators are at risk of pin-site infection. A tool for objective monitoring of pin sites for evolving signs of infection is warranted. We aimed to investigate the temperature (MaxTp) difference between clean and visually inflamed pin sites using thermography and to establish the optimal cut-off value of MaxTp using thermography as a screening tool for inflammation detection.Methods: This was a cross-sectional study performed in the USA and Denmark of patients with circular external fixators. Pin sites were visually judged by a surgeon or a nurse as clean or as showing signs of inflammation. The MaxTp was obtained at the pin site by thermographic imaging using an infrared camera (FLIR T540).Results: We included 1,970 pin sites from 83 patients. The mean MaxTp for clean pin sites (n = 1,739) was 33.1°C (95% confidence interval [CI] 32.8–33.4) and the mean MaxTp for visual inflamed pin sites (n = 231) was 34.0°C (CI 33.6–34.3). The mean difference, when adjusted for repeated observations of patients and pin sites, was statistically significant with a difference of 0.9°C (CI 0.7–1.1) (P < 0.001). The area under the receiver operating characteristic curve for MaxTp as a screening tool to detect visual signs of inflammation was 0.71 (CI 0.65–0.76). The empirically optimal cut-off value was 34.1°C with a sensitivity of 65%, a specificity of 72%, a positive predictive value of 23%, and a negative predictive value of 94%.Conclusion: We found a statistically significant difference in mean temperature between pin sites with and without visual signs of inflammation. Thermography could be a promising tool for future point of care technology for monitoring inflammation around pin sites.
Fracture-related infections after osteosynthesis for hip fracture are associated with higher mortality: A retrospective single-center cohort study
Authors: Khalili Pendar , Brüggemann Anders , Tevell Staffan , Fischer Per , Hailer Nils P , Wolf Olof 
Published: September 2024

Background and purpose: Fracture-related infections (FRIs) after osteosynthesis for hip fractures have not been thoroughly investigated. Our primary aim was to assess the association between FRIs and mortality after osteosynthesis for hip fracture. Secondary aims were to investigate the incidence, microbiology, and general epidemiological aspects of these FRIs.Methods: This retrospective single-center study included 1,455 patients > 18 years old with non-pathological hip fractures treated with osteosynthesis between 2015 and 2019. Medical records were reviewed and FRIs were diagnosed based on current consensus criteria. The follow-up period was 2 years. Mortality was estimated using Kaplan–Meier survival analysis. Cox regression analyses were performed to investigate the potential association between FRIs, as a time-dependent variable, and increased mortality.Results: The median age for the entire cohort was 83 (interquartile range 75–89) years and 69% were females. At the 2-year follow-up mark, the crude mortality rate was 33% in the non-FRI group and 69% (11 of 16 patients) in the FRI group. Cox regression analysis assessing mortality risk revealed a hazard ratio of 3.5 (95% confidence interval [CI] 1.9–6.4) when adjusted for confounders. The incidence of FRI was 1.1% (16 of 1,455 patients). Staphylococcus aureus was the most common pathogen. Most FRI patients (94%) required at least 1 revision and 56% underwent ≥ 2 revision.Conclusion: We found an association between FRIs after hip fracture osteosynthesis and increased mortality, underscoring the critical need for FRI prevention measures in this frail patient group. The incidence and microbiological findings were consistent with previous studies.
Efektivitas Model Pembelajaran Berbasis Proyek dalam Pendidikan Karakter dalam Kurikulum 2013
Authors: Mutholaah Mutholaah 
Published: September 2024

Penelitian ini bertujuan untuk menginvestigasi pengaruh model pembelajaran berbasis proyek dalam pendidikan karakter di MAN 1 Banyumas. Metode penelitian yang digunakan adalah kuantitatif dengan desain penelitian eksperimen semu. Sampel penelitian terdiri dari siswa kelas XI IPA2, XI IPA 3, XI IPA 4 XI IPA 5 dan XI IPA 6 yang dipilih secara purposive sampling. Data dikumpulkan melalui instrumen berupa kuesioner yang diisi oleh siswa sebelum dan setelah penerapan model pembelajaran berbasis proyek. Analisis data dilakukan menggunakan teknik statistik deskriptif dan inferensial. Hasil penelitian menunjukkan adanya peningkatan yang signifikan dalam sikap positif, pemahaman nilai-nilai, dan perilaku siswa setelah penerapan model pembelajaran berbasis proyek. Temuan ini memberikan dukungan yang kuat terhadap efektivitas model pembelajaran berbasis proyek dalam pendidikan karakter. Hal ini menunjukkan bahwa melalui model pembelajaran berbasis proyek, siswa dapat mengembangkan sikap positif, memahami nilai-nilai yang baik, dan menerapkan perilaku positif dalam kehidupan sehari-hari. Penelitian ini memberikan kontribusi penting dalam pengembangan pendidikan karakter di MAN 1 Banyumas. Temuan peningkatan sikap positif, pemahaman nilai-nilai, dan perilaku siswa setelah penerapan model pembelajaran berbasis proyek memberikan bukti yang mendukung efektivitas pendekatan ini dalam mencapai tujuan pendidikan karakter dalam Kurikulum 2013. Dalam konteks teori-teori pendidikan karakter, pembelajaran berbasis proyek dapat dilihat sebagai pendekatan yang mendukung perkembangan sosial, moral, dan perilaku siswa. Meskipun demikian, penelitian lebih lanjut dan penelitian dengan desain yang lebih kuat diperlukan untuk mengkonfirmasi temuan ini secara lebih mendalam dan menyeluruh.
Pendidikan Qur’an Hadis Berwawasan Integratif Inklusif
Authors: Lidyaningsih Windy , Misbah M. 
Published: September 2024

The learning of Islamic Religious Education delivered in schools still impresses that this subject only stands alone and only teaches worship and sharia. Even though the content of the material in Islamic Religious Education has a relationship and teaches mutual respect. So there needs to be an understanding that Islamic Religious Education is not a subject that only stands alone and causes a dichotomy of science. The purpose of the study is to understand the material of Islamic Religious Education, especially in the Qur'an and Hadist families that are intergative and inclusive. The research method used is qualitative descriptive by collecting research data sources from libraries such as journals, books, documents, and other freelance articles. The result in this study is the content in the Qur'an and Hadith which in itself has an inclusive and integrative insight. This requires a deep understanding so that you can know what verses of the Qur'an and Hadith are inclusive and integrative. This proves that the Qur'an and Hadith as scientific sources need to be tested for truth through scientific aids. For example, Surah An-Nur verse 43 regarding the process of rain that can be integrated with natural science. Then in Surah al-Kafirun verse 6 which means "for you your religion and for me my religion" here that there is no compulsion in religion and mutual respect for differences in adhering to religion.
Keywords: Education, Qur'an Hadith, Integrative, Inclusive
Strategi Orang Tua dalam Pembinaan Akhlak Remaja: Analisis Dampak Media Sosial di Desa Sibrama
Authors: Fian Khafifatul , Muhamad Slamet Yahya  
Published: September 2024

Perlunya pembinaan terhadap akhlak remaja untuk membentuk akhlak baik dalam dirinya. Tulisan ini bertujuan untuk mendeskripsikan bagaimana strategi orang tua dalam membina akhlak remaja dengan analisis dampak dari penggunaan media sosial di Desa Sibrama. Jenis penelitian ini adalah kualitatif dengan teknik pengumpulan data melalui proses wawancara. Guna mendukung hasil wawancara disertakan pula hasil persentase terkait penggunaan media sosial yang diperoleh melalui google formulir sekaligus untuk memperkuat analisis dampak dari media sosial bagi remaja. Setelah data dikumpulkan, berikutnya data direduksi yang selanjutnya dianalisis dan dilengkapi dengan penelitian terdahulu yang sesuai dengan pembahasan. Setelah tahapan tersebut dilakukan, berikutnya adalah langkah terakhir yaitu penarikan kesimpulan. Hasil penelitian menunjukkan bahwa strategi orang tua dalam melakukan pembinaan terhadap akhlak remaja dengan cara pembatasan penggunaan media sosial serta dengan pemberian nasihat-nasihat. Sebesar 70,8% remaja menyatakan bahwa dirinya sering menggunakan media sosial dan mayoritas media sosial yang digunakan yaitu Instagram serta Whatsapp dengan perolehan persentase sebesar 8,3%. Dampak dari penggunaan media sosial terhadap akhlak remaja yaitu perubahan pola pikir dan perilaku. Sebesar 62,5% menyatakan bahwa remaja pernah menunda pekerjaan dan lebih asyik dengan media sosial. Berikutnya faktor pendorong dalam melakukan pembinaan terhadap akhlak remaja berkaitan dengan fasilitas yang tersedia sedangkan faktor penghambatnya adalah lingkungan atau pengaruh dari teman sebaya.
Development of an Enhanced Human Face Recognition Model
Authors: Yoro Rume Elizabeth , Achimugu Oluwatolani , Achimugu Philip , Damilare Olalekan Sunday , Idakwo Monday Abutu 
Published: September 2024

Abstract
Face recognition plays an important role in various areas of life and has attracted the interest of many scholars in the domain of computer vision, pattern recognition, and artificial intelligence. Most of the existing techniques adopted in the recognition of humans through facial images were found to be efficient but are computationally expensive due to the high dimension of facial images, which in turn increases processing speed and memory consumption. In this research, an enhanced model is proposed. Consequently, 6 facial images from 60 individuals were locally acquired using a Canon digital camera of default size 1200 × 1200. Thereafter, 240 images were used for training, while 120 images were used for testing. The enhanced model reduced the high dimension of images with improved feature extraction accuracy. Results showed significant improvement when compared to the existing ones.