bluuebunny/crossref_metadata_2025_split huggingface dataset:
Magnetic Resonance Elastography and Computational Modeling Identify Heterogeneous Lung Biomechanical Properties during Cystic Fibrosis
Authors: Cho Youjin , Fakhouri Faisal , Ballinger Megan N. , Englert Joshua A. , Hayes Don , Kolipaka Arunark , Ghadiali Samir N. 
Published: March 2024

Abstract
The lung is a dynamic mechanical organ and several pulmonary disorders are characterized by heterogeneous changes in the lung’s local mechanical properties (i.e. stiffness). These alterations lead to abnormal lung tissue deformation (i.e. strain) which have been shown to promote disease progression. Although heterogenous mechanical properties may be important biomarkers of disease, there is currently no non-invasive way to measure these properties for clinical diagnostic purposes. In this study, we use a magnetic resonance elastography technique to measure heterogenous distributions of the lung’s shear stiffness in healthy adults and in people with Cystic Fibrosis. Additionally, computational finite element models which directly incorporate the measured heterogenous mechanical properties were developed to assess the effects on lung tissue deformation. Results indicate that consolidated lung regions in people with Cystic Fibrosis exhibited increased shear stiffness and reduced spatial heterogeneity compared to surrounding non-consolidated regions. Accounting for heterogenous lung stiffness in healthy adults did not change the globally averaged strain magnitude obtained in computational models. However, computational models that used heterogenous stiffness measurements predicted significantly more variability in local strain and higher spatial strain gradients. Finally, computational models predicted lower strain variability and spatial strain gradients in consolidated lung regions compared to non-consolidated regions. These results indicate that spatial variability in shear stiffness alters local strain and strain gradient magnitudes in people with Cystic Fibrosis. This imaged-based modeling technique therefore represents a clinically viable way to non-invasively assess lung mechanics during both health and disease.
Development and validation of a nomogram for predicting pulmonary complications in elderly patients after thoracic surgery
Authors: Liu Jingjing , Xue Dinghao , Wang Long , Li Yanxiang , Liu Luyu , Liao Guosong , Cao Jiangbei , Liu Yanhong , Lou Jingsheng , Li Hao , Yang Yongbin , Mi Weidong , Fu Qiang 
Published: March 2024

Abstract

Background
Postoperative pulmonary complications (PPCs) remain a prevalent concern among elderly surgical patients, with a notably higher incidence observed in the elderly undergoing thoracic surgery. This study aimed to construct a nomogram to predict the risk of PPCs in this population.
Methods
A total of 2963 elderly patients who underwent thoracic surgery were randomly enrolled and divided into a training cohort (80%, n = 2369) and a validation cohort (20%, n = 593). Univariate and multivariate logistic regression analyses were conducted to identify risk factors for PPCs, and a nomogram was developed based on the findings from the training cohort. The validation cohort was used to validate the model. The predictive accuracy of the model was evaluated by receiver operating characteristic curve (ROC), area under ROC (AUC), calibration curve and decision curve analysis (DCA).
Results
A total of 918 (31.0%) patients reported PPCs. Nine independent risk factors for PPCs were identified: preoperative presence of chronic obstructive pulmonary disease (COPD), elevated leukocyte count, higher partial pressure of arterial carbon dioxide (PaCO2) levels, location of surgery, thoracotomy, intraoperative hypotension, blood loss > 100 mL, surgery duration > 180 min and malignant tumor. The AUC value for the training cohort was 0.739 (95% CI: 0.719–0.762), and that for the validation cohort was 0.703 (95% CI: 0.657–0.749). The P values for the Hosmer-Lemeshow test were 0.633 and 0.144 for the training and validation cohorts, respectively, indicating good calibration curve fit. The DCA curve showed that the nomogram could be applied clinically if the risk threshold was between 12% and 84%, which was found to be between 8% and 82% in the validation cohort.
Conclusions
This study underscores the pressing need for early detection of PPCs in elderly patients undergoing thoracic surgery. The nomogram exhibited promising predictive efficacy for PPCs in elderly individuals undergoing thoracic surgery, enabling the identification of high-risk patients and consequently aiding in the implementation of preventive interventions.
Constructing Small Sample Datasets with Game Mixed Sampling and Improved Genetic Algorithm
Authors: Zhu Bailin , Wang Hongliang , Fan Mi 
Published: March 2024

Abstract
In domains dealing with unbalanced data categorization, the dataset is expected to be balanced by adding a few more classes of data, which results in more data and low data quality. Therefore, The paper proposes an innovative hybrid method that combines game-based mixed sampling and an improved genetic algorithm to solve imbalanced data classification with a small dataset. Initially, the framework utilizes game theory to establish balanced sampling methods and ratios to address data imbalances. Subsequently, it employs the SelectKBest technique to optimize feature selection. Finally, the improved genetic algorithm will refine the sampling size and sample selection. In the feature encoding stage of the genetic algorithm, an ensemble learning method is adopted, using K-nearest neighbor (KNN), decision tree (DT), support vector machine (SVM), random forest (RF), and Adaboost, combined with precision, F1 score, and MCC performance evaluation indicators to measure, preventing premature convergence and optimizing the entire solution space, thus enhancing data sampling quality. Determination of the minimum stable population size employs a sliding standard deviation approach. Empirical findings corroborate the efficacy of this approach in tackling challenges associated with imbalanced data classification, refining the sample space, and improving sample quality. This methodology demonstrates significant practical utility in augmenting classifier performance when dealing with imbalanced datasets.
Factors that influence the uptake of virtual care solutions in Australian primary care practice: a systematic scoping review
Authors: Delaforce Alana , Maddock Emma , Wheeler Pamela , Jayasena Rajiv , Parkinson Joy 
Published: March 2024

Abstract

Background
The use of virtual care solutions in primary care settings has increased exponentially. Current evidence suggests high patient satisfaction with virtual care, but it is not without limitations. Research is needed to understand what factors influence the implementation of virtual care so that it can be delivered to the right patient, in the right clinical context at the right time as business-as-usual healthcare. Implementation science offers theories and models to assist with this, but none yet comprehensively address virtual care solution delivery.
Methods
A systematic scoping review was undertaken to identify empirical research studies that reported factors influencing the uptake of virtual care solutions within the Australian primary care setting. Searches were undertaken in Embase, PubMed, Scopus and Web of Science. The Consolidated Framework for Implementation Research (CFIR) was used to code factors influencing the implementation of virtual care solutions.
Results
14 studies were identified as eligible for inclusion. A cluster of five common influencing factors were identified. Three were from the existing CFIR framework, and two were newly developed constructs. CFIR constructs included: innovation relative advantage, capability and information technology infrastructure. New constructs included accessibility and suitability. A further six new constructs were identified (trust, privacy, governance, unintended consequences, preference and choice) but they were not prominently mentioned.
Conclusions
There are common influencing factors among primary care settings that implemented virtual care. The CFIR assisted in conceptualising these but was not sufficient for capturing factors unique to virtual care. Newly developed constructs are noted to be of importance in the literature, but further primary research is needed to understand if they are applicable in multiple contexts.
Assessing Blood-brain Barrier Function in the Context of Pain Management
Authors: Hassanzadeh Kiabi Farshad , Gharooee Ahangar Saeed , Beiranvand Siavash 
Published: March 2024

:
One essential component of the neurovascular system is known as the blood-brain barrier
(BBB). This highly effective biological barrier plays a pivotal role in regulating the brain's internal
microenvironment and carefully controlling the passage of various chemicals into and out of
the brain. Notably, it serves as a safeguard for the brain, particularly when it comes to the selective
transportation of drugs like opioids and non-steroidal anti-inflammatory medications (NSAIDs),
which are commonly used in the management of chronic pain. It's important to note that during the
development of chronic pain, the activation of microglia and astrocytes can potentially disrupt or
damage the integrity of the BBB. In this comprehensive review, we aim to delve into the intricate
interplay between the blood-brain barrier and the transportation of pain-relieving drugs, shedding
light on the challenges and mechanisms involved in this process.
Potential Biomolecule Fisetin: Molecular and Pharmacological Perspectives
Authors: Kamboj Ashu , Kamboj Anjoo , Malhotra Hitesh , Kaushik Peeyush 
Published: March 2024

Abstract:
The naturally occurring, bioactive dietary flavonoid known as fisetin, also
known as a tetrahydroxy flavone, is widely present in foods like apples, strawberries,
grapes, persimmons, onions, kiwi, kale, and others. In addition, due to their increased
safety, affordability, and practicality for oral administration, dietary flavonoids are
the focus of intense research. The configuration, quantity, and kind of hydroxyl
groups it contains in relation to functional groups in the nuclear structure determine
its bioavailability, metabolism, and biological activity. Fisetin exerts its wide range of
pharmacological activities by modulating various pathways, making it useful for diverse
biological conditions. These pathways include PI-3 kinase/AKT/p38, TFEB and
Nrf2, suppression of EGF-induced MMP-9 & sp-1 transcription, AKT/MAPK, JAKSTAT/
NF-kB, MEK/ERK, COX-2/iNOS, NF-kB/p300/IKK, VEGFR1/p-ERK1/2/
p38/pJNK, NF-κB/I-κBα, COX-2/WNT/EGFR/NF-κB, CDKN1B/P70S6K, PI3K/
AKT/CREB, PI3K/AKT/GSK3β, TLR4/NF-κB, and TXNIP/MAPKs, contributing to
apoptotic cell death and potential therapeutic applications, making it a valuable molecule
in various health contexts. Pleiotropic pharmacological properties of the polyphenol
fisetin, make the molecule effective as antihyperalgesic, antileishmanial, antiinflammatory,
antidiabetic, antihypertensive & cardioprotective, anti-photo inflammatory,
antiproliferative, anti-cancer drug and used in psoriasis, ACD, AMD, SCI,
hair growth promoter, SLE, AOM, SS2 infections, UL, PVR, Huntington’s, Alzheimer’s
diseases. This study explores the flavone molecule fisetin and its structural,
chemical, biological, pharmacological, and molecular properties.
Hubungan Mindfulness dan Student Engagement pada Mahasiswa
Authors: Hidayah Fajriyah Nurul 
Published: March 2024

Penelitian ini didasarkan pada fenomena banyaknya mahasiswa yang tidak terlibat dalam aktivitas belajar, seperti tidak fokus dan tidak memperhatikan saat pembelajaran berlangsung. Penelitian ini bertujuan untuk mengetahui keterkaitan antara mindfulness dengan student engagement pada mahasiswa. Adapun pendekatan yang digunakan ialah pendekatan kuantitatif dengan jenis penelitian korelasional. Sejumlah 150 mahasiswa dari angkatan 2018 di Universitas Negeri Yogyakarta menjadi subjek penelitian dengan mengisi skala mindfulness yang disusun berdasarkan konsep Five Facet Mindfulness Questionnaire (FFMQ) (α=0,727) dan skala student engagement (α=0,756). Analisis data penelitian menggunakan teknik korelasi product moment. Indeks korelasi yang didapatkan sebesar 0,508 dengan nilai signifikansi (p) antara variabel mindfulness dan student engagement sebesar 0,000 (p0,05) dan koefisien determinasi (R2) sebesar 25,8%. Hasil penelitian menunjukkan bahwa terdapat hubungan positif antara mindfulness dengan student engagement pada mahasiswa. Hal ini berarti, mahasiswa yang memiliki mindfulness tinggi cenderung memiliki keterlibatan tinggi ketika belajar, begitu juga sebaliknya.
Integrating Virtual Mindfulness-Based Stress Reduction Into Inflammatory Bowel Disease Care: Mixed Methods Feasibility Trial
Authors: Chappell Kaitlyn Delaney , Meakins Diana , Marsh-Joyal Melanie , Bihari Allison , Goodman Karen J , Le Melledo Jean-Michel , Lim Allen , Peerani Farhad , Kroeker Karen Ivy 
Published: March 2024

Background
Individuals with inflammatory bowel disease (IBD) experience cycles of aggressive physical symptoms including abdominal pain, diarrhea, and fatigue. These acute symptoms regress and return, and chronic symptoms and complications often linger. The nature of the disease can also cause individuals to experience psychological distress including symptoms of anxiety and depression; however, unlike the physical symptoms of IBD, these psychological symptoms often remain untreated.

Objective
This study aims to evaluate the feasibility, acceptability, and effectiveness of virtual mindfulness-based stress reduction (v-MBSR) for adults with IBD.

Methods
IBD patients with self-reported anxiety or depression were recruited from clinics in Alberta, Canada to participate in an 8-week v-MSBR intervention. Eligible patients participated in v-MBSR delivered by psychiatrists using a videoconferencing platform. Primary feasibility outcomes included trial uptake, adherence, attendance, and attrition rates. Secondary effectiveness outcomes included measures of anxiety, depression, quality of life (QoL), and mindfulness. Effectiveness data were collected at 3 time points: baseline, at intervention completion, and 6 months after completion. To further assess feasibility and acceptability, participants were invited to participate in a semistructured interview after completing v-MBSR.

Results
A total of 16 of the 64 (25%) referred patients agreed to participate in v-MBSR with the most common reason for decline being a lack of time while 7 of the 16 (43.8%) participants completed the program and experienced encouraging effects including decreased anxiety and depression symptoms and increased health-related QoL with both improvements persisting at 6-month follow-up. Participants described improved coping strategies and disease management techniques as benefits of v-MBSR.

Conclusions
Patients with IBD were interested in a psychiatrist-led virtual anxiety management intervention, but results demonstrate v-MBSR may be too time intensive for some patients with IBD patients. v-MBSR was acceptable to those who completed the intervention, and improvements to anxiety, depression, and QoL were promising and sustainable. Future studies should attempt to characterize the patients with IBD who may benefit most from interventions like v-MBSR.
Smartphone-Based Speech Therapy for Poststroke Dysarthria: Pilot Randomized Controlled Trial Evaluating Efficacy and Feasibility
Authors: Kim Yuyoung , Kim Minjung , Kim Jinwoo , Song Tae-Jin 
Published: March 2024

Background
Dysarthria is a common poststroke speech disorder affecting communication and psychological well-being. Traditional speech therapy is effective but often poses challenges in terms of accessibility and patient adherence. Emerging smartphone-based therapies may offer promising alternatives for the treatment of poststroke dysarthria.

Objective
This study aimed to assess the efficacy and feasibility of smartphone-based speech therapy for improving speech intelligibility in patients with acute and early subacute poststroke dysarthria. This study also explored the impact of the intervention on psychological well-being, user experience, and overall feasibility in a clinical setting.

Methods
Participants were divided into 2 groups for this randomized, evaluator-blinded trial. The intervention group used a smartphone-based speech therapy app for 1 hour per day, 5 days per week, for 4 weeks, with guideline-based standard stroke care. The control group received standard guideline-based stroke care and rehabilitation. Speech intelligibility, psychological well-being, quality of life, and user acceptance were assessed using repeated measures ANOVA.

Results
In this study, 40 patients with poststroke dysarthria were enrolled, 32 of whom completed the trial (16 in each group). The intervention group showed significant improvements in speech intelligibility compared with the control group. This was evidenced by improvements from baseline (F1,30=34.35; P<.001), between-group differences (F1,30=6.18; P=.02), and notable time-by-group interactions (F1,30=6.91; P=.01). Regarding secondary outcomes, the intervention led to improvements in the percentage of correct consonants over time (F1,30=5.57; P=.03). In addition, significant reductions were noted in the severity of dysarthria in the intervention group over time (F1,30=21.18; P<.001), with a pronounced group effect (F1,30=5.52; P=.03) and time-by-group interaction (F1,30=5.29; P=.03). Regarding quality of life, significant improvements were observed as measured by the EQ-5D-3L questionnaire (F1,30=13.25; P<.001) and EQ-VAS (F1,30=7.74; P=.009) over time. The adherence rate to the smartphone-based app was 64%, with over half of the participants completing all the sessions. The usability of the app was rated high (system usability score 80.78). In addition, the intervention group reported increased self-efficacy in using the app compared with the control group (F1,30=10.81; P=.003).

Conclusions
The smartphone-based speech therapy app significantly improved speech intelligibility, articulation, and quality of life in patients with poststroke dysarthria. These findings indicate that smartphone-based speech therapy can be a useful assistant device in the management of poststroke dysarthria, particularly in the acute and early subacute stroke stages.

Trial Registration
ClinicalTrials.gov NCT05146765; https://clinicaltrials.gov/ct2/show/NCT05146765
Preferred child number as the primary determinant of higher parity in women aged 45-49 in Eastern Indonesia: the 2017 IDHS data analysis
Authors: Putri Nur A'isyah Amalia , Hastono Sutanto Priyo , Besral  
Published: March 2024

Purpose: This research aims to determine the determinants of higher parity in women aged 45-49 years in Eastern Indonesia.
Methods: This research uses a quantitative approach and analysis of secondary data from the 2017 IDHS, utilizing a cross-sectional study design. Meanwhile, this research was conducted on 1,055 samples of the 2017 IDHS and analyzed using a complex survey method.
Results: The research finds that 72.2% of women aged 45-49 years in Eastern Indonesia have higher parity. Multiple logistic regression analysis indicates that women in this age group who gave birth for the first time before the age of 20 (p-value: 0.005; aOR: 2.04), those who have used a birth control method or device (p-value: 0.001; aOR: 0.30), those with the lowest welfare index (p-value: 0.015; aOR: 1.90), those who have experienced child mortality (p-value: 0.001; aOR: 4.46), and those preferred more than two children (p-value: 0.001; aOR: 5.47) are statistically significant related to higher parity.
Conclusion: The research concludes that key determinants of higher parity in women aged 45-49 years in Eastern Indonesia include early age at first birth, previous use of a birth control method or device, lowest welfare index, experience of child mortality, and a preference for having more than two children. Among these, the preferred child number is the most dominant variable related to higher parity.
The effect of breastfeeding counseling using card media on the knowledge and skills of breastfeeding mothers using the Quasy Experiment research approach
Authors: Anis Jumrotul , Supariasa I Dewa Nyoman , Fajar Ibnu , Prasetyo Yoyok Bekti 
Published: March 2024

Purpose: This research aims to analyze the effect of breastfeeding counseling cards on the knowledge and breastfeeding skills level in mothers of babies 0-6 months.
Methods: This research used a quasi-experimental design with two treatment groups. The research sample of 30 respondents was calculated with the help of G-Power Analysis 3.1 based on a 2-group t-test with an alpha error of .05, power of study 0.80, and large effect size (0.9).
Results: The average age of breastfeeding mothers is 26.7 years, with the majority education level being senior high school (SMA) at 63.3% and the number of children at one level being 53.3%. Counseling with cards had a significant effect on the level of knowledge of breastfeeding mothers (p < 0.000). Counseling also significantly affects changes in skills (p < 0.000). The intensity of counseling is also a factor that influences the improvement of the mother's skills, so the more frequent contact between the mother and the counselor, the more often the mother will receive information, indirectly improving the mother's skills.
Conclusion: The results of this study can be used as a reference for further research related to breastfeeding counseling and exclusive breastfeeding. The results of this research can be developed with other media, both print and electronic media, by taking advantage of advances in technology and society that continue to develop to increase the knowledge and skills of breastfeeding mothers and achieve exclusive breastfeeding.
The effectiveness of health education based on local wisdom of the people of Tulungagung Regency on maternal parenting in preventing stunting
Authors: Astuti Dita Apriana Dwi , Winarti Eko , Mirasa Yudied Agung 
Published: March 2024

Purpose: This study was to determine the effectiveness of Health Education Based on Local Wisdom of the People of Tulungagung Regency on Mother Parenting in Fulfilling Toddler Nutrition as an Effort to Prevent Stunting.
Methods: This research uses a quasi-experimental approach. The research location is in Bandung District, Tulungagung Regency. The population is all mothers who have children under five (0-3 years) in Bandung District, Tulungagung Regency. The research sample consisted of 60 respondents which were divided into 30 treatment groups and 30 control groups, which were taken using cluster random sampling technique. Data was collected using a questionnaire that had been tested for validity and reliability before and after the education was implemented. Data analysis using a two-way ANOVA test.
Results: There is an interaction of knowledge and parenting style variables together with time (pre-test and post-test) and group (intervention and control) when viewed from the p-value <0.05. The results of this analysis, the group of mothers who receive health education through the lecture method and local wisdom-based modules is related to the knowledge and parenting patterns of mothers.
Conclusion: Health education interventions through the lecture method and local wisdom-based modules have been shown to have a significant effect on maternal parenting in stunting prevention.