bluuebunny/crossref_metadata_2025_split huggingface dataset:
Different trajectories for becoming bilingual lead to comparable outcomes in cognitive flexibility
Authors: Gade Miriam , Philipp Andrea M. , Prior Anat 
Published: April 2024

Aims and Objective: Bilingualism has been proposed to affect cognitive flexibility, but findings in the literature are mixed. One reason for this might be the different trajectories of how participants acquired the second language, either through immersion or formal education. The present study investigates differences and commonalities of becoming bilingual depending on trajectory. Methodology: To assess cognitive flexibility, participants completed a task-switching and a language-switching paradigm, which were well-matched to each other. Language capabilities were assessed by self-report, objective fluency measures, and balance quotients. We assessed participants of five bilingual populations who together spoke five different languages. Data and Analysis: We analyzed global mixing costs, reflecting proactive language and task control, as well as local switch costs, reflecting reactive language and task control processes. The impact of language capabilities on mixing costs was assessed using linear mixed models. We also report correlations among language capability measures, sociodemographic variables, and working memory. Findings: We observed reliable mixing costs but no switch costs. Task and language mixing costs were smaller in participants who had a later age of L2 onset and higher L2 phonemic fluency, namely those who followed the formal education path to bilingualism. L2 phonemic fluency was the most consistent predictor for overall performance speed and reduced mixing costs. Originality: Using three different study sites and participants differing in their trajectory of becoming bilingual, this study provides a more diverse picture than many previous studies. Furthermore, using small language populations, the study shows the benefits of language fluency measures that are widely available. Significance and Implications: The present study bolsters the conceptualization of bilingualism as a multifaceted experience. Nonetheless, in the current study, bilingualism led to comparable outcomes in cognitive flexibility. Finally, measuring language capabilities should carefully consider cognitive processes not related to language that could explain variability in performance.
Use of aspirin in cardiovascular disease prevention—the role of online information search
Authors: Zhu Jingrong , Chen Wenjia 
Published: April 2024

Objectives This study intends to examine influences of online information search on the use of aspirin in cardiovascular diseases (CVDs) prevention among the applicable adult population in the United States. Methods We used data of 2018 National Health Interview Survey (NHIS). Our study sample is limited to adults age 40 or older to be consistent with the American Heart Association/American College of Cardiology Foundation (AHA/ACCF) guidelines for aspirin use. Linear probability models were used to test the association between patient's aspirin use behaviors and the variables of interest in four separate models. Results Our results show that the use of aspirin for CVD prevention was associated with online health information seeking in different ways. When patients received doctors’ advice to use aspirin, online information seeking has a negative influence, depending on whether the individual has CVD risk factors. However, for patients without recommendations from providers, the effects of online information seeking on self-initiated aspirin use depend on the different types of preventions (primary vs. secondary) and CVD risk factors. Conclusion Overall, online health information might lead to both overuse and underuse of aspirin in CVD preventions. Findings in this study may lead to decision-making that is not consistent with advice from healthcare professionals and/or established clinical guidelines.
Which self-reported measures are useful to explore diabetes support needs among adults with diabetes and severe mental illness?
Authors: Stenov Vibeke , Willaing Ingrid , Joensen Lene Eide , Knudsen Lenette , Andersen Gregers Stig , Hansen Dorte Lindqvist , Cleal Bryan 
Published: April 2024

Objectives To construct and test patient-reported outcome measures (PROMs) for identifying diabetes support needs of adults with co-existing diabetes and severe mental illness (SMI) provided by mental health professionals at psychiatric outpatient clinics. Methods Design thinking was used to identify, select, and modify PROMs in collaboration with 18 adults with type 1 or type 2 diabetes and SMI and 10 healthcare experts. The PROMs were then tested with 86 adults with diabetes and SMI recruited from eight psychiatric outpatient clinics in Denmark. Data were analysed using systematic text condensation (questionnaire construction) and descriptive statistics (testing). Results Four principles for PROMs were identified: (a) be modified to be relevant for the target group, (b) be concise and simple to complete, (c) have a clear and unambiguous wording, and (d) be designed to measure topics that are perceived as meaningful. Test of the questionnaire contained 49 items in four domains. Missing response rates in the test were 1.2–4.7% in three domains and 4.7–11.6% in a domain addressing potential sources of diabetes support. Discussion PROMs can successfully be constructed in collaboration with this vulnerable population that yield low rates of missing responses.
Development of an algorithm for identifying paraneoplastic ischemic stroke in association with lung, pancreatic, and colorectal cancer
Authors: Kassubek Rebecca , Winter Marc-Andre G. R. , Dreyhaupt Jens , Laible Mona , Kassubek Jan , Ludolph Albert C. , Lewerenz Jan 
Published: April 2024

Background: Paraneoplastic ischemic stroke has a poor prognosis. We have recently reported an algorithm based on the number of ischemic territories, C-reactive protein (CRP), lactate dehydrogenase (LDH), and granulocytosis to predict the underlying active cancer in a case-control setting. However, co-occurrence of cancer and stroke might also be merely incidental. Objective: To detect cancer-associated ischemic stroke in a large, unselected cohort of consecutive stroke patients by detailed analysis of ischemic stroke associated with specific cancer subtypes and comparison to patients with bacterial endocarditis. Methods: Retrospective single-center cohort study of consecutive 1612 ischemic strokes with magnetic resonance imaging, CRP, LDH, and relative granulocytosis data was performed, including identification of active cancers, history of now inactive cancers, and the diagnosis of endocarditis. The previously developed algorithm to detect paraneoplastic cancer was applied. Tumor types associated with paraneoplastic stroke were used to optimize the diagnostic algorithm. Results: Ischemic strokes associated with active cancer, but also endocarditis, were associated with more ischemic territories as well as higher CRP and LDH levels. Our previous algorithm identified active cancer-associated strokes with a specificity of 83% and sensitivity of 52%. Ischemic strokes associated with lung, pancreatic, and colorectal (LPC) cancers but not with breast and prostate cancers showed more frequent and prominent characteristics of paraneoplastic stroke. A multiple logistic regression model optimized to identify LPC cancers detected active cancer with a sensitivity of 77.8% and specificity of 81.4%. The positive predictive value (PPV) for all active cancers was 13.1%. Conclusion: Standard clinical examinations can be employed to identify suspect paraneoplastic stroke with an adequate sensitivity, specificity, and PPV when it is considered that the association of ischemic stroke with breast and prostate cancers in the stroke-prone elderly population might be largely incidental.
There is no association between anxiety and lifestyle in older adults during the COVID-19 pandemic: A cross-sectional study
Authors: Moya-Salazar Jeel , Damián Daysi Y , Goicochea-Palomino Eliane A , Cañari Betsy , Moya-Salazar Belén , Contreras-Pulache Hans 
Published: April 2024

Introduction and objective: The COVID-19 pandemic has caused mental health problems worldwide. Older people have been particularly affected by the lockdown as their health conditions have changed, although they have been kept in isolation to avoid exposure to contagion. We sought to determine the association between lifestyles and anxiety in older adults during the COVID-19 pandemic. Materials and methods: This study was cross-sectional. We enrolled 150 older adults of both sexes and with a history of chronic diseases from the municipality of El Agustino (Lima, Peru). The 20-item Geriatric Anxiety Scale and the 25-item Lifestyle Questionnaire on eating, physical activity, rest, and sleep were administered in Spanish during July–August 2021. Results: The mean age was 70.8 ± 8.1 years, 54.7% were male, and 75.3% practiced exercise. During the COVID-19 pandemic, 99.3% of the elderly had healthy lifestyles and 40% presented anxiety (mild, moderate, and severe anxiety in 26.7%, 8.7%, and 4.7%, respectively). We found no association between anxiety and lifestyle ( p = 0.189), physical exercise was a predictor of lifestyle ( p < 0.001) and we did not find predictors of anxiety symptoms ( p > 0.05). Conclusions: Our results suggest that there was no link between anxiety symptoms and lifestyle in older adults during the lockdown. It is important to conduct in-depth research on factors associated with anxiety symptoms among older residents in other regions, focusing on population groups with the highest rates of infection and death from COVID-19.
Morphological and pomological assessments of seedling-originated walnut (Juglans regia L.) trees to select the promising late-leafing genotypes
Authors: Einollahi Fariba , Khadivi Ali 
Published: April 2024

Abstract
Background
In many parts of the world, including Iran, walnut (Juglans regia L.) production is limited by late-spring frosts. Therefore, the use of late-leafing walnuts in areas with late-spring frost is the most important method to improve yield. In the present study, the phenotypic diversity of 141 seedling genotypes of walnut available in the Senejan area, Arak region, Markazi province, Iran was studied based on morphological traits to obtain superior late-leafing genotypes in the cropping seasons of 2022 and 2023.

Results
Based on the results of the analysis of variance, the studied genotypes showed a significant variation in terms of most of the studied morphological and pomological traits. Therefore, it is possible to choose genotypes for different values ​​of a trait. Kernel weight showed positive and significant correlations with leaf length (r = 0.32), leaf width (r = 0.33), petiole length (r = 0.26), terminal leaflet length (r = 0.34), terminal leaflet width (r = 0.21), nut length (r = 0.48), nut width (r = 0.73), nut weight (r = 0.83), kernel length (r = 0.64), and kernel width (r = 0.89). The 46 out of 141 studied genotypes were late-leafing and were analyzed separately. Among late-leafing genotypes, the length of the nut was in the range of 29.33–48.50 mm, the width of the nut was in the range of 27.51–39.89 mm, and nut weight was in the range of 8.18–16.06 g. The thickness of shell was in the range of 1.11–2.60 mm. Also, kernel length ranged from 21.97–34.84 mm, kernel width ranged from 21.10–31.09 mm, and kernel weight ranged from 3.10–7.97 g.

Conclusions
Based on important and commercial traits in walnut breeding programs, such as nut weight, kernel weight, kernel percentage, kernel color, and ease of kernel removal from nuts, 15 genotypes, including no. 92, 91, 31, 38, 33, 18, 93, 3, 58, 108, 16, 70, 15, 82, and 32 were superior and could be used in walnut breeding programs in line with the introduction of new cultivars and the revival of traditional walnut orchards to commercialize them.
Methods of determining optimal cut-point of diagnostic biomarkers with application of clinical data in ROC analysis: an update review
Authors: Hassanzad Mojtaba , Hajian-Tilaki Karimollah 
Published: April 2024

Abstract
Introduction
An important application of ROC analysis is the determination of the optimal cut-point for biomarkers in diagnostic studies. This comprehensive review provides a framework of cut-point election for biomarkers in diagnostic medicine.

Methods
Several methods were proposed for the selection of optional cut-points. The validity and precision of the proposed methods were discussed and the clinical application of the methods was illustrated with a practical example of clinical diagnostic data of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and malondialdehyde (MDA) for prediction of inflammatory bowel disease (IBD) patients using the NCSS software.

Results
Our results in the clinical data suggested that for CRP and MDA, the calculated cut-points of the Youden index, Euclidean index, Product and Union index methods were consistent in predicting IBD patients, while for ESR, only the Euclidean and Product methods yielded similar estimates. However, the diagnostic odds ratio (DOR) method provided more extreme values for the optimal cut-point for all biomarkers analyzed.

Conclusion
Overall, the four methods including the Youden index, Euclidean index, Product, and IU can produce quite similar optimal cut-points for binormal pairs with the same variance. The cut-point determined with the Youden index may not agree with the other three methods in the case of skewed distributions while DOR does not produce valid informative cut-points. Therefore, more extensive Monte Carlo simulation studies are needed to investigate the conditions of test result distributions that may lead to inconsistent findings in clinical diagnostics.
Spatial-temporal Bayesian accelerated failure time models for survival endpoints with applications to prostate cancer registry data
Authors: Wang Ming , Li Zheng , Lu Jun , Zhang Lijun , Li Yimei , Zhang Liangliang 
Published: April 2024

AbstractProstate cancer is the most common cancer after non-melanoma skin cancer and the second leading cause of cancer deaths in US men. Its incidence and mortality rates vary substantially across geographical regions and over time, with large disparities by race, geographic regions (i.e., Appalachia), among others. The widely used Cox proportional hazards model is usually not applicable in such scenarios owing to the violation of the proportional hazards assumption. In this paper, we fit Bayesian accelerated failure time models for the analysis of prostate cancer survival and take dependent spatial structures and temporal information into account by incorporating random effects with multivariate conditional autoregressive priors. In particular, we relax the proportional hazards assumption, consider flexible frailty structures in space and time, and also explore strategies for handling the temporal variable. The parameter estimation and inference are based on a Monte Carlo Markov chain technique under a Bayesian framework. The deviance information criterion is used to check goodness of fit and to select the best candidate model. Extensive simulations are performed to examine and compare the performances of models in different contexts. Finally, we illustrate our approach by using the 2004-2014 Pennsylvania Prostate Cancer Registry data to explore spatial-temporal heterogeneity in overall survival and identify significant risk factors.
Hemophagocytic lymphohistiocytosis and myopericarditis induced by campylobacter: a case report
Authors: Chang Chia Hua , Kao Chih-Chuan 
Published: April 2024

Abstract
Background
Hemophagocytic lymphohistiocytosis (HLH) is a severe disorder characterized by excessive activation of the immune system, leading to hypercytokinemia and damage to multiple organs. We report a rare case of HLH with myopericarditis caused by Campylobacter infection.

Case presentation
A 28-year-old male patient with a history of hypertension without medicine control presented at the hospital after a four-day fever, decreasing urine amount, rashes on his trunk and limbs, and other symptoms. He was admitted with a provisional diagnosis of atypical infection and allergic skin rash related to diclofenac. However, his condition deteriorated, and he developed shock, tachycardia, chest distress, and bilateral pleural effusion after admission. Further investigations revealed cardiogenic shock related to myopericarditis, and he was transferred to the ICU. In addition, a stool PCR panel subsequently revealed a positive result for Campylobacter. On day 6, he was diagnosed with HLH. Under Clarithromycin and dexamethasone infusion, leukocytosis, anemia and thrombocytopenia with cardiogenic shock status improved. Then, he was later discharged in stable condition.

Conclusions
HLH and myopericarditis caused by Campylobacter are very rare. Early detection of Campylobacter-induced HLH and multiple organ failure, as well as prompt use of antibiotics and immunosuppressants, can be helpful for prognosis.
Deep transfer learning with fuzzy ensemble approach for the early detection of breast cancer
Authors: Sannasi Chakravarthy S. R. , Bharanidharan N. , Vinoth Kumar V. , Mahesh T. R. , Alqahtani Mohammed S. , Guluwadi Suresh 
Published: April 2024

AbstractBreast Cancer is a significant global health challenge, particularly affecting women with higher mortality compared with other cancer types. Timely detection of such cancer types is crucial, and recent research, employing deep learning techniques, shows promise in earlier detection. The research focuses on the early detection of such tumors using mammogram images with deep-learning models. The paper utilized four public databases where a similar amount of 986 mammograms each for three classes (normal, benign, malignant) are taken for evaluation. Herein, three deep CNN models such as VGG-11, Inception v3, and ResNet50 are employed as base classifiers. The research adopts an ensemble method where the proposed approach makes use of the modified Gompertz function for building a fuzzy ranking of the base classification models and their decision scores are integrated in an adaptive manner for constructing the final prediction of results. The classification results of the proposed fuzzy ensemble approach outperform transfer learning models and other ensemble approaches such as weighted average and Sugeno integral techniques. The proposed ResNet50 ensemble network using the modified Gompertz function-based fuzzy ranking approach provides a superior classification accuracy of 98.986%.
Association between prenatal vitamin D deficiency with dental caries in infants and children: a systematic review and meta-analysis
Authors: Bahardoust Mansour , Salari Salar , Ghotbi Nader , Rahimpour Elham , Haghmoradi Meisam , Alipour Homan , Soleimani Mahsa 
Published: April 2024

AbstractPrenatal vitamin D (PVD) is a vital micronutrient for dental caries (DCs). The association between prenatal vitamin D deficiencies (PVDD) and DCs in children has been conflicting in different reports. This meta-analysis aimed to investigate the association between PVDD and DCs in children for the first time. We searched PubMed, Scopus, Web of Sciences, Embase, and Scholar databases to find relevant studies based on mesh terms from 2000 to October 2023. This study was conducted based on the 2020 version of the PRISMA checklist. Cochran’s Q and I2 tests were used to evaluate heterogeneity between studies. Egger’s test was used to evaluate publication bias. The effect size of the association between PVDD and DCs was reported by the odds ratio (OR) at the 95% confidence interval (95% CI).Twelve studies, including 11,021 participants, were reviewed. The pooled prevalence of PVDD was estimated at 4353 (32%). The prevalence of DCs in children of mothers with and without PVDD was 44% and 25%, respectively. PVDD was significantly associated with an increased risk of DCs in children (OR: 1.35, 95% CI (1.22, 1.47), I2 = 86.6%). The association of DCs with PVDD was different based on gestational age groups, children’s age groups, and vitamin D levels. This meta-analysis showed PVDD can be associated with an increased risk of DCs in children, especially in mothers with prenatal vitamin D levels ≤ 35 nmol/L. Adequate vitamin D levels throughout pregnancy can help prevent DCs in children.
SABR-Dual: a phase II/III trial of two-fraction versus five-fraction stereotactic radiotherapy for localized low- and favorable intermediate-risk prostate cancer
Authors: Fredman Elisha , Icht Oded , Moore Assaf , Bragilovski Dimitri , Kindler Jonathan , Golan Shay , Limon Dror 
Published: April 2024

Abstract
Background
Dose-escalated radiotherapy is known to improve progression free survival in patients with localized prostate cancer, and recent advances have led to the standardization of ultrahypofractionated stereotactic ablative radiotherapy (SABR) delivered in just 5-fractions. Based on the known effectiveness of the accepted though invasive 2-fraction treatment method of high-dose-rate brachytherapy and given the ubiquity of prostate cancer, a further reduction in the number of treatments of external-beam SABR is possible. This study aims to evaluate the safety, efficacy, and non-inferiority of generalizable 2-fraction SABR compared to the current 5-fraction regimen.

Methods
502 patients will be enrolled on this phase II/III randomized control trial. Eligible patients will have previously untreated low- or favorable intermediate-risk adenocarcinoma of the prostate. Patients will be randomized between standard SABR of 40 Gy in 5 fractions given every-other-day and 27 Gy in 2 fractions at least two days apart but completing within seven days. MRI-based planning, radiopaque hydrogel spacer insertion, and fiducial marker placement are required, and SABR will be delivered on either a standard CT-guided linear accelerator or MR-LINAC. The primary endpoint will be freedom from disease progression, with additional secondary clinical, toxicity, and quality of life endpoints.

Discussion
This study will be the largest prospective randomized trial, adequately powered to demonstrate non-inferiority, comparing 2-fraction SABR to standard 5-fraction SABR for localized prostate cancer. As the protocol does not obligate use of an MRI-LINAC or other adaptive technologies, results will be broadly generalizable to the wider community.

Trial registration
This trial is registered on Clinicaltrials.gov: ClinicalTrials.gov Identifier: NCT06027892.