bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of repetitive transcranial magnetic stimulation with different application parameters for post-stroke cognitive impairment: a systematic review
Authors: Wang Yuhan , Wang Linjia , Ni Xixiu , Jiang Minjiao , Zhao Ling 
Published: March 2024

BackgroundCognitive impairment is a prevalent consequence of stroke, seriously affecting recovery and quality of life while imposing substantial burdens on both patients’ families and society. Repetitive transcranial magnetic stimulation (rTMS) has emerged as an effective intervention for post-stroke cognitive impairment (PSCI). However, the a lack of standardized and explicit guidelines regarding rTMS application parameters. Therefore, this study systematically evaluated the efficacy of various parameters of rTMS in treating PSCI and explored its potential mechanism.MethodsWe conducted a comprehensive search across seven scientific databases, namely China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform (Wanfang), China Science and Technology Journal Database (VIP), Web of Science, PubMed, Embase, and Cochrane Library, to identify randomized controlled trials (RCTs) investigating the efficacy of rTMS for PSCI. The search encompassed the period from database creation until July 28, 2023. To evaluate the risk of bias in included studies, we employed the Cochrane recommended risk of bias assessment tool. Furthermore, we extracted relevant clinical application parameters associated with rTMS and performed comparative analyses to assess their therapeutic effects under different parameter settings.ResultsThe present study included 45 RCTs involving a total of 3,066 patients with PSCI. Both high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) and low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) demonstrated safety and efficacy, yet failed to exhibit significant differentiation in terms of cognitive improvement. Furthermore, intermittent theta burst stimulation (iTBS), although yielding positive results, did not surpass traditional rTMS in effectiveness. Combining HF-rTMS with LF-rTMS resulted in superior efficacy compared to single rTMS intervention. Moreover, the combination of rTMS with other cognitive therapies exhibited potential for enhanced benefits among patients.ConclusionrTMS can effectively and safely enhance cognitive function, improve quality of life, and enhance activities of daily living in patients with PSCI. Furthermore, the combination of rTMS with other conventional rehabilitation methods can yield additional positive effects. However, due to insufficient evidence, an optimal parameter protocol for rTMS can not be currently recommended. Future research should prioritize orthogonal experimental design methods that incorporate multiple parameters and levels to determine the optimal parameter protocol for rTMS in PSCI.
Evaluation of the reach and utilization of the American College of Lifestyle Medicine’s Culinary Medicine Curriculum
Authors: Staffier Kara Livingston , Holmes Shannon , Karlsen Micaela Cook , Kees Alexandra , Shetty Paulina , Hauser Michelle E. 
Published: March 2024

IntroductionDespite the growing interest in “food as medicine,” healthcare professionals have very limited exposure to nutrition as part of their training. Culinary medicine (CM), an evidence-based field integrating nutrition education with culinary knowledge and skills, offers one approach to fill this training gap. The American College of Lifestyle Medicine published a complimentary Culinary Medicine Curriculum (CMC) in 2019, and the objective of this study is to evaluate its reach and utilization, as well as to collect feedback from users.MethodsIndividuals who downloaded the CMC prior to March 1, 2022 (N = 6,162) were emailed an invitation to participate in an online, cross-sectional survey. The survey included both multiple choice and free-text questions about whether CM sessions were conducted, if and how the CMC was used, if and how it was modified for use, and additional requested resources. Free-text responses were inductively coded, and quantitative data was summarized using descriptive statistics.ResultsA total of 522 respondents provided consent, indicated that they had downloaded the curriculum, and completed the survey. Of the 522, 366 (70%) reported that they had not led or created any CM sessions. The top-reported reason for not leading a session was lack of time (29%). The remaining respondents who did create a CM session did so across various settings, including academic, clinical, coaching, and other settings, and a variety of professionals delivered the CMC sessions, including physicians (50%), registered dietitian nutritionists (30%), and chefs (25%). The majority of respondents (81%) modified the CMC in some way, with many using the curriculum for guidance or ideas only. Patient education materials (66%) and cooking technique instruction videos (59%) were among top requested resources.DiscussionThe CMC is a versatile resource that can be successfully adapted for use across various settings and by various types of health professionals and practitioners. Future research should investigate whether training in CM results in improved health outcomes for patients/clients. The curriculum will continue to grow to address the needs of users by expanding to include more digital content such as curriculum videos and cooking technique videos.
CT-based radiomics for predicting lymph node metastasis in esophageal cancer: a systematic review and meta-analysis
Authors: Liu Liangsen , Liao Hai , Zhao Yang , Yin Jiayu , Wang Chen , Duan Lixia , Xie Peihan , Wei Wupeng , Xu Meihai , Su Danke 
Published: March 2024

ObjectiveWe aimed to evaluate the diagnostic effectiveness of computed tomography (CT)-based radiomics for predicting lymph node metastasis (LNM) in patients diagnosed with esophageal cancer (EC).MethodsThe present study conducted a comprehensive search by accessing the following databases: PubMed, Embase, Cochrane Library, and Web of Science, with the aim of identifying relevant studies published until July 10th, 2023. The diagnostic accuracy was summarized using the pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the curve (AUC). The researchers utilized Spearman’s correlation coefficient for assessing the threshold effect, besides performing meta-regression and subgroup analysis for the exploration of possible heterogeneity sources. The quality assessment was conducted using the Quality Assessment of Diagnostic Accuracy Studies-2 and the Radiomics Quality Score (RQS).ResultsThe meta-analysis included six studies conducted from 2018 to 2022, with 483 patients enrolled and LNM rates ranging from 27.2% to 59.4%. The pooled sensitivity, specificity, PLR, NLR, DOR, and AUC, along with their corresponding 95% CI, were 0.73 (0.67, 0.79), 0.76 (0.69, 0.83), 3.1 (2.3, 4.2), 0.35 (0.28, 0.44), 9 (6, 14), and 0.78 (0.74, 0.81), respectively. The results demonstrated the absence of significant heterogeneity in sensitivity, while significant heterogeneity was observed in specificity; no threshold effect was detected. The observed heterogeneity in the specificity was attributed to the sample size and CT-scan phases (P &lt; 0.05). The included studies exhibited suboptimal quality, with RQS ranging from 14 to 16 out of 36. However, most of the enrolled studies exhibited a low-risk bias and minimal concerns relating to applicability.ConclusionThe present meta-analysis indicated that CT-based radiomics demonstrated a favorable diagnostic performance in predicting LNM in EC. Nevertheless, additional high-quality, large-scale, and multicenter trials are warranted to corroborate these findings.Systematic Review RegistrationOpen Science Framework platform at https://osf.io/5zcnd.
Interstitial needles versus intracavitary applicators only for locally advanced cervical cancer: results from real-life dosimetric comparisons
Authors: Cordoba Abel , Gesta Estelle , Escande Alexandre , Noeuveglise Alexandra , Cayez Romain , Halty Adrien , Ladjimi Mohamed Tahar , Narducci Fabrice , Hudry Delphine , Martinez Gomez Carlos , Cordoba Sofia , Le Deley Marie-Cécile , Barthoulot Maël , Lartigau Eric F. 
Published: March 2024

Background and purposeImage-guided adapted brachytherapy (IGABT) is superior to other radiotherapy techniques in the treatment of locally advanced cervical cancer (LACC). We aimed to investigate the benefit of interstitial needles (IN) for a combined intracavitary/interstitial (IC/IS) approach using IGABT over the intracavitary approach (IC) alone in patients with LACC after concomitant external beam radiotherapy (EBRT) and chemotherapy.Materials and methodsWe included consecutive patients with LACC who were treated with IC/IS IGABT after radiochemotherapy (RCT) in our retrospective, observational study. Dosimetric gain and sparing of organs at risk (OAR) were investigated by comparing the IC/IS IGABT plan with a simulated plan without needle use (IC IGABT plan) and the impact of other clinical factors on the benefit of IC/IS IGABT.ResultsNinety-nine patients were analyzed, with a mean EBRT dose of 45.5 ± 1.7 Gy; 97 patients received concurrent chemotherapy. A significant increase in median D90% High Risk Clinical target volume (HR-CTV) was found for IC/IS (82.8 Gy) vs IC (76.2 Gy) (p &lt; 10-4). A significant decrease of the delivered dose for all OAR was found for IC/IS vs IC for median D2cc to the bladder (77.2 Gy), rectum (68 Gy), sigmoid (53.2 Gy), and small bowel (47 Gy) (all p &lt; 10-4).ConclusionHR-CTV coverage was higher with IC/IS IGABT than with IC IGABT, with lower doses to the OAR in patients managed for LACC after RCT. Interstitial brachytherapy in the management of LACC after radiotherapy provides better coverage of the target volumes, this could contribute to better local control and improved survival of patients.
Cross-cultural adaptation, reliability and validity of the Spanish version of the long-term quality of life questionnaire
Authors: León-Salas Beatriz , Bilbao-González Amaia , de Pascual y Medina Ana María , Esteva Magdalena , Toledo-Chávarri Ana , Fuentes-Sánchez Claudio , Bohn-Sarmiento Uriel , Padrón-Peña Pilar , González-Sánchez Sonia , Valcárcel-López Rafael , Trujillo-Martín María del Mar 
Published: March 2024

PurposeThe aim of this study was to translate, culturally adapt, and evaluate the psychometric properties of the Spanish Long-Term Quality of Life (LTQL) questionnaire.MethodsThe LTQL was initially translated into Spanish and cross-culturally adapted based on established guidelines. The Spanish LTQL was administered to patients with breast cancer who had completed their initial treatment 5 years earlier, along with other self-report measures: Quality of Life in Adult Cancer Survivors (QLACS), Hospital Anxiety and Depression Scale (HADS) and EORT-QLQ-BR23. Reliability was evaluated using internal consistency and test-retest. Convergent and known-groups validity were examined. Structural validity as determined by confirmatory factor analysis (CFA) and Rasch analyses was used to assess the unidimensionality and item-functioning of the LTQL domains.ResultsCronbach’s alpha were above 0.7 in all domains. Test-retest coefficients were between 0.72 to 0.96 for LTQL domains. LTQL total score was correlated with others total scores of other measures: QLACS (r=-0.39), HADS depression (r=-0.57), HADS anxiety (-0.45) and EORTC-QLQ-BR23 (r=-0.50). CFA provided satisfactory fit indices, with RMSEA value of 0.077 and TLI and CFI values of 0.901 and 0.909, respectively. All factor loadings were higher than 0.40 and statistically significant (P&lt;0.001). Rasch analysis showed that Somatic Concerns domain had 4 misfitting items, and Philosophical/Spiritual View of Life and social Support domains only 1 misfit item. However, unidimensionality was supported for the four domains.ConclusionThe findings support the validity and reliability of the Spanish version of LTQL questionnaire to be used in long-term cancer female survivors.
Accelerometer-based measures in Friedreich ataxia: a longitudinal study on real-life activity
Authors: Fichera Mario , Nanetti Lorenzo , Monelli Alessia , Castaldo Anna , Marchini Gloria , Neri Marianna , Vukaj Xhuljano , Marzorati Mauro , Porcelli Simone , Mariotti Caterina 
Published: March 2024

Quantitative measurement of physical activity may complement neurological evaluation and provide valuable information on patients’ daily life. We evaluated longitudinal changes of physical activity in patients with Friedreich ataxia (FRDA) using remote monitoring with wearable sensors. We performed an observational study in 26 adult patients with FRDA and 13 age-sex matched healthy controls (CTR). Participants were asked to wear two wearable sensors, at non-dominant wrist and at waist, for 7 days during waking hours. Evaluations were performed at baseline and at 1-year follow-up. We analysed the percentage of time spent in sedentary or physical activities, the Vector Magnitude on the 3 axes (VM3), and average number of steps/min. Study participants were also evaluated with ataxia clinical scales and functional tests for upper limbs dexterity and walking capability. Baseline data showed that patients had an overall reduced level of physical activity as compared to CTR. Accelerometer-based measures were highly correlated with clinical scales and disease duration in FRDA. Significantly changes from baseline to l-year follow-up were observed in patients for the following measures: (i) VM3; (ii) percentage of sedentary and light activity, and (iii) percentage of Moderate-Vigorous Physical Activity (MVPA). Reduction in physical activity corresponded to worsening in gait score of the Scale for Assessment and Rating of Ataxia. Real-life activity monitoring is feasible and well tolerated by patients. Accelerometer-based measures can quantify disease progression in FRDA over 1 year, providing objective information about patient’s motor activities and supporting the usefulness of these data as complementary outcome measure in interventional trials.
Rain splash-mediated dispersal of Escherichia coli from fecal deposits to field-grown lettuce in the mid- and south Atlantic U.S. regions is affected by mulch type
Authors: Hopper Adam L. , Hudson Claire L. , Klair Diksha , Ding Qiao , Gao Zhujun , Jha Aprajeeta , Bryan Austin , Tikekar Rohan V. , Coolong Timothy , Dunn Laurel L. , Micallef Shirley A. 
Published: March 2024

IntroductionWildlife feces can contaminate vegetables when enteric bacteria are released by rain and splashed onto crops. Regulations require growers to identify and not harvest produce that is likely contaminated, but U.S. federal standards do not define dimensions for no-harvest zones. Moreover, mulching, used to retain soil moisture and maximize crop yield may impact rain-mediated bacterial dispersal from feces.MethodsTo assess Escherichia coli dissemination from a fecal point source to lettuce grown on various mulches, lettuce cv. ‘Magenta’ was transplanted into raised beds with plastic, biodegradable plastic, straw, or left uncovered at field sites in Maryland and Georgia. Eleven days post-transplant, 10 g of rabbit manure spiked with ~8 log CFU g-1E. coli were deposited in each bed. One day following natural or simulated rain events, lettuce was sampled along 1.5 m transects on either side of fecal deposits. Lettuce-associated E. coli was semi-quantified with an MPN assay and dependence on fecal age (stale or fresh), lettuce age (baby leaf or mature head), distance from point source, mulch and post-rain days were statistically evaluated.ResultsDistance (p&lt;0.001), fecal age (p&lt;0.001) and mulch (p&lt;0.01) were factors for E. coli transfer from point source to lettuce. The highest and lowest E. coli estimates were measured from lettuce grown on biodegradable plastic and straw, respectively, with a 2-log MPN difference (p&lt;0.001). Mulch and distance were also significant factors in E. coli recovery 3 days post-rain (both p&lt;0.001), where plastic mulches differed from bare ground and straw (p&lt;0.01). For all treatments, fewer E. coli were retrieved from lettuce at 0.3 m, 3 days post-rain compared to 1 day (p&lt;0.001). Fitting the data to a Weibull Model predicated that a 7-log reduction in E. coli from fecal levels would be achieved at 1.2-1.4 m from the point source on plastic mulches, 0.75 m on bare soil (p&lt;0.05) and 0.43 m on straw (p&lt;0.01).DiscussionStraw and bare ground limited rain-mediated E. coli dispersal from feces to lettuce compared to plastic mulches. Fecal age was negatively associated with E. coli dispersal. These findings can inform harvesting recommendations for measures related to animal intrusion in vegetable production areas.
Somatic symptom profile in patients with chronic heart failure with and without depressive comorbidity
Authors: Müller-Tasch Thomas , Löwe Bernd , Frankenstein Lutz , Frey Norbert , Haass Markus , Friederich Hans-Christoph 
Published: March 2024

BackgroundPatients with chronic heart failure (CHF) frequently suffer from depressive comorbidity. CHF and depressive comorbidity can cause somatic symptoms. The correct attribution of somatic symptoms is important. Thus, we aimed to assess potential differences in somatic symptom severity between CHF patients with and without depressive comorbidity.MethodsWe evaluated depressive comorbidity using the Patient Health Questionnaire-9 (PHQ-9), somatic symptom severity with the Patient Health Questionnaire-15 (PHQ-15), and sociodemographic and medical variables in 308 CHF outpatients. To compare somatic symptom severity between CHF patients with and without depressive comorbidity, we conducted item-level analyses of covariance.ResultsOf the 308 participating patients, 93 (30.3%) met the PHQ-9 criteria for depressive comorbidity. These patients did not differ from those without depressive comorbidity with regard to age, sex, left ventricular function, and multimorbidity. Patients with depressive comorbidity scored significantly higher on ten out of thirteen PHQ-15 items than patients without depressive comorbidity. The largest effect sizes (0.71-0.80) were shown for symptoms of headache, chest pain, shortness of breath, and palpitations, and the latter three were potentially attributable to heart failure.ConclusionsAmong patients with CHF, somatic symptoms are more pronounced in those with depressive comorbidity than those without depressive comorbidity. This finding is especially true for cardiac symptoms independent of CHF severity. The potential interpretation of somatic symptoms as correlates of depressive comorbidity must be recognized in clinical practice.
Case Report: Vascular access in paediatric haemodialysis patients—creating and maintaining the patency of an arteriovenous fistula
Authors: Stroescu Ramona , Comsa Serban , Chisavu Flavia , Gafencu Mihai 
Published: March 2024

IntroductionPaediatric vascular access is a demanding field. The need for a multidisciplinary team is mandatory in children with end-stage kidney disease (ESKD). Central venous catheters (CVCs) remain the preferred option worldwide. Recent emerging data demonstrated the benefits of using arteriovenous fistulas (AVFs) in the paediatric population for long-term vascular access. The small vessel size in children represents a surgical challenge for vascular access.Case presentationWe report three cases from our haemodialysis department and the difficulty in maintaining permanent vascular access. The first case is an adolescent girl who required a change in vascular approach after multiple central venous catheter (CVC) infections and catheter thrombosis secondary to thrombophilia. Three AVFs were performed but failure occurred early. The patient was also diagnosed with a complex vascular thrombosis with total occlusion of the inferior vena cava and completed distal thrombosis of the superior vena cava. A permanent CVC was placed in the right jugular vein with the tip in the azygos vein. The second case is of an adolescent boy with systemic vasculitis with multiple CVC infections secondary to immunosuppression. The first thrombosis of two right AVFs occurred early with the development of a pseudo-aneurysm that required surgical intervention. The left brachial-cephalic fistula required surgery for closing the collaterals, repositioning and superficialisation. The third case is an adolescent boy with one surgical stage brachial-basilic left AVF and difficulties in venous puncturing.ConclusionVascular access in paediatric haemodialysis remains a demanding field. There is a need for a multidisciplinary team, consisting of a vascular surgeon and an interventional radiologist specialising in children.
Enhanced Tracking in Legged Robots through Model Reduction and Hybrid Control Techniques: Addressing Disturbances, Delays, and Saturation
Authors: Zhao Yongyong , Wang Jinghua , Cao Guohua , Yao Xu 
Published: March 2024

This study introduces a reduced-order leg dynamic model to simplify the controller design and enhance robustness. The proposed multi-loop control scheme tackles tracking control issues in legged robots, including joint angle and contact-force regulation, disturbance suppression, measurement delay, and motor saturation avoidance. Firstly, model predictive control (MPC) and sliding mode control (SMC) schemes are developed using a simplified model, and their stability is analyzed using the Lyapunov method. Numerical simulations under two disturbances validate the superior tracking performance of the SMC scheme. Secondly, an Nth-order linear active disturbance rejection control (LADRC) is designed based on a simplified model and optimization problems. The second-order LADRC-SMC scheme reduces the contact-force control error in the SMC scheme by ten times. Finally, a fourth-order LADRC-SMC with a Smith Predictor (LADRC-SMC-SP) scheme is formulated, employing each loop controller independently. This scheme simplifies the design and enhances performance. Compared to numerical simulations of the above and existing schemes, the LADRC-SMC-SP scheme eliminates delay oscillations, shortens convergence time, and demonstrates fast force-position tracking responses, minimal overshoot, and strong disturbance rejection. The peak contact-force error in the LADRC-SMC-SP scheme was ten times smaller than that in the LADRC-SMC scheme. The integral square error (ISE) values for the tracking errors of joint angles θ1 and θ2, and contact force f, are 1.6636×10−28 rad2⋅s, 1.7983×10−28 rad2⋅s, and 1.8062×10−30 N2⋅s, respectively. These significant improvements in control performance address the challenges in single-leg dynamic systems, effectively handling disturbances, delays, and motor saturation.