bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cartilage graft and temporal muscle fascia graft in revision myringoplasty: a comparison of anatomical and functional results with an innovative surgical technique
Authors: Canale Andrea , Boldreghini Marco , Abboud Ili , Peluso Patrizia , Vestrini Elisa , Riva Gluseppe , Albera Andrea 
Published: January 2025

BackgroundThe temporal muscle fascia is the most widely used type of tissue graft in revision myringoplasty procedures. The aim of this study was to verify if the use of a cartilage graft may be a valid alternative to temporalis fascia. Tympanic reperforations are frequent after myringoplasty, especially in complicated, large, or anterior perforations, so we decided to compare the neodrum stability of two different surgical techniques.Materials and methodsThe study was conducted on 42 patients who underwent revision myringoplasty, carried out with the overlay technique, between 2004 and 2020. In all patients, the retroauricular approach was used. The subjects included in the study were divided into 2 groups: the former was treated with a cartilage graft, while in the latter a temporalis fascia graft was used. In the comparison of the two groups, the following outcomes were taken into consideration: engraftment rate, incidence of complications, pre- and postoperative air conduction pure tone average and air-bone gap.ResultsThe success rate was 100% for the first group and 83.3% for the second, with a statistically not significant difference. Among the subjects treated with cartilage graft, complications were observed in 8.3% of the cases, while in patients treated with fascia graft the observed complication rate was 43.3% (p = 0.03), maybe due to the shorter follow-up period of the first group. The improvement of the air conduction pure tone average was greater with cartilage graft (p = 0.02), whereas the difference between air-bone gap closures in the two groups was not statistically significant.ConclusionThe cartilage graft can represent a valid alternative to temporal muscle fascia, guaranteeing excellent engraftment, fewer complication rate and satisfactory hearing outcomes.
Selective correlation of hippocampal volumes with WADA memory scores in mesial temporal sclerosis patients
Authors: Khalife Lourdes , Nasreddine Wassim , Jaafar Fatima , Abboodi Huda , Nasreddine Karim , Beydoun Ahmad 
Published: January 2025

ObjectiveThe WADA test is used to determine cerebral language dominance and assess the risk of postoperative amnesia following mesial temporal lobe resection. This study aims to explore the correlation between automated measures of hippocampal volume and WADA memory scores and to evaluate whether these volumetric measurements can reliably predict WADA memory scores.MethodsThis study included patients who underwent a comprehensive presurgical assessment along with bilateral WADA testing. Hippocampal volumes were measured from high-resolution brain MRIs using automated software (volBrain), which were harmonized and normalized to whole brain volume. These harmonized and normalized volumes were then correlated with ipsilateral WADA memory scores and stratified according to brain MRI findings. A similar analysis was conducted between hippocampal volume asymmetry and WADA memory score asymmetry (WMA). A Receiver Operating Characteristic (ROC) curve was generated to compare the sensitivity and specificity in predicting successful WADA outcomes based on ipsilateral harmonized normalized hippocampal volumes.ResultsIn patients with mesial temporal sclerosis (MTS), significant positive correlations were found between harmonized normalized hippocampal volumes and ipsilateral WADA memory scores, as well as between harmonized hippocampal volume asymmetries and WMA. However, no significant correlations were found in patients with epileptogenic lesions other than MTS or those with normal brain MRIs. A harmonized normalized hippocampal volume threshold of ≥ 28.94 units was identified as a predictor of a WADA memory score exceeding 50% following contralateral carotid artery injection, with a sensitivity of 62.1% and a specificity of 100%.SignificanceThis study indicates that hippocampal volumetry could potentially serve as an alternative to the WADA test in patients with MTS. Conversely, in individuals with normal MRI results or other types of epileptogenic lesions, hippocampal volumetry does not reliably predict memory deficits, necessitating the use of the WADA test or functional MRI for planning resections of mesial temporal structures in the dominant hemisphere.
Application of deconvolutional networks for feature interpretability in epilepsy detection
Authors: Shao Sihao , Zhou Yu , Wu Ruiheng , Yang Aiping , Li Qiang 
Published: January 2025

IntroductionScalp electroencephalography (EEG) is commonly used to assist in epilepsy detection. Even automated detection algorithms are already available to assist clinicians in reviewing EEG data, many algorithms used for seizure detection in epilepsy fail to account for the contributions of different channels. The Fully Convolutional Network (FCN) can provide the model’s interpretability but has not been applied in seizure detection.MethodsTo address these challenges, a novel convolutional neural network (CNN) model, combining SE (Squeeze-and-Excitation) modules, was proposed on top of the FCN. The epilepsy detection performance for patient-independent was evaluated on the CHB-MIT dataset. Then, the SE module was removed from the model and integrated the model with Inception, ResNet, and CBAM modules separately.ResultsThe method showed superior advancement, stability, and reliability compared to the other three methods. The method demonstrated a G-Mean of 82.7% for sensitivity (SEN) and specificity (SPE) on the CHB-MIT dataset. In addition, The contributions of each channel to the seizure detection task have also been quantified, which led us to find that the FZ, CZ, PZ, FT9, FT10, and T8 brain regions have a more pronounced impact on epileptic seizures.DiscussionThis article presents a novel algorithm for epilepsy detection that accurately identifies seizures in different patients and enhances the model’s interpretability.
Fusion of EEG and EMG signals for detecting pre-movement intention of sitting and standing in healthy individuals and patients with spinal cord injury
Authors: Li Chenyang , Xu Yuchen , Feng Tao , Wang Minmin , Zhang Xiaomei , Zhang Li , Cheng Ruidong , Chen Weihai , Chen Weidong , Zhang Shaomin 
Published: January 2025

IntroductionRehabilitation devices assist individuals with movement disorders by supporting daily activities and facilitating effective rehabilitation training. Accurate and early motor intention detection is vital for real-time device applications. However, traditional methods of motor intention detection often rely on single-mode signals, such as EEG or EMG alone, which can be limited by low signal quality and reduced stability. This study proposes a multimodal fusion method based on EEG–EMG functional connectivity to detect sitting and standing intentions before movement execution, enabling timely intervention and reducing latency in rehabilitation devices.MethodsEight healthy subjects and five spinal cord injury (SCI) patients performed cue-based sit-to-stand and stand-to-sit transition tasks while EEG and EMG data were recorded simultaneously. We constructed EEG–EMG functional connectivity networks using data epochs from the 1.5-s period prior to movement onset. Pairwise spatial filters were then designed to extract discriminative spatial network topologies. Each filter paired with a support vector machine classifier to classify future movements into one of three classes: sit-to-stand, stand-to-sit, or rest. The final prediction was determined using a majority voting scheme.ResultsAmong the three functional connectivity methods investigated—coherence, Pearson correlation coefficient and mutual information (MI)—the MI-based EEG–EMG network showed the highest decoding performance (94.33%), outperforming both EEG (73.89%) and EMG (89.16%). The robustness of the fusion method was further validated through a fatigue training experiment with healthy subjects. The fusion method achieved 92.87% accuracy during the post-fatigue stage, with no significant difference compared to the pre-fatigue stage (p &gt; 0.05). Additionally, the proposed method using pre-movement windows achieved accuracy comparable to trans-movement windows (p &gt; 0.05 for both pre- and post-fatigue stages). For the SCI patients, the fusion method showed improved accuracy, achieving 87.54% compared to single- modality methods (EEG: 83.03%, EMG: 84.13%), suggesting that the fusion method could be promising for practical rehabilitation applications.ConclusionOur results demonstrated that the proposed multimodal fusion method significantly enhances the performance of detecting human motor intentions. By enabling early detection of sitting and standing intentions, this method holds the potential to offer more accurate and timely interventions within rehabilitation systems.
The influence of different forms of apple products on all-cause mortality in patients with hypertension
Authors: Sun Chuang , Chen Yingying , Guan Yue , Zeng Yiming , Li Jie , Chen Liang 
Published: January 2025

ObjectiveApple consumption has a positive effect on human health. Some studies have shown that an appropriate amount of apple intake can reduce the incidence of hypertension. However, few studies have investigated whether eating different forms of apples has the same benefits as eating whole apples. This study is aimed to evaluate the effect of different forms of apple on all-cause mortality in patients with hypertension.MethodsThe study included 2,368 patients with hypertension. All participants were followed up for at least 10 years. Cox regression model was constructed to analyze the correlation between apple, apple juice, and apple sauce consumption and all-cause mortality in patients with hypertension.ResultsThe consumption of apples 3–6 times/week was associated with a 48% reduction in the risk of all-cause mortality in patients with hypertension (HR = 0.52, 95% CI: 0.37–0.72, p &lt; 0.001). However, the consumption of apple juice (HR = 1.02, 95% CI: 0.67–1.56, p = 0.930) and sauce (HR = 1.28, 95% CI: 0.59–2.74, p = 0.531) tended to increase the risk of death in patients with hypertension, although this study did not obtain a statistically result.ConclusionModerate consumption of whole apples is associated with a reduced risk of all-cause death in patients with hypertension, whereas apple juice and sauce may increase the risk of death.
Time to dietary diversity of complementary feeding improvements and its associated factors among infants aged 6–12 months in Ethiopia: evidence from performance monitoring for action
Authors: Bayisa Feyisa Shasho , Nimani Teshome Demis , Darcho Samuel Demissie , Tekola Abainash 
Published: January 2025

BackgroundInfant and Young Child Feeding significantly affect the health, development, and nutritional status of children under 2 years old, ultimately affecting their survival. The aim of this study is to determine the time to improvement in dietary diversity and associated factors in infants aged 6 to 12 months.MethodsThe study used secondary data from the PMA Ethiopia longitudinal panel survey, involving pregnant women from January to March 2024. The data management and analysis were performed using Stata version 17. The Kaplan–Meier survival curve (KM) and the log-rank test method were implemented. A Cox proportional-hazard regression model was used to explore the association between independent variables and the outcome variable. The strength of the association was indicated by the adjusted hazard ratio (AHR) with a 95% confidence interval. The threshold of p &lt; 0.05 was applied to determine the significance of an association.ResultsThe study found that the proportion of infants with improved dietary diversity aged 6–12 months was 22% (95% CI: 19.5, 25%). Factors associated with improved dietary diversity in infants aged 6 to 12 months were married women (AHR = 9.3, 95% CI = 1.19, 8.30), women with a secondary school (AHR = 1.9, 95% CI = 1.05, 3.51), women with technical and vocational (AHR = 2.0, 95% CI = 1.01, 4.05) and women with a university degree (AHR = 2.9, 95% CI = 1.51, 5.38). Moreover, women in the highest wealth quintile (AHR = 3.5, 95% CI = 1.31, 9.41), women visiting PNC (AHR = 1.7, 95% CI = 1.13, 2.62), women visiting ANC 1–3, and more than four times were (AHR = 2.4, 95% CI = 1.51, 3.74) and (AHR = 3.6, 95% CI = 2.28, 5.67) times higher for improving dietary diversity.ConclusionThe findings of this study showed that the proportion of dietary diversity improvement was 22%. Which is relatively low. Marital status, educational status, wealth index, PNC, and ANC visits were identified as statistically significant factors associated with dietary diversity improvements. It suggests that public health interventions should focus on enhancing maternal knowledge and promoting regular healthcare visits to mitigate malnutrition and improve infant health outcomes in Ethiopia.
The impact of dietary fiber on colorectal cancer patients based on machine learning
Authors: Ji Xinwei , Wang Lixin , Luan Pengbo , Liang Jingru , Cheng Weicai 
Published: January 2025

ObjectiveThis study aimed to evaluate the impact of enteral nutrition with dietary fiber on patients undergoing laparoscopic colorectal cancer (CRC) surgery.MethodsBetween January 2023 and August 2024, 164 CRC patients were randomly assigned to two groups at our hospital. The control group received standard nutritional intervention, while the observation group received enteral nutritional support containing dietary fiber. Both groups were subjected to intervention and continuously observed until the 14th postoperative day. An observational analysis assessed the impact of dietary fiber intake on postoperative nutritional status in CRC patients. The study compared infection stress index, inflammatory factors, nutritional status, intestinal function recovery, and complication incidence between groups. Additionally, four machine learning models—Logistic Regression (LR), Random Forest (RF), Neural Network (NN), and Support Vector Machine (SVM)—were developed based on nutritional and clinical indicators.ResultsIn the observation group, levels of procalcitonin (PCT), beta-endorphin (β-EP), C-reactive protein (CRP), interleukin-1 (IL-1), interleukin-8 (IL-8), and tumor necrosis factor-alpha (TNF-α) were significantly lower compared to the control group (p &lt; 0.01). Conversely, levels of albumin (ALB), hemoglobin (HB), transferrin (TRF), and prealbumin (PAB) in the observation group were significantly higher than those in the control group (p &lt; 0.01). Furthermore, LR, RF, NN, and SVM models can effectively predict the effects of dietary fiber on the immune function and inflammatory response of postoperative CRC patients, with the NN model performing the best. Through the screening of machine learning models, four key predictors for CRC patients were identified: PCT, PAB, ALB, and IL-1.ConclusionPostoperative dietary fiber administration in colorectal cancer enhances immune function, reduces disease-related inflammation, and inhibits tumor proliferation. Machine learning-based CRC prediction models hold clinical value.
Association between nutritional inflammation index and diabetic foot ulcers: a population-based study
Authors: Lin Zhou , Zhuang Wanli , Wang Lei , Lan Weifeng 
Published: January 2025

BackgroundDiabetic foot ulcers (DFU), a frequent complication of the worldwide disease (diabetes), are the primary causes of amputations and early mortality. The development of DFU is inseparably linked with inflammation and nutrition, necessitating a comprehensive evaluation of their impact on DFU risk. This study aimed to establish a new predictive metric that integrated immune inflammation and nutritional markers to holistically assess the risk of DFU development.MethodsData were sourced from NHANES, extracting participant from 1999 to 2004. Analysis of multivariate logistic regression and restricted cubic spline were employed to elucidate the connection and non-linear relationship between albumin/neutrophil to lymphocyte ratio (ANLR) and DFU. Stratified subgroup analysis identified advantageous populations, while interaction analysis evaluated variable interactions with ANLR. These approaches collectively contributed to a sensitivity analysis, improving the reliability of the outcomes.ResultsOut of 29,608 participants extracted, 1,531 qualified based on the study criteria. Employing the ANLR low group as a reference, the high group demonstrated a 54% reduction in DFU risk. Every increase of 0.1 unit in ANLR correlated with a 5% decrease in DFU risk. Moreover, an L-shaped non-linear link was observed. The turning point was at 3.09. Left of the inflection point, the relationship was negatively correlated. Beyond this point, further increased in ANLR no longer decrease DFU risk.ConclusionThe study not only proposed a new comprehensive indicator for predicting DFU for the first time but also specified the impact of ANLR on DFU risk. Broadly, a negative correlation existed between the two. Yet, a detailed analysis revealed that this negative correlation involved an inflection point effect. Furthermore, the study investigated how dynamic changes in ANLR affect DFU risk, aiding clinicians in more accurately assessing individual DFU risk and facilitating earlier identification and intervention of DFU. Therefore, for diabetic patients with low serum albumin, appropriate supplementation of albumin was crucial. Additionally, maintaining the NLR at an appropriate level should not be overlooked. Given the components of ANLR were widely used and readily available in clinical settings, their future clinical applications hold great potential.
Systemic antihyperalgesic effect of a novel conotoxin from Californiconus californicus in an inflammatory pain model
Authors: López-Carrillo Joaquín , Bernáldez-Sarabia Johanna , Pawar Tushar J. , Jiménez Samanta , Dueñas Salvador , Figueroa-Montiel Andrea , Olivares-Romero José L. , Granados-Soto Vinicio , Licea-Navarro Alexei F. , Caram-Salas Nadia L. 
Published: January 2025

IntroductionThis study explores the analgesic potential of the novel conotoxin O1_cal6.4b, derived from Californiconus californicus, as a candidate for pain management in a model of inflammatory pain.MethodsO1_cal6.4b was systemically administered to Wistar rats, and its effects on thermal hyperalgesia and motor coordination were evaluated. Comparative analyses were conducted against O1_cal6.4d, ω-MVIIA, and standard analgesics (morphine, dexamethasone, and diclofenac). Structural differences between O1_cal6.4b and O1_cal6.4d were examined using in silico modeling and molecular dynamics simulations.ResultsSystemic administration of O1_cal6.4b significantly reduced thermal hyperalgesia in a dose-dependent manner without impairing motor coordination. The analgesic effect of O1_cal6.4b was superior to that of O1_cal6.4d, ω-MVIIA, and standard analgesics. Structural analyses revealed notable differences between O1_cal6.4b and O1_cal6.4d, suggesting unique functional properties.DiscussionThe findings indicate that O1_cal6.4b exhibits a promising analgesic profile with advantages over traditional opioid-based therapies. These results underscore the molecular diversity of conotoxins and highlight their potential as innovative analgesic treatments. Further research is needed to elucidate the mechanism of action of this novel conotoxin.
Down syndrome and outcomes in critically ill pediatric patients
Authors: Tantaleán Da Fieno José , León Paredes Rosa , Palomo Luck Patricia , Del Águila Villar Carlos , Rizo Patrón Emiliana 
Published: January 2025

IntroductionInformation regarding children with Down syndrome (DS) in the Pediatric Intensive Care Unit (PICU) is limited and conflicting. We aimed to investigate the association between DS and clinical outcomes in pediatric patients admitted to the PICU at the Instituto Nacional de Salud del Niño (National Institute for Child Health, INSN for the acronym in Spanish) and to assess nutritional status within the study cohort.MethodsThis study involved the secondary analysis of a database. We included patients consecutively admitted to INSN, a tertiary care children's hospital in Lima, Peru. We collected demographic data, clinical characteristics, and nutritional status using standardized tables. The outcomes assessed included mortality, length of stay, duration of mechanical ventilation (DMV), ventilator-free days (VFD), and healthcare-associated infections (HAI). We applied Cox regression and Poisson regression analyses to explore the relationship between Down syndrome and clinical outcomes, providing both crude and adjusted results.ResultsA total of 525 children (average age 71.3 months, range 1–218 months) were analyzed. Children with DS were younger and had a higher prevalence of comorbidities, congenital heart disease, and underweight. Both crude bivariate and multivariate analyses demonstrated that children with DS had higher mortality rates, increased frequency of HAIs, longer DMV, longer PICU stay, and fewer VFD. Adjusted multivariate analysis revealed that children with DS had a significantly higher risk of developing HAIs (RR 2.95; 95% CI 1.10, 7.87) and longer DMV (RR 1.43; 95% CI 1.24, 1.65). Among the 525 children, underweight was associated with increased risk of mechanical ventilation (MV) use and longer DMV.DiscussionCritically ill children with DS are at increased risk of developing HAIs and longer DMV. In all 525 children, underweight is associated with higher risk of MV use and longer duration of MV.
The effectiveness of ERCP in managing preoperative complications of choledochal cysts in children and its role in facilitating early surgical intervention
Authors: Zhang Tian , Wu Wenjie , Shu Yijun , Weng Hao , Weng Mingzhe , Zhou Ying , Wang Xuefeng 
Published: January 2025

IntroductionCurrently, there is no established guideline for the application of ERCP in children with choledochal cyst. This study aimed to investigate the safety and effectiveness of ERCP in managing preoperative complications of choledochal cyst in children, as well as the timing for definitive surgery following ERCP.MethodsWe conducted a retrospective review of medical records for 68 pediatric patients who presented with complications of choledochal cyst, including pancreatitis and biliary obstruction combined with cholangitis. All patients underwent ERCP treatment followed by definitive surgery. The primary outcomes assessed included treatment efficacy, post-ERCP complication, and the impact of ERCP on definitive surgical procedures.ResultsAmong the 68 patients studied, 41 presented with pancreatitis, while the remaining patients had biliary obstruction and cholangitis. Sixty-five patients successfully completed their treatments, with 64 experiencing alleviation of symptoms. Significant improvements were observed in serum amylase levels and liver function tests following ERCP. Post-ERCP complications occurred in three cases, including one case of pancreatitis and two cases of infection. The median interval between ERCP and surgery was 11 days. There was no significant difference in primary outcomes, such as surgical duration, rate of minimally invasive surgery, conversion to open surgery, intraoperative bleeding volume, intraoperative blood transfusion, postoperative complications, or average length of hospital stay, between the early surgery group (≤2 weeks) and the late surgery group (&gt;2 weeks).ConclusionsERCP was proved to be a safe and effective intervention for alleviating preoperative complications in pediatric patients with choledochal cyst. Early definitive surgery following ERCP did not significantly impact the perioperative outcomes of pediatric patients.