bluuebunny/crossref_metadata_2025_split huggingface dataset:
Investigating the application of “Guttmann Cognitest”® in older adults and people with acquired brain injury
Authors: Cattaneo Gabriele , Roca-Ventura Alba , Heras Eva , Anglada Maria , Missé Jan , Ulloa Encarnació , Fankhauser Simon , Opisso Eloy , García-Molina Alberto , Solana-Sánchez Javier 
Published: January 2024

IntroductionDigital solutions for cognitive assessment are currently not only widely used in experimental contexts but can also be useful in clinical practice for efficient screening and longitudinal follow-up. The “Guttmann Cognitest”®, which includes seven computerized tasks designed to assess main cognitive functions, revealed in a previous validation study to be a potential useful tool to assess cognitive functioning in healthy middle-aged adults.MethodHere, we present results from a validation in two different populations: one consisting of older adults, and the other comprising young and middle-aged individuals, some of them affected by acquired brain injury. To perform a convergent validity test, older adults were also administered with the MOCA, while young and middle-aged individuals were administered with a short neuropsychological assessment including gold-standard neuropsychological tests. We also conducted sensitivity and specificity analysis to establish the utility of this instrument in identifying potential cognitive dysfunctions in the two groups.ResultsResults demonstrated strong convergent validity as well as good specificity and sensitivity characteristics.DiscussionThis tool is a valid and useful instrument to assess cognitive functioning and detecting potential cases of cognitive dysfunctions in older adults and clinical populations.
Effects of a virtual reality-based mirror therapy system on upper extremity rehabilitation after stroke: a systematic review and meta-analysis of randomized controlled trials
Authors: Okamura Ryohei , Nakashima Akira , Moriuchi Takefumi , Fujiwara Kengo , Ohno Kanta , Higashi Toshio , Tomori Kounosuke 
Published: January 2024

IntroductionVirtual reality-based mirror therapy (VRMT) has recently attracted attention as a novel and promising approach for treating upper extremity dysfunction in patients with stroke. However, the clinical efficacy of VRMT has not been investigated.MethodsThis study aimed to conduct a meta-analysis to evaluate the effects of VRMT on upper extremity dysfunction in patients with stroke. We screened articles published between January 2010 and July 2022 in PubMed, Scopus, MEDLINE, and Cochrane Central Register of Controlled Trials. Our inclusion criteria focused on randomized controlled trials (RCTs) comparing VRMT groups with control groups (e.g., conventional mirror therapy, occupational therapy, physical therapy, or sham therapy). The outcome measures included the Fugl–Meyer assessment upper extremity test (FMA-UE), the box and block test (BBT), and the manual function test (MFT). Risk of bias was assessed using the Cochrane Collaboration risk-of-bias tool 2.0. We calculated the standardized mean differences (SMD) and 95% confidence intervals (95% CI). The experimental protocol was registered in the PROSPERO database (CRD42022345756).ResultsThis study included five RCTs with 148 stroke patients. The meta-analysis showed statistical differences in the results of FMA-UE [SMD = 0.81, 95% CI (0.52, 1.10), p &lt; 0.001], BBT [SMD = 0.48, 95% CI (0.16, 0.80), p = 0.003], and MFT [SMD = 0.72, 95% CI (0.05, 1.40), p = 0.04] between the VRMT and the control groups.DiscussionVRMT may play a beneficial role in improving upper extremity dysfunction after stroke, especially when combined with conventional rehabilitation. However, there were differences in the type of VRMT, stage of disease, and severity of upper extremity dysfunction. Multiple reports of high-quality RCTs are needed to clarify the effects of VRMT.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42022345756.
What neuro-otology specialists need for better care of dizzy patients: a national survey
Authors: Mantokoudis Georgios , Zwergal Andreas , Heg Dik , Kerkeni Hassen , Diener Suzie , Kalla Roger , Korda Athanasia , Candreia Claudia , Welge-Lüssen Antje , Tarnutzer Alexander Andrea 
Published: January 2024

BackgroundA substantial fraction of dizzy patients are assessed by neurologists and ear–nose–throat (ENT) physicians. With the differential diagnosis being broad and often different specialties involved, we aimed to assess the interaction with generalists from the specialists’ perspective to identify limitations and needs and to define strategies for improvement in patient care and education by the specialist.MethodsOne hundred eleven board-certified neurologists (n = 62) and ENT physicians (n = 49) working in Switzerland participated in an online survey. Here, we focused on limitations faced in the diagnostic workup and treatment of the dizzy patient and potential strategies to improve the standard of care and the interaction between generalists and specialists. Descriptive statistical analyses were performed. We hypothesized that those specialists applying modern concepts in history-taking and bedside examination techniques reach a specific diagnosis more often and request fewer referrals.ResultsSpecialists indicated higher confidence in reaching a specific diagnosis for patients presenting with acute dizziness than episodic/chronic dizziness (80% vs. 60%) at the first consultation. Knowledge of the timing-and-trigger concept [odds ratio (OR) = 0.81 (0.67–0.98), p = 0.034], as well as of subtle oculomotor/vestibular signs [OR = 0.80 (0.68–0.94), p = 0.007] was predictive of the self-reported probability of reaching a specific diagnosis in patients with episodic/chronic dizziness, while no such differences were observed in the care of acutely dizzy patients. Further referrals of acutely dizzy patients were significantly higher in neurologists than in ENT physicians (17% vs. 10%, p &lt; 0.001) and in specialists located in the Latin part of Switzerland [OR = 2.84 (1.63–4.93), p &lt; 0.001], while this was not the case for patients with episodic/chronic dizziness. Identified unmet needs included regular communication between physicians (27%/53%; always/often true) and sufficiently detailed information on the previous workup from the referrals (27%/53%). Specialists expressed most interest in hands-on courses/workshops, webinars, and practical guidelines for education.ConclusionIn our survey, bedside state-of-the-art assessments were key in reducing the fraction of unclear dizzy cases. Several gaps were identified that should be addressed. Specifically, referring physicians should provide more comprehensive details regarding urgency, prior diagnostics, and treatment. Specifically, when promoting the knowledge of neurologists and ENT physicians, this should be preferentially done by offering a combination of hands-on courses and webinars.
Association between ambient temperature and stroke risk in high-risk populations: a systematic review
Authors: Danh Nathan , Ho Chau , Ford Emily , Zhang Jian , Hong Hua , Reid Christopher , Xu Dan 
Published: January 2024

BackgroundSignificant associations exist between ambient temperature and stroke risk, but results in high cardiovascular risk populations are lacking. This systemic review summarised current evidence on ambient temperature and overall stroke risk in a high cardiovascular risk population.MethodsWe performed a systematic literature search across MEDLINE, Embase, PsycINFO, CINAHL, Web of Science, and GEOBASE, from inception to 3 July 2023, to identify all population-based studies. Eligible studies screened by independent reviewers recruited individuals aged 18 years and over, where minimum 80% of participants had a high cerebral vascular disease (CVD) risk profile. The primary outcomes are stroke morbidity and mortality, while the secondary outcomes are morbidity and mortality of ischaemic stroke (IS), intracranial cerebral haemorrhage (ICH), and subarachnoid haemorrhage (SH).ResultsThe database searches identified 9,025 articles. After removing duplicates, 7,647 articles were screened in title and abstract to identify 380 articles for full-text screening. After the full-text screening of 380 articles by two independent reviewers, 23 articles were included in the review.ConclusionThe evidence for an association between ambient temperature and stroke incidence is that lower temperatures were more likely to increase morbidity and mortality risk of both haemorrhagic and ischaemic stroke in older people. Conversely, higher ambient temperature is significantly associated with intracranial haemorrhage risk, but decreased risk with IS. Higher and lower ambient temperatures consistently increase stroke risks in patients with comorbidities of congestive heart failure and dyslipidaemia. This evidence implies the need to establish clinical guidelines for preventive intervention in patients with high stroke risks during extreme ambient temperatures.
Development and validation of a nomogram predictive model for cerebral small vessel disease: a comprehensive retrospective analysis
Authors: Li Ning , Li Ying-lei , Li Li-tao 
Published: January 2024

BackgroundCerebral small vessel disease (CSVD) is a significant contributor to stroke, intracerebral hemorrhages, and vascular dementia, particularly in the elderly. Early diagnosis remains challenging. This study aimed to develop and validate a novel nomogram for the early diagnosis of cerebral small vessel disease (CSVD). We focused on integrating cerebrovascular risk factors and blood biochemical markers to identify individuals at high risk of CSVD, thus enabling early intervention.MethodsIn a retrospective study conducted at the neurology department of the Affiliated Hospital of Hebei University from January 2020 to June 2022, 587 patients were enrolled. The patients were randomly divided into a training set (70%, n = 412) and a validation set (30%, n = 175). The nomogram was developed using multivariable logistic regression analysis, with variables selected through the Least Absolute Shrinkage and Selection Operator (LASSO) technique. The performance of the nomogram was evaluated based on the area under the receiver operating characteristic curve (AUC-ROC), calibration plots, and decision curve analysis (DCA).ResultsOut of 88 analyzed biomarkers, 32 showed significant differences between the CSVD and non-CSVD groups. The LASSO regression identified 12 significant indicators, with nine being independent clinical predictors of CSVD. The AUC-ROC values of the nomogram were 0.849 (95% CI: 0.821–0.894) in the training set and 0.863 (95% CI: 0.810–0.917) in the validation set, indicating excellent discriminative ability. Calibration plots demonstrated good agreement between predicted and observed probabilities in both sets. DCA showed that the nomogram had significant clinical utility.ConclusionsThe study successfully developed a nomogram predictive model for CSVD, incorporating nine clinical predictive factors. This model offers a valuable tool for early identification and risk assessment of CSVD, potentially enhancing clinical decision-making and patient outcomes.
Enhancing spatial navigation skills in mild cognitive impairment patients: a usability study of a new version of ANTaging software
Authors: Stramba-Badiale Chiara , Tuena Cosimo , Goulene Karine Marie , Cipresso Pietro , Morelli Sandra , Rossi Mirko , D’Avenio Giuseppe , Stramba-Badiale Marco , Riva Giuseppe 
Published: January 2024

IntroductionMild Cognitive Impairment (MCI) often presents challenges related to spatial navigation and retention of spatial information. Navigating space involves intricate integration of bodily and environmental cues. Spatial memory is dependent on two distinct frame of reference systems for organizing this information: egocentric and allocentric frames of reference. Virtual Reality (VR) has emerged as a promising technology for enhancing spatial navigation skills and spatial memory by facilitating the manipulation of bodily, environmental, and cognitive cues.MethodsThis usability study was based on a fully within-subjects design in which seven MCI patients underwent two kinds of VR conditions: participants were required to complete the ANTaging demo both in Oculus Rift S (immersive condition) and in Samsung UHD 4K monitor (semi-immersive condition). Participants were seated and they had to use a foot-motion pad to navigate and explore the environment to collect and relocate some objects in the virtual environment. Post-interaction, users provided feedback on their experiences. Additionally, usability, potential side effects, data analysis feasibility, and user preferences with immersive and semi-immersive technologies were assessed through questionnaires.ResultsResults indicated higher usability ratings for the semi-immersive setup, with fewer negative effects reported compared to the immersive counterpart. According to qualitative analyses of the interviews, patients do seem to like both VR apparatuses even though the semi-immersive condition was perceived as the most suitable choice because of the size of the screen. Patients generally found it difficult to remember object locations. Participants expressed the need for more practice with the foot-motion pad, despite an overall positive experience. They generally would like to use this system to improve their memory.DiscussionIdentifying these key aspects was crucial for refining the system before the upcoming clinical trial. This study sheds light on the potential of semi-immersive VR in aiding individuals with MCI, paving the way for enhanced spatial navigation interventions.
Multi-label classification of retinal disease via a novel vision transformer model
Authors: Wang Dong , Lian Jian , Jiao Wanzhen 
Published: January 2024

IntroductionThe precise identification of retinal disorders is of utmost importance in the prevention of both temporary and permanent visual impairment. Prior research has yielded encouraging results in the classification of retinal images pertaining to a specific retinal condition. In clinical practice, it is not uncommon for a single patient to present with multiple retinal disorders concurrently. Hence, the task of classifying retinal images into multiple labels remains a significant obstacle for existing methodologies, but its successful accomplishment would yield valuable insights into a diverse array of situations simultaneously.MethodsThis study presents a novel vision transformer architecture called retinal ViT, which incorporates the self-attention mechanism into the field of medical image analysis. To note that this study supposed to prove that the transformer-based models can achieve competitive performance comparing with the CNN-based models, hence the convolutional modules have been eliminated from the proposed model. The suggested model concludes with a multi-label classifier that utilizes a feed-forward network architecture. This classifier consists of two layers and employs a sigmoid activation function.Results and discussionThe experimental findings provide evidence of the improved performance exhibited by the suggested model when compared to state-of-the-art approaches such as ResNet, VGG, DenseNet, and MobileNet, on the publicly available dataset ODIR-2019, and the proposed approach has outperformed the state-of-the-art algorithms in terms of Kappa, F1 score, AUC, and AVG.
Shedding light on the next pandemic path, from outpatient to ICU, the effect of vitamin D deficiency in the SARS-CoV-2 pandemic
Authors: Celikmen F. , Tunaligil V. , Keles E. C. , Celikmen D. S. M. , Sarikaya S. 
Published: January 2024

BackgroundVitamin D insufficiency is named “the pandemic of our era” by some experts. World Health Organization warns against a “deadlier outbreak” than the COVID-19 pandemic. Critical evidence is hereby for future pandemic prevention, with special emphasis on Vitamin D.MethodsA cross-sectional study was conducted with 172 unvaccinated adult participants, who presented to the emergency department. Blood measurements, radiological findings, and demographic features were evaluated in the four categories of “healthy adults, COVID-19 outpatients, hospitalized inpatients on the wards, and in the ICU.”ResultsResults were statistically significant in association with age, gender, weight, Vitamin D, glucose, urea, creatinine, leucocyte, aspartate transaminase, hemoglobin, C-reactive protein, troponin, platelet/thrombocyte, ferritin, D-dimer, triglycerate, glycated haemoglobin, lactate dehydrogenase measurements, and chest computed tomography features (each p &lt; 0.050).ConclusionThis article presents evidence to support the importance of Vitamin D for global public health. Patients with adequate levels of Vitamin D, glucose, urea, creatinine, leucocyte, aspartate transaminase, hemoglobin, C-reactive protein, troponin, platelet/thrombocyte, ferritin, D-dimer, triglycerate, glycated haemoglobin, lactate dehydrogenase are less likely to be admitted to ICU versus being outpatients. Factors include gender, age, weight, comorbidities, and computed tomography findings. The ultimate goal is to globally minimize preventable burdens of disease and death.
Ready-to-eat cereal consumption is associated with improved nutrient intakes and diet quality in Canadian adults and children across income levels
Authors: Sanders Lisa M. , Zhu Yong , Jain Neha , Normington James , Holschuh Norton , Nechanicky Megan , Tucker Michelle , Garcia-Bailo Bibiana 
Published: January 2024

BackgroundResults from observational studies suggest ready-to-eat cereal (RTEC) consumption is associated with higher diet quality. In the United States, studies have shown that RTEC is an important contributor to nutrient intakes across income levels. However, it is unknown if this association varies by income level in the Canadian population. Given its affordability, RTEC may represent an important source of nutrients for lower-income individuals.ObjectiveThis study evaluated the association of RTEC consumption with nutrient intakes and diet quality across household income levels in Canadian adults and children.MethodsIncome and dietary data from 24 h dietary recalls were obtained from the 2015 Canadian Community Health Survey (CCHS)—Nutrition in 6,181 children (2–18 years) and 13,908 adults (19+ years). Diet quality was assessed with a modified Nutrient Rich Food Index (NRF) 9.3. Income levels were stratified into low, middle, and high based on family size, and data were analyzed by RTEC consumption and income level using multivariate linear regression adjusted for energy, age, and sex.ResultsDiet quality was greater in adult and child RTEC consumers across all household income levels. Children and adults consuming RTEC also had higher nutrient intakes, including shortfall nutrients such as calcium, dietary fiber, iron, magnesium, and vitamin D. RTEC provided &lt;10% of energy intake, &lt;4% of saturated fat intake, and &lt;9% of total sugar intake across all ages and income levels, while also providing one-third of daily iron intake and at least 10% of daily intake of dietary fiber, thiamin, folate, and vitamin B6.ConclusionRTEC consumption was associated with improved nutrient intakes and diet quality in adults and children across household income levels. Nutrient dense and affordable food choices, such as RTEC, may be a helpful strategy to improve the diet quality of Canadians, particularly those with a lower household income.
Isolated but not combined ergogenic effects of caffeine and L-arginine during an isokinetic knee extension
Authors: Zart Sebastian , Brachtendorf Maximilian , Becker Stephan , Fröhlich Michael 
Published: January 2024

IntroductionThe use of single supplements as ergogenic aids to enhance performance in strength-oriented sports is widespread among athletes (74%). The aim of this study was to increase knowledge about the combined effects of caffeine and L-arginine dietary supplements on performance.MethodsIn this double-blind, randomized and counterbalanced crossover study, 29 participants (age: 23.2 ± 3.6 yr.; height: 181.0 ± 7.6 cm; weight: 77.0 ± 8.8 kg) each underwent six trials. In each trial performance tests were conducted to examine the effects of the supplement combinations on maximum (NmMax) and averaged torque (NmM), maximum (JMax) and averaged work (JM), the blockwise mean values of torque and work, and rate of perceived exertion (RPE) during an isokinetic leg extension task (90°·s−1) with the right leg for two sets of 40 repetitions and a set rest of 3 min on a dynamometer. The first and second trials were used to familiarize the participants with the movements in the dynamometer and no supplements were taken. After this 2-week pre-test trial, the supplement combinations of placebo/placebo, caffeine/placebo (5 mg·kg−1), L-arginine/placebo (0.15 g·kg−1), and caffeine/L-arginine (5 mg·kg−1 + 0.15 g·kg−1) were ingested.ResultsThe main finding of this study is the absence of an ergogenic effect of the combined supplements caffeine and L-arginine during voluntary maximal isokinetic leg extensions, although an increase of 3.5% was noted for Nmmax compared to the placebo trial. However, the administration of caffeine was able to increase the NmMax of the quadriceps femoris muscle about 5.1% (p = 0.043). In addition, caffeine (4.2%, p = 0.026) and also L-arginine (4.2%, p = 0.040) significantly increased NmM over a complete set. No single or combined supplement had an effect on muscle fatigue looking at the blockwise mean values of torque and work or RPE (all p &gt; 0.05).ConclusionThe combination of caffeine and L-arginine was not superior to the isolated intake of both supplements in a strength-based exercise and a synergistic effect was absent.
Integrated 16s RNA sequencing and network pharmacology to explore the effects of polyphenol-rich raspberry leaf extract on weight control
Authors: Wang Tao , Yang Jing , Huang Ziang , Wang Fei , Liu Ruzi , Liu Yongping , Li Xiaojun 
Published: January 2024

IntroductionObesity is recognized as a chronic low-grade inflammation associated with intestinal flora imbalance, leading to dyslipidemia and inflammation. Modern research has found that polyphenols have anti-obesity effects. However, the mechanism of action of raspberry leaf extract (RLE) with high polyphenols in regulating obesity is still unknown. This study investigated the improvement effect of supplementing RLE on high-fat diet (HFD) induced obesity in mice.MethodsRLE was used to intervene in HFD induced C57BL/6J male mice during prevention stage (1-16 weeks) and treatment stage (17-20 weeks). Their weight changes and obesity-related biochemical indicators were measured. The changes in intestinal flora were analyzed using 16S rRNA sequencing, and finally the targets and pathways of the 7 typical polyphenols (quercetin-3-O-glucuronide, ellagic acid, kaempferol-3-O-rutinoside, chlorogenic acid, brevifolin carboxylic acid, quercetin-3-O-rutinoside, and quercetin) of RLE in the regulation of obesity were predicted by network pharmacology approach.Results and discussionThe results showed that RLE effectively prevented and treated weight gain in obese mice induced by HFD, alleviated adipocyte hypertrophy, reduced Interleukin-6 and Tumor Necrosis Factor Alpha levels, and improved intestinal flora, especially Muriaculaceae, Alistipes and Alloprevotella, and decreased the Firmicutes/Bacteroidota ratio. Network pharmacology analysis selected 60 common targets for 7 RLE polyphenols and obesity. Combined with protein-protein interaction network, enrichment analysis and experimental results, TNF, IL-6, AKT1, and PPAR were predicted as potential key targets for RLE polyphenols.ConclusionThe potential mechanism by which polyphenol-rich RLE regulates obesity may be attributed to the specific polyphenols of RLE and their synergistic effects, therefore RLE has a great anti-obesity potential and may be used as a means to alleviate obesity and related diseases.