bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evidence of physiological changes associated with single-session pre-frontal tDCS: a pilot study
Authors: Rembrandt Hannah N. , Riley Ellyn A. 
Published: February 2025

ObjectiveTranscranial direct current stimulation (tDCS), a non-invasive, painless method of applying direct current electrical stimulation to specific areas of the brain, is an effective method for enhancing attention and post-stroke fatigue, as shown by behavioral improvements in post-stroke populations. While behavioral evidence supports this method, there is a paucity of physiological data corroboration of this improvement. The current study is designed to investigate if a single session of tDCS will improve attention and fatigue as shown by relevant physiological methods in persons with post-stroke aphasia.MethodsTen participants (5 male; mean age: 62.8) engaged in two identically structured data collection sessions with at least a 3-day wash-out period between them. Sessions started with a sustained attention task with simultaneous electroencephalography (EEG) and pupillometry data collection, followed by an attention training program with simultaneous active or sham tDCS. Following tDCS, participants repeated the sustained attention task with simultaneous EEG and pupillometry data collection. Participants received active tDCS during one session, and sham tDCS during the other, with the order randomized.ResultsNo differences between conditions were found for either behavioral results from the sustained attention task (i.e., reaction time of correct responses; n = 9 p = 0.39) or EEG measured attention state data for any of the four attention states: no attention (n = 10, p = 0.83), distracted attention (n = 10, p = 0.20), moderate attention (n = 10, p = 0.95), or high attention (n = 10, p = 0.62). Pupil dilation was significantly greater in the post-active tDCS stimulation condition than in either pre-training condition (n = 10, p &lt; 0.01). tDCS stimulation lessened the increase in task-based fatigue from the beginning to the end of the session such that there was a significant increase in task-based fatigue when participants received sham tDCS (n = 10, p = 0.01) but no significant change in task-based fatigue during the active condition session (n = 10, p = 0.12).ConclusionChanges in pupil diameter observed in the active stimulation condition suggest activation of the locus coeruleus-norepinephrine (LC-NE) pathway within a single session of tDCS administration, but the lack of significant changes for either response time or attention states indicate no direct effect on behaviorally measured or EEG measured attention within the same timeframe. Responses to active stimulation in terms of subjective fatigue rating varied between individual participants; overall, active tDCS mitigated task-based fatigue. More research is needed to investigate this relationship.
Association between serum A/G ratio and stroke: data from NHANES 2009–2020
Authors: Tan Xingle , Lv Cunming , Lu Chao , Luo Yanan , Mei Zhi-gang 
Published: February 2025

BackgroundThe serum albumin-to-globulin ratio (A/G) has been widely used as a biomarker to assess inflammation, immunity, and nutritional status. However, relatively few studies have been conducted on the predictive value of serum A/G in stroke. Therefore, this study aimed to evaluate the correlation between serum A/G levels and stroke prognosis, to provide a new reference for risk assessment and management of stroke patients.MethodsData were sourced from the National Health and Nutrition Examination Survey (NHANES) for 2009–2020. The study utilized questionnaire responses and 24-h dietary recall interviews. Participants were stratified by serum albumin/globulin (A/G) ratios into tertiles. Multivariable logistic regression, curve fitting, subgroup analyses, and interaction tests were conducted to assess the associations with serum A/G ratios.ResultsOf the 82,298 participants initially considered, 52,119 had complete data and no history of stroke, albumin, or globulin deficiency, which were included in the analysis. We observed a decrease in stroke incidence with increasing A/G ratios. Higher A/G ratios were also associated with lower incidences of moderate exercise, diabetes, and coronary heart disease. The relationship between A/G ratios and stroke was moderated by covariates such as gender, hypertension, diabetes, smoking, and body mass index.ConclusionIn the US population, serum A/G ratios positively correlate with stroke incidence. Serum A/G could be a simple and economical marker for identifying stroke risk in the population, though further prospective studies are required to validate these findings.
A patient with penile metastasis secondary to small cell lung cancer successfully treated with PD-1 inhibitors and chemotherapy: a case report and literature review
Authors: Zhang Kai-cong , Li Wei-jun , Xu Hui-xin , Liang Hui-min , Yang Qiong 
Published: February 2025

BackgroundPenile metastasis is an uncommon condition, with most primary malignancies originating in the abdominal cavity and pelvis. There have been very few reported cases originating from lung cancer, most of squamous cell carcinoma without small cell lung cancer.MethodsWe presented a case of penile metastasis secondary to small cell lung cancer, along with a review of relevant literature from the CNKI database.ResultsA 73-year-old male presented with a one-month history of palpable swelling in the penis without any chest symptoms. Beside penile lesion, PET/CT imaging also revealed a lesion in the left lobe of the lung, as well as multiple enlarged lymph nodes in the left hilum, mediastinum, and left supraclavicular fossa. Fiberoptic biopsy confirmed small cell lung cancer for the pulmonary mass, while biopsies of the penile mass confirmed metastatic small cell carcinoma. The patient received first-line treatment of 6 cycles of PD-1 inhibitor (Toripalimab) combined with etoposide and cisplatin, achieving a partial response (PR). Subsequently, second-line therapy of etoposide and cisplatin regimen and later-line therapies of Irinotecan followed by Anlotinib were administered. The overall survival was approximately 2 years.ConclusionPenile metastasis from small cell lung cancer is extremely rare. Treatment strategies based on guidelines for small cell lung cancer had been proven effective approaches.
Data augmented lung cancer prediction framework using the nested case control NLST cohort
Authors: Jiang Yifan , Manem Venkata S. K. 
Published: February 2025

PurposeIn the context of lung cancer screening, the scarcity of well-labeled medical images poses a significant challenge to implement supervised learning-based deep learning methods. While data augmentation is an effective technique for countering the difficulties caused by insufficient data, it has not been fully explored in the context of lung cancer screening. In this research study, we analyzed the state-of-the-art (SOTA) data augmentation techniques for lung cancer binary prediction.MethodsTo comprehensively evaluate the efficiency of data augmentation approaches, we considered the nested case control National Lung Screening Trial (NLST) cohort comprising of 253 individuals who had the commonly used CT scans without contrast. The CT scans were pre-processed into three-dimensional volumes based on the lung nodule annotations. Subsequently, we evaluated five basic (online) and two generative model-based offline data augmentation methods with ten state-of-the-art (SOTA) 3D deep learning-based lung cancer prediction models.ResultsOur results demonstrated that the performance improvement by data augmentation was highly dependent on approach used. The Cutmix method resulted in the highest average performance improvement across all three metrics: 1.07%, 3.29%, 1.19% for accuracy, F1 score and AUC, respectively. MobileNetV2 with a simple data augmentation approach achieved the best AUC of 0.8719 among all lung cancer predictors, demonstrating a 7.62% improvement compared to baseline. Furthermore, the MED-DDPM data augmentation approach was able to improve prediction performance by rebalancing the training set and adding moderately synthetic data.ConclusionsThe effectiveness of online and offline data augmentation methods were highly sensitive to the prediction model, highlighting the importance of carefully selecting the optimal data augmentation method. Our findings suggest that certain traditional methods can provide more stable and higher performance compared to SOTA online data augmentation approaches. Overall, these results offer meaningful insights for the development and clinical integration of data augmented deep learning tools for lung cancer screening.
Community pharmacy professionals’ knowledge, attitudes, and practices toward substandard and falsified medicines and associated factors in Bahir Dar City, Northwest Ethiopia
Authors: Mekonnen Biset Asrade , Berhanu Kidest , Solomon Nebiyu , Worku Minichil Chanie , Anagaw Yeniewa Kerie 
Published: February 2025

BackgroundThe availability of substandard and/or falsified medicines (SFMs) in the market poses a severe threat to health and the national economy. Therefore, pharmacy professionals are highly responsible for controlling SFMs distribution in the market to improve the health of the population.ObjectiveThe aim of this study was to assess community pharmacy professionals’ knowledge, attitudes, and practices (KAP) toward SFMs and to identify associated factors in Bahir Dar City, Northwest Ethiopia.MethodsA community-based descriptive cross-sectional study was conducted from 1 August 2024, to 30 September 2024. Participants were recruited using a simple random sampling method. A structured and self-administered questionnaire was used to collect data on sociodemographic characteristics and KAP toward SFMs. The collected data were entered and analysed using SPSS version 26. Multivariate logistic regression analysis was used to identify factors associated with participants’ KAP toward SFMs. Variables with a P value &lt; 0.05 were considered statistically significant.ResultsOf the 162 participants, 80.5% had a good knowledge and 54.9% had a positive attitude toward SFMs. However, 46.3% had a good level of practice toward SFMs. Educational levels with a master’s degree (AOR = 2.6, 95% CI: 1.06–4.35) and work experience of 21–25 years (AOR = 2.19, 95% CI: 1.79–2.80) were associated with participants’ knowledge. Educational levels with a master’s degree (AOR = 1.65, 95% CI: 0.85–2.95), work experience of 21–25 years (AOR = 1.3, 95% CI: 0.85–1.86), good knowledge (AOR: 1.21, 95% CI: 0.94–1.51), and good practice (AOR = 1.33, 95% CI: 0.85–2.01) were associated with the participants’ attitude. The practice of participants is affected by educational levels with a master’s degree (AOR = 1.2, 95% CI: 1.14–1.26), 21–25 years of work experience (AOR = 2.74, 95% CI: 1.33–5.63), good knowledge (AOR: 2.71, 95% CI: 1.50–4.92), and positive attitude (AOR = 1.06, 95% CI: 0.89–2.23).ConclusionThe study revealed that the majority of the participants had a good knowledge, and more than half had a positive attitude; however, less than half of the participants had a good level of practice toward SFMs. Education/training is required to enhance the role of community pharmacy professionals to combat their distribution and threats in the future.
Time-varying cost-effectiveness analysis of sodium-glucose cotransporter-2 inhibitors in Chinese patients with heart failure and reduced ejection fraction: A microsimulation of the real-world population
Authors: Zou Xinyu , He Xingchen , Shi Qingyang , Wang Si , Li Nan , Zhou Yiling , Hu Ming , Luo Li , Shen Yiwen , Zhu Ye , Lang Chim C. , Zhu Zhiming , Tian Haoming , Li Sheyu 
Published: February 2025

ObjectiveSodium-glucose cotransporter-2 (SGLT2) inhibitors showed time-varying effects in heart failure and reduced ejection fraction (HFrEF), but corresponding cost-effectiveness in different timeframes remained poorly understood. This study estimated the time-varying cost-effectiveness of SGLT2 inhibitors in HFrEF from the perspective of the Chinese healthcare system.MethodsBased on real-world individual patient data, a 2-year microsimulation model was constructed to evaluate the cost-effectiveness of adding SGLT2 inhibitors to standard therapy compared with standard therapy alone among patients with HFrEF. A published prediction model informed transition probabilities for all-cause death and hospitalization for heart failure. The time-varying effects of SGLT2 inhibitors, medical costs, and utility values were derived from the published literature. Scenario analyses in different timeframes were conducted to assess the trend of cost-effectiveness over time.ResultsCompared with standard therapy alone, SGLT2 inhibitors plus standard therapy were found cost-effective at a willingness‐to‐pay (WTP) threshold of $12,741 per quality‐adjusted life year (QALY) gained in 2 years. The incremental cost-effectiveness ratio (ICER) decreased from $12,346.07/QALY at 0.5 years to $9,355.66/QALY at 2 years. One-direction sensitivity analysis demonstrated that the cost-effectiveness of SGLT2 inhibitors was most sensitive to the cost of SGLT2 inhibitors, the cost of hospitalization for heart failure, the cost of standard therapy for heart failure, and the baseline risks of all-cause death and hospitalization for heart failure. Probabilistic sensitivity analysis proved the robustness of the results.ConclusionAdding SGLT2 inhibitors to standard therapy was found to be cost-effective in Chinese patients with HFrEF. Longer treatment appeared to be more economically favorable, but further explorations are warranted.
Verbal encouragement in coaching: enhancing small-sided game performance in youth basketball players
Authors: Yılmaz Osman , Jahrami Haitham , Batalik Ladislav , Trabelsi Khaled , Ammar Achraf , Soylu Yusuf 
Published: February 2025

BackgroundVerbal coach encouragement is a key motivational strategy that enhances skill development, game strategy execution, and team cohesion. In youth basketball, where players are still developing technical and decision-making abilities, coach encouragement can play a crucial role in sustaining effort, improving focus, and fostering resilience under small-sided games (SSGs). This study investigated how coach encouragement (CE) influences young basketball players’ technical performance and psychophysiological responses during competitive gameplay.MethodsSixteen male basketball players (age = 15.19 ± 1.05 years) voluntarily participated in the study. Heart rate, ratings of perceived exertion, mood states and technical activities were recorded with coach encouragement and without coach encouragement during SSGs.ResultsThe results showed that SSGs with coach encouragement were associated with significantly higher heart rate (p ≤ 0.05, d = 1.69), maximum heart rate percentage (p ≤ 0.05, d = 1.15), ratings of perceived exertion (p ≤ 0.05, d = 1.69), enjoyment (p ≤ 0.007, d = 0.86), technical abilities (e.g., successful passes and shots; p ≤ 0.05, d ranging from 1.08 to 1.25), and fatigue (p ≤ 0.03, d = 1.47).ConclusionThe findings of this study highlight the importance of CE in improving the psychophysiological and technical abilities of young basketball players during SSGs. CE improves coach-athlete relationships and increases game performance.
Assessment of the maternal key micronutrient supply and its correlation with cord blood parameters in twin pregnancies
Authors: Zgliczynska Magdalena , Ostrowska Magdalena , Zebrowska Kinga , Rzucidlo-Szymanska Iga , Szymusik Iwona , Kowalski Konrad , Kosinska-Kaczynska Katarzyna 
Published: February 2025

BackgroundMultiple pregnancy constitutes a large metabolic expense, so women with twin pregnancies and neonates born as twins might be at risk for micronutrient deficiencies. Therefore, the aim of the study was to assess the supplementation used and supply with key micronutrients: iron, vitamin B12, folic acid and vitamin D in women with twin pregnancies and the correlations with cord blood indicators.MethodsMaternal and cord blood samples were collected from 51 patients with twin pregnancies and 102 newborns born from those pregnancies between October 2020 and September 2023. Ferritin, vitamin B12, folic acid and vitamin D metabolites concentrations were measured. Additionally, the patients completed a questionnaire regarding pre-and intragestational supplementation.ResultsIron, vitamin B12, and vitamin D deficiency were diagnosed in 20.8, 13.7 and 12.5% of women with twin pregnancies, respectively. No maternal folate deficiency was identified. Positive weak to moderate correlations were demonstrated between the concentrations of all studied indicators in the maternal and cord blood. Pregestational folic acid and vitamin D supplementation was associated with higher cord blood levels of folic acid and 3-epi-25(OH)D3, respectively. 25(OH)D3 and total 25(OH)D concentrations were higher in newborns whose mothers had supplemented vitamin D during pregnancy.ConclusionThe problem of iron, vitamin B12 and vitamin D deficiencies in twin pregnancies is still valid. Pre-and intragestational supplementation, as well as maternal micronutrient supply affect the cord blood composition of twins.
Prevalence of scoliosis and congenital heart disease based on school screening in Jinghong City, Yunnan Province
Authors: Qian Genghao , Zhang Li , Zhao Zhi , Wang Yingsong , Lu Jiang , Bi Ni , Yang Xiaochen , Xie Weijie , Shi Zhiyue , Li Tao , Zhang Zhaoquan , Song Zhibo 
Published: February 2025

ObjectiveTo investigate the prevalence of scoliosis and congenital heart disease (CHD) in the same area and to explore the relationship between them according to a joint school screening.MethodsAll students aged 6–15 years in 20 schools in Jinghong City, Yunnan Province, China was screened for scoliosis and CHD. Scoliosis screening completed through the Adam's forward bending test with scoliometer measurement, and CHD screening completed through auscultation combined with portable echocardiography (ECHO). The gender, age, distribution of ethnic groups, types of CHD, angle of trunk rotation (ATR) and location of scoliosis were recorded. The severity was divided into 3 grades by ATR. Then the relationship between scoliosis and CHD was analyzed.ResultsA total of 17,134 students was screened with a prevalence of suspected scoliosis of 1.7% (298 students), and the prevalence of suspected scoliosis in female was higher than that in male (2.4 vs. 1.2%, P &lt; 0.001), which increased with age (P &lt; 0.01). The prevalence of suspected scoliosis was no different among ethnic groups (P &gt; 0.05). The severity of scoliosis was mainly grade 1 (68.5%), followed by grade 2 (27.2%) and grade 3 (4.4%). And scoliosis was mainly located in lumbar (37.6%). The prevalence of CHD was 3.15‰, and there was no difference in the prevalence of CHD between different gender, age and ethnic groups (P &gt; 0.05). The most common type of CHD was atrial septal defect (27.78%), followed by ventricular septal defect (16.67%). There was only one CHD student in 298 suspected scoliosis students.ConclusionThe prevalence of suspected scoliosis among primary school students was 1.74%, while the prevalence of congenital heart disease was 3.15‰ in Jinghong City, Yunnan Province. And the incidence of CHD in patients with mild suspected scoliosis was low and close to that in normal population.
Adverse events and contributing factors in Chinese nursing homes: a multisite cross-sectional study
Authors: Wang Zhangan , Qi Xiang , Shi Ying , Shao Lu , Li Wei , Xie Xiyan , Wu Bei , Zhang June 
Published: February 2025

BackgroundAdverse events in nursing homes, which are unintended incidents causing unnecessary harm to older residents. Previous studies in Chinese populations often focused on adverse events in hospitals, rather than residents in nursing homes. Additionally, they tended to focus on single incident rather than multiple types of adverse events. This study aims to assess the occurrence and contributing factors of multiple adverse events perceived by staff in Chinese nursing homes.MethodsA cross-sectional survey was conducted among 691 frontline staff from 11 nursing homes in Southern China (August 2021–January 2022). Data were collected using a General Information Questionnaire, the Adverse Event Reporting Awareness Scale, and the Adverse Event Reporting Habit Scale. Logistic regression models were employed to analyze the contributing factors of adverse events.ResultsA total of 13 types of adverse events were screened out in nursing homes, and 477 (69.0%) participants reported that the adverse events “had happened” in the past year. The most common events were falls, unplanned extubation, and pressure sores. Clinical staff were 2.06 times more likely than frontline workers to report adverse events (95% CI = 1.13–3.76). Increased awareness (OR = 1.24, 95% CI = 1.15–1.34) and habitual reporting of adverse events (OR = 1.04, 95% CI = 1.01–1.08) were positively associated with higher reporting rates.ConclusionA significant proportion of staff reported adverse events, with clinical staff and those with better reporting habits noting higher occurrences. To enhance resident safety, nursing homes must prioritize preventing high-risk adverse events. Targeting frontline workers with lower reporting awareness and habits is crucial for effective interventions.
The effects of family directed power mobility on self-care, mobility, and social function in very young children with severe multiple developmental impairments
Authors: Aceros Juan , Cesar Guilherme M. , Rodriguez Ayshka , Lundy Mary 
Published: February 2025

IntroductionChildren with impaired mobility often experience negative impact on overall development leading to depression, social isolation, and perceived lower quality of life.ObjectiveOur study explored the effects of Power Mobility Devices (PMD), in the form of modified ride-on toy cars with two distinct activation/steering technologies, on functional independent and social function in young children with severe multiple developmental impairments.MethodologyTwelve children (age range 12–54 months) with neuromuscular, musculoskeletal, and genetic diagnoses, and metabolic progressive diseases participated. Significant cognitive, visual, or communication impairment was not exclusionary. Two types of activation and steering modifications (proportional control joystick and line follower technologies) were provided. Paired samples t-test contrasted pre-post functional capabilities after three months of PMD use in both Pediatric Evaluation of Disability Inventory scales of Functional Skills and Caregiver Assistance, each with the subscales self-care, mobility, and social/cognitive.FindingsImprovements were observed in all three subscales for Functional Skills (significant 9.8% increase in self-care, 21.4% in mobility, and 17.5% social/cognitive) and Caregiver Assistance (significant 35.4% increase in self-care).ConclusionThese quantitative results support findings of previous studies analyzing qualitative data, suggesting that early power mobility interventions provide positive improvements in the quality of life of children with severe developmental disabilities.