bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prediction models for lymph node metastasis in cervical cancer based on preoperative heart rate variability
Authors: Guan Weizheng , Wang Yuling , Zhao Huan , Lu Hui , Zhang Sai , Liu Jian , Shi Bo 
Published: February 2024

BackgroundThe occurrence of lymph node metastasis (LNM) is one of the critical factors in determining the staging, treatment and prognosis of cervical cancer (CC). Heart rate variability (HRV) is associated with LNM in patients with CC. The purpose of this study was to validate the feasibility of machine learning (ML) models constructed with preoperative HRV as a feature of CC patients in predicting CC LNM.MethodsA total of 292 patients with pathologically confirmed CC admitted to the Department of Gynecological Oncology of the First Affiliated Hospital of Bengbu Medical University from November 2020 to September 2023 were included in the study. The patient’ preoperative 5-min electrocardiogram data were collected, and HRV time-domain, frequency-domain and non-linear analyses were subsequently performed, and six ML models were constructed based on 32 parameters. Model performance was assessed using the area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, and specificity.ResultsAmong the 6 ML models, the random forest (RF) model showed the best predictive performance, as specified by the following metrics on the test set: AUC (0.852), accuracy (0.744), sensitivity (0.783), and specificity (0.785).ConclusionThe RF model built with preoperative HRV parameters showed superior performance in CC LNM prediction, but multicenter studies with larger datasets are needed to validate our findings, and the physiopathological mechanisms between HRV and CC LNM need to be further explored.
Associations of micronutrient dietary patterns with sarcopenia among US adults: a population-based study
Authors: Liu Yining , Liu Xiangliang , Duan Linnan , Zhao Yixin , He Yuwei , Li Wei , Cui Jiuwei 
Published: February 2024

BackgroundCurrent epidemiological evidence points to an association between micronutrient (MN) intake and sarcopenia, but studies have focused on single MN, and no combined effects on MNs have been reported. The aim of this study was to investigate the relationship between different MN intake patterns and sarcopenia and skeletal muscle mass.MethodsWe performed a population-based cross-sectional study, with a total of 5,256 U.S. adults aged 20–59 years, and we collected total daily MN intake and appendicular skeletal muscle mass measured by Dual-Energy X-ray Absorptiometry (DXA). Principal component analysis (PCA) was used to obtain nutrient patterns and principal component scores based on the intake of 14 MNs, and logistic regression analysis was used to assess the effects of single MN and MN intake patterns on sarcopenia and muscle mass.ResultsWe defined three MN intake patterns by PCA: (1) adherence to VitB-mineral, high intake of vitamin B and minerals; (2) adherence to VitAD-Ca-VB12, high intake of vitamin A, vitamin D, calcium and vitamin B12; and (3) adherence to Antioxidant Vit, high intake of antioxidant vitamins A, C, E, and K. These three nutrient patterns explained 73.26% of the variance of the population. A negative association was observed between most single MN intakes and sarcopenia, and after adjusting for confounders, adherence to the highest tertile of the three nutrient patterns was associated with a lower risk of sarcopenia and relatively higher skeletal muscle mass compared to the lowest adherence. In subgroup analysis, MN intake patterns were significantly correlated with sarcopenia in middle-aged females.ConclusionNutritional patterns based on MN intake were significantly related to sarcopenia, indicating that MNs interact with each other while exerting their individual functions, and that MN dietary patterns may provide promising strategies for preventing the loss of muscle mass, with further prospective studies warranted in the future.
Case report: Ectopic corpus cavernosum presented as bladder tumor in a 3-year-old boy
Authors: Chai Jia-gui , Zhao Yan-liang , Yin Si-fan , Yin Zhi-yuan , Zhao Shen-zhao , Feng Run-lin , Ke Chang-xing 
Published: February 2024

BackgroundEctopic tissue is rarely found in the bladder for adults. Currently, there have been reports of ectopic prostate and colon tissue in the bladder. These ectopic tissues are manifested as a bladder mass and cause lower urinary tract symptoms. However, the ectopic corpus cavernosum in the bladder has never been reported, and its clinical characteristics and treatment have not been explored yet.Case summaryA 3-year-old boy was admitted to the hospital due to 1 month of urinary frequency. The physical examination was unremarkable. Urine analysis from other hospitals showed an elevated urine white blood cell count of 17.9/ul. In addition, ultrasound indicated a possible bladder mass. CT and MRI showed a well-margined lesion (1.9×1.9 cm) in the bladder trigone. Through preoperative imaging, we diagnosed a bladder tumor (inclined towards benign). The transurethral resection of the bladder tumor was performed. Unfortunately, the surgery was unsuccessful due to the difficulty in removing the excised tissue through the urethra. Subsequently, bladder incision and tumor resection were performed. The tumor was successfully removed. Surprisingly, the postoperative pathology showed that the tumor tissue was corpus cavernosum. The pathological diagnosis was ectopic corpus cavernosum in the bladder. No complications were found after the operation, and no recurrence was observed during follow-up.ConclusionThe ectopic corpus cavernosum in the bladder has never been reported for children, which is presented as a benign tumor with rapid proliferation and large size. Surgery is recommended. However, the transurethral resection of bladder tumors is difficult to perform due to narrow urethra and limited surgical instruments. Bladder incision and tumor resection may be preferred.
Case report: A rare case of immunotherapy induced isolated left CN VI palsy in a patient with unresectable melanoma
Authors: Low Samantha Su Ping , El-Shakankery Karim , Brown Ewan , Christie Alan , McCormack Sally , Stares Mark 
Published: February 2024

IntroductionImmune checkpoint inhibitors are the mainstay of treatment in patients with unresectable or metastatic melanoma. Combination immunotherapy with ipilimumab and nivolumab has shown to improve survival outcomes as compared to single agent immunotherapy in these patients. Neurological immune-related adverse effects (irAEs) are uncommon and cranial nerve palsies are seen even more infrequently.Case presentationA 66-year-old woman with a background of metastatic, unresectable melanoma with supraclavicular and axillary lymph nodal involvement presented with a headache, photophobia and diplopia 3 weeks after her first cycle of ipilimumab and nivolumab. She was subsequently diagnosed with a left-sided cranial nerve VI palsy and treated with high dose oral steroids and steroid eye drops, with complete resolution of symptoms. She also experienced Grade 3 dermatitis requiring topical steroids, Grade 2 hypothyroidism and vitiligo. She continues to have an excellent clinical and radiological response, despite further immunotherapy being suspended.ConclusionThis is the first reported UK case of immunotherapy-induced isolated cranial nerve VI palsy. Multiple irAEs are more common with combination immunotherapy and its occurrence is associated with more favourable outcomes in melanoma. Immunotherapy continues to revolutionise oncological care, but clinicians must be cognizant of unpredictable irAEs, which may require prompt assessment and intervention.
Efficacy of a vaginal suppository formulation prepared with Acacia arabica (Lam.) Willd. gum and Cinnamomum camphora (L.) J. Presl. in heavy menstrual bleeding analyzed using a machine learning technique
Authors: Fazmiya Mohamed Joonus Aynul , Sultana Arshiya , Heyat Md Belal Bin , Parveen Saba , Rahman Khaleequr , Akhtar Faijan , Khan Azmat Ali , Alanazi Amer M. , Ahmed Zaheer , Díez Isabel de la Torre , Ballester Julién Brito , Saripalli Tirumala Santhosh Kumar 
Published: February 2024

Objective: This study aims to determine the efficacy of the Acacia arabica (Lam.) Willd. and Cinnamomum camphora (L.) J. Presl. vaginal suppository in addressing heavy menstrual bleeding (HMB) and their impact on participants' health-related quality of life (HRQoL) analyzed using machine learning algorithms.Method: A total of 62 participants were enrolled in a double-dummy, single-center study. They were randomly assigned to either the suppository group (SG), receiving a formulation prepared with Acacia arabica gum (Gond Babul) and camphor from Cinnamomum camphora (Kafoor) through two vaginal suppositories (each weighing 3,500 mg) for 7 days at bedtime along with oral placebo capsules, or the tranexamic group (TG), receiving oral tranexamic acid (500 mg) twice a day for 5 days and two placebo vaginal suppositories during menstruation at bedtime for three consecutive menstrual cycles. The primary outcome was the pictorial blood loss assessment chart (PBLAC) for HMB, and secondary outcomes included hemoglobin level and SF-36 HRQoL questionnaire scores. Additionally, machine learning algorithms such as k-nearest neighbor (KNN), AdaBoost (AB), naive Bayes (NB), and random forest (RF) classifiers were employed for analysis.Results: In the SG and TG, the mean PBLAC score decreased from 635.322 ± 504.23 to 67.70 ± 22.37 and 512.93 ± 283.57 to 97.96 ± 39.25, respectively, at post-intervention (TF3), demonstrating a statistically significant difference (p &lt; 0.001). A higher percentage of participants in the SG achieved normal menstrual blood loss compared to the TG (93.5% vs 74.2%). The SG showed a considerable improvement in total SF-36 scores (73.56%) compared to the TG (65.65%), with a statistically significant difference (p &lt; 0.001). Additionally, no serious adverse events were reported in either group. Notably, machine learning algorithms, particularly AB and KNN, demonstrated the highest accuracy within cross-validation models for both primary and secondary outcomes.Conclusion: The A. arabica and C. camphora vaginal suppository is effective, cost-effective, and safe in controlling HMB. This botanical vaginal suppository provides a novel and innovative alternative to traditional interventions, demonstrating promise as an effective management approach for HMB.
Developing an evaluation index system for the online learning literacy of physical education teachers in China
Authors: Tian Hengxing , Sun Mingzhu , Yin Zhihua , Liu Haohui , Li Fangfei 
Published: February 2024

BackgroundThe convenience of online learning helps physical education teachers overcome geographic barriers and promotes safe, accessible, high-quality education. This three-stage study developed an evaluation index system for online learning literacy of physical education (PE) teachers (OLLPET).MethodsUsing two rounds of the Delphi method and one round of the Expert ranking method, consult with 15 PE experts from universities, primary and secondary schools, and teaching-research staff to draw up, revise, and finalize an evaluation index system for OLLPET.ResultsOur OLLPET evaluation index system includes three first-level indicators, seven second-level indicators and 30 third-level indicators. The first-level indicators includes online learning values (OLV), online learning essential character (OLEC), and online learning key competencies (OLKC)–with equal weighting given to OLV (0.367) and OLKC (0.367) and slightly less given to OLEC (0.267).ConclusionThe OLLPET evaluation index system is a theoretical yet practical tool that governments, schools, and teachers can use to evaluate PE teachers’ online learning literacy to improve their learning capacity in a targeted manner.
Development of a revised version of the transdiagnostic skills scale (T2S-R)
Authors: Vancappel Alexis , Gillet Nicolas , Fouquereau Evelyne , Chevalier Séverine , Aubouin-Bonnaventure Julia , Coillot Hélène , Mangolini Anna , Jansen Eline , Dicosimo Cinzia , El-Hage Wissam 
Published: February 2024

IntroductionThe transdiagnostic approach has been shown to offer promising prospects in psychopathology, based on the observation that common factors may be involved in different psychiatric disorders. The transdiagnostic skills scale (T2S) was developed recently to assess the skills that are disrupted in these disorders. However, studies have shown that the T2S has lower predictive power for externalizing than internalizing disorders. This may be due to the fact that the skills assessed do not include the control of urges and cravings. The aims of the current study are thus to develop a revised version of the T2S (T2S-R) integrating this dimension, and to assess its factor structure and invariance across employment status (workers vs. students) and the level of psychopathology.MethodWe recruited 1,298 French participants online through social media. They completed the revised version of the T2S and the symptomatic transdiagnostic test (S2T), which evaluates 11 clusters of psychiatric symptoms. We assessed the factor structure, internal consistency, invariance, and predictive validity of the revised T2S.ResultsWe found a good fit for a bifactor exploratory structural equation modeling (B-ESEM) approach including a global skills factor and seven specific factors. The results also indicate that the new dimension (i.e., control of urges and cravings) has good predictive value, especially for externalizing problems. We also found total invariance of the scale across employment status and partial invariance across the level of psychopathology.ConclusionThe revised version of the T2S-R has good psychometric properties. It predicts better externalizing problems than the original version. However, the scale remains more correlated with internalizing than externalizing problems. We discuss the implications of the results on the transdiagnostic conceptualization and the interest of using a mixed approach combining transdiagnostic and diagnostic analyses.
Anxiety disorders among children and adolescents during COVID-19 lockdowns and school closures: a cross-sectional study in Kuwait
Authors: Alamiri Bibi , Alkhamis Moh A. , Naguy Ahmed , Alenezi Hend F. , Al Shekaili Muna 
Published: February 2024

IntroductionInvestigating the epidemiology of mental health disorders resulting from COVID-19 intervention measures, primary school closures, and social isolation in children and adolescents needs to be prioritized over adults at the post-pandemic stage. Most preliminary psychosocial studies conducted during the pandemic have demonstrated that younger age groups are the most vulnerable to such implications. Thus, this study aims to estimate the probable prevalence of specific anxiety disorders in children and quantify their relationships with relevant demographic risk factors.MethodsWe used a cross-sectional study comprising 430 children aged between 8- and 18 years old living in Kuwait during the period of school closures as well as full and partial lockdowns. The survey included questions about participants’ characteristics, children's anxiety using the Screen for Child Anxiety Related Emotional Disorders Questionnaire (SCARED) scale, and children's emotions and behaviours using the Strengths and Difficulties Questionnaire (SDQ). Univariate and multivariate logistic regression analyses were used to summarize the demographic and characteristics of the participants and their association with general, social, and generalized anxieties, as well as behavioural and emotional difficulties. ResultsWe inferred that 24.83% of our participants had at least one anxiety disorder, while 20.19% were classified as abnormal on the SDQ scale. Our multivariate analysis revealed that lockdown duration and sex of the child were consistently significant predictors (p-values &lt; 0.05) of the broad spectrum of selected mental disorders. Additionally, we inferred notable increases in the likelihood of mental disorders associated with the increased duration of lockdowns. ConclusionsOur findings revealed preliminary insights into the vulnerability of young populations to the indirect negative impacts of strict public health measures during pandemic emergencies. Thus, authorities should consider such implications when planning and implementing similar interventions in future pandemics.
A day in the life: psychological impact on emergency responders during the 22 March 2016 terrorist attacks
Authors: Muysewinkel Emilie , Vesentini Lara , Van Deynse Helena , Vanclooster Stephanie , Bilsen Johan , Van Overmeire Roel 
Published: February 2024

IntroductionTerrorist attacks can cause severe long-term mental health issues that need treatment. However, in the case of emergency responders, research is often vague on the type of stressors that emergency responders encounter. For example, in addition to the threat that they work under, studies have shown that ill-preparation adds to the stress experienced by emergency responders. However, few studies have looked into the experience of emergency responders. In this study, we looked at the experience of emergency responders during the 22 March 2016 terrorist attacks in Belgium.MethodsWe used a qualitative design, in which we interviewed different types of emergency responders. Police officers, nurses, soldiers, firefighters, and Red Cross volunteers were included. Interviews were coded by two researchers and analyzed using a thematic approach.ResultsFour large themes were developed: constant threat and chaos, frustrations with lack of preparedness and training, ethical decisions, and debriefings. In addition, although emergency responders encountered constant threat, they often felt that they were ill-prepared for such attacks. One specific example was their lack of training in tourniquet usage. Furthermore, in a disaster setting, the emergency responders had to make life-and-death decisions for which they were not always prepared. Finally, debriefings were conducted in the aftermath of the attacks. Whereas most were perceived as positive, the debriefings among police officers were viewed as insufficient.ConclusionsEmergency responding to terrorist attacks has many different dimensions of events that can cause stress. Our study revealed that preparation is key, not only in terms of material but also in terms of ethics and debriefings.
Effects of physical activity and sedentary behaviors on cardiovascular disease and the risk of all-cause mortality in overweight or obese middle-aged and older adults
Authors: Zhang Yongqiang , Liu Xia 
Published: February 2024

AimThe aim of this study was to respectively explore the relationships between physical activity and sedentary behaviors and cardiovascular disease (CVD) and all-cause mortality risk in overweight/obese middle-aged and older patients, and also assess the interaction between physical activity and sedentary behaviors.MethodsData of middle-aged and older adults with body mass index (BMI) ≥25 kg/m2 were extracted from the National Health and Nutrition Examination Surveys (NHANES) database in 2007–2018 in this retrospective cohort study. Weighted univariate and multivariate logistic regression analyses were used to explore the associations between physical activity and sedentary behaviors and CVDs; weighted univariate and multivariate Cox regression analyses were used to explore the relationships between physical activity and sedentary behaviors with the risk of all-cause mortality. The interaction effect between physical activity and sedentary behaviors on CVD and all-cause mortality was also assessed. We further explored this interaction effect in subgroups of age and BMI. The evaluation indexes were odds ratios (ORs), hazard ratios (HRs), and 95% confidence intervals (CIs).ResultsAmong 13,699 eligible patients, 1,947 had CVD, and 1,560 died from all-cause mortality. After adjusting for covariates, patients who had high sedentary time seemed to have both high odds of CVD [OR = 1.24, 95% CI: (1.06–1.44)] and a high risk of all-cause mortality [HR = 1.20, 95% CI: (1.06–1.37)]. Furthermore, being insufficiently active was linked to high odds of CVD [OR = 1.24, 95% CI: (1.05–1.46)] as well as a high risk of all-cause mortality [HR = 1.32, 95% CI: (1.15–1.51)]. High sedentary time and being insufficiently active had an interaction effect on both high odds of CVD [OR = 1.44, 95% CI: (1.20–1.73)] and high risk of all-cause mortality [HR = 1.48, 95% CI: (1.24–1.76)]. Individuals of different ages with/without obesity need to focus on the potential CVD/mortality risk of high sedentary time and low physical activity (all P &lt; 0.05).ConclusionReducing sedentary time combined with increasing physical activity may benefit health by reducing both the risk of CVD and all-cause mortality in overweight or obese middle-aged and older adults.
Sense of coherence promotion and occupational and family stress mitigation may improve heart health behaviors in middle-aged working women: a structural equation modelling approach
Authors: Moon Ji Hyun , Seo Eunhye 
Published: February 2024

AimsThis study aimed to construct a model that describes heart health behaviors in middle-aged working women and verify the goodness-of-fit of the model based on Salutogenesis.Methods and resultsThis study adopted a cross-sectional design. Participants were 330 middle-aged working women in South Korea. Data were analyzed using structural equation modelling with Sobel’s Z test. In the multiple mediation model, stress coping strategy (β = 0.26; p &lt; 0.001), social support (β = 0.41; p &lt; 0.001), and health self-efficacy (β = 0.36; p &lt; 0.001) had significant direct effects on sense of coherence (SOC). SOC had a significant direct effect on occupational (β = −0.72; p &lt; 0.001) and family stress (β = −0.76; p &lt; 0.001). Additionally, SOC (β = 0.67; p &lt; 0.001), occupational stress (β = −0.46; p &lt; 0.001), and family stress (β = −0.28; p &lt; 0.001) had significant direct effects on heart health behaviors. Moreover, SOC had a significantly partial mediating effect on heart health behaviors through occupational stress (Z = 3.17; p = 0.002) and family stress (Z = 2.26; p = 0.024).ConclusionOccupational and family stress mediated the relationship between SOC and heart health behaviors in middle-aged working women.Clinical evidenceInterventions that mitigate occupational and family stress may improve heart health behaviors among middle-aged working women.