bluuebunny/crossref_metadata_2025_split huggingface dataset:
Machine-learning assisted swallowing assessment: a deep learning-based quality improvement tool to screen for post-stroke dysphagia
Authors: Saab Rami , Balachandar Arjun , Mahdi Hamza , Nashnoush Eptehal , Perri Lucas X. , Waldron Ashley L. , Sadeghian Alireza , Rubenfeld Gordon , Crowley Mark , Boulos Mark I. , Murray Brian J. , Khosravani Houman 
Published: November 2023

IntroductionPost-stroke dysphagia is common and associated with significant morbidity and mortality, rendering bedside screening of significant clinical importance. Using voice as a biomarker coupled with deep learning has the potential to improve patient access to screening and mitigate the subjectivity associated with detecting voice change, a component of several validated screening protocols.MethodsIn this single-center study, we developed a proof-of-concept model for automated dysphagia screening and evaluated the performance of this model on training and testing cohorts. Patients were admitted to a comprehensive stroke center, where primary English speakers could follow commands without significant aphasia and participated on a rolling basis. The primary outcome was classification either as a pass or fail equivalent using a dysphagia screening test as a label. Voice data was recorded from patients who spoke a standardized set of vowels, words, and sentences from the National Institute of Health Stroke Scale. Seventy patients were recruited and 68 were included in the analysis, with 40 in training and 28 in testing cohorts, respectively. Speech from patients was segmented into 1,579 audio clips, from which 6,655 Mel-spectrogram images were computed and used as inputs for deep-learning models (DenseNet and ConvNext, separately and together). Clip-level and participant-level swallowing status predictions were obtained through a voting method.ResultsThe models demonstrated clip-level dysphagia screening sensitivity of 71% and specificity of 77% (F1 = 0.73, AUC = 0.80 [95% CI: 0.78–0.82]). At the participant level, the sensitivity and specificity were 89 and 79%, respectively (F1 = 0.81, AUC = 0.91 [95% CI: 0.77–1.05]).DiscussionThis study is the first to demonstrate the feasibility of applying deep learning to classify vocalizations to detect post-stroke dysphagia. Our findings suggest potential for enhancing dysphagia screening in clinical settings. https://github.com/UofTNeurology/masa-open-source.
Association of dietary live microbe intake with abdominal aortic calcification in US adults: a cross-sectional study of NHANES 2013–2014
Authors: Huo Xingwei , Jia Shanshan , Zhang Xin , Sun Lirong , Liu Xueting , Liu Lu , Zuo Xianghao , Chen Xiaoping 
Published: November 2023

ObjectTo explore the potential association between dietary live microbe intake and abdominal aortic calcification (AAC).MethodsWe conducted a cross-section study based on the National Health and Nutrition Examination Survey (NHANES). We categorized the participants into three groups (low, medium, and high dietary intake of live microbes) according to Sanders’s dietary live microbe classification system and participants’ 24-h dietary recall data. AAC was quantified by using dual-energy X-ray absorptiometry (DXA) and diagnosed by using the Kauppila AAC-24 score system. The analyses utilized weighted logistic regression and weighted linear regression.ResultsA total of 2,586 participants were included. After the full adjustment for covariates, compared to participants with a low dietary live microbe intake, participants with a high dietary live microbe intake had a significantly lower risk of severe AAC (OR: 0.39, 95% CI: 0.22, 0.68, p = 0.003), and the AAC score was also significantly decreased (β:−0.53, 95% CI: −0.83, −0.23, p = 0.002).ConclusionIn this study, more dietary live microbial intake was associated with lower AAC scores and a lower risk of severe AAC. However, more research is needed to verify this.
High resting energy expenditure in women with episodic migraine: exploring the use of predictive formulas
Authors: Martins Laís Bhering , Ribeiro Jéssica Sales , Rodrigues Ana Maria dos Santos , Santos Luana Caroline dos , Teixeira Antonio Lúcio , Ferreira Adaliene Versiani Matos 
Published: November 2023

IntroductionMigraine is a common and disabling primary headache, and its pathophysiology is not fully understood. Previous studies have suggested that pain can increase humans’ Resting Energy Expenditure (REE). However, no previous study has investigated whether the REE of individuals with migraine differs from the general population. Therefore, this study aims to assess whether the REE of women with migraine differs from that of women without headaches. We also tested the accuracy of REE predictive formulas in the migraine patients.MethodsThis cross-sectional study involves 131 adult women aged between 18 and 65 years, 83 with migraine and 48 without (controls). We collected clinical, demographic, and anthropometric data. Migraine severity was measured using the Migraine Disability Test and Headache Impact Test, version 6. The REE was measured by indirect calorimetry, and it was compared with the predicted REE calculated by formulas.ResultsPatients with migraine had higher REE when compared to controls (p &lt; 0.01). There was a positive correlation between REE and the patient-reported number of migraine attacks per month (Rho = 0.226; p = 0.044). Mifflin-St Jeor and Henry and Rees were the predictive formulas that have more accuracy in predicting REE in women with migraine.DiscussionConsidering the benefits of nutritional interventions on treating migraines, accurately measuring REE can positively impact migraine patient care. This study enhances our understanding of the relationship between pain and energy expenditure. Our results also provide valuable insights for healthcare professionals in selecting the most effective predictive formula to calculate energy expenditure in patients with migraine.
TORCH-R trial protocol: hypofractionated radiotherapy combined with chemotherapy and toripalimab for locally recurrent rectal cancer: a prospective, single-arm, two-cohort, phase II trial
Authors: Wan Juefeng , Wu Ruiyan , Fu Miaomiao , Shen Lijun , Zhang Hui , Wang Yan , Wang Yaqi , Zhou Shujuan , Chen Yajie , Xia Fan , Zhang Zhen 
Published: November 2023

For patients with locally recurrent rectal cancer (LRRC), the response rate to chemoradiotherapy is 40%–50%. Additionally, only approximately 40%–50% of patients with recurrent rectal cancer are able to undergo R0 resection. Recent studies in locally advanced rectal cancer (LARC) have shown promising synergistic effects when combining immunotherapy (PD-1/PD-L1 antibodies) with neoadjuvant chemoradiotherapy (nCRT). Therefore, incorporating immunotherapy into the treatment regimen for LRRC patients has the potential to further improve response rates and prognosis. To investigate this, the TORCH-R trial was conducted. This prospective, single-arm, two-cohort, phase II trial focuses on the use of hypofractionated radiotherapy, chemotherapy, and immunotherapy in LRRC patients without or with oligometastases. The trial will include two cohorts: cohort A consists of rectal cancer patients who are treatment-naive for local recurrence, and cohort B includes patients with progressive disease after first-line chemotherapy. Cohort A and cohort B patients will receive 25–40 Gy/5 Fx irradiation or 15–30 Gy/5 Fx reirradiation for pelvic recurrence, respectively. Subsequently, they will undergo 18 weeks of chemotherapy, toripalimab, and stereotactic ablative radiotherapy (SABR) for all metastatic lesions between chemoimmunotherapy cycles. Decisions regarding follow-up of complete response (CR), radical surgery, sustained treatment of non-resection, or exiting the trial are made by a multidisciplinary team (MDT). The primary endpoint of this study is the local objective response rate (ORR). The secondary endpoints include the extrapelvic response rate, duration of response, local recurrence R0 resection rate, progression-free survival (PFS), overall survival (OS), and safety and tolerability. Notably, this trial represents the first clinical exploration of inducing hypofractionated radiotherapy, chemotherapy, and immunotherapy in LRRC patients.Clinical trial registrationhttps://clinicaltrials.gov/study/NCT05628038, identifier NCT05628038.
The systematic review and meta-analysis evaluated the efficacy and safety of nefopam for catheter-related bladder discomfort based on randomized controlled trials
Authors: Chi Junpeng , Wu Jinhui , Lou Keyuan , Ma Jian , Wu Jitao , Cui Yuanshan 
Published: November 2023

Background: Catheter-related bladder discomfort (CRBD) is a frequent occurrence following urinary catheterization during surgical procedures, as well as a commonly experienced bladder pain syndrome after surgery. There have been various studies on drugs and interventions to manage CRBD, but their comparative efficacy and safety are still a topic of debate. We conducted a meta-analysis to assess the efficacy and safety of nefopam for managing postoperative CRBD.Methods: A systematic search of PubMed, Embase, Cochrane Library, and Web of Science was conducted to find randomized controlled trials (RCTs) on using nefopam in postoperative CRBD. The study employed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Data analysis was performed using RevMan version 5.4.1.Results: Five RCTs with 405 patients were analyzed to evaluate the efficacy of nefopam on postoperative CRBD. Short-term and long-term periods were defined as within 6 h and longer than 12 h after surgery, respectively. The incidence and severity of CRBD were compared between the two groups during these time periods. The analysis proved that nefopam reduced the short-term incidence of postoperative CRBD (RR 0.36; 95% CI, 0.18–0.70; p = 0.003, I2 = 78%) and the long-term incidence (RR 0.49; 95% CI, 0.32–0.74; p = 0.0007, I2 = 0%) significantly. We compared the incidence of moderate-to-severe CRBD between groups based on the scaling system (none, mild, moderate, and severe). This was used to assess the severity of postoperative CRBD. The results showed that patients in the nefopam group had a significantly lower incidence of moderate-to-severe CRBD compared to those in the placebo group in the short-term (RR 0.19; 95% CI, 0.10–0.34; p &lt; 0.00001; I2 = 0%). However, there were no significant differences between the two groups in the incidence of moderate-to-severe CRBD in the long-term (RR 0.61; 95% CI, 0.21–1.76; p = 0.36; I2 = 0%). There were no significant variations in the occurrence of adverse events between the nefopam and control groups, mainly including postoperative nausea and vomiting (PONV) (RR 1.14; 95% CI, 0.40–3.21; p = 0.81), and tachycardia (RR 0.25; 95% CI, 0.03–2.11, p = 0.20).Conclusion: The findings of this meta-analysis indicate that nefopam significantly reduced the incidence of short or long-term postoperative CRBD. Nefopam decreased the severity of postoperative CRBD, particularly significantly reducing the occurrence of moderate to severe CRBD in the short-term. Overall, patients have good tolerance and no apparent side effects.Systematic Review Registration: identifier PROSPERO (CRD42023475012)
Relationship of PIEZO1 and PIEZO2 vascular expression with diabetic neuropathy
Authors: Garcia-Mesa Yolanda , Cabo Roberto , González-Gay Mario , García-Piqueras Jorge , Viña Eliseo , Martínez Irene , Cobo Teresa , García-Suárez Olivia 
Published: November 2023

Introduction: Diabetic distal symmetric polyneuropathy (DDSP) is the most prevalent form of diabetic peripheral neuropathy, and 25% of patients develop pain in their toes. DDSP is associated with increased cutaneous microvessel density (MVD), reduced skin blood flow, endothelial dysfunction, and impaired fluid filtration with vasodilation. The Piezo family of mechanosensitive channels is known to be involved in the control of vascular caliber by converting mechanical force into intracellular signals. Furthermore, Piezo2 is particularly involved in peripheral pain mechanisms of DDSP patients. To date, very little is known about the number, structure, and PIEZO expression in cutaneous blood vessels (BVs) of individuals with DDSP and their relation with pain and time span of diabetes.Methods and results: We studied microvessels using endothelial markers (CD34 and CD31) and smooth cell marker (α-SMA) by indirect immunohistochemical assay in sections of the glabrous skin of the toes from patients and controls. MVD was assessed through CD34 and CD31 immunoreaction. MVD determined by CD34 is higher in short-term DDSP patients (less than 15 years of evolution), regardless of pain. However, long-term DDSP patients only had increased BV density in the painful group for CD31. BVs of patients with DDSP showed structural disorganization and loss of shape. The BVs affected by painful DDSP underwent the most dramatic structural changes, showing rupture, leakage, and abundance of material that occluded the BV lumen. Moreover, BVs of DDSP patients displayed a Piezo1 slight immunoreaction, whereas painful DDSP patients showed an increase in Piezo2 immunoreaction.Discussion: These results suggest that alterations in the number, structure, and immunohistochemical profile of specific BVs can explain the vascular impairment associated with painful DDSP, as well as the temporal span of diabetes. Finally, this study points out a possible correlation between increased vascular Piezo2 immunostaining and pain and decreased vascular Piezo1 immunostaining and the development of vasodilation deficiency.
Paradoxical leadership and well-being in turbulent times: a time-lagged study
Authors: Stynen Dave , Semeijn Judith 
Published: November 2023

IntroductionParadoxical leadership has recently been put forward as an approach to leadership that may transcend the inherent contradictions in contemporary organizational and personnel management. Empirical research on its potential role for bolstering employee well-being remains scarce. This study investigated whether paradoxical leadership positively impacts employee well-being, which is operationalized as employees’ job, career and life satisfaction. We rely on sense-making theory to investigate whether such effects are mediated by the mitigation of employee job insecurity perceptions.MethodsConvenience sampling techniques were used to collect longitudinal survey data between March and September 2021. In total 287 workers provided usable data. Their ages ranged from 18 to 67 years and were active in various organizations in the Netherlands. Validated measures were used to assess paradoxical leadership, job insecurity, job, career, and life satisfaction. A time-lagged path analysis in Mplus 7.0 was conducted to investigate relationships.ResultsThe results suggest that paradoxical leadership is positively related to job, career and life satisfaction over time. The relationships between paradoxical leadership and job and career satisfaction are partially mediated by the mitigation of perceived job insecurity.DiscussionParadoxical leadership plays a role in fostering worker well-being in these turbulent times. Paradoxical leaders may also help their followers to reframe and better deal with challenging working conditions. Despite the longitudinal data design, an additional data-wave would allow for more stringent testing of the proposed mediation effect, and due to convenience sampling generalization of findings is limited.
Does WeChat use intensity influence Chinese college students' mental health through social use of WeChat, entertainment use of WeChat, and bonding social capital?
Authors: Xia Mengfan , Liu Jing 
Published: November 2023

BackgroundPrevious research notes that the usage of WeChat is significantly related to individuals' mental health, but the underlying mechanism is still not completely discovered. The present study aimed to explore the sequential mediating roles of WeChat use motivations and bonding social capital on the effects of WeChat use intensity on mental health in Chinese college students.MethodThe present study adopted an online survey with a total of 487 Chinese college students. Correlation analysis and serial mediation analysis were measured by process regarding the hypothesis.ResultsThe study presented findings indicating that WeChat use intensity had both direct and indirect impacts on the levels of life satisfaction and loneliness experienced by college students in China. Specifically, the utilization of WeChat for social motivation and entertainment motivation was found to have a suppressive effect on the relationship between the intensity of WeChat usage and individuals' life satisfaction. The association between the intensity of WeChat usage and mental health outcomes (life satisfaction and loneliness) was found to be mediated by bonding social capital. Furthermore, the association between the intensity of WeChat usage and mental health was found to be mediated by the sequential mediation effects of using WeChat for social motivation and bonding social capital, as well as the sequential mediation effects of using WeChat for entertainment motivation and bonding social capital.ConclusionOur findings provide implications for policymakers and social workers regarding renovating the perceptions of the relationships between WeChat use intensity and overall mental health. Specifically, practical online activities and services of SNSs are recommended to be designed for meeting social and recreational gratifications and boosting bonding social capital, which in turn promotes psychological wellbeing.
Healthy eating habits and a prudent dietary pattern improve Nanjing international students’ health-related quality of life
Authors: Walker Anita Nyarkoa , Weeto Makhala Mary , Priddy Christiana Babymay , Yakubu Salimata , Zaitoun Margaret , Chen Qianfeng , Li Bohan , Feng Yucong , Zhong Yuxia , Zhang Yuandie , Wei Tao , Bafei Solim Essomandan Clémence , Feng Qing 
Published: November 2023

PurposeLow-quality dietary practices, such as fast food consumption and skipping meals, deteriorate the quality of life. However, the available studies on diet and health-related quality of life (HRQoL) used matrices not specific to nutrition. Moreover, how diet affects the HRQoL of international students in China is unknown. Therefore, using a cross-sectional study, the effect of dietary patterns and habits on the HRQoL of international students in Nanjing, China, was examined.MethodsThe researchers collected dietary data using a food frequency questionnaire (FFQ) from February to March 2022. Then, the Food Benefit Assessment (FBA) was used to access HRQoL. Finally, the effect of eating habits and dietary patterns on HRQoL was explored using multilinear regression.ResultsApproximately 454 responses were obtained, with the responses mostly from male subjects (56.4%) and those aged 26 years and above (75.6%). The quality of life according to the food consumed was about average for all the constructs except for aesthetics and disease prevention, as 65.8% skipped meals, particularly breakfast (47.8%). Furthermore, three dietary patterns were identified: prudent, Western, and animal protein patterns. Consequently, by skipping breakfast, vitality (β = −2.362, p = 0.04), wellbeing (β = −3.592, p = 0.007), digestive comfort (β = −4.734, p = 0.008), and disease prevention (β = −5.071, p = 0.031) were all reduced. However, consuming at least three meals daily enhanced vitality (β = 2.254, p = 0.003) and disease prevention (β = 4.441, p = 0.019). Furthermore, aesthetics (β = 4.456, p = 0.05), physical appearance (β = 5.927, p = 0.003), and vitality (β = 3.323, p = 0.009) were also significantly increased by healthy dietary patterns. However, a more Westernized diet led to frequent snacking (β = −4.631, p = 0.032), a decline in wellbeing (β = −5.370, p &lt; 0.001), and discomfort with digestion (β = −5.101, p = 0.01). Finally, increased frequency of snacking (β = −6.036, p = 0.012), a decrease in wellbeing (β = −4.494, p = 0.004), digestive comfort (β = −9.940, p &lt; 0.001), physical appearance (β = −4.926, p = 0.027), and disease prevention (β = −5.835, p = 0.043) were all associated with an increase in animal protein patterns.ConclusionThis research indicates that healthy eating habits and patterns positively impact international students’ HRQoL. Therefore, the appropriate authorities should advise students to consume healthy foods regularly to improve their HRQoL.
Accuracy of artificial intelligence model for infectious keratitis classification: a systematic review and meta-analysis
Authors: Sarayar Randy , Lestari Yeni Dwi , Setio Arnaud A. A. , Sitompul Ratna 
Published: November 2023

BackgroundInfectious keratitis (IK) is a sight-threatening condition requiring immediate definite treatment. The need for prompt treatment heavily depends on timely diagnosis. The diagnosis of IK, however, is challenged by the drawbacks of the current “gold standard.” The poorly differentiated clinical features, the possibility of low microbial culture yield, and the duration for culture are the culprits of delayed IK treatment. Deep learning (DL) is a recent artificial intelligence (AI) advancement that has been demonstrated to be highly promising in making automated diagnosis in IK with high accuracy. However, its exact accuracy is not yet elucidated. This article is the first systematic review and meta-analysis that aims to assess the accuracy of available DL models to correctly classify IK based on etiology compared to the current gold standards.MethodsA systematic search was carried out in PubMed, Google Scholars, Proquest, ScienceDirect, Cochrane and Scopus. The used keywords are: “Keratitis,” “Corneal ulcer,” “Corneal diseases,” “Corneal lesions,” “Artificial intelligence,” “Deep learning,” and “Machine learning.” Studies including slit lamp photography of the cornea and validity study on DL performance were considered. The primary outcomes reviewed were the accuracy and classification capability of the AI machine learning/DL algorithm. We analyzed the extracted data with the MetaXL 5.2 Software.ResultsA total of eleven articles from 2002 to 2022 were included with a total dataset of 34,070 images. All studies used convolutional neural networks (CNNs), with ResNet and DenseNet models being the most used models across studies. Most AI models outperform the human counterparts with a pooled area under the curve (AUC) of 0.851 and accuracy of 96.6% in differentiating IK vs. non-IK and pooled AUC 0.895 and accuracy of 64.38% for classifying bacterial keratitis (BK) vs. fungal keratitis (FK).ConclusionThis study demonstrated that DL algorithms have high potential in diagnosing and classifying IK with accuracy that, if not better, is comparable to trained corneal experts. However, various factors, such as the unique architecture of DL model, the problem with overfitting, image quality of the datasets, and the complex nature of IK itself, still hamper the universal applicability of DL in daily clinical practice.