bluuebunny/crossref_metadata_2025_split huggingface dataset:
Social determinants of financial stress and association with psychological distress among young adults 18–26 years in the United States
Authors: Nasir Anaiya , Javed Umair , Hagan Kobina , Chang Ryan , Kundi Harun , Amin Zahir , Butt Sara , Al-Kindi Sadeer , Javed Zulqarnain 
Published: January 2025

IntroductionFinancial stress (FS) during young adulthood may have lasting effects on financial security, physical health, and overall wellbeing. This study examines the burden, social determinants and mental health consequences of experienced FS among young adults in the United States, based on objective measures of financial stress.MethodsWe studied young adults aged 18–26 years using pooled data from the 2013–18 National Health Interview Survey. FS was assessed as an aggregate score (6–24) based on worry about six life tasks: paying for: monthly bills, housing expenses, healthcare, illness/accident, maintaining standard of living, saving money for retirement. Individuals in the highest quartile of the score were defined as having high FS. Psychological distress (PD) was measured using the six-item Kessler Psychological Distress Scale (K6); high PD was defined as total K6 score ≥13. Multivariable ordinal and logistic regression models were used to assess key social determinants of FS and the association between FS and PD, respectively.ResultsStudy sample included 19,821 individuals aged 18–26 years (34 million annualized). Overall, 17% (5.8 million nationally) of young adults reported high FS. Female, non-Hispanic Black and Hispanic, low income/low education, uninsured, non-citizen and comorbidities were associated with high FS burden. In fully adjusted models, high FS was associated with over 6-fold (OR = 6.17, 95% CI 4.43–8.61) higher risk of high PD.DiscussionOne in six young adults in the US experiences high FS, which portends high risk of PD. These findings should inform stakeholder deliberations to identify and mitigate the unintended mental health consequences of FS in this vulnerable population.
Work conditions and determinants of health status among industrial shift workers: a cross-sectional study
Authors: Javanmardi Sasha , Rappelt Ludwig , Baumgart Christian , Niederer Daniel , Heinke Lars , Freiwald Jürgen 
Published: January 2025

IntroductionThis study investigated potential health status differences among forging, manufacturing, and logistics workers.MethodsWe included 403 participants (age: 41 ± 12 years) from a medium-sized steel company (forge: 64, manufacturing: 299, logistics: 99). Health status was multifactorial assessed: (1) Frequency of musculoskeletal complaints (German Pain Questionnaire). (2) Pain intensity, physical and psychological load [visual analog scales (VAS) 0–100 points]. (3) Occupational moderate-to-vigorous physical activity (MVPA), total MVPA, and sedentary behavior [Global Physical Activity Questionnaire (GPAQ)]. (4) Quality of life [Short Form Health Survey (SF-36)]. Between-group effects were analyzed via one-way ANOVAs with post-hoc Tukey correction.Results308 workers (76.4%) reported at least one musculoskeletal issue. A significant between-group difference was revealed for left shoulder [F(2,40) = 5.40; p = 0.008; ω2 = 0.17], occupational MVPA [F(2,368) = 9.49; p &lt; 0.001; ω2 = 0.04] and total MVPA [F(2,368) = 6.90; p = 0.001; ω2 = 0.03]. Post-hoc tests revealed a difference (p ≤ 0.007) between manufacturing (left shoulder: n = 22; 42.5 ± 24.8; occupational MVPA: n = 219; 6,978 ± 5,137 METs min/week; total MVPA: n = 219; 8,471 ± 5,390 METs min/week) and logistics workers (left shoulder: n = 14; 70.4 ± 26.3 au; occupational MVPA: n = 96; 9,640 ± 4,605 METs min/week; total MVPA: n = 96; 10,856 ± 4,680 METs min/week). No other between-group differences were observed.DiscussionVariations in health disparities across work conditions were observed. Yet, clear distinctions between work conditions and health outcomes remain a challenge. Effective interventions should be focused on job-specific and personalized health profiles rather than a stratification of work conditions to enhance health, productivity, and workforce sustainability.
Does urban–rural integration contribute to environmental health? Exploring the interplay between urban–rural integration and air quality dynamics in Yangtze River middle reaches city cluster
Authors: Yang Jixin , Fu Bowen , Cui Xufeng 
Published: January 2025

BackgroundExploring the coordinated relationship between urban–rural integration and air quality has significant implications for promoting urban–rural development, preventing air pollution and ensuring residents’ health. This study takes Yangtze River middle reaches city cluster as a case study, calculates the levels of urban–rural integration and air quality development, analyzes their coupled coordination relationship and driving factors, and explores the path of coordinated development.MethodsThis study constructs a coupling coordination degree model to analyze the relationship between the urban–rural integration development level and air quality development level. We use the trend surface method to analyze the spatial divergence characteristics of the coordination degree between urban–rural integration and air quality. In addition, we used a geographic detector to analyze the factors affecting the coordination degree.Results(1) The overall level of urban–rural integration development showed an upward trend. High-value regions were concentrated in the Wuhan, Chang-Zhu-Tan, and Nanchang metropolitan areas. (2) The Air Quality Index showed an overall decline, with the most significant improvements observed in Wuhan, Changsha, and Jiujiang. (3) The coupling degree increased from 0.570 in 2013 to 0.794 in 2021, and the coordination degree increased from 0.337 in 2013 to 0.591 in 2021. The link between urban–rural integration and air quality has deepened over time, and the two promote each other, making city cluster develop towards environmental friendliness. The spatial distribution of coordination degree shows a “high in the west and low in the east, high in the north and low in the south” trend. (4) Per capita GDP, non-agricultural employment ratio, urban–rural spatial circulation media, population urbanization level, and fixed asset investment were identified as the core factors driving the coordination degree between urban–rural integration and air quality.ConclusionThis study confirms that the urban–rural integration and air quality of Yangtze River middle reaches city cluster are gradually changing in the direction of high-quality coordination. However, there are great differences among cities, regional imbalance is prominent, and coordination degree is driven by multidimensional factors.
Development of a statewide network hub for screening, referral, and enrollment into food as medicine programs across Kentucky
Authors: Mayfield Christa , Lauckner Carolyn , Bush Joshua , Cosson Ethan , Batey Lauren , Gustafson Alison 
Published: January 2025

Widespread recognition of food as medicine interventions’ role in reducing food insecurity and improving health outcomes has recently emerged. Several states have released In Lieu of Services, state-approved alternative services that may be offered by managed care organizations in place of covered benefits, or 1,115 Medicaid waivers, which may allow for expanded nutrition services to reduce food insecurity and improve health outcomes. However, there are significant gaps in understanding how to create a statewide system for delivering “healthcare by food” interventions. The University of Kentucky Food as Health Alliance first piloted the development of a statewide hub facilitating referral to, enrollment in, and evaluation of food as medicine programs across two healthcare providers (one urban and one rural). We then used a quasi experimental study design to examine effects on systolic and diastolic blood pressure in a target population of Medicaid eligible individuals aged 18–64 with high blood pressure and/or type 2 diabetes in rural and urban areas. Participant allocation was based on geographic location for each program arm with no control group. This feasibility case study aims to: (1) outline the development of a referral system between healthcare and food as medicine providers; (2) describe gaps in referral and enrollment; (3) summarize lessons learned from a statewide network as a blueprint for other states; and (4) present clinical outcomes across three food as medicine programs. Ninety-two referrals were received from UK HealthCare with 21 enrolled in medically tailored meals and 28 enrolled in a grocery prescription (53% enrollment rate). Thirty-two referrals were received from Appalachian Regional Healthcare with 26 enrolled in meal kits (81% enrollment rate). On average, the reduction in systolic blood pressure was 9.67 mmHg among medically tailored meals participants and 6.89 mmHg among grocery prescription participants. Creating a statewide system to address food insecurity and clinical outcomes requires key support from a host of stakeholders. Policy steps moving forward need to consider funding and infrastructure for screening, referral, enrollment and engagement hubs for improved health outcomes.Clinical trial registrationClinicalTrials.gov, NCT06033664.
Traditional Chinese medicine trade among RCEP countries: structural characteristics and determinants
Authors: Fang Yue , Tang Meng Xue , Liu Xu 
Published: January 2025

BackgroundWith the increasing global focus on health and the growing popularity of natural therapies, Traditional Chinese Medicine (TCM) products, including extracts, crude drugs, and herbal preparations, are widely utilized as both primary and complementary medicines worldwide. The Regional Comprehensive Economic Partnership (RCEP), spanning 15 countries across East Asia, Southeast Asia, and Oceania, offers a vast market for TCM. However, limited research has been conducted on the complex trade relations among RCEP members.MethodsThe structural features and nodes attributes are analyzed using Social Network Analysis (SNA). Influencing factors are studied through the Quadratic Assignment Procedure (QAP) model. We also compiled a list of medicinal plants among RCEP member countries and the main TCM export products.ResultsThe scale of TCM trade among RCEP members has fluctuated over time, with a temporary spike during the COVID-19 pandemic, followed by a gradual normalization. The trade network does not exhibit small-world properties, indicating a relatively balanced trade relationship. Due to its resource advantages, China occupies a central role acting as a dominant producer and leading exporter. Vietnam’s export performance has been excellent in recent years, with the highest annual growth rate. Emerging markets, such as Myanmar, warrant closer attention. Economic size and population significantly positively affect trade value, while geographic distance and land adjacency have no significant impact. Trade activity is positively influenced by cultural and linguistic similarities, and countries with higher levels of economic freedom tend to engage in more trade. Tonifying TCM products with antioxidant and immune-boosting properties are more widely recognized in international markets.ConclusionRCEP has established an excellent trade platform for the export of TCM. The factors influencing TCM trade are predominantly long-term and structural, rather than being driven by the occurrence of any single, isolated event. Member states should strengthen collaboration in standardization, technology coordination, and knowledge sharing to establish a mutually beneficial trade ecosystem for TCM.
Preliminary study on the correlation between thyroid magnetic resonance parameters and radiation dose after radiotherapy for nasopharyngeal carcinoma
Authors: Lu Kuan , Zhou Chenxia , Ren Jiaming , Ni Jialu , Yang Weisen , Wang Yeqing , Jin Dan , Qian Jianjun , Zhu Yaqun , Shi Dai , Hu Wentao , Xu Liang 
Published: January 2025

BackgroundHypothyroidism is a common sequela after radiotherapy for nasopharyngeal carcinoma (NPC). Magnetic resonance imaging (MRI) has gained prominence in thyroid imaging, leveraging its non-ionizing radiation, high spatial resolution, multiparameter and multidirectional imaging. Few previous studies have investigated the evaluation of radiation-induced thyroid injury by MRI.MethodsMRI and radiotherapy data of 32 patients who were first diagnosed with nasopharyngeal carcinoma in our hospital from April 2015 to April 2024 and underwent radiotherapy in the radiotherapy department were retrospectively collected. Before, during and after radiotherapy, the thyroid morphology was observed on MR images, and the quantitative parameters of size (width, thickness) were measured on T1-weighted images. The signal intensity (SI) of the thyroid gland was measured on T1-weighted imaging (T1WI), T2-weighted imaging (T2WI) and contrast-enhanced T1-weighted imaging. The differences in thyroid parameters at different time points before and after radiotherapy were compared. The correlation between the MRI quantitative parameters of the thyroid and the radiation dose volume of the thyroid and the radiation dose of the pituitary were analyzed.ResultsThe width, thickness and volume of the thyroid decreased gradually before, during and 6 and 12 months after radiotherapy. They were negatively correlated with the mean thyroid dose and V50 (p &lt; 0.05), but were not significantly correlated with the maximum and minimum thyroid doses, V30 and V35 (p &gt; 0.05). The T1WI relative signal intensity (RSI), T2WI RSI, and enhanced T1WI RSI of the thyroid gland gradually decreased from before radiotherapy to during radiotherapy and 6 months and 12 months after radiotherapy. The T1WI RSI, T2WI RSI, and enhanced T1WI RSI during radiotherapy and 6 months and 12 months after radiotherapy were negatively correlated with the mean radiation dose, V40, V45, and V50 of the thyroid gland (p &lt; 0.05), but were not significantly correlated with the maximum radiation dose, minimum radiation dose, V30, and V35 of the thyroid gland or the radiation dose of the pituitary gland (p &gt; 0.05).ConclusionQuantitative MRI analysis can non-invasively and effectively show the changes in thyroid shape, size and signal intensity in patients with nasopharyngeal carcinoma before and after radiotherapy, which is crucial for early and accurate assessment of thyroid damage, enabling timely treatment to preserve thyroid function.
Grammar-constrained decoding for structured information extraction with fine-tuned generative models applied to clinical trial abstracts
Authors: Schmidt David M. , Cimiano Philipp 
Published: January 2025

BackgroundIn the field of structured information extraction, there are typically semantic and syntactic constraints on the output of information extraction (IE) systems. These constraints, however, can typically not be guaranteed using standard (fine-tuned) encoder-decoder architectures. This has led to the development of constrained decoding approaches which allow, e.g., to specify constraints in form of context-free grammars. An open question is in how far an IE system can be effectively guided by a domain-specific grammar to ensure that the output structures follow the requirements of a certain domain data model.MethodsIn this work we experimentally investigate the influence of grammar-constrained decoding as well as pointer generators on the performance of a domain-specific information extraction system. For this, we consider fine-tuned encoder-decoder models, Longformer and Flan-T5 in particular, and experimentally investigate whether the addition of grammar-constrained decoding and pointer generators improve information extraction results. Toward this goal, we consider the task of inducing structured representations from abstracts describing clinical trials, relying on the C-TrO ontology to semantically describe the clinical trials and their results. We frame the task as a slot filling problem where certain slots of templates need to be filled with token sequences occurring in the input text. We use a dataset comprising 211 annotated clinical trial abstracts about type 2 diabetes and glaucoma for training and evaluation. Our focus is on settings in which the available training data is in the order of a few hundred training examples, which we consider as a low-resource setting.ResultsIn all our experiments we could demonstrate the positive impact of grammar-constrained decoding, with an increase in F1 score of pp 0.351 (absolute score 0.413) and pp 0.425 (absolute score 0.47) for the best-performing models on type 2 diabetes and glaucoma datasets, respectively. The addition of the pointer generators had a detrimental impact on the results, decreasing F1 scores by pp 0.15 (absolute score 0.263) and pp 0.198 (absolute score 0.272) for the best-performing pointer generator models on type 2 diabetes and glaucoma datasets, respectively.ConclusionThe experimental results indicate that encoder-decoder models used for structure prediction for information extraction tasks in low-resource settings clearly benefit from grammar-constrained decoding guiding the output generation. In contrast, the evaluated pointer generator models decreased the performance drastically in some cases. Moreover, the performance of the pointer models appears to depend both on the used base model as well as the function used for aggregating the attention values. How the size of large language models affects the performance benefit of grammar-constrained decoding remains to be more structurally investigated in future work.
Robust predictive framework for diabetes classification using optimized machine learning on imbalanced datasets
Authors: Abousaber Inam , Abdallah Haitham F. , El-Ghaish Hany 
Published: January 2025

IntroductionDiabetes prediction using clinical datasets is crucial for medical data analysis. However, class imbalances, where non-diabetic cases dominate, can significantly affect machine learning model performance, leading to biased predictions and reduced generalization.MethodsA novel predictive framework employing cutting-edge machine learning algorithms and advanced imbalance handling techniques was developed. The framework integrates feature engineering and resampling strategies to enhance predictive accuracy.ResultsRigorous testing was conducted on three datasets—PIMA, Diabetes Dataset 2019, and BIT_2019—demonstrating the robustness and adaptability of the methodology across varying data environments.DiscussionThe experimental results highlight the critical role of model selection and imbalance mitigation in achieving reliable and generalizable diabetes predictions. This study offers significant contributions to medical informatics by proposing a robust data-driven framework that addresses class imbalance challenges, thereby advancing diabetes prediction accuracy.
Evaluation of positions of four lingula shapes for mandibular ramus surgery
Authors: Hsu Kun-Jung , Chen Pei-Jung , Chen Han-Sheng , Lee Kun-Tsung , Chen Chun-Ming 
Published: January 2025

BackgroundThe lingula is an important landmark for conducting certain mandibular surgery procedures, such as sagittal split ramus osteotomy (SSRO) and intraoral vertical ramus osteotomy (IVRO). The purpose of this study was to investigate the location of the lingula in both horizontal and vertical planes among four different shapes of the mandibular ramus.MethodsNinety patients, 60 female and 30 male, underwent cone beam computed tomography scans to evaluate the measurements of the lingula tip (Li) in relation to the anterior border (AB), posterior border (PB), sigmoid notch (SN), and inferior border (IB) of the ramus. The proportional relationship of the Li in both the horizontal and vertical planes is indicated by the Li–AB/AB–PB ratio and Li–SN/SN–IB. lingula shapes were categorized into triangular, truncated, nodular, and assimilated shapes. Statistical analyses were performed to compare the variations in the measurements between different shapes of lingula and genders.ResultsThe mean Li–AB distance was 18.88 mm, and it was determined to be significantly greater with the truncated shape when compared to the other three shapes. The mean Li–PB distance was 15.23 mm, with no significant differences observed among the four shapes. The mean Li–AB/AB–PB ratio was found to be 55.3%. The truncated shape had a ratio of 57.2%, which was significantly higher compared to the nodular shape (54%) and assimilated shape (50.4%). The mean distance was 19.95 mm for the Li–SN and 31.34 mm for the Li–IB. There was no significant difference in these distances among the 4 lingula shapes. The mean Li–SN/SN–IB ratio was 38.5%. There were no significant differences in measurements between male and female.ConclusionSignificant differences were observed in the 4 lingula shapes in relation to the Li position, which was situated superiorly and posteriorly to the central point of the ramus. Therefore, it is crucial to take into account the differences in lingula shapes during SSRO and IVRO procedures on the ramus.
Factors influencing salivary lactate dehydrogenase levels in oral squamous cell carcinoma and oral potentially malignant disorders
Authors: López-Pintor Rosa María , González-Serrano José , Vallina Carmen , Ivaylova Serkedzhieva Katerina , Virto Leire , Nuevo Paula , Caponio Vito Carlo Alberto , Iniesta Margarita , Rodríguez Santamarta Tania , Lequerica Fernández Paloma , Iglesias Velázquez Óscar , Hernández Gonzalo , de Vicente Juan Carlos 
Published: January 2025

IntroductionSalivary Lactate Dehydrogenase (sLDH) levels seem to be higher in patients with Oral Squamous Cell Carcinoma (OSCC) and Oral Potentially Malignant Disorders (OPMD) than a control group (CG).MethodsCase-control study. Patients with OPMD [oral leukoplakia (OL) and oral lichen planus (OLP)] and OSCC who attended two services in Spain were selected. sLDH in saliva was measured. Epidemiological, periodontal and specific variables related to OPMD and OSCC were collected.ResultsA total of 92 patients were included: 12 with OSCC, 51 with OPMD (17 OL and 34 OLP), and 29 controls. sLDH values were higher in the OSCC, followed by the OPMD and CG groups, although no significant differences were observed. In the OSCC group, larger tumor size was associated with higher sLDH levels. In the OLP group, sLDH values were higher in patients with symptomatic lesions than in patients with only white lesions, but not significantly. No associations were observed between sLDH and the type of OL (homogeneous vs. non-homogeneous) and the degree of dysplasia. When analyzing periodontal variables among OSCC, OPMD and CG, periodontal probing depth (PPD) and bleeding on probing were significantly higher in the OSCC group, while the plaque index was higher in OPMD patients. The linear regression model for sLDH in the total group identified age and PPD as significant predictors of sLDH levels.DiscussionAlthough sLDH values were higher in OSCC and OPMD patients than in a CG, the results do not support the use of sLDH as a reliable prognostic biomarker of malignancy. Future studies need to consider other factors that may influence sLDH levels, such as age and periodontal status.