bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of single and combined median nerve stimulation and repetitive transcranial magnetic stimulation in patients with prolonged disorders of consciousness: a prospective, randomized, single-blinded, controlled trial
Authors: Xiong Qi , Le Kai , Tang Yunliang , Ye Wen , Wang Yan , Zhong Yuan , Zhou Yao , Feng Zhen 
Published: April 2023

ObjectiveTo investigate the efficacy of median nerve stimulation (MNS) combined with repetitive transcranial magnetic stimulation (rTMS), MNS alone, and rTMS alone in elevating the level of consciousness in patients with prolonged disorders of consciousness (pDOC).Participants and methodsWe enrolled 75 eligible inpatients suffering from pDOC as a result of traumatic or non-traumatic brain injury. Participants were randomly assigned to one of the following three treatment groups: (1) rTMS+sham-MNS; (2) MNS + sham-rTMS; or (3) MNS + rTMS. The rTMS protocol involved stimulation above the left dorsolateral prefrontal cortex at a 10 Hz frequency and 90% resting motor threshold. The MNS protocol involved the delivery of a 15–20 mA current at the median nerve point 2 cm from the wrist crease of the right distal forearm. The primary outcome was the change from baseline of the Coma Recovery Scale-Revised (CRS-R) score after treatment. Secondary outcomes included post-treatment changes from baseline of the Glasgow Coma Scale (GCS) score, awaken ratio, electroencephalography (EEG) scores, and the latency and amplitude of N20 on somatosensory evoked potentials.ResultsBefore the intervention, there were no significant differences between groups in the CRS-R, GCS scores, age, duration of pDOC, clinical diagnosis, EEG scores, latency and amplitude of N20, sex, job, marital status, education level, or disease etiology. Within the three groups, the total CRS-R, GCS scores and amplitude of N20 on both side significantly increased and latency of N20 on poor side significantly decreased post-intervention. Significantly greater improvement in CRS-R, GCS total scores, amplitude of N20 on both side and latency of N20 on the poor side were observed in the MNS + TMS group compared to those of the groups receiving rTMS alone or MNS alone. The patients receiving TMS and MNS intervention showed a greater EEG activity improvement, and the EEG activity improved ratio significantly differ between groups, while there were no significant differences in the awakening ratios between the three groups.ConclusionThe combination of MNS + rTMS was more efficacious in improving the level of consciousness than MNS alone or rTMS alone in patients with pDOC.
Genetic variations in the retrograde endocannabinoid signaling pathway in Chinese patients with major depressive disorder
Authors: Xu Huifang , Li Tongtong , Gong Qiyong , Xu Haizhen , Hu Yongbo , Lü Wenqi , Yang Xin , Li Jin , Xu Wenming , Kuang Weihong 
Published: April 2023

BackgroundThe retrograde endocannabinoid (eCB) pathway is closely associated with the etiology of major depressive disorder (MDD) at both pathophysiological and genetic levels. This study aimed to investigate the potential role of genetic mutations in the eCB pathway and underlying mechanisms in Han Chinese patients with MDD.MethodsA total of 96 drug-naïve patients with first-episode MDD and 62 healthy controls (HCs) were recruited. Whole-exome sequencing was performed to identify the gene mutation profiles in patients with MDD. Results were filtered to focus on low-frequency variants and rare mutations (minor allele frequencies &lt;0.05) related to depressive phenotypes. Enrichment analyses were performed for 146 selected genes to examine the pathways in which the most significant enrichment occurred. A protein–protein interaction (PPI) network analysis was performed to explore the biological functions of the eCB pathway. Finally, based on current literature, a preliminary analysis was conducted to explore the effect of genetic mutations on the function of this pathway.ResultsOur analysis identified 146 (15.02%) depression-related genetic mutations in patients with MDD when compared with HCs, and 37 of the mutations were enriched in the retrograde eCB signaling pathway. Seven hub genes in the eCB pathway were closely related to mitochondrial function, including Complex I genes (NDUFS4, NDUFV2, NDUFA2, NDUFA12, NDUFB11) and genes associated with protein (PARK7) and enzyme (DLD) function in the regulation of mitochondrial oxidative stress.ConclusionThese results indicate that genetic mutations in the retrograde eCB pathway represent potential etiological factors associated with the pathogenesis of MDD.
Prediction of gastrointestinal cancers in the ONCONUT cohort study: comparison between logistic regression and artificial neural network
Authors: Donghia Rossella , Guerra Vito , Misciagna Giovanni , Loiacono Carmine , Brunetti Antonio , Bevilacqua Vitoantonio 
Published: April 2023

BackgroundArtificial neural networks (ANNs) and logistic regression (LR) are the models of chosen in many medical data classification tasks. Several published articles were based on summarizing the differences and similarities of these models from a technical point of view and critically assessing the quality of the models. The aim of this study was to compare ANN and LR the statistical techniques to predict gastrointestinal cancer in an elderly cohort in Southern Italy (ONCONUT study).MethodIn 1992, ONCONUT was started with the aim of evaluating the relationship between diet and cancer development in a Southern Italian elderly population. Patients with gastrointestinal cancer (ICD-10 from 150.0 to 159.9) were included in the study (n = 3,545).ResultsThis cohort was used to train and test the ANN and LR. LR was evaluated separately for macro- and micronutrients, and the accuracy was evaluated based on true positives and true negatives versus the total (97.15%). Then, ANN was trained and the accuracy was evaluated (96.61% for macronutrients and 97.06% for micronutrients). To further investigate the classification capabilities of ANN, k-fold cross-validation and genetic algorithm (GA) were used after balancing the dataset among classes.ConclusionsBoth LR and ANN had high accuracy and similar performance. Both models had the potential to be used as decision clinical support integrated into clinical practice, because in many circumstances, the use of a simple LR model was likely to be adequate for real-world needs, but in others in which there were large amounts of data, the application of advanced analytic tools such as ANNs could be indicated, and the GA optimizer needed to optimize the accuracy of ANN.
Management of B-cell lineage acute lymphoblastic leukemia: expert opinion from an Indian panel via Delphi consensus method
Authors: Mathews Vikram , Korula Anu , Chakrapani Anupam , Bhurani Dinesh , Bhattacharyya Jina , Sengar Manju , Malhotra Pankaj , Boyella Pavan Kumar , Singh Pawan Kumar , Ganesan Prasanth , Dhawan Rishi , Melinkeri Sameer , Damodar Sharat , Dolai Tuphan Kanti , Radhakrishnan Venkatraman 
Published: April 2023

IntroductionCurrently, there are no guidelines for the management of B-cell lineage acute lymphoblastic leukemia (B-ALL) from an Indian perspective. The diagnostic workup, monitoring, and treatment of B-ALL vary among different physicians and institutes.ObjectiveTo develop evidence-based practical consensus recommendations for the management of B-ALL in Indian settings.MethodsModified Delphi consensus methodology was considered to arrive at a consensus. An expert scientific committee of 15 experts from India constituted the panel. Clinically relevant questions belonging to three major domains were drafted for presentation and discussion: (i) diagnosis and risk assignment; (ii) frontline treatment; and (iii) choice of therapy (optimal vs. real-world practice) in relapsed/refractory (R/R) settings. The questionnaire was shared with the panel members through an online survey platform. The level of consensus was categorized into high (≥ 80%), moderate (60%–79%), and no consensus (&lt; 60%). The process involved 2 rounds of discussion and 3 rounds of Delphi survey. The questions that received near or no consensus were discussed during virtual meetings (Delphi rounds 1 and 2). The final draft of the consensus was emailed to the panel for final review.ResultsExperts recommended morphologic assessment of peripheral blood or bone marrow, flow cytometric immunophenotyping, and conventional cytogenetic analysis in the initial diagnostic workup. Berlin–Frankfurt–Münster (BFM)–based protocol is the preferred frontline therapy in pediatric and adolescent and young adult patients with B-ALL. BFM/German Multicenter Study Group for Adult Acute Lymphoblastic Leukemia–based regimen is suggested in adult patients with B-ALL. Immunotherapy (blinatumomab or inotuzumab ozogamicin) followed by allogeneic hematopoietic cell transplantation (allo-HCT) is the optimal choice of therapy that would yield the best outcomes if offered in the first salvage in patients with R/R B-ALL. In patients with financial constraints or prior allo-HCT (real-world practice) at first relapse, standard-intensive chemotherapy followed by allo-HCT may be considered. For subsequent relapses, chimeric antigen receptor T-cell therapy or palliative care was suggested as the optimal choice of therapy.ConclusionThis expert consensus will offer guidance to oncologists/clinicians on the management of B-ALL in Indian settings.
A phantom for the quantitative determination and improvement of the spatial resolution in slice-selective 2D-FT magnetic resonance micro-imaging and -microscopy based on Deep X-ray Lithography (DXRL)
Authors: Berg Andreas Georg , Börner Martin 
Published: April 2023

Introduction: The most important assessed quality-control (QC) criteria for improvements in high-resolution imaging are represented by the contrast-to-noise-ratio and spatial resolution. Ultra-High-Field (UHF) Magnetic-Resonance-scanners (B ≥ 7 T) for medical research allowed for the improvement in spatial resolution up to the microimaging and nominal microscopy range [pixel-size: ps &lt; (100 μm)2], even in-vivo on humans just recently. Preclinical MRI- and dedicated MR-microscopy (MRM) scanners already allow for microimaging and MRM (1-256 μm) but lack a sensible spatial resolution phantom for QC and performance improvements in hardware, pulse-sequencing and MRprotocols. In most scientific MRI articles, the spatial resolution is characterized by the ps, though this measurement parameter only limits the actual resolution.Methods: Here the Modulation-Transfer-Function (MTF) is used as evaluation concept for the determination of the spatial resolution in MRM using simple intensity profiles. The resolution limit is defined using a critical modulation-level. In approaching visual impressions on spatial resolution an additional criterion derived from the Modulation-depth-to-Noise-Ratio (MNR) is proposed. A practical method for assessment based on a concrete phantom design and its realization is shown.Results: The phantom design consists of several sets of fine grids, specifically featuring high structural anisotropy for optimum SNR and CNR, with different spatial periods ranging from a1 = 256 μm down to a8 = 2 μm, not only for a quick visual qualitative check, but also for quantification of resolution using the MTF for two different spatial encodings in two orthogonal in-plane directions. The challenging demands on the manufacturing technology especially with regard to the aspect-ratio are approached using Deep-X-Ray-Lithography (DXRL) relying on the high brilliance of Synchroton-radiation. Smallest grid plates with width of 4 μm corresponding to 125 line pairs/mm at a plate depth of 100 μm were achieved.Discussion: MR-microscopic images, originating from a microscopy insert on a human UHF-MR-scanner, were used for demonstration of the evaluation process with two independent resolution-criteria. The developed prototype offers unique possibilities for quantitative resolution QC on UHF human and preclinical MR-scanners. Such a resolution-phantom might be very important for the improvement of MR-pulse-sequences, MR-protocols and even hardware. In principle the phantom can also be used for other microscopic imaging-modalities as for instance μCT and Optical-Coherence-Tomography (OCT).
Applying a muscle fatigue model when optimizing load-sharing between muscles for short-duration high-intensity exercise: A preliminary study
Authors: Michaud Florian , Frey-Law Laura A. , Lugrís Urbano , Cuadrado Lucía , Figueroa-Rodríguez Jesús , Cuadrado Javier 
Published: April 2023

Introduction: Multiple different mathematical models have been developed to represent muscle force, to represent multiple muscles in the musculoskeletal system, and to represent muscle fatigue. However, incorporating these different models together to describe the behavior of a high-intensity exercise has not been well described.Methods: In this work, we adapted the three-compartment controller (3CCr) muscle fatigue model to be implemented with an inverse-dynamics based optimization algorithm for the muscle recruitment problem for 7 elbow muscles to model a benchmark case: elbow flexion/extension moments. We highlight the difficulties in achieving an accurate subject-specific approach for this multi-level modeling problem, considering different muscular models, compared with experimental measurements. Both an isometric effort and a dynamic bicep curl were considered, where muscle activity and resting periods were simulated to obtain the fatigue behavior. Muscle parameter correction, scaling and calibration are addressed in this study. Moreover, fiber-type recruitment hierarchy in force generation was added to the optimization problem, thus offering an additional novel muscle modeling criterion.Results: It was observed that: i) the results were most accurate for the static case; ii) insufficient torque was predicted by the model at some time points for the dynamic case, which benefitted from a more precise calibration of muscle parameters; iii) modeling the effects of muscular potentiation may be important; and iv) for this multilevel model approach, the 3CCr model had to be modified to avoid reaching situations of unrealistic constant fatigue in high intensity exercise-resting cycles.Discussion: All the methods yield reasonable estimations, but the complexity of obtaining accurate subject-specific human models is highlighted in this study. The proposed novel muscle modeling and force recruitment criterion, which consider the muscular fiber-type distinction, show interesting preliminary results.
Why do employees actively work overtime? The motivation of employees’ active overtime in China
Authors: Tan Jinke , Zhang Chunsheng , Li Zhengyang 
Published: April 2023

IntroductionPrevious studies have defined “workaholic” effort as “bad effort” while work engagement is defined as “good effort.” Active overtime is a mapping of work effort, but at this stage there is still relatively little exploration of the motivation behind “good effort” in the Chinese context.MethodsThis study explores the reasons that promote employees’ initiative to perform overtime work in Chinese enterprises based on the two-factor theory. The study mainly used data empirical research approaches, including exploratory factor analysis, validation factor analysis, and data modeling. The questionnaire scale was developed based on factors that have been proven to be of high reliability and validity. The data are mainly for employees who are currently employed in Chinese companies.Results and discussionWe received a total of 1741 valid questionnaires, which provided a good database for this study. The results of the study show that both motivational and hygiene factors can positively promote employees’ motivation to intentionally work overtime to a certain extent. Among them, overtime culture, institutional agreement, good physical office environment, career growth, financial rewards, and work challenges can positively promote motivation to work overtime. Work stress can increase the frequency and intensity of overtime work, but negatively promote motivation to work overtime. The study helps to improve enterprise management, optimize work design, and enhance psychological satisfaction.
Effects of a brief mindfulness meditation practice on Pavlovian-to-instrumental transfer in alcohol use disorder – a pilot study
Authors: Rosenthal Annika , Garbusow Maria , Romanczuk-Seiferth Nina , Beck Anne 
Published: April 2023

IntroductionPavlovian conditioned contextual cues have been suggested to modulate instrumental action and might explain maladaptive behavior such as relapse in participants suffering from alcohol use disorder (AUD). Pavlovian-to-Instrumental transfer (PIT) experimentally assesses the magnitude of this context-dependent effect and studies have shown a larger PIT effect in AUD populations. Taken this into account, a reduction of the influence of cues on behavior seems warranted and one approach that could alter such cue reactivity is mindfulness. Mindfulness-based interventions have been shown to be efficient in the treatment of AUD, but underlying mechanisms are yet to be elucidated. Therefore, we aim at investigating the effect of a brief mindful body scan meditation on the magnitude of the PIT effect in AUD subjects and matched controls.MethodsUsing a randomized within-subjects design, we compared the effect of a short audio guided body scan meditation against a control condition (audio of nature sounds) on PIT in healthy (n = 35) and AUD (n = 27) participants.ResultsWe found no differences in PIT effect between healthy and AUD participants as well as between conditions. However, a significant interaction effect points to a decreased PIT effect after body scan meditation in AUD subjects only.DiscussionThese pilot results suggest that AUD might be susceptible to mindfulness-induced changes in PIT, with these findings contributing to entangling the underlying mechanisms of the efficacy of mindfulness-based interventions in AUD. However, further investigation should confirm these preliminary results and the efficacy of mindfulness meditation practice in decreasing the PIT effect.
Cortical hierarchy disorganization in major depressive disorder and its association with suicidality
Authors: Shiwei Lin , Xiaojing Zhang , Yingli Zhang , Shengli Chen , Xiaoshan Lin , Ziyun Xu , Gangqiang Hou , Yingwei Qiu 
Published: April 2023

ObjectivesTo explore the suicide risk-specific disruption of cortical hierarchy in major depressive disorder (MDD) patients with diverse suicide risks.MethodsNinety-two MDD patients with diverse suicide risks and 38 matched controls underwent resting-state functional MRI. Connectome gradient analysis and stepwise functional connectivity (SFC) analysis were used to characterize the suicide risk-specific alterations of cortical hierarchy in MDD patients.ResultsRelative to controls, patients with suicide attempts (SA) had a prominent compression from the sensorimotor system; patients with suicide ideations (SI) had a prominent compression from the higher-level systems; non-suicide patients had a compression from both the sensorimotor system and higher-level systems, although it was less prominent relative to SA and SI patients. SFC analysis further validated this depolarization phenomenon.ConclusionThis study revealed MDD patients had suicide risk-specific disruptions of cortical hierarchy, which advance our understanding of the neuromechanisms of suicidality in MDD patients.
The role of the university in recovering from COVID-19 and preparing for future crises—perspectives and experiences from Sunway University, Malaysia
Authors: Renganathan Elil , Guinto Renzo , Mahmood Jemilah , Lacey-Hall Oliver , Veerakumarasivam Abhi , Poppema Sibrandes 
Published: April 2023

This article is part of the Research Topic ‘Health Systems Recovery in the Context of COVID-19 and Protracted Conflict’.Universities, as engines of knowledge creation and dissemination and as incubators of disciplined yet original thinking, have a key role to play in tackling the most complex challenges that societies and our planet face, from infectious diseases to the climate emergency. This commentary presents the perspectives from Sunway University, a young private university in Malaysia that made a strong commitment to the sustainable development goals (SDGs) prior to the pandemic, and its experiences in promoting research, innovation, and learning as part of COVID-19 recovery and in preparation for future crises such as the climate emergency. Some of the university’s initiatives include embracing the planetary health approach, reviving essential public health functions, exploring pandemic resilience, addressing ‘infodemics’ and promoting science diplomacy. The example of Sunway University provides some insights on the opportunities and challenges that academic institutions face as they seek to reorient the paradigm of education, research, and service away from disciplinary siloes and towards a more integrated, preventive, accessible and translational approach.
A call to create evidence-based mental health promotion interventions for youth that are equitable across ethnic/racial subgroups: Advocates 4-ALL Youth
Authors: Kaar Jill L. , Bowen Anne E. , Simon Stacey L. , Dadematthews Adefunke , Chandrasekhar Jessica L. , Musci Rashelle , Pangelinan Melissa 
Published: April 2023

BackgroundAdolescents from historically racial and ethnic minoritized and low-income communities have higher rates of early-life and chronic difficulties with anxiety and depression compared to non-Hispanic White youth. With mental health distress exacerbated during and in the wake of the COVID-19 pandemic, there is a need for accessible, equitable evidence-based programs that promote psychological well-being, strengthen one’s ability to adapt to adversity, and build self-efficacy prior to adolescence.MethodsAn evidenced-based resiliency-focused health coaching intervention was adapted using a health equity implementation framework to meet the needs of a Title I elementary school in rural Alabama (AL) that serves over 80% Black and Hispanic students. To ensure that the program met local community needs while maintaining core program educational activities, all adaptations were documented utilizing a standard coding system.ResultsLeveraging an existing academic-community partnership with Auburn University and a local AL school district, a new program, Advocates 4-All Youth (ALLY), was created. Three major adaptations were required: (1) the use of local community volunteers (ALLYs) to deliver the program versus health coaches, (2) the modification of program materials to meet the challenge of varying levels of general and health-related literacy, and (3) the integration of the Empower Action Model to target protective factors in a culturally-tailored delivery to ensure key program outcomes are found equitable for all students.ConclusionWith continued increases in youth mental health distress, there is a need for the development of universal primary prevention interventions to promote mental well-being and to strengthen protective factors among youth from historically disadvantaged backgrounds. ALLY was created to meet these needs and may be an effective strategy if deemed efficacious in improving program outcomes.