bluuebunny/crossref_metadata_2025_split huggingface dataset:
Associations of night eating with body mass index and waist circumference among health sciences students living in a post-conflict region
Authors: Aleksic Vojkan , Gazibara Tatjana , Jeremic Biljana , Kulic Ljiljana , Dotlic Jelena , Stevanovic Jasmina , Milovanovic Vesna , Milic Marija 
Published: January 2025

Background Stressors associated with the ongoing ethnic tensions may be the drivers of more frequent night eating, and subsequently, a higher body mass index. Aim To examine the association of night eating with body mass index (BMI) and waist circumference among health sciences students in Northern Kosovo. Methods A cross-sectional study was carried out at the University of Prishtina in Kosovska Mitrovica from November 2018 to March 2019. Participants completed a socio-demographic questionnaire, the Night Eating Questionnaire (NEQ), the Beck's Anxiety Inventory (BAI) and the Perceived Stress Scale (PSS). Body weight, height, and waist circumference were measured by the research team. Results The study sample consisted of 534 students. The night eating score was 14.4 ± 4.5 out of 52 (prevalence of night eating syndrome was 3.0%). Overall, the average BMI was 23.7 ± 4.5 kg/m2 (27.2% of students were overweight and 7.5% were obese). Moderate level of stress as measured by the PSS was observed 61.8% and high level of stress was recorded among 5.8%. Also, 9.2% students reported moderate BAI score and 6.0% students reported severe BAI score. After adjustment for socio-demographic characteristics, health behaviors, sleep, stress and anxiety levels, no association of night eating with BMI and waist circumference was observed. Conclusion These findings showed that there is an absence of the association between night eating, BMI and waist circumference among students who live in a post-conflict setting. There may be other factors that mediate the relationship between food intake at night and body mass index.
Unlocking the secrets: How well do nutrition and dietetics students understand diabulimia and health literacy?
Authors: Çelik Zehra Margot , Bayram Hatice Merve 
Published: January 2025

Background Despite the significant health risks associated with it, diabulimia, which involves the omission of insulin for the purpose of weight control in individuals with type 1 diabetes, remains underrecognized. Aim This study assessed diabulimia knowledge in third- and fourth-year nutrition and dietetics students and its relationship with health literacy. Methods This cross-sectional study included 231 students (90.5% female) in the third (38.5%) and fourth (61.5%) years of the Nutrition and Dietetics Departments at two universities and was carried out between June and July 2024. A questionnaire covering demographic characteristics, Diabulimia Knowledge Level Scale (DKLS) and Turkish Health Literacy Scale (THLS-32) was administered to the students in person. Data analysis was performed using SPSS 28.0. Results DKLS scores of third-year students were lower than those of the fourth-year students ( p = 0.014). Similarly, THLS-32 scores were higher in fourth-year students ( p = 0.012). However, there was no statistical significance in DKLS, THLS-32 scores and THLS-32 classification between the universities ( p = 0.307, p = 0.137, and p = 0.491, respectively). No relationship between age, DKLS and THLS-32 was found. Conclusion Fourth-year students demonstrated higher diabulimia knowledge and health literacy scores, highlighting the impact of advanced education. However, no differences were found between the universities. These findings underscore the need for further research to explore the factors contributing to knowledge and health literacy development, including curriculum design, teaching methods, and clinical training. Additionally, expanding this investigation to include other healthcare professionals could provide a broader perspective of existing gaps in diabulimia awareness and health literacy.
An effective COVID-19 classification in X-ray images using a new deep learning framework
Authors: Thilagavathi P. , Geetha R. , Jothi Shri S. , Somasundaram K. 
Published: January 2025

Background The global concern regarding the diagnosis of lung-related diseases has intensified due to the rapid transmission of coronavirus disease 2019 (COVID-19). Artificial Intelligence (AI) based methods are emerging technologies that help to identify COVID-19 in chest X-ray images quickly. Method In this study, the publically accessible database COVID-19 Chest X-ray is used to diagnose lung-related disorders using a hybrid deep-learning approach. This dataset is pre-processed using an Improved Anisotropic Diffusion Filtering (IADF) method. After that, the features extraction methods named Grey-level Co-occurrence Matrix (GLCM), uniform Local Binary Pattern (uLBP), Histogram of Gradients (HoG), and Horizontal-vertical neighbourhood local binary pattern (hvnLBP) are utilized to extract the useful features from the pre-processed dataset. The dimensionality of a feature set is subsequently reduced through the utilization of an Adaptive Reptile Search Optimization (ARSO) algorithm, which optimally selects the features for flawless classification. Finally, the hybrid deep learning algorithm, Multi-head Attention-based Bi-directional Gated Recurrent unit with Deep Sparse Auto-encoder Network (MhA-Bi-GRU with DSAN), is developed to perform the multiclass classification problem. Moreover, a Dynamic Levy-Flight Chimp Optimization (DLF-CO) algorithm is applied to minimize the loss function in the hybrid algorithm. Results The whole simulation is performed using the Python language in which the 0.001 learning rate accomplishes the proposed method's higher classification accuracy of 0.95%, and 0.98% is obtained for a 0.0001 learning rate. Overall, the performance of the proposed methodology outperforms all existing methods employing different performance parameters. Conclusion The proposed hybrid deep-learning approach with various feature extraction, and optimal feature selection effectively diagnoses disease using Chest X-ray images demonstrated through classification accuracy.
Diagnostic accuracy of combined screening algorithm for early detection of congenital heart disease among term newborns in India
Authors: Rajani Hassan S. , Narayanappa Doddaiah 
Published: January 2025

Objective To determine the validity of a screening algorithm based on combination of clinical examination and pulse oximetry, for early detection of congenital heart disease (CHD) in term newborns. CHD is the most frequent major congenital anomaly, with prevalence of 6–12 per 1000 live births. Clinical examination alone may fail to detect CHD in more than 50% of affected newborns. Recent studies have concluded that pulse oximetry has a high sensitivity and specificity as a screening tool for critical CHD. Setting JSS Hospital, Mysuru, Karnataka, India. Methods In this prospective observational study, all term neonates delivered at the hospital were included. The screening algorithm consisted of seven clinical parameters and pulse oximetry screening guidelines recommended by the American Academy of Paediatrics. Term newborns with the presence of any one of the above parameters in the algorithm were considered screen-positive. Echocardiography was done in all screen positives. Newborns were classified into those with and without CHD, based on echocardiography findings at birth and clinical examination and echocardiography findings at follow-up at 6 weeks. Results Among 1009 term neonates included in the study, CHD was detected in 57 (5.6%) with cyanotic CHD in 12. The sensitivity and specificity of combined screening to detect CHD was 71.93% and 95.8%, respectively. The positive predictive value was 50.62% and the negative predictive value was 98.28%. Conclusion Screening for CHD with a simple comprehensive algorithm, integrating clinical evaluation and pulse oximetry, has moderate sensitivity and high specificity in detecting CHD in term newborns. Further work is needed to evaluate this form of screening.
Recent policy recommendations won’t protect young people from alcohol-related content on social media: what needs to change?
Authors: Patsouras Maree , Kuntsche Emmanuel , Pennay Amy , O’Brien Paula , Riordan Benjamin 
Published: January 2025

Objective: The federal Australian government has introduced legislation to require social media platforms to restrict access to their platforms for young people under 16 years of age. Amongst the conversations about protecting the health and wellbeing of young people, we have yet to see discussion on the impact of alcohol imagery as a pervasive ‘unhealthy’ industry on social media. This is problematic because young people consume a large amount of social media content and are exposed to glamorised alcohol depictions and targeted advertising. Conclusions: According to current regulations, the sponsoring of social media posts by alcohol companies should be declared, but enforcement of these requirements is challenging and most alcohol posts (whether sponsored or not) tend to glorify alcohol use. Better regulation, but not necessarily a social media ban, is needed to protect young viewers from pervasive alcohol exposure on social media.
Fluoxetine and fractures after stroke: an individual patient data meta-analysis of three large randomised controlled trials of fluoxetine for stroke recovery
Authors: Mead Gillian Elizabeth , Graham Catriona , Lundström Erik , Hankey Graeme J , Hackett Maree L , Billot Laurent , Näsman Per , Forbes John , Dennis Martin 
Published: January 2025

Background Observational studies have shown that selective serotonin reuptake inhibitors are associated with an increased risk of bone fractures, but the association can be confounded by indication and other sources of systematic bias that can be minimised in randomised controlled trials (RCTs). Aim Our aim was to report the rate, site, context, and predictors of fractures after stroke, and whether the fractures modified the effect of fluoxetine on modified Rankin score (mRS) at six months in an individual patient data meta-analysis of 5907 patients enrolled in three RCTs of fluoxetine (20mg for six months) for stroke recovery. Methods We classified fractures by treatment allocation, site (and thus likelihood of osteoporosis) and context, then performed multivariable analyses to explore independent predictors of fractures. We explored whether the trend towards a poorer mRS at 6 months was explained by a fracture excess. Risk of bias was assessed using GRADE. Results Among 5907 patients randomised at a mean of 6.6 days (SD3.6) post-stroke onset and followed for six months, the number with fractures at 6 months was 93 (3.15%) in the fluoxetine group vs 41 (1.39%) in the control group (difference 1.76%, 95% CI 0.10 to 2.51%). 128 patients with fractures were suitable for further analyses. Of these 102 (80%) were in sites typically affected by osteoporosis; 115 (90%) were associated with falls and one (1%) with a seizure. Independent fracture risk factors were female sex (hazard ratio (HR) 1.96; 95% CI 1.37 to 2.81, p=0.0002), age>70 years (HR 2.30, 95% CI 1.52 to 3.49, p<0.001), previous fractures (HR 0.63 for no previous fractures, 95% CI 0.42 to 0.94, p=0.0227), and randomised treatment (fluoxetine) (HR 2.39; 95% CI 1.64 to 3.49, p<0.001). The common odds ratio for the effect of fluoxetine on mRS at 6 months was unchanged after excluding fracture patients. Risk of bias was high for imprecision. Conclusion Fractures were more common in the fluoxetine group but the absolute risk of fractures was small and risk estimates were imprecise. Most fractures occurred with a fall, and in osteoporotic locations. Fractures did not modify the effect of fluoxetine on functional outcome.
Factors associated with individual-level changes in BMI as a result of COVID-19 in the general- and migrant-origin populations in Finland
Authors: Prinkey T. , Lundqvist A. , García Velázquez R. , Lilja E. , Skogberg N. 
Published: January 2025

Aims There is limited information on changes in body mass index (BMI) due to the COVID-19 pandemic among persons of migrant origin. The aim of the present study was to examine factors associated with changes in BMI among the general- and migrant-origin populations in Finland. Methods Longitudinal data to explore individual-level changes in self-reported BMI among migrant-origin persons ( N = 3313) were obtained from the FinMonik Survey conducted in 2018 and the MigCOVID Survey conducted 2020–2021. Data for the general population reference group were obtained from the FinHealth 2017 Study conducted 2017–2018 and its follow-up conducted in 2020 ( N = 2982). Logistic regression was applied to examine whether age, sex, education, economic activity, length of residence in Finland, language skills, smoking, alcohol usage, sleep, physical activity, snacking, and fruit and vegetable consumption were associated with an increase or decrease in BMI. A change in BMI was defined as a 5% or greater increase or decrease. Results Twenty-seven per cent of the migrant-origin population experienced an increase in BMI, while 14% had a decrease in BMI. These results corresponded to figures observed among the general population in Finland (27% and 14%). Persons of migrant origin who were other than students or employed faced greater odds of an increase in BMI of at least 5% (OR = 1.71). In the general population, an increase in BMI of at least 5% had greater odds of occurring among women (OR = 1.61), those who were other than students or employed (OR = 1.68), those who increased their alcohol intake (OR = 1.64), those who increased their snacking (OR = 1.40) and decreased their fruit and vegetable intake (OR = 1.85). Conclusions Most examined factors applied differently to general- and migrant-origin populations and by migrant-origin group. These differences must be considered when planning future public health promotion efforts, particularly those during crisis situations.
Preoperative Risk Assessment for Lumbar Fusion in Patients With Diabetes: Data-Driven Stratification of HbA1c and Same Day Glucose Levels that Predict 90-Day Complication Rates
Authors: Farnham Chloe , Liu Ivan Z. , Agarwal Amil R. , Parel Philip , Quan Theodore , Durand Wesley M. , Raad Michael , Jain Amit 
Published: January 2025

Study Designs Retrospective Database Analysis. Objectives Pre-operative glycemic control in diabetic patients undergoing lumbar fusion (LF) is essential for evaluating complication risk. However, current thresholds for preoperative HbA1c and same-day-glucose (SDG) are either non-specific or have low predictive power. This study uses HbA1c and SDG to provide data-driven risk stratification for 90-day major and wound complications in LF patients. Methods Using a national database, patients undergoing LF from 2013-2022 with a recorded preoperative HbA1c and SDG level were included for analysis. Multiple HbA1c and SDG strata were identified using stratum specific likelihood ratio analysis (SSLR). Each stratum was then propensity-score matched to the lowest strata and compared using risk ratios. Significance level was set at a P-value <0.05. Results 12,026 patients met inclusion criteria. For 90-day major complications, SSLR identified 3 predictive HbA1c (4.5-5.4, 5.5-7.9, and 8.0+) and SDG strata (60-159, 160-239, and 240+). Following propensity-matching, the 90-day major complication risk sequentially increased for HbA1c: 5.5-7.9 (1.69; P = 0.001; 95% CI 1.24-2.30), 8.0+(2.31; P < 0.001; 95% CI 1.56-3.43). Following propensity-matching, the SDG strata similarly demonstrated sequentially increasing 90-day major complication risk: 160-239 (1.34; P < 0.001; 95% CI 1.18-1.54), 240+ (1.64; P < 0.001; 95% CI 1.31-2.05). Matched analysis demonstrated a higher relative-risk of 90-day wound complications for the 8.0+ HbA1c strata (2.23; P = 0.001; 95% CI 1.37-3.63) compared to the HbA1c 4.5-5.4 strata. No other strata were identified that predicted differences in 90-day wound complications. Conclusions This study identified data-driven HbA1c and SDG strata that better risk-stratify 90-day major complications following LF. Instead of current single-value thresholds, these multiple strata may be utilized for better preoperative guidance.
Antibacterial activity of selenium nanoparticles/copper oxide (SeNPs/CuO) nanocomposite against some multi-drug resistant clinical pathogens
Authors: Asaad Ahmed Morad , Saied Sara A. , Torayah Mohammad M. , Abu-Elsaad N. I. , Awad. Samah Mohammed 
Published: January 2025

Abstract

Background
Recent advances in nanomedicine have derived novel prospects for development of various bioactive nanoparticles and nanocomposites with significant antibacterial and antifungal properties. This study aims to investigate some characteristics of the novel Se-NPs/Cu2O nanocomposite such as morphological, physicochemical, and optical properties, as well as to assess the antibacterial activity of this fabricated composite in different concentrations against some MDR Gram-positive and Gram-negative clinical bacterial isolates.

Methods
The Se-NPs/Cu2O nanocomposite was fabricated using the chemical deposition method. The fabricated nanocomposite was fully characterized by X-Ray diffraction analysis (XRD), fourier transforms infrared spectroscopy (FTIR), and transmission electron microscope (TEM). The antimicrobial activity of Se-NPs/Cu2O was investigated using the standard broth microdilution method. The fabricated Se-NPs/Cu2O nanocomposites were detected as stable and highly crystallized nanospheres with an average size of 98.6 nm.

Results
The Se-NPs/Cu2O nanocomposite showed a potent antimicrobial activity with MIC values ranged from 6.25 to 12.5 µg/ml for Gram-positive isolates, and 25 to 50 µg/ml for gram-negative isolates. The bactericidal activity was higher for gram-negative isolates with MBC/MIC ratios of 1–2 µg/ml for gram-negative, versus 8 µg/ml for gram positive pathogens.

Conclusion
These findings would support further research in development of a novel Se-NPs/Cu2O nanocomposite as a promising alternative therapeutic option for improving the quality of patients’ management.
Combination therapy versus monotherapy: retrospective analysis of antibiotic treatment of enterococcal endocarditis
Authors: Saman Razan , Primus Christopher P. , West Robert , Woldman Simon J. , Sandoe Jonathan A. T. 
Published: January 2025

Abstract

Background
Guidelines suggest treating fully penicillin-susceptible Enterococcus faecalis strains causing infective endocarditis with amoxicillin combined with gentamicin or ceftriaxone, but clinical evidence to support this practice is limited and monotherapy cohorts were excluded from studies. We describe antibiotic treatment, complications, and outcomes in patients with Enterococcus faecalis infective endocarditis, specifically comparing monotherapy versus combination therapy.

Methods
Retrospective analysis of prospectively collected cohort of patients with definite or possible infective endocarditis from 2 English centres between 2006 and 2021. The primary outcome was 30-day mortality. Secondary outcomes included acute kidney injury, relapse, and clinical cure.

Results
178 individuals were included: median age was 72 years (interquartile range 60–79), male sex majority (138, 78%) and mostly native valve endocarditis (108, 61%). Thirty-nine patients (22%) received monotherapy (penicillin/glycopeptide/linezolid/daptomycin), 128 (72%) combination with gentamicin, 11 (6%) combination with ceftriaxone. Patients on combination therapy with gentamicin had a statistically significant lower 30-day mortality than those treated with monotherapy (21 (16.4%) versus 15 (38.5%) p = 0.035) and higher rates of clinical cure (101 (78.9%) versus 23 (59.0%) p = 0.018). Patient receiving gentamicin were more likely to experience acute kidney injury (64 (50%) versus 11 (28.2%) p = 0.057). Ceftriaxone combination was associated with poor outcomes, but the sample size was small.

Conclusion
Patients treated with combination gentamicin therapy had better clinical outcomes than patients treated with monotherapy. Low-dose gentamicin regimens were associated with acute kidney injury. Patients treated with combinations were different to those treated with monotherapy and confounding remains a concern with observational analyses. An adequately powered clinical trial is needed to determine optimal treatment of enterococcal endocarditis.

Clinical trial number
Not applicable.
Three-dimensional sonographic findings of diprosopus: a case report and literature review
Authors: Zhou Qiao , Sha Enbo , Ding Qian , Jing Chunli 
Published: January 2025

Abstract

Background
Diprosopus is one of the rarest anomalies. It typically manifests as bilateral alterations and often involves anomalies within the cranial structures. In this report, we present a case of a fetus with diprosopus diagnosed prenatally. Along with reviewing relevant literature on prenatal ultrasound diagnosis of diprosopus, we aim to raise awareness of its ultrasound characteristics.

Case presentation
We report a case of craniofacial and intracranial abnormalities detected during a 26-week ultrasound examination. Two-dimensional ultrasound (2D ultrasound) demonstrates significant increases in head circumference, widening of the interocular distance, and abnormal echo patterns in the facial structure. Three-dimensional ultrasound (3D ultrasound) revealed the presence of three eye sockets (the lateral eye sockets contained eyeballs, while the central region exhibited fusion without visible eyeballs), two noses, and two mouths, with no abnormalities observed in other areas. The ultrasound findings suggested diprosopus. Following risk counseling at the prenatal diagnosis center, the pregnant woman decided to induce labor. The newborn passed away thirty minutes after delivery. The facial features of the newborn were consistent with the 3D ultrasound imaging, and the appearance of the trunk and limbs was normal. Both CT and MRI scans confirmed the diagnosis of diprosopus.

Conclusion
The prenatal 2D ultrasound revealed intracranial and facial abnormalities in the fetus. 3D ultrasound imaging clearly displayed the facial duplication anomalies, highlighting the advantages of 3D ultrasound in diagnosing diprosopus. We hope to raise awareness of this rare condition and provide insights into prenatal ultrasound diagnosis through this case.