bluuebunny/crossref_metadata_2025_split huggingface dataset:
Virtual reality to improve low-back pain and pelvic pain during pregnancy: a pilot RCT for a multicenter randomized controlled trial
Authors: García-López Francisco-José , Pastora-Bernal José-Manuel , Moreno-Morales Noelia , Estebanez-Pérez María-José , Liñán-González Antonio , Martín-Valero Rocío 
Published: September 2023

A significant proportion of women experience low back and pelvic pain during and after pregnancy, which can negatively impact their daily lives. Various factors are attributed to these complaints, and many affected women do not receive adequate healthcare. However, there is evidence to support the use of different physiotherapeutic interventions to alleviate these conditions. Virtual reality is a promising complementary treatment to physiotherapy, particularly in improving pain perception and avoidance. The primary objective of this study is to evaluate the efficacy of a four-week program combining VR and physiotherapy compared to standard physiotherapy in pregnant women with low back and pelvic pain, in terms of improving pain avoidance, intensity, disability, and functional level. The study also aims to investigate patient satisfaction with the VR intervention. This research will be conducted through a multi-center randomized controlled clinical trial involving pregnant patients residing in the provinces of Seville and Malaga with a diagnosis of low back and pelvic pain during pregnancy. The alternative hypothesis is that the implementation of a Virtual Reality program in combination with standard physiotherapy will result in better clinical outcomes compared to the current standard intervention, which could lead to the development of new policies and interventions for these pathologies and their consequences.Clinical trial registration: clinicaltrials.gov, identifier NCT05571358.
Patient-reported outcomes of serum eye drops manufactured from Australian blood donations and packaged using Meise vials
Authors: Gemelli Carley N. , Mondy Phillip , Kakkos Athina , O’Donovan Justine , Diaz Perfecto , Knight Elizabeth , Hirani Rena 
Published: September 2023

IntroductionSerum eye drops (SED) are an effective treatment for dry eye syndrome. However, autologous serum collection can have challenges. Patient-tailored (allogeneic) SED (PT-SED) can be made from healthy blood donors. Australian Red Cross Lifeblood has manufactured both autologous SED (Auto-SED) and PT-SED and, in May 2021, introduced Meise vial packaging. This study aimed to explore SED patient-reported outcomes and vial packaging satisfaction.MethodsA prospective cohort study was conducted with recruitment between 1 November 2021 and 30 June 2022. Participants completed the dry eye questionnaire (DEQ5), health-related quality-of-life (SF-8™), functional assessment of chronic illness therapy-treatment satisfaction-general (FACIT-TS-G), and general wellbeing surveys. Existing patients completed these once, and new patients were surveyed at baseline, 3 months post-treatment, and 6 months post-treatment.ResultsParticipants who completed all study requirements were 24 existing and 40 new Auto-SED and 10 existing and 8 new PT-SED patients. Auto-SED patients were younger [56.2 (±14.7) years] than PT-SED patients [71.4 (±10.0) years]. Participants used a mean of 1.8 (±1.1) SED, 5.3 (±2.9) times per day. In new patients, DEQ5 scores improved within 6 months from 14.0 (±2.9) to 10.6 (±3.4) for Auto-SED and from 12.9 (±3.7) to 11.4 (±2.8) for PT-SED. General wellbeing measures improved in the new Auto-SED from 7.0 (±1.9) to 7.8 (±1.7) but were reduced for new PT-SED from 6.7 (±2.9) to 6.1 (±2.9).DiscussionSED improved dry eye symptoms in most patients, regardless of the serum source. Patients using PT-SED showed decreases in some quality-of-life measures; however, recruitment was reduced due to operational constraints, and concurrent comorbidities were not assessed. General feedback for SED and vial packaging was positive, with some improvements identified.
A systematic review and meta-analysis of health utility values among patients with ischemic stroke
Authors: Zhou Jiting , Wei Qiran , Hu Hongfei , Liu Wei , Guan Xin , Ma Aixia , Wang Luying 
Published: September 2023

PurposeIschemic stroke (IS) has a considerable impact on the health-related quality of life (HRQoL) of patients. A systematic review was conducted to summarize and synthesize the HRQoL reported from IS patients.MethodsAn electronic search was performed in PubMed, Web of Science, ScienceDirect, Embase, and Cochrane Library databases from inception to February 2022 for studies measuring utility values in IS patients. Basic information about the studies, patient characteristics, measurement of the utility values, and utility values were extracted and summarized. Utility values were pooled according to the time of evaluation, and disease severity was classified with modified Rankin Scale (mRS) scores. The quality of the studies was assessed according to key criteria recommended by the National Institute for Health and Care Excellence.ResultsA total of 39 studies comprising 30,853 participants were included in the study. Measured with EQ-5D-3L, the pooled utility values were 0.42 [95% confidential interval (CI): 0.13 to 0.71], 0.55 (95% CI: 0.43 to 0.68), 0.65 (95% CI: 0.52 to 0.78), 0.60 (95% CI: 0.43 to 0.78), and 0.67 (95% CI: 0.60 to 0.74) for patients diagnosed with IS within 1, 3, 6, 12, and 24 months or above among poststroke patients. Four studies reported utility values classified by mRS scores where synthesized estimates stratified by mRS scores ranged from 0.91 (95% CI: 0.85 to 0.97) for patients with an mRS score of 1 to−0.04 (95% CI:−0.18 to 0.11) for those with an mRS score of 5. As for the health dimension profiles, usual activity was the most impacted dimension, while self-care was the least impacted one.ConclusionThis study indicated that the utility values in IS patients kept increasing from stroke onset and became relatively stabilized at 6 months poststroke. Health utility values decreased significantly as mRS scores increased. These results facilitate economic evaluations in utility retrieval and selection. Further exploration was required regarding the factors that affect the HRQoL of IS patients.
Assessing white matter microstructural changes in idiopathic normal pressure hydrocephalus using voxel-based R2* relaxometry analysis
Authors: Kano Yuya , Uchida Yuto , Kan Hirohito , Sakurai Keita , Kobayashi Susumu , Seko Kento , Mizutani Keisuke , Usami Toshihiko , Takada Koji , Matsukawa Noriyuki 
Published: September 2023

BackgroundR2* relaxometry and quantitative susceptibility mapping can be combined to distinguish between microstructural changes and iron deposition in white matter. Here, we aimed to explore microstructural changes in the white matter associated with clinical presentations such as cognitive impairment in patients with idiopathic normal-pressure hydrocephalus (iNPH) using R2* relaxometry analysis in combination with quantitative susceptibility mapping.MethodsWe evaluated 16 patients clinically diagnosed with possible or probable iNPH and 18 matched healthy controls (HC) who were chosen based on similarity in age and sex. R2* and quantitative susceptibility mapping were compared using voxel-wise and atlas-based one-way analysis of covariance (ANCOVA). Finally, partial correlation analyses were performed to assess the relationship between R2* and clinical presentations.ResultsR2* was lower in some white matter regions, including the bilateral superior longitudinal fascicle and sagittal stratum, in the iNPH group compared to the HC group. The voxel-based quantitative susceptibility mapping results did not differ between the groups. The atlas-based group comparisons yielded negative mean susceptibility values in almost all brain regions, indicating no clear paramagnetic iron deposition in the white matter of any subject. R2* and cognitive performance scores between the left superior longitudinal fasciculus (SLF) and right sagittal stratum (SS) were positively correlated. In addition to that, R2* and gait disturbance scores between left SS were negatively correlated.ConclusionOur analysis highlights the microstructural changes without iron deposition in the SLF and SS, and their association with cognitive impairment and gait disturbance in patients with iNPH.
Infant formula containing large, milk phospholipid-coated lipid droplets and dairy lipids affects cognitive performance at school age
Authors: Schipper Lidewij , Bartke Nana , Marintcheva-Petrova Maya , Schoen Stefanie , Vandenplas Yvan , Hokken-Koelega Anita C. S. 
Published: September 2023

BackgroundBreastfeeding has been positively associated with infant and child neurocognitive development and function. Contributing to this effect may be differences between human milk and infant formula in the milk lipid composition and milk fat globule structure.ObjectiveTo evaluate the effects of an infant formula mimicking human milk lipid composition and milk fat globule structure on childhood cognitive performance.MethodsIn a randomized, controlled trial, healthy term infants received until 4 months of age either a Standard infant formula (n = 108) or a Concept infant formula (n = 115) with large, milk phospholipid coated lipid droplets and containing dairy lipids. A breastfed reference group (n = 88) was included. Erythrocyte fatty acid composition was determined at 3 months of age. Neurocognitive function was assessed as exploratory follow-up outcome at 3, 4, and 5 years of age using the Flanker test, Dimensional Change Card Sort (DCCS) test and Picture Sequence Memory test from the National Institutes of Health Toolbox Cognition Battery. Mann–Whitney U test and Fisher exact test were used to compare groups.ResultsErythrocyte omega-6 to -3 long-chain polyunsaturated fatty acid ratio appeared to be lower in the Concept compared to the Standard group (P = 0.025). At age 5, only the Concept group was comparable to the Breastfed group in the highest reached levels on the Flanker test, and the DCCS computed score was higher in the Concept compared to the Standard group (P = 0.021).ConclusionThese outcomes suggest that exposure to an infant formula mimicking human milk lipid composition and milk fat globule structure positively affects child neurocognitive development. Underlying mechanisms may include a different omega-3 fatty acid status during the first months of life.Clinical trial registrationhttps://onderzoekmetmensen.nl/en/trial/28614, identifier NTR3683 and NTR5538.
Wild and backyard food use during COVID-19 in upstate New York, United States
Authors: Coffin-Schmitt Jeanne L. , Clements Nia , Marshall Grace , Liu Lu , Trombitas Aly , Wang Zi , Yuan Shuai , Safi Amelia Greiner , Hanson Karla L. , Fiorella Kathryn J. 
Published: September 2023

IntroductionCOVID-19 acutely shocked both socio-economic and food systems in 2020. We investigated the impact of COVID-19 on production and consumption of gardened produce, backyard poultry, wild game and fish, and foraged mushrooms, berries, and other plants in New York State, aiming to understand crisis influenced food choice and motivations, including food security.MethodsWe conducted an online, cross-sectional survey in October–December 2020 with a convenience sample of participants (n = 505) with an interest in gardening, poultry rearing, foraging, hunting, and/or fishing from six counties in upstate New York. We recruited through the New York Department of Environmental Conservation, Cornell Cooperative Extension, and other relevant email and social media pages.ResultsAcross the wild and backyard food production strategies, 4.0–14.3% of respondents reported engaging for the first time and 39.6–45.7% reported increased production (a little or a lot more), and 31.6–42.7% of respondents’ production was the same as the previous year. Consumption of foods produced was widespread, including fruit and vegetables (97.6% of producers also consumed), backyard eggs (92.7%), and foraged foods (93.8%). For meats, a majority consumed backyard poultry meat (51.2%), wild-caught fish (69.7%), and wild game they hunted (80.1%). The frequency of consumption of fruit and vegetables (average of 13.5 times/month) and eggs (16.4 times/month) was very high, while average consumption of poultry meat, foraged foods, fish, and wild game ranged from 3.1 to 5.8 times/month. The number of respondents who reported “have more control over food availability” as motivation to produce all wild and backyard foods increased from 2019 to 2020 (p &lt; 0.05 - p &lt; 0.001). There was also a significant relationship between experiences of COVID-19 related hardship (i.e., food insecurity, income loss) with gardening and poultry-rearing (p ≤ 0.05), but not with other production methods or with consumption of wild and backyard foods.DiscussionOur findings help to locate wild and backyard foods within COVID-19 impacted food environments, and describe food security as a particularly relevant motivation, among others, reported by respondents in 2020. Given this, New York State service providers can use these findings to tailor current future support for households exerting control over their own food environments with wild and backyard foods, allowing the state to be better prepared for future crises.
Clinical evaluation on automatic segmentation results of convolutional neural networks in rectal cancer radiotherapy
Authors: Li Jing , Song Ying , Wu Yongchang , Liang Lan , Li Guangjun , Bai Sen 
Published: September 2023

PurposeImage segmentation can be time-consuming and lacks consistency between different oncologists, which is essential in conformal radiotherapy techniques. We aimed to evaluate automatic delineation results generated by convolutional neural networks (CNNs) from geometry and dosimetry perspectives and explore the reliability of these segmentation tools in rectal cancer.MethodsForty-seven rectal cancer cases treated from February 2018 to April 2019 were randomly collected retrospectively in our cancer center. The oncologists delineated regions of interest (ROIs) on planning CT images as the ground truth, including clinical target volume (CTV), bladder, small intestine, and femoral heads. The corresponding automatic segmentation results were generated by DeepLabv3+ and ResUNet, and we also used Atlas-Based Autosegmentation (ABAS) software for comparison. The geometry evaluation was carried out using the volumetric Dice similarity coefficient (DSC) and surface DSC, and critical dose parameters were assessed based on replanning optimized by clinically approved or automatically generated CTVs and organs at risk (OARs), i.e., the Planref and Plantest. Pearson test was used to explore the correlation between geometric metrics and dose parameters.ResultsIn geometric evaluation, DeepLabv3+ performed better in DCS metrics for the CTV (volumetric DSC, mean = 0.96, P&lt; 0.01; surface DSC, mean = 0.78, P&lt; 0.01) and small intestine (volumetric DSC, mean = 0.91, P&lt; 0.01; surface DSC, mean = 0.62, P&lt; 0.01), ResUNet had advantages in volumetric DSC of the bladder (mean = 0.97, P&lt; 0.05). For critical dose parameters analysis between Planref and Plantest, there was a significant difference for target volumes (P&lt; 0.01), and no significant difference was found for the ResUNet-generated small intestine (P &gt; 0.05). For the correlation test, a negative correlation was found between DSC metrics (volumetric, surface DSC) and dosimetric parameters (δD95, δD95, HI, CI) for target volumes (P&lt; 0.05), and no significant correlation was found for most tests of OARs (P &gt; 0.05).ConclusionsCNNs show remarkable repeatability and time-saving in automatic segmentation, and their accuracy also has a certain potential in clinical practice. Meanwhile, clinical aspects, such as dose distribution, may need to be considered when comparing the performance of auto-segmentation methods.
Biliary drainage in malignant biliary obstruction: an umbrella review of randomized controlled trials
Authors: Wang Yaoqun , Wen Ningyuan , Xiong Xianze , Li Bei , Lu Jiong 
Published: September 2023

BackgroundThere are still many controversies about biliary drainage in MBO, and we aimed to summarize and evaluate the evidence associated with biliary drainage.MethodsWe conducted an umbrella review of SRoMAs based on RCTs. Through July 28, 2022, Embase, PubMed, WOS, and Cochrane Database were searched. Two reviewers independently screened the studies, extracted the data, and appraised the methodological quality of the included studies. GRADE was used to evaluate the quality of the evidence.Results36 SRoMAs were identified. After excluding 24 overlapping studies, 12 SRoMAs, including 76 RCTs, and 124 clinical outcomes for biliary drainage in MBO were included. Of the 124 pieces of evidence evaluated, 13 were rated “High” quality, 38 were rated “Moderate”, and the rest were rated “Low” or “Very low”. For patients with MBO, 125I seeds+stent can reduce the risk of stent occlusion, RFA+stent can improve the prognosis; compared with PC, SEMS can increase the risk of tumor ingrowth and reduce the occurrence of sludge formation, and the incidence of tumor ingrowth in C-SEMS/PC-SEMS was significantly lower than that in U-SEMS. There was no difference in the success rate of drainage between EUS-BD and ERCP-BD, but the use of EUS-BD can reduce the incidence of stent dysfunction. For patients with obstructive jaundice, PBD does not affect postoperative mortality compared to direct surgery. The use of MS in patients with periampullary cancer during PBD can reduce the risk of re-intervention and stent occlusion compared to PC. In addition, we included four RCTs that showed that when performing EUS-BD on MBO, hepaticogastrostomy has higher technical success rates than choledochoduodenostomy. Patients who received Bilateral-ENBD had a lower additional drainage rate than those who received Unilateral-ENBD.ConclusionsOur study summarizes a large amount of evidence related to biliary drainage, which helps to reduce the uncertainty in the selection of biliary drainage strategies for MBO patients under different circumstances.
An experimental study on tolerance to hypoxia in tardigrades
Authors: Hagelbäck Philip , Jönsson K. Ingemar 
Published: September 2023

Introduction: Tardigrades are small aquatic invertebrates with well documented tolerance to several environmental stresses, including desiccation, low temperature, and radiation, and an ability to survive long periods in a cryptobiotic state under arrested metabolism. Many tardigrade populations live in habitats where temporary exposure to hypoxia is expected, e.g., benthic layers or substrates that regularly undergo desiccation, but tolerance to hypoxia has so far not been thoroughly investigated in tardigrades.Method: We studied the response to exposure for hypoxia (&lt;1 ppm) during 1–24 h in two tardigrade species, Richtersius cf. coronifer and Hypsibius exemplaris. The animals were exposed to hypoxia in their hydrated active state.Results: Survival was high in both species after the shortest exposures to hypoxia but tended to decline with longer exposures, with almost complete failure to recover after 24 h in hypoxia. R. cf. coronifer tended to be more tolerant than H. exemplaris. When oxygen level was gradually reduced from 8 to 1 ppm, behavioral responses in terms of irregular body movements were first observed at 3–4 ppm.Discussion: The study shows that both limno-terrestrial and freshwater tardigrades are able to recover after exposure to severe hypoxia, but only exposure for relatively short periods of time. It also indicates that tardigrade species have different sensitivity and response patterns to exposure to hypoxia. These results will hopefully encourage more studies on how tardigrades are affected by and respond to hypoxic conditions.
“Unpacking” cultural differences in social anxiety between Japanese and European Americans: the roles of threat appraisal and attentional bias
Authors: Krieg Alexander , Xu Yiyuan 
Published: September 2023

IntroductionCultural differences in self-reported social anxiety between people of East Asian heritage and European heritage may be related to differences in independent and interdependent self-construals, which potentially influence the processing of social threat.MethodsWe examined the roles of two different aspects of threat bias: threat appraisal (Study 1) and attentional bias (Study 2) to explain cultural group differences in social anxiety between Japanese and European American college students.ResultsStudy 1 demonstrated that sequential mediations of lower independent self-construal and higher appraisal of threat among Japanese could explain their higher social anxiety compared to European Americans. However, Study 2 failed to find the relation between cultural group differences in self-construals and attentional bias. In addition, the cultural group differences in attentional bias were unexpectedly due to stronger selective attention toward neutral stimuli among European Americans, rather than bias toward social threat among Japanese. After selective attention was experimentally manipulated, there were significant cultural group differences in self-reported social anxiety and anxious behavior in a speech task.DiscussionThese conflicting findings suggested that an alternative theoretical framework other than the self-construal theory might be needed to fully account for cultural differences in attentional bias in explaining cultural group differences in social anxiety.
The intersection of race and femininity in the classroom
Authors: Faber Naomi S. , Williams Monnica T. 
Published: September 2023

HighlightsRace as a discussion topic is actively avoided or derailed by White students; women strategically use their gender to this end.There is societal deference toward the visible distress made by a White woman in public that is not afforded other racial groups.This knowledge is used strategically by White women with and without their conscious intent to decenter people of color and center themselves.
Social support: mediating the emotional intelligence-academic stress link
Authors: Ullah Muhammad Shariat , Akhter Sharmeen , Aziz Muhammad Abdul , Islam Muhaiminul 
Published: September 2023

IntroductionThis study examines the relationship between emotional intelligence (EI) and academic stress among tertiary-level students who continued academic activities remotely during the pandemic and the mediating role of social support (SS) in the relationship.MethodsUsing a cross-sectional survey design, 429 students studying business, engineering, social science, and science in Bangladesh provided data via Qualtrics. Using the Structural Equation Modeling in SmartPLS 4 (4.0.8.9), we modeled emotional intelligence as the reflective-formative and social support (support from family, friends, and significant other) and perceived academic stress as the reflective-reflective, second-order constructs. We also conducted a one-way between-groups analysis of variance (ANOVA) to investigate the impact of gender (male and female) and current stage of academic study (Undergraduate year one to four and post-graduation) on emotional intelligence and academic stress, respectively.Results and discussionResults show that all the hypothesized relationships are statistically significant: EI is negatively related to perceived academic stress, and SS significantly mediates the relationship between EI and academic stress. Hence, essential strategies are suggested to help students for managing academic stress.