bluuebunny/crossref_metadata_2025_split huggingface dataset:
A sequential learning model with GNN for EEG-EMG-based stroke rehabilitation BCI
Authors: Li Haoyang , Ji Hongfei , Yu Jian , Li Jie , Jin Lingjing , Liu Lingyu , Bai Zhongfei , Ye Chen 
Published: April 2023

IntroductionBrain-computer interfaces (BCIs) have the potential in providing neurofeedback for stroke patients to improve motor rehabilitation. However, current BCIs often only detect general motor intentions and lack the precise information needed for complex movement execution, mainly due to insufficient movement execution features in EEG signals.MethodsThis paper presents a sequential learning model incorporating a Graph Isomorphic Network (GIN) that processes a sequence of graph-structured data derived from EEG and EMG signals. Movement data are divided into sub-actions and predicted separately by the model, generating a sequential motor encoding that reflects the sequential features of the movements. Through time-based ensemble learning, the proposed method achieves more accurate prediction results and execution quality scores for each movement.ResultsA classification accuracy of 88.89% is achieved on an EEG-EMG synchronized dataset for push and pull movements, significantly outperforming the benchmark method's performance of 73.23%.DiscussionThis approach can be used to develop a hybrid EEG-EMG brain-computer interface to provide patients with more accurate neural feedback to aid their recovery.
Brain iron content in cerebral amyloid angiopathy using quantitative susceptibility mapping
Authors: Sharma Breni , Beaudin Andrew E. , Cox Emily , Saad Feryal , Nelles Krista , Gee Myrlene , Frayne Richard , Gobbi David G. , Camicioli Richard , Smith Eric E. , McCreary Cheryl R. 
Published: April 2023

IntroductionCerebral amyloid angiopathy (CAA) is a small vessel disease that causes covert and symptomatic brain hemorrhaging. We hypothesized that persons with CAA would have increased brain iron content detectable by quantitative susceptibility mapping (QSM) on magnetic resonance imaging (MRI), and that higher iron content would be associated with worse cognition.MethodsParticipants with CAA (n = 21), mild Alzheimer’s disease with dementia (AD-dementia; n = 14), and normal controls (NC; n = 83) underwent 3T MRI. Post-processing QSM techniques were applied to obtain susceptibility values for regions of the frontal and occipital lobe, thalamus, caudate, putamen, pallidum, and hippocampus. Linear regression was used to examine differences between groups, and associations with global cognition, controlling for multiple comparisons using the false discovery rate method.ResultsNo differences were found between regions of interest in CAA compared to NC. In AD, the calcarine sulcus had greater iron than NC (β = 0.99 [95% CI: 0.44, 1.53], q &lt; 0.01). However, calcarine sulcus iron content was not associated with global cognition, measured by the Montreal Cognitive Assessment (p &gt; 0.05 for all participants, NC, CAA, and AD).DiscussionAfter correcting for multiple comparisons, brain iron content, measured via QSM, was not elevated in CAA compared to NC in this exploratory study.
Increased dietary fiber is associated with weight loss among Full Plate Living program participants
Authors: Kelly Rebecca K. , Calhoun Janet , Hanus Amy , Payne-Foster Pamela , Stout Ron , Sherman Bruce W. 
Published: April 2023

IntroductionPrior studies have demonstrated that an intake of foods rich in dietary fiber is associated with a favorable impact on health status and body weight. However, the association between fiber intake and weight loss has not been well-studied in employer settings. This research aimed to assess the relationship between dietary fiber and weight loss among individuals participating in the Full Plate Living (FPL) program.MethodsThe 16-week plant-predominant fiber-rich eating program was delivered to 72 employers, primarily in the Southwest U.S., over 3 years (2017–2019). Participants received weekly video lessons, FPL materials, and additional online resources. A retrospective analysis of repeated measures was conducted using participant data obtained from 4,477 participants, of which 2,792 (62.5%) reduced body weight. Analysis of variance with post hoc analysis was used to assess the statistical significance of the changes between baseline and follow-up measures of dietary fiber intake in each of the food categories, specifically the relationship between changes in individual and combined (composite) daily servings of fruits, vegetables, whole grains, beans, and nuts on body weight measures among three groups at follow-up: those who lost, maintained, or gained weight. Multilevel modeling was used to test the hypothesis that increased intake of fiber was associated with greater weight loss.ResultsThe mean weight loss for the weight loss group was 3.28 kg. As compared to the two other groups, the intake of whole fiber-rich foods at follow-up was significantly higher among the weight loss group with fruits (2.45 servings), vegetables (2.99 servings), beans (1.03 servings), and total fiber composites (9.07 servings; P &lt; 0.001). A significant increase in servings of grains was also noted (P &lt; 0.05). Multilevel modeling demonstrated that a higher total fiber composite (Model 1), as well as higher intakes of either vegetables or fruits (Model 2), resulted in greater weight loss.DiscussionOur findings indicate that the FPL program can be a part of a lifestyle medicine approach to healthy eating and weight loss. Delivering the program in clinical, community, and workplace settings can increase its reach as an effective and low-cost offering.
Transitioning to sustainable dietary patterns: learnings from animal-based and plant-based dietary patterns in French Canadian adults
Authors: Rochefort Gabrielle , Brassard Didier , Desroches Sophie , Robitaille Julie , Lemieux Simone , Provencher Véronique , Lamarche Benoît 
Published: April 2023

IntroductionMany dietary guidelines promote the substitution of animal proteins with plant-based proteins for health benefits but also to help transitioning toward more sustainable dietary patterns. The aim of this study was to examine the food and nutrient characteristics as well as the overall quality and costs of dietary patterns consistent with lower intakes of animal-based protein foods and with higher intakes of plant-based protein foods among French Canadian adults.MethodsDietary intake data, evaluated with 24 h recalls, from 1,147 French-speaking adults of the PRÉDicteurs Individuels, Sociaux et Environnementaux (PREDISE) study conducted between 2015 and 2017 in Québec were used. Usual dietary intakes and diet costs were estimated with the National Cancer Institute’s multivariate method. Consumption of animal- and plant-based protein foods was classified into quarters (Q) and differences in food and nutrient intakes, Healthy Eating Food Index (HEFI)-2019 scores and diet costs across quarters were assessed using linear regression models adjusted for age and sex.ResultsParticipants with lower intakes of animal-based protein foods (Q1 vs. Q4) had a higher HEFI-2019 total score (+4.0 pts, 95% CI, 0.9 to 7.1) and lower daily diet costs (-1.9 $CAD, 95% CI, –2.6 to -1.2). Participants with higher intakes of plant-based protein foods (Q4 vs. Q1) had a higher HEFI-2019 total score (+14.6 pts, 95% CI, 12.4 to 16.9) but no difference in daily diet costs (0.0$CAD, 95% CI, -0.7 to 0.7).DiscussionIn a perspective of diet sustainability, results from this study among French-speaking Canadian adults suggest that a shift toward a dietary pattern focused primarily on lower amounts of animal-based protein foods may be associated with a better diet quality at lower costs. On the other hand, transitioning to a dietary pattern focused primarily on higher amounts of plant-based protein foods may further improve the diet quality at no additional cost.
An mHealth-based school health education system designed to scale up salt reduction in China (EduSaltS): A development and preliminary implementation study
Authors: Zhang Puhong , Sun Jingwen , Li Yinghua , Li Yuan , Sun Yuewen , Luo Rong , Nie Xueqiong , Li Li , Liu Yu , He Feng J 
Published: April 2023

BackgroundHigh-salt diet is an important risk factor for several non-communicable diseases. School-based health education has been found effective in reducing salt intake among children and their families in China. However, no such interventions have been scaled up in the real world. For this purpose, a study was launched to support the development and scale-up of an mHealth-based system (EduSaltS) that integrated routine health education and salt reduction and was delivered through primary schools. This study aims to elaborate the framework, development process, features, and preliminary scaling-up of the EduSaltS system.MethodsThe EduSaltS system evolved from previously successfully tested interventions to reduce family salt intake by empowering schoolchildren through school health education. EduSaltS was designed by following the WHO’s conceptual framework for developing a scaling-up strategy which accounted for the nature of the innovation, the capacity of the implementing organizations, the characteristics of the environment, the resources available, and type of scaling up. The system was then developed step by step from determination of online platform architecture, definition of component interventions and activities, development of specific educational materials and tools, to the development of the online/offline hybridized system. The system was tested and refined by a pilot in two schools and a preliminary scale-up in two cities in China.ResultsEduSaltS was developed as an innovative health education system, including an online WeChat-based education platform, a set of offline activities, and an actual administrative website showing the progress and setting the system. The WeChat platform could be installed on users’ smartphones to automatically deliver 20 sessions of five-minute well-structured cartoon video classes, followed by other online interactive activities. It also helps support project implementation and real-time performance evaluation. As a first-stage roll-out, a one-year course has been successfully implemented among 54,538 children and their families from 209 schools in two cities, and the average course completion rate was 89.1%.ConclusionAs an innovative mHealth-based health education system, EduSaltS was developed based on successfully tested interventions and an appropriate framework for scaling up. The early-stage roll-out has shown its preliminary scalability, and further evaluation is ongoing.
Trends in cutaneous squamous cell carcinoma on the lip incidence and mortality in the United States, 2000–2019
Authors: Zhang Jin , Yang Quyang , Wu Jinyan , Yuan Ruoyue , Zhao Xiansheng , Li Yue , Cheng Xiujun , Wu Baojin , Zhu Ningwen 
Published: April 2023

ObjectiveThis study provided a systematic analysis of the trend in incidence and incidence-based mortality for cutaneous squamous cell carcinoma (cSCC) on the lips in the USA using demographic characteristics from the Surveillance, Epidemiology, and End Results (SEER) database.MethodsPatients diagnosed with cSCC on the lips between 2000 and 2019 from the 17 registries of the USA were identified. Incidence and incidence-based mortality rates were analyzed using SEER*Stat 8.4.0.1 software. This paper calculated incidence rates and incidence-based mortality rates by 100,000 person-years for sex, age, race, SEER registries, median household income ($/year), rural-urban distribution, and primary site. The annual percent changes (APC) in incidence and incidence-based mortality rates were then calculated using joinpoint regression software.ResultsAmong 8,625 patients diagnosed with cSCC on the lips from 2000 to 2019, men (74.67%), white (95.21%), and 60–79 years old were the most common population, and 3,869 deaths from cSCC on the lips occurred. The overall incidence of cSCC on the lips was 0.516 per 100,000 person-years. cSCC on the lip incidence rates were highest among men, white, and patients aged 60–79 years old. cSCC on the lip incidence rates decreased by 3.210%/year over the study period. The incidence of cSCC on the lips has been decreasing in all sexes, ages, high- or low-income households, and urban or rural patients. The overall incidence-based mortality rate of cSCC on the lips during 2000–2019 was 0.235 per 100,000 person-years. cSCC on the lip incidence-based mortality rates were highest among men, whites, and people older than 80 years old. cSCC on the lip incidence-based mortality increased by 4.975%/year over the study period. cSCC on the lip incidence-based mortality rates increased for all sexes, races, ages, primary sites, high- or low-income households, and urban or rural patients during the study period.ConclusionAmong patients in the USA diagnosed with cSCC on the lips from 2000 to 2019, the overall incidence decreased by 3.210% annually, and incidence-based mortality increased by 4.975%/year. These findings update and supplement the epidemiological information of cSCC on the lips in the USA.
TIDE: adjuvant tislelizumab plus donafenib combined with transarterial chemoembolization for high-risk hepatocellular carcinoma after surgery: protocol for a prospective, single-arm, phase II trial
Authors: Qi Weili , Peng Wei , Qi Xin , Qiu Zhancheng , Wen Tianfu , Li Chuan 
Published: April 2023

BackgroundThe high recurrence rate of hepatocellular carcinoma (HCC) after surgery negatively affects the prognosis of patients. There is currently no widely accepted adjuvant therapy strategy for patients with HCC. A clinical study of effective adjuvant therapy is still needed.MethodsIn this prospective, single-arm, phase II clinical trial, an adjuvant regimen of donafenib plus tislelizumab combined with transarterial chemoembolization (TACE) will be used to treat enrolled HCC patients after surgery. Briefly, patients newly diagnosed with HCC by pathological examination who underwent curative resection and had a single tumor more than 5 cm in diameter with microvascular invasion as detected by pathological examination are eligible. The primary endpoint of the study is the recurrence-free survival (RFS) rate at 3 years, and secondary endpoints are the overall survival (OS) rate and the incidence of adverse events (AEs). The planned sample size, 32 patients, was calculated to permit the accumulation of sufficient RFS events in 3 years to achieve 90% power for the RFS primary endpoint.DiscussionVascular endothelial growth factor (VEGF) and programmed cell death protein 1 (PD-1)/programmed cell death ligand 1 (PD-L1) pathways regulate the relevant immunosuppressive mechanisms of HCC recurrence. Our trial will evaluate the clinical benefit of adding donafenib plus tislelizumab to TACE in patients with early-stage HCC and a high risk of recurrence.Clinical trial registrationwww.chictr.org.cn, identifier ChiCTR2200063003.
The association between tyrosine kinase inhibitors and fatal arrhythmia in patients with non-small cell lung cancer in Taiwan
Authors: Chang Wei-Ting , Lin Hui-Wen , Chang Ting-Chia , Lin Sheng-Hsiang , Li Yi-Heng 
Published: April 2023

ObjectiveAs a standard therapy, tyrosine kinase inhibitors (TKIs) improved survival in patients with non-small cell lung cancer (NSCLC) and epidermal growth factor receptor (EGFR) mutation. However, treatment-related cardiotoxicity, particularly arrhythmia, cannot be ignored. With the prevalence of EGFR mutations in Asian populations, the risk of arrhythmia among patients with NSCLC remains unclear.MethodsUsing data from the Taiwanese National Health Insurance Research Database and National Cancer Registry, we identified patients with NSCLC from 2001 to 2014. Using Cox proportional hazards models, we analyzed outcomes of death and arrhythmia, including ventricular arrhythmia (VA), sudden cardiac death (SCD), and atrial fibrillation (AF). The follow-up duration was three years.ResultsIn total, 3876 patients with NSCLC treated with TKIs were matched to 3876 patients treated with platinum analogues. After adjusting for age, sex, comorbidities, and anticancer and cardiovascular therapies, patients receiving TKIs had a significantly lower risk of death (adjusted HR: 0.767; CI: 0.729–0.807, p &lt; 0.001) than those receiving platinum analogues. Given that approximately 80% of the studied population reached the endpoint of mortality, we also adjusted for mortality as a competing risk. Notably, we observed significantly increased risks of both VA (adjusted sHR: 2.328; CI: 1.592–3.404, p &lt; 0.001) and SCD (adjusted sHR: 1.316; CI: 1.041–1.663, p = 0.022) among TKI users compared with platinum analogue users. Conversely, the risk of AF was similar between the two groups. In the subgroup analysis, the increasing risk of VA/SCD persisted regardless of sex and most cardiovascular comorbidities.ConclusionsCollectively, we highlighted a higher risk of VA/SCD in TKI users than in patients receiving platinum analogues. Further research is needed to validate these findings.
Association of n-3 polyunsaturated fatty acid intakes with juvenile myopia: A cross-sectional study based on the NHANES database
Authors: Zhou Zixiu , Li Sizhen , Yang Qingsong , Yang Xiaodong , Liu Yating , Hao Kuanxiao , Xu Shanshan , Zhao Na , Zheng Pengjie 
Published: April 2023

AimInflammation is involved in the development of myopia. n-3 polyunsaturated fatty acids (n-3 PUFAs) have vasodilating and anti-inflammatory effects, which may be involved in controlling myopia. It is of great significance to explore the relationship between n-3 PUFA intakes and juvenile myopia in order to control and alleviate myopia among teenagers through dietary intervention.MethodsSociodemographic data, information of nutrient intakes, cotinine, PUFAs, and eye refractive status of 1,128 juveniles were extracted from the National Health and Nutrition Examination Survey (NHANES) database in this cross-sectional study. PUFAs contained total polyunsaturated fatty acid (TPFAs), alpha-linolenic acid, octadecatetraenoic acid, eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and docosahexaenoic acid (DHA). Covariates were screened by comparison among groups of normal vision, low myopia, and high myopia. The association between n-3 PUFA intakes and the risk of juvenile myopia was evaluated using univariate and multivariate logistic regression analyses with odds ratios (ORs) and 95% confidence intervals (CIs).ResultsAmong the juveniles, 788 (70.68%) had normal vision, 299 (25.80%) had low myopia, and 41 (3.52%) had high myopia. There were significant differences in average EPA and DHA intakes among the three groups, and mean DPA and DHA intakes in the normal vision group were lower than those in the low myopia group (P &lt; 0.05). After adjustment for age, gender, TPFAs, and cotinine, a high dietary intake of EPA (≥11 mg/1,000 kcal) in juveniles seemed to be associated with the risk of high myopia (OR = 0.39, 95% CI: 0.18–0.85), while no significant associations were identified between n-3 PUFA intakes and the risk of low myopia.ConclusionA high dietary intake of EPA may be associated with a decreased risk of high myopia among juveniles. A further prospective study is needed to validate this observation.
Impact of parental and healthcare professional concern on the diagnosis of pediatric sepsis: a diagnostic accuracy study
Authors: Sever Zoe , Schlapbach Luregn J. , Gilholm Patricia , Jessup Melanie , Phillips Natalie , George Shane , Gibbons Kristen , Harley Amanda 
Published: April 2023

ObjectiveThe Surviving Sepsis Campaign recommends systematic screening for sepsis. Although many sepsis screening tools include parent or healthcare professional concern, there remains a lack of evidence to support this practice. We aimed to test the diagnostic accuracy of parent and healthcare professional concern in relation to illness severity, to diagnose sepsis in children.DesignThis prospective multicenter study measured the level of concern for illness severity as perceived by the parent, treating nurse and doctor using a cross-sectional survey. The primary outcome was sepsis, defined as a pSOFA score &gt;0. The unadjusted area under receiver-operating characteristic curves (AUC) and adjusted Odds Ratios (aOR) were calculated.SettingTwo specialised pediatric Emergency Departments in QueenslandPatientsChildren aged 30 days to 18 years old that were evaluated for sepsisInterventionNoneMain Results492 children were included in the study, of which 118 (23.9%) had sepsis. Parent concern was not associated with sepsis (AUC 0.53, 95% CI: 0.46–0.61, aOR: 1.18; 0.89–1.58) but was for PICU admission (OR: 1.88, 95% CI: 1.17–3.19) and bacterial infection (aOR: 1.47, 95% CI: 1.14–1.92). Healthcare professional concern was associated with sepsis in both unadjusted and adjusted models (nurses: AUC 0.57, 95% CI-0.50, 0.63, aOR: 1.29, 95% CI: 1.02–1.63; doctors: AUC 0.63, 95% CI: 0.55, 0.70, aOR: 1.61, 95% CI: 1.14–2.19).ConclusionsWhile our study does not support the broad use of parent or healthcare professional concern in isolation as a pediatric sepsis screening tool, measures of concern may be valuable as an adjunct in combination with other clinical data to support sepsis recognition.Clinical Trial RegistrationACTRN12620001340921.
Case report: Multisystem inflammatory syndrome in children associated with COVID-19, macrophage activation syndrome, and incomplete Kawasaki disease
Authors: Martínez-García Jesús Javier , López-Acosta Jesús Ramon , Arce-Cabrera Daniela , León-Sicairos Nidia , Hernández-Parra Ana Cristina , Cuen-Diaz Hector Melesio , Zatarain-Lopez Ricardo , Canizalez-Roman Adrian 
Published: April 2023

BackgroundMultisystem inflammatory syndrome in children (MIS-C), is a severe complication of coronavirus disease 2019 (COVID-19), characterized by persistent fever, systemic inflammatory response, and organ failure. MIS-C with a history of COVID-19 may share clinical features with other well-defined syndromes such as macrophage activation syndrome, Kawasaki disease, hemophagocytic syndrome and toxic shock syndrome.Case 1An 11-year-old male with a history of hypothyroidism and precocious puberty with positive antibody test for COVID-19 was admitted for fever, poor general condition, severe respiratory distress, refractory shock, and multiple organ failure. His laboratory examination showed elevated inflammatory parameters, and bone marrow aspirate showed hemophagocytosis.Case 2A 13-year-old male with a history of attention deficit hyperactivity disorder and cognitive delay presented clinical manifestations of Kawasaki disease, fever, conjunctival congestion, exanthema, and hyperemia in oral mucosa, tongue, and genitals, with refractory shock and multiple organ failure. Reverse transcriptase polymerase chain reaction (RT-PCR) and antibodies for COVID-19 were negative, inflammation parameters were elevated, and bone marrow aspirate showed hemophagocytosis. Patients required intensive care with invasive mechanical ventilation, vasopressor support, intravenous gamma globulin, systemic corticosteroids, low molecular weight heparin, antibiotics, and monoclonal antibodies and, patient 2 required renal replacement therapy.ConclusionsMultisystemic inflammatory syndrome in children can have atypical manifestations, and identifying them early is very important for the timely treatment and prognosis of patients.