bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and validation to predict visual acuity and keratometry two years after corneal crosslinking with progressive keratoconus by machine learning
Authors: Liu Yu , Shen Dan , Wang Hao-yu , Qi Meng-ying , Zeng Qing-yan 
Published: July 2023

PurposeTo explore and validate the utility of machine learning (ML) methods using a limited sample size to predict changes in visual acuity and keratometry 2 years following corneal crosslinking (CXL) for progressive keratoconus.MethodsThe study included all consecutive patients with progressive keratoconus who underwent CXL from July 2014 to December 2020, with a 2 year follow-up period before July 2022 to develop the model. Variables collected included patient demographics, visual acuity, spherical equivalence, and Pentacam parameters. Available case data were divided into training and testing data sets. Three ML models were evaluated based on their performance in predicting case corrected distance visual acuity (CDVA) and maximum keratometry (Kmax) changes compared to actual values, as indicated by average root mean squared error (RMSE) and R-squared (R2) values. Patients followed from July 2022 to December 2022 were included in the validation set.ResultsA total of 277 eyes from 195 patients were included in training and testing sets and 43 eyes from 35 patients were included in the validation set. The baseline CDVA (26.7%) and the ratio of steep keratometry to flat keratometry (K2/K1; 13.8%) were closely associated with case CDVA changes. The baseline ratio of Kmax to mean keratometry (Kmax/Kmean; 20.9%) was closely associated with case Kmax changes. Using these metrics, the best-performing ML model was XGBoost, which produced predicted values closest to the actual values for both CDVA and Kmax changes in testing set (R2 = 0.9993 and 0.9888) and validation set (R2 = 0.8956 and 0.8382).ConclusionApplication of a ML approach using XGBoost, and incorporation of identifiable parameters, considerably improved variation prediction accuracy of both CDVA and Kmax 2 years after CXL for treatment of progressive keratoconus.
Delayed 18F-FDG PET imaging provides better metabolic asymmetry in potential epileptogenic zone in temporal lobe epilepsy
Authors: Hong Yang , Fu Chang , Xing Yazhou , Tao James , Zhao Ting , Wang Na , Chen Yanan , You Yang , Ren Zhe , Hong Yingxing , Wang Qi , Zhao Yibo , Yang Yang , Zhang Jiewen , Xu Junling , Han Xiong 
Published: July 2023

ObjectiveTo investigate the value of 18F-FDG positron emission tomography/computed tomography (PET/CT) two time point imaging for the identification of the potential epileptogenic zone (EZ) in temporal lobe epilepsy (TLE).MethodsFifty-two patients with TLE were prospectively enrolled in the 18F-FDG PET/CT two time point imaging study. The early imaging was obtained approximately 40 min (43.44 ± 18.04 min) after 18F-FDG injection, and the delayed imaging was obtained about 2 to 3 h (160.46 ± 28.70 min) after the injection. Visual and semi-quantitative analysis of 18F-FDG uptake were performed at the two time points in EZ and contralateral symmetrical region. The mean standardized uptake value (SUVmean) of EZ and contralateral symmetrical region was calculated to determine the asymmetry index (AI) of the early and delayed images, as well as in the MRI positive and negative patient groups.ResultsSemi-quantitative analysis demonstrated that AI of the early and delayed 18F-FDG PET/CT images was 13.47 ± 6.10 and 16.43 ± 6.66, respectively. The ΔAI was 2.95 ± 3.05 in 52 TLE patients between the two time points. The AI of the EZ was significantly elevated in delayed images compared to the early images (p &lt; 0.001). The AI of delayed imaging was also significantly elevated compared to the early imaging in both MRI positive (ΔAI = 2.81 ± 2.54, p &lt; 0.001) and MRI negative (ΔAI = 3.21 ± 3.91, p &lt; 0.003) groups, and more pronounced in MRI negative group. Visual analysis also showed that the delayed imaging appeared to be superior to the early imaging for identification of potential EZ.ConclusionDelayed 18F-FDG PET imaging provided significantly better than the early imaging in the identification of potential EZ, which can be valuable during epilepsy pre-surgical evaluation in patients with TLE.
Comparative efficacy of five most common traditional Chinese medicine monomers for promoting recovery of motor function in rats with blunt spinal cord injury: a network meta-analysis
Authors: Xu Luchun , Yang Yongdong , Zhong Wenqing , Li Wenhao , Liu Chen , Guo Ziwei , Yu Xing 
Published: July 2023

ObjectiveThis research employed a network meta-analysis (NMA) to examine the effectiveness of five traditional Chinese medicine (TCM) monomers for promoting motor function recovery in rats with blunt spinal cord injury (SCI).MethodsWangfang, China National Knowledge Infrastructure, Web of Science, Embase, Chinese Scientific Journal Database, PubMed, and the Chinese Biomedical Literature Databases were searched for retrieving relevant articles published from their inception to December 2022. Two reviewers performed screening of search results, data extraction, and literature quality assessment independently.ResultsFor this meta-analysis, 59 publications were included. Based on the recovery of motor function at weeks 1, 2, 3, and 4 in NMA, almost all TCM groups had significantly increased positive effects than the negative control animals. In terms of cumulative probability, the tanshinone IIA (TIIA) group ranked first in restoring motor function in the first week after blunt SCI, and the resveratrol (RSV) group ranked first during the last 3 weeks.ConclusionThe NMA revealed that TCM monomers could effectively restore motor function in the rat model of blunt SCI. In rats with blunt SCI, TIIA may be the most effective TCM monomer during the first week, whereas RSV may be the most effective TCM monomer during the last 3 weeks in promoting motor function recovery. For better evidence reliability in preclinical investigations and safer extrapolation of those findings into clinical settings, further research standardizing the implementation and reporting of animal experiments is required.Systematic Review Registrationhttps://inplasy.com/, identifier INPLASY202310070.
Associations between serum trace elements and the risk of nasopharyngeal carcinoma: a multi-center case-control study in Guangdong Province, southern China
Authors: Ge Xin-Yu , Xie Shang-Hang , Wang Hao , Ye Xin , Chen Wenjie , Zhou Hang-Ning , Li Xueqi , Lin Ai-Hua , Cao Su-Mei 
Published: July 2023

BackgroundAssociations between trace elements and nasopharyngeal carcinoma (NPC) have been speculated but not thoroughly examined.MethodsThis study registered a total of 225 newly diagnosed patients with NPC and 225 healthy controls matched by sex and age from three municipal hospitals in Guangdong Province, southern China between 2011 and 2015. Information was collected by questionnaire on the demographic characteristics and other possibly confounding lifestyle factors. Eight trace elements and the level of Epstein–Barr virus (EBV) antibody were measured in casual (spot) serum specimens by inductively coupled plasma–mass spectrometry (ICP-MS) and enzyme-linked immunosorbent assay (ELISA), respectively. Restricted cubic splines and conditional logistic regression were applied to assess the relationship between trace elements and NPC risk through single-and multiple-elements models.ResultsSerum levels of chromium (Cr), cobalt (Co), nickel (Ni), arsenic (As), strontium (Sr) and molybdenum (Mo) were not associated with NPC risk. Manganese (Mn) and cadmium (Cd) were positively associated with NPC risk in both single-and multiple-element models, with ORs of the highest tertile compared with the reference categories 3.90 (95% CI, 1.27 to 7.34) for Mn and 2.30 (95% CI, 1.26 to 3.38) for Cd. Restricted cubic splines showed that there was a linear increasing trend between Mn and NPC risk, while for Cd there was a J-type correlation.ConclusionSerum levels of Cd and Mn was positively related with NPC risk. Prospective researches on the associations of the two trace elements with NPC ought to be taken into account within the future.
Concept and considerations of a medical device: the active noise cancelling incubator
Authors: Jaschke Artur C. , Bos Arend F. 
Published: July 2023

BackgroundAn increasingly 24/7 connected and urbanised world has created a silent pandemic of noise-induced hearing loss. Ensuring survival to children born (extremely) preterm is crucial. The incubator is a closed medical device, modifying the internal climate, and thus providing an environment for the child, as safe, warm, and comfortable as possible. While sound outside the incubator is managed and has decreased over the years, managing the noise inside the incubator is still a challenge.MethodUsing active noise cancelling in an incubator will eliminate unwanted sounds (i.e., from the respirator and heating) inside the incubator, and by adding sophisticated algorithms, normal human speech, neonatal intensive care unit music-based therapeutic interventions, and natural sounds will be sustained for the child in the pod. Applying different methods such as active noise cancelling, motion capture, sonological engineering. and sophisticated machine learning algorithms will be implemented in the development of the incubator.Projected ResultsA controlled and active sound environment in and around the incubator can in turn promote the wellbeing, neural development, and speech development of the child and minimise distress caused by unwanted noises. While developing the hardware and software pose individual challenges, it is about the system design and aspects contributing to it. On the one hand, it is crucial to measure the auditory range and frequencies in the incubator, as well as the predictable sounds that will have to be played back into the environment. On the other, there are many technical issues that have to be addressed when it comes to algorithms, datasets, delay, microphone technology, transducers, convergence, tracking, impulse control and noise rejection, noise mitigation stability, detection, polarity, and performance.ConclusionSolving a complex problem like this, however, requires a de-disciplinary approach, where each discipline will realise its own shortcomings and boundaries, and in turn will allow for innovations and new avenues. Technical developments used for building the active noise cancellation-incubator have the potential to contribute to improved care solutions for patients, both infants and adults.Code available at: 10.3389/fped.2023.1187815.
Research on prescribing cascades: a scoping review
Authors: Chen Zhe , Liu Zheng , Zeng Linan , Huang Liang , Zhang Lingli 
Published: July 2023

Background: The concept of prescribing cascades has been proposed for more than 20 years, but the research progress and cognitive level varied in different countries. The aim of this study was to systematically evaluate the current status of relevant original research on prescribing cascades, and to provide references for further research and continuous improvement in clinical practice.Methods: We searched three English databases and four Chinese databases from inception until January 2022. Relevant studies about prescribing cascades meeting the eligibility criteria were extracted independently by two reviewers, and a descriptive analysis was conducted to compare the methods and outcomes of the included studies.Results: A total of 32 studies involving 7,075,200 patients in 11 countries were included, including 13 cross-sectional studies, 11 case reports, 7 cohort studies, and 1 case-control study. The target population was mainly elderly people (24 studies). The purpose of the included studies could be divided into three categories: prevention (4 studies), identification (17 studies), and resolution (11 studies) of prescribing cascades. 49 prescribing cascade routes were identified and mainly attributed to the cardiovascular system, most primary diseases of which were dementia, the initial medications of prescribing cascades were mainly calcium channel blockers, and two to six drugs were involved in the prescribing cascade routes.Conclusion: Prescribing cascades have attracted more attention internationally and current studies have mainly focused on the elderly and their cardiovascular diseases and nervous diseases, but still not yet formed integral research in other special populations of drug use, such as children and pregnant women. It is necessary to further conduct in-depth studies with a broader range, and to establish a series of effective measures to decrease the incidence of prescribing cascades in the high-risk group of drug use.
Comparing the hemodynamic effect of a large arteriovenous fistula during high and low cardiac output states
Authors: Valerianova A. , Mlcek M. , Malik J. , Grus T. , Tejkl L. , Kolosova B. , Lejsek V. , Kittnar O. 
Published: July 2023

Background: A large arteriovenous fistula (AVF) is a low-resistant circuit that affects organ perfusion and systemic hemodynamics even in standard conditions. The extent of its’ effect in critical states has not been elucidated yet. We used norepinephrine to create systemic vasoconstriction, dobutamine to create high cardiac output, and rapid right ventricle pacing as a model of acute heart failure in a porcine model of high-flow AVF circulation.Methods: The protocol was performed on nine domestic female pigs under general anesthesia. AVF was created by connecting two high-diameter ECMO cannulas inserted in the femoral artery and vein. Continuous hemodynamic monitoring was performed throughout the protocol. Three interventions were performed–moderate dose of norepinephrine (0.25 ug/kg/min), moderate dose of dobutamine (10 ug/kg/min) and rapid right ventricle pacing to simulate low cardiac output state with mean arterial pressure under 60 mmHg. Measurements were taken with opened and closed arteriovenous fistula.Results: Continuous infusion of norepinephrine with opened AVF significantly increased mean arterial pressure (+20%) and total cardiac output (CO) (+36%), but vascular resistance remained virtually unchanged. AVF flow (Qa) rise correlated with mean arterial pressure increase (+20%; R = 0.97, p = 0.0001). Effective cardiac output increased, leading to insignificant improvement in organ perfusion. Dobutamine substantially increased cardiac output with insignificant effect on AVF flow and mean arterial pressure. Carotid artery blood flow increased significantly after dobutamine infusion by approximately 30%, coronary flow velocity increased significantly only in closed AVF state. The effective cardiac output using the heart failure model leading to decrease of carotid artery flow and worsening of brain and peripheral tissue oximetry. AVF blood flow also dropped significantly and proportionally to pressure, but Qa/CO ratio did not change. Therefore, the effective cardiac output decreased.Conclusion: In abovementioned extreme hemodynamic conditions the AVF flow was always directly proportional to systemic perfusion pressure. The ratio of shunt flow to cardiac output depended on systemic vascular resistance. These experiments highlight the detrimental role of a large AVF in these critical conditions’ models.
The role of ipsilateral motor network in upper limb movement
Authors: Ding Hao , Seusing Nelly , Nasseroleslami Bahman , Anwar Abdul Rauf , Strauss Sebastian , Lotze Martin , Grothe Matthias , Groppa Sergiu , Muthuraman Muthuraman 
Published: July 2023

The execution of voluntary movements is primarily governed by the cerebral hemisphere contralateral to the moving limb. Previous research indicates that the ipsilateral motor network, comprising the primary motor cortex (M1), supplementary motor area (SMA), and premotor cortex (PM), plays a crucial role in the planning and execution of limb movements. However, the precise functions of this network and its interplay in different task contexts have yet to be fully understood. Twenty healthy right-handed participants (10 females, mean age 26.1 ± 4.6 years) underwent functional MRI scans while performing biceps brachii representations such as bilateral, unilateral flexion, and bilateral flexion-extension. Ipsilateral motor evoked potentials (iMEPs) were obtained from the identical set of participants in a prior study using transcranial magnetic stimulation (TMS) targeting M1 while employing the same motor tasks. The voxel time series was extracted based on the region of interest (M1, SMA, ventral PM and dorsal PM). Directed functinal connectivity was derived from the extracted time series using time-resolved partial directed coherence. We found increased connectivity from left-PMv to both sides M1, as well as right-PMv to both sides SMA, in unilateral flexion compared to bilateral flexion. Connectivity from left M1 to left-PMv, and left-SMA to right-PMd, also increased in both unilateral flexion and bilateral flexion-extension compared to bilateral flexion. However, connectivity between PMv and right-M1 to left-PMd decreased during bilateral flexion-extension compared to unilateral flexion. Additionally, during bilateral flexion-extension, the connectivity from right-M1 to right-SMA had a negative relationship with the area ratio of iMEP in the dominant side. Our results provide corroborating evidence for prior research suggesting that the ipsilateral motor network is implicated in the voluntary movements and underscores its involvement in cognitive processes such as movement planning and coordination. Moreover, ipsilateral connectivity from M1 to SMA on the dominant side can modulate the degree of ipsilateral M1 activation during bilateral antagonistic contraction.
The challenge of education for sustainability in higher education: key themes and competences within the University of the Basque Country
Authors: Idoiaga Mondragon Nahia , Yarritu Ion , Saez de Cámara Estibaliz , Beloki Nekane , Vozmediano Laura 
Published: July 2023

IntroductionOne of the major challenges for higher education institutions in the last decade has been (and will continue to be) the integration of sustainability into their curricula and the development of sustainability competences in students. Education for Sustainability (ES) can help prepare students to meet the challenges of making societies more sustainable. However, as a first step toward this goal, teachers need to incorporate ES into their teaching. In this regard, this research aimed to analyze if members of the teaching staff have started this integration and, if so, which sustainability-related topics have been introduced and which skills do they consider contribute to the development of future graduates.MethodsA questionnaire was administered to teaching staff at the University of the Basque Country in 2022. A total of 403 teachers completed the questionnaire, expressing their perceptions through open-ended questions.ResultsIn general terms teachers incorporate ES into their teaching (71.22%). However, they do this mainly within the framework of two general themes: “Environmental awareness and energy” – most used by teachers of experimental sciences and engineering – and “Social commitment,” most used by teachers of social sciences and those who are familiar with the UN 2030 Agenda for Sustainable Development. Regarding the key competences that ES provides for future graduates, those most frequently mentioned were “training of professionals committed to society” and “critical thinking and ethics.” These competences were particularly notable in the discourse of teachers who were aware of the 2030 Agenda and who use active methodologies in their classrooms. Finally, the opinion that sustainability has little to do with their teaching (28.78%) was notably expressed by teachers less familiar with the 2030 Agenda.DiscussionThus, it can be concluded that, aside from knowledge of the 2030 Agenda, factors such as the sustainability policy of the institution, area of teaching expertise, and the use of active methodologies all play a significant role in determining whether competences for sustainable development are integrated into higher education teaching.
How serving helps leading: mediators between servant leadership and affective commitment
Authors: Bai Mayangzong , Zheng Xinyi , Huang Xu , Jing Tiantian , Yu Chenhao , Li Sisi , Zhang Zhiruo 
Published: July 2023

IntroductionServant leadership has long been associated with maintaining employee’s affective commitment, yet the underlying mechanism remains unclear. Research from non-western cultures remains scarce.MethodsThis study sought to fill in such research gap by introducing insights from social exchange theory perspective, and examined two potential mediators (viz., psychological safety and job burnout) with a largescale, representative Chinese sample.ResultsA total of 931 staffs in a Chinese hospital were surveyed, and structural equation models revealed that psychological safety (indirect effect = 0.052, 95% Bootstrap CI = [0.002, 0.101]) and job burnout (indirect effect = 0.277, 95% Bootstrap CI = [0.226, 0.331]) parallelly (and partially) mediated the effect of servant leadership on affective commitment. Moreover, these effects held the same between permanent and temporary staffs, as well as between male and female staffs.DiscussionResults suggested that a leader’s orientation to care, validate, and respond to their followers’ needs was effective in creating a psychological safe environment and downplaying job burnout in workplace, in exchange to which, followers remained affectively committed to their organization in a long term. Not only did this study contribute to existing literature by providing non-western data for service leadership research, it also provided a deeper understanding of associated mechanisms of how servant leadership might cast on talent retain and organizational development in a long term. These mechanisms shed light on how serving helps leading and advocate servant leadership for hospitals, as well as other serving organizations.