bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impacts of adapted dance on mood and physical function among persons living with Alzheimer's disease
Authors: Bennett Crystal G , Guttmann Rodney P , Hackney Madeleine E , Amin Raid , Weaver Savannah 
Published: December 2024

Background Most individuals living with Alzheimer's disease and related dementias (ADRD) experience one or more neuropsychiatric symptoms, such as agitation which negatively impacts their quality of life. Adapted dance integrates recorded music and movement that is appropriate for people with cognitive limitations. Adapted dance may be an enjoyable activity for persons living with ADRD and may provide psychological and physical benefits. Objective The purpose of this pilot study was to assess the feasibility of an adapted dance intervention with persons with ADRD and the impacts of 12 weeks of adapted dancing on agitation, balance, gait, lower extremity strength, and caregiver burden. Methods This study used an experimental design with repeated measures. Participants with ADRD were randomly assigned to a usual care or adapted line dance group that met 60 min twice a week. At pre-test, 4-, 8-, and 12 weeks of intervention, measures were collected for agitation, balance, gait, lower extremity strength, and caregiver burden. Results The sample consisted of 4 males and 12 females (n = 16) with ADRD whose age ranged from 69–97 years. Twelve weeks of adapted line dance was found acceptable by ADRD participants. Participants attended ≥90% of dance sessions and did not experience loss of balance or fall. ADRD participants danced an average of 70 min per week. Both groups had improvements in agitation from baseline to 12 weeks. Conclusions Twelve weeks of adapted dance was shown to be feasible and enjoyable for persons living with ADRD. Clinicians should consider adapted dance as part of an exercise prescription.
Determinants of Liraglutide Treatment Discontinuation in Type 1 Diabetes: A Post Hoc Analysis of ADJUNCT ONE and ADJUNCT TWO Randomized Placebo-Controlled Clinical Studies
Authors: Shah Viral N. , Agesen Rikke M. , Bardtrum Lars , Christiansen Erik , Snaith Jennifer , Greenfield Jerry R. 
Published: December 2024

Introduction: Two phase 3 randomized controlled studies (ADJUNCT ONE (Clinicaltrials.gov: NCT01836523), ADJUNCT TWO (Clinicaltrials.gov: NCT02098395)) evaluated liraglutide (1.8, 1.2 or 0.6 mg) vs placebo in participants with type 1 diabetes (T1D) as an adjunct to insulin therapy. This paper aims to improve our understanding of the potential mechanisms leading to premature discontinuation of this treatment regimen. Methods: Post hoc comparisons were conducted on baseline characteristics and adverse event (AE) rates of participants completing and not completing the ADJUNCT studies due to AEs/lack of tolerance using summary tables and variance analysis. Results: Non-completers (liraglutide and placebo combined) had lower baseline body mass index (BMI) (ADJUNCT ONE: 27.8 kg/m2 vs 29.8 kg/m2, P < .0001; ADJUNCT TWO: 26.3 kg/m2 vs 29.2 kg/m2, P < .0001), longer duration of T1D (25.8 years vs 21.0 years, P < .0001; 24.1 years vs 21.0 years, P = .04), lower daily insulin doses by continuous infusion (46.4 U vs 57.3 U, P = .01; 40.9 U vs 57.4 U, P = .12) or multiple injections (58.4 U vs 68.5 U, P = .006; 56.0 U vs 65.8 U, P =.03) and a higher proportion of participants with undetectable C-peptide (91.5% vs 81.3%; 87.0% vs 84.9%) compared to completers. When analyzed by treatment group, only duration of T1D and C-peptide differed between completers and non-completers among liraglutide (and not placebo) participants. The AE rates were higher for non-completers. Conclusion: Individuals with longer-standing T1D and low levels of C-peptide at baseline were more likely to discontinue adjunctive liraglutide treatment due to AEs/lack of tolerance than individuals with residual insulin production. Lower BMI predicted a greater likelihood of non-completion for the included participants, regardless of treatment. These new findings may be relevant for clinical practice.
Chemical Analysis, Antioxidant Activity, and in vitro Digestibility of Crataegus azarolus Leaves and Fruits in Goats
Authors: Sammari Houcem , Jedidi Saber , Abidi Anouar , Selmi Houcine , Sebai Hichem 
Published: December 2024

Introduction In the aim to investigate the possible influence the variation of the food composition on ruminant performances, several approaches was based on medicinal plants for their beneficial effects on digestibility. Our study was oriented to determine the phytochemical screening, the antioxidant activity, and the in vitro digestibility of Crataegus azarolus leaves (CALAE) and berries (CABAE) collected from the Ain Draham region, which is located in the northwest of Tunisia. Methods Colorimetric analyses were used for the quantification of phenolic compounds, and the antioxidant activity of azerole extracts was evaluated using DPPH-free radical scavenging activity. The in vitro ruminal fermentation was determined using the gas production method. Results Leaves contained the highest levels of mineral matter, neutral detergent fibre (NDF), and nitrogen matter (TNM) when compared to those of berries. Furthermore, the DPPH assay showed that Crataegus azarolus aqueous extracts were characterized by a high antioxidant capacity, which is proportional to total phenolic concentrations. The in vitro digestibility evaluation demonstrates a significant variation in each ruminal parameter, and the highest levels of gas production, metabolizable energy (ME), and volatile fatty acids (VFA) were observed in leaves. Conclusion Data showed that azerole berries and leaves contained an important level of total fiber, nutrients, and mineral matter. The phytochemical analyses demonstrated a strong correlation between the richness of phenolic compounds and their antioxidant capacity. Indeed, yellow azerole berries and leaves can be recommended as an additive in goat feed rations to improve the animals’ quality.
Ultrasound diagnosis of cystic cystitis with von Brunn’s nest in two cats
Authors: Moreau Morgane , Haudiquet Philippe , Monton Clémence , Arnault Fabien , Jossier Renaud 
Published: December 2024

Case series summary Two cats were initially evaluated for recurrent dysuria and haematuria, which were unresponsive to antibiotic and anti-inflammatory treatments. An abdominal ultrasound revealed focal wall thickening with a severe hypoechoic multicystic parietal lesion at the bladder apex. Surgical excision of the lesion (apical cystectomy) led to complete resolution of the clinical signs in both cases. The histological findings were consistent with large cystic von Brunn’s nest hyperplasia, along with foci of small glandular metaplasia. Urine and tissue cultures were negative. Cystitis cystica was diagnosed. No recurrence was reported within 2 years of surgery in both cases. Relevance and novel information This case series illustrates the occurrence and ultrasonographic features of a type of cystitis rarely described in animals: cystic cystitis with von Brunn’s nest hyperplasia. These lesions result from chronic irritation and can lead to recurrent cystitis if not excised. Cystic cystitis has previously been described histologically in cats. To the authors’ knowledge, this is the first report of macroscopic apical cystic cystitis with pre-treatment ultrasound diagnosis. Surgical resection of the hyperplastic von Brunn’s nests appeared to be curative in both cases.
Exploring the Impact of Prior Cannabis Use on 90-Day Complications Following Foot and Ankle Procedures: A Comprehensive Analysis and Clinical Implications
Authors: Kishan Arman , Kubsad Sanjay , Bergstein Victoria E. , Zhu Stanley E. , Ficke James R. , Aiyer Amiethab A. 
Published: December 2024

Category: Ankle; Midfoot/Forefoot Introduction/Purpose: With the rising prevalence of cannabis consumption among individuals undergoing foot and ankle procedures, there is a critical need for a comprehensive investigation into the impact of cannabis use on post-operative outcomes. The shifting societal attitudes towards cannabis, coupled with legislative changes promoting increased accessibility, underscore the urgency of understanding the implications for both patients and surgeons. This study aims to address this gap in knowledge and provide insights that can guide pre-operative evaluations and post-operative care planning. Methods: Utilizing data from PearlDiver, patients who underwent interphalangeal fusion, arthrodesis, arthroscopy, total ankle arthroplasty, ankle fracture repair, lateral ankle ligament reconstruction, calcaneal tendon repair, bunionectomy and calcaneal osteotomy were identified. These patients with prior history of cannabis use were propensity-matched with a cohort without prior history of cannabis use based on age, sex and Charlson Comorbidity Index in a 1:4 ratio. Both cohorts were evaluated for 90-day occurrence of medical complications using univariate analysis. Results: In this study, we matched 59,797 patients with a history of cannabis use undergoing foot or ankle procedures with 239,086 without such history. Those with prior cannabis use showed significantly elevated rates of medical conditions compared to controls: pneumonia (6.1% vs. 2.2%, p < .001), deep vein thrombosis (1.5% vs. 0.8%, p < .001), pulmonary embolism (0.4% vs. 0.2%, p < .001), myocardial infarction (1.6% vs. 0.5%, p < .001), stroke (1.8% vs. 0.8%, p < .001), surgical site infections (4.0% vs. 2.2%, p < .001), acute kidney injury (6.8% vs. 3.0%, p < .001), urinary tract infections (9.0% vs. 3.5%, p < .001), sepsis (4.6% vs. 2.0%, p < .001), and hypoglycemia (1.2% vs. 0.5%, p < .001). Conclusion: This study highlights a compelling correlation between prior cannabis use and heightened risks of medical complications post foot and ankle surgeries. The findings emphasize the imperative for healthcare professionals to include cannabis use history in pre-operative assessments and post-operative care planning. Acknowledging the evolving landscape of cannabis use among surgical patients, further research is essential to refine clinical approaches and enhance patient outcomes in this context.
Assessing the accuracy and quality of artificial intelligence (AI) chatbot-generated responses in making patient-specific drug-therapy and healthcare-related decisions
Authors: Shiferaw Meron W. , Zheng Taylor , Winter Abigail , Mike Leigh Ann , Chan Lingtak-Neander 
Published: December 2024

Abstract
Background
Interactive artificial intelligence tools such as ChatGPT have gained popularity, yet little is known about their reliability as a reference tool for healthcare-related information for healthcare providers and trainees. The objective of this study was to assess the consistency, quality, and accuracy of the responses generated by ChatGPT on healthcare-related inquiries.

Methods
A total of 18 open-ended questions including six questions in three defined clinical areas (2 each to address “what”, “why”, and “how”, respectively) were submitted to ChatGPT v3.5 based on real-world usage experience. The experiment was conducted in duplicate using 2 computers. Five investigators independently ranked each response using a 4-point scale to rate the quality of the bot’s responses. The Delphi method was used to compare each investigator’s score with the goal of reaching at least 80% consistency. The accuracy of the responses was checked using established professional references and resources. When the responses were in question, the bot was asked to provide reference material used for the investigators to determine the accuracy and quality. The investigators determined the consistency, accuracy, and quality by establishing a consensus.

Results
The speech pattern and length of the responses were consistent within the same user but different between users. Occasionally, ChatGPT provided 2 completely different responses to the same question. Overall, ChatGPT provided more accurate responses (8 out of 12) to the “what” questions with less reliable performance to the “why” and “how” questions. We identified errors in calculation, unit of measurement, and misuse of protocols by ChatGPT. Some of these errors could result in clinical decisions leading to harm. We also identified citations and references shown by ChatGPT that did not exist in the literature.

Conclusions
ChatGPT is not ready to take on the coaching role for either healthcare learners or healthcare professionals. The lack of consistency in the responses to the same question is problematic for both learners and decision-makers. The intrinsic assumptions made by the chatbot could lead to erroneous clinical decisions. The unreliability in providing valid references is a serious flaw in using ChatGPT to drive clinical decision making.
Reprogramming tumor-associated macrophages with lipid nanosystems reduces PDAC tumor burden and liver metastasis
Authors: Palencia-Campos Adrián , Ruiz-Cañas Laura , Abal-Sanisidro Marcelina , López-Gil Juan Carlos , Batres-Ramos Sandra , Saraiva Sofia Mendes , Yagüe Balbino , Navarro Diego , Alcalá Sonia , Rubiolo Juan A. , Bidan Nadège , Sánchez Laura , Mura Simona , Hermann Patrick C. , de la Fuente María , Sainz Bruno 
Published: December 2024

Abstract
Background
Pancreatic ductal adenocarcinoma (PDAC) requires innovative therapeutic strategies to counteract its progression and metastatic potential. Since the majority of patients are diagnosed with advanced metastatic disease, treatment strategies targeting not only the primary tumor but also metastatic lesions are needed. Tumor-Associated Macrophages (TAMs) have emerged as central players, significantly influencing PDAC progression and metastasis. Our objective was to validate an innovative therapeutic strategy involving the reprogramming of TAMs using lipid nanosystems to prevent the formation of a pro-metastatic microenvironment in the liver.

Results
In vitro results demonstrate that M2-polarized macrophages lose their M2-phenotype following treatment with lipid nanoemulsions composed of vitamin E and sphingomyelin (VitE:SM), transitioning to an M0/M1 state. Specifically, VitE:SM nanoemulsion treatment decreased the expression of macrophage M2 markers such as Arg1 and Egr2, while M1 markers such as Cd86, Il-1b and Il-12b increased. Additionally, the TGF-βR1 inhibitor Galunisertib (LY2157299) was loaded into VitE:SM nanoemulsions and delivered to C57BL/6 mice orthotopically injected with KPC PDAC tumor cells. Treated mice showed diminished primary tumor growth and reduced TAM infiltration in the liver. Moreover, we observed a decrease in liver metastasis with the nanoemulsion treatment in an intrasplenic model of PDAC liver metastasis. Finally, we validated the translatability of our VitE:SM nanosystem therapy in a human cell-based 3D co-culture model in vivo, underscoring the pivotal role of macrophages in the nanosystem’s therapeutic effect in the context of human PDAC metastasis.

Conclusions
The demonstrated effectiveness and safety of our nanosystem therapy highlights a promising therapeutic approach for PDAC, showcasing its potential in reprogramming TAMs and mitigating the occurrence of liver metastasis.

Graphical abstract
BOLD-CSF dynamics assessed using real-time phase contrast CSF flow interleaved with cortical BOLD MRI
Authors: Roefs Emiel C. A. , Eiling Ingmar , de Bresser Jeroen , van Osch Matthias J.P. , Hirschler Lydiane 
Published: December 2024

Abstract
Background
Cerebrospinal fluid (CSF) motion and pulsatility has been proposed to play a crucial role in clearing brain waste. Although its driving forces remain debated, increasing evidence suggests that large amplitude vasomotion drives such CSF fluctuations. Recently, a fast blood-oxygen-level-dependent (BOLD) fMRI sequence was used to measure the coupling between CSF fluctuations and low-frequency hemodynamic oscillations in the human cortex. However, this technique is not quantitative, only captures unidirectional flow and is sensitive to B0-fluctuations. Real-time phase contrast (pcCSF) instead measures CSF flow dynamics in a fast, quantitative, bidirectional and B0-insensitive manner, but lacks information on hemodynamic brain oscillations. In this study we propose to combine the strengths of both sequences by interleaving real-time phase contrast with a cortical BOLD scan, thereby enabling the quantification of the interaction between CSF flow and cortical BOLD.

Methods
Two experiments were performed. First, we compared the CSF flow measured using real-time phase contrast (pcCSF) with the inflow-sensitized BOLD (iCSF) measurements by interleaving both techniques at the repetition level and planning them at the same location. Next, we compared the BOLD-CSF coupling obtained using the novel pcCSF interleaved with cortical BOLD to the coupling obtained with the original iCSF. To time-lock the CSF fluctuations, participants were instructed to perform slow, abdominal paced breathing.

Results
pcCSF captures bidirectional CSF dynamics with a more pronounced in- and outflow curve than the original iCSF method. With the pcCSF method, the BOLD-CSF coupling was stronger (mean cross-correlation peak increase = 0.22, p = .008) and with a 1.9 s shorter temporal lag (p = .016), as compared to using the original iCSF technique.

Conclusions
In this study, we introduce a new method to study the coupling of CSF flow measured in the fourth ventricle to cortical BOLD fluctuations. In contrast to the original approach, the use of phase contrast MRI to measure CSF flow provides a quantitative in- and outflow curve, and improved BOLD-CSF coupling metrics.
Subtopic-specific heterogeneity in computer-based learning behaviors
Authors: Lee HaeJin , Bosch Nigel 
Published: December 2024

Abstract
Background
Self-regulated learning (SRL) strategies can be domain specific. However, it remains unclear whether this specificity extends to different subtopics within a single subject domain. In this study, we collected data from 210 college students engaged in a computer-based learning environment to examine the heterogeneous manifestations of learning behaviors across four distinct subtopics in introductory statistics. Further, we explore how the time spent engaging in metacognitive strategies correlated with learning gain in those subtopics.

Results
By employing two different analytical approaches that combine data-driven learning analytics (i.e., sequential pattern mining in this case), and theory-informed methods (i.e., coherence analysis), we discovered significant variability in the frequency of learning patterns that are potentially associated with SRL-relevant strategies across four subtopics. In a subtopic related to calculations, engagement in coherent quizzes (i.e., a type of metacognitive strategy) was found to be significantly less related to learning gains compared to other subtopics. Additionally, we found that students with different levels of prior knowledge and learning gains demonstrated varying degrees of engagement in learning patterns in an SRL context.

Conclusion
The findings imply that the use—and the effectiveness—of learning patterns that are potentially associated with SRL-relevant strategies varies not only across contexts and domains, but even across different subtopics within a single subject. This underscores the importance of personalized, context-aware SRL training interventions in computer-based learning environments, which could significantly enhance learning outcomes by addressing the heterogeneous relationships between SRL activities and outcomes. Further, we suggest theoretical implications of subtopic-specific heterogeneity within the context of various SRL models. Understanding SRL heterogeneity enhances these theories, offering more nuanced insights into learners’ metacognitive strategies across different subtopics.
The Structure, Function, and Adaptation of Lower-Limb Aponeuroses: Implications for Myo-Aponeurotic Injury
Authors: Hulm Scott , Timmins Ryan G. , Hickey Jack T. , Maniar Nirav , Lin Yi-Chung , Knaus Katherine R. , Heiderscheit Bryan C. , Blemker Silvia S. , Opar David A. 
Published: December 2024

AbstractThe aponeurosis is a large fibrous connective tissue structure within and surrounding skeletal muscle and is a critical component of the muscle–tendon unit (MTU). Due to the lack of consensus on terminology and the heterogeneous nature of the aponeurosis between MTUs, there are several questions that remain unanswered. For example, the aponeurosis is often conflated with the free tendon rather than being considered an independent structure. This has subsequent implications when interpreting data regarding the structure, function, and adaptation of the aponeuroses from these studies. In recent years, a body of work has emerged to suggest that acute injury to the myo-aponeurotic complex may have an impact on return-to-sport timeframes and reinjury rates. Therefore, the purpose of this review is to provide a more detailed understanding of the morphology and mechanical behaviour common to all aponeuroses, as well as the unique characteristics of specific lower-limb aponeuroses that are commonly injured. This review provides the practitioner with a current understanding of the mechanical, material, and adaptive properties of lower limb aponeuroses and suggests directions for future research related to the myo-aponeurotic complex.
Comprehension of the adapted Urticaria Activity Score measure and patient guidance document: qualitative interviews with adults and adolescents with chronic spontaneous urticaria
Authors: Skalicky Anne M. , Wang Yan , Eseyin Olabimpe R. , Stefan Marissa , Rane Pallavi B. , McLaren Julie , Maurer Marcus 
Published: December 2024

Abstract
Objective
A key component of determining that a patient-reported outcome (PRO) measure is fit-for-purpose is to ensure that respondents understand its instructions and items. Any modification to a measure should be evaluated for relevance and understandability. The objective of the study was to assess comprehension of the adapted Urticaria Activity Score (UAS) questionnaire among adolescents aged populations with chronic spontaneous urticaria (CSU) and the modification to UAS question 2 to include patient-friendly terminology “wheals (hives).” A patient guidance document for completing the adapted UAS was also examined.

Methods
A non-interventional, cross-sectional, qualitative study involving hybrid concept elicitation and cognitive interviews was conducted among adults and adolescents with CSU. Eligibility included clinician confirmation of CSU and experience of itch and hives for ≥ 6 weeks. Study participants were recruited from US clinical sites and online CSU patient communities. Telephone interviews were conducted using a semi-structured interview guide. Participants reviewed the UAS and provided their input on the UAS guidance document.

Results
Twenty-two interviews were conducted (seven adolescents and 15 adults; mean age 34 ± 18 years, 64% female, 77% White, 77% non-Hispanic, and 59% moderate to severe CSU symptoms). All participants (n = 22/22, 100%) stated that the adapted UAS was clear and “easy” to understand. For the adapted UAS “wheals (hives)” item, several participants were unfamiliar with the term “wheals,” but the term “hives” was well understood by US participants. Most participants reported that it was “easy” or “not difficult” to count and recall the number of hives they had over the past 24 h. Participants found the adapted UAS guidance document “helpful” and “easy to understand” for determining and counting hives in a 24-hour period. Suggestions for improving the guide included adding a picture to aid in counting hives.

Conclusions
Itch and hives are important symptoms of CSU. Results support the content validity of an adapted UAS as a daily measure of severity of itch and hives and provided valuable suggestions for improving its patient guidance, which can be used in future clinical trials involving adults and adolescents ≥ 12 years old with CSU to assess the severity of itch and hives.