bluuebunny/crossref_metadata_2025_split huggingface dataset:
Augmented Effect of Combined Robotic Assisted Gait Training and Proprioceptive Neuromuscular Facilitation-irradiation Technique on Muscle Activation and Ankle Kinematics in Hemiparetic Gait: A Preliminary Study
Authors: Yoon Buhyeon , Park Seonmi , Oh Seungjun , You Joshua Sung H. 
Published: December 2024

Background Proprioceptive neuromuscular facilitation (PNF) alone has limited effectiveness in restoring gait, while robotic-assisted gait training (RAGT) improves motor relearning through repetitive, task-specific movements. Combining PNF with robotic gait training (PRGT) may enhance locomotor recovery by promoting proprioceptive awareness and muscle activation alongside repetitive gait retraining in stroke patients. Objective This study compares the immediate effects of PRGT and RAGT on ankle dorsiflexion and muscle activity in chronic hemiparetic stroke patients and healthy controls. Methods Thirty participants, including 15 stroke patients and 15 healthy controls, were randomly assigned to PRGT or RAGT for a single 30-min session. Muscle activity (pectoralis major, external oblique, internal oblique/transverse abdominis, rectus femoris, tibialis anterior) was measured using electromyography, while ankle dorsiflexion angle was assessed using a dual-axis inclinometer. Results PRGT significantly increased muscle activations compared to RAGT in stroke patients ( p < 0.05). Additionally, there was a significant difference in ankle dorsiflexion between RAGT and PRGT in both groups ( p < 0.05). Conclusion PRGT demonstrated superior immediate effects on muscle activation and ankle movement, suggesting that combining PNF with robotic-assisted gait training is beneficial for chronic stroke rehabilitation.
Verified Human Trafficking Allegations Among Single and Dual System-Involved Children: Predicting Initial and Repeat Victimization
Authors: Cutbush Starseed Stacey , Kluckman Marianne , Tueller Stephen , Yu Lilly , Scaggs Sam 
Published: December 2024

There is a dearth of research examining repeat human trafficking victimization among children involved with the child welfare system (i.e., single system involvement) and children involved with both the child welfare and juvenile justice systems (i.e., dual system involvement). This study uses longitudinal statewide linked administrative data from the Florida Department of Children and Families (DCF) and Florida Department of Juvenile Justice (DJJ) to investigate both initial and subsequent verified human trafficking allegations among single and dual system-involved children. We conducted logistic regression models to identify youth characteristics, prior DCF experiences, and prior DJJ experiences that predict initial and subsequent trafficking victimization. We also conducted survival analysis to identify time until human trafficking victimization and revictimization. Prior maltreatment, placement history, missing child events, referral without adjudication, community supervision, and residential facility placement predict initial trafficking victimization. These same indicators predict revictimization, except for prior placement history, residential facility commitment, prior physical abuse and prior sexual abuse. Approximately 1 in 5 child victims experience trafficking revictimization; the median time between initial and subsequent revictimization is about 6 months. This research has implications for policy and practice among system-involved children at greatest risk for human trafficking revictimization.
Neurostatus-SMARTCARE clinical trial: Enabling health care professionals to assess EDSS for decentralized trials in multiple sclerosis
Authors: Mallucci Giulia , Zimmer Andrea , Sfikas Nikolaos , Cerdá-Fuertes Nuria , Wunderlin Simon , Athanasopoulou Ioanna , Mroczek Magdalena , Phavanh Vanny , Sanak Lisa , Suter Jolanda , Friedli Bernadette , Kel Jakob , Trouillet Thomas , Simmen Sarah , Ocampo Alex , Wei Wenjia , Kieseier Bernd , Kamm Christian P , Kappos Ludwig , D’Souza Marcus 
Published: December 2024

Background: Neurostatus-Expanded Disability Status Scale (EDSS) is the standard measure used to assess impairment and disability in multiple sclerosis (MS) trials but requires trained expert neurologists. Objectives: This study aims to evaluate the concordance of Neurostatus-EDSS assessments from specially trained health care professionals (HCPs) and standardized trained neurologists. Methods: A Swiss multicenter, randomized, cross-over study with 100 people with MS. HCPs were trained to assess the Neurostatus-EDSS based on the newly developed SMARTCARE-EDSS training method. Results: The concordance rate between HCPs and neurologists was 0.87 (95% confidence interval (CI) = 0.815–0.925). Conclusion: Trained HCPs can reliably perform Neurostatus-EDSS assessments, supporting broader implementation and improved trial access.
‘I did what I could to earn some money and be of use’: A qualitative exploration of autistic people’s journeys to career success and fulfilment
Authors: Davies Jade , Melinek Rachel , Livesey Adam , Killick Estelle , Sam Evelyn , Romualdez Anna Melissa , Pellicano Elizabeth , Remington Anna 
Published: December 2024

Employment contributes to well-being, yet many autistic people who want to work face barriers to meaningful employment. Much research focuses solely on employment rates, rather than taking a more holistic view of professional trajectories and occupational experiences. We conducted semi-structured interviews with 18 autistic adults to explore their experiences of, and perspectives on, career success. Our participants highlighted the overarching importance of finding fulfilment in one’s career. Using reflexive thematic analysis, we identified five additional key themes: (1) volatile career journeys, (2) the need for continuing career support, (3) the impact (positive or negative) of social interactions, (4) the important role of organisations and (5) the catastrophic impact of poor experiences. Our findings highlight the importance of tailored, lifelong employment support and inclusive workplaces in enabling autistic people to thrive at work. Enabling autistic career fulfilment requires moving beyond entry-level hiring to foster sustainable, fulfilling employment for all autistic people. Lay abstract Many autistic people want to work but have trouble finding jobs they like and can stick with. Most research tries to help more autistic people get jobs, but does not look at whether those jobs are fulfilling, or how people progress once they start working. We spoke to 18 autistic people about their experiences at work, and their ideas about success at work. Participants said finding fulfilment in their careers was key. We found five common ‘themes’ across the interviews. First, autistic people’s careers often take unexpected turns. For example, many participants only got diagnosed as adults, which sometimes changed their work plans. Second, autistic people might need ongoing help with their career, including help with finding jobs they would enjoy and be good at, and advice on how to progress in their job. Third, getting along with others at work is really important. Having supportive colleagues helped our participants thrive, but workplace bullying forced some to leave their jobs. Fourth, workplaces need to be welcoming to everybody. Adjustments and understanding managers helped, but many of our participants’ workplaces were not inclusive. Finally, bad work experiences can be devastating for mental health and well-being and negative experiences like bullying led some participants to quit working entirely. Our findings show that lifelong support tailored to each person and welcoming workplaces are important for autistic people to thrive at work. It is not enough to just hire autistic people – we need to help them have jobs they like and can stick with long-term.
CT Radiomic Nomogram Using Optimal Volume of Interest for Preoperatively Predicting Invasive Mucinous Adenocarcinomas in Patients with Incidental Pulmonary Nodules: A Multicenter, Large-Scale Study
Authors: Zuo Zhichao , Zhang Guochao , Chen Jing , Xue Qi , Lin Shanyue , Zeng Ying , Ge Wu , Qi Wanyin , Yang Lu , Liu Haibo , Fan Xiaohong , Zhang Shuangping 
Published: December 2024

Introduction This study evaluated the efficacy of radiomic analysis with optimal volumes of interest (VOIs) on computed tomography images to preoperatively differentiate invasive mucinous adenocarcinoma (IMA) from non-mucinous adenocarcinoma (non-IMA) in patients with incidental pulmonary nodules (IPNs). Methods This multicenter, large-scale retrospective study included 1383 patients with IPNs, 110 (8%) of whom were pathologically diagnosed with IMA postoperatively. Radiomic features were extracted from multi-scale VOI subgroups (VOI−2 mm, VOIentire, VOI + 2 mm, and VOI + 4 mm). Resampling methods, specifically, the synthetic minority oversampling technique, addressed the imbalance between the majority (IMA) and minority (non-IMA) groups. Radiomic features were identified using the least absolute shrinkage and selection operator algorithm. Radscores were calculated by linearly combining the selected features with their weights. A combined nomogram integrating the optimal VOI-based radiomic model with the image-finding classifier was constructed. Results Bubble lucency and lower lobe predominance were significant in establishing an image-finding classifier to differentiate between IMA and non-IMA in IPNs, achieving an area under the curve (AUC) value of 0.684 (0.568-0.801). Across all radiomic models, IMA had a higher Radscore than did non-IMA. Specifically, the VOI + 2 mm-based radiomic model exhibited the highest performance, with an AUC of 0.832 (0.753-0.911). The combined nomogram outperformed the recognized image-finding classifier and radiomic models, achieving an AUC of 0.850 (0.776-0.925). Conclusion A nomogram that combines a recognized image-finding classifier with an optimal VOI-based radiomic model effectively predicts IMA in IPNs, aiding physicians in developing comprehensive treatment strategies.
Repeat adolescent pregnancies in Southwestern Uganda: A cross-sectional study
Authors: Ramachandran Rupa , Namatovu Shakillah , Atwine Daniel , Tumuhairwe Jackline , Nyakato Viola Nilah , Kemigisha Elizabeth , Ivanova Olena 
Published: December 2024

Background: Pregnancy in adolescents continues to remain a significant public health challenge, with repeat pregnancies in this age group often receiving insufficient attention. In Uganda, repeat adolescent pregnancy varies between 26.1% and 55.6%. Evidence shows that repeat pregnancy in adolescence is more common in settings of high poverty, low educational attainment and low use of long-acting reversible contraceptives among others. Objectives: The main aim of this study is to determine the underlying risk and protective factors of repeat adolescent pregnancy in Uganda. Design: This was a cross-sectional study among adolescent girls and young women aged between 13 and 22 years with single and repeat pregnancies in four districts in Southwestern Uganda. Methods: The questionnaire was administered on a portable PC to collect information on socio-demographic characteristics, sexual behaviours, sexual and reproductive health (SRH) knowledge, pregnancy outcome, experience of violence and mental health. Descriptive statistics and logistic regression were performed. Results: A total of 115 girls with single and 93 with repeat pregnancies participated in the survey. Of these, 42 (20.2%) were 18 years and younger. The majority (92%) had dropped out of school, having achieved primary-level education (67%). The mean age of sexual debut (15.6 versus 16.4 years) and the mean age at first pregnancy (16.4 versus 17.3 years) were lower among those in repeat-pregnancy group compared to those in single-pregnancy group. The odds of having repeat pregnancy were higher among participants who engaged in risky behaviour (AOR 3; 95% CI (1.28–7.37)) and experienced any form of violence (AOR 4.67; 95% CI (1.5–16.56)). Being single, having the first pregnancy in older age (16 and above) and having a positive first pregnancy outcome (live birth) served as protective factors for repeat pregnancy. Conclusions: Adolescents with repeat pregnancies have significantly more SRH risks compared to those with single pregnancies. These findings underscore the importance of multi-faceted and timely interventions for adolescent girls in this setting, with an emphasis on the mitigation of violence, and enhancing access to comprehensive sexuality education, and SRH services.
Mapping the gap: A study on the confidence in knowledge and reporting of relative energy deficiency in sport (REDs) in Canadian University cross-country coaches and athletes
Authors: Schulz Jenna M. , Hewitt Chloe M. , Stellingwerff Trent , Stellingwerff Hilary , Ackerman Kathryn E. , Thornton Jane S. 
Published: December 2024

Background/Objective To assess athletes’ and coaches’ confidence in knowledge and recognition of Relative Energy Deficiency in Sport (REDs) before and after an education session at the Canadian University Sports (U SPORTS) National Cross-Country Championships (UXC). Methods We hosted an education session and panel discussion surrounding causes and risk factors, health and performance outcomes, prevention, as well as personal experiences the day before UXC. A cross-sectional in-person survey (39 pre- and 29 post-session questions) was implemented around the session. Sixty-eight athletes (85% ages 19–24y, 73.5% women) and 20 coaches (30% > 50y, 35% women) completed the survey. Results Pre-panel, 80% of coaches and 59% of athletes were able to correctly identify the underlying cause of REDs (low energy availability). However, only 50% of coaches and 13% of athletes were completely confident in their answers. The most common correctly identified symptoms were fatigue (coaches = 40%, athletes = 53%) and amenorrhoea (coaches = 30%, athletes = 57%). However, only 20% of coaches and 7% of athletes were completely confident in their answers. After the panel, confidence levels of coaches in identifying signs/symptoms did not change (p = 0.52; complete confidence = 20%), but significantly improved in athletes (p < 0.001; complete confidence = 32%). Low libido was a commonly identified learned symptom. Conclusion An education session and panel discussion surrounding REDs significantly increased the confidence in REDs knowledge among UXC athletes, but not among coaches. Further exploration of REDs knowledge dissemination strategies, that should be different for athletes versus coaches, is needed to improve awareness of REDs.
Efficacy of the intravenous formulation of fentanyl citrate administered orally as premedication in paediatric patients undergoing open cardiac surgery
Authors: Elbardan Islam Mohamed , Shehab Ahmed Sayed , Yacout Ahmed Galaleldin , Mabrouk Ibrahim Mabrouk 
Published: December 2024

Background: Recently, fentanyl has become prevalent as a sedative premedication. Methods: A non-inferiority parallel design quadruple-blinded randomised controlled trial of 1- to 7-year-old children scheduled for elective cardiac surgery was conducted. Participants were assigned a 1:1 allocation ratio to a control group ( n = 50) given a parenteral formulation of midazolam 0.5 mg/kg and an intervention group ( n = 50) given a parenteral formulation of fentanyl 10 μg/kg 30 min before admission to the operating room. Results: Fentanyl was shown to be inferior when compared to midazolam during inhalational induction but not in the ‘after premedication’ and ‘during separation’ periods. A lower percentage of children disliked the medication in the fentanyl group. Conclusions: A parenteral formulation of fentanyl can be a satisfactory alternative when given orally as a sedative pre-anaesthetic medication in paediatric cardiac surgery before admission to the operating room.
Femoral bone metastasis is a poor prognostic factor in EGFR-TKIs-treated patients with EGFR-mutated non-small-cell lung cancer: a retrospective, multicenter cohort study
Authors: Tanaka Ichidai , Hori Kazumi , Koyama Junji , Gen Soei , Morise Masahiro , Kodama Yuta , Matsui Akira , Miyazawa Ayako , Hase Tetsunari , Hibino Yoshitaka , Yokoyama Toshihiko , Kimura Tomoki , Yoshida Norio , Sato Mitsuo , Ishii Makoto 
Published: December 2024

Background: Epidermal growth factor receptor ( EGFR)-mutant non-small-cell lung cancers (NSCLCs) have higher frequencies of bone metastases than those of wild type; however, the metastatic pattern and influence on clinical outcome remain unclear. Objectives: To analyze the association between bone metastatic sites and the clinical efficacy of the first-, second-, and third-generation EGFR-tyrosine kinase inhibitors (TKI), in these patients. Design: Retrospective multicenter cohort study. Methods: The clinical data of patients with advanced-NSCLC harboring EGFR mutation, who were treated by EGFR-TKIs as first-line treatment at five medical institutions ( N = 411), were retrospectively assessed for bone metastatic sites, overall survival (OS), and progression-free survival (PFS). Results: Bone metastases were found in 41.1% of the patients at diagnosis, including 13.1%, 8.0%, and 20.0 for single, double, and multiple lesions (⩾3), respectively. The vertebra (76.3%) and pelvis (60.9%) were the most frequent metastatic sites. Femoral-, sternum-, and scapula-metastases were remarkably increased in the patients with multiple-bone metastases. In the EGFR-mutant NSCLC patient treated with osimertinib, both the OS and the PFS of the patients with femoral bone metastasis were significantly shorter than those of the patients without femoral bone metastasis (OS: not reached vs 12.1 months, p < 0.0001; and PFS: 17.2 vs 9.3 months, p < 0.0018). Furthermore, a multivariable Cox regression analysis, including several poor prognostic factors, such as L858R mutation and liver metastasis, demonstrated that femoral bone metastasis was a statistically independent predictor of OS. Conclusion: Femoral bone metastasis is associated with poor survival of EGFR-mutant NSCLC patients who were treated with EGFR-TKIs, including osimertinib, and is an independent prognostic factor of OS.
Exploring relationships among gait, balance, and physical activity in individuals with Huntington's disease
Authors: Tueth Lauren E. , Haussler Allison M. , Baudendistel Sidney T. , Earhart Gammon M. 
Published: December 2024

Background Individuals with Huntington's disease (HD) experience a variety of motor and non-motor symptoms, but little is known about how these symptoms are related to one another. It is important to characterize the deficits present and explore the relationships among these symptoms in order to provide high quality clinical care. Objective The purpose of this study was to characterize gait, balance, and physical activity level in individuals with HD and explore the relationships among motor and non-motor symptoms. Methods Individuals completed one lab visit and wore a sensor for seven days to capture physical activity level. During the lab visit, gait, balance, and cognitive status were assessed using validated measures. A 2 × 2 ANOVA (Group×Condition) was used to assess differences in gait between individuals with HD vs. controls, while t-tests were used for other clinical measures. Correlations as well as a mixed effects model explored relationships among clinical measures in the HD group. Results Individuals with HD walk significantly slower and have significantly worse balance than controls. Gait velocity and balance were significantly correlated with cognitive status in individuals with HD. Additionally, balance performance and balance confidence were not significantly correlated, indicating that there may be a lack of self-awareness of deficits present in individuals with HD. In-lab measures were not significant predictors of physical activity. Conclusions Motor impairments in individuals with HD are correlated with cognitive impairment. Clinicians should be aware of the impact of cognitive impairment when selecting interventions to address motor symptoms in individuals with HD.
Microbial Dysbiosis in Nasopharyngeal Carcinoma: A Pilot Study on Biomarker Potential
Authors: Lu Yen-Ting , Hsin Chung-Han , Chuang Chun-Yi , Huang Cheng-Chen , Su Mao-Chang , Wen Wei-Sheng , Wang Shao-Hung , Chen Yih-Yuan , Lee Cheng-Yang , Li Yu-Xuan , Lu Ying-Chou , Chang Tzu-Hao , Yang Shun-Fa 
Published: December 2024

Importance Nasopharyngeal carcinoma (NPC) is closely linked to microorganisms, especially intra-tumoral microbiota. However, the role of commensal microbiota in NPC remains underexplored, with implications for understanding disease mechanisms. Objective This study aims to analyze and compare the bacterial microbiota in the nasopharynx and middle meatus (MM) of individuals with NPC and those without NPC. Additionally, the study seeks to identify potential microbial biomarkers that can distinguish between NPC and non-NPC (nNPC) individuals. Design Cross-sectional study. Setting Study conducted in a clinical setting with NPC and non-NPC participants to evaluate microbial diversity relevant to NPC. Participants Ten NPC cases and 15 non-NPC controls were recruited based on clinical eligibility. Main Outcome Measures Bacterial microbiota sampling from the nasopharynx and MM was analyzed by 16S rRNA sequencing. Microbiota diversity (alpha and beta diversity indices), presence of bacterial taxa with biomarker potential, and prediction model accuracy [area under the curve (AUC)]. Results Microbiota diversity was significantly lower in NPC patients versus controls. In nasopharyngeal samples, alpha diversity (Chao1 index, P = .02) and beta diversity (PERMANOVA, P = .001) differed notably between groups, though MM samples showed no significant difference (Chao1 index, P = .23). Machine learning identified Pseudomonas, Cutibacterium, and Finegoldia as potential NPC biomarkers (AUC = 0.86). Conclusions and Relevance This pioneering study highlights dysbiosis in nasopharyngeal microbiota among NPC patients. Findings suggest that Pseudomonas, Cutibacterium, and Finegoldia may be useful biomarkers for NPC diagnosis, warranting further investigation into microbial roles in NPC pathogenesis.
Exploring ways to improve knee osteoarthritis care: The role of mobile apps in enhancing therapeutic exercise—a systematic review
Authors: Paolucci Teresa , Pezzi Letizia , Bressi Federica , Russa Raffaele La , Zobel Bruno Beomonte , Bertoni Gianluca , Farì Giacomo , Bernetti Andrea 
Published: December 2024

Objective Osteoarthritis (OA), particularly knee OA, is a leading cause of disability and poses significant challenges in healthcare management. Mobile applications (apps) have emerged as potential tools to support therapeutic exercise by providing tailored programs, instructional content, and progress tracking. This systematic review evaluates the efficacy of mobile apps in enhancing therapeutic exercise for knee OA management. Methods A systematic review was conducted, analyzing randomized controlled trials (RCTs) to assess the impact of mobile apps on pain and knee function in patients with OA. The review followed the Cochrane Handbook guidelines and was registered with PROSPERO. Inclusion criteria focused on RCTs involving adults aged 40 and above with knee OA, and outcomes were measured based on pain intensity and knee function. Results Five RCTs met the inclusion criteria. The results varied: while some studies demonstrated minor improvements in pain and function with app-based interventions, others showed comparable effectiveness to traditional methods. The review highlights the potential of mobile apps to offer benefits in managing knee OA, though outcomes were inconsistent due to intervention and population heterogeneity. Conclusion Despite the low certainty of evidence, mobile app-based interventions appear to have a positive impact on reducing pain and improving physical function in patients with knee OA. Continued research is essential to better understand the effectiveness and long-term impact of mobile technology in OA management, underscoring the value of digital health interventions in enhancing patient care.