bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Baduanjin on motor function in children with developmental coordination disorders: study protocol for a randomised controlled trial
Authors: Gao Jiaxin , Ke Xiaohua , Huang Dunbing , Wu Yangxin , Xu Xiaqing , Ren Hongfei , Zhang Anren , Song Wei 
Published: December 2024

IntroductionChildren diagnosed with developmental coordination disorder (DCD) exhibit a range of challenges in both gross and fine motor skills, characterised by sluggish and awkward movements. Additionally, they experience deficits in balance and coordination. Without appropriate intervention, these difficulties may endure into adolescence and adulthood, impacting various facets of their daily lives, including learning, social interactions and recreational activities.Methods and analysisEmploying a randomised controlled trial design, 60 children diagnosed with DCD will be randomly assigned to two groups. The experimental group will receive Baduanjin training in addition to health education, while the control group will undergo health education alone. Following an 8-week intervention period, assessments using motor assessment battery for children-second edition, ProKin 254 Balance Test System will be conducted to evaluate the impact of Baduanjin on the motor coordination and balance in children with DCD. Furthermore, functional near-infrared spectroscopy will be employed to capture haemodynamic data from the children’s brain movement-related cortex during functional activities. These data will be analysed to assess the level of cortical activation, strength of functional connectivity and their correlation with changes in motor function, with the goal of investigating the cerebral blood oxygenation mechanisms underlying the effectiveness of the Baduanjin intervention.Ethics and disseminationThis study has been submitted for approval and has received ethical clearance from the Medical Ethics Committee of Shanghai Fourth People’s Hospital (2023080-001). The results of the study will be published in a peer-reviewed scientific journal.Trial registration numberChiCTR2300078980.
Protocol for a multicentre randomised triple-blind controlled trial assessing the clinical efficacy of intra-articular platelet-rich plasma injections versus placebo in symptomatic knee osteoarthritis (PIKOA)
Authors: Eymard Florent , Oubaya Nadia , Ornetti Paul , Sellam Jeremie , Richette Pascal , Chevalier Xavier 
Published: November 2024

IntroductionDespite their exponential use, intra-articular (IA) injections of platelet-rich plasma (PRP) are not part of the recommended treatments for knee osteoarthritis (OA) by most international scientific societies. The most recent clinical trials have shown conflicting results, and some did not find any clinical benefit of PRP injections. The PRP In Knee OsteoArthritis (PIKOA) trial was designed to assess the clinical efficacy and structural benefit of IA injections of PRP vs saline solution (placebo) in symptomatic knee OA.Methods and analysisPIKOA is an academic phase 3, superiority, triple-blind (patients, investigators and injectors), multicentre, randomised placebo-controlled trial (1:1 ratio). It compares the efficacy of 1 weekly IA injection of 5 mL PRP or placebo (saline solution) for 3 weeks with a 6-month follow-up. The trial will enrol 210 participants ≥40 years old with symptomatic and moderate radiographic knee OA (Kellgren and Lawrence grade 2 or 3). PRP is prepared with the A-CP-Kit-T (20 mL) kit and its cellular composition is characterised for each patient. The main objective is to compare change in pain on a 0 mm to 100 mm visual analogue scale (VAS) between W0 and W14. The secondary objectives are to compare the two groups in terms of decrease in VAS pain, Western Ontario and McMaster Universities Osteoarthritis Index total score and subscores, analgesics consumption, OMERACT-Osteoarthritis Research Society International responder rate and improvement in quality of life measured by the EQ-5D-5L score. All these criteria are assessed at W8, W14 and W26. The decrease in serum Coll2-1 and Coll2-1 NO₂ levels (catabolic markers, reflecting cartilage destruction or joint inflammation) and increase in N-propeptide of cartilage IIA level (reflecting cartilage formation) are assessed at W8 and W14. Adverse events and study withdrawals are collected during the study.Ethics and disseminationEthics approval was obtained from the Nord Ouest ethical committee (2021-A00742-39). All participants need to provide written informed consent. The findings will be published in peer-reviewed journals.Trial registration numberNCT05378815(ClinicalTrials.gov); pre-results.Protocol version and number: V.3 of 17 July 2023.
Cohort profile: AI-driven national Platform for CCTA for clinicaL and industriaL applicatiOns (APOLLO)
Authors: Baskaran Lohendran , Leng Shuang , Dutta Utkarsh , Teo Lynette , Yew Min Sen , Sia Ching-Hui , Chew Nicholas WS , Huang Weimin , Lee Hwee Kuan , Vaughan Roger , Ngiam Kee Yuan , Lu Zhongkang , Wang Xiaohong , Tan Eddy Wei Ping , Cheng Nicholas Zi Yi , Tan Swee Yaw , Chan Mark Y , Zhong Liang 
Published: December 2024

PurposeCoronary CT angiography (CCTA) is well established for the diagnostic evaluation and prognostication of coronary artery disease (CAD). The growing burden of CAD in Asia and the emergence of novel CT-based risk markers highlight the need for an automated platform that integrates patient data with CCTA findings to provide tailored, accurate cardiovascular risk assessments. This study aims to develop an artificial intelligence (AI)-driven platform for CAD assessment using CCTA in Singapore’s multiethnic population. We will conduct a hybrid retrospective-prospective recruitment of patients who have undergone CCTA as part of the diagnostic workup for CAD, along with prospective follow-up for clinical endpoints. CCTA images will be analysed locally and by a core lab for coronary stenosis grading, Agatston scoring, epicardial adipose tissue evaluation and plaque analysis. The images and analyses will also be uploaded to an AI platform for deidentification, integration and automated reporting, generating precision AI toolkits for each parameter.ParticipantsCCTA images and baseline characteristics have been collected and verified for 4196 recruited patients, comprising 75% Chinese, 6% Malay, 10% Indian and 9% from other ethnic groups. Among the participants, 41% are female, with a mean age of 55±11 years. Additionally, 41% have hypertension, 51% have dyslipidaemia, 15% have diabetes and 22% have a history of smoking.Findings to dateThe cohort data have been used to develop four AI modules for training, testing and validation. During the development process, data preprocessing standardised the format, resolution and other relevant attributes of the images.Future plansWe will conduct prospective follow-up on the cohort to track clinical endpoints, including cardiovascular events, hospitalisations and mortality. Additionally, we will monitor the long-term impact of the AI-driven platform on patient outcomes and healthcare delivery.Trial registration numberNCT05509010.
Correlation between colonoscopy difficulty and personality traits: study protocol for a prospective, observational, multicentre study
Authors: Wang Duan , Zhang Shengyu , Jiang Yinan , Ren Yutang , Kuai Dayu , Zhao Ruihong , Wu Dong 
Published: December 2024

BackgroundColonoscopy is widely used for screening and treatment of early colonic lesions and is critical for the early diagnosis of colorectal cancer. However, due to its invasive nature, colonoscopy can cause pain and discomfort for patients and is often associated with prolonged insertion times or failed attempts. Difficult colonoscopy is characterised by a caecal insertion time greater than 10 min, multiple insertion attempts or failed insertion, with an incidence rate of approximately 25%. Studies have shown that objective factors such as gender, age, body mass index, bowel preparation quality and history of abdominal or pelvic surgery can make colonoscopy difficult. Integrating clinical evidence and the established impact of personality traits on certain gastrointestinal conditions, a patient’s personality traits and emotional and psychological states may also influence caecal insertion time during colonoscopy. Currently, no studies have investigated the predictive role of patients’ personality on the difficulty of colonoscopy. This study used the Chinese-Language 44-Item Big Five Personality Inventory to assess patients' personality traits, aiming to observe whether there is a correlation between the degree of difficulty of colonoscopy and any of the personality traits.Methods and analysisThis is a prospective, observational, multicentre study. Patients undergoing colonoscopy will be required to complete the Big Five Inventory, the General Anxiety Disorder 7-item scale and the Patient Health Questionnaire 9-item Depression Scale before colonoscopy. During the colonoscopy, the endoscopist will record the primary endpoint of caecal insertion time. The Boston Bowel Preparation Scale, patients pain scores and willingness to undergo a subsequent colonoscopy will be recorded as the secondary endpoints. The study plans to enrol a total of 322 patients. Survival analysis will be used to examine the correlation between colonoscopy difficulty and the Big Five personality traits.Ethics and disseminationThis study was approved by the Ethics Committee of the Peking Union Medical College Hospital (No. K2128). All participants in this study will provide written informed consent. The results of this study will be published in an open-access way. There is no independent data monitoring committee because this is an observational and low-risk study.Trial registration numberNCT05584423.
Spatial distribution and determinants of early postnatal discharge among vaginally delivered mothers in Ethiopia: spatial and multilevel analysis of Ethiopian demographic survey data
Authors: Bitew Desalegn Anmut , Getnet Mihret , Maru Lemlemu , Adugna Dagnew Getnet , Tesfaye Ephrem 
Published: November 2024

BackgroundPostnatal hospital care is aimed to detect any complications for both mother and child. Postnatal care should start as early as possible, especially during the first 24 hours. No study assessed the hotspot areas of early postnatal discharge and its community and individual level determinants in Ethiopia. Therefore this study aimed to fill the mentioned gap.MethodsThis study used the Ethiopian demographic and health survey 2016. A total of 2443 delivered mothers were included in the analysis. The non-spatial analysis was conducted using Stata V.14. A mixed-effect multilevel logistic regression model was fitted. Model comparison was done using Akaike’s information criterion and log-likelihood ratio. Global Moran’s index, spatial autocorrelations and spatial scan statistics were conducted. Multicollinearity was checked. P values <0.25 and 0.05 were used as a cut-off point to declare statistical significance for the bivariable and multivariable regression models, respectively.ResultsThe early postnatal discharge was spatially clustered (Moran’s index=0.077, p<0.05). Hotspots of early postnatal discharge were detected in most parts of Benishangul Gumuz, central Amhara, north east Southern Nations, Nationalities, and Peoples' Region (SNNPR) and western Oromiya. Being literate, no media exposure, having three to four antenatal care visits, size of child and history of abortion were statistical significant determinants of early postnatal discharge.ConclusionsHotspot areas of early postnatal discharge were detected in parts of central Amhara region, Benishangul gumz, the northeastern parts of SNNPR and western Oromiya. Sociodemographic and reproductive related factors determine early postnatal discharge.
Impact of immunological aging on T cell-mediated therapies in older adults with multiple myeloma and lymphoma
Authors: Ullrich Fabian , Bröckelmann Paul J , Turki Amin T , Khan Abdullah M , Chiru Elena-Diana , Vetter Marcus , Tresckow Bastian von , Wirth Rainer , Cordoba Raul , Ortiz-Maldonado Valentín , Fülöp Tamas , Neuendorff Nina Rosa 
Published: December 2024

The treatment landscape for lymphoma and multiple myeloma, which disproportionally affect older adults, has been transformed by the advent of T cell-mediated immunotherapies, including immune checkpoint inhibition, T cell-engaging bispecific antibodies, and chimeric antigen receptor (CAR) T cell therapy, during the last decade. These treatment modalities re-enable the patient’s own immune system to combat malignant cells and offer the potential for sustained remissions and cure for various diseases.Age profoundly affects the physiological function of the immune system. The process of biological aging is largely driven by inflammatory signaling, which is reciprocally fueled by aging-related alterations of physiology and metabolism. In the T cell compartment, aging contributes to T cell senescence and exhaustion, increased abundance of terminally differentiated cells, a corresponding attrition in naïve T cell numbers, and a decrease in the breadth of the receptor repertoire. Furthermore, inflammatory signaling drives aging-related pathologies and contributes to frailty in older individuals. Thus, there is growing evidence of biological aging modulating the efficacy and toxicity of T cell-mediated immunotherapies.Here, we review the available evidence from biological and clinical studies focusing on the relationship between T cell-mediated treatment of hematologic malignancies and age. We discuss biological features potentially impacting clinical outcomes in various scenarios, and potential strategies to improve the safety and efficacy of immune checkpoint inhibitors, T cell-engaging bispecific antibodies, and CAR-T cell therapy in older patients.
Effect of optimisation to contemporary HFrEF medical therapy with sacubitril/valsartan (Entresto) and dapaglifloziN on left Ventricular reverse remodelling as demonstrated by cardiac magnetic resonance (CMR) Imaging: the ENVI study
Authors: Zheng Alice , Adam Robert , Peebles Charles , Harden Stephen , Shambrook James , Abbas Ausami , Vedwan Katharine , Adam Georgina , Haydock Paul , Cowburn Peter , Young Christopher , Long Jane , Walkden Michelle , Smith Simon , Greenwood Elizabeth , Olden Paula , Flett Andrew 
Published: December 2024

IntroductionHeart failure with reduced ejection fraction (HFrEF) guidelines recommend ‘four pillars’ of medical therapy and device therapy if left ventricular ejection fraction (LVEF) remains ≤35% after 3 months optimum medical therapy.We conducted the first study to examine the effects of optimisation to contemporary medical therapy on cardiac reverse remodelling, as demonstrated by cardiac magnetic resonance imaging (CMR).We hypothesised a proportion of patients would undergo beneficial remodelling and LVEF improvement above the threshold for complex device prescription after 6 months.MethodsHFrEF patients with symptomatic LVEF≤35% despite ACE inhibitor/beta blocker/mineralocorticoid receptor antagonist therapy, and qualified for sacubitril/valsartan switchover were recruited to this single centre prospective study.CMR was performed at baseline and at follow-up. Clinical, volumetric and outcome data were collected and compared.ResultsBetween June 2021 and August 2022, 49 patients were recruited. The majority (80%) were male, mean age 63±14 years. 35 (71%) had non-ischaemic cardiomyopathy. 2 (4%) patients died and 47 were followed up for a median of 7.4 months. There were no heart failure hospitalisations.Significant reductions were seen in median indexed left atrial volume: 54 mL/m2(41–72) to 39 mL/m2(30–60) (p<0.001); indexed left ventricular end-diastolic volume: 109 mL/m2(74–125) to 76 mL/m2(58–102) (p<0.001); indexed left ventricular end-systolic volume: 74mL/m2(50–92) to 43 mL/m2(27–58) (p<0.001) and mean indexed left ventricular mass: 72±13 g/m2to 62±13 g/m2(p<0.001).Median LVEF increased by 12 points from 31% to 43% (p<0.001). 29 (59%) patients improved to LVEF>35%. 13 (27%) patients improved to LVEF≥50%.Median N-terminal pro B type natriuretic peptide (NTproBNP) reduced from 883 ng/L (293–2043) to 429 ng/L (171–1421) (p<0.001).ConclusionsOptimisation to contemporary HFrEF medical therapy results in beneficial cardiac reverse remodelling and significant improvements in LVEF and NTproBNP at 6 months as demonstrated by CMR. 59% of our cohort no longer met complex device indications. Guidelines suggest re-assessment of LVEF at 3 months, but our data suggests a longer period is required.Trial registration numberNCT05348226.
Diagnostic performance of a point-of-care high-sensitivity cardiac troponin I assay among Chinese patients with chest pain
Authors: Ho Jonathan Ka Ming , Wong Janet Yuen Ha , Tse Gary , Chong Andy Chun Yin , Chau Calvin Chi Wai , Wong Chi Yip , Tse Johnson Wai Keung , Tam Jeremy Yan Hon , Lam Simon Ching 
Published: December 2024

BackgroundA novel handheld point-of-care high-sensitivity cardiac troponin I analyser has recently been introduced to the market. Evaluating its diagnostic performance against laboratory standards is imperative, given the variations in cardiac troponin levels across populations. This study compared the diagnostic performance between the point-of-care high-sensitivity cardiac troponin I assay (Siemens Healthineers Atellica VTLi) and a laboratory high-sensitivity cardiac troponin I assay (Abbott ARCHITECT STAT High Sensitive Troponin-I) performed using blood samples from various populations (overall, male, female, younger and older) of Chinese patients with chest pain.MethodsThis cross-sectional study included 585 consecutive Chinese patients (age ≥18 year) who presented to an emergency department with chest pain (lasting >5 min) and were managed following the chest pain protocol between 1 August 2023 and 12 June 2024. For both assays, blood samples were collected at two time points (0 hour (initial) and 3 hour (subsequent)). The primary outcome was the diagnostic performance of the two assays, evaluated with their 99th percentile upper reference limits used as the cut-off values for diagnosing myocardial infarction. The gold standard for comparison was the final diagnoses made by attending physicians.ResultsThe point-of-care and laboratory assays exhibited equivalent sensitivity and negative predictive values (both 100%) for blood samples collected at both time points. However, the point-of-care assay outperformed the laboratory assay in terms of specificity (initial: 90.5% to 96.3% vs 79.8% to 94.7%; subsequent: 87.8% to 94.8% vs 77.7% to 92.4%) and positive predictive value (initial: 24.4% to 30.8% vs 11.6% to 23.5%; subsequent: 12.5% to 25.0% vs 5.9% to 18.8%), particularly in older patients.ConclusionThe point-of-care assay is recommended for rapid clinical decision-making. Future studies should explore the effects of its integration into clinical practice and the feasibility of using sex–race–age-specific 99th percentile upper reference limits to enhance its diagnostic performance.
Rotating charged black holes in EMS theory: shadow studies and constraints from EHT observations
Authors: Yunusov Odil , Rayimbaev Javlon , Sarikulov Furkat , Zahid Muhammad , Abdujabbarov Ahmadjon , Stuchlík Zdeněk 
Published: December 2024

Abstract
One of the possible ways to test gravity theories and get constraints on parameters of a gravity theory and a black hole is based on studies of black hole shadow applying Event Horizon Telescope (EHT) data from the shadow sizes of M87* and Sgr A*. In this sense, we study the shadow of rotating charged black holes in Einstein–Maxwell scalar (EMS) theory. First, we obtain a rotating EMS black hole solution and analyze the horizon properties. We derive the effective potential for the circular motion of photons along null geodesics around the rotating black hole and obtain the black hole shadow using celestial coordinates. The effects of the black charge and spin and EMS theory parameters on the shape of the black hole shadow, its radius, and distortion parameters are analyzed in detail. We have obtained upper and lower limits for spin and black hole charges of Sgr A* and M87* using their shadow size for various values of EMS parameters. Lastly, we computed and examined the standard shadow radius, equatorial, and polar quasinormal modes using the geometric-optic relationship between the parameters of the quasinormal mode and the conserved values along the geodesics.
Supporting Ada in the ROSE Compiler
Authors: Pirkelbauer Peter , Liao Chunhua , Lin Pei-Hung , Wright David , Reynolds Charles , Quinlan Daniel 
Published: December 2024

Manual code maintenance of large code bases is tedious, time-consuming, and error-prone. To enable the engineering of source code maintenance tools for Ada, a mature infrastructure that provides capabilities for parsing, unparsing, semantic analysis, and transformations is needed.
This work discusses our progress of adding Ada support to ROSE, a mature source-to-source translation infrastructure. The paper discusses the design of ROSE, the extensions required for adding Ada, difficulties we encountered with processing existing code bases, and several prototype analysis and translation tools enabled by the new Ada support in ROSE.
Tales of Cancer-Induced Bone Disease from the Senescent Osteocyte Crypt
Authors: Frieling Jeremy S. , Lynch Conor C. 
Published: December 2024

Cancer-induced bone disease greatly diminishes the quality of life for patients with bone metastatic breast cancer, resulting in painful skeletal-related events including bone loss and fracture. Improved understanding of the roles of osteoblasts and osteoclasts, and how tumors alter their biology, has led to blockbuster therapies that significantly reduce skeletal-related events, but the disease remains incurable. However, emerging technologies and tools for studying the role of other stromal and immune components in controlling tumor–host interactions have begun to reveal new insights that may yield tractable therapeutic targets to further mitigate the painful effects of bone metastases. In this issue of Cancer Research, Kaur and colleagues study osteocytes, which are terminally differentiated osteoblasts and entombed within the bone matrix, from established bone metastatic breast cancer and report how the disease ages them as characterized by a senescence-associated secretory phenotype. This premature development of osteocyte senescence in turn enhances bone destruction and osteoclastogenic potential. Targeting senescent cells using senolytics suppressed bone resorption and preserved bone mass. Collectively, these findings underscore osteocyte involvement in the “vicious cycle” of bone metastasis, and targeting senescent osteocytes represents a new avenue for managing cancer-induced bone disease.See related article by Kaur et al., p. 3936