bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intercostal bypass graft pseudoaneurysm repaired with percutaneous glue embolization utilizing CT needle guidance: A case report
Authors: Moroney James , Plumb Andrew , Scheidt Matthew , Malinowski Michael 
Published: December 2024

Objectives Pseudoaneurysm formation in connective tissue patients postoperatively can be a challenging and life-threatening problem to treat. Repair of an aorta to intercostal bypass graft pseudoaneurysm post open thoracoabdominal aortic aneurysm repair by percutaneous glue embolization utilizing Dyna CT Needle Guidance technology is a safe, minimally invasive method with low morbidity and short post-procedural recovery. Methods A 30-year-old male with suspected connective tissue disorder who developed a Type B aortic dissection complicated by limb threatening right lower extremity ischemia treated with left-to-right fem-fem bypass and RLE fasciotomies. His thoracic aortic dissection subsequently was repaired urgently for persistent chest pain and rapid aortic expansion by open thoracoabdominal aortic aneurysm repair with aorta to intercostal bypass graft. Seven weeks postop patient presented with hemoptysis and was noted to have an enlarging T9 intercostal pseudoaneurysm requiring repair. Results and conclusions Post discharge follow-up thoracic CTA performed showed complete resolution of the T9 intercostal pseudoaneurysm. Therefore, percutaneous NBCA glue embolization with iGuide technology is a viable alternative to open thoracic pseudoaneurysm repair and offers distinct advantages over other imaging modalities for localization.
Efficacy and Mechanisms of Qianghuo Shengshi Tang in Rheumatoid Arthritis: A Network Pharmacology and Experimental Study
Authors: Han Junjun , Wang Mengyue , Lin Yue , Tian Lu , Liu Guiqin , Wang Qian , Duo Delong , Zhu Junbo , Jia Qiangqiang , Duan Yabing , Nima Cairang , Li Xiangyang 
Published: December 2024

Objective This study assesses the anti-inflammatory and therapeutic effects of Qianghuo Shengshi Tang (QHSST) on rheumatoid arthritis (RA) through network pharmacology and experimental validation and explore the underlying mechanisms. Methods Complete composition analysis of QHSST using UPLC-Q-Orbitrap-MS. And collection potential targets using relevant databases. Protein–protein interaction (PPI) networks were constructed and Kyoto Encyclopedia of Genes and Genomes (KEGG) and Gene Ontology (GO) enrichment analyses were conducted. Anti-inflammatory activity of QHSST was evaluated in RAW264.7 cells by assessing apoptosis, NO, interleukin (IL)-6, IL-10, and tumor necrosis factor-α (TNF-α). In rats with wind-cold-dampness paralysis-RA, efficacy of QHSST was confirmed by evaluating foot volumes, arthritis scoring index (AI), blood routine, rheumatoid factor (RF), anti-cyclic citrullinated peptide (CCP) antibody, and hematoxylin and eosin (H&E) staining and inflammatory factors. Enzyme-linked immunosorbent assay (ELISA) and immunohistochemistry were used to examine protein expression in the ankle joints to elucidate the mechanism of QHSST action. Results We identified 44 compounds using UPLC-Q-Orbitrap-MS. Additionally, network pharmacology revealed five active ingredients and seven key targets. GO and KEGG analyses highlighted the involvement of PI3K-Akt signaling and tyrosine kinase inhibitor resistance pathways. Cell studies showed that QHSST reduced apoptosis, NO, IL-6, and TNF-α levels, while increasing IL-10 level in the dexamethasone and 3.125 µg/mL groups, indicating its anti-inflammatory effects. Animal experiments revealed that QHSST and methotrexate significantly decreased AI scores, foot volumes, and blood routine. H&E staining revealed varying degrees of joint harm, accompanied by a decrease in RF, anti-CCP antibody, IL-6, and TNF-α levels, and an increase in IL-10 level, underscoring the efficacy of QHSST in treating RA. ELISA and immunohistochemistry suggest that QHSST may exerts its effects by modulating the EGFR/SRC/PI3 K/AKT/NF-κB pathway. Conclusion Our findings provide a scientific foundation for therapeutic benefits of QHSST in alleviating RA by confirming the anti-inflammatory and RA-relieving properties of the supplement.
Comparison of Early-Stage Knee Osteoarthritis Induced by Medial Meniscus Tear Versus Tibial Osteotomy in the Rat Model
Authors: Thever Yogen , Shen Xuanrong Michael , Rong Chuin Toh , Bin Abd Razak Hamid Rahmatullah 
Published: December 2024

Objective Medial meniscus tear (MMT) is a common method to induce osteoarthritis in rats, but mimics secondary osteoarthritis. A novel method of carrying out a medial wedge closing tibial osteotomy (TO) has been recently developed to induce primary osteoarthritis. This study aims to validate it, compared to MMT. Methods Twenty rats were divided equally into 2 groups. Outcome measures such as histology graded according to Osteoarthritis Research Society International (OARSI) guidelines and computed tomography (CT) scans were analyzed at 6 weeks post-operatively. Observational gait analysis and serum biomarkers such as C-terminal cross-linked telopeptides of type II collagen (CTX-II) and interleukin-1 beta (IL-1β) were collected at 2-weekly intervals up to 6 weeks post-operatively. Results Serum CTX-II and IL-1β levels did not reveal a statistically significant difference across all time points between the 2 groups. CT grading was significantly more severe (2.80 ± 1.10 vs 1.40 ± 0.548, P = 0.0389) in the MMT group compared to the TO group. In addition, histological gradings such as calcified cartilage score (2.10 ± 1.91 vs 0.00 ± 0.00, P < 0.01) and cartilage degeneration score (4.80 ± 5.18 vs 0.00 ± 0.00, P < 0.01) revealed significantly more severe osteoarthritis in the MMT compared to TO group. Synovial membrane score did not reveal a statistically significant difference (1.10 ± 0.994 vs 1.00 ± 0.00, P = 1.00). Conclusion TO is a novel method in inducing primary osteoarthritis in the rat model compared to MMT between the 6 and 12 weeks’ time frame.
Protocol of a mixed-methods evaluation of Perfect Fit: A personalized mHealth intervention with a virtual coach to promote smoking cessation and physical activity in adults
Authors: van Vliet Milon H. M. , Versluis Anke , Chavannes Niels H. , Scheltinga Bouke L. , Albers Nele , Penfornis Kristell M. , Baccinelli Walter , Meijer Eline ,   on behalf of the Perfect Fit consortium
Published: December 2024

Objective Adopting healthy behavior is vital for preventing chronic diseases. Mobile health (mHealth) interventions utilizing virtual coaches (i.e., artificial intelligence conversational agents) can offer scalable and cost-effective solutions. Additionally, targeting multiple unhealthy behaviors, like low physical activity and smoking, simultaneously seems beneficial. We developed Perfect Fit, an mHealth intervention with a virtual coach providing personalized feedback to simultaneously promote smoking cessation and physical activity. Through innovative methods (e.g., sensor technology) and iterative development involving end-users, we strive to overcome challenges encountered by mHealth interventions, such as shortage of evidence-based interventions and insufficient personalization. This paper outlines the content of Perfect Fit and the protocol for evaluating its feasibility, acceptability, and preliminary effectiveness, the role of participant characteristics, and the study's feasibility. Methods A single-arm, mixed-method, real-world evaluation study will be conducted in the Netherlands. We aim to recruit 100 adult daily smokers intending to quit within 6 weeks. The personalized intervention will last approximately 16 weeks. Primary outcomes include Perfect Fit's feasibility and acceptability. Secondary outcomes are preliminary effectiveness and study feasibility, and we will measure participant characteristics. Quantitative data will be collected through questionnaires administered at baseline, post-intervention and 2, 6, and 12 months post-intervention. Qualitative data will be gathered via semi-structured interviews post-intervention. Data analysis will involve descriptive analyses, generalized linear mixed models (quantitative) and the Framework Approach (qualitative), integrating quantitative and qualitative data during interpretation. Conclusions This study will provide novel insight into the potential of interventions like Perfect Fit, as a multiple health behavior change strategy. Findings will inform further intervention development and help identify methods to foster feasibility and acceptability. Successful mHealth interventions with virtual coaches will prevent chronic diseases and promote public health.
Prospective acceptability of using mHealth interventions for oral health promotion in a sample of Egyptian women: A cross-sectional study
Authors: Sharaf Mariam , Abou El Fadl Reham Khaled 
Published: December 2024

Background Unless a health intervention is acceptable to target audience and aligns with their needs and preferences, there is increased likelihood that they would not engage with and benefit from it as planned. Despite that, there is paucity of studies exploring acceptability of oral health promotion interventions prior to implementation. This cross-sectional study was designed to investigate Egyptian women's “ prospective acceptability” to use mobile technologies in promoting access to oral health services. Methods A total of 959 participants completed a questionnaire, based on Sekhon's theoretical framework of acceptability, either in-person or virtually. Data was collected on sociodemographics, smartphones’ ownership and usage patterns, acceptability to use mHealth interventions, and any potential motivators and barriers. Chi-square test was used for descriptive statistics and regression analysis was performed to identify predictors of acceptability to use digital technology in improving oral and dental health. Results 83 % of women residing in urban settings versus 80.7% in rural settings believed that mHealth could improve health outcomes. WhatsApp was identified by 68% of participants as the preferred application for adopting mobile health services. Health awareness (36.8%) and effort & time saving (29%) were the most commonly cited motivators for using mHealth while lack of time (33%) and privacy issues (14.2%) were the main barriers. Conclusions mHealth is perceived as a highly acceptable approach for promoting oral health among Egyptian women. However, mHealth interventions should take into consideration privacy concerns and personal security when targeting this group.
Universal school-based e-health interventions for wellbeing, anxiety and depression: A systematic review and meta-analysis
Authors: Miller Edward , Thabrew Hiran 
Published: December 2024

Background Given that ‘digitally native’ children and young people spend much time at school, universal e-mental health interventions (ueMHIs) may have a role in supporting their wellbeing and reducing common mental health problems like anxiety and depression. However, the efficacy of school-based ueMHIs has never formally been evaluated. Methods During this systematic review and meta-analysis, we searched online databases MEDLINE, ERIC and ACM and the grey literature for trials of school-based ueMHIs targeted at improving wellbeing or reducing anxiety or depression in students aged 5–18. Primary outcomes were changes in symptoms of wellbeing, anxiety and depression at <3 months. Secondary outcomes were changes in these symptoms at 3–12 months and >12 months. Meta-analysis was conducted using a random effects model. Quality of included studies was appraised using the Cochrane risk of bias (RoB) tool. This study was registered with PROSPERO, CRD42023421872. Findings From 11,026 screened records, 15 papers were found and included in a systematic review. Of these, 14 papers including 8844 students were analysed in the meta-analysis. School-based ueMHIs did not significantly reduce anxiety (SMD = −0.55, 95% CI −1.68, 0.59) or depression (SMD = −0.29, 95% CI = −0.89, 0.32) at <3 months. School-based ueMHIs also did not significantly reduce anxiety (SMD = −1.03, 95% CI −3.20, 1.14) or depression (SMD = −0.47, 95% CI −1.40, 0.46) at 3–12 months. School-based ueMHIs did not significantly improve wellbeing at <3 months (SMD = 0.01, 95% CI −0.12, 0.14) and favoured control condition at 3–12 months (SMD = −0.14, 95% CI −0.23, −0.05). RoB was high across most studies and the overall quality of evidence was very low. Interpretation Although existing school-based ueMHIs show promise for addressing pupil mental health concerns, further higher-quality evidence is needed. There is room for the development of new school-based ueMHIs for reducing pupil anxiety and depression and improving wellbeing in a scalable, clinically and cost-effective manner, whilst not causing harm.
Management of a Rare Complex Triad Injury of the Elbow Joint: Radial Head Fracture, Triceps Tendon Avulsion, and Rupture of the Medial Collateral Ligament
Authors: Shekhbihi Abdelkader , Masoud Mohammad , Reichert Winfried 
Published: December 2024

Background: Isolated triceps tendon injuries are infrequent, and their combination with a medial ligament avulsion is even rarer. Eccentric force on the triceps tendon following a fall on the outstretched hand, combined with a valgus torque at the elbow joint, exposes the medial side to stretching forces, potentially disrupting the ulnar collateral ligament (UCL). Furthermore, compressive forces on the lateral side could result in injury to the radial head. Currently, there is no standardized surgical approach for managing such combined injuries. Indications: The complex triad injury presented in this publication is debilitating and warrants primary surgical intervention to restore stability and function of the afflicted elbow. Technique Description: A slightly curved posterior skin incision is made, creating medial and lateral full-thickness skin flaps. The ulnar nerve is explored and tagged with a vessel loop for protection without a full release. Palpation of the medial joint capsule reveals a rupture of the medial collateral ligament. The radial head is palpated during forearm rotation. The fascia overlying the radial head is incised along with the annular ligament. The radial head fracture is debrided and provisionally fixed with a 1.6-mm K-wire and then stabilized with two 2.0-mm mini screws. The bony origin of the triceps tendon is scraped to remove debris. A V-shaped triceps tendon repair is performed using two 3.5-mm titanium Twinfix suture anchors. A Krackow-type suture is placed medially, laterally, and centrally on the tendon. The tendon is reduced and fixed with a 1.8-mm K-wire, which is then replaced by a button fixation. The UCL tear is identified as a humeral avulsion and repaired using two 3.5-mm titanium Twinfix suture anchors. The triceps fascia, annular ligament, and overlying fascia are then repaired, and the wound is closed in layers after thorough irrigation. Results: Repair of all 3 injuries was successfully accomplished through the same approach, with initial postoperative follow-up showing active free supination/pronation and passive flexion limited to 70°. Discussion/Conclusion: The described surgical technique provides a comprehensive approach to addressing the rare and complex injuries involving the radial head, triceps tendon, and medial collateral ligament. This article includes practical tips and tricks to ensure successful execution of the procedure. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Comparison of the Effects of Diaphragmatic Breathing and Pursed-lip Breathing Exercises on the Sleep Quality of Elderly Patients with Chronic Obstructive Pulmonary Disease (COPD): A Clinical Trial Study
Authors: Dodange Zahra , Darvishpour Azar , Ershad Mohamad Javad , Gholami-Chaboki Bahare 
Published: December 2024

Background Sleep-related disorders are common among older adults with chronic obstructive pulmonary disease (COPD). Breathing exercises, a key component of pulmonary rehabilitation programs, may improve sleep quality. However, there is a paucity of research on the impact of breathing exercises on sleep quality in elderly patients with COPD. Objective This study aimed to compare the effects of diaphragmatic breathing (DB) and pursed-lip breathing (PLB) exercises on sleep quality in elderly patients with COPD. Design Crossover clinical trial. Methods In this study, 60 elderly patients with COPD were randomly assigned to two groups: DB followed by PLB (Group 1) and PLB followed by DB (Group 2). Each exercise was performed for 4 weeks. Participants completed the Pittsburgh Sleep Quality Index (PSQI), Abbreviated Mental Test Score (AMTS), and COPD Assessment Test (CAT) questionnaires before training. Data were analyzed using descriptive and inferential statistics in SPSS version 21, with a significance level of 0.05. Results Both DB and PLB exercises significantly improved sleep quality in elderly patients with COPD ( P < 0.05). No significant difference was found between the two exercises. However, the sequence of exercises in Group 1 (DB followed by PLB) resulted in greater improvement in average sleep quality compared to Group 2. Conclusion This study demonstrates that DB and PLB exercises enhance sleep quality in elderly patients with COPD. These exercises are recommended as an effective non-pharmacological approach to improve sleep quality in this population.
The Impact of Fetal Hemoglobin Levels on Some Inflammatory Markers in Steady State Sickle Cell Anemia Patients
Authors: Akulue John Chuks , Ezekekwu Chinedu Anthony , Olaniyi John Ayodele , Ogundeji Peter Sunday , Akunwata Chima Uzoma 
Published: December 2024

Background
Sickle cell anemia (SCA) is a multifaceted disease characterized by both acute and chronic inflammation. Even in the steady state; inflammatory oxidative stress gradually destroys tissues. Studies have shown that a higher fetal hemoglobin is associated with mild disease but there is no evidence of an association between inflammatory markers and HbF levels in our environment. The purpose of this study was to determine fetal hemoglobin levels and the plasma levels of some inflammatory markers in adult sickle cell anemia patients in steady state and to correlate these inflammatory markers with the fetal hemoglobin level.
Methods
This was a cross-sectional comparative study involving sickle cell anemia patients in steady state and apparently healthy hemoglobin AA individuals. Blood samples were collected and analysed for complete blood count using hematology autoanalyser. Interleukin 17 (IL-17), interferon-gamma (IFN-γ), monocyte chemoattractant protein-1 (MCP-1) and C-reactive protein (CRP) were analysed using enzyme linked immunosorbent assay methods. Fetal hemoglobin (HbF) level was quantified using high performance liquid chromatography. Statistical analysis was done with SPSS software, version 25.
Results
One hundred participants comprising 50 adults with sickle cell anemia and 50 healthy controls (HbAA) adults, with age range 18-59 years, were studied.Platelets and white blood cell count were significantly higher while hematocrit was lower in SCA compared to the control population. HbF levels in SCA ranged from 2% to 21%. IL-17, IFN-γ, MCP-1 and CRP, were all significantly higher in patients with SCA compared to HbAA controls. There was a significant negative correlation between HbF and MCP-1 while the correlation of HbF with CRP, IL-17 and IFN-γ were not significant.There was a statistically significant negative correlation between HbF level and platelet count.
Conclusion
Patients with sickle cell anemia in steady state have higher levels of interleukin 17, interferon-gamma, monocyte chemoattractant protein-1 and C-reactive protein compared to HbAA individuals. Fetal hemoglobin has a significant negative relationship with monocyte chemoattractant protein-1 and platelet count in sickle cell anemia.
Artificial Reasoning Approaches for Predicting Hemophilia a Severity
Authors: Rawal Atul , Ou Jiayi (Kelly) , Sauna Zuben E. 
Published: December 2024

Background: Hemophilia A (HA) is an X-linked congenital bleeding disorder, which leads to deficiency of clotting factor VIII (FVIII). Even though it mostly affects males, and females are considered carriers, variants in F8 in females can result in HA. Many females go undiagnosed and untreated for HA and their bleeding complications are attributed to other causes. Predicting the severity of HA for female patients can provide valuable insights for treating conditions associated with the disease such as heavy bleeding.
Objective: To predict the severity of HA in women based on F8 genotype and identify genotypes with a higher association for severe disease using artificial reasoning (AR) approaches.
Methods: Using multiple datasets of variants in the F8 and disease severity various repositories (e.g., My Life Our Future (MLOF)), we derived the sequence for the Factor VIII (FVIII) protein. Using the derived sequences, we used causal learning and artificial reasoning approaches such as ML classification models and Explainable AI (XAI) to predict the severity of HA in female patients and highlight genotypes with a higher association for severe HA.
Results: We apply causal learning to observational data to highlight the specific genotypes that have a direct cause-and-effect relation with severe HA in women. Utilizing different machine learning (ML) classification models, we validated our approach with predictive F1-scores of 0.88, 0.99, 0.93, 0.99 and 0.90 for all the validation sets. We picked the top-performing ML model to apply XAI via SHAP to identify genotypes with a higher association with severe HA.
Conclusion: AR-based approaches were successfully employed to predict HA severity in females based on variants in the F8. This study confirms previous research findings that ML can help predict the severity of hemophilia and provides new insights into genotypes with a higher association for severe disease. These results can be valuable for future studies in female patients with HA which is an urgent unmet need.