bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Longitudinal Study of the Association of Awareness of Disease Incurability with Patient-Reported Outcomes in Heart Failure
Authors: Lee Jia Jia , Malhotra Chetna , Sim Kheng Leng David , Yeo Khung Keong , Finkelstein Eric , Ozdemir Semra 
Published: November 2024

Objectives To examine awareness of disease incurability among patients with heart failure over 24 mo and its associations with patient characteristics and patient-reported outcomes (distress, emotional, and spiritual well-being). Methods This study analyzed 24-mo data from a prospective cohort study of 251 patients with heart failure (New York Heart Association class III/IV) recruited from inpatient wards in Singapore General Hospital and National Heart Centre Singapore. Patients were asked to report if their doctor told them they were receiving treatment to cure their condition. “No” responses were categorized as being aware of disease incurability, while “Yes” and “Uncertain” were categorized as being unaware and being uncertain about disease incurability, respectively. We used mixed-effects multinomial logistic regression to investigate the associations between awareness of disease incurability and patient characteristics and mixed-effects linear regressions to investigate associations with patient outcomes. Results The percentage of patients who were aware of disease incurability increased from 51.6% at baseline to 76.4% at 24-mo follow-up ( P < 0.001). Compared with being unaware of disease incurability, being aware was associated with older age (relative risk ratio [RRR] = 1.04; P = 0.005), adequate self-care confidence (RRR = 5.06; P < 0.001), participation in treatment decision making (RRR = 2.13; P = 0.006), higher education (RRR = 2.00; P = 0.033), financial difficulty (RRR = 1.18; P = 0.020), symptom burden (RRR = 1.08; P = 0.001), and ethnicity ( P < 0.05). Compared with being unaware of disease incurability, being aware was associated with higher emotional well-being (β = 0.76; P = 0.024), while being uncertain about disease incurability was associated with poorer spiritual well-being (β = −3.16; P = 0.006). Conclusions Our findings support the importance of being aware of disease incurability, addressing uncertainty around disease incurability among patients with heart failure, and helping patients make informed medical decisions. The findings are important to Asian and other cultures where the prognosis disclosure to terminally ill patients is generally low with an intention to “protect” patients. Highlights Our 24-mo study with heart failure patients showed an increase from 52% to 76% in patients being aware of disease incurability. Compared with being unaware of disease incurability, being aware was associated with higher emotional well-being, while uncertainty about disease incurability was associated with poorer spiritual well-being.
An Empirical Study of the Constituent Factors of Player Behaviour
Authors: Dumblekar Vinod , Dubey Jigyasu , Dhar Upinder 
Published: November 2024

Background Player behaviour comprises thoughts, decisions and other actions that arise from multiple sources and contexts in games and is based on the players’ complex environment of information, vicarious experiences and perspectives. Learning and superior performance within the game are shaped by the players’ goal orientation, conviction and interactions. Objectives of the study: The study sought to understand the concept, functions and constituents of player behaviour from their perspectives, expectations, beliefs and traits. Recognising player behaviour in terms of its constituent elements would clarify and enhance knowledge of human behaviour and make it simple to use the understanding in deeper enquiry and applications. Method An instrument of 43 statements was first developed based on extant research and refined by the responses of 45 university teachers. It was then administered to 1,260 university students from whom 711 valid responses were received. The sample was processed by exploratory factor analysis under varimax rotation to yield the scale of player behaviour at a Cronbach alpha of .96 and a cumulative variance of 54 percent. Results The seven factors of the scale had an eigenvalue each of more than one, and Cronbach α values of .58 to .90. The exploratory factor analysis generated seven factors that were named conviction, experience sharing, uncertainty, unpredictability, insights, preparedness and planning. Discussion The study identified the factors of player behaviour and studied the effect of gender and education on player behaviour. It showed that player behaviour emerges from convictions which are perspectives backed by ready resources, skills and action plans to simplify, understand and respond to situations and likely problems. The behavioural differences between gender, type of programme and level of education were not significant. The study also discussed the nature of each factor and the limitations, suggestions and implications of the study.
Characteristics of submacular hemorrhage with bacillary layer detachment and intrabacillary hemorrhage
Authors: Choudhary Ayushi , Kapoor Saloni , Sehgal Gaurang , Gandhi Priyanka , Kathare Rupal , Prabhu Vishma , Hande Prathiba , Yadav Naresh Kumar , Chhablani Jay , Venkatesh Ramesh 
Published: November 2024

Purpose To study the outcomes of patients presenting with submacular hemorrhage (SMH) and bacillary layer detachment (BALAD) following intervention. Methods This retrospective study examined fundus photographs and optical coherence tomography (OCT) scans to identify treatment-naive SMH and BALAD cases. Two groups were formed: SMH cases with and without BALAD. The treatment outcomes of these cases were assessed. Results Thirteen (65%) of the 20 eyes with SMH had BALAD. Blunt trauma was the most common cause of SMH (n = 10, 50%). Median age was 46 years (IQR range: 28–70). Demographic, clinical, or OCT imaging findings between the groups ( p > 0.05) were comparable. Nine (45%) patients each underwent intravitreal gas injection alone or along with PPV and TpA injection. At 1-month post-treatment, VA improved (logMAR VA – 0.89; p = 0.017). BALADs and intrabacillary hemorrhage had resolved in eight (61%) cases. Intraretinal, subretinal, and sub-RPE fluids resolved in 100%, 70%, and 43% of cases, respectively. Eyes with resolved BALAD showed greater improvement in VA (logMAR VA – 0.98) than eyes with persisting BALAD (logMAR VA – 1.1) and resulted in significant decrease in central macular ( p = 0.016) and retinal thicknesses ( p = 0.031). SMH eyes without pre-treatment BALAD also observed statistically significant improvement in visual acuity following intervention ( p = 0.031). Conclusion BALAD and intrabacillary hemorrhage in SMH are relatively common. A significant proportion of cases had their BALAD and intrabacillary haemorrhage resolved following treatment. Persistence of BALAD had no effect on VA.
Interwoven nitinol stent-assisted arteriovenous fistula maturation: 2 year-outcomes of a single center experience
Authors: Suwanruangsri Veera , Bokerd Surakiat , Chanchitsopon Virapat 
Published: November 2024

Objectives The aim of this study was to report 2-year outcomes of interwoven nitinol (SuperaTM) stent-assisted arteriovenous fistula (AVF) maturation in patients who presented with non-matured AVF. Methods We reviewed the clinical data of 20 patients who presented with non-matured AVF (19 patients with brachiocephalic AVF and 1 patient with radiocephalic AVF) and underwent balloon angioplasty followed by SuperaTM stenting in the cephalic vein for long-term hemodialysis between January 2017 and January 2022. The outcomes were evaluated in these patients in terms of technical success, post-intervention complications, reintervention, and cumulative patency (6 months, 1 year, and 2 years). Results The study included 20 patients who presented with non-matured AVF. The mean age of the patients was 65 years (range, 40–85). The SuperaTM stents of size 6.5 mm were used in 15 patients (75%), and those of 7.5 mm and 5.5 mm were used in 4 (20%) and 1 (5%) patient, respectively. The average stent length was 99.5 mm (range, 80–120). Technical success was achieved in all patients. Early use within 1 week by needling at the SuperaTM stent segment (cannulation zone) was successful in all patients without any complications. The mean follow-up time was 24.5 months. During the follow-up period, reinterventions to maintain the function of AVF were performed in 8 patients (40%) (7 patients with juxta-anastomotic stenosis, 1 patient with in-stent restenosis). The reintervention rate was 0.39 procedures per patient per year. The primary patency at 6 months, 1 year, and 2 years were 85.5%, 62.6%, and 54.2%, respectively. The assisted primary patency at 6 months, 1 year, and 2 years were 95%, 84.5%, and 78.8%, respectively. Conclusions The use of the SuperaTM stent to improve the AVF maturation rate was associated with acceptable outcomes at 2 years. Its benefit over other strategies was the early use of the access for hemodialysis.
The Phenomenology of Animation
Authors: Parry Jack 
Published: November 2024

This paper presents a framework for a phenomenology based on pure transcendental phenomenology that examines the nature of both the experience of viewing and creating animation. The technological innovation of film and cinema in general is based upon two overarching principles. The first is the phenomenon of the captured frame and the second is the spectator’s phenomenological experience of sequences of such captured frames. It is argued among animation and film theorists alike that the insights offered by the consideration of the phenomenon of the cinematic frame should form the nexus of all film theories. This paper argues that a complete theory of film and cinema should start by explaining this fundamental conceptual bedrock, and that the ‘already-created’ frame of film restricts insight into the phenomenology of cinema spectatorship. The article also shows how the practice of animation is instrumental to the proposition and elaboration of a phenomenology of animation.
Provision of online information and resources for resistance training in Australian youth sports: A scoping review
Authors: Kennedy SG , Murray SJ , Guagliano JM , Lloyd RS , Lubans DR , Smith JJ , Eather N , Bennie A 
Published: November 2024

Objectives This study aimed to identify and synthesize online information/resources related to resistance training provided by governing bodies of the ten most popular youth sports in Australia. Design A scoping review. Methods The top 10 organised out-of-school sports were eligible for the review. A systematic search of national sporting organisation and associated websites was conducted, using key search terms. Data were extracted regarding information and/or resources aligning with current international youth muscle-and-bone strengthening activity guidelines (i.e., 5–17 years, three days per week). Results For all ten sports, information/resources on resistance training were provided for athletes or coaches, however the type of information and level of detail varied. There was lack of consistency between guidelines and information provided by sports. Age of commencement recommendations ranged from four years (athletics) to 14 years (Australian football), whilst others suggested resistance training for all ages (gymnastics) or did not provide an explicit age range (tennis and cricket). Regarding frequency, few sports organisations provided a recommendation for how many days per week resistance training should be performed. Some sports alluded to the need for youth to develop muscular fitness to enhance fitness and performance, whilst others focused primarily on the need for resistance training as an injury prevention tool. Conclusions Our findings highlight the gap that exists in the provision of information in relation to resistance training in Australian sports. It is important that national sporting organisations look to educate athletes and coaches (and parents) from grassroots levels on the need for muscular fitness.
Alterations of Gut Microbiome Composition and Function Pre- and Post-Adenotonsillectomy in Children with Obstructive Sleep Apnea
Authors: Chuang Hai-Hua , Lee Li-Ang , Chuang Li-Pang , Li Hsueh-Yu , Huang Yu-Shu , Chou Shih-Hsuan , Lee Guo-She , Kuo Terry B. J. , Yang Cheryl C. H. , Huang Chung-Guei 
Published: November 2024

Importance Obstructive sleep apnea (OSA) in children is linked with alterations in the gut microbiome. The influence of adenotonsillectomy (AT), a primary intervention for OSA, on gut microbiota dynamics relative to disease severity remains to be elucidated. Objective This study aimed to investigate the impact of OSA severity and AT on the gut microbiome in pediatric patients. Design A prospective observational study. Setting Tertiary referral center. Participants A cohort of 55 pediatric patients treated with AT for OSA. Intervention Total tonsillectomy and adenoidectomy procedures. Main Outcome Measures Comprehensive evaluations included in-laboratory polysomnography and 16S rRNA gut microbiome profiling at baseline, and again at 3rd and 12thmonth following surgery. Results Initial findings showed uniform α-diversity across different severities of OSA, while β-diversity was significantly elevated in the severe OSA subgroup. Certain gut microbiota taxa ( Lachnospiraceae NK4A136 group, Ruminococcaceae UCG-002, Ruminococcaceae UCG-014, Alloprevotella, Christensenellaceae R-7 group, Ruminococcaceae UCG-005, Lactobacillus murinus, and Prevotella nigrescens) were found to inversely correlate with the apnea-hypopnea index (AHI). Significant post-AT improvements in AHI and other polysomnographic metrics were observed. Notably, AHI changes post-AT were positively associated with microbial α-diversity (species richness), β-diversity, and specific bacterial taxa ( Enterobacter, Parasutterella, Akkermansia, Roseburia, and Bacteroides plebeius DSM 17135), but negatively with other taxa ( Fusicatenibacter, Bifidobacterium, UBA1819, Ruminococcus gnavus group, Bifidobacterium longum subsp. Longum, and Parabacteroides distasonis) and specific metabolic pathways (purine metabolism, transcription factors, and type II diabetes mellitus). The postoperative patterns of α- and β-diversity mirrored baseline values. Conclusions and Relevance This study documents significant changes in the gut microbiome of pediatric patients after AT, including variations in α- and β-diversities, bacterial communities, and inferred metabolic functions. These changes suggest a potential association between the surgical intervention and microbiome alterations, although further studies are necessary to discern the specific contributions of AT amidst possible confounding factors such as antibiotic use.
Association of the Universal Designated Hitter Rule With Changes to Injuries in Major League Baseball Pitchers
Authors: Kholodovsky Eric , Luxenburg Dylan , Hodgens Blake , Liebmann Kevin , Baraga Michael 
Published: November 2024

Background: In 2022, Major League Baseball (MLB) implemented the universal designated hitter (DH) rule, thus allowing the pitcher to focus solely on defense while the DH, who bats for the pitcher, focuses solely on offense. Purpose/Hypothesis: The purpose of our study was to determine if implementation of the universal DH rule affected the incidence of injuries in MLB pitchers when compared with before implementation. It was hypothesized that the shift to the universal DH rule would be associated with a decrease in the rate of offense-related pitcher injuries. Study Design: Descriptive epidemiology study. Methods: Using publicly available data, we identified injuries sustained by MLB pitchers during the 2021 (before the DH rule change) and 2022 (after the rule change) regular seasons. Pitchers placed on the injured list for non–gameplay related reasons were excluded. Statistical analysis was performed with the chi-square and independent t tests. Results: The injury incidence rate decreased significantly from before to after the rule change for MLB pitchers overall (from 6.58 to 5.60 injuries/1000 athlete game-exposures [AGE]; P = .02) and for National League pitchers (from 7.62 to 6.26 injuries/1000 AGE; P = .04). No significant changes were seen in American League pitchers ( P = .20). Injury locations that decreased from before to after the rule change were the thigh (from 0.52 to 0.21 injuries/1000 AGE; P = .003) and the hand/finger/wrist (from 0.63 to 0.30 injuries/1000 AGE; P = .01). Total time lost decreased from 9471 days before the rule change to 8857 days after the rule change ( P = .00001). Conclusion: Implementation of the universal DH rule was associated with a decrease in pitcher injuries overall and within the National League. Injuries to the thigh and hand/finger/wrist also decreased overall and within the National League. Furthermore, total days lost decreased from before to after the rule change. These findings may be due to the elimination of offensive gameplay requirements for pitchers, which highlights a positive consequence of the universal DH rule, but further studies are needed.
Experiences of caregivers of patients with noncancer diseases readmitted to an emergency department at the end of life
Authors: Amado-Tineo Jose , Oscanoa-Espinoza Teodoro , Loli-Ponce Rudi , Delgado-Guay Marvin Omar 
Published: November 2024

Abstract
Background
When there is limited access to primary care or end-of-life services for patients with chronic diseases, caregivers often need to bring their loved ones to emergency departments (EDs) to solve or control distressing physical and psychosocial-spiritual problems. There is limited literature about the experiences of primary caregivers of patients with nononcologic chronic diseases who are at the end of life and are evaluated in EDs in Latin America.

Methods
We conducted in-depth interviews with primary caregivers of adult patients with advanced and terminal chronic nononcologic diseases who were evaluated in the ED of a hospital in Lima, Peru. This qualitative study employed a phenomenological approach. Themes, categories, codes, and quotes were analyzed using ATLAS.ti 9.1.4.

Results
Twelve primary caregivers, aged 38 to 76 years old, mostly female immediate family members (daughter or wife), participated. They described their experiences in the ED, including feelings of despair and anguish due to prolonged waiting times, insufficient resources, incomplete information regarding the patient’s problems, and “insensitive” treatment by the staff. Some also expressed gratitude for “saving patient’s lives.” They also experienced deficiencies in home care follow-up and patient transfers, which worsened during the COVID-19 pandemic; many times they felt that “they were ignored.” When caring for patients at home, caregivers felt sad, helpless, and frustrated as they observed patients’ progressive deterioration. As patients approached death, caregivers expressed that they tried to “give them all the love” and to have them present for as long as possible, although at the same time caregivers did not want patients to continue to suffer and hoped for “a better place” after this life. Caregivers found their faith to be a source of strength as they continued to care for and be with their loved one until the end.

Conclusion
Caregivers reported “traumatic” and “shocking” experiences during ED care, as well as conflict between wanting the patient’s suffering to end and wanting to prolong their lives. They also expressed feelings of gratitude, resignation, love, faith, and hope.
SGLT2 inhibition improves coronary flow velocity reserve and contractility: role of glucagon signaling
Authors: Göpel Sven O. , Adingupu Damilola , Wang Jue , Semenova Elizaveta , Behrendt Margareta , Jansson-Löfmark Rasmus , Ahlström Christine , Jönsson-Rylander Ann-Cathrine , Gopaul V. Sashi , Esterline Russell , Gan Li-Ming , Xiao Rui-Ping 
Published: November 2024

Abstract
Background
SGLT2 inhibitors, a T2DM medication to lower blood glucose, markedly improve cardiovascular outcomes but the underlying mechanism(s) are not fully understood. SGLT2i’s produce a unique metabolic pattern by lowering blood glucose without increasing insulin while increasing ketone body and glucagon levels and reducing body weight. We tested if glucagon signaling contributes to SGLT2i induced improvement in CV function.

Methods
Cardiac contractility and coronary flow velocity reserve (CFVR) were monitored in ob/ob mice and rhesus monkeys with metabolic syndrome using echocardiography. Metabolic status was characterized by measuring blood ketone levels, glucose tolerance during glucose challenge and Arg and ADMA levels were measured. Baysian models were developed to analyse the data.

Results
Dapagliflozin improved CFVR and contractility, co-application of a glucagon receptor inhibitor (GcgRi) blunted the effect on CFVR but not contractility. Dapagliflozin increased the Arg/ADMA ratio and ketone levels and co-treatment with GcgRi blunted only the Dapagliflozin induced increase in Arg/ADMA ratio but not ketone levels.

Conclusions
Since GcgRi co-treatment only reduced the Arg/ADMA increase we hypothesize that dapagliflozin via a glucagon-signaling dependent pathway improves vascular function through the NO-signaling pathway leading to improved vascular function. Increase in ketone levels might be a contributing factor in SGLT2i induced contractility increase and does not require glucagon signaling.

Graphical Abstract
Role of inflammasomes in Toxoplasma and Plasmodium infections
Authors: Wang Zhi-xin , Jiao Wan-jun , Yang Yong , Liu Hong-li , Wang Hai-long 
Published: November 2024

Abstract
Background
The detection of pathogen-associated molecular patterns (PAMPs) or damage-associated molecular patterns (DAMPs) by multimeric protein complexes, known as inflammasomes, triggers an inflammatory response, which is a critical component of the innate immune system. This inflammatory response plays a pivotal role in host resistance against parasitic infections, presenting a significant global health challenge.

Methods
We systematically searched for relevant articles from the Pubmed and the Web of Science database to summarize current insights into how inflammasomes function in preventing infections caused by the apicomplexan parasites Toxoplasma and Plasmodium.

Results
In vivo and in vitro studies have extensively explored inflammasomes such as the absent in melanoma 2 (AIM2), NLR family pyrin-containing protein 1 (NLRP1), NLRP3, and NLRP12 inflammasomes, alongside noncanonical inflammasomes, with particular emphasis on the NLRP1 and the NLRP3 inflammasome during Toxoplasma gondii infection or the AIM2 and the NLRP3 inflammasome at various stages of Plasmodium infection. Toxoplasma gondii interacts with inflammasomes to activate or inhibit immune responses.

Conclusions
Inflammasomes control parasite burden and parasite-induced cell death, contribute to immune recognition and inflammatory responses and thus influence apicomplexan parasite-associated pathogenesis and the severity of clinical outcomes. Hence, inflammasomes play crucial roles in the progression and outcomes of toxoplasmosis and malaria. A comprehensive understanding of how parasitic infections modulate inflammasome activity enhances insight into host immune responses against parasites.

Graphical Abstract