bluuebunny/crossref_metadata_2025_split huggingface dataset:
STRIVE pilot trial: a protocol for a multicentre pragmatic internal pilot randomised controlled trial of Structured TRaining to Improve fitness in a Virtual Environment (STRIVE) before surgery
Authors: McIsaac Daniel I , Tandon Puneeta , Kidd Gurlavine , Branje Karina , Hladkowicz Emily , Hallet Julie , Wijeysundera Duminda Nalaka , Lee Susan , McNeely Margaret L , Taljaard Monica , Gillis Chelsia ,   on behalf of the STRIVE Trial Investigators
Published: November 2024

IntroductionHome-based, virtually-supported care models may represent the most efficient and scalable approach to delivering prehabilitation services. However, virtual approaches to prehabilitation are understudied. This manuscript describes the protocol for an internal pilot randomised controlled trial of a virtually-delivered, multimodal prehabilitation intervention.Methods and analysisWe will conduct a pragmatic, individual patient, internal pilot randomised controlled trial of home-based, virtually supported, multimodal prehabilitation compared with standard perioperative care in adults undergoing elective, inpatient thoracic, abdominal, pelvic and vascular surgery at five Canadian hospitals. Participants will be partially blinded; clinicians and outcome assessors will be fully blinded. The intervention consists of 3–12 weeks of a home-based, multimodal (exercise, nutrition and psychosocial support) prehabilitation programme supported through an online platform. The primary feasibility outcomes and their progression targets are (1) monthly recruitment of>6 participants at each centre, (2) intervention adherence of>75%, (3) retention of>90% of participants at the patient-reported primary outcome point of 30-days after surgery and (4) elicitation of patient, clinician and researcher-identified barriers to our pragmatic trial. A sample size of 144 participants will be adequate to estimate recruitment, adherence and retention rates with acceptable precision. All participants will be followed to either death or up to 1 year. As an internal pilot, if no substantive changes to the trial or intervention design are required, pilot participant outcome data will migrate, unanalysed by allocation, to the future full-scale trial.Ethics and disseminationEthical approval has been granted by Clinical Trials Ontario (Project ID: 4479) and our ethics review board (Protocol Approval #20230399–01T). Results will be disseminated through presentations at scientific conferences, peer-reviewed publications, partner organisations and engagement of social and traditional media.Trial registration numberClinicalTrials.gov identifierNCT06042491. Protocol, V.1.2, dated 6 June 2024.
Dermatomal spread in lateral quadratus lumborum blocks versus transversus abdominus plane blocks after laparoscopic colorectal surgery: a randomized clinical trial
Authors: George Renuka M , McSwain Julie R , Gukasov Mamikon , Wilson Dulaney A , Nitchie Haley , Wilson Sylvia H 
Published: November 2024

IntroductionPostoperative pain after laparoscopic abdominal surgery remains complex. While lateral quadratus lumborum (QL) block and transversus abdominus plane (TAP) block are similar techniques, no studies have examined if one technique has greater dermatomal spread.MethodsLaparoscopic colorectal surgical patients were randomized to lateral QL or TAP blocks. Dermatomal anesthetic spread, as measured by loss of sensation to temperature in the postanesthesia care unit, was the primary outcome. If a clear level of dermatomal anesthesia could not be defined, the block was categorized as “indeterminate.” Secondary outcomes included opioid consumption, pain scores, and opioid-related side effects.Results153 patients completed the study (75 QL and 78 TAP). Mean (95% CI) number of dermatomes with loss of sensation to ice was greater in subjects randomized to QL (4.2 (3.7 to 4.8)) versus TAP (2.7 (2.2 to 3.2); p=0.0001), and the QL group was more likely to have loss of sensation above T8 (p=0.01) and T10 (p=0.02). Indeterminate block was more often noted with TAP blocks (p<0.0001). Opioid consumption at 24 hours, pain scores, and opioid-related side effects did not differ.DiscussionCompared with TAP blocks, QL blocks had greater dermatomal anesthesia spread and lower rates of an indeterminate block. However, differences in pain and opioid consumption were not noted. The clinical importance of these findings should be investigated in future trials.Trial registration numberNCT03490357.
Once-Marking and Always-Marking 1-Limited Automata
Authors: Pighizzini Giovanni , Prigioniero Luca 
Published: November 2024

Single-tape nondeterministic Turing machines that are allowed to replace the symbol in each tape cell only when it is scanned for the first time are also known as [Formula: see text]-limited automata. These devices characterize, exactly as finite automata, the class of regular languages. However, they can be extremely more succinct. Indeed, in the worst case, the size gap from [Formula: see text]-limited automata to one-way deterministic finite automata is double exponential. Here we introduce two restricted versions of [Formula: see text]-limited automata, once-marking[Formula: see text]-limited automata and always-marking[Formula: see text]-limited automata, and study their descriptional complexity. We prove that once-marking [Formula: see text]-limited automata still exhibit a double exponential size gap to one-way deterministic finite automata. However, their deterministic restriction is polynomially related in size to two-way deterministic finite automata, in contrast to deterministic [Formula: see text]-limited automata, whose equivalent two-way deterministic finite automata in the worst case are exponentially larger. For always-marking [Formula: see text]-limited automata, we prove that the size gap to one-way deterministic finite automata is only a single exponential. The gap remains exponential even in the case the given machine is deterministic. We obtain other size relationships between different variants of these machines and finite automata and we present some problems that deserve investigation.
An Attentional Graph Neural Network-Based Fault Point Positioning Model for Low-Voltage Distribution Networks
Authors: Meng Yuan , Yao Keqi , He Jun , Li Shun , Gu Chao 
Published: November 2024

With the rapid development of the smart grid, the fast and accurate fault location of low-voltage distribution networks has become the key to ensuring the stability and reliability of the power supply. This paper aims to explore and construct a fault location model of low-voltage distribution network based on an attention diagram neural network. First, this paper analyzes the current situation and challenges of fault location in low-voltage distribution network, and points out that traditional methods have limitations when processing large-scale and high-dimensional power system data. Subsequently, a graph neural network (GNN) is introduced for processing graph-structured network data, and combined with attention mechanisms. Thus, an innovative attention-graph neural network model (named as A-GNN) is proposed for the purpose. The model can make full use of the topology structure and node feature information in the power grid, and dynamically adjust the information aggregation weight between different nodes through the attention mechanism. This is expected to achieve efficient and accurate fault location. In the experimental part, we trained and tested the A-GNN model based on the real low-voltage distribution network dataset, and compared it with several prediction models. The experimental results show that the A-GNN model has higher accuracy and recall rate in fault location tasks, especially in complex fault scenarios.
Chronic Kidney Disease: Decreasing Serum Klotho Levels Predict Adverse Renal and Vascular Outcomes
Authors: Konnur Abhijit , Gang Sishir , Hegde Umapati , Patel Hardik , Pandya Akash , Shete Nitiraj 
Published: November 2024

Background and Objectives: Soluble alpha Klotho (s.Klotho) is an emerging marker for chronic kidney disease (CKD) prognosis. The objective was to study the association between s.Klotho and CKD‐related decrease in glomerular filtration rate (GFR), bone and vascular damage.Method: A total of 118 patients with CKD stage 2–4 were enrolled and 107 patients continued in the study. Clinical and laboratory parameters were recorded at time of enrollment and 12 months. A double sandwich ELISA for s.Klotho was recorded in controls (n = 25) and patients’ serum samples at 6 months (n = 107) and 12 months (n = 102). Primary endpoints like 40% or more fall in GFR, a requirement for renal replacement therapy (RRT), and death with different grades of s.Klotho deficiency were studied.Results: Of the 107 patients (80 male and 27 female), mean s.Klotho was 3.46 ng/mL (02.3–04.2). The GFR fall was significantly different (p value < 0.0001) in the different grades of s.Klotho deficiency with Grade 4 s.Klotho deficiency (0.1–2.99 ng/mL) having the maximum fall of GFR at 9.2 mL/min/1.73 m2 (04.8–12.0) and minimum in Grade 2 (3–5.99 ng/mL) at 1.35 mL/min/1.73 m2 (03.0–02.75). The Ankle Brachial Pressure Index positively correlated with s.Klotho and the correlation coefficient was 0.536 (0.382–0.662) (p < 0.001). The carotid intimal medial thickness negatively correlated with s.Klotho and the correlation coefficient was −0.712 (95% CI: −0.797–−0.601, p < 0.001). All five deaths had s.Klotho Grade 4 (severe) deficiency. The event‐free survival rate was maximum (100%) in Grade 2 Klotho deficiency and lowest (55%) in Grade 4 s.Klotho deficiency.Conclusions: s.Klotho levels decreased significantly in patients with progressive kidney failure. s.Klotho levels significantly correlated with the presence of vascular disease. Death and need for RRT were significantly more in patients with severe s.Klotho deficiency.
The Role of Influencer-Generated Contents to the Cognition and Emotional Attachment Among Generation Z Consumers in Manila, Philippines
Authors: Angeles Rhea Jane G. , Clemente Carmhiella A. , Malimban Renoa Lorraine O. , Santos Jean Erika G. , Tan Jian Carlo D. 
Published: November 2024

Along with the rising digitalization of businesses, social media influencers (SMI) have been essential in redefining how the online promotional system operates. In the Philippines alone, social media influencers are central to all online discussions. The country is known as the "social media capital of the world," as 86.3% of Filipinos follow at least one influencer and spend about 11 hours each week on social media.
With the use of an existing theory and testable hypotheses, the researchers will gather data while adhering to the positivist philosophy. To obtain objective and statistically significant results, the researchers will measure, document, and examine the data through a survey. Moreover, the researchers will carry out various statistical testing, including PLS-SEM, average variance extraction (AVE), heterotrait-monotrait (HTMT) ratio, variance inflation factor (VIF), squared multiple correlation (R2), Stone–Geisser’s Q2, etc. using SmartPLS.
Delving into the results, it was shown that influencer-branded content's interestingness does affect users to be emotionally attached. Research findings also revealed that influencer-generated content's novelty does not significantly affect users' emotional attachment to influencers. It was also shown that reliability positively affects emotional attachment, as well as information quality. But when it comes to understandability it shows no relationship with emotional attachment. Lastly, it is revealed that there is no significant relationship between emotional attachment and users' intention to disagree with the influencer.
As a conclusion, social media influencers have become instrumental in making digital platforms a more enjoyable place to dwell.
Learning Recovery Plan (LRP) in Addressing Learning Gaps of Effective and Efficient Learning Outcomes after Pandemic among Different School in the Division of San Pablo
Authors: Dionglay Perlyn V. , Callo Eden C. 
Published: November 2024

The Department of Education (DepEd) adopts the National Learning Recovery Program (NLRP) through DepEd Order No. 013, s. 2023 which aims to strengthen the learning recovery and continuity program, improve literacy and numeracy, and accelerate the achievement of education targets. This study aimed to examine the respondents perceptions on the implementation of the Learning Recovery Plan (LRP) in addressing the learning gaps, starts with assessing fundamental skills such as the literacy and numeracy in the early grades. Detecting learners who have not developed the full range of reading and numeracy skills are provided with appropriate programs. A post pandemic program from the Department of Education, that which aims to identify the level of responsiveness, relevance and appropriateness of the different school in the Division of San Pablo City, and how effective and efficient is this study as to upskilling and reskilling of teachers, stakeholders effort, updating, review of different projects and programs and teaching methodology to recover the learning gaps after pandemic.
Random sampling was conducted because of the limited access for face to face contact and all the big schools, three-year plan beginning SY 2022-2023, which shall be adopted by all DepEd implementing units and schools by aligning respective plans and implementation to the directions and priorities specified in this policy.
Based on the finding the relevance, resilience and appropriateness in the level of in the implementation of learning recovery plan (LRP)addressing the learning gaps are “always observed” among the different school in the division of San Pablo regardless of age, length of service and district from which they belong, moreover the level of effectivity and efficiency in the learning, have significant effect in terms of physical and mental resilience, communication plan, professionalism , community stakeholder and support system in upskilling and reskilling of teachers, stakeholders effort, improvement of learning environment, updating and review of projects and programs and the teaching methodology.
Hemangioma in Children: Literature Review
Authors: Arviansyah Arviansyah , Wihastyoko Herman , Agustina Wilma , Siswanto Yudi , Sintaningrum Elisabeth 
Published: November 2024

Hemangioma is a vascular anomaly that is benign and generally occurs in children. ISVVA 2018 classifies vascular anomalies into two categories, namely vascular malformations and vascular tumors (hemangioma). The prevalence of hemangioma is higher in low birth weight babies, premature babies, and girls. Several theories suggest that hemangiomas are caused by vasculogenesis and angiogenesis or an imbalance between angiogenic and antiangiogenic factors. Hemangiomas grow through a proliferation phase, involution phase, and post-involution phase. Hemangioma classification is based on the depth of the lesion, time of appearance of the lesion, distribution of the lesion, and its relationship to syndrome complication.. Diagnosis of hemangioma is based on anamnesis, physical examination, and supporting examinations which include USG, MRI, and CT-Scan. Hemangiomas that lead to complications should require immediate treatment. Hemangioma treatment can be done with topical therapy, systemic therapy (propranolol, corticosteroids, β-blockers, vincristine, rapamycin), laser therapy (PDL, diode, Nd: YAG, argon, KTP, CO2, IPL), and other treatments consisting of from surgical and non-surgical procedures (bleomycin injection).
Trem2/Tyrobp Signaling Protects Against Aortic Dissection and Rupture by Inhibiting Macrophage Activation in Mice
Authors: Zhang Zenghui , Wu Maoxiong , Yao Lei , Zhou Weibin , Liu Xiao , Chen Zhiteng , Hua Ping , Xu Leibo , Lv Lei , Liu Chiyu , Huang Chunling , Chen Sixu , Huang Zhaoqi , Huang Yuna , He Jiaqi , Chen Tingfeng , Wang Jingfeng , Yuan Woliang , Liu Zhaoyu , Chen Yangxin 
Published: November 2024

BACKGROUND:
The development of aortic dissection (AD) is closely associated with inflammation. The Trem2 (triggering receptor expressed on myeloid cells 2)/Tyrobp (TYRO protein tyrosine kinase-binding protein) signaling pathway critically regulates innate immunity and has emerged as an important target in cardiovascular diseases; however, its role in AD remains unclear.

METHODS:

Transcriptome data from human and mouse ADs were used to perform differentially expressed gene–based protein-protein interaction network analyses.
Tyrobp
knockout (Tyrobp
−/−
), myeloid cell–specific
Tyrobp
−/−
(Tyrobp
fl/fl
Lyz2
cre
), and
Trem2
knockout (Trem2
−/−
) mice were given β-aminopropionitrile monofumarate in drinking water to induce AD. To dissect the role of macrophages in
Tyrobp
deficiency–mediated AD progression, macrophages were depleted using clodronate liposomes. Bulk and single-cell RNA sequencing, immunofluorescence staining, and quantitative real-time polymerase chain reaction were performed to assess inflammation and the underlying mechanisms of Tyrobp in AD.

RESULTS:

Network analysis identified
Tyrobp
as a hub gene of AD, with elevated levels observed in both human and mouse ADs. Global deletion and myeloid cell–specific deficiency of
Tyrobp
in mice significantly increased AD incidence and exacerbated extracellular matrix degradation and macrophage infiltration within the aortic wall. Macrophage depletion mitigated the adverse effects of
Tyrobp
deficiency on AD progression. Additionally,
Tyrobp
deficiency enhanced TLR (Toll-like receptor)-4 signaling and macrophage activation, which were abrogated by TLR4 inhibitors. Furthermore, deletion of the Tyrobp-associated receptor
Trem2
significantly aggravated mouse AD development, whereas Trem2 agonist treatment conferred protection against AD.

CONCLUSIONS:
Our findings suggest a novel role for the Trem2/Tyrobp axis in AD development in mice. Enhancement of Trem2/Tyrobp signaling may represent a promising strategy for the prevention and treatment of AD. Future studies to clarify the role of Trem2/Tyrobp in human AD are warranted.
I2U2 and Regional Stability in the Middle East
Authors: Sheikh Mohmad Saleem 
Published: November 2024

Abstract
Participation in the Middle East Quad (I2U2) indicates that India, Israel, and the UAE are exercising “strategic autonomy” and have engineered a redirection of their foreign policy agendas. These countries no longer face any strategic dilemma in expanding their outreach, and formalising a transactional relationship for mutual strategic and geo-economic growth in the unstable and volatile Middle East. Is India’s involvement in the Middle East Quad Group beneficial to its foreign policy, keeping in view it’s cautious and ‘hands-off approach’ in the region? How far can these accords help in achieving regional stability? This paper attempts to answer these questions. It also deals with how India strikes a balance between the Abraham Accord countries and Iran, despite mutual rivalry in relation to several regional issues. This study observes that the Quad countries are driven by geo-strategic and geo-economic interests and exercise strategic autonomy in this transregional arrangement. This article employs analytical and interpretative methods through a forward-thinking conceptual framework centred on “strategic autonomy”. It concludes that India’s participation in this grouping does not hinder its ability to pursue relations with other countries, such as Iran, for its economic security. Rather, geopolitical shifts prompt national decisions on the part of different, even mutually confrontational actors, in a way that corresponds to the respective levels of their strategic autonomies or vulnerabilities. Strategic outcomes with peace dividends, such as regional multipolarity and economic diversification are identified as part of this process. such
Tanzania’s Position on the Ukraine Crisis: Neutrality with a Stance or Just Sitting on the Fence?
Authors: Minja Rasul A. 
Published: November 2024

Abstract
The Ukraine crisis has morphed into a political minefield for countries far removed from the war zone. While some states have been vociferous in supporting sanctions against Moscow or denouncing Kyiv’s ambition to join the North Atlantic Treaty Organization (NATO), others have ‘played it safe’ by maintaining a neutral position. Tanzania abstained in most of the voting rounds at the United General Assembly (UNGA) on the crisis. The Russia-Ukraine conflict has had significant economic effects on the country, but its diplomatic relations with these belligerent parties have remained unscathed. But what has been Tanzania’s position on the Ukraine crisis since 2014? What has been the voting trend at the UNGA by the country and other East African Community (EAC) partner states on the Ukraine crisis? These are some of the questions that the current article seeks to answer.
Smartphone-Based Cognitive Behavioral Therapy and Customized Sound Therapy for Tinnitus: A Randomized Controlled Trial
Authors: Goshtasbi Khodayar , Tawk Karen , Khosravi Pooya , Abouzari Mehdi , Djalilian Hamid R. 
Published: November 2024

Objective: To evaluate the efficacy of a smartphone-based application providing tinnitus-specific cognitive behavioral therapy and customized sound therapy for tinnitus. Methods: In a prospective randomized controlled trial, the treatment group participated in daily sound therapy and weekly interactive CBT modules, and the control group did not receive the program (waitlisted). Outcome measures after 8 weeks included the Tinnitus Functional Index (TFI), Generalized Anxiety Disorder (GAD-7), Patient Health Questionnaire (PHQ-9), Perceived Stress Scale (PSS), and Pittsburgh Sleep Quality Index (PSQI). Results: Ninety-two patients (mean age = 57.2 ± 11.9 years) were included. The treatment (n = 47) and control (n = 45) cohorts had similar TFI, PHQ-9, GAD-7, PSS, and PSQI scores at presentation (all P > .05). Treatment-group patients had significantly higher improvements than controlled patients in their TFI (16.7 ± 14.9 vs 1.9 ± 10.8, P < .001), PHQ-9 (1.9 ± 4.2 vs −0.7 ± 3.4, P = .002), GAD-7 (1.1 ± 3.6 vs −0.9 ± 3.3, P = .009), and PSQI scores (2.5 ± 3.2 vs −1.1 ± 2.1, P < .001). Treatment-group subjects also significantly improved in 7 of the 8 TFI domains (all P < .05). TFI improvements of ≥20 occurred in 18 (38.3%) treatment subjects. Of the 9 treatment-group patients presenting with moderate-severe depression, 4 (44.4%) improved to minimal depression. Of the 4 treatment-group patients with moderate-severe anxiety, 2 (50.0%) improved to minimal anxiety. Of the 17 treatment-group patients with moderate-severe sleep difficulties, 10 (55.6%) had considerable sleep improvement. Conclusion: This novel smartphone application providing cognitive behavioral therapy and customized sound therapy was effective in reducing symptom severity and improving anxiety, sleep, and mood for tinnitus patients.