bluuebunny/crossref_metadata_2025_split huggingface dataset:
Actual and imagined music-cued gait training for people with multiple sclerosis: a multicentre qualitative study
Authors: Seebacher Barbara , Helmlinger Birgit , Hotz Isabella , Pinter Daniela , Ehling Rainer , Enzinger Christian , Deisenhammer Florian , Brenneis Christian 
Published: July 2024

ObjectivesTo explore the experiences and acceptability of music-cued motor imagery (MCMI), music-cued gait training (MCGT), and combined MCMI and MCGT (MCMI-MCGT) in people with multiple sclerosis (pwMS). We also aimed to explore participants’ self-rated health status postintervention and gather recommendations for further programme development.DesignQualitative study alongside the double-blind randomised controlled real and imagined gait training with music-cueing (RIGMUC) multicentre trial of MCMI, MCGT and MCMI-MCGT.SettingPwMS recruited for the RIGMUC trial from Departments of Neurology at Medical Universities of Innsbruck and Graz and Clinic for Rehabilitation Muenster, Austria.ParticipantsAll 132 pwMS with mild to moderate disability randomised into the trial were included in the analysis.MethodsParticipants practised home-based MCMI, MCGT or MCMI-MCGT for 30 min, 4×/week, for 4 weeks. Three trained researchers conducted weekly semistructured telephone interviews during the intervention period, supporting adherence, addressing problems, sharing experiences and assessing intervention acceptability. Follow-up interviews at 4-week postintervention aimed to understand participants’ self-rated changes in walking, fatigue and overall health compared with their prestudy condition. Investigator triangulation was employed among the researchers to enhance trustworthiness and credibility.ResultsUsing thematic analysis, we identified five themes: (1) empowerment, (2) remaining in sync, (3) interconnection between imagined and actual walking, (4) sustaining focus and (5) real-world transfer. Participants appreciated and found the imagined and actual MCGT innovative. Problems included concentration issues, early fatigue in advanced disability and difficulty synchronising with music cues. Positive changes in walking, fatigue and overall health postinterventions were reported offering valuable insights for programme development.ConclusionsA participatory study to codevelop a music-cued exercise programme for pwMS seems appropriate as participants appreciated the innovation and effectiveness of both imagined and actual MCGT. Future studies should also investigate pwMS’ potential and limitations in enhancing their MCMI abilities with intensive therapist-supported practice.Trial registration numberDRKS00023978.
Plasma matrix metalloproteinases and tissue inhibitors of metalloproteinases explored in relation to the severity and progression of diabetic retinopathy in patients with type 1 diabetes: baseline and prospective analyses
Authors: Hector Sven , Thulesius Hans Olav , Thunander Maria , Hillman Magnus , Landin-Olsson Mona , Melin Eva Olga 
Published: July 2024

AimsTo explore whether circulating matrix metalloproteinase-2 (MMP-2), MMP-9, MMP-9/neutrophil gelatinase-associated lipocalin, MMP-9/tissue inhibitor of metalloproteinase-1 (TIMP-1), MMP-14, TIMP-2 and TIMP-3 were associated with the severity and progression of diabetic retinopathy (DR) in patients with type 1 diabetes (T1D).MethodsBaseline and prospective analyses were conducted over a period of 10.5 person-years. In 2009, recruitment and biochemical analyses (MMPs, TIMPs, glycated haemoglobin (HbA1c), serum creatinine, macroalbuminuria) were performed. Fundus photography, performed at baseline and at follow-up in accordance with the regional screening programme, was compared after being categorised according to the International Clinical Diabetic Retinopathy Disease Severity Scale. ‘DR progression at least one leve’ was calculated. High MMP-2 was defined as ≥178 ng/mL (≥75th percentile) and high TIMP-2 as ≥205 ng/mL (≥75th percentile). DR was dichotomised as ‘at least moderate DR’ or ‘no/mild DR’.ResultsThe study included 267 participants, 57% of whom were men. At baseline, the prevalence of high MMP-2 (p=0.001) and high TIMP-2 (p=0.008) increased with the severity of DR. ‘At least moderate DR’ (adjusted OR (AOR) 2.4, p=0.008) and macroalbuminuria (AOR 3.6, p=0.025) were independently associated with high MMP-2. ‘At least moderate DR’ (AOR 2.3, p=0.009) and macroalbuminuria (3.4, p=0.031) were independently associated with high TIMP-2. DR progression occurred in 101 (46%) patients (p<0.001). HbA1c≥53 mmol/mol was associated with the progression of DR (crude OR 3.8, p=0.001). No other MMPs or TIMPs were linked to the severity or the progression of DR.ConclusionsHigh levels of MMP-2 and TIMP-2 indicated more severe DR or diabetic nephropathy. Only HbA1c was associated with the progression of DR in 267 patients with T1D.
Psychosocial health stigma related to COVID-19 disease among COVID-19 patients in Jordan: a comparative study
Authors: Daoud Lina Jalal , El-hneiti Mamdouh , Al-Hussami Mahmoud Ogla 
Published: July 2024

ObjectiveBeyond its effects on physical health, COVID-19 psychosocial stigma has emerged as a result of this global crisis, making people feel ashamed, alone and discriminated against. This comparative study aims to assess the psychosocial health stigma of COVID-19, and to evaluate the perceived stigma according to the sociodemographic variables during the pandemic in Jordan.MethodA study in Jordan compared stigma between 112 COVID-19 patients (52 males and 60 females) and 118 healthy controls (56 males and 62 females), with participants ranging from 18 to over 60 years old in both groups.ResultsAccording to the data, 27% of COVID-19 patients had high-level stigma, with total stigma scores ranging from 46 to 111 and a mean of 80.23 (SD=12.79). Quartile results showed 50% scored 80, 25% over 88 and 75% over 78, indicating moderate stigma within a 0–160 range. On the other hand, the total scores of stigma among the healthy controls ranged from 40 to 112, with a mean of 78.55 (SD=12.41). 30.3% report high levels of stigma. Quartile results showed 50% scored 78, 25% over 85 and 75% over 71, indicating moderate stigma. No significant stigma score difference was found between patients and controls (t=1.09, p=0.28). No significant correlation with demographics, except among medical workers (t=−3.32, p=0.001).ConclusionThe study revealed negligible differences in stigma between the two groups, but greater stigma among medical field workers highlighting the need for integrated community and policy support to fight stigma.
Community childhood obesity assessment in elementary school, anthropometric indices as screening tools: a community cross-sectional study in Indonesia
Authors: Liberty Iche Andriyani , Septadina Indri Seta , Rizqie Muhammad Qurhanul , Mariana Mariana , Pariyana Pariyana , Amalia Resy , Hasyim Hamzah 
Published: July 2024

BackgroundRepresentative anthropometric epidemiological data are needed to formulate screening and intervention methods to prevent obesity in children. This study aims to conduct community childhood obesity assessment in elementary school based on anthropometric measurements and evaluate its predictive value.MethodsThis cross-sectional study was carried out in Palembang, Indonesia, and involved 1180 elementary school students. The anthropometric parameters were divided into (1) basic data: stature, weight and waist circumference (WC), hip circumference (HC); (2) structural dimensions: the segmental dimensions of head-neck, trunk, upper extremity, hand, lower extremity and foot and (3) postural dimensions: the relative spacial dimensions when standing. Six anthropometric indices were considered: body mass index, waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), Conicity Index (CI), Body Adiposity Index (BAI) and Tri-ponderal Mass Index (TMI).ResultsThe proportion of overweight and obesity was 50.17% (n=592) and normal weight was 49.83% (n=588). The mean age was 8.26±1.71 years. The averages of all measured indices in overweight/obese versus normal weight were significant difference among boys and girls in height, weight, WC, HC, neck circumference, WHR, WHtR, neck-to-height ratio, BAI, TMI and CI (p<0.05 for all). TMI was the best predictor of obesity based on area under the curve (AUC) values, both in boys (sensitivity=90.48; specificity=91.53; AUC=0.975) and in girls (sensitivity=90.28; specificity=90.00; AUC=0.968).ConclusionsA trustworthy anthropometric database of primary school students might be a helpful local resource when working on projects involving children. In order to improve the quality of life through better-suited and secure products and environmental designs, it is crucial to build an anthropometric database.
Tracking changes in weight status in primary school children in Birmingham: an analysis of the National Child Measurement Programme – a retrospective cohort study
Authors: Mohamed Muna , Pallan Miranda J 
Published: July 2024

One-in-four 4–5 years and more than one-in-three 10–11 years have excess weight in England.AimTo identify characteristics associated with (1) having overweight, obesity and severe obesity at 11 years and (2) rapid weight gain (defined as increasing weight status by one or more body mass index (BMI) categories) between the ages of 4–5 and 10–11 years.MethodUsing National Child Measurement Programme data, BMI at reception (4–5 years) and year 6 (10–11 years) were linked for 15 390 children. Weight categories were identified at both time points using BMI centile classifications.For each child, the number of BMI categories they crossed between reception and year 6 was identified. Logistic regression models were fitted to explore associations with sociodemographic characteristics of children with excess weight at age 10–11 years and with children experiencing rapid weight gain between reception and year 6.ResultsOverall, 61.9% of children remained in their original weight category; 30% whose weight increased by ≥1 weight categories and 11.7% by ≥2 weight categories. Only 7.8% had decreased ≥1 weight categories and 0.9% had decreased ≥2 weight categories.Adjusting for other sociodemographic characteristics, girls were less likely than boys to increase ≥2 weight categories between reception and year 6 (OR 0.64; 95% CI 0.58 to 0.71; p<0.001). Compared to white children, Asian and mixed-ethnicity children had higher odds of rapid weight gain. Children with the highest deprivation were over 6 times more likely to increase ≥2 weight categories between reception and year 6 compared with children with the lowest deprivation (OR 6.1; 95% CI 1.92 to 19.10; p<0.01).ConclusionMale children, children of Asian and mixed ethnicity and children with high deprivation are at higher risk of rapid weight gain and should be targeted for intervention.
Characterisation of HBV and co-infection with HDV and HIV through spatial transcriptomics
Authors: Cross Amy , Harris James M , Arbe-Barnes Edward , Nixon Colin , Dhairyawan Rageshri , Hall Andrew , Quaglia Alberto , Issa Fadi , Kennedy Patrick T F , McKeating Jane A , Gill Upkar S , Peppa Dimitra 
Published: July 2024

Background and aimsThe intrahepatic processes associated with chronic hepatitis B (CHB), especially in the context of hepatitis delta virus (HDV) and HIV co-infection, require a better understanding. Spatial transcriptomics can provide new insights into the complex intrahepatic biological processes, guiding new personalised treatments. Our aim is to evaluate this method characterising the intrahepatic transcriptional landscape, cellular composition and biological pathways in liver biopsy samples from patients with hepatitis B virus (HBV) and HDV or HIV co-infection.MethodThe NanoString GeoMx digital spatial profiling platform was employed to assess expression of HBV surface antigen and CD45 in formalin-fixed paraffin-embedded (FFPE) biopsies from three treatment-naïve patients with chronic HBV and HDV or HIV co-infection. The GeoMx Human Whole Transcriptome Atlas assay quantified the expression of genes enriched in specific regions of interest (ROIs). Cell type proportions within ROIs were deconvoluted using a training matrix from the human liver cell atlas. A weighted gene correlation network analysis evaluated transcriptomic signatures across sampled regions.ResultsSpatially discrete transcriptomic signatures and distinct biological pathways were associated with HBV infection/disease status and immune responses. Shared features including ‘cytotoxicity’ and ‘B cell receptor signalling’ were consistent across patients, suggesting common elements alongside individual traits. HDV/HBV co-infection exhibited upregulated genes linked to apoptosis and immune cell recruitment, whereas HIV/HBV co-infection featured genes related to interferon response regulation. Varied cellular characteristics and immune cell populations, with an abundance of γδT cells in the HDV/HBV sample, were observed within analysed regions. Transcriptional differences in hepatocyte function suggest disrupted metabolic processes in HDV/HBV co-infection potentially impacting disease progression.ConclusionThis proof-of-principle study shows the value of this platform in investigating the complex immune landscape, highlighting relevant host pathways to disease pathogenesis.
Ascertainment and description of pedestrian and bicycling injuries and fatalities in Ontario from administrative health records 2003–2017: contributions of non-collision falls and crashes
Authors: Harris M. Anne , Watson Tristan , Branion-Calles Michael , Rosella Laura 
Published: July 2024

IntroductionPedestrian and bicycling injuries may be less likely to be captured by traffic injury surveillance relying on police reports. Non-collision injuries, including pedestrian falls and single bicycle crashes, may be more likely than motor vehicle collisions to be missed. This study uses healthcare records to expand the ascertainment of active transportation injuries and evaluate their demographic and clinical features.MethodsWe identified pedestrian and bicyclist injuries in records of deaths, hospitalisations and emergency department visits in Ontario, Canada, between 2002 and 2017. We described the most common types of clinical injury codes among these records and assessed overall counts and proportions of injury types captured by each ascertainment definition. We also ascertained relevant fall injuries where the location was indicated as ‘street or highway’.ResultsPedestrian falls represented over 50% of all pedestrian injuries and affected all age groups, particularly non-fatal falls. Emergency department records indicating in-traffic bicycle injuries not involving a collision with motor vehicles increased from 14% of all bicycling injury records in 2003 to 34% in 2017. The overall number of injuries indicated by these ascertainment methods was substantially higher than official counts derived from police reports.ConclusionThe use of healthcare system records to ascertain bicyclist and pedestrian injuries, particularly to include non-collision falls, can more fully capture the burden of injury associated with these transportation modes.
Cultivating the next generation of healthcare leaders: reflections from an established healthcare leader
Authors: Kamran Rakhshan , Doria Andrea S 
Published: July 2024

BackgroundDr Andrea Doria is Professor and Vice-Chair of Radiology (Clinical Practice Improvement) at the University of Toronto, Research Director, Senior Scientist and Imaging Lead of Personalised Child Health, The Hospital for Sick Children (SickKids), Toronto, Canada. Over the past few decades, Dr Doria has established a track record of healthcare leadership. Based on Dr Doria’s extensive leadership experience, she believes it is essential for established healthcare leaders to be involved in cultivating emerging healthcare leaders.MethodsAn interview was conducted with Dr Doria to learn about key lessons she believes are essential for healthcare leaders to help develop the next generation. Dr Doria reflected on her leadership style and experiences, sharing what has worked to improve the effectiveness of her teams.ResultsKey messages were reflected upon, including practical ways for senior leaders to support the next generation; leadership insights gained from the pandemic; the importance of building diversity in teams and nurturing leaders from underrepresented minorities; challenges to be aware of for the future of healthcare leadership; finding inspiration from team members and essential traits for healthcare leaders.ConclusionThrough cultivating the next generation of healthcare leaders, established leaders can be involved in establishing a brighter future for healthcare. This article describes reflections and practical takeaways that can help established leaders support emerging leaders and build their leadership skills.
Time to surgical stabilization of rib fractures: does it impact outcomes?
Authors: Forrester Joseph D , Sarani Babak , Forssten Maximilian Peter , Cao Yang , Hildebrand Frank , Mohammad Ismail Ahmad , Ribeiro Marcelo A F , Mohseni Shahin 
Published: July 2024

ObjectivesRib fractures are common, morbid, and potentially lethal. Intuitively, if interventions to mitigate downstream effects of rib fractures can be implemented early, likelihood of developing these complications should be reduced. Surgical stabilization of rib fractures (SSRF) is one therapeutic intervention shown to be useful for mitigating complications of these common fractures. Our aim was to investigate for association between time to SSRF and complications among patients with isolated rib fractures undergoing SSRF.MethodsThe 2016–2019 American College of Surgeons Trauma Quality Improvement Program (TQIP) database was queried to identify patient >18 years with isolated thoracic injury undergoing SSRF. Patients were divided into three groups: SSRF ≤2 days, SSRF >2 days but <3 days, and SSRF >3 days. Poisson regression, and adjusting for demographic and clinical covariates, was used to evaluate the association between time to SSRF and the primary endpoint, in-hospital complications. Quantile regression was used to evaluate the effects of time to SSRF on the secondary endpoints, hospital and intensive care unit (ICU) length of stay (LOS).ResultsOut of 2185 patients, 918 (42%) underwent SSRF <2 days, 432 (20%) underwent SSRF >2 days but <3 days, and 835 (38%) underwent SSRF >3 days. Hemothorax was more common among patients undergoing SSRF >3 days, otherwise all demographic and clinical variables were similar between groups. After adjusting for potential confounding, SSRF >3 days was associated with a threefold risk of composite in-hospital complications (adjusted incidence rate ratio: 3.15, 95% CI 1.76 to 5.62; p<0.001), a 4-day increase in total hospital LOS (change in median LOS: 4.09; 95% CI 3.69 to 4.49, p<0.001), and a nearly 2-day increase in median ICU LOS (change in median LOS: 1.70; 95% CI 1.32 to 2.08, p<0.001), compared with SSRF ≤2 days.ConclusionAmong patients undergoing SSRF in TQIP, earlier SSRF is associated with less in-hospital complications and shorter hospital stays. Standardization of time to SSRF as a trauma quality metric should be considered.Level of evidenceLevel II, retrospective.
Diagnostic and therapeutic considerations in cases of civilian intravascular ballistic embolism: a review of case reports
Authors: Russell Nicole , Vieira Ethan J , Freeman Lexi R , Eastman Alexander L , Khan Uzer , Schluterman Haley M , Beakes Caroline , Kirkpatrick Sioned , Grant Jennifer L 
Published: July 2024

BackgroundBallistic embolism (BE) is a rare complication of firearm injuries notoriously associated with a vexing clinical picture in the trauma bay. Unless considered early, the associated confusion can lead to needless delay in the management of the patient with a gunshot wound. Despite this known entity, there is a relative paucity of high-grade evidence regarding complications, management, and follow-up in these patients.MethodsAn electronic database literature search was conducted to identify cases of acute intravascular BE in pediatric and adult civilians occurring during index hospitalization, filtered to publications during the past 10 years. Exclusion criteria included non-vascular embolization, injuries occurring in the military setting, and delayed migration defined as occurring after discharge from the index hospitalization.ResultsA total of 136 cases were analyzed. Nearly all cases of BE occurred within 48 hours of presentation. Compared with venous emboli, arterial emboli were significantly more likely to be symptomatic (71% vs. 7%, p<0.001), and 43% of patients developed symptoms attributable to BE in the trauma bay. In addition, arterial emboli were significantly less likely to be managed non-invasively (19% vs. 49%, p<0.001). Open retrieval was significantly more likely to be successful compared with endovascular attempts (91% vs. 29%, p<0.001). Patients with arterial emboli were more likely to receive follow-up (52% vs. 39%) and any attempt at retrieval during the hospitalization was significantly associated with outpatient follow-up (p=0.034). All but one patient remained stable or had clinically improved symptoms after discharge.ConclusionConsideration for BE is reasonable in any patient with new or persistent unexplained signs or symptoms, especially during the first 48 hours after a penetrating firearm injury. Although venous BE can often be safely observed, arterial BE generally necessitates urgent retrieval. Patients who are managed non-invasively may benefit from follow-up in the first year after injury.
Two different rims functionalized pillar[5]arene stationary phase for capillary gas chromatography
Authors: Zhang Yuanyuan , Ba Mengyi , Li Wen , Song Yanli , Xu Xiang , Liu Haixin , Zhao Wenxuan , Sun Tao , Cai Zhiqiang 
Published: July 2024

Herein, we synthesized and used a novel pillar[5]arene with two functionalizable rims (AP5A-C10-OAc) as stationary phase in gas chromatography (GC). The AP5A-C10-OAc column (0.25 mm, i.d.) showed a high column efficiency of 4107 plates/m and medium polarity. The AP5A-C10-OAc stationary phase possesses unique amphiphilic structure, including a π-electron rich cavity and two functionalized arms composed of five nonpolar alkyl chains and five polar ester chains, and showed good separation performance for diverse types of analytes and isomers (apolar/polar, aliphatic/aromatic). Particularly, the AP5A-C10-OAc phase showed high selectivity for the challenging isomers of chloronitrobenzenes, bromonitrobenzenes, benzenediols, and iodoanilines with distinct advantages if compared with the commercial polysiloxane column.
Study on the temperature dissipation performance of brake pads with different surface patterns
Authors: Wu Gang , Tian Chen , Liu ZhiPeng 
Published: July 2024

Drum brakes may fail due to overheating in the contact area during frequent braking. This research takes the honeycomb structure with excellent heat dissipation and strength as the biomimetic object, and processes different biomimetic patterns on the surface of the brake pad. Using a self-made drum brake test bench, the changes in braking duration and surface temperature of different biomimetic pattern brake pads under emergency braking and repeated braking tests at different braking intervals are studied. The experimental results indicate that the braking duration of patterned brake pad is 7.82%–11.8% shorter than that of normal brake pads. Although the temperature of normal brake pads is lower at the end of braking, as the heat dissipation cycle prolongs, patterned brake pads exhibit faster heat dissipation, with honeycomb patterns having better heat dissipation than circular and square patterns. Using the least squares method, it was calculated that when the braking cycles were greater than 10.3, 12.0, and 14.5 s, the braking heat dissipation effect of honeycomb, circular, and square brake pads was better than that of normal brake pads. These results validate that honeycomb patterned brake pads can alleviate the occurrence of thermal degradation in drum brakes.