bluuebunny/crossref_metadata_2025_split huggingface dataset:
Resolution of occult anastomotic stricture with anal dilator: challenges with the conventional diagnostic criteria in low anterior rectal resection patient—a case report
Authors: Cao Gaoyang , Zhang Xinjie , Wu Songtao , Zhou Wei 
Published: August 2024

BackgroundAnastomotic stricture (AS) is a common complication following rectal cancer surgery with anastomosis, but its diagnosis and management pose significant challenges due to the lack of standardized diagnostic criteria. We present a case highlighting the complexities encountered in diagnosing and managing occult AS post-rectal cancer surgery.Case presentationA 51-year-old male patient presented with symptoms suggestive of AS following robot-assisted laparoscopic low anterior resection for rectal adenocarcinoma. Despite conventional evaluations, including colonoscopy, digital rectal examination, and radiography, AS was not identified. Following prolonged and ineffective treatment for suspected conditions such as low anterior resection syndrome (LARS), the patient underwent anal dilatation, resulting in significant symptom improvement.ConclusionsThis case underscores the challenges associated with diagnosing and managing occult AS following rectal cancer surgery. The absence of standardized diagnostic criteria and reliance on conventional modalities may lead to underdiagnosis and inadequate treatment. A comprehensive diagnostic approach considering intestinal diameter, elasticity, and symptoms related to difficult defecation may enhance diagnostic accuracy. Further research is needed to refine the diagnostic and therapeutic strategies for occult AS.
Design and application of a novel 3D printing digital navigation template for cubitus varus deformity in children
Authors: Zou Ming , He Youzhi , Xu Yuxia , Shi Qiang , Zeng Hao 
Published: August 2024

BackgroundThis study was aimed to assess the feasibility and efficacy of 3D printing digital template for treatment of cubitus varus deformity.Methods32 patients who underwent lateral closing osteotomy were evaluated between January 2018 and January 2020 in this retrospective study. Navigation templates were used in 17 cases, while conventional surgery in 15 cases. The carrying angles before and after surgery, operation time and elbow joint function were compared.ResultsNavigation templates matched well with the anatomical markers of the lateral humerus. More accurate osteotomy degrees, shorter operation time and less radiation exposure were achieved in the navigation template group (p &lt; 0.05). At the last follow-up time, significant difference was found based on the Bellemore criteria (p = 0.0288).ConclusionsThe novel navigation template can shorten operation time, improve the lateral closing osteotomy accuracy and improve postoperative elbow joint function.
The impact of emotion regulation strategies on disordered eating behavior in children and adolescents with type 1 diabetes: a cross-sectional study
Authors: Yang Xin , Jiang Hui , Lin Meng , Yu Shuang , Wu Jin 
Published: August 2024

ObjectiveDifficulties in emotion regulation (DERs) can contribute to disordered eating behavior in children and adolescents with type 1 diabetes (T1D), although it is unknown how DERs may affect eating behavior in these children and adolescents. This study examined the relationship between disordered eating behaviors and emotion regulation in children and adolescents with T1D.MethodsFor this cross-sectional study, 128 patients (aged 8–16 years) were recruited to complete the Diabetes Eating Problem Survey-Revised (DEPS-R) and Difficulties in Emotion Regulation Scale (DERs).ResultsThe mean age of the 128 patients (99 females) who completed the DEPS-R was 11.63 ± 2.27 years. The participants' mean DEPS-R score was 17.78 ± 8.56 points. Of the total sample, 61 participants' scores surpassed the established threshold, resulting in a DEPS-R positivity rate of 47.66%. The participants' mean total DERS score was 72.3 ± 21.15 points, and it was found that children and adolescents with T1D who had a positive DEPS-R screening result had significant differences in emotional regulation and that eating behavior disorders were positively correlated with emotional regulation and all dimensions scores.ConclusionsThe prevalence of disordered eating behavior is high among children and adolescents with T1D. DERs are related to disordered eating behavior in children and adolescents with T1D. The novel finding that DERs may be a predictor of eating problems lends preliminary support for the inclusion of DERs in future risk models and as a potential target for intervention.
Exploring the prevalence and chest CT predictors of Long COVID in children: a comprehensive study from Shanghai and Linyi
Authors: Yin Yong , Yang Guijun , Wang Na , Zeng Mei , Jiang Hejun , Yuan Shuhua , Wu Jinhong , Zhang Jing , Cui Juan , Zhou Guifang , Yang Xin , Zhang Yunqin , Sun Zhichao , Yuan Jiajun , Lin Jilei , Chen Jiande , Tang Mingyu , Chen Jing 
Published: August 2024

IntroductionCOVID-19 constitutes a pandemic of significant detriment to human health. This study aimed to investigate the prevalence of Long COVID following SARS-CoV-2 infection, analyze the potential predictors of chest CT for the development of Long COVID in children.MethodsA cohort of children who visited the respiratory outpatient clinics at Shanghai Children's Medical Center or Linyi Maternal and Child Health Care Hospital from December 2022 to February 2023 and underwent chest CT scans within 1 week was followed up. Data on clinical characteristics, Long COVID symptoms, and chest CT manifestations were collected and analyzed. Multivariate logistic regression models and decision tree models were employed to identify factors associated with Long COVID.ResultsA total of 416 children were included in the study. Among 277 children who completed the follow-up, the prevalence of Long COVID was 23.1%. Chronic cough, fatigue, brain fog, and post-exertional malaise were the most commonly reported symptoms. In the decision tree model for Long COVID, the presence of increased vascular markings, the absence of normal CT findings, and younger age were identified as predictors associated with a higher likelihood of developing Long COVID in children. However, no significant correlation was found between chest CT abnormality and the occurrence of Long COVID.DiscussionLong COVID in children presents a complex challenge with a significant prevalence rate of 23.1%. Chest CT scans of children post-SARS-CoV-2 infection, identified as abnormal with increased vascular markings, indicate a higher risk of developing Long COVID.
EMT-related gene classifications predict the prognosis, immune infiltration, and therapeutic response of osteosarcoma
Authors: Li Meng-Pan , Long Si-Ping , Liu Wen-Cai , Long Kun , Gao Xing-Hua 
Published: August 2024

BackgroundOsteosarcoma (OS), a bone tumor with high ability of invasion and metastasis, has seriously affected the health of children and adolescents. Many studies have suggested a connection between OS and the epithelial-mesenchymal transition (EMT). We aimed to integrate EMT-Related genes (EMT-RGs) to predict the prognosis, immune infiltration, and therapeutic response of patients with OS.MethodsWe used consensus clustering to identify potential EMT-Related OS molecular subtypes. Somatic mutation, tumor immune microenvironment, and functional enrichment analyses were performed for each subtype. We next constructed an EMT-Related risk signature and evaluated it by Kaplan-Meier (K-M) analysis survival and receiver operating characteristic (ROC) curves. Moreover, we constructed a nomogram to more accurately predict OS patients’ clinical outcomes. Response effects of immunotherapy in OS patients was analyzed by Tumor Immune Dysfunction and Exclusion (TIDE) analysis, while sensitivity for chemotherapeutic agents was analyzed using oncoPredict. Finally, the expression patterns of hub genes were investigated by single-cell RNA sequencing (scRNA-seq) data analysis.ResultsA total of 53 EMT-RDGs related to prognosis were identified, separating OS samples into two separate subgroups. The EMT-high subgroup showed favourable overall survival and more active immune response. Significant correlations were found between EMT-Related DEGs and functions as well as pathways linked to the development of OS. Additionally, a risk signature was established and OS patients were divided into two categories based on the risk scores. The signature presented a good predictive performance and could be recognized as an independent predictive factor for OS. Furthermore, patients with higher risk scores exhibited better sensitivity for five drugs, while no significant difference existed in immunotherapy response between the two risk subgroups. scRNA-seq data analysis displayed different expression patterns of the hub genes.ConclusionWe developed a novel EMT-Related risk signature that can be considered as an independent predictor for OS, which may help improve clinical outcome prediction and guide personalized treatments for patients with OS.
Circ-CDK8 regulates SLC7A11-mediated ferroptosis by inhibiting miR-615-5p to promote progression in oral squamous cell carcinomas
Authors: Sun Kai , Gao Ling , Li Shaoming , Zheng Jingjing , Zhu Zhuang , Zhi Keqian , Ren Wenhao 
Published: August 2024

Introduction: Ferroptosis is a new mode of programmed cell death distinct from necrosis, apoptosis, and autophagy, induced by iron-ion-dependent lipid peroxide accumulation. Circular RNAs are a class of endogenous non-coding RNAs that regulate the biological behavior of tumors. However, the role of circ-CDK8 in regulating ferroptosis, migration, and invasion of oral squamous cell carcinoma (OSCC) remains unknown.Methods: The effect of circ-CDK8 on OSCC cell ferroptosis, migration, and invasion was evaluated using CCK-8, wound healing, transwell, reactive oxygen species (ROS), malondialdehyde (MDA), and GSH assays and Western blotting. Bioinformatics analyses and luciferase reporter assays were performed and revealed targeted relationships between circ-CDK8 and miR-615-5p, miR-615-5p and SLC7A11. Interference with circ-CDK8 expression reduced SLC7A11 expression by sponging miR-615-5p, suppressed OSCC cell migration and invasion, and promoted ferroptosis by increasing ROS, MDA, and iron levels and decreasing GSH and GPX4 levels in OSCC cells. Furthermore, in vivo, animal experiments confirmed that circ-CDK8 interference inhibited OSCC cell proliferation and SLC7A11 expression.Results: Collectively, this study revealed a novel strategy to upregulate erastin-induced ferroptosis in OSCC cells via the circ-CDK8/miR-615-5p/SLC7A11 axis, providing new insights into OSCC and a potential therapeutic strategy for OSCC.
Psychometric evaluation of the Chinese version of the Academic Resilience Scale-30 (C-ARS-30) in college students
Authors: Tan Wen-ying , Chen Jia-ni , Lu Sui-hua , Liu Chun-qin , Luo Qing , Ma Yu , Zhou Ying , Wong Thomas K. S. , Chen Hui-fang , Song Li-qin , Miao Chu-yuan , Chen Jing-wen , Smith Graeme D. 
Published: August 2024

BackgroundAmidst the expansion of student enrollment in higher education, the well-being and retention rates of students have emerged as important concerns. Resilience, especially academic resilience, a multidimensional construct that can lead to academic success in adversity, is pivotal in enabling students to successfully cope with academic challenges. While the Academic Resilience Scale-30 (ARS-30) has been validated as an effective instrument in various languages, its applicability for Chinese students in higher education remains unexplored.ObjectiveThis study aims to translate and validate the ARS-30 in Chinese, assessing its reliability and validity among Chinese college students in higher education.MethodsA convenience sample of 1,542 students participated in this study. The inventory included the demographic form, Chinese version of ARS-30 (C-ARS-30), 10-item Connor Davidson Resilience Scale (CD-RISC-10), and General Self-Efficacy Scale (GSES). The assessment of validity was conducted by analyzing content validity, construct validity, convergent and discriminant validity, as well as criterion-related validity. Construct validity was evaluated through Confirmatory Factor Analysis (CFA), Exploratory Factor Analysis (EFA) and Exploratory Structural Equation Modeling (ESEM). Reliability analysis was performed using Cronbach’s alpha and test–retest reliability.ResultsThe C-ARS-30 demonstrated commendable content validity, with the CVI value of items ranging from 0.833 to 1.000, and a total scale CVI of 0.986. ESEM analysis revealed a solid four-factor structure, maintaining the scale’s 30 items with excellent fit indices (χ2/df = 2.647, CFI = 0.937, TLI = 0.915, RMSEA = 0.057, SRMR = 0.027). The total score of C-ARS-30 exhibited positive correlations with the CD-RISC-10 (r = 0.542) and the GSES (r = 0.488). The scale demonstrated high internal consistency (Cronbach’s α = 0.930) and test–retest reliability (0.794, p &lt; 0.01).ConclusionThe C-ARS-30 is a reliable and valid instrument for assessing academic resilience among Chinese college students, offering a valuable tool for educational and psychological evaluations.
Effects of cooling vest and personal protective equipment removal on thermoregulation in wildland firefighters during progressive thermal loads
Authors: Gutiérrez-Arroyo Jorge , Rodríguez-Marroyo Jose A. , García-Heras Fabio , Rodríguez-Medina Juan , Collado Pilar S. , Villa-Vicente José G. , Carballo-Leyenda Belén 
Published: August 2024

BackgroundWildland firefighters (WFFs) regularly face demanding physical and environmental conditions during their duties, such as high ambient temperatures, challenging terrains, heavy equipment and protective gear. These conditions can strain thermoregulatory responses, leading to increased fatigue and posing risks to their health and safety. This study examined the effectiveness of two cooling interventions during physical activity in hot environments.MethodsEight active male WFFs participated, comparing the effects of wearing a cooling vest (VEST) and personal protective equipment removal (PASSIVE) against a control condition (PPE). Participants walked on a treadmill at a speed of 6 km·h−1 for approximately 75-min under hot conditions (30°C and 30% relative humidity). Incremental slope increases were introduced every 15 min after the initial 20 min of activity, with 5-min passive recovery between each increment. Physiological and perceptual parameters were monitored throughout the protocol.ResultsSignificant main effects (p &lt; 0.05) were observed in skin temperature (36.3 ± 0.2, 36.2 ± 0.4 and 35.4 ± 0.6°C in PPE, PASSIVE and VEST, respectively), physiological strain index (5.2 ± 0.4, 5.6 ± 1.1 and 4.3 ± 1.4 in PPE, PASSIVE and VEST) and thermal sensation (6.6 ± 0.6, 6.4 ± 0.7 and 5.3 ± 0.7 in PPE, PASSIVE, and VEST). However, no significant effects of the cooling strategies were observed on heart rate, gastrointestinal temperature or performance.ConclusionDespite the observed effects on physiological responses, neither cooling strategy effectively mitigated thermal strain in WFFs under the experimental conditions tested.
“Losing access to outdoor spaces was the biggest challenge for children to be healthy”: pandemic restrictions and community supports for children’s movement in Nova Scotia
Authors: Locke Maggie , Feicht Becky , Stone Michelle R. , Burke Emily , Rehman Laurene , Kirk Sara F. L. , Faulkner Guy , Moore Sarah A. 
Published: August 2024

IntroductionHealth-focused communities can promote physical activity for children by providing them with safe and supportive environments to move. Across the COVID-19 pandemic many community spaces and services were closed due to public health restrictions. During the pandemic, Atlantic Canada uniquely implemented an agreement between four provinces to restrict travel and reduce the spread of the virus. The “Atlantic bubble” led to fewer cases of COVID-19 and restrictions to community spaces and services. With restrictions now removed, community spaces and services likely play a critical role in facilitating the recalibration of children’s movement. Perspectives from families who experienced the “Atlantic bubble” may offer valuable insights to the use of these spaces during and after the removal of restrictions.ObjectiveThis study explored the role of community spaces and services on their child’s physical activity across the COVID-19 pandemic from the perspectives of Nova Scotia caregivers.MethodsWe employed a qualitative description approach and conducted semi-structured interviews with 14 caregivers of children aged 5–11 years who lived in Nova Scotia, Canada. Interviews were transcribed verbatim and analyzed using reflexive thematic analysis.ResultsFour themes were generated: (1) Public health restrictions limited community movement behaviors and social connections, (2) Spaces, locations, and environments influenced how families experienced physical activity during public health restrictions, (3) Virtual realities: screens supported a new sense of community for children throughout the pandemic, and (4) “Facilitated” and “forced adaptability”: public health restrictions changed family dynamics, routines, and movement behaviors.ConclusionDespite living in the “Atlantic bubble,” Nova Scotian caregivers shared that COVID-19 related public health restrictions shifted their family’s dynamics, routines, and ability to engage in physical activity within their communities. Community spaces and services can be leveraged to recalibrate children’s movement as pandemic-related restrictions are reduced. In future public health crises, community spaces and services should remain in place to whatever extent possible to reduce the collateral consequences of public health restrictions on children’s health.
Unraveling the dynamics of loneliness and cognition in late life: a cross-lagged panel model
Authors: Abaei Elnaz , Martin Peter 
Published: August 2024

IntroductionLoneliness and cognitive decline are pressing concerns among older adults, yet little research has explored cognition as a predictor of loneliness. This study investigates the dynamic relationship between loneliness and cognitive function in older adults using the random intercept cross-lagged panel model (RI-CLPM).MethodsData were drawn from Waves 9–14 of the Health and Retirement Study (HRS), encompassing 8,473 individuals aged 65 years and older. Loneliness was assessed using the UCLA Loneliness Scale, and cognitive function was measured using immediate and delayed word recall and serial 7s from the HRS RAND file. Age, gender, education, marital status, self-health report, and depression were included as covariates. Using Mplus, we computed RI-CLPMs. The first three models were conducted on loneliness and cognitive functions. Then unconditional RI-CLPMs with no exogenous predictors were computed.ResultsThree conditional model results showed that age, gender, marital status, self-health report, and depression were significantly associated with loneliness in the first wave, but only age and self-health report were significantly associated with immediate and delayed word recall at the first wave, not with serial 7s. For carry-over effects, loneliness showed significant positive associations across consecutive waves, but cognitive functions showed significant positive associations just in the last two waves. Some spill-over effects were found between loneliness and cognitive functions. For within-person effects, although initially non-significant, a negative association between loneliness and immediate and delayed word recall emerged in later waves (11–12 and 13–14). The conditional models indicated that older age, not being married, male gender, low self-reported health, and high depression levels were positively associated with loneliness. However, only older age and lower self-reported health were positively linked to cognitive functions.DiscussionThis study underscores the link between loneliness and cognitive function decline in older adults, emphasizing the need to address loneliness to potentially reduce cognitive decline. Insights into demographic predictors of loneliness and cognitive function could inform targeted interventions for promoting successful aging.
Effects of outdoor activity time, screen time, and family socioeconomic status on physical health of preschool children
Authors: Zong Bobo , Li Lun , Cui Yufang , Shi Wenxia 
Published: August 2024

ObjectiveExperienced 3 years of pandemic-induced home life, in the post-epidemic period, preschoolers in China are falling short of the World Health Organization’s standards for screen time and outdoor activities. This notably impacts their physical well-being. The study aims to probe the associations between screen time, outdoor activities, and the physical health of preschoolers, offering insights to shape interventions targeting myopia and obesity prevention in children.MethodsA cross-sectional study was conducted in Guangdong Province, involving a representative sample of 23,992 preschoolers and their caregivers recruited through proportional stratified cluster sampling. Data collection utilized the Chinese Early Human Capability Index (CHeHCI, eHCi), a questionnaire on children’s media use in daily family life, and Body Mass Index (BMI). Linear regression and binary logistic regression models were employed to analyze the impact of screen time and outdoor activity duration on the physical health of preschoolers.ResultsIn the high family socioeconomic status (SES) group, children had significantly less screen time compared to those in the medium and low SES groups. Outdoor activity time varied significantly based on SES, with higher SES linked to extended outdoor engagement. Additionally, children’s eHCi health dimension score exhibited significant SES-related differences, showcasing higher scores for children in higher SES groups. In terms of gender differences, boys dedicated significantly more time to outdoor activities than girls, yet boys had a notably higher overweight rate. Furthermore, girls demonstrated better health outcomes based on eHCi health scores. A significant association emerged between overweight and screen time in children with high SES, indicating that prolonged screen time was linked to a higher likelihood of overweight based on BMI. Additionally, a substantial negative correlation was observed between children’s eHCi health dimension score and screen time. Furthermore, children’s outdoor activity time exhibited a significant positive correlation with eHCi health dimension score. Regression analysis revealed that screen time could significantly negatively predict children’s physical health score, while outdoor activity time could significantly positively predict children’s eHCi physical health score.ConclusionThe current study highlights that family SES, age, and gender play pivotal roles in influencing preschoolers’ screen time and outdoor activity duration, with family SES being particularly influential. Higher family SES correlates with reduced screen time, increased outdoor activity, and elevated health levels among children. Importantly, children’s screen time negatively predicts their health status, while outdoor time positively predicts their health status.