bluuebunny/crossref_metadata_2025_split huggingface dataset:
"To exercise sustainably" – Patients’ experiences of compulsive exercise in eating disorders and the CompuLsive Exercise Activity TheraPy as a treatment: a qualitative interview study.
Authors: Simón Emma Thell , Monell Elin , Lindstedt Katarina , Wiberg Anne-Charlotte , Mantilla Emma Forsén 
Published: August 2024

Abstract

Background: Compulsive exercise (CE) is common in eating disorders (EDs), but a systematic treatment model has been missing. The CompuLsive Exercise Activity TheraPy (LEAP) is a cognitive behavioral therapeutic (CBT) treatment for CE in EDs, aiming to promote healthy physical activity (PA). LEAP is currently evaluated in a randomized efficacy trial. In parallel, it is crucial to learn more about its acceptability and feasibility by qualitatively investigating participants’ experiences.
Methods: Nine patients with various EDs participating in the LEAP trial were interviewed about their experiences of taking part in LEAP and about CE as an ED symptom using a semi-structured interview guide. The interviews were analyzed according to thematic analysis.
Results: The informants expressed that CE had not been addressed in their standard ED treatment and that LEAP as such provided an important complement, spurring reflection, awareness, and changed feelings and behaviors in relation to CE. Initially, increased PA was triggered for some, but this side effect was transitory. A wish for more treatment time, in terms of longer or additional sessions, was expressed.
Conclusions: Overall, LEAP seemed to fill an important treatment need and seemed both acceptable and feasible to patients. However, treatment time and the initial increase in PA may need further investigation and attention in order to optimize this treatment.
Trial registration: The trial is registered with the ISRCTN registry (registration date 2020-03-25), trial ID: ISRCTN80711391.
The pupillary dark reflex in acute disorders of consciousness
Authors: Zarifkar Pardis , Othman Marwan H. , Hansen Karen Irgens Tanderup , Amiri Moshgan , Stückler Sarah Gharabaghi , Fabritius Maria Louise , Sigurdsson Sigurdur Thor , Hassager Christian , Birkeland Peter F. , Hauerberg John , Møller Kirsten , Kjaergaard Jesper , Larson Merlin D. , Kondziella Daniel 
Published: August 2024

Abstract

Background. In intensive care patients with disorders of consciousness (DoC), the pupillary light reflex is a measure of pupillary parasympathetic function. By contrast, the pupillary dark reflex leads to pupil dilation in response to darkness and primarily reflects the sympathetic function of the pupil. To our knowledge, this reflex has not been systematically investigated in DoC patients. We hypothesized that the pupillary dark reflex correlates with consciousness levels after acute brain injury, and that this correlation is not necessarily the same as that of the pupillary light reflex.
Methods. From November 2022 to March 2023, we enrolled 100 study participants: 25 clinically unresponsive (coma or unresponsive wakefulness syndrome) and 25 clinically low-responsive (minimally conscious state or better) patients from the intensive care units of a tertiary referral center, and 50 age- and sex-matched healthy controls. Exclusion criteria were active or chronic eye disease. We used automated pupillometry to assess the pupillary dark reflex and the pupillary light reflex of both eyes under scotopic conditions in all study participants.
Results. The pupillary dark reflex was strongly correlated with consciousness levels (r = 0.62, p < 0.001), the increase in pupillary diameters being smallest in unresponsive patients (mean ± SD: 20% ± 21%), followed by low-responsive patients (47% ± 26%) and healthy controls (67 % ± 17%; p < 0.001). Similar, yet less pronounced patterns were observed for the pupillary light reflex. Twenty-one of 25 unresponsive patients had preserved pupillary light reflexes, but only seven had preserved pupillary dark reflexes (p < 0.0001). Of these seven patients, five regained awareness.
Conclusion. The pupillary dark reflex is more sensitive to consciousness levels after brain injury than the pupillary light reflex. The clinical implications of this finding seem worthy of further investigation, particularly regarding possible benefits for neuromonitoring and prognostication after brain injury.
Anti-Synthetase Syndrome with Anti-PL-7 Antibody Positive in a Child: A Case Report and Literature Review
Authors: Liu Jia , Nie Nana , Zhang Ranran , Wang Dahai , Lin Yi , Chang Hong 
Published: August 2024

Abstract

Background: Anti-synthetase syndrome (ASS) is a rare autoimmune myopathy and forms part of the idiopathic inflammatory myopathies (IIMs). A distinctive feature of ASS is the presence of anti-aminoacyl tRNA synthase (ARS) antibodies, which target synthetases, leading to inflammation in muscles, lungs, and other tissues.
Case presentation: A case of a 12-year-old Chinese girl with recurrent fever, myalgia, and Gottron's papules is reported. Serum creatine kinase was markedly elevated, and chest CT revealed interstitial changes. Magnetic Resonance Imaging (MRI) of the left thigh indicated soft tissue swelling and interstitial fluid accumulation. Electromyography demonstrated myogenic injury. Pathological examination of a left thigh muscle biopsy revealed local edema, focal lymphocyte infiltration, and proliferation and dilation of interstitial small vessels. The myositis antibody spectrum test was positive for anti-PL-7 antibodies. Treatment with glucocorticoids and methotrexate led to significant improvement in her condition.
Conclusion: This case represents the youngest reported patient with PL-7 positive ASS to date.
Assessing the safety and performance of the easyEndoTM Universal Linear Cutting Stapler in laparoscopic gastric bypass surgery: a monocentric post-market observational study.
Authors: Pype Willem , Melsens Elodie , Aelst Pieter Van , Rycx Astrid , Haesen Dorien , Dillemans Bruno 
Published: August 2024

Abstract

Purpose: Laparoscopic Roux-en-Y gastric bypass (RYGB) is a key treatment for obesity. This study aimed to assess the safety and performance of the easyEndoTM Universal Linear Cutting Stapler and Reloads (EziSurg Medical CO., LTD, Shanghai, China) in laparoscopic RYGB.
Methods: Adult patients undergoing laparoscopic RYGB were recruited. The primary endpoint was to evaluate the occurrence of peri- and post-operative anastomotic leaks and intraluminal/intraperitoneal bleeding. Patient’s weight loss, primary technical success of the procedure, device performance, complications and re-interventions were evaluated as secondary outcomes.
Results: One hundred and fifty patients successfully underwent laparoscopic RYGB using the easyEndoTM Universal Linear Cutting Stapler. Mean weight pre-RYGB was 116.26±19.50 kg, body mass index (BMI) was 40.54±3.64 kg/m2 and mean excess weight was 44.77±13.70 kg. Pulsatile bleeding occurred in 3.3% of cases that could be clipped, and staple line disruption in 1.3% that was oversewn. Primary technical success was 90.7%. Regarding the primary endpoint, 1 post-operative bleeding occurred on the gastrojejunostomy created by a circular stapler. Post-operative melaena occurred in 3 patients. At 24 months, average BMI dropped to 25.91±4.07 kg/m2, with a percentage excess weight loss (%EWL) of 95.74±26.59% and a percentage total weight loss (%TWL) of 35.59±9.53%. Nineteen post-operative complications occurred in 15 patients (10.0%), mainly internal herniation and small bowel obstruction. Re-interventions were required in 11 patients (7.3%).
Conclusion: RYGB with the easyEndoTM Universal Linear Cutting Stapler and Reloads is safe and effective with significant weight loss and comparable complication rates to existing literature.
Prospectively registered at ClinicalTrials.gov (NCT03968757) in May2019.
Comparison of Laparoscopy without Use of Uterine Manipulator and Laparatomy for Staging Surgery for High Grade and Serous Endometrial Carcinoma Running Title: Laparoscopy and Laparatomy for Endometrial Carcinoma
Authors: Erkilinc Selcuk , Iscan Serhan Can , Ata Can , Atlıhan Ufuk , Cakir Ilker , Avsar Huseyin Aytug , Bildaci Tevfik Berk 
Published: August 2024

Abstract

Introduction: To Evaluate perioperative and oncological outcomes of laparoscopy without the use of uterine manipulators and laparatomy in high-grade and serous endometrial cancer
Material and Methods: The patients with grade III endometrioid adenocancer and serous carcinoma between 2018 and 2022 were included to the study. A preoperative staging with PET/CT or thoracoabdominal CT was performed. All patients underwent staging surgery including hysterectomy, bilateral salpingoopherectomy,peritoneal washing, omentectomy pelvic and paraaortic lymphadenectomy up to renal vein. Laparoscopic paraaortic lymphadenectomy was perofmed by extraperitoneal approach. No uterine manipulator was used for laparoscopic hysterectomy. Age, CA 125 level, BMI, accompanying diseases, pathologic data including stage, lymphovascular invasion, number of pelvic and paraaortic lymph nodes and surgical data including operative time, surgical complications and ajuvant therapies were collected from hospital database.
Results: Eighty-nine patients were included in the study: 34 underwent laparotomy and 55 underwent laparoscopy. Operation time were similar between groups. Mean pelvic lymph node count in LT and LS groups were 33 and 34 respectively. Mean paraaortic lymph node count was 23 and 22 respectively. Red blood cell transfusion, hemorrhage, urinary tract infection, postoperative fever, bladder atony, bladder injury, and chylous leakage showed no significant differences. However, ileus, intestinal injury and eviscerations were significantly higher in the LT group. Hospital stay was significantly loonger in LT compared to LS. Overall and recurrence-free survival were similar between the groups
Conclusion: Our study concluded that laparoscopic surgery, performed without manipulators, provides comparable oncological outcomes to open surgery in the treatment of high-grade endometrial cancer, while also offering improved perioperative results.
Appropriate timing for the removal of urinary catheters in gastrointestinal surgery with epidural anesthesia: A randomized controlled trial
Authors: Miyakawa Teppei , Honda Michitaka , Kawamura Hidetaka , Yamamoto Ryuya , Toshiyama Satoshi , Mashiko Ryutaro , Kakinuma Hirohito , Hori Soshi , Nakao Eiichi , Todate Yukitoshi , Takano Yoshinao , Kono Koji 
Published: August 2024

Abstract

Purpose: The purpose of this randomized controlled trial was to evaluate whether early urinary catheter removal is feasible during epidural anesthesia during gastrointestinal surgery in male patients at high risk for urinary retention.
Methods: Male patients who underwent radical surgery for gastric or colon cancer were enrolled in this randomized controlled trial. Patients were randomized 1:1 into 2 groups: the early group, in which the urinary catheter was removed before removal of the epidural catheter on the second or third postoperative day, and the late group, in which the urinary catheter was removed after removal of the epidural catheter. The randomization adjustment factors were age (≥ 65 or < 65 years) and operative site (gastric or colon). The primary endpoint was urinary retention. The secondary endpoints were the incidence of urinary tract infection and length of postoperative hospital stay.
Results: Seventy-three patients were enrolled between March 2020 and February 2024 and assigned to the Early (n=37) and Late (n=36) groups. Four patients withdrew their consent after randomization. The intention-to-treat analysis showed that urinary retention occurred in 4 patients (11.1%) in the early group and 1 patient (3.0%) in the late group (P = 0.20). Urinary tract infection occurred in 1 patient (3.0%) in the late group. The median postoperative hospital stay was 9 days in both groups.
Conclusion: Early urinary catheter removal in male patients undergoing gastrointestinal surgery with epidural anesthesia could increase urinary retention within the expected acceptable range.
Trial registration number:UMIN000040468
Date of registration: May 21, 2020
An innovative electrical neurostimulation approach to mimic reflective urination control in spinal cord injury models
Authors: Li Jun , Deng Guoxian , Li Xianping , Yin Lingxuan , Yuan Chunhui , Shao Wei , Chen Yuangui , Yan Junan , Yao Jiwei 
Published: August 2024

Abstract

Neurogenic lower urinary tract dysfunction (NLUTD) is a frequent consequence of spinal cord injury (SCI), leading to symptoms that significantly impact quality of life. However, existing treatment strategies for managing NLUTD exhibit limitations and drawbacks. The demand for a novel, effective approach to restore bladder function and re-establish urination control. In this study, we introduce a new electrical neuromodulation strategy involving electrical stimulation of the major pelvic ganglion (MPG) to initiate bladder contraction, in conjunction with innovative programmable (IPG) electrical stimulation on the pudendal nerve (PN) to induce external urethral sphincter (EUS) relaxation in freely moving or anesthetized SCI mice. Furthermore, we conducted the void spot assay and cystometry coupled with EUS electromyography (EMG) recordings to evaluate voiding function and monitor bladder pressure and EUS muscle activity. Our findings demonstrate that our novel electrical neuromodulation approach effectively triggers coordinated bladder detrusor contraction and EUS relaxation, effectively counteracting SCI-induced NLUTD. Additionally, this electrical neuromodulation method enhances voiding efficiency, closely resembling natural reflexive urination in SCI mice. Thus, our study offers a promising electrical neurostimulation approach aimed at restoring physiological coordination and potentially offering personalized treatment for improving voiding efficiency in individuals with SCI-associated NLUTD.
Association between air pollutants and blood cell counts in pediatric patients with asthma: A retrospective observational study
Authors: Huang Kuo-Chen , Pan Hsiu-Yung , Hsieh Ting-Min , Cheng Fu-Jen 
Published: August 2024

Abstract

Background
Asthma is a common respiratory disease in children, and air pollution is a risk factor for pediatric asthma. However, how air pollution affects blood cells in pediatric patients with asthma remains unclear.
Methods
This retrospective observational study, performed in 2007–2018 at a medical center, enrolled non-trauma patients aged < 17 years who visited the emergency department and had asthma. Medical records and blood cell counts, including absolute neutrophil count (ANC), eosinophil count, and platelet count were extracted. The concentrations of PM2.5, PM10, sulfur dioxide (SO2), nitrogen dioxide (NO2), and ozone (O3) were measured from 11 air-monitoring stations in Kaohsiung City.
Results
One-unit increases in PM2.5 (regression coefficient = 0.098; S.E. =5.937; p < 0.001), PM10 (regression coefficient = 0.129; S.E. =3.541; p < 0.001), NO2 (regression coefficient = 0.110; S.E. =15.857; p < 0.001), SO2 (regression coefficient = 0.049; S.E. =30.339; p = 0.007), and O3 (regression coefficient = 0.048; S.E. =8.831; p = 0.022) on lag 0–6 (7 d average) correlated positively with ANC. One-unit increases in PM2.5 (regression coefficient = 0.055; S.E. =0.357; p = 0.016), PM10 (regression coefficient = 0.078; S.E. =0.213; p = 0.001), and SO2 (regression coefficient = 0.041; S.E. =1.811; p = 0.024) on lag 0–6 correlated positively with eosinophil count. Additionally, one-unit increases in PM2.5 (regression coefficient = 0.068; S.E. =0.101; p = 0.003) and PM10 (regression coefficient = 0.086; S.E. =0.06; p < 0.001) on lag 0–6 correlated positively with platelet count. In a two-pollutant model, the impacts of PM2.5 and PMC on ANC and platelet count remained statistically significant after adjusting for other air pollutants. Additionally, PMC correlated significantly with eosinophil count after adjusting for PM2.5, NO2, SO2, and O3. Quartile increases in PM2.5 and PMC levels correlated positively with ANC, eosinophil count, and platelet count, with differences of approximately 13.8% and 16.2%, 18.5% and 17.3%, and 4.4% and 4.6% between the upper and lower quartiles, respectively.
Conclusions
PM2.5, PMC, and NO2 were independently and positively associated with ANC, PMC was positively associated with eosinophil count, and PM2.5 and PMC were positively associated with platelet count in pediatric patients with asthma. Our results highlight the impact of air pollution on immunity and coagulation in pediatric patients with asthma.
WITHDRAWN: Deciphering PCSK9 and LDLR Gene Expression in Coronary Artery Disease Patients: Implications for Blood Lipid Regulation
Authors: Zahid Aqsa , Batool Andleeb , Khan Muhammad Ajmal , Ahmad Ajaz , Ullah Amin , Wajid Abdul 
Published: August 2024

Abstract

The main purpose of this study to calculate the frequency, risk factors, sedentary lifestyle, prevalence and expression of PCSK9 and LDLR genes showed a substantial role in cholesterol homeostasis involving in prognosis of coronary artery disease patients in Pakistan. Therefore, there is an urgent need to assess the frequency and risk factors involved and expression and regulation of a PCSK9 and LDLR in patients. A demographic survey involving CAD patients from different cardiac Hospitals in Pakistan was conducted and 100 CAD patients and 100 controls were included for the investigation of the expression level of PCSK9 and LDLR gene by using RT-PCR. CAD patients (males = 803, Females = 307) that participated in this study consisted of smokers (55%) and non-smokers (45%), the majority had a family history (62% positive, 38% negative). The participants also had diverse weight profiles (underweight 14%, active or normal 21%, overweight 27%, and obese 34%); while the majority claimed that they suffered stress (stress 85%, no stress 15%). Strong negative correlations (p < 0.01) were observed between CAD & gender, Diet, age of diagnosis, BMI, marital status, stress, different risk factors and family history. A negative correlation (p < 0.05) was seen between CAD and Sleep and with exercise also. The results indicated that the PCSK9 and LDLR expression level were considerably higher P was less than 0.05 in the patient group as compared to the healthy group. The AUC value of expression of PCSK9 (P = 6.58337E-4) and LDLR (P = 0.00111) were significant. The cox model result showed that high expression of LDLR and PCSK9 have significant effect, both the differences and overall survival rate were (P > 0.05) statistically significant. The findings of this study will help improve the management and treatment of CAD worldwide, the expression of PCSK9 and LDLR in CAD’s patient’s with specific implications in under developed countries.
Transcriptomic analysis reveals key molecular signatures across recovery phases of hemorrhagic fever with renal syndrome
Authors: Hu Yuanyuan , Wu Chao , Li Tuohang , Wu Yang , Yao Kun , Zhang Mengtian , Li Pan , Bian Xuzhao 
Published: August 2024

Abstract

Background
Hemorrhagic fever with renal syndrome (HFRS), a life-threatening zoonosis caused by hantavirus, poses significant mortality risks and lacks specific treatments. This study aimed to delineate the transcriptomic alterations during the recovery phases of HFRS.
Methods
RNA sequencing was employed to analyze the transcriptomic alterations in peripheral blood mononuclear cells from HFRS patients across the oliguric phase (OP), diuretic phase (DP), and convalescent phase (CP). Twelve differentially expressed genes (DEGs) were validated using quantitative real-time PCR in larger sample sets.
Results
Our analysis revealed pronounced transcriptomic differences between DP and OP, with 38 DEGs showing consistent expression changes across all three phases. Notably, immune checkpoint genes like CD83 and NR4A1 demonstrated a monotonic increase, in contrast to a monotonic decrease observed in antiviral and immunomodulatory genes, including IFI27 and RNASE2. Furthermore, this research elucidates a sustained attenuation of immune responses across three phases, alongside an upregulation of pathways related to tissue repair and regeneration.
Conclusion
Our research reveals the transcriptomic shifts during the recovery phases of HFRS, illuminating key genes and pathways that may serve as biomarkers for disease progression and recovery.
Long-term hot spring bathing on improving sleep quality with the decrease of TNF-α and increase of 5-HT
Authors: Yang Fen , Zou Yue , Zhang Ying-ying , Li Hong-xia , Xu Yi-hang , Zhang Bao-chao , Liao Lin-xuan , Cao Meng-xi , Wang Rui-xue , Yuan Yuan , Zhou Yun , Zeng Da-yong , Pei Xiaofang 
Published: August 2024

Abstract

Previous studies investigating the influence of hot spring bathing on sleep quality have predominantly focused on the short-term effects basically depending on questionnaire without blood collection for biochemical tests. In this study, we undertook comprehensive investigation on the long-term health effects of hot spring bathing among the residents of Hot Spring Village and collected their blood samples for biochemical tests, including inflammatory cytokines (TNF-α) and neurotransmitters (5-HT and BDNF) analysis as well. We found that hot spring bathing (OR=0.18, 95%CI: 0.05-0.68), with the length of more than 30 minutes (OR=0.10, 95%CI: 0.02-0.53), and the frequency of more than 3 times per week (OR=0.07, 95%CI: 0.01-0.32) were protective factors for sleep quality (P<0.05). Interestingly, we observed at the first time that the blood TNF-α significantly decreased (P<0.05), with an increasing trend of 5-HT and BDNF in the bathing group. Besides, participants with good sleep quality exhibited significantly lower levels of TNF-α compared to those of poor ones, and among good sleepers aged 65 and older, higher levels of 5-HT were observed. Further logistic analysis revealed that a decrease of TNF-α (OR=1.03, 95% CI: 1.01-1.06) and an increase of 5-HT (OR=0.98, 95% CI: 0.97-0.99) were associated with good sleep quality. Additionally, the trends of decreasing TNF-α and increasing 5-HT were also
observed in the hot spring bathing group with good sleep quality for the first time. These findings suggested that hot spring bathing might improve sleep quality with the alteration of TNF-α and 5-HT, which could serve as potential indicators for future studies on health benefits of bathing.