bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does intervention engagement mediate physical activity change in a web-based computer-tailored physical activity intervention?—Secondary outcomes from a randomised controlled trial
Authors: Vandelanotte Corneel , Short Camille E. , Plotnikoff Ronald C. , Schoeppe Stephanie , Alley Stephanie J. , To Quyen , Rebar Amanda L. , Duncan Mitch J. 
Published: May 2024

IntroductionThe relationship between intervention engagement and behaviour change may vary depending on the specific engagement metric being examined. To counter this composite engagement measures may provide a deeper understanding of the relationship between engagement and behaviour change, though few studies have applied such multidimensional engagement metrics. The aim of this secondary analysis of RCT data was to examine how a composite engagement score mediates the effect of a web-based computer-tailored physical activity intervention.Methods501 inactive Australian adults were randomised to a no-treatment control or intervention group. Intervention participants received 8 sessions of web-based personalised physical activity advice over a 12-week intervention period and the ability to complete action plans. Change in physical activity was assessed using Actigraph accelerometers at baseline, 3-months and 9-months. Engagement with the intervention (i.e., a composite score including frequency, intensity, duration and type) was continuously assessed during the intervention period using website tracking software and database metrics. Generalised structural equation models were used to examine how a composite engagement score mediated intervention effects at 3 months and 9 months.ResultsAt 3 months, mediation analysis revealed that the intervention group had significantly higher engagement scores than the control group [a-path exp(b) = 6.462, 95% CI = 5.121–7.804, p &lt; 0.001]. Further, increased engagement with the intervention platform was associated with an increased time spent in moderate-to-vigorous physical activity [ab-coefficient exp(b) = 1.008, 95% CI = 1.004–1.014, P &lt; 0.001]; however, the magnitude of this effect was small. There were no significant mediation effects at the 9-month time point.DiscussionThe findings suggest that a composite intervention engagement score has a small positive influence on physical activity changes and that other factors (e.g., behaviour change techniques) are likely to be more important drivers of behaviour change.
Vascular service provision during the COVID-19 pandemic worsened major amputation rates in socially deprived diabetic populations
Authors: AlMajali Ali S. , Richards Thomas , Yusuf Syed Waquar , Telgenkamp Bjorn 
Published: May 2024

IntroductionThe Coronavirus Disease – 2019 (COVID-19) pandemic significantly impacted healthcare service provision and put diabetic patients at increased risk of adverse health outcomes. We aimed to assess the impact of the COVID-19 pandemic on the incidence and demographic shift of major lower-limb amputation in diabetic patients.MethodsWe performed a retrospective analysis of diabetic patient records undergoing major lower-limb amputation between 01/03/2019 and 01/03/2021 at the Royal Sussex County Hospital, the regional arterial hub for Sussex. Primary outcomes were amputation incidence rates and patient demographics compared between the prepandemic and pandemic cohorts.ResultsThe incidence rate ratio of major lower-limb amputations shows a drop in amputations during the pandemic compared to pre-pandemic (IRR 0.82; 95% CI 0.57–1.18). Data suggests a shift in the social deprivation background of patients receiving amputations to disproportionately affect those in the more deprived 50% of the population (p=0.038). Younger patients received more amputations during the pandemic compared to prepandemic levels (p=0.001).ConclusionResults suggest that during the COVID-19 pandemic there was a paradoxical reduction in amputations compared to prepandemic levels. However, changes to the demographic makeup of patient’s receiving amputations are alarming as younger, and more deprived patients have been disproportionately affected by the pandemic.
New findings on retinal microvascular changes in patients with primary COVID-19 infection: a longitudinal study
Authors: Zhang Chenxi , Cheng Shiyu , Chen Huan , Yang Jingyuan , Chen Youxin 
Published: May 2024

PurposeTo investigate the longitudinal alterations of retinal microvasculature in patients with primary coronavirus disease 2019 (COVID-19) infection.MethodsA cohort of participants, who had never been infected with COVID-19, was recruited between December 2022 and May 2023 at Peking Union Medical College Hospital in Beijing, China. Participants underwent comprehensive ophthalmologic examinations and fundus imaging, which included color fundus photography, autofluorescence photography, swept-source optical coherence tomography (SS-OCT) and SS-OCT angiography (SS-OCTA). If participants were infected with COVID-19 during the study, follow-ups with consistent imaging modality were conducted within one week and two months after recovery from the infection.Results31 patients (61 eyes), with a mean age of 31.0 ± 7.2 years old, were eligible for this study. All participants contracted mild COVID-19 infection within one month of baseline data collection. The average period was 10.9 ± 2.0 days post-infection for the first follow-up and 61.0 ± 3.5 days for the second follow-up. No clinical retinal microvasculopathy features were observed during the follow-ups. However, SS-OCTA analysis showed a significant increase in macular vessel density (MVD) from 60.76 ± 2.88% at baseline to 61.59 ± 3.72%(p=0.015) at the first follow-up, which subsequently returned to the baseline level of 60.23 ± 3.33% (p=0.162) at the two-month follow-up. The foveal avascular zone (FAZ) remained stable during the follow-ups with areas of 0.339 ± 0.097mm2, 0.342 ± 0.093mm2, and 0.344 ± 0.098mm2 at the baseline, first follow-up (p=0.09) and second follow-up (p=0.052), respectively. Central macular thickness, cube volume and ganglion cell-inner plexiform layer showed a transient decrease at the first follow-up(p&lt;0.001, p=0.039, p=0.002, respectively), and increased to baseline level at the two-month follow-up(p=0.401, p=0.368, p=0.438, respectively).ConclusionMild COVID-19 infection may temporarily and reversibly impact retinal microvasculature, characterized by a transient increase in retinal blood flow during the early recovery phase, which returns to the pre-infection level two months post-infection.
Factors contributing to sepsis-associated encephalopathy: a comprehensive systematic review and meta-analysis
Authors: Zhang Zhiyang , Guo Li , Jia Lijing , Duo Hong , Shen Limin , Zhao Heling 
Published: May 2024

BackgroundThis study aims to systematically assess the risk factors, the overall strength of association, and evidence quality related to sepsis-associated encephalopathy.MethodsA systematic search was conducted in the Cochrane Library, PubMed, Web of Science, and Embase for cohort or case-control studies published up to August 2023 on risk factors associated with sepsis-related encephalopathy. The selected studies were screened, data were extracted, and the quality was evaluated using the Newcastle–Ottawa Scale. Meta-analysis was performed using RevMan 5.3 software. The certainty of the evidence was assessed using the GRADE criteria.ResultsA total of 13 studies involving 1,906 participants were included in the analysis. Among these studies, 12 were of high quality, and one was of moderate quality. Our meta-analysis identified six risk factors significantly associated with Serious Adverse Events (SAE). These included APACHE II, SOFA, age, tau protein, and IL-6, which were found to be risk factors with significant effects (standard mean difference SMD: 1.24–2.30), and albumin, which was a risk factor with moderate effects (SMD: −0.55). However, the certainty of evidence for the risk factors identified in this meta-analysis ranged from low to medium.ConclusionThis systematic review and meta-analysis identified several risk factors with moderate to significant effects. APACHE II, SOFA, age, tau protein, IL-6, and albumin were associated with sepsis-related encephalopathy and were supported by medium- to high-quality evidence. These findings provide healthcare professionals with an evidence-based foundation for managing and treating hospitalized adult patients with sepsis-related encephalopathy.
A role of NLRP3 and MMP9 in migraine progression: a systematic review of translational study
Authors: Rushendran Rapuru , Singh Anuragh , Ankul Singh S. , Chitra Vellapandian , Ilango Kaliappan 
Published: May 2024

BackgroundMigraines affect one billion individuals globally, with a higher occurrence among young adults and women. A significant survey in the United States indicated that 17.1% of women and 5.6% of men suffer from migraines. This study seeks to investigate the potential connection between NLRP3 and MMP9 in migraine pathology.MethodsThe research involved searching databases such as PubMed, Scopus, Science Direct, Google Scholar, and Proquest, with the search concluding on March 31, 2024. Following PRISMA guidelines, PICO data were collected, focusing exclusively on animal models induced by Nitroglycerine (10 mg/kg), while excluding clinical studies.ResultsThe study, originally registered in Prospero Reg. No. CRD42022355893, conducted bias analysis using SYRCLE’s RoB tool and evaluated author consensus using GraphPad v9.5.1. Out of 7,359 search results, 22 papers met the inclusion criteria. Inter-rater reliability among reviewers was assessed using Cohen’s kappa statistics.ConclusionThis review summarizes 22 preclinical studies on Nitroglycerin (NTG), NLRP3, MMP9, and related biomarkers in migraine. They reveal that NTG, especially at 10 mg/kg, consistently induces migraine-like symptoms in rodents by activating NLRP3 inflammasome and stimulating proinflammatory molecule production.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, CRD42022355893.
Developmental trajectory of care dependency in older stroke patients
Authors: Lin Qinger , Dong Xiaohang , Huang Tianrong , Zhou Hongzhen 
Published: May 2024

BackgroundStroke is the leading cause of death in China. Older stroke survivors often have other chronic conditions, not only musculoskeletal deterioration due to age, but also changes in body image that can be brought on by stroke and other diseases, making them unable to take good care of themselves and dependent on others. The degree of dependency affects the rehabilitation progress of stroke survivors and shows dynamic changes that need to be recognized.ObjectivesThis study investigates the trajectory of dependency changes in older stroke patients with comorbidities and analyze the influencing factors.MethodsGrounded in the Chronic Illness Trajectory Framework (CITF), a longitudinal study was conducted from February 2023 to October 2023, tracking 312 older stroke patients with comorbidities admitted to two tertiary hospitals in Guangzhou. Care dependency levels were assessed using Care Dependency Scale on admission day 5 (T0), at discharge (T1), 1 month post-discharge (T2), and 3 months post-discharge (T3). Growth Mixture Model were utilized to identify trajectory categories, and both univariate analysis and multivariate logistic regression methods were employed to explore factors associated with different developmental trajectories.ResultsA total of four developmental trajectories were fitted, C1 (high independence-slow increased group, 52.0%), C2 (moderate independence-rapid increased group, 13.0%), C3 (moderate independence-slow increased group, 25.0%), and C4 (low independence-increased and decreased group, 10.0%). Length of hospital stay, place of residence, level of social support, residual functional impairments, NIHSS score, and BI index independently influence the trajectory categories.ConclusionThere is heterogeneity in care dependency among older stroke patients with comorbidities. Most patients gradually reduce their dependency and become more independent, but others remain dependent for an extended period of time. It is recommended to focus on patients who live in rural areas, have low social support, have high admission NIHSS scores and have residual functional impairment, and provide them with personalized continuity of care and rehabilitation services in order to reduce care dependency and the burden of care, and to improve patients’ quality of life.
A multimodal approach to automated hierarchical assessment of bulbar involvement in amyotrophic lateral sclerosis
Authors: Rong Panying , Heidrick Lindsey , Pattee Gary L. 
Published: May 2024

IntroductionAs a hallmark feature of amyotrophic lateral sclerosis (ALS), bulbar involvement leads to progressive declines of speech and swallowing functions, significantly impacting social, emotional, and physical health, and quality of life. Standard clinical tools for bulbar assessment focus primarily on clinical symptoms and functional outcomes. However, ALS is known to have a long, clinically silent prodromal stage characterized by complex subclinical changes at various levels of the bulbar motor system. These changes accumulate over time and eventually culminate in clinical symptoms and functional declines. Detection of these subclinical changes is critical, both for mechanistic understanding of bulbar neuromuscular pathology and for optimal clinical management of bulbar dysfunction in ALS. To this end, we developed a novel multimodal measurement tool based on two clinically readily available, noninvasive instruments—facial surface electromyography (sEMG) and acoustic techniques—to hierarchically assess seven constructs of bulbar/speech motor control at the neuromuscular and acoustic levels. These constructs, including prosody, pause, functional connectivity, amplitude, rhythm, complexity, and regularity, are both mechanically and clinically relevant to bulbar involvement.MethodsUsing a custom-developed, fully automated data analytic algorithm, a variety of features were extracted from the sEMG and acoustic recordings of a speech task performed by 13 individuals with ALS and 10 neurologically healthy controls. These features were then factorized into 10 composite outcome measures using confirmatory factor analysis. Statistical and machine learning techniques were applied to these composite outcome measures to evaluate their reliability (internal consistency), validity (concurrent and construct), and efficacy for early detection and progress monitoring of bulbar involvement in ALS.ResultsThe composite outcome measures were demonstrated to (1) be internally consistent and structurally valid in measuring the targeted constructs; (2) hold concurrent validity with the existing clinical and functional criteria for bulbar assessment; and (3) outperform the outcome measures obtained from each constituent modality in differentiating individuals with ALS from healthy controls. Moreover, the composite outcome measures combined demonstrated high efficacy for detecting subclinical changes in the targeted constructs, both during the prodromal stage and during the transition from prodromal to symptomatic stages.DiscussionThe findings provided compelling initial evidence for the utility of the multimodal measurement tool for improving early detection and progress monitoring of bulbar involvement in ALS, which have important implications in facilitating timely access to and delivery of optimal clinical care of bulbar dysfunction.
Cubeb (Piper cubeba L.): nutritional value, phytochemical profiling and dermacosmeceutical properties
Authors: Drissi Badr Eddine , Mahdi Ismail , Ortaakarsu Ahmet Buğra , Abdelfattah Mohamed A. O. , Bakrim Widad Ben , Khatib Sohaib , Mahmoud Mona F. , Bouissane Latifa , Sobeh Mansour 
Published: May 2024

IntroductionCubeb, Piper cubeba L., has been used for centuries in traditional medicine and culinary practices, with a wide range of biological and pharmacological activities.ObjectiveHerein, we determined the phytochemical profile, mineral, fatty acids, and amino acid contents of P. cubeba berries and assessed the dermacosmeceutical properties of their water extract and essential oil (EO). These included assessing their antioxidant and antibacterial activities as well as their in vitro inhibitory activities against tyrosinase and elastase enzymes. In addition, molecular docking and molecular dynamics studies were performed on the major identified compounds of the EO.Results and discussionA total of forty-three compounds belonging to organic acids, phenolic acids and flavonoids were found in the water extract, while 36 volatile compounds were identified in the EO with Z-isoeugenol, dihydroeugenol, β-pinene, E-caryophyllene, and 1,8-cineole as major constituents. The berries were found to be rich in sodium and iron, have moderate zinc content along with low contents of total nitrogen, phosphorus, and potassium. Amino acid analysis revealed a considerable concentration of isoleucine and phenylalanine, whereas 11,14,17-eicosatrienoic acid and linoleic acid were identified as the major fatty acids. In the DPPH and FRAP assays, the water extract elicited considerable antioxidant activity compared to the reference compounds. Enzyme inhibitory assays revealed that the EO had a potential to inhibit tyrosinase and elastase enzymes with IC50 values of 340.56 and 86.04 μg/mL, respectively. The water extract and EO completely inhibited the bacterial growth at MIC of 50 mg/mL and 20%, respectively. At sub-MIC concentrations, the extract and the EO substantially reduced the biofilm formation by up to 26.63 and 77.77%, respectively, as well as the swimming and swarming motilities in a dose-dependent manner. Molecular docking and molecular dynamics showed that the five main components of P. cubeba EO could be the major contributors to the elastase and tyrosinase inhibitory effect.ConclusionThis study emphasizes the promising potential of P. cubeba as a valuable source of natural compounds that can be utilized for the development of innovative pharmaceuticals, dietary supplements, and dermacosmeceutical agents.
A glutamatergic biomarker panel enables differentiating Grade 4 gliomas/astrocytomas from brain metastases
Authors: Lange Falko , Gade Richard , Einsle Anne , Porath Katrin , Reichart Gesine , Maletzki Claudia , Schneider Björn , Henker Christian , Dubinski Daniel , Linnebacher Michael , Köhling Rüdiger , Freiman Thomas M. , Kirschstein Timo 
Published: May 2024

BackgroundThe differentiation of high-grade glioma and brain tumors of an extracranial origin is eminent for the decision on subsequent treatment regimens. While in high-grade glioma, a surgical resection of the tumor mass is a fundamental part of current standard regimens, in brain metastasis, the burden of the primary tumor must be considered. However, without a cancer history, the differentiation remains challenging in the imaging. Hence, biopsies are common that may help to identify the tumor origin. An additional tool to support the differentiation may be of great help. For this purpose, we aimed to identify a biomarker panel based on the expression analysis of a small sample of tissue to support the pathological analysis of surgery resection specimens. Given that an aberrant glutamate signaling was identified to drive glioblastoma progression, we focused on glutamate receptors and key players of glutamate homeostasis.MethodsBased on surgically resected samples from 55 brain tumors, the expression of ionotropic and metabotropic glutamate receptors and key players of glutamate homeostasis were analyzed by RT-PCR. Subsequently, a receiver operating characteristic (ROC) analysis was performed to identify genes whose expression levels may be associated with either glioblastoma or brain metastasis.ResultsOut of a total of 29 glutamatergic genes analyzed, nine genes presented a significantly different expression level between high-grade gliomas and brain metastases. Of those, seven were identified as potential biomarker candidates including genes encoding for AMPA receptors GRIA1, GRIA2, kainate receptors GRIK1 and GRIK4, metabotropic receptor GRM3, transaminase BCAT1 and the glutamine synthetase (encoded by GLUL). Overall, the biomarker panel achieved an accuracy of 88% (95% CI: 87.1, 90.8) in predicting the tumor entity. Gene expression data, however, could not discriminate between patients with seizures from those without.ConclusionWe have identified a panel of seven genes whose expression may serve as a biomarker panel to discriminate glioblastomas and brain metastases at the molecular level. After further validation, our biomarker signatures could be of great use in the decision making on subsequent treatment regimens after diagnosis.
The value of the malignant subregion-based texture analysis in predicting the Ki-67 status in breast cancer
Authors: Hua Chao , Wenwen Chen , Huijuan Rui , Ting Pan , Jin Zhang 
Published: May 2024

ObjectiveTo evaluate the value of the malignant subregion-based texture analysis in predicting Ki-67 status in breast cancer.Materials and methodsThe dynamic contrast-enhanced magnetic resonance imaging data of 119 histopathologically confirmed breast cancer patients (81 patients with high Ki-67 expression status) from January 2018 to February 2023 in our hospital were retrospectively collected. According to the enhancement curve of each voxel within the tumor, three subregions were divided: washout subregion, plateau subregion, and persistent subregion. The washout subregion and the plateau subregion were merged as the malignant subregion. The texture features of the malignant subregion were extracted using Pyradiomics software for texture analysis. The differences in texture features were compared between the low and high Ki-67 expression cohorts and then the receiver operating characteristic (ROC) curve analysis to evaluate the predictive performance of texture features on Ki-67 expression. Finally, a support vector machine (SVM) classifier was constructed based on differential features to predict the expression level of Ki-67, the performance of the classifier was evaluated using ROC analysis and confirmed using 10-fold cross-validation.ResultsThrough comparative analysis, 51 features exhibited significant differences between the low and high Ki-67 expression cohorts. Following feature reduction, 5 features were selected to build the SVM classifier, which achieved an area under the ROC curve (AUC) of 0.77 (0.68–0.87) for predicting the Ki-67 expression status. The accuracy, sensitivity, and specificity were 0.76, 0.80, and 0.68, respectively. The average AUC from the 10-fold cross-validation was 0.72 ± 0.14.ConclusionThe texture features of the malignant subregion in breast cancer were potential biomarkers for predicting Ki-67 expression level in breast cancer, which might be used to precisely diagnose and guide the treatment of breast cancer.