bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exercise perceptions and practices of people receiving peritoneal dialysis: An international cross-sectional survey
Authors: MacRae Jennifer M , Tam Trinity A , Harrison Tyrone , Harasemiw Oksana , Bohm Clara , Bennett Paul N , Verdin Nancy , Scholes-Robertson Nicki , Warren Madeleine , Thompson Stephanie 
Published: April 2024

Background: Low physical activity and functional impairment are prevalent and unaddressed in people receiving peritoneal dialysis (PD). Exercise has been shown to improve physical function and mental health for people with kidney disease. Methods: Cross-sectional descriptive survey aimed at identifying the exercise and physical activity perceptions and practice patterns of people receiving PD. The survey was developed and pretested with persons living with kidney disease, PD clinicians and exercise specialists. Results: There were 108 respondents (people receiving PD) with the majority from Canada (68%) and the United Kingdom (25%). Seventy-one per cent were engaged in physical activity two or more times per week. Most (91.8%) believed that physical activity is beneficial, and 61.7% reported healthcare provider discussion about physical activity. Perceptions regarding weightlifting restrictions varied: 76% were told not to lift weight with a maximum amount ranging from 2 kg to 45 kg. Few (28%) were instructed to drain PD fluid prior to physical activity. Mixed advice regarding swimming ability was common (44% were told they could swim and 44% were told they should not). Conclusions: Knowledge gaps suggest that education for both healthcare providers and patients is needed regarding the practice of exercise for people living with PD. Common areas of confusion include the maximum weight a person should lift, whether exercise was safe with or without intrabdominal PD fluid in situ and whether swimming is allowed. Further research is needed to provide patients with evidence-based recommendations rather than defaulting to restricting activity.
Patterns of Physical Activity and its Association with Gender and Academic Year Among Undergraduate Medical Students
Authors: Nishanthi Anandabaskar , Agilan Packirisamy , Vimal Mourouguessine , Shanthi Manickam 
Published: April 2024

Aim This study aimed to determine the patterns of physical activity (PA) and its association with gender and academic year among undergraduate medical students of a tertiary care hospital in South India. Materials and Methods A cross-sectional study was conducted among undergraduate medical students from August to October 2022 at a tertiary care teaching hospital in South India. PA was determined using the self-administered long form of the International Physical Activity Questionnaire (IPAQ). Statistical analysis was performed using SPSS software. Results A total of 223 students aged 18 to 25 years completed the questionnaire, with the majority being females (59.2%). Their median total PA (metabolic equivalent [MET] minutes/week) was 1320, with 2073 and 771 MET minutes/week among male and female students, respectively. Fourth-year students were the most physically active, with higher energy expenditure per week, followed by second-year, third-year, and first-year students ( p = 0.007). Out of the total 223 students, 141 (63.2%), 62 (27.8%), and 20 (9%) students belonged to low, moderate, and high PA levels, respectively. There was a greater proportion of students with low PA among females (70.5%) compared to male (52.7%) participants ( p < 0.001). Conclusion Most undergraduate medical students had a low level of PA, especially females and students in the first academic year. To increase the PA levels among medical students, curricular reforms by incorporating sports/exercise training, and ensuring the availability of adequate facilities and trainers for sports in every college/university is warranted. Future research focusing on the exploration of barriers to PA and designing innovative strategies to promote PA among medical students is the need of the hour.
Risk of depression and anxiety in multiple sclerosis and neuromyelitis optica spectrum disorder: A nationwide cohort study in South Korea
Authors: Kwon Soonwook , Han Kyung-Do , Jung Jin Hyung , Cho Eun Bin , Chung Yeon Hak , Park Junhee , Choi Hea Lim , Jeon Hong Jin , Shin Dong Wook , Min Ju-Hong 
Published: April 2024

Background: We investigated the risks of depression/anxiety in patients with multiple sclerosis (pwMS) or patients with neuromyelitis optica spectrum disorder (pwNMOSD). Objectives: MS/NMOSD cohorts were collected from Korean National Health Insurance Service, using the International Classification of Diseases-10th and information on Rare Intractable Disease program. Patients who were younger than 20 years, had a previous depression/anxiety, or died in the index year were excluded. Methods: Hazard ratios (HRs) of depression/anxiety in pwMS and pwNMOSD from controls matched 1:5 for age, sex, hypertension, diabetes, and dyslipidemia were calculated using Cox regressions with a 1-year lag period and estimated over time. Results: During a mean follow-up of 4.1 years, adjusted hazard ratios (aHR) for depression were 3.25 (95% confidence interval (CI) = 2.59–4.07) in MS and 2.17 (1.70–2.76) in NMOSD, and aHRs for anxiety were 1.83 (1.49–2.23) in MS and 1.56 (1.26–1.91) in NMOSD. The risks of anxiety/depression did not differ between MS and NMOSD and were highest in the second year after diagnosis of MS/NMOSD. The relative risk of depression was higher in younger pwMS/pwNMOSD, and the relative risk of anxiety was higher in pwMS who was male, had low income, or lived in a non-urban area. Conclusion: The risk of depression and anxiety was increased in pwMS/pwNMOSD.
Probing Effect of 6 MeV Electron Beam Irradiation on Haemoglobin Protein Using Spectroscopic Techniques
Authors: Hinge Sarika , Dhole Sanjay , Banpurkar Arun , Kulkarni Gauri 
Published: April 2024

In this work, we study the effect of 6 MeV electron beam irradiation on the physicochemical properties of lyophilized Human Haemoglobin A (HbA). Electron beams generated from Race Track Microtron accelerator with energy 6 MeV were used to irradiate HbA at fluences of 5 × 1014e−/cm2and 10 × 1014e−/cm2. Pristine and electron beam irradiated HbA were characterized using UV-visible and Fourier transform infrared spectroscopy (FTIR) spectroscopy. The interfacial tension of the aqueous solutions of HbA are also analysed by pendant drop method. Absorbance intensity, % transmittance and interfacial tension decrease with fluence. The peak position of the Soret band (λsoret= 404 nm) remains unaffected by the fluences. FTIR spectroscopy confirms the changes in the secondary structure of the haemoglobin. In the amide band I, the percentage of α-helix reduced from 8% to 1%, and an increase in β-sheet (19% to 29%) and β helix (6.3% to 15%) is observed. Interfacial tension decreases from 46.0 mN/m and 44.0 mN/m with increase in irradiation dose. These finding provides realistic guideline for biological cells exposure to electron beam radiation doses.
Powerlifting participation and engagement across all ages: A retrospective, longitudinal, population analysis with comparison to community strength norms
Authors: van den Hoek Daniel J , Mallard Alistair , Garrett Joel M , Beaumont Patrick L , Howells Robert J , Spathis Jemima G , Pearson Joshua , Latella Christopher 
Published: April 2024

Background In Australia, one-third of people ≥15 years perform regular resistance training and 90% of those do not meet current health guidelines. All age groups should engage in regular resistance exercise, to maintain strength and function. Objectives To identify trends in powerlifting competition participation in Australia by sex and age group from 1968 to 2022, and to compare the strength of powerlifting competitors to population age- and sex-based normative values. Method The number of unique participants and total competition entries for each year were analysed using Australian powerlifting competition data. Subdomains of age and sex were investigated, and mean ± SD, frequency, range, and trend analyses reported. United Nations age classifications were used to identify age trends. Comparisons to population strength norms were explored descriptively. Results We included 21,514 individual competitors from 1942 powerlifting competitions between 1968 and 2022. Exponential growth was seen in competition entries from 115 in 1981, to 759 in 1994, 1014 in 2011, and to 6803 in 2022, (R2 = 0.86). At first participation 18–25-year olds (51.1%) followed by ≥36 years (16%) were most represented. Strength comparison to available population norms demonstrates superior upper- (bench press [most competitors above 70th percentile) and lower-body (squat [majority rated ‘excellent’) strength. Conclusions Superior strength levels of powerlifters further the evidence base for this sport as an effective way to develop muscular strength, with low injury. We advocate for public health promotion and additional support for powerlifting as an underutilised community health tool.
Machine Learning-Based Prediction of Stroke in Emergency Departments
Authors: Abedi Vida , Misra Debdipto , Chaudhary Durgesh , Avula Venkatesh , Schirmer Clemens M. , Li Jiang , Zand Ramin 
Published: April 2024

Background: Stroke misdiagnosis, associated with poor outcomes, is estimated to occur in 9% of all stroke patients. Objectives: We hypothesized that machine learning (ML) could assist in the diagnosis of ischemic stroke in emergency departments (EDs). Design: The study was conducted and reported according to the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis guidelines. We performed model development and prospective temporal validation, using data from pre- and post-COVID periods; we also performed a case study on a small cohort of previously misdiagnosed stroke patients. Methods: We used structured and unstructured electronic health records (EHRs) of 56,452 patient encounters from 13 hospitals in Pennsylvania, from September 2003 to January 2021. ML pipelines, including natural language processing, were created using pre-event clinical data and provider notes in the EDs. Results: Using pre-event information, our model’s area under the receiver operating characteristics curve (AUROC) ranged from 0.88 to 0.92 with a similar range accuracy (0.87–0.90). Using provider notes, we identified five models that reached a balanced performance in terms of AUROC, sensitivity, and specificity. Model AUROC ranged from 0.93 to 0.99. Model sensitivity and specificity reached 0.90 and 0.99, respectively. Four of the top five performing models were based on the post-COVID provider notes; however, no performance difference between models tested on pre- and post-COVID was observed. Conclusion: This study leveraged pre-event and at-encounter level EHR for stroke prediction. The results indicate that available clinical information can be used for building EHR-based stroke prediction models and ED stroke alert systems.
Patient-Reported Outcomes After Surgically Treated Anterior Horn Tears in the Pediatric Discoid Meniscus
Authors: Talathi Nakul , Bennett Abbie , Chiou Daniel , Beck Jennifer 
Published: April 2024

Background: As a subset of symptomatic discoid lateral meniscal (DLM) tears, anterior horn (AH) meniscal tears are not well studied in the pediatric population. There are even fewer studies reporting patient-reported outcomes after surgical treatment of AH tears in DLM. Purpose: To compare reported outcomes after surgical treatment of DLM tears involving the AH versus other locations in pediatric patients. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective review of prospectively collected patient data between 2013 and 2020 was conducted. Patients aged <18 years who underwent arthroscopic treatment of a symptomatic DLM were included. Pathology was classified as tears of the AH or tears not involving the anterior horn (NAH). Demographic data along with patient-reported outcome scores (Pediatric International Knee Documentation Committee [Pedi-IKDC] and Patient Assessment Questionnaire [PAQ]) were collected preoperatively through 24 months of follow-up. Results: A total of 41 patients were included (median age, 12.9 years; range, 7-17 years; 32% female, 68% male). The mean follow-up time for was 25 months (range, 8-58 months). There were 17 (41%) patients in the AH group and 24 (59%) patients in the NAH group. Of the AH group, 16 (94%) were treated with meniscal repair (vs menisectomy), while 19 (79%) of the NAH group were treated with meniscal repair. All patients achieved significant pre- to postoperative improvement on both the Pedi-IKDC and the PAQ. At 24-month follow-up, there were no differences between the AH and NAH groups on the Pedi-IKDC (92.51 vs 89.72; P = .18) or the PAQ (2.57 vs 2.61; P = .06). Conclusion: Patients who underwent meniscal repair for AH DLM reported positive postoperative outcomes.
Evaluation of a Virtual Reality-Based Open Educational Resource Software
Authors: Würstle Silvia , Spanke Lisa-Marie , Mehlhase Niklas , Stanley Gail , Koff Jonathan , Dimitriadis Stavros , König Sarah , Hann Alexander 
Published: April 2024

OBJECTIVES Virtual reality (VR) teaching methods have potential to support medical students acquire increasing amounts of knowledge. EVENT (Easy VR EducatioN Tool) is an open educational resource software for immersive VR environments, which is designed for use without programming skills. In this work, EVENT was used in a medical student VR course on pancreatic cancer. METHODS Medical students were invited to participate in the course. Before and after VR simulation, participants completed a multiple-choice knowledge assessment, with a maximum score of 10, and a VR experience questionnaire. The primary endpoint compared pre- and post-VR simulation test scores. Secondary endpoints included usability and factors that could affect learning growth and test results. RESULTS Data from 117 of the 135 participating students was available for analysis. Student test scores improved by an average of 3.4 points (95% CI 3.1-3.7, P < 0.001) after VR course. The secondary endpoints of gender, age, prior knowledge regarding the medical subject, professional training completed in the medical field, video game play, three-dimensional imagination skills, or cyber-sickness had no major impact on test scores or final ranking (top or bottom 25%). The 27 students whose post-VR simulation test scores ranked in the top 25% had no prior experience with VR. The average System Usability Scale score was 86.1, which corresponds to an excellent outcome for user-friendliness. Questionnaire responses post-VR simulation show students (81.2% [95/117]) interest in more VR options in medical school. CONCLUSIONS We present a freely available software that allows for the development of VR teaching lessons without programming skills.
Unveiling the therapeutic potential of Dl-3-n-butylphthalide in NTG-induced migraine mouse: activating the Nrf2 pathway to alleviate oxidative stress and neuroinflammation
Authors: Liu Yingyuan , Gong Zihua , Zhai Deqi , Yang Chunxiao , Lu Guangshuang , Wang Shuqing , Xiao Shaobo , Li Chenhao , Chen Ludan , Lin Xiaoxue , Zhang Shuhua , Yu Shengyuan , Dong Zhao 
Published: April 2024

Abstract
Background
Migraine stands as a prevalent primary headache disorder, with prior research highlighting the significant involvement of oxidative stress and inflammatory pathways in its pathogenesis and chronicity. Existing evidence indicates the capacity of Dl-3-n-butylphthalide (NBP) to mitigate oxidative stress and inflammation, thereby conferring neuroprotective benefits in many central nervous system diseases. However, the specific therapeutic implications of NBP in the context of migraine remain to be elucidated.

Methods
We established a C57BL/6 mouse model of chronic migraine (CM) using recurrent intraperitoneal injections of nitroglycerin (NTG, 10 mg/kg), and prophylactic treatment was simulated by administering NBP (30 mg/kg, 60 mg/kg, 120 mg/kg) by gavage prior to each NTG injection. Mechanical threshold was assessed using von Frey fibers, and photophobia and anxious behaviours were assessed using a light/dark box and elevated plus maze. Expression of c-Fos, calcitonin gene-related peptide (CGRP), Nucleus factor erythroid 2-related factor 2 (Nrf2) and related pathway proteins in the spinal trigeminal nucleus caudalis (SP5C) were detected by Western blotting (WB) or immunofluorescence (IF). The expression of IL-1β, IL-6, TNF-α, Superoxide dismutase (SOD) and malondialdehyde (MDA) in SP5C and CGRP in plasma were detected by ELISA. A reactive oxygen species (ROS) probe was used to detect the expression of ROS in the SP5C.

Results
At the end of the modelling period, chronic migraine mice showed significantly reduced mechanical nociceptive thresholds, as well as photophobic and anxious behaviours. Pretreatment with NBP attenuated nociceptive sensitization, photophobia, and anxiety in the model mice, reduced expression levels of c-Fos and CGRP in the SP5C and activated Nrf2 and its downstream proteins HO-1 and NQO-1. By measuring the associated cytokines, we also found that NBP reduced levels of oxidative stress and inflammation. Most importantly, the therapeutic effect of NBP was significantly reduced after the administration of ML385 to inhibit Nrf2.

Conclusions
Our data suggest that NBP may alleviate migraine by activating the Nrf2 pathway to reduce oxidative stress and inflammation in migraine mouse models, confirming that it may be a potential drug for the treatment of migraine.

Graphical Abstract
The prevalence and demographic associations of headache in the adult population of Peru: a national cross-sectional population-based study
Authors: Quispe Guiovanna , Loza Cesar , Limaco Luis , Gallegos Ruth , Palomino Carlos , Cruz Ivett , Miranda Jacqueline , Rodriguez Liliana , Husøy Andreas , Steiner Timothy J 
Published: April 2024

Abstract
Background
The Global Campaign against Headache is conducting a series of population-based studies to fill the large geographical gaps in knowledge of headache prevalence and attributable burden. One major region not until now included is South America. Here we present a study from Peru, a country of 32.4 million inhabitants located at the west coast of South America, notable for its high Andes mountains.

Methods
The study was conducted in accordance with the standardized methodology used by the Global Campaign. It was a cross-sectional survey using cluster randomised sampling in five regions to derive a nationally representative sample, visiting households unannounced, and interviewing one randomly selected adult member (aged 18–65 years) of each using the Headache-Attributed Restriction, Disability, Social Handicap and Impaired Participation (HARDSHIP) questionnaire translated into South American Spanish. The neutral screening question (“Have you had headache in the last year?”) was followed by diagnostic questions based on ICHD-3 and demographic enquiry.

Results
The study included 2,149 participants from 2,385 eligible households (participating proportion 90.1%): 1,065 males and 1,084 females, mean age 42.0 ± 13.7 years. The observed 1-year prevalence of all headache was 64.6% [95% CI: 62.5–66.6], with age-, gender- and habitation-adjusted prevalences of 22.8% [21.0-24.6] for migraine (definite + probable), 38.9% [36.8–41.0] for tension-type headache (TTH: also definite + probable), 1.2% [0.8–1.8] for probable medication-overuse headache (pMOH) and 2.7% [2.1–3.5] for other headache on ≥ 15 days/month (H15+). One-day prevalence of headache (reported headache yesterday) was 12.1%. Migraine was almost twice as prevalent among females (28.2%) as males (16.4%; aOR = 2.1; p < 0.001), and strongly associated with living at very high altitude (aOR = 2.5 for > 3,500 versus < 350 m).

Conclusion
The Global Campaign’s first population-based study in South America found headache disorders to be common in Peru, with prevalence estimates for both migraine and TTH substantially exceeding global estimates. H15 + was also common, but with fewer than one third of cases diagnosed as pMOH. The association between migraine and altitude was confirmed, and found to be strengthened at very high altitude. This association demands further study.
Evaluation of elevated serum apelin-13 and D-dimer concentrations in individuals diagnosed with pulmonary embolism
Authors: Mehrban Alireza , Hajikolaei Fatemeh Ahmadi , Karimi Mehdi , Khademi Reza , Ansari Akram , Qujeq Durdi , Hajian-Tilaki Karimollah , Monadi Mahmood 
Published: April 2024

Abstract
Background
Given the limited specificity of D-dimer, there is a perceived need to discover a more precise marker for diagnosing individuals who are suspected of having pulmonary embolism (PE). In this study, by evaluating the increase in the serum level of Apelin-13 and D-dimer, we found valuable findings about Apelin-13, which can be suggested as an auxiliary and non-invasive diagnostic biomarker in individuals with suspected PE, based on the obtained results.

Methods
In this case-control study, 52 Iranian individuals were included, all of whom were suspected to have PE. These individuals were then divided into two groups based on the results of CT angiography, which is considered the gold standard imaging method for diagnosing PE. The two groups were patients with PE and patients without PE. Finally, the levels of certain markers in the serum were compared between the two groups.

Results
The mean serum D-dimer levels in patients with PE were significantly elevated (p < 0.001) in comparison to those without PE (1102.47 to 456.2 ng/ml). Furthermore, the mean level of Apelin-13 was significantly higher in patients with PE (49.8 to 73.11 ng/L) (p < 0.001). The cutoff point of Apelin-13 has been calculated at 58.50 ng/ml, with 90.9% sensitivity and 90% specificity. The D-dimer cutoff point was 500 ng/ml, with 95.5% sensitivity and 43.3% specificity.

Conclusions
Based on the results of this study, the serum level of Apelin-13 can be used as a novel diagnostic and screening biomarker in patients with pulmonary thromboembolism.
Hypobaric hypoxia exposure regulates tissue distribution of nanomedicine for enhanced cancer therapy
Authors: Tao Ye , Chen Zhongping 
Published: April 2024

Abstract
Background
Effective drug delivery of nanomedicines to targeted sites remains challenging. Given that hypobaric hypoxia and hyperbaric oxygen exposure can significantly change pharmacokinetics of drugs, it is interesting to determine whether they can regulate tissue distribution of nanomedicine, especially in tumor, for enhanced cancer therapy.

Results
Hypobaric hypoxia exposure improved the pharmacokinetics of paclitaxel-loaded liposomes and facilitated their distribution in the heart and liver, whereas hyperbaric oxygen exposure did not benefit and even impaired the pharmacokinetics and distribution. Particularly, both hypobaric hypoxia and hyperbaric oxygen exposure could not improve the distribution in subcutaneous tumor. Thus, we constructed orthotopic liver tumor model and discussed whether high distribution of the liposomal nanomedicine in the liver, facilitated by hypobaric hypoxia exposure, could ensure their effective accumulation in liver tumor for enhanced cancer therapy.

Conclusions
The liposomal nanomedicine with adjuvant hypobaric hypoxia exposure significantly inhibited the growth of orthotopic liver tumor for prolonged survival time, achieved by hypobaric hypoxia-promoted accumulation at tumor sites of the liver. It might be the first example of the application of adjuvant intermittent hypobaric hypoxia exposure in treating liver cancer.