bluuebunny/crossref_metadata_2025_split huggingface dataset:
Physical activity, lifestyle, sociocultural factors and prevalence of excess weight gain among postmenopausal women: A cross-sectional study
Authors: Mensah Bonsu Isaac , Brandt Corlia , Ajidahun Adedayo Tunde , Omoniyi Moses , Myezwa Hellen 
Published: December 2023

Background: Most women experienced postmenopausal symptoms during the menopause transition, and they are a common reason for seeking medical attention and lifestyle modification during this phase of life. Objective: This study assessed the physical activity, lifestyle, and sociocultural levels-associated prevalence of excess weight (overweight and obesity) among postmenopausal women (PW) in Bono-East (Techiman) region, Ghana. Design: This is cross-sectional study. Method: This was a cross-sectional study conducted at Bono-East regional capital, Techiman in Ghana over 5 months. Self-administered questionnaires were used to obtain sociodemographic data, physical activity, lifestyle, and sociocultural associated prevalence of excess weight. Anthropometric indices including ((body mass index (BMI), waist-to-height ratio (WHtR), and waist-to-hip ratio (WHR)) were assessed. Results: A total of 393 postmenopausal women with a mean age of 60.09 ± 6.24 years participated in the study. When reporting prevalence, obesity, and overweight were distinguished. Using the anthropometric parameters (BMI, WHtR, and WHR) as measured for being overweight, the prevalent rates were 35.7%, 21.7%, and 9.0% respectively. Also, when using obesity, the prevalent rate was 37.8%, 70.1%, and 82.0% using BMI, WHtR, and WHR, respectively. Over 55 (55.2%) of the study participants engaged in moderate physical activities, 23.1% were low and 21.7% with high physical activities. Housewives and unemployed participants are shown to have a higher risk of gaining weight (obese) especially when assessed with WHR and WHtR. Most participants responded that cultural beliefs prevent them from losing weight. Most participants had a poor attitude toward their eating habits. Conclusion: According to the findings, postmenopausal Ghanaian women showed a high level of obesity and a moderate level of being overweight. The cultural perception of beauty influences Ghanaian postmenopausal women’s physical activity level and dietary habits.
Does patella lowering as part of multilevel surgery improve knee kinematics in children with cerebral palsy and crouch gait? A meta-analysis of comparative studies
Authors: Galán-Olleros María , Lerma-Lara Sergio , Torres-Izquierdo Beltran , Ramírez-Barragán Ana , Egea-Gámez Rosa M , Hosseinzadeh Pooya , Martínez-Caballero Ignacio 
Published: December 2023

Purpose: To evaluate differences in knee kinematic outcomes of patellar-lowering surgery, specifically patellar tendon advancement or patellar tendon shortening, compared with no-patellar-lowering surgery in multilevel surgery for children with cerebral palsy and crouch gait. Methods: Four databases were searched to retrieve studies published from inception until 2023. Three reviewers independently screened for studies with observational or randomized control designs, comparing two groups of patients with cerebral palsy and crouch gait who underwent multilevel surgery (with patellar-lowering surgery versus no-patellar-lowering surgery), where various gait analysis outcomes were reported (CRD42023450692). The risk of bias was assessed with the Risk Of Bias In Non-randomised Studies - of Interventions (ROBINS-I) tool. Results: Seven studies (249 patients and 368 limbs) met the eligibility criteria. Patients undergoing patellar-lowering surgery demonstrated statistically significant improvements in knee flexion at initial contact (mean difference = −6.39; 95% confidence interval = [−10.4, −2.75]; p = 0.0006; I2 = 84%), minimum knee flexion in stance (mean difference = −14.27; 95% confidence interval = [−18.31, −10.23]; p < 0.00001; I2 = 89%), and clinical knee flexion contracture (mean difference = −5.6; 95% confidence interval = [−9.59, −1.6]; p = 0.006; I2 = 95%), with a significant increase in anterior pelvic tilt (mean difference = 2.97; 95% confidence interval = [0.58, 5.36]; p = 0.01; I2 = 15%). However, improvements in gait deviation index and decrease in peak knee flexion in swing did not reach statistical significance. Subgroup analysis reduced heterogeneity and revealed (1) greater improvement using patellar tendon shortening versus patellar tendon advancement techniques; (2) lack of knee flexion contracture improvement in high-quality or longer-term studies; (3) longer-term improvement only in minimum knee flexion in stance, with a decrease in peak knee flexion in swing; and (4) an inability to assess the potential benefit of rectus femoris procedure and hamstring preservation. Conclusions: Overall, the combination of patellar-lowering surgery with multilevel surgery demonstrated superior improvements in stance-phase knee kinematics compared with multilevel surgery alone, despite an increase in anterior pelvic tilt and a longer-term knee flexion reduction during the swing phase. Level of evidence: Level III, Systematic review of level III studies.
Combined Anterior Thoracic Vertebral Body Tethering and Posterior Lumbar Tethering Results in Quicker Return to Sport and Activity Compared to Posterior Spinal Instrumented Fusion in Patients with Adolescent Idiopathic Scoliosis
Authors: Oeding Jacob F. , Siu Jeremy , O’Donnell Jennifer , Wu Hao-Hua , Allahabadi Sachin , Saggi Satvir , Flores Michael , Brown Kelsey , Baldwin Avionna , Diab Mohammad 
Published: December 2023

Study Design Retrospective comparative study. Objective To compare patient-reported physical activity between anterior thoracic vertebral body tethering and posterior lumbar spine tethering (ATVBT/PLST) and posterior spinal instrumentation and fusion (PSIF) with minimum 2 year follow-up. Methods Consecutive skeletally immature patients with idiopathic scoliosis and a thoracic and lumbar curve magnitude ≥40° who underwent either ATVBT/PLST or PSIF from 2015-2019 were included. The primary outcome was rate of returning to sport. Secondary outcomes included ability to bend and satisfaction with sport performance as well as weeks until return to sport, school, physical education (PE) classes, and running. Results Ten patients underwent ATVBT/PLST and 12 underwent PSIF. ATVBT/PLST patients reported significantly faster return to sport (13.5 weeks vs 27.9 weeks, P = .04), running (13.3 weeks vs 28.8 weeks, P = .02), and PE class (12.6 weeks vs 26.2 weeks, P = .04) compared to PSIF patients. ATVBT/PLST patients reported that they had to give up activities due to their ability to bend at lower rates than PSIF patients while reporting “no changes” in their ability to bend after surgery at higher rates than PSIF patients (0% vs 4% giving up activities and 70% vs 0% reporting no changes in bending ability for ATVBT/PLST and PSIF, respectively, P = .01). Compared to PSIF patients, ATVBT/PLST patients experienced less main thoracic and thoracolumbar/lumbar curve correction at most recent follow-up (thoracic: 41 ± 19% vs 69 ± 18%, P = .001; thoracolumbar/lumbar: 59 ± 25% vs 78 ± 15%, P = .02). No significant differences in the number of revision surgeries were observed between ATVBT/PLST and PSIF patients (4 (40%) and 1 (8%) for ATVBT/PLST and PSIF, respectively, P = .221). Conclusions ATVBT/PLST patients reported significantly faster rates of returning to sport, running, and PE. In addition, ATVBT/PLST patients were less likely to have to give up activities due to bending ability after surgery and reported no changes in their ability to bend after surgery more frequently than PSIF patients. However, the overall rate of return to the same or higher level of sport participation was high amongst both groups, with no significant difference observed between ATVBT/PLST and PSIF patients.
A five-step approach to safer skin surgery
Authors: Smith Hayley , Bhutani Raman , Mitra Angana , Goulden Victoria , Hussain Walayat , Rahim Rajib , Machin Claire , Stables Graeme I 
Published: December 2023

Background: Wrong site skin surgery is a never event with implications for patient well-being, in addition to potential medicolegal ramifications. There is no standardised approach to wrong site surgery (WSS) prevention in the United Kingdom. However, the World Health Organisation surgical checklist and NHS England's safety standards for invasive procedures (NatSSIP) have been useful in guiding the direction of change. Our experience: We describe our experience over the past decade, detailing five cases of WSS including three wrong site biopsies and two re-excisions of the wrong scar. Each provided a learning opportunity, identifying vulnerabilities in the skin surgery pathway. Our five-step approach to safer skin surgery: By reflecting on our experience, we created a simple five-step approach to safer skin surgery which could easily be adopted by other dermatology departments. This includes, developing a Standard operating procedure, requesting a surgical procedure, medical photography, in theatre, and education/governance. Our approach provides a step in the right direction for national standardisation of the skin surgery pathway.
The role of TLR4/MyD88/NF-κB in the protective effect of ulinastatin on the intestinal mucosal barrier in mice with sepsis
Authors: Wenying Song , Jing Huang , Ying Li , Hui Ding 
Published: December 2023

Abstract
Objective
To investigate the effect of the TLR4/MyD88/NF-κB (Toll-like receptor 4/myeloid differentiation factor/nuclear factor kappa B) signalling pathway on the protective effect of ulinastatin on the intestinal mucosal barrier in mice with sepsis.

Methods
A mouse model of sepsis was established by classical caecal ligation and perforation. Forty-four SPF C57BL/6 mice were randomly divided into the following four groups with 11 mice in each group: the control group (Con group), ulinastatin group (Uti group), Uti + LPS (lipopolysaccharide, LPS) group (Uti + LPS group) and LPS group. Mice in the Con group and Uti group received saline or ulinastatin injected 2 h after modelling; Mice in the Uti + LPS group received LPS injected 0 h after modelling, other procedures were the same as in the Uti group; Mice in the LPS group received LPS only. At 48 h after surgery, the levels of TNF-α (tumour necrosis factor-α, TNF-α), IL-6 (interleukin-6, IL-6) and IL-1β (interleukin-1β, IL-1β) in vein, and the expression of TLR4, MyD88 and NF-κB mRNA in small intestinal mucosa tissues using ELISA and RT‒PCR.

Results
The pathological specimens showed increased inflammatory injury in the Con and LPS groups, while these injuries and changes improved in the Uti group. The scores of intestinal mucosal injury at 48 h of Uti injection were significantly lower than those of the Con group (P < 0.001), while the scores of intestinal mucosal injury of Uti + LPS were significantly higher than those of the Uti group (P = 0.044). The expression of TNF-α, IL-6 and IL-1β in the Uti decreased significantly at 48 h after surgery than that in the Con group (P = 0.001, P = 0.014, P = 0.004), while the expression of TNF-α, IL-6 and IL-1β in the Uti + LPS group increased significantly after surgery than that in the Uti group (P = 0.026, P = 0.040, P = 0.039). The expression of TLR4, MyD88 and NF-κB mRNA in the Uti group decreased significantly compared with that in the Con group (P = 0.001, P = 0.021, P = 0.007), while the expression of TLR4, MyD88 and NF-κB mRNA in the Uti + LPS group was higher than that in the Uti group (P = 0.023, P = 0.040, P = 0.045).

Conclusion
These findings indicate that the protective effect of ulinastatin on the intestinal mucosal barrier against sepsis may be mediated through the TLR4/MyD88/NF-κB pathway.
A population study on factors associated with unintentional falls among Iranian older adults
Authors: Sotoudeh Gholam Reza , Mohammadi Reza , Mosallanezhad Zahra , Viitasara Eija , Soares Joaquim J.F. 
Published: December 2023

Abstract
Introduction
Falls among older adults are a significant cause of disability, injury, and death worldwide. The high incidence of falls in older adults, combined with the increased susceptibility to injury of the older adult population, leads to severe global health issues. Further studies are needed to comprehensively evaluate the typical personal and environmental risk factors of falls in the Iranian elderly population. Future preventive strategies and intervention programs will be based on these findings. The study determined the risk factors associated with unintentional falls among a representative sample of older adults living in Tehran, the capital city of Iran.

Methods
The study design was cross-sectional. The target population was men/women aged 65 years and over from the general population living in 22 different districts of Tehran who were selected by stratified random sampling. The researchers gathered the data using validated questionnaires and observations. The informed consent was obtained from all participants before starting the interview. Multivariate logistic regression analysis examined the association between falls occurring during the past 12 months with demographics/ socioeconomics and fall-related predictor factors.

Results
The risk of falls was higher in women (47.0%) and those aged ≥ 75 years (44.1%). Older adults who were married had their fall risk reduced by 36.4% compared with other types of marital status. Older adults who were illiterate (48.1%), housewives (47.0%), and always had concerns about living expenses (53.9%) tended significantly to have a higher risk of falls. Moreover, participants who live with their family were less likely to fall than those who live alone (36.5% vs. 40.4%). Persons with safe homes were less likely to experience falls than persons with unsafe homes (30.9% vs. 41.4%). The logistic regression analysis showed that the female gender, being worried about living expenses, home safety, functional behavior, and function factors, were independently associated with the risk of falls during the past 12 months.

Conclusions
Our findings revealed that a wide range of intrinsic and extrinsic risk factors contributed to injurious falls; based on the literature, some are preventable. The present data may be helpful as a starting point and guide future efforts for health providers and policymakers to allocate additional resources and develop proper falls prevention or intervention programs at the community level.
A hybrid model for hand-foot-mouth disease prediction based on ARIMA-EEMD-LSTM
Authors: Wan Yiran , Song Ping , Liu Jiangchen , Xu Ximing , Lei Xun 
Published: December 2023

Abstract
Background
Hand, foot, and mouth disease (HFMD) is a common infectious disease that poses a serious threat to children all over the world. However, the current prediction models for HFMD still require improvement in accuracy. In this study, we proposed a hybrid model based on autoregressive integrated moving average (ARIMA), ensemble empirical mode decomposition (EEMD) and long short-term memory (LSTM) to predict the trend of HFMD.

Methods
The data used in this study was sourced from the National Clinical Research Center for Child Health and Disorders, Chongqing, China. The daily reported incidence of HFMD from 1 January 2015 to 27 July 2023 was collected to develop an ARIMA-EEMD-LSTM hybrid model. ARIMA, LSTM, ARIMA-LSTM and EEMD-LSTM models were developed to compare with the proposed hybrid model. Root mean square error (RMSE), mean absolute error (MAE) and coefficient of determination (R2) were adopted to evaluate the performances of the prediction models.

Results
Overall, ARIMA-EEMD-LSTM model achieved the most accurate prediction for HFMD, with RMSE, MAPE and R2 of 4.37, 2.94 and 0.996, respectively. Performing EEMD on the residual sequence yields 11 intrinsic mode functions. EEMD-LSTM model is the second best, with RMSE, MAPE and R2 of 6.20, 3.98 and 0.996.

Conclusion
Results showed the advantage of ARIMA-EEMD-LSTM model over the ARIMA model, the LSTM model, the ARIMA-LSTM model and the EEMD-LSTM model. For the prevention and control of epidemics, the proposed hybrid model may provide a more powerful help. Compared with other three models, the two integrated with EEMD method showed significant improvement in predictive capability, offering novel insights for modeling of disease time series.
Early antithrombotic therapy in patients with postinterventional cerebral hyperdensity reduces early neurological deterioration after mechanical thrombectomy
Authors: Luo Yunhe , Chu Min , Wang Daosheng , Gu Xin , Wang Delong , Zheng Jin , Zhao Jing 
Published: December 2023

Abstract
Background
Initiation of early antithrombotic therapy after acute ischemic stroke (AIS) is crucial. We aimed to investigate whether early antithrombotic therapy influences early neurological deterioration (END) in AIS patients with postinterventional cerebral hyperdensity (PCHD) immediately after mechanical thrombectomy (MT).

Methods
We retrospectively analyzed 108 consecutive anterior circulation AIS patients with PCHD immediately after MT. All patients were divided into END group and non-END group and END was defined as an increase of four points or more on the postinterventional National Institutes of Health Stroke Scale (NIHSS) score within the first 72 h after MT. Early antithrombotic therapy was defined as patients with PCHD who received antithrombotic therapy within 24 h after MT. Statistical analyses were performed to evaluate the association between early antithrombotic therapy and the risk of END.

Results
Among 108 patients, 27 (25%) patients developed END. Multivariate regression analysis revealed that early use of antithrombotic therapy (OR = 0.229, 95%CI = 0.083–0.626, P = 0.004) was an independent protector of END and postinterventional low density shadow exceeding 1/3 of the vascular territory (OR = 4.000, 95%CI = 1.157–13.834, P = 0.029) was an independent risk factor for END.

Conclusion
Antithrombotic therapy within 24 h after MT maybe associated with the reduced risk of END in anterior circulation AIS patients with PCHD.
A content analysis of women’s experiences of different models of maternity care: the Birth Experience Study (BESt)
Authors: Pelak Helen , Dahlen Hannah G. , Keedle Hazel 
Published: December 2023

Abstract
Background
Pregnancy, birth, and early parenthood are significant life experiences impacting women and their families. Growing evidence suggests models of maternity care impact clinical outcomes and birth experiences. The aim of this study was to explore the strengths and limitations of different maternity models of care accessed by women in Australia who had given birth in the past 5 years.

Methods
The data analysed and presented in this paper is from the Australian Birth Experience Study (BESt), an online national survey of 133 questions that received 8,804 completed responses. There were 2,909 open-ended comments in response to the question on health care provider/s. The data was analysed using content analysis and descriptive statistics.

Results
In models of fragmented care, including standard public hospital care (SC), high-risk care (HRC), and GP Shared care (GPS), women reported feelings of frustration in being unknown and unheard by their health care providers (HCP) that included themes of exhaustion in having to repeat personal history and the difficulty in navigating conflicting medical advice. Women in continuity of care (CoC) models, including Midwifery Group Practice (MGP), Private Obstetric (POB), and Privately Practising Midwifery (PPM), reported positive experiences of healing past birth trauma and care extending for multiple births. Compared across models of care in private and public settings, comments in HRC contained the lowest percentage of strengths (11.94%) and the highest percentage of limitations (88.06%) while comments in PPM revealed the highest percentage of strengths (95.93%) and the lowest percentage of limitations (4.07%).

Conclusions
Women across models of care in public and private settings desire relational maternity care founded on their unique needs, wishes, and values. The strengths of continuity of care, specifically private midwifery, should be recognised and the limitations for women in high risk maternity care investigated and prioritised by policy makers and managers in health services.

Trial registration
The study is part of a larger project that has been retrospectively registered with OSF Registries Registration DOI https://doi.org/10.17605/OSF.IO/4KQXP.
Untargeted serum metabolomics reveals potential biomarkers and metabolic pathways associated with the progression of gastroesophageal cancer
Authors: Che Jiajing , Zhao Yongbin , Gu Bingbing , Li Shuting , Li Yunfei , Pan Keyu , Sun Tiantian , Han Xinyue , Lv Jiali , Zhang Shuai , Fan Bingbing , Li Chunxia , Wang Cheng , Wang Jialin , Zhang Tao 
Published: December 2023

Abstract
Background
Previous metabolic studies in upper digestive cancer have mostly been limited to cross-sectional study designs, which hinders the ability to effectively predict outcomes in the early stage of cancer. This study aims to identify key metabolites and metabolic pathways associated with the multistage progression of epithelial cancer and to explore their predictive value for gastroesophageal cancer (GEC) formation and for the early screening of esophageal squamous cell carcinoma (ESCC).

Methods
A case-cohort study within the 7-year prospective Esophageal Cancer Screening Cohort of Shandong Province included 77 GEC cases and 77 sub-cohort individuals. Untargeted metabolic analysis was performed in serum samples. Metabolites, with FDR q value < 0.05 and variable importance in projection (VIP) > 1, were selected as differential metabolites to predict GEC formation using Random Forest (RF) models. Subsequently, we evaluated the predictive performance of these differential metabolites for the early screening of ESCC.

Results
We found a distinct metabolic profile alteration in GEC cases compared to the sub-cohort, and identified eight differential metabolites. Pathway analyses showed dysregulation in D-glutamine and D-glutamate metabolism, nitrogen metabolism, primary bile acid biosynthesis, and steroid hormone biosynthesis in GEC patients. A panel of eight differential metabolites showed good predictive performance for GEC formation, with an area under the receiver operating characteristic curve (AUC) of 0.893 (95% CI = 0.816–0.951). Furthermore, four of the GEC pathological progression-related metabolites were validated in the early screening of ESCC, with an AUC of 0.761 (95% CI = 0.716–0.805).

Conclusions
These findings indicated a panel of metabolites might be an alternative approach to predict GEC formation, and therefore have the potential to mitigate the risk of cancer progression at the early stage of GEC.