bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ensemble learning-assisted prediction of prolonged hospital length of stay after spine correction surgery: a multi-center cohort study
Authors: Li Wenle , Zhang Yusi , Zhou Xin , Quan Xubin , Chen Binghao , Hou Xuewen , Xu Qizhong , He Weiheng , Chen Liang , Liu Xiaozhu , Zhang Yang , Xiang Tianyu , Li Runmin , Liu Qiang , Wu Shi-Nan , Wang Kai , Liu Wencai , Zheng Jialiang , Luan Haopeng , Yu Xiaolin , Chen Anfa , Xu Chan , Luo Tongqing , Hu Zhaohui 
Published: February 2024

Abstract
Purpose
This research aimed to develop a machine learning model to predict the potential risk of prolonged length of stay in hospital before operation, which can be used to strengthen patient management.

Methods
Patients who underwent posterior spinal deformity surgery (PSDS) from eleven medical institutions in China between 2015 and 2022 were included. Detailed preoperative patient data, including demographics, medical history, comorbidities, preoperative laboratory results, and surgery details, were collected from their electronic medical records. The cohort was randomly divided into a training dataset and a validation dataset with a ratio of 70:30. Based on Boruta algorithm, nine different machine learning algorithms and a stack ensemble model were trained after hyperparameters tuning visualization and evaluated on the area under the receiver operating characteristic curve (AUROC), precision-recall curve, calibration, and decision curve analysis. Visualization of Shapley Additive exPlanations method finally contributed to explaining model prediction.

Results
Of the 162 included patients, the K Nearest Neighbors algorithm performed the best in the validation group compared with other machine learning models (yielding an AUROC of 0.8191 and PRAUC of 0.6175). The top five contributing variables were the preoperative hemoglobin, height, body mass index, age, and preoperative white blood cells. A web-based calculator was further developed to improve the predictive model's clinical operability.

Conclusions
Our study established and validated a clinical predictive model for prolonged postoperative hospitalization duration in patients who underwent PSDS, which offered valuable prognostic information for preoperative planning and postoperative care for clinicians.
Trial registration ClinicalTrials.gov identifier NCT05867732, retrospectively registered May 22, 2023, https://classic.clinicaltrials.gov/ct2/show/NCT05867732.
PDK4 inhibits osteoarthritis progression by activating the PPAR pathway
Authors: Li Zhengnan , Xie Lifeng , Zeng Hui , Wu Yaohong 
Published: February 2024

Abstract
Background
Osteoarthritis (OA) is a degenerative joint disease caused by the deterioration of cartilage. However, the underlying mechanisms of OA pathogenesis remain elusive.

Methods
Hub genes were screened by bioinformatics analysis based on the GSE114007 and GSE169077 datasets. The Sprague–Dawley (SD) rat model of OA was constructed by intra-articular injection of a mixture of papain and L-cysteine. Hematoxylin–eosin (HE) staining was used to detect pathological changes in OA rat models. Inflammatory cytokine levels in serum were measured employing the enzyme-linked immunosorbent assay (ELISA). The reverse transcription quantitative PCR (RT-qPCR) was implemented to assess the hub gene expressions in OA rat models. The roles of PDK4 and the mechanism regulating the PPAR pathway were evaluated through western blot, cell counting kit-8 (CCK-8), ELISA, and flow cytometry assays in C28/I2 chondrocytes induced by IL-1β.

Results
Six hub genes were identified, of which COL1A1, POSTN, FAP, and CDH11 expressions were elevated, while PDK4 and ANGPTL4 were reduced in OA. Overexpression of PDK4 inhibited apoptosis, inflammatory cytokine levels (TNF-α, IL-8, and IL-6), and extracellular matrix (ECM) degradation protein expressions (MMP-3, MMP-13, and ADAMTS-4) in IL-1β-induced chondrocytes. Further investigation revealed that PDK4 promoted the expression of PPAR signaling pathway-related proteins: PPARA, PPARD, and ACSL1. Additionally, GW9662, an inhibitor of the PPAR pathway, significantly counteracted the inhibitory effect of PDK4 overexpression on IL-1β-induced chondrocytes.

Conclusion
PDK4 inhibits OA development by activating the PPAR pathway, which provides new insights into the OA management.
A scoping review on tsetse fly blood meal sources and its assay methods since 1956 to 2022
Authors: Serem Erick Kibichiy , Mburu David Mwangi , Abdullahi Osman Abdikarim , Bargul Joel Ltilitan 
Published: February 2024

Abstract
Background
Tsetse flies (Glossina spp.) are the definitive biological vectors of African trypanosomes in humans and animals. Controlling this vector is the most promising method of preventing trypanosome transmission. This requires a comprehensive understanding of tsetse biology and host preference to inform targeted design and management strategies, such as the use of olfaction and visual cues in tsetse traps. No current review exists on host preference and blood meal analyses of tsetse flies.

Methods
This review presents a meta-analysis of tsetse fly blood meal sources and the methodologies used to identify animal hosts from 1956 to August 2022. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRIMA-ScR) was applied. This focused on tsetse-endemic countries, blood meal analysis methodologies and the blood meal hosts identified. The articles were retrieved and screened from databases using predetermined eligibility criteria.

Results
Only 49/393 of the articles retrieved matched the inclusion criteria. Glossina's main hosts in the wild included the bushbuck, buffalo, elephant, warthog, bushpig and hippopotamus. Pigs, livestock and humans were key hosts at the domestic interface. The least studied species included Glossina fuscipleuris, G. fusca, G. medicorum, G. tabaniformis and G. austeni. In the absence of preferred hosts, Glossina fed opportunistically on a variety of hosts. Precipitin, haemagglutination, disc diffusion, complement fixation, ELISA and PCR-based assays were used to evaluate blood meals. Cytochrome b (Cyt b) was the main target gene in PCR to identify the vertebrate hosts.

Conclusions
Tsetse blood meal sources have likely expanded because of ecological changes that could have rendered preferred hosts unavailable. The major approaches for analysing tsetse fly blood meal hosts targeted Cyt b gene for species identification by Sanger sequencing. However, small-fragment DNAs, such as the mammalian 12S and 16S rRNA genes, along with second- and third-generation sequencing techniques, could increase sensitivity for host identification in multiple host feeders that Sanger sequencing may misidentify as “noise”. This review of tsetse fly blood meal sources and approaches to host identification could inform strategies for tsetse control.

Graphical Abstract
The phase angle cut-off point capable of discriminating hemodialysis patients with reduced exercise tolerance: a cross-sectional study
Authors: de Souza Francisco Davi , Moraes Igor Gutierrez , Brito Camila Porto , Righetti Renato Fraga , Yamaguti Wellington Pereira 
Published: February 2024

Abstract
Background
Phase angle (PhA) is a prognostic marker of all-cause mortality in chronic kidney disease. However, no study has investigated this marker as a predictor of exercise intolerance in hemodialysis (HD) patients. The aim of this study was to determine a cut-off point for the PhA capable of discriminating HD patients with reduced exercise tolerance.

Methods
Thirty-one patients (80.6% men, median age 69 years) were included. The evaluations were performed on three different days, before the HD session. The outcomes evaluated were: biochemical markers, inflammatory and nutritional status, body composition, peripheral muscle strength and exercise tolerance. Performance ≤50% of the predicted value in the six-minute step test (6MST) was defined as reduced exercise tolerance.

Results
Patients presented an average of 67.6 steps (50.5% of predicted) in the 6MST. Fifteen patients (48.4%) were classified with reduced exercise tolerance. The receiver operating characteristic curve indicated a cut-off point of 3.73° for the PhA (sensitivity = 87%, specificity = 81%, and area under the curve = 0.88 [95% CI: 0.76–1.00]; p < 0.001). Patients with reduced exercise tolerance had worse inflammatory and nutritional status, lower PhA and greater impairment of peripheral muscle strength.

Conclusion
The cut-off point of 3.73° for the PhA is sensitive and specific to discriminate HD patients with reduced exercise tolerance.

Trial registration
This study was registered in the Clinical Trials database (no. NCT03779126, date of first registration 19/12/2018).
Simplified treatment protocols improve recovery of children with severe acute malnutrition in South Sudan: results from a mixed methods study
Authors: Lyles Emily , Ismail Sule , Ramaswamy Maya , Drame Aly , Leidman Eva , Doocy Shannon 
Published: February 2024

Abstract
Background
As part of COVID-19 mitigation strategies, emergency nutrition program adaptations were implemented, but evidence of the effects is limited. Compared to the standard protocol, the full adapted protocol included adapted admissions criteria, simplified dosing, and reduced visit frequency; partially adapted protocols consisting of only some of these modifications were also implemented. To enable evidence-based nutrition program modifications as the context evolved, this study was conducted to characterize how protocol adaptations in South Sudan affected Outpatient Therapeutic Feeding Program outcomes.

Methods
A mixed methods approach consisting of secondary analysis of individual-level nutrition program data and key informant interviews was used. Analyses focused on program implementation and severe acute malnutrition treatment outcomes under the standard, full COVID-19 adapted, and partially adapted treatment protocols from 2019 through 2021. Analyses compared characteristics and outcomes by different admission types under the standard protocol and across four different treatment protocols. Regression models evaluated the odds of recovery and mean length of stay (LoS) under the four protocols.

Results
Very few (1.6%; n = 156) children admitted based on low weight-for-height alone under the standard protocol would not have been eligible for admission under the adapted protocol. Compared to the full standard protocol, the partially adapted (admission only) and partially adapted (admission and dosing) protocols had lower LoS of 28.4 days (CI − 30.2, − 26.5) and 5.1 days (CI − 6.2, − 4.0); the full adapted protocol had a decrease of 3.0 (CI − 5.1, − 1.0) days. All adapted protocols had significantly increased adjusted odds ratios (AOR) for recovery compared to the full standard protocol: partially adapted (admission only) AOR = 2.56 (CI 2.18–3.01); partially adapted (admission + dosing) AOR = 1.78 (CI 1.45–2.19); and fully adapted protocol AOR = 2.41 (CI 1.69–3.45).

Conclusions
This study provides evidence that few children were excluded when weight-for-height criteria were suspended. LoS was shortest when only MUAC was used for entry/exit but dosing and visit frequency were unchanged. Significantly shorter LoS with simplified dosing and visit frequency vs. under the standard protocol indicate that protocol adaptations may lead to shorter recovery and program enrollment times. Findings also suggest that good recovery is achievable with reduced visit frequency and simplified dosing.
The role of exercise therapy in reducing respiratory symptoms in patients with COVID-19: a systematic review
Authors: Akbari Narges Jahantigh , Tahan Nahid , Roostayi Mohammad Mohsen , Daryabor Aliyeh , Naimi Sedigheh Sadat 
Published: February 2024

Background/Aims Respiratory-related complaints such as dyspnoea, shortness of breath and inability to perform their activities of daily living have been reported by people who have contracted COVID-19. Physiotherapy can play a vital role in management of these symptoms. The aim of this review study was to systematically evaluate the role of exercise therapy in reducing respiratory symptoms in patients with COVID-19. Methods A search of PubMed, Cochrane, ScienceDirect, Web of Science, Scopus, and ProQuest databases was conducted from December 2019 to November 2022. Studies were included if: the study design was a randomised controlled trial or quasi-experimental; participants had COVID-19 disease; the intervention was exercise therapy; and respiratory symptoms were evaluated as outcome measures. The quailty of included studies was independently evaluated by two authors using the PEDro scale. Results A total of 11 articles were selected for final analysis, which included both face-to-face therapy and telerehabilitation. Without considering their scientific rigour, the findings of the studies reported that exercise therapy, such as breathing exercises, strengthening exercises, aerobic exercises, lower limb muscle strength exercises and stretching exercises, had significant effects in reducing dyspnoea and increasing physical capacity and lung function. Conclusions Exercise therapy interventions could be effective in improving respiratory symptoms including lung function, dyspnoea and physical capacity. While some studies examined face-to-face exercise therapy and showed improvement in symptoms, it is suggested that the effect of telerehabilitation should be investigated in future studies. Implications for practice Physiotherapists can use exercise therapy alongside other physical therapy interventions for patients with COVID-19 and other similar respiratory viruses.
Effect of strengthening exercises in individuals with patellofemoral pain syndrome: a randomised controlled trial
Authors: Mikaili Saeed , Kalantari Khosro Khademi , Zavieh Minoo Khalkhali , Daryabor Aliyeh , Rezaei Mehdi , Baghban Alireza Akbarzadeh 
Published: February 2024

Background/Aims Muscle imbalance in patella stabilisers leads to patellar lateral glide and can cause patellofemoral pain syndrome. This study investigated the effect of progressive strengthening exercises of the vastus medialis oblique on pain and patellar alignment in patients with patellofemoral pain syndrome and patellar lateral glide. Methods A double-blind, randomised controlled trial was conducted with 40 individuals with patellofemoral pain syndrome with patellar lateral glide aged 20–40 years. The study group received vastus medialis oblique-specific strengthening exercises and routine physiotherapy treatment, and the control group received routine physiotherapy treatment only (stretching exercises, gluteal and quadriceps isometric exercises and conventional transcutaneous electrical nerve stimulation). Participants performed these exercises three times a week for 8 weeks. Pain intensity was measured before and after the intervention using a visual analogue scale and patellar alignment was measured using ultrasonographic parameters, including the trochlear angle, patella offset angle and distance between patellar tip and trochlear groove. Results In the between-groups comparison, there was a significant decrease in pain intensity in both the study and control groups, although the study group had a greater decrease (study group before intervention: 71.15 ± 1.54, study group after intervention: 22.21 ± 0.35, P=0.001); control group before intervention: 70.09 ± 1.22, control group after intervention: 31.82 ± 0.36 (P=0.001)) and patella offset angle (in the study group compared to the control group after 8 weeks of intervention. In within-groups comparison, a significant decrease of the patella offset angle in the study group was observed (before intervention: 16.2 ± 1.53; after intervention: 13.2 ± 1.87, P=0.001). No significant differences were found for the other parameters. Conclusions Specific strengthening of the vastus medialis oblique muscle in patients with patellofemoral pain syndrome and patellar lateral glide can lead to pain reduction and improvement of patellar alignment to correct lateralisation. This change may delay the process of patellofemoral joint degeneration. Including vastus medialis oblique-specific strengthening exercises in standard physiotherapy treatments may help to reduce pain levels in people with patellofemoral pain syndrome. Implications for practice Investigating the main cause of patellofemoral pain syndrome could have an essential role in the rehabilitation treatment of patients.
Characteristics of alpha-1 antitrypsin deficiency related lung disease exacerbations using a daily symptom diary and urinary biomarkers
Authors: Ellis Paul , Parekh Gita , Duvoix Annelyse , Watson Lynne , Sharp Alex , Mobeen Farah , Pye Anita , Stockley Robert , Turner Alice 
Published: February 2024

Background
Pulmonary exacerbations in alpha-1 antitrypsin deficiency (AATD) related lung disease are a significant contributor to disease burden, as with usual COPD. Separating the early stages of an exacerbation from the day-to-day variation in stable COPD is central to the concerns of both clinicians and patients and has been identified as a research priority by NIHR. Clinical tools that distinguish baseline symptoms from those of an exacerbation could allow early and appropriate treatment of AECOPD to reduce the impact and potentially may slow disease progression thereby improving survival and quality of life. Candidate tools include symptom diaries and biomarkers of infection and acute inflammation. Urinary biomarkers of AECOPD have yet to be explored in AATD related COPD.

Methods
55 patients with AATD related lung disease with a history of 2 or more AECOPD in the preceding year were prospectively followed for 18 months. Each patient recorded symptom scores daily via an electronic symptom diary (eDiary) based on Bronkotest. Urinary biomarkers for AAT, NE, CRP, TIMP1 and desmosine were measured weekly using a home urinary lateral flow device. During self-reported AECOPD patients were asked to perform urine analysis on the first 7 consecutive days.

Results
Type I Anthonisen exacerbations and episodes occurring in autumn/winter lasted longer than Type II/III exacerbations and spring/summer episodes respectively. Median urinary CRP concentration across all study participants increased during Type I AECOPD. eDiary adherence was 68% over a median of 17.8 months (IQR 15.7 to 18.5).

Conclusions
Use of an eDiary and urinary biomarkers to detect and characterise AECOPD remotely in AATD related lung disease is feasible over a prolonged period and paves the way for precision detection of exacerbations.
Evaluating the effects of lymphoedema management strategies on functional status and health-related quality of life following treatment for head and neck cancer: Protocol for a systematic review
Authors: Mullan Lauren J. , Blackburn Nicole E. , Lorimer Jill , Semple Cherith J. 
Published: February 2024

Introduction/Background
Patients living with and after head and neck cancer often experience treatment-related consequences. Head and neck lymphoedema can be described as a common chronic side effect of head and neck cancer and recognised as a contributing factor to impairment of functional status, symptom burden and health-related quality of life. The effects of head and neck lymphoedema can limit patients’ involvement in daily activities and alter their appearance, increasing symptom burden and negatively affecting health-related quality of life.

Objective
The protocol outlines the rationale and aims for the systematic review. The main aim of the systematic review is to identify and systematically synthesise the literature on the effectiveness of head and neck lymphoedema management strategies, on both function status and health-related quality of life for head and neck cancer patients.

Methods and analysis
This protocol will be conducted according to the PRISMA-P guidelines. Electronic databases will be systematically searched using MEDLINE via Ovid and PubMed, CINAHL, Cochrane Central Register of Controlled Trials and Scopus. Inclusion criteria will involve intervention studies for head and neck lymphoedema management, English language, and adult human participants following head and neck cancer. The software Covidence will be used to export, manage, and screen results. Risk of bias and quality will be assessed in included studies using the Cochrane Handbook of Systematic Reviews of Intervention risk of bias and GRADE tools. A meta-analysis will be performed if there are sufficient homogenous studies. Alternatively, a narrative synthesis will be completed on study findings.

Ethics and dissemination
No ethical approval is required as the study does not involve patient and public involvement. The findings of the review will be disseminated in conferences and submitted for approval to be published in a peer-reviewed journal.

Prospero registration number
CRD42022378417. (S1 Appendix).
Functional Capacity of Geriatric Patients Hospitalized in Neurology Departments and their Physical and Clinimetric Determinants
Authors: Pawłowski Piotr , Fornal Aleksandra , Kościołek Aneta , Ziętara Karoliona , Fryze Magdalena , Przylepa Katarzyna 
Published: February 2024

Introduction. The functional capacity of patients hospitalized in neurological wards is determined by multifactorial factors. Accompanying illnesses, independent mobility, and the patient’s mental, social, and spiritual state are just a few variables that affect functional performance.
Aim. To analyze the relationship between the results of physical examination elements on the functional capacity of patients hospitalized in Lublin’s neurological wards.
Material and Methods. The study was based on quantitative (diagnostic survey) as well as qualitative (individual focus interview) methods. The research tools were the Barthel Scale, the ADL Scale (Katz), and the author’s interview questionnaire. During the study, a subject examination of each respondent was also conducted according to a standardized scheme. Statistical analyses were conducted using SPSS Statistica and Microsoft Excel 2020 software.
Results. Patients hospitalized in neurology departments, unable to cope with activities of daily living are characterized by moderately severe disability. Circulatory and respiratory parameters, as well as accompanying neurological symptoms, do not affect the functional capacity of patients. Pain complaints, the intensity of pain and localization impinge on the extent of functional capacity.
Conclusions. Functional fitness depends on the intensity of pain and its location. The Barthel Scale and the ADL Scale correlate with the level of functional capacity, especially in terms of mobility. (JNNN 2023;12(3):120–126)