bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of walk advice alone or in combination with supervised or home-based structured exercise on patient-reported physical function and generic and disease-specific health related quality of life in patients with intermittent claudication, a secondary analysis in a randomized clinical trial
Authors: Sandberg Anna , Bäck Maria , Cider Åsa , Jivegård Lennart , Sigvant Birgitta , Nordanstig Joakim 
Published: October 2023

Abstract
Background
Supervised exercise is an integral part of the recommended first-line treatment for patients with intermittent claudication (IC). By reflecting the patients’ perspectives, patient-reported outcome measurements provide additional knowledge to the biomedical endpoints and are important outcomes to include when evaluating exercise interventions in patients with IC. We aimed to evaluate the one-year impact of three strategies: unsupervised Nordic pole walk advice (WA), WA + six months of home-based structured exercise (HSEP) or WA + six months of hospital-based supervised exercise (SEP) on health-related quality of life and patient-reported physical function in patients with IC.

Methods
This secondary exploratory analysis of a multi-center, randomized clinical trial compared three exercise strategies. The primary outcome of the secondary analysis was the one-year change in the 36-Item Short-Form (SF-36). Secondary outcomes were three- and six-months SF-36 changes alongside three, six- and 12-months changes in the disease-specific Vascular Quality of Life instrument (VascuQoL) and the Patient-Specific Functional Scale (PSFS). The Kruskal–Wallis test with Bonferroni-adjusted post-hoc tests were used for between-group comparisons. Effect size calculations were used to describe the size of observed treatment effects, and the clinical meaningfulness of observed changes in the VascuQoL summary score at one year was studied using established minimally important difference (MID) thresholds.

Results
A total of 166 patients with IC, mean age: 72.1 (SD 7.4) years, 41% women, were randomized. No significant between-group differences were observed over time for the SF-36 or the PSFS scores whereas some significant between-group differences were observed in the VascuQoL domain and summary scores over time, favoring SEP and/or HSEP over WA. The observed SF-36 and VascuQoL domain and summary score effect sizes were small to moderate, and many domain score effect sizes also remained unchanged over time. A significantly higher proportion of the patients in the SEP group reached the VascuQoL summary score MID of improvement in one year.

Conclusion
Clinically important improvements were observed in SEP using the VascuQoL, while we did not observe any significant between-group differences using the SF-36. Whereas effect sizes for the observed changes over time were generally small, a significantly higher proportion of patients in SEP reached the VascuQoL MID of improvement.

Trial registration
NCT02341716, January 19, 2015 (retrospectively registered).
Prognostic factors for the long term outcome after surgical celiac artery decompression in MALS
Authors: Woestemeier Anna , Semaan Alexander , Block Andreas , Arensmeyer Jan , Dohmen Jonas , Kania Alexander , Verrel Frauke , Mücke Martin , Kalff Jörg C. , Lingohr Philipp 
Published: October 2023

Abstract
Background
The median arcuate ligament syndrome (MALS) is a rare disease caused by compression of the celiac artery (ORPHA: 293208). Surgical treatment of MALS aims to restore normal celiac blood flow by laparoscopic celiac artery decompression. However, surgical success rates vary widely between patients, therefore adequate selection of patients is essential to improve surgical outcome. Symptoms of MALS might also overlap with other chronic multi-system disorders such as mast cell activation syndrome (MCAS). So far, no clinical or radiological parameter was found to be predictive of the postoperative outcome. We, therefore, aim to study preclinical parameters in one of the largest MALS cohorts with the focus to identify patients that would benefit from surgical MAL release.

Results
By analyzing 20 MALS patients that underwent surgical celiac artery decompression, we found 60% of patients (12/20) had a postoperative relief of their symptoms and a simultaneous decrease of analgetic use. No demographic, radiologic or operative parameter was able to predict postoperative symptom relief. However, mast cell activation syndrome correlated significantly (p = 0.04) with persistent symptoms after the operation.

Conclusions
Overall, laparoscopic MAL release can provide immediate symptomatic relief. Despite the missing predictive value of demographic and imaging data, our data show a correlation between persistent symptoms and a co-existing mast cell activation syndrome. This suggests that MCAS symptoms might be interpreted as MALS symptoms in the presence of celiac artery stenosis and therefore surgical treatment should be evaluated carefully. Overall, the selection of patients who are most likely to respond to surgical MAL release may best be accomplished by an interdisciplinary team of gastroenterologists, radiologists and surgeons.
Genome-wide analyses identify NEAT1 as genetic modifier of age at onset of amyotrophic lateral sclerosis
Authors: Li Chunyu , Wei Qianqian , Hou Yanbing , Lin Junyu , Ou Ruwei , Zhang Lingyu , Jiang Qirui , Xiao Yi , Liu Kuncheng , Chen Xueping , Yang TianMi , Song Wei , Zhao Bi , Wu Ying , Shang Huifang 
Published: October 2023

AbstractBackgroundPatients with amyotrophic lateral sclerosis (ALS) demonstrate great heterogeneity in the age at onset (AAO), which is closely related to the course of disease. However, most genetic studies focused on the risk of ALS, while the genetic background underlying AAO of ALS is still unknown.MethodsTo identify genetic determinants influencing AAO of ALS, we performed genome-wide association analysis using a Cox proportional hazards model in 2,841 patients with ALS (Ndiscovery= 2,272, Nreplication= 569) in the Chinese population. We further conducted colocalization analysis using public cis-eQTL dataset, and Mendelian randomization analysis to identify risk factors for AAO of ALS. Finally, functional experiments including dual-luciferase reporter assay and RT-qPCR were performed to explore the regulatory effect of the target variant.ResultsThe total heritability of AAO of ALS was ~ 0.24. One novel locus rs10128627 (FRMD8) was significantly associated with earlier AAO by ~ 3.15 years (P = 1.54E-08, beta = 0.31, SE = 0.05). This locus was cis-eQTL ofNEAT1in multiple brain tissues and blood. Colocalization analysis detected association signals at this locus between AAO of ALS and expression ofNEAT1. Furthermore, functional exploration supported the variant rs10128627 was associated with upregulated expression ofNEAT1in cell models and patients with ALS. Causal inference suggested higher total cholesterol, low-density lipoprotein, and eosinophil were nominally associated with earlier AAO of ALS, while monocyte might delay the AAO.ConclusionsCollective evidence from genetic, bioinformatic, and functional results suggestedNEAT1as a key player in the disease progression of ALS. These findings improve the current understanding of the genetic role in AAO of ALS, and provide a novel target for further research on the pathogenesis and therapeutic options to delay the disease onset.
Unravelling the intricacies between gaming motivations and internet gaming disorder symptoms in adolescents: a network analysis of 2-year healthy and deteriorating transition profiles
Authors: Chen Shiyun , Zhu Shimin 
Published: October 2023

Abstract
Background
The increasing prevalence of internet gaming disorder (IGD) among adolescents has become a global concern, while gaming plays a large role in many adolescents’ lives. While prior research emphasised the significance of investigating IGD through an etiological lens, the interconnections between diverse gaming motivations and IGD symptoms in adolescents remain inadequately understood. This study explored the associations between distinct gaming motivations and IGD symptoms by conducting network analysis in adolescents.

Methods
Data from a two-year longitudinal school-based survey (N = 2148) was utilized. LPA was used to offer a straightforward and interpretable solution for identifying adolescents with two-year healthy and deteriorating transitions of IGD profiles. Subsequently, we conducted a network analysis to explore and compare the associations between gaming motivations and IGD symptoms in adolescents with two-year healthy transition profiles and deteriorating transition profiles.

Results
Three profiles were delineated: ‘low IGD’ (T1: n = 808, 37.62%; T2: n = 731; 34.03%), ‘middle IGD’ (T1: n = 1063, 49.49%; T2: n = 1103, 51.35%), and ‘severe IGD’ (T1: n = 277, 12.89%; T2: n = 314, 14.62%), classifying adolescents with healthy transitions and those with deteriorating transitions. Three gaming motivations (i.e., ‘Daily entertainment’, ‘I am good at it’, and ‘Improvement of ability and mindset’) were identified as protective motivations. Two others, ‘Enjoy being in the gaming world’ and ‘Preoccupation’, were identified as bridge nodes in adolescents with deteriorating transitions. Three core nodes (i.e., ‘Sense of victory’, ‘Enjoy being in the gaming world’, and ‘Sense of achievement’) were identified in both adolescents with healthy profile transitions and deteriorating transitions.

Conclusion
Findings suggest that not all gaming motivations contribute to the development of IGD in adolescents. Adolescents with deteriorating transitions showed specific gaming motivation and IGD symptom that is closely connected. Future interventions should consider corresponding gaming motivation when addressing IGD among adolescents.
Early postoperative parastomal evisceration after explorative laparotomy: case report of a rare and potentially life-threatening surgical complication
Authors: Hasnaoui Anis , Trigui Racem , Heni Sihem , Kacem Salma 
Published: October 2023

Abstract
Background
Parastomal evisceration represents a preventable surgical complication that should not occur with appropriate technical diligence and surgical skills. While late parastomal hernias are well described in the literature, there is a paucity of reports on the early postoperative occurrence of parastomal intestinal evisceration.

Case presentation
An urgent laparotomy was performed on a 58-year-old female patient for an acute cecal perforation with generalized peritonitis related to underlying colon cancer. Intraoperative revelations necessitated a carcinologic right colectomy and the creation of an end-loop ileocolostomy. Following six sessions of adjuvant chemotherapy, Computed tomography scans raised uncertainties about the presence of peritoneal carcinomatosis. Consequently, a collaborative decision was reached in a multidisciplinary discussion to conduct a surgical biopsy of these deposits before reinstating digestive continuity. The surgical procedure started with stoma mobilization. However, adhesions and a relatively confined aperture curtailed a comprehensive peritoneal cavity exploration. Thus, a midline incision was executed. The verdict from the frozen section examination affirmed metastatic presence, prompting the retention of the stoma. Within 48 h post-surgery, an early-stage parastomal evisceration occurred, stemming from an inadequately sealed aponeurotic sheath. The exposed bowel surface was encased in fibrin, necessitating meticulous irrigation with a warm saline solution before repositioning it within the peritoneal cavity. Accurate adjustment of the aponeurosis closure ensued, coupled with a meticulous reconstitution of the stoma. The postoperative course was uneventful. The patient was subsequently referred for hyperthermic intraperitoneal chemotherapy.

Conclusions
Preventing parastomal evisceration requires adherence to established stoma-creation protocols, including creating a properly sized fascial opening and secure fixation. In instances of excessive fascial opening, ensuring a tension-free and meticulous closure is imperative.
Tumor cell-induced platelet aggregation accelerates hematogenous metastasis of malignant melanoma by triggering macrophage recruitment
Authors: Chen Yuyi , Zhou Jie , Liu Zishen , Wu Tongtong , Li Shumeng , Zhang Yutong , Yin Xiaohui , Yang Guowang , Zhang Ganlin 
Published: October 2023

Abstract
Background
Tumor cell-induced platelet aggregation (TCIPA) is not only a recognized mechanism for paraneoplastic thrombocytosis but also a potential breakthrough alternative for a low response to immune checkpoint inhibitors (ICIs) in hematogenous metastasis of malignant melanoma (MM). However, there is no TCIPA-specific model for further investigation of the relationship among TCIPA, the tumor immune microenvironment (TIME), and metastasis.

Methods
We developed a TCIPA metastatic melanoma model with advanced hematogenous metastasis and enhanced TCIPA characteristics. We also investigated the pathway for TCIPA in the TIME.

Results
We found that TCIPA triggers the recruitment of tumor-associated macrophages (TAMs) to lung metastases by secreting B16 cell-educated platelet-derived chemokines such as CCL2, SDF-1, and IL-1β. Larger quantities of TAMs in the TCIPA model were polarized to the M2 type by B16 cell reprocessing, and their surface programmed cell death 1 ligand 1 (PD-L1) expression was upregulated, ultimately assisting B16 cells in escaping host immunity and accelerating MM hematogenous metastasis.

Conclusions
TCIPA accelerates MM lung metastasis via tumor-educated platelets (TEPs), triggering TAM recruitment, promoting TAM polarization (M2), and remodeling the suppressive TIME in lung metastases.
Transcutaneous electrical vagus nerve stimulation to suppress premature ventricular complexes (TREAT PVC): study protocol for a multi-center, double-blind, randomized controlled trial
Authors: Cai Cheng , Wu Nan , Yang Gang , Yang Shu , Liu Wenjie , Chen Minglong , Po Sunny S. ,   on behalf of the TREAT PVC investigators
Published: October 2023

Abstract
Background
The autonomic nervous system can be responsible for the initiation and maintenance of arrhythmias. Low-level tragus stimulation (LLTS), a noninvasive form of autonomic neuromodulation, has been shown to be effective in treating atrial fibrillation. We intended to treat frequent premature ventricular complexes (PVCs) with LLTS.

Methods and design
The present study will be a prospective multicenter, double-blind, randomized, controlled trial to assess the antiarrhythmic effects of LLTS on frequent PVCs in patients without structured heart disease (SHD). A total of 100 patients with PVC burden > 10% will be randomly assigned to the active or sham LLTS in 1:1 fashion and receive the proposed intervention for 6 months. The primary outcome is PVC burden at 6 months as assessed by 10 days of continuous ambulatory electrocardiographic monitoring. Secondary outcomes include heart rate variability (HRV), quality of life, skin sympathetic nerve activity, and inflammatory markers. Adverse events will also be recorded.

Discussion
The present trial will be the first to evaluate the effect of LLTS on frequent PVCs on patients without SHD. LLTS may serve as a low-cost, minimal-risk, and non-invasive alternative to conventional antiarrhythmic therapy.

Trial registration
ClinicalTrial.gov NCT04909528. Registered on 17 June 2021. World health organization trial registration data set was shown in Supplementary Table 1.
The tooth movement efficiency of different orthodontic thermoplastics for clear aligners: study protocol for a randomized controlled clinical trial
Authors: Mu Chuangchuang , Sun Bingjing , Gong Zhicheng , Wei Yuanyuan , Chen Li , Zhang Wei , Wu Haimiao , Zhao Bingjiao 
Published: October 2023

Abstract
Introduction
With regard to the esthetics and comfort of orthodontic treatment, the requirement for removable clear aligners (CAs) is increasing. Unlike conventional fixed orthodontic appliances, CAs were made of thermoplastic film by thermoforming on the personalized dental models. The construction of orthodontic thermoplastic is a critical factor for orthodontic tooth movement (OTM). Polyethylene terephthalate glycol-modified (PETG) and thermoplastic polyurethane (TPU) are the most commonly orthodontic thermoplastics; however, the evidence of the differences between different orthodontic thermoplastic are limited to vitro environment and the evidence in vivo environment is not available. Therefore, this trial aims to provide reliable evidence for orthodontists’ personalized treatment plans whether the two most commonly used orthodontic thermoplastics of PETG and TPU have differences in the efficiency of OTM.

Methods and analysis
This randomized controlled clinical study will recruit 44 orthodontic patients for orthodontic treatment. All the subjects will be randomized into two groups (PETG and TPU, n = 22 for each group). In the first stage (M0 to M1), clear aligners will be made of two orthodontic thermoplastics and move the maxillary first or second premolars 2 mm. In the second stage, patients will take the standard orthodontic treatments. The primary outcome will be the efficiency of clear aligners made of different materials on the digital models. The secondary outcome will be the efficiency of clear aligners made of different materials on the cone-beam computed tomography (CBCT). The efficiency will be calculated through the superimposition of the digital models and CBCT.

Discussion
The results from this trial will serve as evidence for orthodontists and manufacturers and clarify whether the difference in orthodontic thermoplastics significantly impacts the efficiency of OTM.

Trial registration number
ChiCTR2300070980. Registered on 27 April 2023.
https://www.chictr.org.cn/showproj.html?proj=186253
Pyelo-hepatic abscess caused by staghorn stone infection: a case report
Authors: Salgado Octavio J. , Pesantes-Barros Katherine S. , Rosales Beatriz C. , Espinosa-Martin Lizette 
Published: October 2023

Abstract
Background
The most common source of pyogenic liver abscess is biliary tract infection. Other less common routes include the spread of bacteria from distant foci. However, direct extension of a perinephric infection focus to the liver is extremely rare.

Case report
The patient was a non-diabetic, immunocompetent, 29-year-old woman of mixed race ancestry with a history of recurrent urinary tract infections who was referred to our hospital because of an ultrasound-detected liver abscess. She was initially treated with metronidazole for 20 days at the referring institution for suspected amebic abscess without improvement. On admission to our center, she was febrile and complained of a dull right upper quadrant pain. A POCUS ultrasound suggested a pyogenic abscess, probably from a staghorn calculus infection. She received meroperem and amikacin for 22 and 10 days, respectively. Repeat hemocultures showed no growth, but urine cultures were positive for Proteus sp. Complete remission of clinical and imaging findings was observed under antibiotics. The patient was referred to the urology outpatient clinic to discuss the option of radical nephrectomy.

Conclusion
This case underlines the high morbidity of staghorn calculi.
Numerical solution of Bratu’s boundary value problem based on Green’s function and a novel iterative scheme
Authors: Ahmad Junaid , Arshad Muhammad , Ullah Kifayat , Ma Zhenhua 
Published: October 2023

AbstractWe compute the numerical solution of the Bratu’s boundary value problem (BVP) on a Banach space setting. To do this, we embed a Green’s function into a new two-step iteration scheme. After this, under some assumptions, we show that this new iterative scheme converges to a sought solution of the one-dimensional non-linear Bratu’s BVP. Furthermore, we show that the suggested new iterative scheme is essentially weak $w^{2}$

w
2

-stable in this setting. We perform some numerical computations and compare our findings with some other iterative schemes of the literature. Numerical results show that our new approach is numerically highly accurate and stable with respect to different set of parameters.
Bifurcation and chaos in a discrete Holling–Tanner model with Beddington–DeAngelis functional response
Authors: Yang Run , Zhao Jianglin 
Published: October 2023

AbstractThe dynamics of a discrete Holling–Tanner model with Beddington–DeAngelis functional response is studied. The permanence and local stability of fixed points for the model are derived. The center manifold theorem and bifurcation theory are used to show that the model can undergo flip and Hopf bifurcations. Codimension-two bifurcation associated with 1:2 resonance is analyzed by applying the bifurcation theory. Numerical simulations are performed not only to verify the correctness of theoretical analysis but to explore complex dynamical behaviors such as period-6, 7, 10, 12 orbits, a cascade of period-doubling, quasi-periodic orbits, and the chaotic sets. The maximum Lyapunov exponents validate the chaotic dynamical behaviors of the system. The feedback control method is considered to stabilize the chaotic orbits. These complex dynamical behaviors imply that the coexistence of predator and prey may produce very complex patterns.
Vaccination Attitudes Examination (VAX) Scale: a Bifactor-ESEM approach in a youth sample (15–24 years)
Authors: Jovanović Veljko , Lazić Milica 
Published: October 2023

Abstract
Background
The Vaccination Attitudes Examination (VAX) Scale is a widely used scale designed to measure general attitudes toward vaccinations. However, evidence for the VAX’s structural, convergent, and discriminant validity is still limited, especially in youth samples.

Methods
The present study examined the psychometric multidimensionality and evidence of convergent and discriminant validity of the VAX using the bifactor-exploratory structural equation modeling approach (bifactor-ESEM). Using a sample of 803 Serbian adolescents and young adults (Mage = 18.23, SDage = 2.66, age range = 15–24 years, 59.2% female), we contrasted the original four-factor model of the VAX with alternative solutions (ESEM, bifactor-CFA, and bifactor-ESEM), and investigated associations between vaccination attitudes and a variety of external criteria.

Results
The results supported the bifactor-ESEM solution with one general factor of vaccination attitudes and four specific factors (Mistrust of vaccine benefit, Worries about unforeseen future effects, Concerns about commercial profiteering, and Preference for natural immunity) as the best representation of the data. The general factor was well-defined, and three specific factors showed good validity and specificity after the general factor was taken into account. The results of convergent validity analyses showed that the general factor of vaccine attitudes and one specific factor (Mistrust of vaccine benefit) were good predictors of vaccine conspiracy beliefs, attitudes towards COVID-19 vaccination, intention to get vaccinated against COVID-19, and trust in healthcare. The remaining three specific factors’ contributions to external criteria were generally weak and nonsignificant. Evidence of the discriminant validity of the VAX scores was supported by weak positive associations of the general factor with medical fears and paranoid worry.

Conclusions
The present findings indicate that distinguishing general and specific components of vaccination attitudes offers a more nuanced assessment and understanding of vaccination attitudes.