bluuebunny/crossref_metadata_2025_split huggingface dataset:
Harnessing technology and gamification to increase adult physical activity: a cluster randomized controlled trial of the Columbia Moves pilot
Authors: Monroe Courtney M. , Cai Bo , Edney Sarah , Jake-Schoffman Danielle E. , Brazendale Keith , Bucko Agnes , Armstrong Bridget , Yang Chih-Hsiang , Turner-McGrievy Gabrielle 
Published: November 2023

Abstract
Background
The use of health technologies and gamification to promote physical activity has increasingly been examined, representing an opportunistic method for harnessing social support inherent within existing social ties. However, these prior studies have yielded mixed findings and lacked long-term follow-up periods. Thus, a pilot cluster randomized controlled trial was conducted to gauge the feasibility and preliminary efficacy of a digital gamification-based physical activity promotion approach among teams of insufficiently active adults with existing social ties.

Methods
Teams (N = 24; 116 total participants) were randomized to either a 12-week intervention (Fitbit, step goals, app, feedback; TECH) or the same program plus gamification (TECH + Gamification). Mixed effects models were used to compare group differences in treatment adherence, and changes in social support, steps, and moderate-to-vigorous physical activity at 12 weeks and 52 weeks from baseline, adjusted for sociodemographic characteristics and team size.

Results
TECH had a lower mean number of days of Fitbit self-monitoring versus TECH + Gamification during the intervention (adjusted difference: -.30; 95% CI, -.54 to -.07; P = .01). Post-intervention, TECH had 47% lower odds of self-monitoring 7 days per week versus TECH + Gamification (.53; 95% CI, .31 to .89; P = .02). No differences were observed between TECH + Gamification and TECH in increases in social support (0.04; 95% CI, -.21 to .29; P = .76), ActiGraph-measured daily steps (-425; 95% CI, -1065 to 215; P = .19), or moderate-to-vigorous physical activity minutes (-3.36; 95% CI, -8.62 to 1.91; P = .21) from baseline to 12 weeks or in the regression of these improvements by 1 year (Ps > .05). Although not significant in the adjusted models (Ps > .05), clinically meaningful differences in Fitbit-measured daily steps (TECH, 7041 ± 2520; TECH + Gamification, 7988 ± 2707) and active minutes (TECH, 29.90 ± 29.76; TECH + Gamification, 36.38 ± 29.83) were found during the intervention.

Conclusions
A gamified physical activity intervention targeting teams of adults with existing social ties was feasible and facilitated favorable, clinically meaningful additive physical activity effects while in place but did not drive enhanced, long-term physical activity participation. Future investigations should explore optimal team dynamics and more direct ways of leveraging social support (training teams; gamifying social support).

Trial registration
Clinicaltrials.gov (NCT03509129, April 26, 2018).
Accuracy and safety of a new robotic arm for both femoral and acetabular side in total hip arthroplasty: a cadaveric study
Authors: Lu Xinzhe , Zhang Zian , Wang Wenzhe , Xu Hao , Zhang Haining 
Published: November 2023

Abstract
Background
To investigate the accuracy and safety of a newly constructed robotic arm which can cover the whole process of THA, we performed a series of robot-assisted total hip replacement on the cadaver.

Methods
Fifteen frozen cadaveric specimens (30 hips) were used for this study. In this investigation, united hip system and Longwell robotic-assisted system were used. The entire lower limb was CT scanned prior to surgery. The 3D model was produced based on CT data; the site of the prosthesis, including acetabular anteversion, inclination angle, and the position of femoral prosthesis, was planned. With the assistance of a robotic arm, the surgeon changed the parameters based on the preoperative plan and the actual condition during surgery, and completed the whole procedure. Following surgery, we measured the acetabular anteversion angle, acetabular inclination angle, femur anteversion angle, combined anteversion angle, stem angulation, and canal fill ratio.

Results
The parameters proved that the acetabular anteversion angle was 16.85 ± 3.00°, the acetabular inclination angle was 40.38 ± 5.37°, femur anteversion angle was 15.90 ± 9.01°, combined anteversion angle was 32.75 ± 9.03°, stem angulation was 1.84 ± 0.99°, and leg length discrepancy was 2.47 ± 1.43 mm. The canal fill ratio (CFR) of femoral prosthesis of osteotomy line in sagittal section is 99.72 ± 1.54% and in coronal section is 62.94 ± 8.91%; below osteotomy line 2.5 cm in sagittal section is 100.00% and in coronal section is 81.48 ± 12.94%; below osteotomy line 7.5 cm in sagittal section is 59.51 ± 12.94% and in coronal section is 89.79 ± 11.13%; femoral shaft isthmus in sagittal section is 56.41 ± 13.80% and in coronal section is 84.95 ± 15.17%.

Conclusion
The accuracy and safety of this novel robotic arm are suitable for preparing both the acetabular and femoral sides, providing evidence for clinical trial.
Associations of blood trace elements with bone mineral density: a population-based study in US adults
Authors: Wu Chunli , Xiao Yao , Jiang Yuexia 
Published: November 2023

Abstract
Background
This study aimed to investigate the association between blood trace elements and bone mineral density (BMD) and to determine the association between blood trace elements and the risk of low BMD/osteoporosis among US adults.

Methods
We performed a cross-sectional study using data from National Health and Nutrition Examination Survey (NHANES, 2011–2016). Multivariable linear regression models were employed to assess the associations of BMD in lumbar spine (LS-BMD), pelvic (PV-BMD) and total femur (TF-BMD) with blood trace elements, including Fe, Zn, Cu, Se, Mn, Cd, Pb, Hg. Additionally, the associations of low BMD/osteoporosis with blood trace elements were also evaluated using multivariable logistic regression.

Results
Higher blood Pb levels were found associated with decreased LS-BMD (p for trend < 0.001), PV-BMD (p for trend = 0.007), and TF-BMD (p for trend = 0.003) in female, while higher blood Se levels were associated with increased PV-BMD in female (p for trend = 0.042); no linear association between BMD and other blood trace element was observed. Also, significant associations were found between Pb levels and the prevalence of low BMD (p for trend = 0.030) and the prevalence of osteoporosis (p for trend = 0.036), while association between other blood trace elements and low BMD/osteoporosis was not observed.

Conclusion
This study provides comprehensive insight into the association between blood trace elements and BMD and supports a detrimental effect of blood Pb levels on bone mass in women. Considering our analysis from a representative US general population, further study is warranted for the extreme levels of blood trace elements on bone metabolism.
The prognostic value of a combined immune score in tumor and immune cells assessed by immunohistochemistry in triple-negative breast cancer
Authors: Choi Ji Eun , Lee Jae Seok , Jin Min-Sun , Nikas Ilias P. , Kim Kwangsoo , Yang Sunah , Park Soo Young , Koh Jiwon , Yang Sohyeon , Im Seock-Ah , Ryu Han Suk 
Published: November 2023

Abstract
Background
This study aimed to develop a novel combined immune score (CIS)-based model assessing prognosis in triple-negative breast cancer (TNBC).

Methods
The expression of eight immune markers (PD-1, PD-L1, PD-L2, IDO, TIM3, OX40, OX40L, and H7-H2) was assessed with immunohistochemistry on the tumor cells (TCs) and immune cells (ICs) of 227 TNBC cases, respectively, and subsequently associated with selected clinicopathological parameters and survival. Data retrieved from The Cancer Genome Atlas (TCGA) were further examined to validate our findings.

Results
All immune markers were often expressed in TCs and ICs, except for PD-1 which was not expressed in TCs. In ICs, the expression of all immune markers was positively correlated between one another, except between PD-L1 and OX40, also TIM3 and OX40. In ICs, PD-1, PD-L1, and OX40L positive expression was associated with a longer progression-free survival (PFS; p = 0.040, p = 0.020, and p = 0.020, respectively). In TCs, OX40 positive expression was associated with a shorter PFS (p = 0.025). Subsequently, the TNBC patients were classified into high and low combined immune score groups (CIS-H and CIS-L), based on the expression levels of a selection of biomarkers in TCs (TCIS-H or TCIS-L) and ICs (ICIS-H or ICIS-L). The TCIS-H group was significantly associated with a longer PFS (p < 0.001). Furthermore, the ICIS-H group was additionally associated with a longer PFS (p < 0.001) and overall survival (OS; p = 0.001), at significant levels. In the multivariate analysis, both TCIS-H and ICIS-H groups were identified as independent predictors of favorable PFS (p = 0.012 and p = 0.001, respectively). ICIS-H was also shown to be an independent predictor of favorable OS (p = 0.003). The analysis of the mRNA expression data from TCGA also validated our findings regarding TNBC.

Conclusion
Our novel TCIS and ICIS exhibited a significant prognostic value in TNBC. Additional research would be needed to strengthen our findings and identify the most efficient prognostic and predictive biomarkers for TNBC patients.
Energy performance of compressed biomethane gas production from co-digestion of Salix and dairy manure: factoring differences between Salix varieties
Authors: Kalita Saurav , Ohlsson Jonas A. , Karlsson Potter Hanna , Nordberg Åke , Sandgren Mats , Hansson Per-Anders 
Published: November 2023

AbstractBiogas from anaerobic digestion is a versatile energy carrier that can be upgraded to compressed biomethane gas (CBG) as a renewable and sustainable alternative to natural gas. Organic residues and energy crops are predicted to be major sources of bioenergy production in the future. Pre-treatment can reduce the recalcitrance of lignocellulosic energy crops such as Salix to anaerobic digestion, making it a potential biogas feedstock. This lignocellulosic material can be co-digested with animal manure, which has the complementary effect of increasing volumetric biogas yield. Salix varieties exhibit variations in yield, composition and biomethane potential values, which can have a significant effect on the overall biogas production system. This study assessed the impact of Salix varietal differences on the overall mass and energy balance of a co-digestion system using steam pre-treated Salix biomass and dairy manure (DaM) to produce CBG as the final product. Six commercial Salix varieties cultivated under unfertilised and fertilised conditions were compared. Energy and mass flows along this total process chain, comprising Salix cultivation, steam pre-treatment, biogas production and biogas upgrading to CBG, were evaluated. Two scenarios were considered: a base scenario without heat recovery and a scenario with heat recovery. The results showed that Salix variety had a significant effect on energy output–input ratio (R), with R values in the base scenario of 1.57–1.88 and in the heat recovery scenario of 2.36–2.94. In both scenarios, unfertilised var. Tordis was the best energy performer, while the fertilised var. Jorr was the worst. Based on this energy performance, Salix could be a feasible feedstock for co-digestion with DaM, although its R value was at the lower end of the range reported previously for energy crops.
Occurrence of some common carbapenemase genes in carbapenem-resistant Klebsiella pneumoniae isolates collected from clinical samples in Tabriz, northwestern Iran
Authors: Jafari-Sales Abolfazl , Al-Khafaji Noor S.K. , Al-Dahmoshi Hussein O.M. , Sadeghi Deylamdeh Zahra , Akrami Sousan , Shariat Afsoon , Judi Hawraa K. , Nasiri Rozita , Bannazadeh Baghi Hossein , Saki Morteza 
Published: November 2023

Abstract
Objectives
This study aimed to evaluate the antibiotic resistance patterns and prevalence of carbapenemase genes in Klebsiella pneumoniae isolates in different clinical samples from Tabriz city, northwestern Iran.

Results
This cross-sectional study was conducted in the Department of Microbiology, Islamic Azad University, Ahar Branch, Iran, in 2020. K. pneumoniae isolates were collected from different clinical samples, including blood, wounds, sputum, and urine. The isolates were identified using a series of standard bacteriological tests. Antibiotic resistance was determined by the disc diffusion method. The presence of blaVIM, blaNDM, blaKPC, blaOXA, and blaIMP genes were screened by polymerase chain reaction (PCR). A total of 100 non-duplicated K. pneumoniae isolates were collected from 57 urine samples, 27 blood samples, 13 wound samples, and 3 sputum samples. Overall, 70.0% of the samples were from inpatients, while 30.0% were from outpatients. The most resistance rate was related to ampicillin (94.0%), while the lowest resistance rate was related to imipenem (18.0%) and meropenem (20.0%). Overall, 25.0% of the isolates were carbapenem-resistant, of which 13.0% were resistant to both imipenem and meropenem. The PCR showed the total prevalence of 23.0% for carbapenemase genes, including 18.0% for blaKPC, 3.0% for blaVIM, 1.0% for blaIMP, and 1.0% for blaOXA gene. The blaNDM gene was not detected in any isolate. The prevalence of carbapenemase-producing K. pneumoniae isolates was relatively lower in northwestern Iran than in other regions of the country. However, special attention should be paid to the proper use of antibiotics, particularly carbapenems, to prevent further spread of antibiotic resistance and its related genes.
Epigenetics insights from perceived facial aging
Authors: Vladimir Klemo , Perišić Marija Majda , Štorga Mario , Mostashari Ali , Khanin Raya 
Published: November 2023

AbstractFacial aging is the most visible manifestation of aging. People desire to look younger than others of the same chronological age. Hence, perceived age is often used as a visible marker of aging, while biological age, often estimated by methylation markers, is used as an objective measure of age. Multiple epigenetics-based clocks have been developed for accurate estimation of general biological age and the age of specific organs, including the skin. However, it is not clear whether the epigenetic biomarkers (CpGs) used in these clocks are drivers of aging processes or consequences of aging. In this proof-of-concept study, we integrate data from GWAS on perceived facial aging and EWAS on CpGs measured in blood. By running EW Mendelian randomization, we identify hundreds of putative CpGs that are potentially causal to perceived facial aging with similar numbers of damaging markers that causally drive or accelerate facial aging and protective methylation markers that causally slow down or protect from aging. We further demonstrate that while candidate causal CpGs have little overlap with known epigenetics-based clocks, they affect genes or proteins with known functions in skin aging, such as skin pigmentation, elastin, and collagen levels. Overall, our results suggest that blood methylation markers reflect facial aging processes, and thus can be used to quantify skin aging and develop anti-aging solutions that target the root causes of aging.
Comprehensive analysis of alternative splicing across multiple transcriptomic cohorts reveals prognostic signatures in prostate cancer
Authors: Mou Zhuofan , Spencer Jack , McGrath John S. , Harries Lorna W. 
Published: November 2023

Abstract
Background
Alternative splicing (AS) plays a crucial role in transcriptomic diversity and is a hallmark of cancer that profoundly influences the development and progression of prostate cancer (PCa), a prevalent and potentially life-limiting cancer among men. Accumulating evidence has highlighted the association between AS dysregulation and the onset and progression of PCa. However, a comprehensive and integrative analysis of AS profiles at the event level, utilising data from multiple high-throughput cohorts and evaluating the prognosis of PCa progression, remains lacking and calls for thorough exploration.

Results
We identified a differentially expressed retained intron event in ZWINT across three distinct cohorts, encompassing an original array-based dataset profiled by us previously and two RNA sequencing (RNA-seq) datasets. Subsequent in-depth analyses of these RNA-seq datasets revealed 141 altered events, of which 21 demonstrated a significant association with patients’ biochemical recurrence-free survival (BCRFS). We formulated an AS event-based prognostic signature, capturing six pivotal events in genes CYP4F12, NFATC4, PIGO, CYP3A5, ALS2CL, and FXYD3. This signature effectively differentiated high-risk patients diagnosed with PCa, who experienced shorter BCRFS, from their low-risk counterparts. Notably, the signature's predictive power surpassed traditional clinicopathological markers in forecasting 5-year BCRFS, demonstrating robust performance in both internal and external validation sets. Lastly, we constructed a novel nomogram that integrates patients’ Gleason scores with pathological tumour stages, demonstrating improved prognostication of BCRFS.

Conclusions
Prediction of clinical progression remains elusive in PCa. This research uncovers novel splicing events associated with BCRFS, augmenting existing prognostic tools, thus potentially refining clinical decision-making.
Selective estrogen receptor modulators and deep venous thrombosis after an emergent operation in senior women
Authors: Kishida Keiko , Furukawa Masanobu , Nakashima Masayuki , Kubota Idumi , Hayashi Yukio 
Published: November 2023

Abstract
Background
Selective estrogen receptor modulators (SERMs), clinically applied to osteoporosis, may have potential risk of deep venous thrombosis (DVT) and discontinuation of SERMs may be required before surgery. However, we cannot discontinue SERMs for a certain duration, when patients undergo an emergent operation.

Case presentation
We reported two aged patients undergoing an emergent orthopedic surgery for lower extremities while taking SERMs for osteoporosis before the operation. DVT was newly developed in one patient and worsened in the other patient after the operation. We found eight aged patients underwent the same operation while taking SERMs for recent 3 years, including the two cases and DVT did not occur in the other six patients. Thus, the incidence of DVT in our patient population was 25%.

Conclusion
We showed that DVT developed or worsened after operation in two patients taking SERMs before operation. Ultrasound examination after operation may be recommended in these population. (149 words).
Dexmedetomidine or magnesium to control agitations in patients undergoing tonsillectomy: randomised controlled study
Authors: Saad Beshoy Gamal Nazeem , Saad Basem Boles Gabriale , Agamy Ashraf EL Said Abd EL Rahman EL , Ammar Mona Ahmed Abd Elmotalb , Khalaf Khaled Moustafa Ali 
Published: November 2023

Abstract
Background
Preoperative time is a very stressful time for most patients undergoing surgery, particularly young patients. The primary goal of an anaesthesiologist is to reduce patients’ anxiety before surgery. To lessen this stress response, many anaesthetic pre-medications are used. Magnesium chloride and dexmedetomidine are two of these pre-medications that work well as sedatives. This study examined dexmedetomidine and magnesium sulphate as a pre-anaesthetic medication for kids. Dexmedetomidine and magnesium will be compared for their efficacy and safety in treating children who experience emerging anxiety after having their tonsils removed in this trial. Forty-five children between the ages of 4 and 12 years who were having elective adenotonsillectomy surgery in this comparative prospective, double-blind, randomised controlled clinical research. Children were split up into three groups: group A was given dexmedetomidine, group B was given magnesium infusion, and group C was given normal saline 0.9% infusion.

Results
Ramsay and Cravero scores revealed that children who got dexmedetomidine infusion were less agitated than those who received magnesium sulphate or normal saline infusion (p value 0.01).

Conclusions
When comparing dexmedetomidine to magnesium sulphate, there are a few advantages to its use. It can be administered as an anaesthetic medication to minors undergoing adenotonsillectomy under general anaesthesia in order to lessen postoperative agitation.
Justice strategy can promote cooperation with the joint of dynamic aspiration in social dilemma
Authors: Li Baifeng , Zhang Xiao , Shi Zhenyu , Wei Wei 
Published: November 2023

Abstract
We investigate the concurrent effect of the justice strategy and dynamic aspirations on cooperation in evolutionary game theory. The justice strategy refers to a game in which players play the role of cooperators in the case of cooperation, the role of punishers in the face of defection, and receive the same payoff as their opponents. Players compare the payoffs with their own dynamic aspirations to decide whether to change their strategy. Through simulations, we demonstrate the effectiveness of our model in promoting cooperation and reducing or completely eliminating defections. A higher initial aspiration has a significant impact on reducing defection. Additionally, we find that diverse evolutionary dynamics arise from various initial settings. Remarkably, in specific situations, even a tiny initial fraction of justicers can rapidly retaliate and eventually dominate the entire system. Reflecting real-life scenarios, the influence of punishment typically lags behind the occurrence of defection, allowing justicers to gradually counteract defection upon its cluster emergence.
Preclinical Evaluation of a Novel Steerable Robotic Neuroendoscope Tool
Authors: Yamamoto Kent K. , Brumfiel Timothy A. , Qi Ronghuai , Chern Joshua J. , Desai Jaydev P. 
Published: November 2023

BACKGROUND AND OBJECTIVES:
To improve the outcomes of minimally invasive, endoscopic, intracranial procedures, steerable robotic tools have been developed but still require thorough evaluation before use in a clinical setting. This paper compares a novel steerable robotic neuroendoscope tool against a standard rigid tool.

METHODS:
Seventeen participants, 8 nonmedical and 9 medical (neurosurgery residents and fellows), were recruited. The evaluation trial consisted of a task that was completed using either a rigid tool or the steerable tool, followed by the completion of a qualitative survey. Target reach time and tool movement volume (TMV) were recorded for each trial and analyzed. The tools were evaluated within a realistic phantom model of the brain.

RESULTS:
Preclinical evaluation of both tools showed that average target reach time for the steerable tool among medical personnel (15.0 seconds) was longer than that of the rigid tool (5.9 seconds). However, the average TMV for the steerable tool (0.178 cm3) was much lower than that of the rigid tool (0.501 cm3) for medical personnel, decreasing the TMV by 64.47%.

CONCLUSION:
The steerable tool required more training and practice in comparison with the standard rigid tool, but it decreased the overall endoscope movement volume, which is a source of parenchymal injury associated with endoscopic procedures.