bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness and safety of auricular acupuncture on adjuvant analgesia in patients with total knee arthroplasty: a randomized sham-controlled trial
Authors: Zhang Xingshuo , Chen Hao , Li Jingqiao , Liu Xingang , Wang Xuesong , Xue Pingju , Lin Miao , Li Jidong , She Yanfen 
Published: February 2024

ObjectiveThis study aimed to evaluate the effectiveness and safety of auricular acupuncture (AA) on postoperative analgesia, the degree of postoperative nausea, and the effect of inflammation after total knee arthroplasty (TKA).MethodsThis was a single-center, placebo-controlled, randomized clinical trial. In total, 96 patients were randomly divided into an AA group with an indwelling intradermal needle (n = 48) and a sham auricular acupuncture (SAA) group with a non-penetrating placebo needle (n = 48). Intra-spinal anesthesia was adopted in both groups during surgery, and an epidural analgesic pump was implanted after surgery for 48 h. The primary outcome was the post-surgery visual analog score (VAS) of resting and movement states (at 6, 12 h and 1, 2, 3, 5, and 7 days). The secondary outcomes included additional doses of analgesic injection during the treatment, C-reactive protein (CRP) levels, erythrocyte sedimentation rate (ESR), and white blood cell (WBC) count on the 1st, 3rd, and 7th day after the operation, nausea on the 1st, 2nd, and 3rd day after the operation, the Hospital for Special Surgery Knee Score (HSS) on the 2nd and 12th week after the operation, and adverse events.ResultsThe VAS in the AA group at 6 h, 12 h, 2, 3, and 5 days after surgery were lower than those of the SAA group (p &lt; 0.05). Among the secondary outcomes, the total dose of additional analgesic injection after surgery in the AA group was lower than that in the SAA group (p &lt; 0.05). The serum CRP on the 1st day after operation in the AA group was lower than that in the SAA group (p &lt; 0.05). The degree of nausea on 2nd day after surgery in the AA group was lower than that in the SAA group (p &lt; 0.05). There was no significant difference in other outcomes (p &gt; 0.05).ConclusionIn this study, AA was shown to be an effective and safe complementary and alternative therapy for pain relief after TKA, which was able to reduce the total postoperative dose of additional painkillers, decrease serum CRP 1 day after surgery, and improve the degree of postoperative nausea.Clinical trial registrationwww.chictr.org.cn, ChiCTR2100054403.
A nomogram for predicting the risk of cerebral vasospasm after neurosurgical clipping in patients with aneurysmal subarachnoid hemorrhage
Authors: Zhou Yu , Qian Dongliang , Zhou Zhou , Li Bin , Ma Yong , Chai Erqing 
Published: February 2024

PurposeCerebral vasospasm (CVS) is a common complication that occurs after neurosurgical clipping of intracranial aneurysms in patients with aSAH. This complication can lead to clinical deterioration and a poor prognosis. The aim of this study is to explore the risk factors for CVS in aSAH patients who have undergone neurosurgical clipping, develop a nomogram for CVS, and evaluate its performance.MethodsPatients with aSAH who underwent neurosurgical clipping in the Department of Neurosurgery from January 2018 to January 2023 were selected as the subjects of this research. The clinical data of these patients were retrospectively analyzed. Logistic multivariate regression analysis was employed to identify the independent risk factors of CVS. A clinical prediction model in the form of a nomogram for CVS was developed using the R programming language and subsequently evaluated for its performance and quality.ResultsA total of 156 patients with aSAH were included in the analysis, comprising 109 patients in the training set and 47 patients in the validation set. In the training cohort, 27 patients (24.77%) developed CVS after neurosurgical clipping, while in the validation cohort, 15 patients (31.91%) experienced CVS. Multivariate regression analysis revealed that age, Hcy, WBC, glucose/potassium ratio, aneurysm location, and modified Fisher grade were independent risk factors for CVS. The nomogram exhibited excellent discriminative performance in both the training set (AUC = 0.885) and the validation set (AUC = 0.906).ConclusionCVS was a prevalent complication following neurosurgical clipping in patients with aSAH, with a highly intricate pathogenesis and pathophysiological course. Early prediction of CVS represented a significant challenge in clinical practice. In this study, age, Hcy, WBC, glucose/potassium ratio, aneurysm location, and modified Fisher grade emerged as independent risk factors for CVS. The resulting nomogram demonstrated substantial predictive value.
The effect of the interaction of sleep onset latency and age on ischemic stroke severity via inflammatory chemokines
Authors: Zhou Yuyu , Han Xiaoli , Mu Qingshuang , Xing Lifei , Wu Yan , Li Cunbao , Liu Yanlong , Wang Fan 
Published: February 2024

ObjectiveProlonged sleep onset latency (PSOL) and age have been linked to ischemic stroke (IS) severity and the production of chemokines and inflammation, both of which contribute to IS development. This study aimed to explore the relationship between chemokines, inflammation, and the interplay between sleep onset latency (SOL) and age in influencing stroke severity.MethodsA cohort of 281 participants with mild to moderate IS was enrolled. Stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS), and SOL was recorded. Serum levels of macrophage inflammatory protein-1alpha (MIP-1α), macrophage inflammatory protein-1beta (MIP-1β), monocyte chemoattractant protein-1 (MCP-1), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) were measured.ResultsNIHSS scores of middle-aged participants with PSOL were significantly higher than those with normal sleep onset latency (NSOL) (p = 0.046). This difference was also observed when compared to both the elderly with NSOL (p = 0.022), and PSOL (p &lt; 0.001). Among middle-aged adults with PSOL, MIP-1β exhibited a protective effect on NIHSS scores (β = −0.01, t = −2.11, p = 0.039, R2 = 0.13). MIP-1α demonstrated a protective effect on NIHSS scores in the elderly with NSOL (β = −0.03, t = −2.27, p = 0.027, R2 = 0.12).ConclusionThis study reveals a hitherto undocumented association between PSOL and IS severity, along with the potential protective effects of MIP-1β in mitigating stroke severity, especially among middle-aged patients.
Infratentorial superficial siderosis: report of six cases and review of the literature
Authors: Deng Lixia , Lin Yi , Lin Yu , Huang Weibin 
Published: February 2024

ObjectivesTo investigate the etiology, clinical manifestations, imaging features, and treatment of patients with infratentorial superficial siderosis (iSS), enhance clinicians' comprehension of this rare disease, and conduct oral deferiprone intervention and subsequent monitoring.MethodsSix patients diagnosed with iSS based on magnetic resonance imaging (MRI) and susceptibility weighted imaging (SWI) were enrolled from 2021 to 2023 at the First Affiliated Hospital of Fujian Medical University. Their clinical datas were summarized, and the etiology and imaging characteristics were analyzed. Follow-up was conducted through telephone or outpatient visits.ResultsAmong the 6 patients, there were 3 males and 3 females. The onset age ranged from 35 to 71 years, with an average onset age of 53 years. The clinical symptoms mainly included acoustic disturbances (6/6), gait imbalance (6/6), dysolfactory (6/6), cognitive impairment (2/6), epilepsy (2/6), and pyramidal tract sign (2/6). Evidence of superficial siderosis was observed on MRI across the cortex, brainstem, cerebellum, and spinal cord in all patients. T2-space sequence MRI revealed two instances of dural tear. During the follow-up period ranging from 1 month to 3 years, three patients who received oral deferiprone treatment showed improvement, whereas the remaining three patients who declined deferiprone treatment demonstrated progression.ConclusionThe primary clinical manifestations of iSS include bilateral sensorineural hearing disturbances, progressive cerebellar ataxia, and spinal cord lesions. The key diagnostic criteria involve the presence of linear hypointensity on T2-WI in the surface region of the nervous system. Dural tear caused by various factors is considered to be the most common cause of iSS, and its treatment mainly involves surgical intervention for hemorrhagic primary diseases as well as pharmacotherapy with deferiprone.
Case report: Tall cell carcinoma with reversed polarity of the breast: an additional case and review of the literature
Authors: Lei Zi , Wang Ying-Xia , Wang Zhi-Yuan , Yang Cheng-gang , Pan Guo-Qing 
Published: February 2024

ObjectiveThe aim of this report was to comprehensively investigate the clinicopathological features, histological characteristics, and differential diagnosis of tall cell carcinoma with reversed polarity of the breast (TCCRP) to enhance the understanding of this tumour for precise therapeutic interventions.MethodsThe clinicopathological characteristics and differential diagnosis of a patient with TCCRP were retrospectively analysed, and a systematic literature review was extracted from relevant published studies on PubMed.ResultsAll patients included in the study were female, with a median age of 51 years. Microscopically, the tumour cells exhibited a solid papillary growth pattern with tall columnar morphology and reversed nuclear polarity. Immunohistochemistry revealed that the tumours were triple-negative breast cancer (negative for ER, PR, and HER-2), with a low Ki-67 proliferation index. Different degrees of expression were observed for CK7, Calretinin, and S-100 markers; however, CK5/6 showed high expression levels.ConclusionsTCCRP is an uncommon invasive carcinoma subtype found in the breast. Its histological morphology resembles that of tall cell subtype papillary thyroid carcinoma. Accurate diagnosis requires the integration of histomorphological assessment along with immunohistochemistry and molecular genetics analysis.
Case Report: An unusual case of wide ileoileal intussusception associated with intestinal volvulus in a 8-months-old infant
Authors: Romano Giorgia , Frediani Simone , Aloi Ivan Pietro , Bertocchini Arianna , Pardi Valerio , Accinni Antonella , Inserra Alessandro 
Published: February 2024

IntroductionMidgut volvulus and intussusception are prevalent paediatric abdominal emergencies. To the best of our knowledge, this is the first reported case of a connection between intestinal volvulus and a massive intussusception.Case reportAn 8-month-old male infant was brought to the emergency room with a history of abdominal pain and vomiting for &lt;24 h. On physical examination, the child appeared restless and was found to have a circumferential hard mass of approximately 4 cm in diameter in the epigastric region. Upon admission, laboratory results showed a C-reactive protein level of 0.4 mg/dl, LDH level of 351 U/L, mild leukocytosis with a white blood cell count of 12 × 103 /µl, and 67% neutrophils. A physical exam was significant for abdominal distention, hyperresonance in percussion, and a palpable, painful epigastric mass. The findings of the operation included a dilated and ischemic intestinal loop, approximately 25 cm from the ileocecal valve, twisted upon itself for three turns. After de-rotation, an extensive occluding ileo-ileal invagination with an ischemic intestinal loop was identified, and a length of approximately 55–60 cm of the distal ileum, including the ischemic segment, was resected.DiscussionThis is the first reported case of a connection between intestinal volvulus and a massive intussusception. Currently, only two reported cases describe the connection between volvulus and intussusception, which are insufficient to establish a direct link between the two clinical conditions.
Analysis of depression status and influencing factors in middle-aged and elderly patients with chronic diseases
Authors: Lin Wenjie , Zhang Danling , Wang YiMin , Zhang Li , Yang Jianchuan 
Published: February 2024

ObjectivesTo explore prevalence of depression and its influencing factors in middle-aged and elderly patients with chronic diseases.MethodData were extracted from the 2018 China Health and Retirement Tracking Survey (CHARLS) for 6,704 middle-aged and elderly patients ≥45 years with chronic diseases. The influencing variables were selected based on LASSO-logistic regression model, and a nomogram was further drawn to visualize regression results.ResultsComorbidity between chronic diseases and depression symptoms were detected in 3058 individuals (45.6%). Female, rural, lower education, poor, insomnia, multiple chronic disease, and functional impairment were associated with a higher proportion of depression. Meanwhile, family interaction, intergenerational financial support, social activity intensity, and satisfaction with life can protect against depression.ConclusionDepressive symptoms are common in Chinese older adults with chronic diseases. They need regular assessment and intervention, especially those with multiple diseases, female, rural, alone, impaired, poor sleep, or poor economy. These high-risk elders also need family, medical, and social support and care.
Comparing the impact of the Sport Education model on student motivation in Kuwaiti and American students
Authors: Albaloul Omar , Kulinna Pamela Hodges , van der Mars Hans 
Published: February 2024

BackgroundSport Education (SE) stands as the most researched pedagogical model in physical education. While researchers have consistently underscored its capacity to improve student motivation in physical education, a gap remains concerning its implications in Arab nations. Moreover, no studies have been identified comparing the outcomes of SE between the U.S., where the model originated, and other countries.PurposeThis study was conducted to (1) determine the impact of SE on Kuwaiti students' motivation, (2) determine any differential effects of SE on Kuwaiti and American students' motivation, and (3) explore students' perceptions of SE in both countries.MethodsA replicated mixed methods quasi-experimental pre-test and post-test design was used. Participants were 33 secondary school students (nine girls and 24 boys; ages 11–12) from two classes in southwestern US, and 37 secondary school students (12 girls and 25 boys; ages 10–11) from two classes in Kuwait. Both sets of classes across the two countries were instructed by the same teacher who was trained in teaching SE. Student interest/enjoyment, perceived competence, effort/importance, and pressure/tension were measured using the Intrinsic Motivation Inventory instrument (IMI). Student perceptions of SE were assessed using a group Semi-structured interview. Quantitative data were analyzed using repeated measures and mixed ANOVAs followed by t-tests. Qualitative data were analyzed using a thematic analysis technique.ResultsKuwaiti students' perceived interest/enjoyment, perceived competence, effort/importance, and pressure/tension scores significantly improved in the group that taught using SE only. Comparing the impact of the SE on students' motivation between the two countries showed no significant differences. The interview data reflected further support for the IMI results.ConclusionSE can be effective in increasing Kuwaiti students' motivation in physical education. This motivating effect of SE was observed consistently across both Kuwaiti and American students.
Starting fresh: a mixed method study of follower job satisfaction, trust, and views of their leader’s behavior
Authors: Spector Paul E. , Howard David J. , Eisenberg Eric M. , Couris John D. , Quinn Joann F. 
Published: February 2024

IntroductionThe leadership literature has been dominated by the study of broad styles rather than the identification of specific key behaviors. To address this deficiency, a mixed method approach was utilized to explore how follower behavioral descriptions of their leaders would relate to potential outcomes of trust in that leader and job satisfaction.MethodsData were collected from 273 hospital direct reports of 44 managers. They were asked to first describe the leadership approach of their managers in their own words, and then complete quantitative measures of the two potential outcomes.ResultsThe qualitative responses were coded into nine leadership behavior themes listed here in order from most to least often mentioned: Kindness, Supportive, Open to Input, Allow Autonomy, Engage with Team, Transparency, Fairness, Professionalism, Hold Accountable. All behavior themes related significantly to trust of the leader, with three themes relating significantly to job satisfaction (Transparency, Fairness, and Professionalism).DiscussionThese results provide a more specific view of leader behavior than does the typical style approach.
Anxiety symptoms and coping strategies among high school students in Vietnam after COVID-19 pandemic: a mixed-method evaluation
Authors: Hoa Pham Thi Thu , Trang Do Thi , Lien Nguyen Thi , Vinh Ngo Anh 
Published: February 2024

IntroductionThe objective of the current study was to examine the rate of high school students at risk of anxiety disorder during the COVID-19 pandemic in Vietnam, as well as the coping strategies utilized within this demographic.MethodsAn evaluation was conducted through the utilization of mixed methods, consisting of a combination of a cross-sectional study and in-depth interviews. In this study, a sample of 3,910 students from 13 high schools in Hanoi, Vietnam were selected for participation. The measurement of symptoms of anxiety disorder was conducted through the application of the seven-item General Anxiety Disorder (GAD-7) scale. To comprehend the underlying causes of anxiety and the various coping mechanisms employed, in-depth interviews were conducted.ResultsThe findings indicate a prevalence rate of anxiety disorder symptoms among students at 40.6% The prevalence rates of mild, moderate, and severe anxiety symptoms were found to be 23.9%, 10.9%, and 5.8%, respectively. In-depth interviews uncovered multiple sources of anxiety experienced by high school students, namely their academic performance, social interactions, prejudicial attitudes from their social circle, and familial expectations. Numerous coping strategies were then documented.DiscussionThe current investigation ascertained that there exists a moderate level of anxiety amongst high school students in Hanoi, Vietnam during the COVID-19 outbreak. Furthermore, this study configured potential indicators to identify vulnerable individuals and further suggests the development of targeted interventions.
Association between blood heavy metal exposure levels and risk of metabolic dysfunction associated fatty liver disease in adults: 2015–2020 NHANES large cross-sectional study
Authors: Tang Song , Luo Simin , Wu Zhendong , Su Jiandong 
Published: February 2024

BackgroundThe relationships between heavy metals and fatty liver, especially the threshold values, have not been fully elucidated. The objective of this research was to further investigate the correlation between blood heavy metal exposures and the risk of Metabolic dysfunction Associated Fatty Liver Disease (MAFLD) in adults.MethodsLaboratory data on blood metal exposure levels were obtained from National Health and Nutrition Examination Survey (NHANES) data for the period 2015 to 2020 for a cross-sectional study in adults. Associations between blood levels of common heavy metals and the risk of MAFLD in adults were analyzed using multifactorial logistic regression and ranked for heavy metal importance using a random forest model. Finally, thresholds for important heavy metals were calculated using piecewise linear regression model.ResultsIn a multifactorial logistic regression model, we found that elevated levels of selenium (Se) and manganese (Mn) blood exposure were strongly associated with the risk of MAFLD in adults. The random forest model importance ranking also found that Se and Mn blood exposure levels were in the top two positions of importance for the risk of disease in adults. The restricted cubic spline suggested a non-linear relationship between Se and Mn blood exposure and adult risk of disease. The OR (95% CI) for MAFLD prevalence was 3.936 (2.631–5.887) for every 1 unit increase in Log Mn until serum Mn levels rose to the turning point (Log Mn = 1.10, Mn = 12.61 μg/L). This correlation was not significant (p &gt; 0.05) after serum Mn levels rose to the turning point. A similar phenomenon was observed for serum Se levels, with a turning point of (Log Se = 2.30, Se = 199.55 μg/L).ConclusionBlood heavy metals, especially Se and Mn, are significantly associated with MAFLD in adults. They have a non-linear relationship with a clear threshold.
Generation Pep – study protocol for an intersectoral community-wide physical activity and healthy eating habits initiative for children and young people in Sweden
Authors: Leijon Matti , Algotson Albin , Bernhardsson Susanne , Ekholm David , Ersberg Lydia , Höök Malin J-son , Klüft Carolina , Müssener Ulrika , Garås Elisabeth Skoog , Nilsen Per 
Published: February 2024

BackgroundThere is overwhelming evidence for the preventive effects of regular physical activity and healthy eating habits on the risk for developing a non-communicable disease (NCD). Increasing attention has been paid to community-wide approaches in the battle against NCDs. Communities can create supportive policies, modify physical environments, and foster local stakeholder engagement through intersectoral collaboration to encourage communities to support healthy lifestyles. The Pep initiative is based on intersectoral community-wide collaboration among Sweden’s municipalities. Primary targets are municipality professionals who work with children and young people as well as parents of children &lt;18 years. The goal is to spread knowledge and create commitment to children’s and young people’s health with a special focus on physical activity and healthy eating habits to facilitate and support a healthy lifestyle. The overarching aim of the research project described in this study protocol is to investigate factors that influence the implementation of the Pep initiative in Sweden, to inform tailored implementation strategies addressing the needs and local prerequisites of the different municipalities.MethodsThe project includes a qualitative and a quantitative study and is framed by a theoretical model involving four complementary forms of knowledge, explicitly recognized in the Pep initiative: knowledge about the issue; knowledge about interventions; knowledge about the context; and knowledge about implementation. Study 1 is a focus group study exploring barriers and facilitators for implementing the Pep initiative. The study will be carried out in six municipalities, selected purposively to provide wide variation in municipality characteristics, including population size and geographical location. Data will be analyzed using thematic analysis. Study 2 is a cross-sectional web-based survey investigating the implementability of the Pep initiative in Sweden’s 290 municipalities. Conditions for implementing different areas of the Pep initiative will be examined in terms of the acceptability, appropriateness, and feasibility, three predictors of implementation success. Data will be analyzed using non-parametric statistics.DiscussionThe findings of the two studies will increase understanding of the prerequisites for implementing the Pep initiative in Swedish municipalities, which will provide valuable input into how implementation of the Pep initiative can best be facilitated in the different municipality settings.