bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of cognitive stimulation group programs in patients with mild Alzheimer’s disease
Authors: Kwon Daseul , Kim DeokJu 
Published: February 2025

Objectives: This study examined the effects of a cognitive stimulation group program on cognitive functions, depression, activities of daily living (ADL), and quality of life in patients with mild Alzheimer’s disease (AD). Methods: Sixty patients with mild AD were randomized into the experimental or control groups (30 in each). Both groups underwent conventional occupational therapy for 30 minutes, followed by a 50-minute session of a cognitive stimulation group program for the experimental group and a cognitive workbook group program for the control group. Interventions for both groups were carried out for 4 weeks, five times a week, and once a day. Results: After the interventions, both groups showed significant differences in cognitive functions, depression, ADL, and quality of life ( p < 0.01, p < 0.001), with the experimental group demonstrating slightly higher scores in all assessment items. Significant intergroup differences were found in the scores for memory, the shortened Korean version of the Boston Naming Test, the Elderly Seoul Verbal Learning Test, the Korean version of the Trail Making Test Part A (depression), the Korean version of the Instrumental ADL scale, and quality of life ( p < 0.05, p < 0.01, p < 0.001). Conclusion: It has been shown that the cognitive simulation group program can be an effective intervention method to reduce the depression of mild AD patients and improve cognitive function, ADL, and quality of life. In addition, it is significant that various enjoyable activities were organized for each cognitive domain to induce active participation and motivation of the subjects. It is expected that this study can be usefully used as a guideline for the treatment of AD patients in the future.
Investigating the clinical significance of E2F5 expression in circulating extracellular vesicles in prostate carcinoma
Authors: Huda Noushim Akram , Chatterjee Souvik , Sultana Nahid , Sengupta Sanghamitra , Sarkar Debansu 
Published: February 2025

Background: Prostate-specific antigen (PSA) based screening strategy has caused a marked improvement in prostate cancer detection and reduction in associated mortality. However, its specificity and sensitivity is not optimal for differentiating different forms of prostate cancer, resulting in overtreatment of indolent tumors. E2F5, a member of the family of transcription factors plays essential roles during many cellular processes. E2F5 amplification is a major event in PCa. A liquid biopsy is a minimally invasive procedure to investigate the cancer-related molecules in circulating tumor cells (CTCs), cell-free DNA, and extracellular vesicles (EVs). Serum and plasma are attractive sources of EV-based biomarkers as blood sample acquisition is a minimally invasive procedure. Given, the shortcomings of PSA as a serum marker, the suitability of E2F5 expression and chemical properties of EVs can be used for the diagnosis of clinically significant prostate cancer. Objectives: To technically refine the current histopathology-based diagnosis of PCa by adding it to the molecular readouts specific to disease states and biochemical fingerprints of EVs. Materials and methods: The study included 100 TRUS-biopsied tissues, 50 representing 4 Gleason grades and another 50 representing BPH. Expression of E2F5 was studied in all the qualified tissues by Immunohistochemistry (IHC). Blood from patients was collected and EVs were isolated and characterized. Results: E2F5 was highly upregulated through all Gleason grades, the maximum being in Gleason 10(5 + 5) and the minimum in Gleason 7(3 + 4), as compared to BPH. The EVs isolated from blood plasma were within 30–200 nm in size. Conclusion: E2F5, being a transcription factor, is highly overexpressed in malignant biopsy tissues, through all Gleason grades. BPH tissues served as control samples. EVs from blood plasma might serve as a potential liquid biopsy marker for predicting disease progression and better prognosis.
Uncovering alternative diagnoses in patients with clinical syndromes suggestive of multiple sclerosis: A transversal study from the prospective Barcelona CIS cohort
Authors: Vilaseca Andreu , Tintoré Mar , Carbonell-Mirabent Pere , Rodríguez-Barranco Marta , Arévalo Mª Jesús , Ariño Helena , Auger Cristina , Bollo Luca , Carvajal René , Castilló Joaquín , Cobo-Calvo Alvaro , Comabella Manuel , Fernández Victoria , Galan Ingrid , Midaglia Luciana , Mongay-Ochoa Neus , Nos Carlos , Otero-Romero Susana , Pappolla Agustín , Rio Jordi , Rodriguez-Acevedo Breogan , Sastre-Garriga Jaume , Sceppacuercia Sofía , Tagliani Paula , Tur Carmen , Vidal-Jordana Angela , Villacieros-Álvarez Javier , Zabalza Ana , Rovira Àlex , Montalban Xavier , Arrambide Georgina 
Published: February 2025

Background: It is essential to exclude alternative diagnoses to diagnose multiple sclerosis (MS). However, detailed descriptions of alternative diagnoses in patients with suspected MS presenting with clinically isolated syndrome (CIS) are limited. Objectives: To describe alternative diagnoses in patients presenting with CIS suggestive of MS. Methods: We conducted a descriptive analysis of patients from the Barcelona CIS cohort including subjects under 50 years of age with a CIS suggestive of MS but later diagnosed with conditions other than MS. We collected clinical, biological, and radiological data, and described the alternative etiologies identified. Results: Among 1468 patients in the Barcelona CIS cohort, 100 (6.8%) were diagnosed with an alternative condition. The most common neurological syndrome was optic neuritis (43.0%). Four patients (4.0%) had inflammatory-demyelinating lesions in at least two typical MS topographies on baseline magnetic resonance imaging (MRI), and 2 (2.0%) met the 2017 McDonald MS criteria. The most common etiologies were immune-mediated diseases (42.0%), especially MOGAD, followed by functional neurological disorders (15.0%) and vascular disease (10.0%). Conclusion: The range of alternative diagnoses encountered during the MS diagnostic process highlights the need to rule out better explanations than MS. However, current MS diagnostic criteria effectively identify patients without MS in this context.
Improved intensive care lighting and staff wellbeing: A pilot feasibility service evaluation
Authors: Weerakkody Sampath , Teji Jemima Unwin , Barrett Edward , Kousteni Margarita , Flores-Villa Lorna , Jenkins Emma , Montgomery Hugh 
Published: February 2025

Background: The lighting environment in intensive care units (ICUs) is markedly different from natural light, potentially disrupting patients’ circadian rhythms and impacting staff wellbeing. New lighting technologies may mitigate these effects. Methods: A mixed methods service evaluation was conducted in a London ICU using Dyson Lightcycle™ luminaires (DLs) to evaluate staff wellbeing. Wellbeing assessments and user perceptions of the built environment were conducted using validated questionnaires before, during, and after DL deployment. Existing ambient light usage was measured using HOBO devices installed on the ceiling. Additionally, data on DL usage (including spectral data) were collected continuously using Raspberry Pi™ sensors. Results: DL usage was high (>70% per 24 h), primarily as supplementary lighting. Users found DLs easy to control and beneficial for clinical and administrative tasks. Participants assigned a 12.5% higher satisfaction score rated from 0 to 8 of lighting overall during deployment compared to pre-deployment (6.06 ± 0.29 and 5.06 ± 0.60, respectively; p = 0.20). Control variables for the built environment (noise, temperature and air quality) remained unchanged. Staff reported improvements in mood (38%, p < 0.001), fatigue (17.7%, p < 0.001), and sleep quality (21.2%, p = 0.01) during DL use. Discussion: In the first pilot feasibility service evaluation of its kind, the relationship between ICU lighting quality and staff wellbeing was investigated using DLs. We show that it is feasible to equip an ICU with a novel mode of lighting to evaluate both illuminance and user-centred outcomes. The study suggests a positive association between DL use and staff wellbeing, with notable improvements in mood, fatigue and sleep quality. The nature of the emitted light may enhance the space rather than simply illuminate, thus further adding to a feeling of wellbeing. These findings support data from studies which report effects of light brightness and colour on mood. Additionally, there appears to be a signal towards benefit to the user when additional lighting is provided, compared to the current overhead fluorescent luminaires prevalent in most ICUs. In this service evaluation these benefits were demonstrated in ICU staff operating the device. However, it is conceivable that effects such as improved mood and reduced sleep disturbance may have patient benefits too. Conclusion: Local lighting systems like DLs show promise in enhancing ICU staff wellbeing. Their impact on patient outcomes and the potential for broader implementation deserve further investigation in appropriately designed and powered larger-scale trials.
A Glycolysis and gluconeogenesis-related model for breast cancer prognosis
Authors: Yang Penglu , Jiao Xiong 
Published: February 2025

Background Breast cancer is a malignant tumor with high morbidity and mortality, which seriously endangers the health of women around the world. Biomarker-based exploration will be effective for better diagnosis, prediction and targeted therapy. Objective To construct biomarker models related to glycolysis and gluconeogenesis in breast cancer. Methods The gene expression of 932 breast cancer patients in the Cancer Genome Atlas (TCGA) database was analyzed by Gene Set Variation Analysis (GSVA) using glycolysis and gluconeogenesis-related pathways. Differential expression genes were searched for by the T-test. Univariate Cox proportional hazards model (COX) regression, Least Absolute Shrinkage and Selection Operator (LASSO) regression, and Multivariate COX regression were used to find clinically significant genes for prognostic survival. After that, the constructed gene signature was externally validated through the Gene Expression Omnibus (GEO). Finally, a nomogram was constructed to predict the survival of patients. In addition, analyzing the role of biomarkers in pan-cancer. Results A risk scoring model associated with glycolysis and gluconeogenesis was developed and validated. A nomogram was created to predict 2-, 3-, and 5- survival. Conclusions The predictive model accurately predicted the prognosis of breast cancer patients.
Physiological Characteristics of Young (9-12 Years) and Adolescent (≥13 Years) Rhythmic, Acrobatic, and Artistic Female Gymnasts
Authors: Steinberg Nili , Elbaz Liav , Dar Gali , Nemet Dan , Eliakim Alon 
Published: February 2025

Background: Elite gymnasts are exposed to high levels of physical stress, during both childhood and adolescence, with significantly late maturation and high injury prevalence. Here, we compare the physiological characteristics of female gymnasts in 2 age groups: young (9-12 years) and adolescent (≥13 years) in 3 disciplines of competitive gymnastics. Hypothesis: Participants’ physiological characteristics will differ by age group and by gymnastic discipline. Study Design: Cohort study. Level of Evidence: Level 2. Methods: The study included 274 gymnasts, aged 11.8 ± 1.9 years. Data collection included anthropometric measures, Tanner stage, and menarche age; ultrasound assessments were used to assess bone properties, including bone strength, skeletal age, and final-height prediction. Results: Univariate analysis of variance showed age × discipline interactions for body mass index (BMI) percentiles ( F(2, 266) = 4.379; P = 0.01), skeletal age ( F(2, 241) = 3.808; P = 0.02), and final-height prediction ( F(2, 240) = 3.377, P = 0.04). Moreover, in both age groups, artistic gymnasts exhibited significantly higher BMI percentiles than rhythmic gymnasts ( P < 0.05). In the adolescent group, final-height prediction for rhythmic gymnasts was significantly greater than that of artistic gymnasts ( P < 0.05). Finally, in adolescent gymnasts, regression lines showed that skeletal age was lower than chronological age ( P < 0.05). Conclusion: Artistic gymnasts were shorter than rhythmic and acrobatic gymnasts. Despite similar BMI and body fat, maturity patterns, and training-volume history, artistic gymnasts had lower bone-strength than rhythmic and acrobatic gymnasts. Combined with their high-impact and intensive training, this could increase their risk of musculoskeletal injuries. Clinical Relevance: The current study may help athletic trainers and medical teams define “norms” for different age groups and gymnastic disciplines, based on what may be expected during the athletes’ early and late maturation. This knowledge can be used to modify, individualize, and optimize training programs.
Predictors of prognosis in stroke patients with tandem lesions who undergo emergent stenting
Authors: Ramazanoglu Leyla , Kalyoncu Aslan Isil , Onal Yilmaz , Velioglu Murat , Topcuoglu Osman Melih , Gozke Eren 
Published: February 2025

Background The optimal endovascular approach for tandem lesions (extracranial internal carotid artery and intracranial large vessel occlusion) is not clear. Aims: The aim was to evaluate the follow-up results of stroke patients with tandem lesions who underwent emergent stenting of extracranial lesions with antithrombotic therapy combined with intracranial MT Methods Outcomes and predictors of poor prognosis and mortality compared with those of good prognosis at 90 days, 1 year, and 2 years were assessed. A modified Rankin scale (mRS) score was used. Symptomatic intracranial hemorrhage (sICH), National Institutes of Health Stroke Scale (NIHSS) scores at admission and at 24 h, successful recanalization, asymptomatic ICH, embolization, malignant infarction, decompression, in-stent restenosis and extracranial complications were also evaluated. The best age cutoff for predicting mortality was analyzed Results A total of 71 subjects were included. Using patients with a good prognosis as a reference, the independent variables predicting a poor prognosis were a high 24-h NIHSS score and extracranial complications at all timepoints (3-month, 1-year, and 2-year follow-up). The most appropriate age cutoff for predicting 1-year mortality was 67 years [AUC = 0.802 (95% CI = 0.684–0.920); p < .001]. The age cutoff determined for the first year was correlated with the prediction of mortality in the third month and the second year. No significant association was observed between sICH and the groups Conclusion In this study, the 24-h NIHSS score after reperfusion and age were predictors of poor prognosis and mortality in stroke patients with tandem lesions who underwent emergent stenting during thrombectomy.
Digital health technologies and innovation patterns in diabetes ecosystems
Authors: Giger Odile-Florence , Pfitzer Estelle , Mekniran Wasu , Gebhardt Hannes , Fleisch Elgar , Jovanova Mia , Kowatsch Tobias 
Published: February 2025

Background The global rise in type-2 diabetes (T2D) has prompted the development of new digital technologies for diabetes management. However, despite the proliferation of digital health companies for T2D care, scaling their solutions remains a critical challenge. This study investigates the digital transformation of T2D ecosystems and seeks to identify key innovation patterns. We examine: (1) What are emerging organizations in digital diabetes ecosystems? (2) What are the value streams in digital T2D ecosystems? (3) Which innovation patterns are present in digital T2D ecosystems? Methods We conducted a literature review and market analysis to characterize organizations and value streams in T2D ecosystems, pre- and post-digital transformation. We used the e3-value methodology to visualize T2D ecosystems (RQ1 and RQ2) and conducted expert interviews to identify emerging innovation patterns in digital diabetes ecosystems (RQ3). Results Our analyses revealed the emergence of eight organization segments in digital diabetes ecosystems: real-world evidence analytics, healthcare management platforms, clinical decision support, diagnostic and monitoring, digital therapeutics, wellness, online community, and online pharmacy (RQ1). Visualizing the value streams among these organizations highlights the crucial importance of individual health data (RQ2). Furthermore, our analysis revealed four major innovation patterns within the digital diabetes ecosystem: open ecosystem strategies, outcome-based payment models, platformization, and user-centric software (RQ3). Conclusions Our findings illustrate the transition from traditional value chains in T2D care to platform-based and outcome-oriented models. These innovation patterns can inform strategic decisions for companies and healthcare providers, potentially helping anticipate new digital trends in diabetes care and across other chronic disease ecosystems.
Design and evaluation of a unilateral brace for preventing clubfoot relapse: A prospective study
Authors: Zapparoli Fabricio Y , Volpon José B 
Published: February 2025

Introduction The Ponseti technique is highly effective for correcting congenital clubfoot; however, recurrence must be prevented using orthoses. The double abduction brace (D- A) is recommended by Ponseti and is widely used. However, more user-friendly orthoses have been developed because treatment abandonment with the traditional orthosis is frequent. We report the results obtained using a newly designed unilateral orthosis. Methods A unilateral orthosis (UNIC-Brace) was developed and tested in a prospective non-randomized study conducted between 2017 and 2020. The Pirani score was used to monitor the progression of the deformity during plaster correction. The D-A brace (Denis Browne model) served as the control group. The primary outcomes were recurrence rate, treatment adherence, and caregiver satisfaction. Results The study included 58 patients (87 feet) in the test group and 51 patients (75 feet) in the control group, with a minimum follow-up period of 3 years. No significant differences in epidemiological data or follow-up duration were observed between the two groups. The failure feet rates in D-A brace and UNIC-Brace groups were 41.3% and 17.2%, respectively ( p < .001). Non-adherence patients to treatment were 23.5% in the D-A brace and 13.8% in the UNIC-Brace group ( p < .001). Overall, 13.7% of families were not satisfied with the D-A orthosis, whereas 5.2% were not satisfied with the UNIC- Brace ( p < .001). Conclusions The UNIC-Brace yielded better outcomes than the traditional orthosis at a minimum follow-up period of 3 years.
Complications and Clinical Outcomes of Anterior Lumbar Interbody Fusion in Patients With Primary Hypercoagulable Disorders
Authors: Avetisian Henry , Karakash Will , Abu-Zahra Maya , Ezuma Chimere , Athari Mirbahador , Abdou Marc A. , Patel Dil , Wang Jeffrey C. , Hah Raymond J. , Alluri Ram K. 
Published: February 2025

Study Design Retrospective cohort study. Objectives To evaluate the complications of anterior lumbar interbody fusion (ALIF) in patients with primary hypercoagulable disorders and to compare outcomes between anterior and posterior spine fusions in this patient population. Methods The PearlDiver national patient database was queried for patients with primary hypercoagulable disorders who underwent ALIF. Primary endpoints included the prevalence of hypercoagulable disorders in patients who underwent ALIF, incidence of perioperative anticoagulation utilization, as well as the 30-day risks of postoperative complications, readmissions, and revision surgeries. Multivariate regression analysis was conducted to compare outcomes between hypercoagulable patients and non-hypercoagulable patients undergoing ALIF and between hypercoagulable patients undergoing anterior vs posterior lumbar fusion. Results Of the 211,390 patients who underwent ALIF, 3380 (1.60%) had a hypercoagulable disorder, with only 6.72% receiving perioperative anticoagulation. Within 30 days of ALIF, hypercoagulable disorders were identified as independent risk factors for hospital readmissions and both medical and surgical complications. Compared to posterior spine fusions, the anterior approach poses a greater risk for complications in this patient population. Conclusions Patients with hypercoagulable disorders undergoing ALIF are at increased risk for readmissions and postoperative complications compared to those with normal coagulation profiles. While the posterior approach may be a safer option in this patient population, further research is needed to clarify the safest surgical approach for this high-risk population.
Lateral Decubitus 360° Capsular Release for Treatment of Recalcitrant End-Stage Adhesive Capsulitis
Authors: Villarreal-Espinosa Juan Bernardo , Saad Berreta Rodrigo , Danilkowicz Richard , Dave Udit , Carpenter Melissa , Chahla Jorge , Verma Nikhil N. 
Published: February 2025

Background: Recalcitrant adhesive capsulitis, manifesting as persistent pain and continued range of motion deficits after a trial of conservative care, can be managed via lysis of adhesions with associated capsular release. While traditionally performed in the beach-chair position, capsular release performed via a lateral decubitus approach may provide enhanced visualization and the ability to perform a 360° release without iatrogenic injury to the cartilage surfaces. Indications: Arthroscopic capsular release in the setting of adhesive capsulitis is utilized when conservative strategies, such as physical therapy and/or corticosteroid injections, do not provide pain and range of motion improvement. Technique Description: Upon induction of general anesthesia, the patient is placed on the operating table in a lateral decubitus position utilizing the arm positioner of choice. The shoulder’s bony landmarks are identified for proper placement of the arthroscopic portals. A standard posterior portal is first established followed by an anterior portal in the rotator interval. Two-portal diagnostic arthroscopy then ensues. The rotator interval is then released, as is the superior capsule, to the 12-o’clock position using electrocautery. Next, a basket scissor is utilized to release the anterior capsule to the 6-o’clock position followed by posterior-superior and posterior-inferior capsular release while viewing anteriorly. Scope instrumentation is withdrawn and the shoulder manipulated, achieving full range of motion. Results: It is the senior author’s belief that by performing a capsular release via the lateral decubitus approach, better visualization, and access to the anterior, inferior, and posterior glenoid can be achieved for a complete 360° release. Additionally, risk of cerebral hypoperfusion and iatrogenic injury to the cartilage surfaces while instrumenting the joint is diminished. Upon procedure completion, the patient was observed to have gained full forward flexion, external rotation, and internal rotation. Discussion/Conclusion: Although traditionally approached via a beach-chair approach, capsular release of end-stage adhesive capsulitis via a lateral decubitus approach has shown to facilitate a circumferential view while providing ease of access to the inferior, anterior, and posterior glenoid, thereby substantially and immediately increasing patient range of motion. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.