bluuebunny/crossref_metadata_2025_split huggingface dataset:
Control in the absence of choice: A qualitative study on decision-making about gastrostomy in people with amyotrophic lateral sclerosis, caregivers, and healthcare professionals
Authors: van Eenennaam Remko M. , Rave Neele , Kruithof Willeke J. , Kruitwagen-van Reenen Esther T. , van den Berg Leonard H. , Visser-Meily Johanna A. , Beelen Anita 
Published: September 2023

Background
Gastrostomy is recommended in amyotrophic lateral sclerosis for long-term nutritional support, however, people with amyotrophic lateral sclerosis and healthcare professionals perceive decision-making as complex.

Method
To explore their perspectives on decision-making regarding gastrostomy, we used semi-structured interviews with people with amyotrophic lateral sclerosis, who had made a decision, and their caregivers; healthcare professionals were interviewed separately. Interviews were transcribed and analyzed thematically.

Results
In 14 cases, 13 people with amyotrophic lateral sclerosis and 12 caregivers were interviewed; and in 10 of these cases, 5 healthcare professionals. Participants described decision-making on gastrostomy as a continuous process of weighing (future) clinical need against their values and beliefs in coming to a decision to accept or reject gastrostomy, or to postpone decision-making, while being supported by loved ones and healthcare professionals. Participants described gastrostomy as inevitable, but retained agency through control over the timing of decision-making. They said physical necessity, experiences of loss and identity, and expectations about gastrostomy placement were important factors in decision-making. Decision-making was described as a family affair, with caregivers supporting patient choice. healthcare professionals supported people with amyotrophic lateral sclerosis during the decision-making process and respected their autonomy and values. People with amyotrophic lateral sclerosis stressed the importance of adequate information on the procedure and the benefits.

Conclusion
People with amyotrophic lateral sclerosis feel in control of decision-making on gastrostomy if they are able to make their own choice at their own pace, supported by loved ones and healthcare professionals. Person-centered decision-making on gastrostomy requires early information exchange and repeated discussions with people with amyotrophic lateral sclerosis and their caregivers, incorporating their values and respecting patient choice.
Identification of wheelchair seating criteria in adults with neuromuscular diseases: A Delphi study
Authors: Dupitier Elise , Voisin Manon , Stalens Caroline , Laforêt Pascal , Pouplin Samuel 
Published: September 2023

Background
Adults with neuromuscular diseases like spinal muscular atrophy or Duchenne muscular dystrophy require full-time use of a wheelchair (WC) and perform all activities of daily living in a sitting position. Optimal configuration of the WC and seating system is essential to maintain the health and quality of life of users. However, few recommendations for configuration exist. The aim of this study was to identify and select 10 WC seating criteria that ensure an optimal sitting posture for health and quality of life.

Methods
A four round Delphi method was used to collect the opinions of WC users and health professionals (HP), separately. First, the HP were asked if they believed that different criteria would apply to each disease. Then the HP and SMA II and DMD WC user experts responded to electronic surveys in 4 rounds.

Results
Overall, 74 experts took part: 31 HP, 21 WC users with SMA II and 22 WC users with DMD. In total, 52% of HP believed that different criteria would apply to each disease. Ten criteria were identified by the HP for SMA II and 10 for DMD. Of the 40 criteria selected, 30 (75%) were common to each panel. Six topics were similar across panels: comfort, access to the joystick, prevention of pain, stability, pressure management and power seat functions. However, power seat functions did not reach consensus between HP and WC users (30–33% of agreement for HP and 93–100% for the WC user panels, p < 0.001).

Conclusion
Adults with SMA II and DMD had similar WC seating needs. Therefore, the same recommendations can be applied to these groups. Further research is necessary to understand the impact of cost on the prescription of power seat functions by health professionals.
Study protocol: A systematic review and meta-analysis regarding the influence of coagulopathy and immune activation on new onset atrial fibrillation in patients with sepsis
Authors: Downes Michael , Welters Ingeborg D. , Johnston Brian W. 
Published: September 2023

Background
New onset atrial fibrillation (NOAF) is the most common arrhythmia affecting critically ill patients with sepsis. NOAF is associated with increased intensive care unit mortality, increased hospital mortality, development of heart failure and increased risk of permanent atrial fibrillation and thromboembolic events such as stroke. The pathophysiology of NOAF has been outlined, however, a knowledge gap exists regarding the association between abnormalities in coagulation and immune biomarkers, and the risk of developing NOAF in patients with sepsis.

Methods and analysis
This protocol describes a systematic review and meta-analysis following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guideline (PRISMA-P) and the Meta-Analyses and Systematic Reviews of Observational Studies guideline (MOOSE). We will conduct the literature search in Medline, Scopus and Cochrane Library. We will include studies that report data in adult patients (>18 years) with sepsis that develop NOAF. We will extract data from studies that report at least one coagulation or immune biomarker. Risk of bias will be assessed by using the Newcastle Ottawa Scale (NOS) and Risk of Bias 2 tool (RoB2) for non-randomized and randomized trials respectively. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach will be utilized in assessing the quality of evidence.

Discussion
This systematic review and meta-analysis will explore the scientific literature regarding the association between coagulation and immune activation in critically ill patients with sepsis, who develop NOAF. The findings will add to the existing knowledge base of NOAF in sepsis, highlight areas of uncertainty and identify future areas of interest to guide and improve management strategies for NOAF.

Trial registration
Registration details. CRD42022385225 (PROSPERO).
The relationship between age and sex partner counts during the mpox outbreak in the UK, 2022
Authors: Brainard Julii , Smith Louise E. , Potts Henry W. W. , Rubin G. James 
Published: September 2023

Background
Understanding the dynamics of an infectious disease outbreak linked to sexual activity requires valid expectations of likely counts of unique sex partners during the infectious period. Typically, age is the key demographic trait linked to expected partner count, with many transmission models removing adults from the sexually active pool abruptly at a pre-specified age threshold. Modelling the rate of decline in partner counts with age would benefit from a better description of empirical evidence.

Methods
During the 2022 mpox epidemic in the UK, we asked individuals about their partner counts in the preceding three weeks, which is about the same as usual infectious period for persons with active mpox. We used negative binomial regression (all responses) and Weibull regression (non-zero responses) to analyse the relationship between age and partner counts, adjusted for other demographic data (such as education level and occupation), sub-dividing by three types of respondent: men who have sex with men (MSM), men who have sex with women, and women who have sex with men.

Results
Most respondents had zero or one recent partner, all distributions were skewed. There was a relatively linear declining relationship between age and partner counts for heterosexual partnership groups, but a peak in partner counts and concurrency for MSMs in middle age years (age 35–54), especially for MSM who seemed to be in a highly sexually active subgroup.

Conclusion
Useful data were collected that can be used to describe sex partner counts during the British mpox epidemic and that show distinctive partner count relationships with age, dependent on partnership type.
Effects of aerobic exercise on body self-esteem among Chinese college students: A meta-analysis
Authors: Shu Junwen , Lu Tianci , Tao Baole , Chen Hanwen , Sui Haoran , Wang Lingzhi , Zhang Ye , Yan Jun 
Published: September 2023

Objective
To investigate the effect of aerobic exercise on five dimensions of physical self-worth, exercise capacity, physical condition, physical attractiveness, and physical quality in body self-esteem of Chinese college students.

Methods
By searching PubMed, Web of Science, Cochrane Library, CNIK database, VIP database, WANFANG database platform, we searched for the subject terms or keywords "body self-esteem", "Chinese college students", "Systematic evaluation", "Aerobic exercise", "Exercise intervention", “Meta-Analysis”. The search method was a combination of subject terms and keywords and title, and the search period was from database creation to The search was conducted from database creation to May 2022. A total of 3221 articles were searched, and 9 articles were included in the study through repeated screening. Risk of bias was assessed with Cochrane and the quality of studies in the literature was assessed using Grade pro software. The outcome indicators of the included literature were analysed using review manager 5.4 software and StataMP 17.0 software.

Results
Nine papers including 1613 subjects were included. results of Meta-analysis showed that aerobic exercise was effective in improving physical self-worth (WMD = 1.46, 95% CI: 1.08–1.83, p<0.001), improving exercise capacity (WMD = 1.62, 95% CI: 1.23–2.01, p<0.001), improving physical attractiveness (WMD = 1.32, 95% CI: 0.98–1.67, p<0.001), improved physical condition (WMD = 1.32, 95% CI: 0.98–1.67, P<0.001), improved physical fitness (WMD = 1.51, 95% CI: 1.07–1.95, P<0.001). The differences were all statistically significant.

Conclusion
Aerobic exercise can effectively improve the body self-esteem of Chinese college students. In exercise, male students pursue is athletic ability and physical fitness, and female students pursue is the sense of physical self-worth and physical attractiveness. Aerobic exercise has a greater increase in body self-esteem for obese or Obese college students. Aerobics and physical dance are the most cost-effective for improving body self-esteem. Medium-intensity relative to low-intensity exercise was effective for body self-esteem intervention. A single exercise session of 90 minutes was more effective than a single 30-minute session in boosting body self-esteem, and the overall intervention duration of 16 weeks was more effective than 10 weeks.
Identification of the needs of children with neurodisability and their families at different stages of development: A qualitative study protocol
Authors: Roldán-Pérez Patricia , San Miguel-Pagola Marta , Doménech-García Víctor , Bellosta-López Pablo , Buesa-Estéllez Almudena 
Published: September 2023

BackgroundWithin the field of childhood neurodisability, the tendency in the study of needs has been to categorize them based on ability (motor, verbal, cognitive). However, current perspectives such as F-words, family-centered practices, or the principles of family empowerment, lead the researcher to ask: What are these needs according to the stage of development?Methods and analysisA descriptive qualitative study will be carried out. Several methods will be followed to ensure the reliability and validity of the results, and the Standards for Reporting Qualitative Research and the Consolidated criteria for reporting qualitative research checklists will also be used to guide the project. Data collection is sought from three main sources: Focus groups (detection of needs), a survey to collect sociodemographic and clinical data necessary to obtain an overview of the context of the participants, and a survey to find out the level of satisfaction with this initiative.DiscussionThe results expected to be obtained after this study will respond to the main needs of families with childhood neurodisability, based on age groups and covering the whole territory of the Spanish population. Thanks to these detected needs, it will be possible to design future lines of work to improve the design of family-centered practices and increase the empowerment of families. The intention is to detect needs by stage of development, which can be categorized within the F-words framework, showing families and professionals a clear picture of the needs of this population.
A natural experiment study: Low-profile double plating versus single plating techniques in midshaft clavicle fractures—Study protocol
Authors: Lecoultre Yannic , van de Wall Bryan J. M. , Diwersi Nadine , Pfarr Steffen W. , Galliker Beat , Babst Reto , Link Björn-Christian , Beeres Frank J. P. 
Published: September 2023

Background
Single plate osteosynthesis is commonly employed when performing surgical stabilization of midshaft clavicle fractures. In recent years, a smaller structural low-profile double plating technique has been described as a possible solution for the high removal rates associated with single plating. A previous meta-analysis has demonstrated that low-profile double plating attains the same healing rates as single plating without a higher chance of fracture-related infections. This meta-analysis, however, was based on relatively small studies. Therefore, a multicentre prospective natural experiment was designed using natural variation in treatment regimens and geographical location of the trauma as treatment allocation mechanism to compare both treatments on a larger scale. This manuscript describes its protocol.

Material & methods
Patients (≥16 years) with primary midshaft clavicle fractures that are eligible for operative treatment will be included. Treatment allocation will be determined by the geographical location of the accident and local hospital providing treatment. In two centres, single plating is the treatment of choice for these patients. In two others, low-profile double plating has become the standard treatment. For the low-profile double plating group, one superiorly positioned VariAx 2.0mm and one anterior VariAx 2.4mm or 2.7mm plate will be used. For the single plating group, the standard locally available implant will be used. A total of 336 patients will be included. The primary outcome of interest is re-intervention. Secondary outcomes include complications, operative time, length of incision, functional scores (DASH, EQ-5D-DL, VAS-Pain/Satisfaction) and cost-effectiveness.

Discussion
This study will determine whether low-profile double plating has significant clinical and cost-effective benefits over single plating techniques in midshaft clavicle fractures. The study will also give insight in the performance of a natural experiment study design for orthopedic trauma research.

Trial registration
This study has been registered on ClincialTrials.gov, identifier NCT 05579873.
Engagement in types of activities and frequency of alcohol use in a national sample of United States adolescents
Authors: Sutton Cassandra A. , Grandfield Elizabeth , Yi Richard , Fazzino Tera L. 
Published: September 2023

Objective
Adolescents with fewer sources of environmental reinforcement may be at risk for alcohol use. Behavioral economic theories posit that engagement in some activities may facilitate alcohol use, whereas other activities may be incompatible with use and reduce likelihood of alcohol use. It is unclear which types of activities may facilitate or may be incompatible with alcohol use in adolescence. Using a national sample of adolescents, the current study examined differences in engagement with types of activities that may be incompatible with alcohol use, compared among adolescents who endorsed alcohol use, and adolescents who did not.

Method
Data from the 2019 Monitoring the Future (MTF) study (N = 4626) were analyzed. Potentially incompatible and facilitating activities, and alcohol-involved activities were identified from pre-existing survey measures. Confirmatory factor analysis, measurement invariance, and structural equation modeling were used to examine patterns in activity engagement among those who endorsed alcohol use and those who did not.

Results
Participants who did not endorse alcohol use reported higher engagement in activities that may be incompatible with alcohol use, including enjoyment from school and going to the mall (p < .001). Participants who endorsed alcohol use reported higher engagement in activities that may facilitate alcohol use (p < .001), such as spending time with friends and attending parties. Facilitating activities (β = 0.15, p < .001) and alcohol-involved activities (β = 0.70, p < .001) were positively associated with alcohol use frequency. Observed effect sizes were small in magnitude for all findings.

Conclusions
The findings support the premise of behavioral economic theory, suggesting some activities may serve as protective factors against alcohol use frequency while other activities may facilitate alcohol use among adolescents. National surveys may consider adding specific measure of activity engagement to identify activities that may be incompatible with alcohol use among adolescents.
Trends in all causes and cause specific mortality attributable to ambient particulate matter pollution in China from 1990 to 2019: A secondary data analysis study
Authors: Liu Yingying , Yan Mengmeng 
Published: September 2023

BackgroundParticularly fine particulate matter (PM2.5) has become a significant public health concern in China due to its harmful effects on human health. This study aimed to examine the trends in all causes and cause specific morality burden attributable to PM2.5 pollution in China.MethodsWe extracted data on all causes and cause specific mortality data attributable to PM2.5 exposure for the period 1990–2019 in China from the Global Burden of Disease 2019. The average annual percent change (AAPC) in age-standardized mortality rates (ASMR) and years of life lost (YLLs) due to PM2.5 exposure were calculated using the Joinpoint Regression Program. Using Pearson’s correlation, we estimated association between burden trends, urban green space area, and higher education proportions.ResultsDuring the period 1990–1999, there were increases in mortality rates for All causes (1.6%, 95% CI: 1.5% to 1.8%), Diabetes mellitus (5.2%, 95% CI: 4.9% to 5.5%), Encephalitis (3.1%, 95% CI: 2.6% to 3.5%), Ischemic heart disease (3.3%, 95% CI: 3% to 3.6%), and Tracheal, bronchus and lung cancer (5%, 95% CI: 4.7% to 5.2%). In the period 2010–2019, Diabetes mellitus still showed an increase in mortality rates, but at a lower rate with an AAPC of 1.2% (95% CI: 1% to 1.4%). Tracheal bronchus and lung cancer showed a smaller increase in this period, with an AAPC of 0.5% (95% CI: 0.3% to 0.6%). In terms of YLLs, the trends appear to be similar.ConclusionOur findings highlight increasing trends in disease burden attributable to PM2.5 in China, particularly for diabetes mellitus, tracheal, bronchus, and lung cancer.
Ground state solution for fractional problem with critical combined nonlinearities
Authors: Xu Er-Wei , Sun Hong-Rui 
Published: September 2023

This paper is concerned with the following nonlocal problem with combined critical nonlinearities

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Transformation in substation automation: Cyber-Resilient Digital Substations (CyReDS) in power grids
Authors: Rösch Dennis , Bauer Thomas , Kummerow André , Kühne Marcel , Nicolai Steffen , Bretschneider Peter 
Published: September 2023

AbstractThe digitalization of substations leads to a high degree of automation, which is referred to as Digital Substations with the use of the IEC 61850. An increase in cybersecurity is necessary, and technically enabled by detection and incident response systems – security-by-design is currently often secondary. The next transformation step of substations is introduced and outlined in this paper as a cyber-resilient digital substation. Based on a state-of-the-art description, this paper presents a definition of cyber resilience for digital substations as a basis for the introduced cyber resilience monitor. The monitor acts as a central instance for recording, assessing and responding to security threats and incidents. Furthermore, the requirements for the system structure of the cyber-resilient digital substation are shown and underpinned with current research approaches.
A new hybrid risk assessment process for cyber security design of smart grids using fuzzy analytic hierarchy processes
Authors: Canbolat Sine , Elbez Ghada , Hagenmeyer Veit 
Published: September 2023

Abstract
IT vulnerabilities, cyber threats, and resulting risks significantly impact the stability of current and future power grids. The results of a Risk Assessment process contribute to a better understanding of the causes and nature of the associated risks. The risks assessed by experts are available in both numerical and linguistic representations – this makes it beneficial to include a combination of linguistic and numerical analyses. In this paper, we propose a new Hybrid Risk Assessment method based on fuzzy logic, leading to more precise results. The presented approach specifies the variables and membership functions of fuzzy logic with reference to Smart Grids. For this propose, a case study with five risk events in a small-scale Smart Grid is carried out as an example. The results can then support decision-makers in ensuring grid stability.
Loss of ACOX1 in clear cell renal cell carcinoma and its correlation with clinical features
Authors: Mo Yingxi , Zhao Jun , Zhao Ran , Huang Yiying , Liang Ziyuan , Zhou Xiaoying , Chu Jiemei , Pan Xinli , Duan Siyu , Chen Shiman , Mo Liufang , Huang Bizhou , Huang Zhaozhang , Wei Jiale , Zheng Qian , Luo Wenqi 
Published: September 2023

Abstract
Clear cell renal cell carcinoma (ccRCC) is a major pathological type of kidney cancer with a poor prognosis due to a lack of biomarkers for early diagnosis and prognosis prediction of ccRCC. In this study, we investigated the aberrant expression of Acyl-coenzyme A oxidase 1 (ACOX1) in ccRCC and evaluated its potential in diagnosis and prognosis. ACOX1 is the first rate-limiting enzyme in the peroxidation β-oxidation pathway and is involved in the regulation of fatty acid oxidative catabolism. The mRNA and protein levels of ACOX1 were significantly downregulated in ccRCC, and its downregulation was closely associated with the tumor-node-metastasis stage of patients. The ROC curves showed that ACOX1 possesses a high diagnostic value for ccRCC. The OS analysis suggested that lower expression of ACOX1 was closely related to the worse outcome of patients. In addition, gene set enrichment analysis suggested that expression of ACOX1 was positively correlated with CDH1, CDH2, CDKL2, and EPCAM, while negatively correlated with MMP9 and VIM, which strongly indicated that ACOX1 may inhibit the invasion and migration of ccRCC by reversing epithelial-mesenchymal transition. Furthermore, we screened out that miR-16-5p is upregulated at the mRNA transcript level in ccRCC and negatively correlated with ACOX1. In conclusion, our results showed that ACOX1 is abnormally low expressed in ccRCC, suggesting that it could serve as a diagnostic and prognostic biomarker for ccRCC. Overexpression of miR-16-5p may be responsible for the inactivation of ACOX1.