bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of aerobic exercise training on the fat fraction of the liver in persons with chronic hepatitis B and hepatic steatosis: Trial protocol for a randomized controlled intervention trial— The FitLiver study
Authors: Jespersen Sofie , Plomgaard Peter , Madsbad Sten , Hansen Adam Espe , Bandholm Thomas , Pedersen Bente Klarlund , Ritz Christian , Weis Nina , Krogh-Madsen Rikke 
Published: June 2023

AbstractBackgroundThe global prevalence of chronic hepatitis B is more than 300 million people, and in Denmark, 17,000 people are estimated to have chronic hepatitis B. Untreated, chronic hepatitis B can lead to the development of liver cirrhosis and liver cancer. There is no curable therapy. In persons with obesity and chronic hepatitis B infection, the development of hepatic steatosis imposes a double burden on the liver, leading to an increased risk of cirrhosis and liver cancer. In patients without chronic hepatitis B, exercise interventions have shown beneficial effects on hepatic steatosis through improvements in fat fraction of the liver, insulin resistance, fatty acid metabolism, and glucose metabolism, as well as activation of liver-induced regulatory protein secretion (hepatokines) after the exercise intervention.ObjectiveTo investigate in persons with chronic hepatitis B and hepatic steatosis:Primary: Whether exercise will decrease the fat fraction of the liver.Secondary: If exercise will affect hepatokine secretion and if it will improve lipid- and glucose metabolism, liver status, markers of inflammation, body composition, and blood pressure.MethodsA randomized, controlled, clinical intervention trial consisting of 12 weeks of aerobic exercise training or no intervention. Thirty persons with chronic hepatitis B and hepatic steatosis will be randomized 1:1. Before and after the intervention, participants will undergo an MRI scan of the liver, blood sampling, oral glucose tolerance test, fibroscan, VO2maxtest, DXA scan, blood pressure measurements, and optional liver biopsy. Lastly, a hormone infusion test with somatostatin and glucagon to increase the glucagon/insulin ratio for stimulating secretion of circulating hepatokines will be performed. The training program includes three weekly training sessions of 40 min/session over 12 weeks.DiscussionThis trial, investigating high-intensity interval training in persons with chronic hepatitis B and hepatic steatosis, is the first exercise intervention trial performed on this group of patients. If exercise reduces hepatic steatosis and induces other beneficial effects of clinical markers in this group of patients, there might be an indication to recommend exercise as part of treatment. Furthermore, the investigation of the effect of exercise on hepatokine secretion will provide more knowledge on the effects of exercise on the liver.Trial registrationDanish Capital Regions committee on health research ethics reference: H-21034236 (version 1.4 date: 19–07-2022) and ClinicalTrials.gov: NCT05265026.
Comparison of the pathological response to 2 or 4 cycles of neoadjuvant CAPOX in II/III rectal cancer patients with low/intermediate risks: study protocol for a prospective, non-inferior, randomized control trial (COPEC trial)
Authors: Shen Yu , Shi Wanyue , Huang Cui , Gong Xiaoling , Wei Mingtian , Meng Wenjian , Deng Xiangbing , Wang Ziqiang ,   COPEC groups
Published: June 2023

Abstract
Background
For patients with low- and intermediate-risk stage II/III rectal cancer, current studies have reached a consensus that preoperative radiotherapy may be dispensed with, and neoadjuvant chemotherapy (NCT) alone might achieve an accepted local control. Our previous phase II study has evidenced that the morphological response of NCT could be better judged at a relatively early stage. Low- and intermediate-risk stage II/III rectal cancer patients could achieve a high rate of tumor shrinkage and downgrade after only 4 cycles of NCT and obvious tumor morphological changes could be observed after 2 cycles of NCT. However, there is still a lack of more detailed stratification and evidence for pathological criteria. The aim of the present study (comparison of the pathological response to 2 or 4 cycles of neoadjuvant CAPOX in II/III rectal cancer patients with low/intermediate risks, COPEC trial) is to determine the pathological tumor regression grade (pTRG) rate of 2 or 4 cycles of NCT in low- and intermediate-risk stage II/III rectal cancer and verify the feasibility of early identification of chemotherapy-insensitive population.

Methods/design
This is a multicenter, prospective, non-inferior, randomized controlled trial (RCT) initiated by West China Hospital of Sichuan University and designed to be conducted in fourteen hospitals around China. Eligible patients will be centrally randomized into 2 or 4 cycles of CAPOX in a 1:1 ratio using the central automated randomization system offered by the O-trial online system (https://plus.o-trial.com/) and accept total mesorectal excision after 2 or 4 cycles of CAPOX (oxaliplatin 130 mg/m2, once daily on day 1, every 21 days and capecitabine 1000 mg/m2, twice daily on days 1 to 14, every 21 days). The primary endpoint is the proportion of patients with pathological no-tumor regression (pTRG 3), which is determined postoperatively by each sub-center and verified by the primary center.

Discussion
COPEC trial is designed to verify that the preoperative CAPOX chemotherapy for low- and intermediate-risk stage II/III rectal cancer could achieve a good response judgment after 2 cycles and obtain the tumor pathological response rate after 2 cycles of CAPOX. We hope the COPEC trial could help in establishing a consensus standard of low- and intermediate-risk rectal cancer and the early identification of stage II/III rectal patients with low- and intermediate-risk who are poorly responding to NCT.

Trial registration
Clinicaltrial.gov NCT04922853. Registered on June 4, 2021.
Troponin in acute chest pain to risk stratify and guide effective use of computed tomography coronary angiography (TARGET-CTCA): a randomised controlled trial
Authors: Lee Kuan Ken , Lowe David , O’Brien Rachel , Wereski Ryan , Bularga Anda , Taggart Caelan , Lowry Matthew T. H. , Ferry Amy V. , Williams Michelle C. , Roditi Giles , Byrne John , Tuck Chris , Cranley Denise , Thokala Praveen , Goodacre Steve , Keerie Catriona , Norrie John , Newby David E. , Gray Alasdair J. , Mills Nicholas L. 
Published: June 2023

Abstract
Background
The majority of patients with suspected acute coronary syndrome presenting to the emergency department will be discharged once myocardial infarction has been ruled out, although a proportion will have unrecognised coronary artery disease. In this setting, high-sensitivity cardiac troponin identifies those at increased risk of future cardiac events. In patients with intermediate cardiac troponin concentrations in whom myocardial infarction has been ruled out, this trial aims to investigate whether outpatient computed tomography coronary angiography (CTCA) reduces subsequent myocardial infarction or cardiac death.

Methods
TARGET-CTCA is a multicentre prospective randomised open label with blinded endpoint parallel group event driven trial. After myocardial infarction and clear alternative diagnoses have been ruled out, participants with intermediate cardiac troponin concentrations (5 ng/L to 99th centile upper reference limit) will be randomised 1:1 to outpatient CTCA plus standard of care or standard of care alone. The primary endpoint is myocardial infarction or cardiac death. Secondary endpoints include clinical, patient-centred, process and cost-effectiveness. Recruitment of 2270 patients will give 90% power with a two-sided P value of 0.05 to detect a 40% relative risk reduction in the primary endpoint. Follow-up will continue until 97 primary outcome events have been accrued in the standard care arm with an estimated median follow-up of 36 months.

Discussion
This randomised controlled trial will determine whether high-sensitivity cardiac troponin-guided CTCA can improve outcomes and reduce subsequent major adverse cardiac events in patients presenting to the emergency department who do not have myocardial infarction.

Trial registration
ClinicalTrials.gov Identifier: NCT03952351. Registered on May 16, 2019.
Application of BI-EHEC and BI-EPEC bacteriophages to control enterohemorrhagic and enteropathogenic escherichia coli on various food surfaces
Authors: L.A Leny Agustina , Waturangi Diana Elizabeth 
Published: June 2023

Abstract
Objectives
The purposes of this study were to determine the Efficiency of Plating (EOP) value of Bacteriophage BI-EHEC and BI-EPEC and to evaluate the application of these bacteriophages in reducing population of EHEC and EPEC on various food samples.

Results
In this study, we used bacteriophage BI-EHEC and BI-EPEC, which were isolated from previous study. Both phages were tested with other multiple pathotypes of intestinal pathogenic E. coli to determine the efficiency of plating. BI-EHEC had high efficiency toward ETEC with an EOP value of 2.95 but low efficiency toward EHEC with an EOP value of 0.10, while BI-EPEC had high efficiency toward EHEC and ETEC with EOP values of 1.10 and 1.21, respectively. As biocontrol agents, both bacteriophages able to reduce CFU of EHEC and EPEC in several food samples using 1 and 6-days incubation times at 4 $$\text{?}$$. BI-EHEC reduced the number of EHEC with an overall percentage of bacterial reduction value above 0.13 log10, while BI-EPEC reduced number of EPEC with reduction value above 0.33 log10.
Body mass index and two-year change of in vivo Alzheimer’s disease pathologies in cognitively normal older adults
Authors: Lee Seunghoon , Byun Min Soo , Yi Dahyun , Kim Min Jung , Jung Joon Hyung , Kong Nayeong , Jung Gijung , Ahn Hyejin , Lee Jun-Young , Kang Koung Mi , Sohn Chul-Ho , Lee Yun-Sang , Kim Yu Kyeong , Lee Dong Young ,   for the KBASE Research Group
Published: June 2023

Abstract
Background
Low body mass index (BMI) or underweight status in late life is associated with an increased risk of dementia or Alzheimer’s disease (AD). However, the relationship between late-life BMI and prospective longitudinal changes of in-vivo AD pathology has not been investigated.

Methods
This prospective longitudinal study was conducted as part of the Korean Brain Aging Study for Early Diagnosis and Prediction of Alzheimer’s Disease (KBASE). A total of 194 cognitive normal older adults were included in the analysis. BMI at baseline was measured, and two-year changes in brain Aβ and tau deposition on PET imaging were used as the main outcomes. Linear mixed-effects (LME) models were used to examine the relationships between late-life BMI and longitudinal change in AD neuropathological biomarkers.

Results
A lower BMI at baseline was significantly associated with a greater increase in tau deposition in AD-signature region over 2 years (β, -0.018; 95% CI, -0.028 to -0.004; p = .008), In contrast, BMI was not related to two-year changes in global Aβ deposition (β, 0.0002; 95% CI, -0.003 to 0.002, p = .671). An additional exploratory analysis for each sex showed lower baseline BMI was associated with greater increases in tau deposition in males (β, -0.027; 95% CI, -0.046 to -0.009; p = 0.007), but not in females.

Discussion
The findings suggest that lower BMI in late-life may predict or contribute to the progression of tau pathology over the subsequent years in cognitively unimpaired older adults.
Review of cancer therapies for the perioperative physician
Authors: Dabo-Trubelja Anahita , Gottumukkala Vijaya 
Published: June 2023

AbstractAdvances in cancer treatments over the past decades combining chemotherapy with novel technologies in immunotherapies, radiation therapies, and interventional radiology have prolonged life expectancy. Patients have more options for treatments of their primary or metastatic diseases. Increased procedural techniques amid an aging population with multiple comorbidities present risks and challenges in the perioperative period.Chemotherapy remains the mainstay of cancer treatment, can be given intraoperatively, and is combined with other treatment modalities. Immunotherapy is particular to cancer cells while being less toxic to healthy cells. Cancer vaccines stimulate the immune system to stop disease progression. Oncolytic viruses enhance the immune system’s cytotoxic effect and show promise to halt metastatic disease progression if present in the perioperative period. Novel techniques in radiation therapy combined with traditional treatments show enhanced survival. This review focuses on current cancer treatments encountered in the perioperative period.
The Shear Capacity Estimation of Reinforced Concrete Short Beams with Steel Fiber by Digital Image Correlation Approach
Authors: Hemstapat Narawit , Okubo Kazumasa , Niwa Junichiro , Iwanami Mitsuyasu 
Published: June 2023

AbstractThis research aimed to estimate the shear capacity of reinforced concrete short beams with steel fiber (RSF short beams) using DIC (digital image correlation). Four-point bending tests of RSF short beams with shear span ratio (a/d) of 1.0, 1.5, and 2.0 were conducted. 0.5% or 1.0% volume fraction of steel fiber was used. The distribution of minimum principal strain (Ɛ2) was obtained from DIC then the width of compressive strut was evaluated. The effects of volume fraction of steel fiber and shear span ratio were investigated. Finally, the shear capacity of RSF short beams was estimated with the help of DIC.
Detection of bile acids in bronchoalveolar lavage fluid defines the inflammatory and microbial landscape of the lower airways in infants with cystic fibrosis
Authors: Caparrós-Martín Jose A. , Saladie Montserrat , Agudelo-Romero S. Patricia , Reen F. Jerry , Ware Robert S. , Sly Peter D. , Stick Stephen M. , O’Gara Fergal ,   on behalf of the COMBAT study group
Published: June 2023

Abstract
Background
Cystic Fibrosis (CF) is a genetic condition characterized by neutrophilic inflammation and recurrent infection of the airways. How these processes are initiated and perpetuated in CF remains largely unknown. We have demonstrated a link between the intestinal microbiota-related metabolites bile acids (BA) and inflammation in the bronchoalveolar lavage fluid (BALF) from children with stable CF lung disease. To establish if BA indicate early pathological processes in CF lung disease, we combined targeted mass spectrometry and amplicon sequencing-based microbial characterization of 121 BALF specimens collected from 12-month old infants with CF enrolled in the COMBAT-CF study, a multicentre randomized placebo-controlled clinical trial comparing azithromycin versus placebo. We evaluated whether detection of BA in BALF is associated with the establishment of the inflammatory and microbial landscape of early CF lung disease, and whether azithromycin, a motilin agonist that has been demonstrated to reduce aspiration of gastric contents, alters the odds of detecting BA in BALF. We also explored how different prophylactic antibiotics regimens impact the early life BALF microbiota.

Results
Detection of BA in BALF was strongly associated with biomarkers of airway inflammation, more exacerbation episodes during the first year of life, increased use of oral antibiotics with prolonged treatment periods, a higher degree of structural lung damage, and distinct microbial profiles. Treatment with azithromycin, a motilin agonist, which has been reported to reduce aspiration of gastric contents, did not reduce the odds of detecting BA in BALF. Culture and molecular methods showed that azithromycin does not alter bacterial load or diversity in BALF. Conversely, penicillin-type prophylaxis reduced the odds of detecting BAs in BALF, which was associated with elevated levels of circulating biomarkers of cholestasis. We also observed that environmental factors such as penicillin-type prophylaxis or BAs detection were linked to distinct early microbial communities of the CF airways, which were associated with different inflammatory landscapes but not with structural lung damage.

Conclusions
Detection of BA in BALF portend early pathological events in CF lung disease. Benefits early in life associated with azithromycin are not linked to its antimicrobial properties.
Testicular metastasis 9 years after resection of primary descending colon cancer with simultaneous pulmonary metastasis: a case report
Authors: Yoshimura Daishi , Sekido Yuki , Takahashi Hidekazu , Hata Tsuyoshi , Hamabe Atsushi , Ogino Takayuki , Miyoshi Norikatsu , Uemura Mamoru , Yamamoto Hirofumi , Doki Yuichiro , Eguchi Hidetoshi 
Published: June 2023

Abstract
Background
Metastatic testicular cancer is rare. In particular, primary colorectal cancer rarely metastasizes to the testes. This study reports a case of testicular metastasis recurrence 9 years after the resection of a primary colorectal cancer and a simultaneous metastatic lung tumour.

Case presentation
A 69-year-old man underwent a laparoscopic left hemicolectomy for descending colon cancer. Preoperative computed tomography revealed a solitary left lung mass. Postoperative chemotherapy reduced the size of the lung mass, and 6 months after the primary resection, the patient underwent a left upper segmentectomy. Based on the pathological examination, he was diagnosed with pulmonary metastasis from colorectal cancer. After four courses of adjuvant chemotherapy, the patient was recurrence-free. However, 9 years and 6 months after the primary resection, he complained of discomfort in his left testicle. Physical examination revealed a left testicular mass. Since a malignancy was not excluded via imaging, left testicular resection was performed to confirm the diagnosis. The pathological diagnosis was testicular metastasis from colorectal cancer. The patient was followed up without medication, and remained healthy, without recurrence, 11 months postoperatively.

Conclusions
It is important to follow up with testicular metastasis in mind, although it is rare.
The Perceptions of Elite Professional Rugby League Players and Staff on the National Rugby League Annual Calendar: A Mixed-Methods Study
Authors: Fazackerley Lewis A. , Minett Geoffrey M. , Clark James D. , Kelly Vincent G. 
Published: June 2023

Abstract
Background
In recent years, the length of elite sporting competitions has raised concerns regarding player well-being, highlighting a need to review current match calendars. Therefore, this study aimed to explore the perceptions of elite National Rugby League (NRL) players and staff on the annual training and competition calendar from a player workload and well-being perspective.

Methods
This study adopted a mixed-methods approach, using a sequential explanatory design. Phase one implemented a cross-sectional survey, and phase two utilised semi-structured interviews. Four hundred and thirty-nine elite rugby league players and 46 staff completed the survey. Eighteen elite professional NRL players and six football staff were interviewed, and verbal data were analysed into pre-defined topic summaries using qualitative coding reliability methods. Topics included in-season, off-season, pre-season and well-being.

Results
Data analysis suggests that elite NRL players and staff believe players appear particularly comfortable with the current number of games; however, they are at their maximum capacity. Importantly, this study identified several minority groups that may require support to enhance player well-being. Players believe reducing the pre-season would negate fatigue experienced later in the subsequent season. Players and staff believe this timeframe still provides sufficient time to prepare for the upcoming season. Further, players were open to extending the off-season to 8–10 weeks and believed that extra time would allow for greater recovery from the previous season. Mid-season congested scheduling affects players following the intensified period and requires attention to alleviate fatigue.

Conclusion
The results of this study convey important implications for the NRL, emphasising a need to review their annual training and competitive calendar, or to implement specific strategies to enhance the well-being of minority groups. The findings from this study should be considered when discussing the ideal length and structure of the match calendar to support players’ physical and mental welfare.
Aetiological Factors of Running-Related Injuries: A 12 Month Prospective “Running Injury Surveillance Centre” (RISC) Study
Authors: Burke Aoife , Dillon Sarah , O’Connor Siobhán , Whyte Enda F. , Gore Shane , Moran Kieran A. 
Published: June 2023

Abstract
Background
Running-related injuries (RRIs) are a prevalent issue for runners, with several factors proposed to be causative. The majority of studies to date are limited by retrospective study design, small sample sizes and seem to focus on individual risk factors in isolation. This study aims to investigate the multifactorial contribution of risk factors to prospective RRIs.

Methods
Recreational runners (n = 258) participated in the study, where injury history and training practices, impact acceleration, and running kinematics were assessed at a baseline testing session. Prospective injuries were tracked for one year. Univariate and multivariate Cox regression was performed in the analysis.

Results
A total of 51% of runners sustained a prospective injury, with the calf most commonly affected. Univariate analysis found previous history of injury < 1 year ago, training for a marathon, frequent changing of shoes (every 0–3 months), and running technique (non-rearfoot strike pattern, less knee valgus, greater knee rotation) to be significantly associated with injury. The multivariate analysis revealed previous injury, training for a marathon, less knee valgus, and greater thorax drop to the contralateral side to be risk factors for injury.

Conclusion
This study found several factors to be potentially causative of injury. With the omission of previous injury history, the risk factors (footwear, marathon training and running kinematics) identified in this study may be easily modifiable, and therefore could inform injury prevention strategies. This is the first study to find foot strike pattern and trunk kinematics to relate to prospective injury.
XR Programmers Give Their Perspective on How XR Technology can be Effectively Utilised in High-Performance Sport
Authors: Le Noury Peter J. , Polman Remco C. , Maloney Michael A. , Gorman Adam D. 
Published: June 2023

Abstract
Background
The successful use of extended reality (XR) in sport is highly dependent on the extent to which it can represent the perception–action couplings that exist in the performance setting. However, there are many unknowns regarding the effectiveness of XR technology which is limiting its adoption in sport. Therefore, providing high-performance sporting organisations with more information about the efficacy and utility of XR, specifically its strengths and limitations, is warranted.

Results
The results provide insight into the limitations of XR and how those limitations are likely to reduce the effectiveness of XR for training motor skills. The participants described opportunities provided by XR for measuring athlete performance and highlighted several practical applications for enhancing athlete and coaching performance. Using artificial intelligence (AI) for training tactical decision-making and creating new movement solutions was also a key finding.

Conclusions
The use of XR in sport is in its infancy, and more research is required to establish a deeper understanding of its utility and efficacy. This research provides sporting organisations, coaches, athletes, and XR technology companies with insights into where XR technology can have the greatest positive impact on performance in sport.