bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of tear vasoactive intestinal peptide on dry eyes after laser keratorefractive surgery
Authors: Kang Yang , Hu Qi , Li Xue , Guo Zidan , Wu Qiong , Zhang Hong 
Published: April 2023

Abstract
Background
To explore the changes in vasoactive intestinal peptide (VIP) concentration in tears post laser-assisted sub-epithelial keratomileusis (LASEK) and femtosecond laser-assisted in situ keratomileusis (FS-LASIK) surgeries and related factors, possible association between postoperative dry eye symptoms and VIP concentration in tears, and factors influencing dry eye symptoms after different periods post LASEK and FS-LASIK surgeries.

Methods
In this prospective, non-randomized, longitudinal cohort study, 23 and 22 subjects were recruited and underwent LASEK and FS-LASIK, respectively. After conducting an intact ophthalmic examination and collecting relevant surgical data, all subjects were examined for VIP concentration in their tears using ELISAs, tear-film breakup time, ocular staining and ocular surface disease index questionnaire before surgery and 1 day, 1 week, and 1 month post-surgery.

Results
Tear VIP concentration increased significantly after both LASEK and FS-LASIK, with the highest concentration observed 1 week post-surgery (P ≤ 0.05). Tear VIP concentration correlated negatively with corneal ablation depth (AD). The extent of dry eyes was related to the operation method employed and postoperative recovery period. In FS-LASIK and LASEK subjects, dry eyes were mainly affected by the basic ocular surface status before surgery, and VIP concentration. Furthermore, in LASEK subjects, dry eyes were negatively correlated with AD.

Conclusion
VIP was stimulated and mobilized as an emergency protection post-refractive surgery and a trauma model affected by AD. It can indirectly indicate the inevitable relationship between postoperative dry eye and nerve injury. Elevated post-surgery tear VIP relieves dry eye symptoms, showing its neuroimmune role in regulating adverse injury stimulation. The present study provides a solution to the pathogenesis of postoperative dry eyes.

Trial registration
The trial registration number: 2021JS22. Date of registration: 10 May 2021.
Autophagy-prominent cell clusters among human lens epithelial cells: integrated single-cell RNA-sequencing analysis
Authors: Liu Jiasheng , Zhu Mengchao , Xu Yitong , Zhang Mengdi , Sun Haisen , Wang Yaqi , Yang Qingwen , Li Jin 
Published: April 2023

Abstract
Background
Autophagy is an important process that maintains the quality of intracellular proteins and organelles. There is extensive evidence that autophagy has an important role in the lens. Human lens epithelial cells (HLECs) play a key role in the internal homeostasis of the lens. HLEC subtypes have been identified, but autophagy-prominent cell clusters among HLECs have not been characterized.

Purpose
To explore the existence of autophagy-prominent cell clusters in HLECs.

Methods
Three donated lenses (HLECs from two whole lenses and HLECs from one lens without the anterior central 6-mm zone) were used for single-cell RNA sequencing (scRNA-seq). AUCell and AddModuleScore analysis were used to identify potential autophagy-prominent cell clusters. Transmission electron microscopy (TEM) was used to confirm the results.

Results
High-quality transcripts from 18,120 cells were acquired by scRNA-seq of the two intact lenses. Unsupervised clustering classified the cells into four clusters. AUCell and AddModuleScore analysis revealed cluster 1 is autophagy-prominent. scRNA-seq analysis of HLECs from the lens capsule lacking the central zone confirmed the cluster 1 HLECs was located in the central capsule zone. The TEM result showed that greater autophagy activity was observed in the HLECs in central capsule zone, which further supported the above conclusions based on scRNA-seq analysis that autophagy was prominent in the central zone where the cluster 1 HLECs located.

Conclusions
We identified an autophagy-prominent cell cluster among HLECs and revealed that it was localized in the central zone of the lens capsule. Our findings will aid investigations of autophagy in HLECs and provide insights to guide related research.
The mediating effect of body appreciation between muscle dysmorphia and bulimia nervosa among Lebanese adolescents
Authors: Rahme Deema , Dabbous Mariam , Malaeb Diana , Hallit Souheil , Obeid Sahar 
Published: April 2023

Abstract
Background
Muscle dysmorphia (MD) is a common psychological disorder present in Lebanese adolescents. Several disorders can be present concomitantly with MD such as bulimia nervosa and exercise addiction. This study aims to explore the mediating effect of body appreciation between Muscle dysmorphia and bulimia nervosa, and to validate the exercise addiction inventory scale in Lebanese adolescents.

Methods
This was a cross-sectional designed study, conducted between August-September 2022, and enrolling 403 adolescents currently residing in Lebanon (15 to 18 years old), from all Lebanese governorates (Beirut, Mount Lebanon, North, South, and Bekaa). Our sample was chosen using the snowball technique, a soft copy of the questionnaire was created using google forms software, and an online approach was conceived to proceed with the data collection.

Results
The mean age of the participants was 16.63 ± 1.46 years with 57.3% females. The factor analysis for the Exercise Addiction Inventory suggested one factor, which explained 62.58% of the common variance. The confirmatory factor analysis revealed an adequate fit to the model with satisfactory Maximum Likelihood Chi-Square/Degrees of Freedom (χ2/df), SRMR, CFI, TLI, and AVE. The mediation analysis showed that the direct relation between bulimia and MD was not significant after eliminating the effect of body appreciation (r = .12, p < .001). However, body appreciation was significantly associated with bulimia nervosa (r=-1.06, p < .001) and MD (r=-.28, p < .001).

Conclusion
Body appreciation was found to be a mediator between muscle dysmorphia and bulimia nervosa and thus it is the main factor leading to both disorders. Therefore, body appreciation should be addressed in the evaluation and management of Muscle Dysmorphia.
Effects of high-heeled shoes on lower extremity biomechanics and balance in females: a systematic review and meta-analysis
Authors: Zeng Ziwei , Liu Yue , Hu Xiaoyue , Li Pan , Wang Lin 
Published: April 2023

Abstract
Background
High-heeled shoes (HHS) are widely worn by women in daily life. Limited quantitative studies have been conducted to investigate the biomechanical performance between wearing HHS and wearing flat shoes or barefoot. This study aimed to compare spatiotemporal parameters, kinematics, kinetics and muscle function during walking and balance between wearing HHS and flat shoes or barefoot.

Methods
According to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, PubMed Medline, Cochrane, EMBASE, CINAHL Complete and Web of Science databases were searched from the earliest record to December 2021. A modified quality index was applied to evaluate the risk of bias, and effect sizes with 95% confidence intervals were calculated as the standardized mean differences (SMD). Potential publication bias was evaluated graphically using funnel plot and the robustness of the overall results was assessed using sensitivity analyses.

Results
Eighty-one studies (n = 1501 participants) were included in this study. The reduced area of support requires the body to establish a safer and more stable gait pattern by changing gait characteristics when walking in HHS compared with walking in flats shoes or barefoot. Walking in HHS has a slight effect on hip kinematics, with biomechanical changes and adaptations concentrated in the knee and foot–ankle complex. Females wearing HHS performed greater ground reaction forces earlier, accompanied by an anterior shift in plantar pressure compared with those wearing flat shoes/barefoot. Furthermore, large effect sizes indicate that wearing HHS resulted in poor static and dynamic balance.

Conclusion
Spatiotemporal, kinematic, kinetic and balance variables are affected by wearing HHS. The effect of specific heel heights on women’s biomechanics would benefit from further research.
Revisional bariatric surgery after adjustable gastric band: a multicenter Polish Revision Obesity Surgery Study (PROSS)
Authors: Dowgiałło-Gornowicz Natalia , Janik Michał , Lech Paweł , Kowalski Grzegorz , Major Piotr ,   PROSS –Collaborative Study Group, Pędziwiatr Michał , Rymarowicz Justyna , Zarzycki Piotr , Stefura Tomasz , Ciszek Karol , Małczak Piotr , Myśliwiec Piotr , Hady Hady Razak , Głuszyńska Paulina , Proczko-Stepaniak Monika , Szymański Michał , Walędziak Maciej , Kwiatkowski Andrzej , Materlak Magdalena , Bartosiak Katarzyna , Czyżykowski Łukasz , Mawlichanów Maciej , Kowalewski Piotr , Szeliga Jacek , Kupczyk Wojciech , Harań Anna , Mulek Rafał , Krefft Michał , Wysocki Michał , Orłowski Michał , Franczak Paula , Binda Artur , Tarnowski Wiesław , Jaworski Paweł , Kamiński Mateusz , Pastuszka Maciej , Lisik Wojciech , Szymański Paweł , Katkowski Bartosz , Leśniak Michał , Łabul Michał 
Published: April 2023

Abstract
Background
Adjustable gastric band (AGB) hadbeen the preferred treatment for morbid obesity because it is minimally invasive and reversible. But now it seems to be slowly becoming a historic procedure due to the disappointing effects. The aim of the study was to systematize and present the available data on revisional bariatric surgery (RBS) after AGB among Polish patients.

Methods
It is a multicenter, retrospective analysis of patients undergoing laparoscopic RBS after AGB in 12 Polish bariatric centers. The database included patient demographics, comorbidities and surgical outcomes.

Results
The group consisted of 234 patients who underwent AGB, which accounted for 29% of revisional cases recorded in the Polish Revisional Obesity Surgery Study (PROSS). 195 were women (83%), and 39 were men (17%). One hundred seventy-five patients after AGB experienced a weight regain (74.5%), 36 patients a gastric band slippage (15.0%), 14 patients had gastric band intolerance (6.0%). Types of RBS included 116 sleeve gastrectomies (SG) (49.4%), 86 Roux-en Y gastric by-passes (RYGB) (36.6%), 20 one anastomosis gastric by-passes (OAGB) (8,5%). The highest weight loss expressed as %EBMIL was observed after OAGB (63.5 ± 32.4%).

Conclusions
The main indication for RBS after AGB was weight regain. SG was the most frequently chosen type of RBS after AGB. RBS after AGB leads to weight loss and improvement in type 2 diabetes and hypertension with an acceptable low risk of complications.

Trial registration
NCT05108532.
Pre-operative and early postoperative health-related quality of life of breast cancer woman: a Lebanese prospective study
Authors: El Haidari Rana , Nerich Virginie , Abou-Abbas Linda , Abdel-Sater Fadi , Anota Amelie 
Published: April 2023

AbstractBreast cancer (BC) is a major health concern in Lebanon, with an increasing incidence rate due to advancements in treatment modalities. Evaluating the impact of the BC and its treatment on a woman's Health-Related Quality of Life (HRQoL), and comparing these patterns before and after breast conserving surgery is important to identify areas where interventions may be needed to improve the overall well-being of women with BC. This study aimed to evaluate the HRQoL pre and post-operative breast conserving surgery and just prior to initiation of adjuvant therapy in newly diagnosed patients with BC in Lebanon, specifically focusing on changes in body image. A prospective cohort study was conducted on 120 patients in two health care facilities in Lebanon, collecting sociodemographic and clinical data, and using the EORTC QLQ-C30 and QLQ-BR23 questionnaires to evaluate HRQoL. The outcomes were measured at baseline and then one-day post-operative breast surgery. Results revealed a statistically and clinically significant decrease in body image (mean difference of 8.1 points (95% 4.3;11.1)), physical functioning (mean difference of 6.1 points (95% 3.3;8.5)), and emotional functioning (mean difference of -8.4 points (95%-12.4; -4.9) after surgery. Positive change of physical functioning score was observed among married women. Positive change of emotional functioning score was observed among patients with poor body image score and high future perspective score. Our findings provide valuable insights for clinicians and researchers on the impact of breast conserving surgery on HRQoL in Lebanese women.
The impact of artificial intelligence on the person-centred, doctor-patient relationship: some problems and solutions
Authors: Sauerbrei Aurelia , Kerasidou Angeliki , Lucivero Federica , Hallowell Nina 
Published: April 2023

AbstractArtificial intelligence (AI) is often cited as a possible solution to current issues faced by healthcare systems. This includes the freeing up of time for doctors and facilitating person-centred doctor-patient relationships. However, given the novelty of artificial intelligence tools, there is very little concrete evidence on their impact on the doctor-patient relationship or on how to ensure that they are implemented in a way which is beneficial for person-centred care.Given the importance of empathy and compassion in the practice of person-centred care, we conducted a literature review to explore how AI impacts these two values. Besides empathy and compassion, shared decision-making, and trust relationships emerged as key values in the reviewed papers. We identified two concrete ways which can help ensure that the use of AI tools have a positive impact on person-centred doctor-patient relationships. These are (1) using AI tools in an assistive role and (2) adapting medical education. The study suggests that we need to take intentional steps in order to ensure that the deployment of AI tools in healthcare has a positive impact on person-centred doctor-patient relationships. We argue that the proposed solutions are contingent upon clarifying the values underlying future healthcare systems.
NIR-II-absorbing diimmonium polymer agent achieves excellent photothermal therapy with induction of tumor immunogenic cell death
Authors: Xu Han , Deng Huaping , Ma Xiaoqian , Feng Yushuo , Jia Ruizhen , Wang Yiru , Liu Yaqing , Li Wenli , Meng Shanshan , Chen Hongmin 
Published: April 2023

AbstractPhotothermal therapy has shown great promise for cancer treatment and second near-infrared (NIR-II) -absorbing particles could further improve its precision and applicability due to its superior penetration depth and new imaging ability. Herein, high NIR-II-absorbing polymer particles were prepared by using soluble isobutyl-substituted diammonium borates (P-IDI). The P-IDI showed stronger absorption at 1000–1100 nm, which exhibited excellent photostability, strong photoacoustic imaging ability and high photothermal conversion efficiency (34.7%). The investigations in vitro and in vivo demonstrated that the excellent photothermal effect facilitated complete tumor ablation and also triggered immunogenic cell death in activation of the immune response. The high solubility and excellent photothermal conversion ability demonstrated that polymer IDI particles were promising theranostic agents for treatment of tumors with minor side effects.
Safer opioid supply: qualitative program evaluation
Authors: Haines Marlene , O’Byrne Patrick 
Published: April 2023

Abstract
Background
As the overdose crisis in Canada continues to escalate in severity, novel interventions and programs are required. Safer Supply programs offer pharmaceutical-grade medication to people who use drugs to replace and decrease harms related to the toxic illicit drug supply. Given the paucity of research surrounding these programs, we sought to better understand the experience of being part of a Safer Supply program from the perspective of current participants.

Methods
We completed semi-structured interviews and surveys with Safer Supply participants in Ottawa, Canada. Interviews were audio-recorded, transcribed, and analyzed thematically. Descriptive statistics were used to report survey data.

Results
Participants most commonly discussed Safer Supply benefits. This included programs offering a sense of community, connection, hope for the future, and increased autonomy. Participants also described program concerns, such as restrictive protocols, inadequate drugs, and diversion.

Conclusions
Our research demonstrated that participants found Safer Supply to be effective and impactful for their substance use goals. While participants did discuss concerns about the program, overall, we found that this is an important harm reduction-based program for people who use drugs in the midst of the overdose crisis.
Venous anomalies and thromboembolism
Authors: Dix Caroline , Clements Warren , Gibbs Harry , So Joanne , A Tran Huyen , D McFadyen James 
Published: April 2023

AbstractPatients with venous anomalies are at increased risk of developing venous thromboembolism (VTE) and subsequent complications, but they are often under-recognised. While unprovoked VTE may trigger testing for inherited thrombophilias and malignancy screening, anatomic variants are considered less often. Venous anomalies increase the risk due to venous flow disturbance, resulting in hypertension, reduced flow velocity and turbulence. Recognition is important as endovascular or surgical intervention may be appropriate, these patients have a high rate of VTE recurrence if anticoagulation is ceased, and the anomalies can predispose to extensive VTE and severe post-thrombotic syndrome (PTS). In this case series, we present representative cases and radiological images of May-Thurner syndrome (MTS), inferior vena cava (IVC) variants and venous aneurysms, and review the available literature regarding optimal diagnosis and management in each condition.
Considering depression as a secondary outcome in the optimization of physical activity interventions for breast cancer survivors in the PACES trial: a factorial randomized controlled trial
Authors: Rethorst Chad D. , Carmody Thomas J. , Argenbright Keith E. , Mayes Taryn L. , Hamann Heidi A. , Trivedi Madhukar H. 
Published: April 2023

Abstract
Background
Depressive symptoms result in considerable burden for breast cancer survivors. Increased physical activity may reduce these burdens but existing evidence from physical activity interventions in equivocal. Furthermore, physical activity intervention strategies may differentially impact depressive symptoms, which should be considered in designing and optimizing behavioral interventions for breast cancer survivors.

Methods
The Physical Activity for Cancer Survivors (PACES) trial enrolled 336 participants breast cancer survivors, who were 3 months to 10 years post-treatment, and insufficiently active (< 150 min of moderate-to-vigorous physical activity per week). Participants were randomly assigned to a combination of 4 intervention strategies in a full-factorial design: 1) supervised exercise sessions, 2) facility access, 3) Active Living Every Day, and 4) Fitbit self-monitoring. Depressive symptoms were assessed at baseline, mid-intervention (3 months), and post-intervention (6 months) using the Quick Inventory for Depressive Symptoms. Change in depressive symptoms were analyzed using a linear mixed-effects model.

Results
Results from the linear mixed-effects model indicated that depressive symptoms decreased significantly across the entire study sample over the 6-month intervention (F = 4.09, p = 0.044). A significant ALED x time interaction indicated participants who received the ALED intervention experienced greater reductions in depressive symptoms (F = 5.29, p = 0.022). No other intervention strategy significantly impacted depressive symptoms.

Conclusions
The ALED intervention consists of strategies (i.e., goal setting, social support) that may have a beneficial impact on depressive symptoms above and beyond the effect of increased physical activity. Our findings highlight the need to consider secondary outcomes when designing and optimizing physical activity interventions.

Trial registration
ClinicalTrials.gov NCT03060941. Posted February 23, 2017.
Play Active physical activity policy intervention and implementation support in early childhood education and care: results from a pragmatic cluster randomised trial
Authors: Adams Emma K. , Nathan Andrea , Trost Stewart G. , Schipperijn Jasper , Shilton Trevor , Trapp Georgina , Maitland Clover , Thornton Ashleigh , Mclaughlin Matthew , George Phoebe , Wenden Elizabeth , Christian Hayley 
Published: April 2023

Abstract
Background
Policy interventions to increase physical activity in early childhood education and care (ECEC) services are effective in increasing physical activity among young children. However, a large proportion of ECEC services do not have nor implement a physical activity policy. Play Active is an evidence-informed physical activity policy intervention with implementation support strategies to enable ECEC services to successfully implement their policy. This study examined the effectiveness, implementation, and process outcomes of Play Active.

Methods
A pragmatic cluster randomised trial in 81 ECEC services in Perth, Western Australia was conducted in 2021. Services implemented their physical activity policy over a minimum of three months. The effectiveness outcomes were changes in educator practices related to daily time provided for total physical activity and energetic play. Implementation outcomes included changes in director- and educator-reported uptake of policy practices and director-reported uptake of high impact and low effort policy practices. Process evaluation outcomes included awareness, fidelity, reach, and acceptability of the intervention and implementation strategies. Analysis involved descriptive statistics and generalised linear mixed effects models.

Results
There was a significant increase in the uptake of director-reported policy practices (p = 0.034), but no change in the uptake of the subset of high impact and low effort policy practices. Intervention group educators reported high awareness of the Play Active policy recommendations (90%). Play Active acceptability was high among educators (83%) and directors (78%). Fidelity and reach were high for most implementation support strategies (> 75%). There were no significant changes in the amount of physical activity or energetic play educators provided to children or in the proportion of educators providing the policy recommended ≥ 180 min of physical activity/day or ≥ 30 min of energetic play/day for intervention compared to wait-listed comparison services.

Conclusions
Play Active resulted in significantly higher uptake of physical activity practices. However, there was no change in the amount of physical activity provided to children, which may be explained by the relatively short policy implementation period. Importantly, Play Active had high awareness, fidelity, reach, and acceptability. Future research should investigate the effectiveness of Play Active over longer implementation periods and its scalability potential.

Trial registration
Australian New Zealand Clinical Trials Registry (reference number 12620001206910, registered 13/11/2020, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378304&isReview=true).