bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spontaneous regression of advanced transverse colon cancer with deficient mismatch repair: a case report
Authors: Harata Shinnosuke , Takahashi Hiroki , Ando Nanako , Kato Akira , Watanabe Kaori , Yanagita Takeshi , Suzuki Takuya , Ushigome Hajime , Shiga Kazuyoshi , Ogawa Ryo , Matsuo Yoichi , Mitsui Akira , Kimura Masahiro , Takiguchi Shuji 
Published: April 2023

Abstract
Background
Spontaneous regression (SR) of cancer occurs in 1 in 60,000–100,000 patients. This phenomenon has been reported in almost all cancer types, most commonly neuroblastoma, renal cell carcinoma, malignant melanoma, and lymphoma/leukemia. However, SR in colorectal cancer (CRC) is extremely rare, particularly in advanced cases. Hence, this report describes a very rare case of spontaneous regression of advanced transverse colon cancer.

Case presentation
A 76-year-old female with anemia was diagnosed with a type II well-differentiated adenocarcinoma in the middle transverse colon. Two months later, a second colonoscopy examination was performed for preoperative marking, and it revealed tumor shrinkage and a shift to type 0–IIc morphology. Endoscopic tattooing was then performed, followed by a laparoscopic partial resection of the transverse colon with D3 lymph node dissection. However, the resected specimen contained no tumor, and colonoscopy showed no tumor remnants in the remaining colon. Histopathological examination revealed mucosal regeneration and a mucus nodule in between the submucosal and muscular layers, with no cancer cells detected. Immunohistochemical analysis revealed the loss of MutL homolog 1 (MLH1) and postmeiotic segregation increased 2 (PMS2) expression in the cancer cells of biopsied specimens, suggesting deficient mismatch repair (dMMR). The patient continues to be followed up until 6 years postoperatively, and no recurrence has been observed. In this study, we also reviewed similar reported cases of spontaneous regression of cancer involving dMMR.

Conclusion
This study presents a rare case of spontaneous regression of advanced transverse colon cancer wherein dMMR is strongly involved. However, further accumulation of similar cases is needed to elucidate this phenomenon and to develop new treatment strategies for CRC.
Experience of Playing Sport or Exercising for Women with Pelvic Floor Symptoms: A Qualitative Study
Authors: Dakic Jodie G. , Hay-Smith Jean , Lin Kuan-Yin , Cook Jill , Frawley Helena C. 
Published: April 2023

Abstract
Background
Women participate in sport at lower rates than men, and face unique challenges to participation. One in three women across all sports experience pelvic floor (PF) symptoms such as urinary incontinence during training/competition. There is a dearth of qualitative literature on women’s experiences of playing sport/exercising with PF symptoms. The purpose of this study was to explore the lived experience of symptomatic women within sports/exercise settings and the impact of PF symptoms on sports/exercise participation using in-depth semi-structured interviews.

Results
Twenty-three women (age 26–61 years) who had experienced a breadth of PF symptom type, severity and bother during sport/exercise participated in one–one interviews. Women played a variety of sports and levels of participation. Qualitative content analysis was applied leading to identification of four main themes: (1) I can’t exercise the way I would like to (2) it affects my emotional and social well-being, (3) where I exercise affects my experience and (4) there is so much planning to be able to exercise. Women reported extensive impact on their ability to participate in their preferred type, intensity and frequency of exercise. Women experienced judgement from others, anger, fear of symptoms becoming known and isolation from teams/group exercise settings as a consequence of symptoms. Meticulous and restrictive coping strategies were needed to limit symptom provocation during exercise, including limiting fluid intake and careful consideration of clothing/containment options.

Conclusion
Experiencing PF symptoms during sport/exercise caused considerable limitation to participation. Generation of negative emotions and pain-staking coping strategies to avoid symptoms, limited the social and mental health benefits typically associated with sport/exercise in symptomatic women. The culture of the sporting environment influenced whether women continued or ceased exercising. In order to promote women’s participation in sport, co-designed strategies for (1) screening and management of PF symptoms and (2) promotion of a supportive and inclusive culture within sports/exercise settings are needed.
Implementing digital devices to increase mobility training for people receiving inpatient rehabilitation: protocol for a feasibility hybrid type II randomized controlled trial
Authors: Aravind Nisha , Treacy Daniel , Chagpar Sakina , Harvey Lisa A. , Glinsky Joanne V. , Sherrington Catherine , Hassett Leanne M. 
Published: April 2023

Abstract
Background
People with mobility limitations can benefit from rehabilitation programs incorporating intensive, repetitive, and task-specific exercises using digital devices such as virtual reality gaming systems, tablet and smartphone applications, and wearable devices. The Activity and MObility UsiNg Technology (AMOUNT) rehabilitation trial (n = 300) showed improvements in mobility in people using these types of digital devices in addition to their usual rehabilitation care when the intervention was provided by an additional study-funded physiotherapist. However, it is not clear if this intervention can be implemented by hospital physiotherapists with a usual clinical load. The AMOUNT Implementation trial aims to explore the feasibility of conducting a large-scale implementation trial.

Methods
A pragmatic, assessor blinded, feasibility hybrid type II randomized controlled trial will be undertaken at a public hospital in Australia. There will be two phases. Phase I (Implementation phase) will involve implementing the digital devices into physiotherapy practice. Physiotherapists from the rehabilitation ward will receive a multifaceted implementation strategy guided by the Capabilities, Opportunities, Motivation-Behaviour (COM-B) theoretical model. The implementation strategy includes identifying and training a clinical champion; providing digital devices and education and training; facilitating use of the devices through clinical reasoning sessions and journal clubs; and audit and feedback of exercise dosage documentation. Phase II (Trial phase) will involve randomising 30 eligible inpatients from the same ward into either usual care or usual care plus an additional 30 min or more of exercises using digital devices. This intervention will be provided by the physiotherapists who took part in the implementation phase. We will collect data on feasibility, implementation, and patient-level clinical outcomes. The three primary outcome measures are the extent to which physiotherapists document the dosage of exercises provided to participants (feasibility criteria: exercise practice sheets complete for ≥85% of all participants); ability to recruit participants; and fidelity to the protocol of using digital devices to prescribe exercises (feasibility criteria: average of ≥ 30mins per day for > 50% intervention participants).

Discussion
This feasibility study will provide important information to guide the planning and conduct of a future large-scale implementation trial.

Trial registration
Australian and New Zealand Clinical Trial Registry; ACTRN12621000938808; registered 19/07/2021. Trial sponsor: Prince of Wales Hospital. 320–346 Barker Street, Randwick, NSW, 2031, Australia. Protocol version: 6.2 7th April 2021.
Mediation effect of trust on willingness to pay for health insurance among co-operative members in Tanzania
Authors: Nzowa Petro G. , Nandonde Felix A. , Seimu Somo M. L. 
Published: April 2023

AbstractThis study analysed co-operative members’ willingness to pay (WTP) for health insurance. The social capital theory was adopted to analyse the mediation role of trust issues on other variables determining co-operative members’ WTP for health insurance. A single Contingent Valuation Method (CVM) was used to elicit and estimate the amount co-operative members that were willing to pay for health insurance. The Partial Least Square Structural Equation Modelling (PLS-SEM) was used to analyse variables affecting co-operative members’ WTP for health insurance. Findings indicated that most co-operative members were willing to pay for health insurance. Further, except for price, trust issues fully and partially mediate quality attributes and access criteria, respectively, when it comes to WTP for health insurance. Firm trust is required among co-operators, management, health insurers, and health facilities in order to increase WTP for health insurance among co-operative members.
Effects of Burosumab Treatment on Mineral Metabolism in Children and Adolescents With X-linked Hypophosphatemia
Authors: Ewert Annika , Rehberg Mirko , Schlingmann Karl Peter , Hiort Olaf , John-Kroegel Ulrike , Metzing Oliver , Wühl Elke , Schaefer Franz , Kemper Markus J , Derichs Ute , Richter-Unruh Annette , Patzer Ludwig , Albers Norbert , Dunstheimer Desiree , Haberland Holger , Heger Sabine , Schröder Carmen , Jorch Norbert , Schmid Elmar , Staude Hagen , Weitz Marcus , Freiberg Clemens , Leifheit-Nestler Maren , Zivicnjak Miroslav , Schnabel Dirk , Haffner Dieter 
Published: April 2023

Abstract

Context
Burosumab has been approved for the treatment of children and adults with X-linked hypophosphatemia (XLH). Real-world data and evidence for its efficacy in adolescents are lacking.

Objective
To assess the effects of 12 months of burosumab treatment on mineral metabolism in children (aged &lt;12 years) and adolescents (aged 12-18 years) with XLH.

Design
Prospective national registry.

Setting
Hospital clinics.

Patients
A total of 93 patients with XLH (65 children, 28 adolescents).

Main Outcome Measures
Z scores for serum phosphate, alkaline phosphatase (ALP), and renal tubular reabsorption of phosphate per glomerular filtration rate (TmP/GFR) at 12 months.

Results
At baseline, patients showed hypophosphatemia (−4.4 SD), reduced TmP/GFR (−6.5 SD), and elevated ALP (2.7 SD, each P &lt; .001 vs healthy children) irrespective of age, suggesting active rickets despite prior therapy with oral phosphate and active vitamin D in 88% of patients. Burosumab treatment resulted in comparable increases in serum phosphate and TmP/GFR in children and adolescents with XLH and a steady decline in serum ALP (each P &lt; .001 vs baseline). At 12 months, serum phosphate, TmP/GFR, and ALP levels were within the age-related normal range in approximately 42%, 27%, and 80% of patients in both groups, respectively, with a lower, weight-based final burosumab dose in adolescents compared with children (0.72 vs 1.06 mg/kg, P &lt; .01).

Conclusions
In this real-world setting, 12 months of burosumab treatment was equally effective in normalizing serum ALP in adolescents and children, despite persistent mild hypophosphatemia in one-half of patients, suggesting that complete normalization of serum phosphate is not mandatory for substantial improvement of rickets in these patients. Adolescents appear to require lower weight-based burosumab dosage than children.
Secondary Neurologic Deterioration After Moderate Traumatic Brain Injury: Development of a Multivariable Prediction Model and Proposition of a Simple Triage Score
Authors: Aries Philippe , Ognard Julien , Cadieu Amandine , Degos Vincent , Huet Olivier 
Published: April 2023

BACKGROUND:
Identifying patients at risk of secondary neurologic deterioration (SND) after moderate traumatic brain injury (moTBI) is a challenge, as such patients will need specific care. No simple scoring system has been evaluated to date. This study aimed to determine clinical and radiological factors associated with SND after moTBI and to propose a triage score.

METHODS:
All adults admitted in our academic trauma center between January 2016 and January 2019 for moTBI (Glasgow Coma Scale [GCS] score, 9–13) were eligible. SND during the first week was defined either by a decrease in GCS score of >2 points from the admission GCS in the absence of pharmacologic sedation or by a deterioration in neurologic status associated with an intervention, such as mechanical ventilation, sedation, osmotherapy, transfer to the intensive care unit (ICU), or neurosurgical intervention (for intracranial mass lesions or depressed skull fracture). Clinical, biological, and radiological independent predictors of SND were identified by logistic regression (LR). An internal validation was performed using a bootstrap technique. A weighted score was defined based on beta (β) coefficients of the LR.

RESULTS:
A total of 142 patients were included. Forty-six patients (32%) showed SND, and 14-day mortality rate was 18.4%. Independent variables associated with SND were age above 60 years (odds ratio [OR], 3.45 [95% confidence interval {CI}, 1.45–8.48]; P = .005), brain frontal contusion (OR, 3.22 [95% CI, 1.31–8.49]; P = .01), prehospital or admission arterial hypotension (OR, 4.86 [95% CI, 2.03–12.60]; P = .006), and a Marshall computed tomography (CT) score of 6 (OR, 3.25 [95% CI, 1.31–8.20]; P = .01). The SND score was defined with a range from 0 to 10. The score included the following variables: age >60 years (3 points), prehospital or admission arterial hypotension (3 points), frontal contusion (2 points), and Marshall CT score of 6 (2 points). The score was able to detect patients at risk of SND, with an area under the receiver operating characteristic curve (AUC) of 0.73 (95% CI, 0.65–0.82). A score of 3 had a sensitivity of 85%, a specificity of 50%, a VPN of 87%, and a VPP of 44 % to predict SND.

CONCLUSIONS:
In this study, we demonstrate that moTBI patients have a significant risk of SND. A simple weighted score at hospital admission could be able to detect patients at risk of SND. The use of the score may enable optimization of care resources for these patients.
Comparison of cell size, chlorophyll fluorescence and cadmium (Cd2+) bioaccumulation between wild-type and mutant strains of Chlamydomonas reinhardtii upon exposure to Cd2+
Authors: Ynalvez Ruby , Gonzalez-Cantu Hector , Vazquez-Cano Erick 
Published: April 2023

Background: Heavy metal contamination presents a constant threat to biological systems. Simultaneously, heavy metals have become one of the major contaminants in the aquatic ecosystems. In this regard, the investigation of heavy metal-tolerance genes in algae is relevant. Chlamydomonas reinhardtii is a unicellular green alga, and an excellent model organism used in heavy metal studies. In C. reinhardtii, a novel gene designated as Cia7, was hypothesized to play a role in heavy metal homeostasis due to CIA7’s conserved cysteine-residue motif. This study compared two strains of C. reinhardtii, cc4425, the wild-type with the functional CIA7 protein and cc5013, the mutant strain with the disrupted cia7- gene. The hypothesis was that the expression of Cia7 contributes to an increased cadmium (Cd)-tolerance in C. reinhardtii. The Cd-tolerance would be described by physiological markers of microalgae health, and by intracellular accumulation of the metal. Methods: The objectives of this study were (1) to compare chlorophyll fluorescence and cell size in cc4425 and cc5013 exposed to Cd2+, and (2) to compare Cd2+ bioaccumulation in cc4425 and cc5013 strains in different growth media. Flow cytometry, and inductively coupled plasma optical emission spectrometry (ICP-OES) analysis were performed. Results: There was no significant statistical difference in Cd2+ bioaccumulation between the two strains, cc4425 and cc5013, regardless of growth media. However, a statistically significant difference in Cd2+ bioaccumulation (p<0.0001) was determined between the media (with acetate and without acetate). The cia7- mutant, cc5013 was found to be more susceptible to a Cd2+-induced decrease in chlorophyll fluorescence and had a reduced cell size compared to cc4425, the wild-type strain. Conclusions: These observed differences between the strains suggest that CIA7’s biological activity could play a direct or indirect role in increasing Cd tolerance in C. reinhardtii.
Beta-blockers used in cardiac failure and blood glucose level impairment - a literature review
Authors: Fularska Kamila , Oleszko Michal , Wąsiewicz Edward , Kuźniar Aleksandra , Szawica Dominik 
Published: April 2023

Introduction: Blood sugar level impairment, especially diabetes mellitus (DM) is a significant problem. DM leads to many serious complications. Patients suffering from cardiac failure (HF) and diabetes have a risk of hospitalization increased 1.5 times compared to the control group without DM. That is why it is very important to keep appropriate glycemic control. β-blockers, are considered to cause a blood glucose level impairment. The relationship between the use of β-blockers and the development of DM is one of the most interesting and controversial issues in diabetology. Despite many benefits, some doctors are reluctant to prescribe β-blockers because of perceived negative metabolic effects.Aim of study: The purpose of the study was to review the literature describing oral β-blockers, used in HF, influence on glucose metabolism and to discover the best β-blocker treatment for cardiac failured diabetics and prediabetics.
Methods: A systemic review was conducted using PubMed, ScienceDirect, Google Scholar databases. The search strategy was based on the following terms: beta-blocker, blood glucose level, metoprolol, nebivolol, carvedilol, bisoprolol.
Results: β-blockers differ in terms of their mechanism of action and their effects on glucose metabolism. Metoprolol is associated with a worsening of glucose and lipid control. Bisoprolol have a neutral impact on glucose metabolism. Vasodilating β-blockers may improve glycemic profile.Conclusions: All four β-blockers used in HF have similar blood pressure lowering effect but different metabolic effect. Metoprolol should not be used as a drug of choice in patients with impaired glucose metabolism. Bisoprolol, nebivolol or carvedilol may be recommended as a drug of choice in patients with cardiac failure and impaired carbohydrate metabolism. The choice between bisoprolol and vasodilating β-blockers in patients with glycemic disorders is still an unresolved issue.
Influence of Moisture Content and Fine Levels on Angle of Repose for Pelletized Materials
Authors: Dean Ryan H. , Turner Aaron P. , Koc Ali B , Karthikeyan Raghupathy 
Published: April 2023

HighlightsThe influence of moisture content and fine levels on the angle of repose (AoR) was evaluated for multiple pellet types.Filling angle of repose (AoR) show some increases with moisture, but values remained in the “free-flowing” range.Emptying and tilting table AoR were more impacted by additional moisture and fines.Image analysis was successfully used to measure the angle of repose.Abstract. Biomass and feed pellets can be handled and stored using similar equipment to that used for other bulk materials; however, their unique physical characteristics can lead to handling challenges. Understanding the flow characteristics of these materials is essential for handling and storage system design, but these characteristics are not well defined in less-than-ideal conditions. The overall objective of this study was to evaluate how moisture content and level of fines influence the angle of repose (AoR) of hardwood, pine bedding, and feed pellets. Three moisture levels (unconditioned, two and four percentage points above equilibrium) and four particle fine levels (0%, 5%, 10%, and 15% fines) were evaluated. Multiple methods for measuring AoR were assessed, including the fixed funnel (both lose and confined base), tilting table, and a clear-sided test fixture to measure emptying and filling AoR simultaneously. An image analysis tool using a polyline fit to the pellet boundary was developed and used to measure the respective angles. The impact of increasing moisture and fine levels varied by pellet type and AoR measurement method, but generally resulted in an increase in AoR. The filling (dynamic) AoR was least impacted by moisture and fine levels, showing no differences among fine levels, and limit differences among moisture levels. Emptying (static) AoR was linearly correlated with the tilting table method, but the tilting table AoR was on average 15.5° higher. Utilizing the combined test fixture, the overall filling (dynamic) AoR for hardwood, pine bedding, and feed pellets inclusive of all moisture contents and percent fine levels were 33.8°, 35.0°, and 35.4°, respectively, while emptying (static) AoR’s were 39.9°, 44.2°, and 42.7°. Keywords: Angle of repose, Biomass, Moisture content, Particle size, Pellets, Physical properties.
Broadband polarization-independent achromatic varifocal metalens in the terahertz region
Authors: Wu Qi , Fan Wen-Hui , Qin Chong , Jiang Xiao-Qiang 
Published: April 2023

Lenses with tunable focal lengths are quite critical to various optical sensors, imaging, and detection systems. A traditional varifocal system is usually composed of multiple conventional refractors and needs to mechanically adjust the axial distance among them, inevitably leading to complex operation and bulky volume. Recently, metasurfaces have provided an alternative for flexibly shaping the electromagnetic field. However, simultaneously realizing continuous zoom and achromatic function remains a challenge. This paper proposes an achromatic continuous varifocal metalens consisting of two coaxial metasurfaces working in the terahertz range. The underlying mechanism depending on the superimposed phase distribution of these two metasurfaces is similar to a spherical lens, and the focal length can be continuously varied by changing the mutual rotation angle. The tuning range of focal length is continuous from 3.08 mm to 11.52 mm, corresponding to the numerical aperture from 0.58 to 0.19. Meanwhile, careful dispersion engineering based on the particle swarm optimization algorithm has also achieved achromatic bandwidth ranging from 0.9 THz to 1.2 THz. The maximum deviation of the focus length is below 8%, and the coefficient variations of the focal lengths among the entire bandwidth are under the allowed scope (5%) of the international standard of chromatic aberration, while a focusing efficiency of 32% can be obtained simultaneously. This scheme will provide promising opportunities and possibilities for future display technology and integrated optical imaging systems.