bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevention of muscle atrophy in ICU patients without nerve injury by neuromuscular electrical stimulation: a randomized controlled study
Authors: Bao Weiwei , Yang Jiajia , Li Mingna , Chen Kang , Ma Zheng , Bai Yuehong , Xu Yiming 
Published: August 2022

Abstract
Background
Extensive muscle atrophy is a common occurrence in orthopaedics patients who are bedridden or immobilized. The incidence is higher in intensive care unit (ICU) inpatients. There is still controversy about how to use neuromuscular electrical stimulation (NMES) in ICU patients. We aim to compare the effectiveness and safety of NMES to prevent muscle atrophy in intensive care unit (ICU) patients without nerve injury.

Methods
ICU patients without central and peripheral nerve injury were randomized into experimental group I (Exp I: active and passive activity training (APAT) + NMES treatment on the gastrocnemius and tibialis anterior muscle), experimental group II (Exp II: APAT + NMES treatment on gastrocnemius alone), and control group (Ctl: APAT alone). Changes in the strength of gastrocnemius, the ankle range of motion, and the muscle cross-section area of the lower leg were evaluated before and after the intervention. Also, changes in prothrombin time, lactic acid, and C-reactive protein were monitored during the treatment.

Results
The gastrocnemius muscle strength, ankle joint range of motion, and cross-sectional muscle area of the lower leg in the three groups showed a downward trend, indicating that the overall trend of muscle atrophy in ICU patients was irreversible. The decrease in gastrocnemius muscle strength in Exp I and Exp II was smaller than that in the control group (P < 0.05), but there was no difference between Exp I and Exp II. The decrease in active ankle range of motion and cross-sectional area of the lower leg Exp I and Exp II was smaller than that in the control group (P < 0.05), and the decrease in Exp I was smaller than that of Exp II (all P < 0.05). The curative effect in Exp I was better than in Exp II. There were no significant differences in the dynamic changes of prothrombin time, lactic acid, and C-reactive protein during the three groups (P > 0.05).

Conclusion
In addition to early exercise training, NMES should be applied to prevent muscle atrophy for patients without nerve injury in ICU. Also, simultaneous NMES treatment on agonist/antagonist muscle can enhance the effect of preventing muscle atrophy.

Trial registration
This study was prospectively registered in China Clinical Trial Registry (www.chictr.org.cn) on 16/05/2020 as ChiCTR2000032950.
Early menopause and weight loss are significant factors associated with risk of future fracture in middle-aged women
Authors: Moberg Louise , Hamrefors Viktor , Fedorowski Artur , Rogmark Cecilia 
Published: August 2022

Abstract
Background
To identify factors related to reproductive history and weight change associated with first incident fracture in middle-aged women.

Methods
In total, 18,326 women from the Malmö Diet and Cancer study were included in this prospective population-based cohort study. Participants were included 1991–1996 and followed to 2016. Using data from the National Patient Registry, linked with every participants’ unique personal identification number, any first fracture affecting spine, thoracic cage, upper and lower extremities was identified. The association of baseline factors with incident fracture risk was analyzed using Cox regression models.

Results
For participating women, median age 56.0 years, the multivariable Cox regression analysis observed that early menopause (40–44 years) (hazard ratio (HR) 1.14, 95% confidence interval (CI) 1.03–1.27) but not premature menopause < 40 years (HR 1.06, 95% CI 0.91–1.24) was associated with future fracture risk. Self-reported weight loss since age 20 was also associated with future fracture risk (HR 1.39, 95% CI 1.17–1.65) whereas a daily alcohol consumption in the third quartile (5.36–11.42 g/day) compared to the lowest quartile (0–0.80 g/day) was associated with decreased future fracture risk (HR 0.88, 95% CI 0.81–0.96). The multivariable Cox regression analysis also observed that increasing age and weight at baseline, current smoking, a positive history of previous fracture and family history of fractures were associated with increased fracture risk whereas an increasing BMI was associated with a decreased fracture risk. No association to parity or period of lactation was observed nor ever-use of oral contraceptives and menopausal hormone therapy.

Conclusion
This study shows that early menopause between 40 to 45 years and self-reported weight loss since age of 20 are relevant factors associated with increased fracture risk in middle-aged women. These factors were independent of traditional predictors of fracture risk among women and may be considered in preventive initiatives.

Trial registration
Clinicaltrials.gov with identifier: NCT04151732, since Nov 5th 2018.
Treatment decision-making process after an anterior cruciate ligament injury: patients’, orthopaedic surgeons’ and physiotherapists’ perspectives
Authors: Grevnerts Hanna Tigerstrand , Krevers Barbro , Kvist Joanna 
Published: August 2022

Abstract
Objective
To investigate the treatment decision-making process after an anterior cruciate ligament (ACL) injury from patients’, orthopaedic surgeons’ and physiotherapists’ perspectives.

Methods
The study is a part of the NACOX study, which is designed to describe the natural corollaries after ACL injury. For the present study, a subgroup 101 patients were included. Patients, their orthopaedic surgeons and their physiotherapists, answered a Shared Decision-Making Process (SDMP) questionnaire, when treatment decision for ACL reconstruction surgery (ACLR) or non-reconstruction (non-ACLR) was taken. The SDMP questionnaire covers four topics: “ informed patient”, “ to be heard”, “ involvement” and “ agreement”.

Results
Most (75–98%) patients considered their needs met in terms of being heard and agreement with the treatment decision. However, fewer in the non-ACLR group compared to the ACLR group reported satisfaction with information from the orthopaedic surgeon (67% and 79%), or for their own involvement in the treatment decision process (67% and 97%).

Conclusion and practice implications
Most patients and caregivers considered that patients’ needs to be informed, heard and involved, and to agree with the decision about the treatment process, were fulfilled to a high extent. However, patients where a non-ACLR decision was taken experienced being involved in the treatment decision to a lower extent. This implies that the non-ACLR treatment decision process needs further clarification, especially from the patient involvement perspective.
Conservative interventions and clinical outcome measures used in the perioperative rehabilitation of breast cancer patients undergoing mastectomy: a scoping review
Authors: Mathieu Janny , Daneau Catherine , Lemeunier Nadège , Doyon Annabelle , Marchand Andrée-Anne , Descarreaux Martin 
Published: August 2022

Abstract
Background
Mastectomy is the first-line treatment approach for more than 90% of breast cancer patients. The numerous physical impairments associated with this surgical procedure negatively impact the patient’s quality of life. To date, rehabilitation resources available for breast cancer patients undergoing mastectomy within the institutions affiliated to the Centre intégré universitaire de soins de santé et de services sociaux de la Mauricie-et-du-Centre-du-Québec (CIUSSS-MCQ) are lacking and do not always seem to reflect the particularities of breast cancer care pathways. The purpose of this review was to identify and describe the conservative interventions and the clinical outcome measures used in the perioperative physical rehabilitation of women with breast cancer who are awaiting or have undergone mastectomy. We also aimed to report on the barriers and facilitators to study participation and completion.

Methods
MEDLINE, CINAHL, and the Cochrane Library were searched from inception to January 2021, and we updated the search on July 11, 2022. We included peer-reviewed English and French literature with quantitative designs, describing conservative interventions and clinical outcome measures used within rehabilitation programs designed for women who were awaiting or had undergone mastectomy. Paired reviewers independently reviewed all citations and articles using a two-phase screening process and independently extracted the data.

Results
Of the 6080 articles identified, 57 met the inclusion criteria. Most interventions were multimodal, which combined exercise with patient education, manual therapy, and/or lymphatic drainage. The most frequently used objective measures of physical function were shoulder range of motion, muscle strength, and signs of lymphedema. In contrast, the primary patient-reported outcome measures were quality of life, shoulder function, and pain. Undergoing another breast surgery, death, and cancer recurrence were the most reported barriers to study completion.

Conclusion
This scoping review reports on the heterogeneity and wide range of conservative interventions and clinical outcome measures used in the physical rehabilitation of breast cancer patients who had undergone or were scheduled to undergo mastectomy. Tailoring interventions to breast cancer patients’ needs and promoting outpatient rehabilitation interventions appear to be better suited to the particularities of breast cancer care pathways. Further research is needed to better identify barriers and facilitators to study participation and completion.
How gender norms and ‘good girl’ notions prevent adolescent girls and young women from engaging with PrEP: qualitative insights from Zimbabwe
Authors: Skovdal Morten , Clausen Camilla Lysemose , Magoge-Mandizvidza Phyllis , Dzamatira Freedom , Maswera Rufurwokuda , Nyamwanza Rangarirayi Primrose , Nyamukapa Constance , Thomas Ranjeeta , Gregson Simon 
Published: August 2022

Abstract
Background
Pre-exposure prophylaxis, or PrEP, has been hailed for its promise to provide women with user-control. However, gender-specific challenges undermining PrEP use are beginning to emerge. We explore the role of gender norms in shaping adolescent girls and young women’s (AGYW) engagement with PrEP.

Methods
We draw on qualitative data from 12 individual interviews and three focus group discussions with AGYW from eastern Zimbabwe. Interviews were transcribed and thematically coded in NVivo 12. Emerging themes were further investigated using Connell’s notion of ‘emphasised femininity’.

Results
Participants alluded to the patriarchal society they are part of, with ‘good girl’ notions subjecting them to direct and indirect social control. These controls manifest themselves through the anticipation of intersecting sexuality- and PrEP-related stigmas, discouraging AGYW from engaging with PrEP. AGYW recounted the need for permission to engage with PrEP, forcing them to consider engaging with PrEP in secrecy. In addition, limited privacy at home, and fear of disclosure of their health clinic visits, further heightened their fear of engaging with PrEP. PrEP is not simply a user-controlled HIV prevention method, but deeply entrenched within public gender orders.

Conclusion
AGYW face significant limitations in their autonomy to initiate and engage with PrEP. Those considering PrEP face the dilemma of Scylla and Charybdis: The social risks of stigmatisation or risks of HIV acquisition. Efforts to make PrEP available must form part of a combination of social and structural interventions that challenge harmful gender norms.
Does artificial intelligence aid in the detection of different types of breast cancer?
Authors: Raafat Mariam , Mansour Sahar , Kamal Rasha , Ali Hedaya W. , Shibel Passant E. , Marey Ahmed , Taha Sherif N. , Alkalaawy Basma 
Published: August 2022

AbstractBackgroundOn mammography many cancers may be missed even in retrospect either due to the breast density, the small size of the tumor or the subtle signs of cancer that are imperceptible. We aimed to compare the sensitivity of artificial intelligence (AI) to that of digital mammography in the detection of different types of breast cancer. Also, the sensitivity of AI in picking up the different breast cancer morphologies namely mass, pathological calcifications, asymmetry, and distortion was assessed. Tissue biopsy and pathology were used as the standard reference. The study included 123 female patients with 134 proved carcinoma. All patients underwent digital mammogram (DM) examination scanned with artificial intelligence algorithm.ResultsAI achieved higher sensitivity than mammography in detecting malignant breast lesions. The sensitivity of AI was 96.6%, and false negative rate was 3.4%, while mammography sensitivity was 87.3% and false negative rate 12.7%. Our study showed AI performed better than mammography in detecting ductal carcinoma in situ and invasive lobular carcinoma with sensitivity (100% and 96.6%) vs (88.9% and 82.2%) respectively. AI was more sensitive to detect cancers presented with suspicious mass 95.2% vs 75%, suspicious calcifications 100% vs 86.5% and asymmetry and distortion 100% vs 84.6%, than mammography.ConclusionsAI showed potential values to overcome mammographic limitations in the detection of breast cancer even those with challenging morphology as invasive lobular carcinoma, ductal carcinoma in situ, tubular carcinoma and micropapillary carcinoma.
Diagnosis and demonstration of single coronary artery by multidetector CT angiography: series of two cases
Authors: Singh Neha , Gupta Yashraj , Singh Bhanupriya , Agrawal Gaurav Raj , Rajput Subhash 
Published: August 2022

Abstract
Background
Single coronary artery (SCA) is a rare anomaly, usually diagnosed incidentally during coronary artery angiogram. Individuals with this anomaly mostly remain asymptomatic while some present with symptoms such as chest pain, dyspnoea and even sudden death. The origin and the proximal course of anomalous coronary artery are the main prognostic factors. Several classification systems have been proposed based on the site of origin and anatomical distribution of anomalous artery. Coronary computed tomography angiography has become the reference method for such an assessment noninvasively. Herein, we report a series of two cases of SCA diagnosed on CT angiography. In one case it was single left coronary artery associated with other congenital cardiac anomalies, whereas in other it was single right coronary artery and was an isolated anomaly.

Case presentation
Our first case was of a 19-year-old female who presented with chest pain and dyspnoea. Transthoracic Echocardiography (TTE) features were suggestive of Tetralogy of Fallot (TOF) with infective endocarditis. Cardiac CT angiography revealed the presence of a large SCA arising from left aortic sinus with absence of normal origin of right coronary artery (RCA). This artery was dividing into and supplying different coronary arterial territories with pre-pulmonic course of RCA. The patient underwent Aortic valve replacement with pulmonary Commissurotomy and improved in post-operative period. Our second case was of a 50-year-old man with complaints of breathlessness and normal ECG and Echocardiography examination findings. Coronary CT angiography revealed the presence of SCA arising from right aortic sinus and supplying the territories of both RCA and Left coronary artery (LCA). The patient was managed conservatively with emphasis on aggressive control of risk factors.

Conclusions
SCA is a rare anomaly and may lead to catastrophic life threatening complications. The accurate delineation of the origin and course of the anomalous vessel is of paramount importance while planning surgical intervention. Management usually involves a multi-disciplinary approach with cardiologists and cardiac surgeons aiming for deciding an individual plan based on presentation and anatomy of each case.
Developing an implementation research logic model: using a multiple case study design to establish a worked exemplar
Authors: Czosnek Louise , Zopf Eva M. , Cormie Prue , Rosenbaum Simon , Richards Justin , Rankin Nicole M. 
Published: August 2022

Abstract
Background
Implementation science frameworks explore, interpret, and evaluate different components of the implementation process. By using a program logic approach, implementation frameworks with different purposes can be combined to detail complex interactions. The Implementation Research Logic Model (IRLM) facilitates the development of causal pathways and mechanisms that enable implementation. Critical elements of the IRLM vary across different study designs, and its applicability to synthesizing findings across settings is also under-explored. The dual purpose of this study is to develop an IRLM from an implementation research study that used case study methodology and to demonstrate the utility of the IRLM to synthesize findings across case sites.

Method
The method used in the exemplar project and the alignment of the IRLM to case study methodology are described. Cases were purposely selected using replication logic and represent organizations that have embedded exercise in routine care for people with cancer or mental illness. Four data sources were selected: semi-structured interviews with purposely selected staff, organizational document review, observations, and a survey using the Program Sustainability Assessment Tool (PSAT). Framework analysis was used, and an IRLM was produced at each case site. Similar elements within the individual IRLM were identified, extracted, and re-produced to synthesize findings across sites and represent the generalized, cross-case findings.

Results
The IRLM was embedded within multiple stages of the study, including data collection, analysis, and reporting transparency. Between 33-44 determinants and 36-44 implementation strategies were identified at sites that informed individual IRLMs. An example of generalized findings describing “intervention adaptability” demonstrated similarities in determinant detail and mechanisms of implementation strategies across sites. However, different strategies were applied to address similar determinants. Dependent and bi-directional relationships operated along the causal pathway that influenced implementation outcomes.

Conclusions
Case study methods help address implementation research priorities, including developing causal pathways and mechanisms. Embedding the IRLM within the case study approach provided structure and added to the transparency and replicability of the study. Identifying the similar elements across sites helped synthesize findings and give a general explanation of the implementation process. Detailing the methods provides an example for replication that can build generalizable knowledge in implementation research.
Congenital smooth muscle hamartoma of the tongue in a neonate — a case report
Authors: Shah Amar A. , Lahmar Abdelilah , Shah Anirudh V. 
Published: August 2022

Abstract
Background
Hamartoma is a benign, tumor-like proliferation of mature tissue that is natural to the organ from which it developed. Oral hamartomas are rare and can occur as an isolated finding or as a part of a syndrome.

Case presentation
We report a 4-day-old male neonate who was postnatally noted to have a large 3.5 × 3.5 cm lobulated mass over the tip of the tongue. The mass was causing protrusion of the tongue and feeding difficulties following which surgical excision was planned. The postoperative recovery was uneventful.

Conclusion
Although rare, lingual hamartomas should be considered in the differential diagnosis algorithm for congenital tongue lesions. The definitive diagnosis is histopathological with complete resection of the tumor resulting in a favorable prognosis.
Combinatorial therapeutic approaches of photodynamic therapy and immune checkpoint blockade for colon cancer treatment
Authors: Hao Yang , Chung Chih Kit , Gu Zili , Schomann Timo , Dong Xiaoxu , Veld Ruben V. Huis in ‘t , Camps Marcel G. M. , ten Dijke Peter , Ossendorp Ferry A. , Cruz Luis J. 
Published: August 2022

AbstractPhotodynamic therapy (PDT) has shown impressive therapeutic effects on various types of cancers by reactive oxygen species (ROS) generation and induction of immune responses. However, under certain conditions, the immune responses induced by PDT are not always sufficient to eradicate the remaining tumor cells. On the other hand, the photosensitizer indocyanine green (ICG) can mediate PDT under near-infrared (NIR) illumination, thereby enhancing the penetration depth of the excitation light into the tumor. We found that ICG is rapidly taken upin vitroby colorectal MC38 and CT26 tumor cells and it promotes PDT-mediated cell-killing effects. Our results furthermore revealed that ICG induces immunogenic cell death (ICD), as dendritic cells (DCs) were found to engulf ICG-PDT-treated tumor cells and undergo phenotypic maturation. ICG accumulated in tumors 2 h after administration, as measured by fluorescence and photoacoustic imaging. Considering the advantages of ICG as a photosensitizer, we sought to design a therapy that combines PDT and immune checkpoint blockade to maximize tumor control. To this end, a 25% thermosensitive polymer 407 hydrogel was included as a co-delivery platform for this treatment scheme. NIR-PDT under 808 nm irradiation in combination with cytotoxic T-lymphocyte-associated protein 4 (CTLA4)/programmed death-ligand 1 (PD-L1) checkpoint blockade prolonged survival rate of colorectal tumor-bearing mice by inducing a series of immune responses, like the phagocytosis of tumor debris by macrophages and DCs, and induction of acute inflammation, leukocyte infiltration, maturation and activation of DCs. Altogether, our work presents a NIR-triggered PDT strategy in combination with immune checkpoint blockade. Compared to a single treatment, the combination treatment increased efficiency to inhibit solid tumor growth and improved the survival rate of tumor-bearing mice.
Longitudinal Sex Steroid Data in Relation to Birth Weight in Preterm Boys
Authors: Allvin Kerstin , Ankarberg-Lindgren Carina , Dahlgren Jovanna 
Published: August 2022

Abstract

Context
There is a lack of knowledge on longitudinal sex steroid patterns during infancy, especially for boys born preterm or with low birth weight (LBW).

Objective
To find out whether LBW boys have a disturbed sex steroid profile during infancy.

Design and setting
Population-based longitudinal study performed at Sahlgrenska University Hospital, Gothenburg, Sweden.

Participants
Ninety-eight singleton boys (47 LBW) born at gestational age 32.0 to 36.9 weeks were included. Because of dropout, 83 of the boys were still in the study at 10 months’ corrected age.

Main outcome measures
Serum androgen and estrogen concentrations were analyzed by gas chromatography-tandem mass spectrometry and IGF-I was determined with radioimmunoassay in umbilical cord and at 0, 2, 5, and 10 months’ corrected age.

Results
Serum levels of androstenedione, estrone, and estradiol declined gradually from birth to 10 months corrected age. In both LBW boys and their counterparts, a surge was seen at 2 months’ corrected age (3 months’ chronological age) for testosterone, median (range) 6.5 (2.0-18.9) nmol/L, and in dihydrotestosterone 1.2 (0.4-4.3) nmol/L. At birth, LBW boys had higher median testosterone (0.7 vs 0.4 nmol/L, P = 0.019), and at 0 months’ corrected age, both had higher testosterone (5.7 vs 3.5 nmol/L, P = 0.003) and dihydrotestosterone (1.2 vs 0.9 nmol/L, P = 0.006) than their counterparts. At 10 months’ corrected age, catch-up in weight SD score from birth correlated with testosterone (rho = 0.27, P = 0.044) and androstenedione (rho = 0.29, P = 0.027).

Conclusions
Moderately to late preterm LBW boys showed a disturbed sex hormone profile, with elevated concentrations of androgens in early infancy.