Miracle-dz/UniFAR-FTUs huggingface dataset:
The effect of non-pharmacological interventions on physical restraint reduction in intensive care units: a protocol for an umbrella review of systematic reviews and meta-analysis.

BACKGROUND As the last resort in intensive care units, physical restraint reduction is affected by various interventions. Several non-pharmacological interventions may directly reduce physical restraints, such as staff education, or indirectly reduce physical restraint, such as delirium prevention; however, their effectiveness has remained inconclusive. Therefore, we devised a protocol for umbrella reviews to summarize the evidence integrating data of different non-pharmacological interventions that may reduce physical restraint use. METHODS The umbrella review will be conducted following the methodology formulated by the Joanna Briggs Institute (JBI). Electronic databases, including Web of Science, PubMed, EMBASE, PsycInfo, Psyc Articles, Psychology and Behavioral Science Collection, Cumulative Index to Nursing and Allied Health Literature (CINAHL), JBISRIS (JBI Database of Systematic Reviews and Implementation Reports), Cochrane Database of Systematic Reviews, China National Knowledge Infrastructure (CNKI, for Chinese literature), SinoMed (for Chinese literature), and WANFANG DATA (for Chinese literature), will be searched to identify articles published from January 2016 to December 2020. A systematic review and metaanalysis quality will be critically assessed by AMSTAR 2 (A Measurement Tool to Assess Systematic Reviews). According to the GRADE (Grades of Recommendation, Assessment, Development, and Evaluation) guidelines, the evidence quality of each intervention will be assessed. Overlapping studies and the excess significance test will be performed to assess whether previous evidences are bias. DISCUSSION This protocol was devised according to the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). Umbrella reviews will be an excellent supplement to the evidence of the guideline adaptation and provide a broader picture of non-pharmacological interventions that may reduce the use of physical restraint, which can provide critical care nurses in intensive care units with the evidence they need. TRIAL REGISTRATION This umbrella review protocol was documented in the PROSPERO registry (CRD42021242586).
Targeting the Standardized Blood Pressure: New Guidelines for Blood Pressure Management in Chronic Kidney Disease

Blood Pressure Management in Chronic Kidney Disease Hypertension is common and challenging to treat among patients with chronic kidney disease (CKD). Recent evidence for cardiovascular benefit with more intensive management of blood pressure (BP) in high-risk hypertensive populations, including those with CKD, has led to recommendations of lower, yet evolving, BP targets (1, 2). In their article, Tomson and colleagues (3) summarize the 2021 Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline for the Management of Blood Pressure in Chronic Kidney Disease, which addresses BP management in adults with CKD who are not receiving dialysis and have not had a kidney transplant. Tomson and colleagues' synopsis focuses on the aspects of the recommendations most relevant to general internists: how to measure BP andwhat the BP goal should be.
Cost‐effectiveness analysis of telephone‐based cognitive behaviour therapy compared to treatment as usual CBT for cancer patients: Evidence from a small, randomised controlled trial

A previous equivalence randomised trial indicated that Telephone‐based Cognitive Behaviour Therapy (T‐CBT) was not inferior to Treatment as Usual CBT (TAU‐CBT) delivered face to face in terms of psychological benefit with both groups showing post‐therapy improvements compared to pre‐therapy baseline. The aim here is to clarify costs and benefits through an economic evaluation of the two therapy models.
Utility of the DECAF score for predicting survival of patients with COPD: a meta-analysis of diagnostic accuracy studies.

OBJECTIVE The DECAF (Dyspnea, Eosinopenia, Consolidation, Acidemia, Atrial Fibrillation) score is a widely used system for predicting the survival of patients with acute aggravation of chronic obstructive pulmonary disease (COPD). Evaluations of the predictive accuracy of DECAF have shown differing results. We performed this meta-analysis to evaluate the DECAF score as a survival predictor in patients with COPD. MATERIALS AND METHODS We have included the studies examining the accuracy of DECAF scoring system as index test with occurrence of events (mortality and need for invasive/non-invasive ventilation) as reference standards irrespective of the study design employed, type of participants and severity of the condition. We conducted a systematic search for all studies reporting the predictive accuracy of DECAF scores in the databases of PubMed Central, Scopus, Medline, Embase, and Cochrane from inception until September 2020. We have used the quality assessment of diagnostic accuracy studies-2 (QUADAS-2) tool to evaluate the risk of bias. We used the STATA software "midas" package to perform the meta-analysis. RESULTS We included 21 studies with 6429 patients. Most studies included were prospective. Most studies were conducted in the United Kingdom. Most studies used a cut-off value of the DECAF score ≥3 to predict the in-hospital or 30-day mortality and need for mechanical ventilation. All the studies used the occurrence of in-hospital/30-day mortality or patient undergoing mechanical ventilation as the reference standards. The pooled sensitivity and specificity of the DECAF score for predicting in-hospital mortality among patients with acute exacerbation of COPD were 74% (95% CI, 67%-79%) and 76% (95% CI, 68%-82%), respectively; and those for the 30-day mortality were 72% (95% CI, 59%-82%) and 83% (95% CI, 67%-93%), respectively. The overall quality of the studies in our meta-analysis was high. We found no significant publication biases as per Deek's test and funnel plot. CONCLUSIONS This review has certain strengths. It is the first meta-analysis assessing the predictive utility of the DECAF score for in-hospital mortality among patients with AECOPD. Most studies included were of high quality according to the QUADAS-2 tool. Despite these strengths, our review had some limitations. We found a significant between-study variability in our analysis that can limit its value for inferring or interpreting the pooled findings. The predictive accuracy of the scoring system depends on many factors such as the ethnicity of the participants or patients, the timing of the scoring system assessment, and the AECOPD severity. We could not assess the influence of these variables in our study. Despite these shortcomings, our findings provide valuable information and important implications for the clinical practice involving patients with AECOPD. We found that the DECAF score can predict in-hospital and 30-day mortalities with satisfactory sensitivity and specificity.
Analysis of the interaction between personality dysfunction and traits in the statistical prediction of physical aggression: Results from outpatient and community samples.

The Alternative Model for Personality Disorders (AMPD), included in the Diagnostic and Statistical Manual of Mental Disorders (5th ed.) and the World Health Organization's International Classification of Diseases (11th ed.; ICD-11) are, respectively, hybrid categorical-dimensional and dimensional frameworks for personality disorders (PDs). Both models emphasize personality dysfunction and personality traits. Previous studies investigating the links between the AMPD and ICD-11, and self-reported physical aggression have mostly focused on traits and did not take into account the potential interaction between personality dysfunction and traits. Thus, the aim of this study is to identify dysfunction*trait interactions using regression-based analysis. Outpatients with personality disorder from a specialized public clinic (N = 285) and community participants (N = 995) were recruited to complete self-report questionnaires. Some small-size, albeit significant and clinically/conceptually meaningful personality dysfunction*trait interactions were found to predict physical aggression in both samples. Interaction analyses might further inform, to some degree, about the current discussion pertaining to the potential redundancy between dysfunction and traits, the optimal personality dysfunction structure (in the case of the AMPD), as well as clinical assessment based on AMPD/ICD-11 PD frameworks.
Cognitive Reserve Moderates Associations Between Walking Performance Under Single and Dual-Task Conditions and Incident Mobility Impairment in Older Adults.

BACKGROUND Among older adults, walking performance is a reliable indicator of adverse health outcomes including incident mobility impairment. Whereas, attention and executive functions have been implicated in cognitive control of locomotion, much less is known about the role of Cognitive Reserve (CR) in predicting mobility impairments among older adults. Specifically, whether CR moderates the relationship between gait performance and incident mobility impairment, has not been reported. To address this gap in the literature, we examined whether gait performance under Single-Task-Walk (STW) and Dual-Task-Walk (DTW) conditions predicted incident mobility impairment and whether CR moderated this relationship. METHODS Participants were 176 (mean age=75.57; %female=53) older adults with baseline SPPB scores of 10-12. Participants completed neuropsychological testing, the SPPB, and a dual-task walking protocol. CR was evaluated using the Wide Range Achievement Test 3 rd edition (WRAT-3). Participants were followed for three years; individuals whose SPPB scores declined below 10 were defined as incident cases of mobility impairment (n=42). RESULTS Moderation analyses revealed significant interaction effects of CR with walking velocity under STW (b = 0.09, 95% CI [0.01, 0.17], z = 2.30, p = 0.02), and DTW (b = 0.10, 95% CI [0.02, 0.17], z = 2.55, p = 0.01) conditions wherein slower gait predicted increased risk of incident mobility impairment among individuals with lower CR. CONCLUSION These findings extend knowledge about the interrelation of cognitive and mobility functions, revealing the critical role of CR in identifying older adults at risk of developing incident mobility impairment.
Economic long‐term effects of intensive interdisciplinary pain treatment in paediatric patients with severe chronic pain: Analysis of claims data

Chronic pain in children and adolescents gives rise to high healthcare costs. Successful treatment is supposed to reduce the economic burden. The objective of this study was to determine the changes in healthcare utilization and expenditures from 1 year before (Pre) intensive interdisciplinary pain treatment (IIPT) to the first (Post 1) and second (Post 2) years after discharge in a sample of paediatric chronic pain patients.
Characteristics of ovarian endometrioma during pregnancy

During pregnancy, the ovarian endometrioma generally decreases in size and occasionally ruptures. We evaluated (1) whether and how ovarian‐endometrioma size changes from the first trimester to the postdelivery period, and (2) the type of endometrioma more likely to rupture during pregnancy.
Changing language input following market integration in a Yucatec Mayan community

Like many indigenous populations worldwide, Yucatec Maya communities are rapidly undergoing change as they become more connected with urban centers and access to formal education, wage labour, and market goods became more accessible to their inhabitants. However, little is known about how these changes affect children’s language input. Here, we provide the first systematic assessment of the quantity, type, source, and language of the input received by 29 Yucatec Maya infants born six years apart in communities where increased contact with urban centres has resulted in a greater exposure to the dominant surrounding language, Spanish. Results show that infants from the second cohort received less directed input than infants in the first and, when directly addressed, most of their input was in Spanish. To investigate the mechanisms driving the observed patterns, we interviewed 126 adults from the communities. Against common assumptions, we showed that reductions in Mayan input did not simply result from speakers devaluing the Maya language. Instead, changes in input could be attributed to changes in childcare practices, as well as caregiver ethnotheories regarding the relative acquisition difficulty of each of the languages. Our study highlights the need for understanding the drivers of individual behaviour in the face of socio-demographic and economic changes as it is key for determining the fate of linguistic diversity.
Motivated attention to stimuli related to social networking sites: A cue-reactivity study

Abstract Background and aims It has been argued that similar to addictive behaviors, problematic Social Network sites use (PSNSU) is characterized by sensitized reward processing and cue-reactivity. However, no study to our knowledge has yet investigated cue-reactivity in PSNSU. The present study aims at investigating cue-reactivity to Social Network sites (i.e., Facebook)-related visual cues in individuals identified as problematic vs. non-problematic Facebook users by the Problematic Facebook Use Scale. Methods The Event-Related Potentials (ERPs) were recorded during the passive viewing of Facebook-related, pleasant, unpleasant, and neutral pictures in 27 problematic and 26 non-problematic users. Moreover, craving for Facebook usage was collected using a Likert scale. Results Despite problematic users were more likely to endorse higher craving than non-problematic ones, Facebook-related cues elicited larger ERP positivity (400–600 ms) than neutral, and comparable to unpleasant stimuli, in all Facebook users. Only in problematic users we found larger positivity (600–800 ms) to pleasant than unpleasant cues and higher craving to be related with lower later positivity (800–1,000 ms) to pleasant and unpleasant cues. Discussion Regardless of whether Facebook usage is problematic or non-problematic, Facebook-related cues seem to be motivationally relevant stimuli that capture attentional resources in the earlier stages of “motivated” attentional allocation. Moreover, our results support the view that in higher-craving problematic users, reduced abilities to experience emotions would be the result of defective emotion regulation processes that allow craving states to capture more motivational/attentional resources at the expense of other emotional states.
ASSESSMENT OF CARDIOVASCULAR RISK IN PATIENTS WITH TYPE 2 DIABETES MELLITUS AND ASSOCIATED OBESITY AND WAYS OF ITS CORRECTION.

OBJECTIVE The aim: To analyze and calculate CVR in patients with T2DM and concomitant obesity. PATIENTS AND METHODS Materials and methods: The selection of patients was carried out based on the Uzhhorod District Clinical Hospital, in the period from November 2016 to January 2020. All patients were divided into 3 groups: 1 (n=93) with T2DM and concomitant obesity, 2 (n=87) with T2DM, 3 (n=39) with obesity. The treatment period lasted 1 year and included dosed exercise for at least 30 minutes per day and dietary recommendations. Patients in groups 1 and 2 received metformin 850 mg twice daily in combination with dapagliflozin 10 mg once daily. CVR was determined at the time of enrollment and after 1 year of treatment using: American College of Cardiology / American Heart Association Guideline on the Assessment of Cardiovascular Risk (2013) (ASCVD Risk) and Framingham Risk Score (FRS). RESULTS Results: The data obtained as a result of the study revealed the highest CVR in patients of group 1, in contrast to group 2 and 3 (p<0.05). After 1 year of complex treatment, CVR indicators were statistically significantly reduced in all experimental groups (p<0.05). CONCLUSION Conclusions: Determining CVR parameters and exposure to them within 10 years can remove unwanted cardiovascular complications.
Nursing Students’ Perceptions about Effective Pedagogy: Netnographic Analysis

Background Effective pedagogy that encourages high standards of excellence and commitment to lifelong learning is essential in health professions education to prepare students for real-life challenges such as health disparities and global health issues. Creative learning and innovative teaching strategies empower students with high-quality, practical, real-world knowledge and meaningful skills to reach their potential as future health care providers. Objective The aim of this study was to explore health profession students’ perceptions of whether their learning experiences were associated with good or bad pedagogy during asynchronous discussion forums. The further objective of the study was to identify how perceptions of the best and worst pedagogical practices reflected the students’ values, beliefs, and understanding about factors that made a pedagogy good during their learning history. Methods A netnographic qualitative design was employed in this study. The data were collected on February 3, 2020 by exporting archived data from multiple sessions of a graduate-level nursing course offered between the fall 2016 and spring 2020 semesters at a large private university in the southeast region of the United States. Each student was a data unit. As an immersive data operation, field notes were taken by all research members. Data management and analysis were performed with NVivo 12. Results A total of 634 posts were generated by 153 students identified in the dataset. Most of these students were female (88.9%). From the 97 categories identified, four themes emerged: (T) teacher presence built through relationship and communication, (E) environment conducive to affective and cognitive learning, (A) assessment and feedback processes that yield a growth mindset, and (M) mobilization of pedagogy through learner- and community-centeredness. Conclusions The themes that emerged from our analysis confirm findings from previous studies and provide new insights. Our study highlights the value of technology as a tool for effective pedagogy. A resourceful teacher can use various communication techniques to develop meaningful connections between the learner and teacher. Styles of communication will vary according to the unique expectations and needs of learners with different learning preferences; however, the aim is to fully engage each learner, establish a rapport between and among students, and nurture an environment characterized by freedom of expression in which ideas flow freely. We suggest that future research continue to explore the influence of differing course formats and pedagogical modalities on student learning experiences.
Multiomic analysis of the function of SPOCK1 across cancers: an integrated bioinformatics approach

Objective To investigate SPARC (osteonectin), cwcv and kazal like domains proteoglycan 1 (SPOCK1) gene expression across The Cancer Genome Atlas (TCGA) cancers, both in cancer versus normal tissues and in different stages across the cancer types. Methods This integrated bioinformatics study used data from several bioinformatics databases (Cancer Cell Line Encyclopedia, Genotype-Tissue Expression, TCGA, Tumor Immune Estimation Resource [TIMER]) to define the expression pattern of the SPOCK1 gene. A survival analysis was undertaken across the cancers. The search tool for retrieval of interacting genes (STRING) database was used to identify proteins that interacted with SPOCK1. Gene Set Enrichment Analysis was conducted to determine pathway enrichment. The TIMER database was used to explore the correlation between SPOCK1 and immune cell infiltration. Results This multiomic analysis showed that the SPOCK1 gene was expressed differently between normal tissues and tumours in several cancers and that it was involved in cancer progression. The overexpression of the SPOCK1 gene was associated with poor clinical outcomes. Analysis of gene expression and tumour-infiltrating immune cells showed that SPOCK1 correlated with several immune cells across cancers. Conclusions This research showed that SPOCK1 might serve as a new target for several cancer therapies in the future.
Adiponectin agonist treatment in diabetic pregnant rats

Gestational diabetes mellitus (GDM) reduces maternal adiponectin and docosahexaenoic acid (DHA) materno-fetal transfer, which may have negative consequences for the offspring. Our aim was to evaluate the effects of the administration of a novel adiponectin agonist (AdipoRon) to GDM rats on the long-term consequences in glycaemia and fatty acids (FA) profile in the offspring. Pregnant rats were randomized to three groups: GDM rats (GDM, n = 8), GDM rats treated with AdipoRon (GDM + ADI, n = 9), and control rats (n = 10). Diabetes was induced with streptozotocin (50 mg/kg) on day 12 of gestation. GDM+ADI received 50 mg/kg/day AdipoRon from day 14 until delivery. Glycaemia and FA profile were determined in mothers and adult offspring (12 weeks old). AdipoRon tended to reduce fasting glucose in diabetic mothers. Diabetic rats presented the foetus with intrauterine growth restriction and higher adiposity, which tried to be counteracted by AdipoRon. In the adult offspring, both GDM + ADI and control animals showed better glucose recovery after oral glucose overload with respect to GDM. DHA in offspring plasma was significantly reduced in both GDM and GDM + ADI compared to controls (P = 0.043). Nevertheless, n-6/n-3 polyunsaturated FA (PUFA) ratio improved in plasma of GDM + ADI adult offspring (GDM: 14.83 ± 0.85a%; GDM + ADI: 11.49 ± 0.58b%; control: 10.03 ± 1.22b%, P = 0.034). Inflammatory markers and oxidative stress were reduced in the adult offspring of AdipoRon-treated mothers. In conclusion, AdipoRon administration to pregnant diabetic rats improved glycaemia in the mothers and long-term glucose tolerance in the offspring. In addition, it tended to reduce excessive foetal fat accumulation and improved n-6/n-3 PUFA ratio significantly in offspring at the adult state.
Vaccination Against Receptor for Advanced Glycation End Products Attenuates the Progression of Diabetic Kidney Disease

Effective treatment of diabetic kidney disease (DKD) remains a large unmet medical need. Within the disease’s complicated pathogenic mechanism, activation of the advanced glycation end products (AGEs)–receptor for AGE (RAGE) axis plays a pivotal role in the development and progression of DKD. To provide a new therapeutic strategy against DKD progression, we developed a vaccine against RAGE. Three rounds of immunization of mice with the RAGE vaccine successfully induced antigen-specific serum IgG antibody titers and elevated antibody titers were sustained for at least 38 weeks. In addition, RAGE vaccination significantly attenuated the increase in urinary albumin excretion in streptozotocin-induced diabetic mice (type 1 diabetes model) and leptin-receptor–deficient db/db mice (type 2 diabetes model). In microscopic analyses, RAGE vaccination suppressed glomerular hypertrophy and mesangial expansion in both diabetic models and significantly reduced glomerular basement membrane thickness in streptozotocin-induced diabetic mice. Results of an in vitro study indicated that the serum IgG antibody elicited by RAGE vaccination suppressed the expression of AGE-induced vascular cell adhesion molecule 1 and intracellular adhesion molecule 1 in endothelial cells. Thus, our newly developed RAGE vaccine attenuated the progression of DKD in mice and is a promising potential therapeutic strategy for patients with DKD.