bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementation of Highly Challenging Balance Training for Parkinson’s disease in Clinical Practice: A Process Evaluation
Authors: Leavy Breiffni , Joseph Conran , Kwak Lydia , Franzén Erika 
Published: April 2020

Abstract
Background
Process evaluations provide contextual insight into the way in which interventions are delivered. This information is essential when designing strategies to implement programs into wider clinical practice. We performed a process evaluation of the HiBalance effectiveness trial investigating the effects of a 10-week of highly challenging and progressive balance training for mild-moderate Parkinson’s disease (PD). Study aims were to investigate i) the quality and quantity of intervention delivery and ii) barriers and facilitators for implementation.
Methods
Process outcomes included; Fidelity; Dose (delivered and received) Recruitment and Reach. Investigation of barriers and facilitators was guided by the Consolidated Framework for Implementation Research. Program delivery was assessed across four neurological rehabilitation sites during a two-year period. Data collection was mixed-methods in nature and quantitative and qualitative data were merged during the analysis phase.
Results
Thirteen program trainers delivered the intervention to 12 separate groups during 119 training sessions. Trainer fidelity to program core components was very high in 104/110 (94%) of the sessions. Participant responsiveness to the core components was generally high, although adherence to the home exercise program was low (50%). No significant context-specific differences were observed across sites in terms of fidelity, dose delivered/ received or participant characteristics, despite varying recruitment methods. Facilitators to program delivery were; PD-specificity, high training frequency and professional autonomy. Perceived barriers included; cognitive impairment, absent reactional balance among participants, as well a heterogeneous group in relation to balance capacity.
Conclusion
These findings provide corroborating evidence for outcome evaluation results and valuable information for the further adaptation and implementation of this program. Important lessons can also be learned for researchers and clinicians planning to implement challenging exercise training programs for people with mild-moderate PD.
Trial registration:
ClinicalTrials.gov, NCT02727478, registered 30 march − Retrospectively registered. https://clinicaltrials.gov/ct2/show/NCT02727478
Social Determinants of Mental Health Care Systems: Intensive Community Based Care in The Veterans Health Administration
Authors: Bhalla Ish P , Stefanovics Elina A , Rosenheck Robert A 
Published: April 2020

Abstract
Background
Since deinstitutionalization in the 1950s-1970s, public mental health care has changed its focus from asylums to general hospitals, outpatient clinics and specialized community-based programs addressing both clinical and social determinants of mental health. Analysis of the place of community-based programs within a comprehensive health system such as the Veterans Health Administration (VHA) may illuminate the role of social forces in shaping contemporary public mental health systems.
Methods
National VHA administrative data were used to compare veterans who exclusively received outpatient clinic care to those receiving four types of specialized community-based services, addressing: 1) functional disabilities from severe mental illness (SMI), 2) justice system involvement, 3) homelessness, and 4) vocational rehabilitation. Bivariate comparisons and multinomial logistic regression analyses compared groups on demographics, diagnoses, service use, and psychiatric prescription fills.
Results
An hierarchical classification of 1,386,487 Veterans who received specialty mental health services from VHA in Fiscal Year 2012, showed 1,134,977 (81.8%) were seen exclusively in outpatient clinics; 27,931 (2.0%) received intensive SMI-related services; 42,985 (3.1%) criminal justice services; 160,273 (11.6%) specialized homelessness services; and 20,921 (1.5%) vocational services. Compared to those seen only in clinics, veterans in the four community treatment groups were more likely to be black, diagnosed with HIV and hepatitis, had more numerous substance use diagnoses and made more extensive use of mental health outpatient and inpatient care.
Conclusions
Almost one-fifth of VHA mental health patients receive specialized community-based services addressing, most prominently, major social determinants of health and multimorbid substance use disorders.
Triple therapy combined with ventriculoperitoneal shunts can improve neurological function and shorten hospitalization time in non-HIV cryptococcal meningitis patients with increased intracranial pressure
Authors: Li Min , Liu Jia , Deng Xuhui , Gan Qingzhou , Wang Yijie , Xu Xiaofeng , Jiang Ying , Peng Fuhua 
Published: April 2020

Abstract
Background: Raised intracranial pressure (ICP) and insufficient antifungal regimens, are the two main factors result to unsatisfactory outcomes in non-HIV cryptococcal meningitis (CM) patients. In this study, we try to discuss that whether triple therapy of amphotericin B (AmB), fluconazole (Flu), 5-flucytosine (5-FC) plus ventriculoperitoneal shunts (VPS) is superior to AmB, 5-FC, Flu plus intermittent lumbar puncture in induction therapy in non-HIV CM patients with increased ICP. Methods: We reviewed 66 clinical records from non-HIV CM patients with increased ICP. The demographic and clinical characteristics, BMRC staging, cerebrospinal ﬂuid proﬁles (CSF), brain magnetic resonance imaging, treatment, and outcomes of these individuals were retrospectively analyzed. All non-HIV CM patients with increased ICP (≥ 25 cmH2O) were divided into two groups, including 27 patients treated with triple antifungal agents and 39 patients treated with the same triple therapy plus VPS. Results: Triple therapy plus VPS group had a significantly higher frequency of satisfactory outcomes. More patients in triple therapy plus VPS group have CSF sterilization at 10 weeks follow-up. And patients in triple therapy plus VPS group present with lower CSF opening pressure, less CSF cryptococci count and CSF culture positive, and lower BMRC staging scores one week after VPS. Patients in triple therapy plus VPS group got the improvement in neurological function circumstances evaluated by comparing the BMRC staging before and after VPS. Triple therapy plus VPS group patients had shorter hospital stay. Conclusion: Triple antifungal agents combined with VPS can effectively reduce ICP, have faster rate of clearance of Cryptococcus, improve nerve function, shorten hospitalization time and get better outcomes in non-HIV CM patients with increased ICP. Our study indicated that triple therapy plus early VPS is maybe the optimal treatment for non-HIV CM patients with increased ICP.
OTX1 Exerts an Oncogenic Role and is Negatively Regulated by miR129-5p in Laryngeal Squamous Cell Carcinoma
Authors: Tu Xiu-Ping , Li Hao , Chen Liang-Si , Luo Xiao-Ning , Lu Zhong-Ming , Zhang Si-Yi , Chen Shao-Hua 
Published: April 2020

Abstract
Background Orthodenticle homeobox 1 (OTX1) is a transcription factor that plays important roles in various human cancers. However, the function of OTX1 in laryngeal squamous cell carcinoma (LSCC) is largely unknown. We aim to explore the roles of OTX1 in LSCC and possible molecular mechanism.Methods The expression levels of OTX1 were assessed in LSCC cell lines and tissue samples. We further examined the effect of OTX1 on LSCC progression. The upstream regulator of OTX1 was identified using computer algorithm and confirmed experimentally.Results OTX1 was highly expressed in 70.7% (70/99) of LSCC patient tissues. The OTX1 expression in LSCC was significantly correlated with lymph node metastasis. High OTX1 expression in LSCC patients was correlated with poor prognosis. Knockdown of OTX1 inhibits proliferation, colony formation, migration and invasion in LSCC cells. Knockdown of OTX1 inhibits tumor growth in a xenograft mouse model. Mechanistically, OTX1 might act as a direct target of miR-129-5p. OTX1 enhances tumorigenicity and tumor growth both in vitro and in vivo.Conclusions Our findings support that OTX1 is an oncogene in LSCC tumorigenesis and progression. Furthermore, OTX1as a direct target of miR-129-5p in LSCC cells.Taken together, OTX1 is a promising diagnostic and therapeutic marker for LSCC.
Developing a model of best practice for teams managing crisis in people with dementia: A consensus approach
Authors: Yates Jen , Stanyon Miriam , Challis David , Coleston-Shields Donna Maria , Dening Tom , Hoe Juanita , Jawahar Kaanthan , Lloyd-Evans Bryn , Moniz-Cook Esme , Poland Fiona , Streater Amy , Trigg Emma , Orrell Martin 
Published: April 2020

Abstract
Background: Teams delivering crisis resolution services for people with dementia and their carers provide short-term interventions to prevent admission to acute care settings. There is great variation in these services across the UK. This article reports on a consensus process undertaken to devise a Best Practice Model and evaluation Tool for use with teams managing crisis in dementia. Methods: The Best Practice Model and Tool were developed over a three stage process: (i) Evidence gathering and generation of candidate standards (systematic review and scoping survey, interviews and focus groups); (ii) Prioritisation and selection of standards (consultation groups, a consensus conference and modified Delphi process); (iii) Refining and operationalising standards (consultation group and field-testing). Results: 165 candidate standards arose from the evidence gathering stage; were refined and reduced to 90 through a consultation group exercise; and then reduced to 50 during the consensus conference and weighted using a modified Delphi process. Standards were then operationalised through a clinical consultation group and field-tested with 11 crisis teams and 5 non-crisis teams. Scores ranged from 48-92/100. The median score for the crisis teams was 74.5 (range 67-92), and the median score for non-crisis teams was 60 (range 48-72).Conclusions: With further psychometric testing, this Best Practice Model and Tool will be ideal for the planning, improvement and national benchmarking of teams managing dementia crises in the future.
Neuromonitoring with Intermittent Transcranial Doppler Sonography and Continuous Near Infrared Spectroscopy in Aortic Arch Surgery: An Observational Study
Authors: Thudium Marcus , Kornilov Evgeniya , Hilbert Tobias , Duerr Georg Daniel , Gestrich Christopher 
Published: April 2020

Abstract

Background

Aortic Arch repair for aortic dissection is still associated with a high mortality rate. Adequate means of neuromonitoring to guide cerebral hemodynamics, especially during selective anterior cerebral perfusion (SACP) are desirable. It is possible that this cannot be achieved by one monitoring modality alone. It was the objective of this study to investigate an easy multimodal monitoring setup consisting of EEG, near infrared spectroscopy (NIRS) and transcranial doppler sonography.
Methods

Patients with surgery for aortic dissection were included. In addition to standard hemodynamic monitoring, patients received continuous bilateral NIRS, processed EEG with bispectral index (BIS) and intermittent transcranial doppler sonography of the medial cerebral artery (MCA) with a standard B-mode ultrasound device. Doppler measurements were taken bilaterally before cardiopulmonary bypass (CPB), during CPB and during the selective brain perfusion phase in regular intervals
Results

Six patients with aortic dissection could be included. Two patients died, one in the operating room and one on ICU. Four patients survived without neurological deficit. Two, however, suffered from transient postoperative delirium. Multimodal monitoring led to change in CPB flow or cannula repositioning in 3 patients (50%). Left sided mean flow velocities of the MCA significantly decreased during selective brain perfusion (p = 0.028), as did BIS values (p = 0.028)
Conclusions

Multimodal monitoring consisting of BIS, NIRS and B-Mode transcranial sonography can have an impact on hemodynamic management in aortic arch operations. More research is needed to establish target parameters of cerebral perfusion.
Willingness and Cognition Toward Reporting Travel History to High-Risk Coronavirus Disease 2019 Epidemic Regions Among The Chinese Public: A Cross-Sectional Study
Authors: Wei Lifeng , Sha Zhuowa , Wang Ying , Zhang Gangyu , Jia Haonan , Zhou Shuang , Li Yuanheng , Liu Chao , Jiao Mingli , Sun Shufan , Wu Qunhong 
Published: April 2020

Abstract
Background
The coronavirus disease 2019 (COVID-19) that originated in Wuhan, China, is currently spreading throughout China. The majority of infected patients either traveled to Wuhan or came into contact with an infected person from Wuhan. Investigating members of the public with a travel history to Wuhan became the primary focus of the Chinese government’s epidemic prevention and control measures, but several instances of withheld histories were uncovered as localized clusters of infections broke out. This study investigated the public’s willingness and cognition toward reporting travel history to high-risk epidemic regions, to provide effective suggestions and measures for encouraging travel reporting.
Methods
A cross-sectional study was conducted online between February 12 and 19, 2020. Descriptive analysis, chi-squared test, and Fisher’s exact test were used to identify socio-demographic factors and cognition toward reporting, as well as their impact on the willingness to report on travel history to high-risk epidemic regions.
Results
Of the 1,344 respondents, 91 (6.77%) expressed an inclination to deliberately withhold travel history. Those who understood the benefits of reporting and the legal consequences for deliberately withholding information, showed greater willingness to report their history (P < 0.05); conversely, those who believed reporting would stigmatize them and feared being quarantined after reporting showed less willingness to report (P < 0.05).
Conclusions
As any incident of withheld history can have unpredictable outcomes, the proportion of people who deliberately withhold information deserves attention. Appropriate public risk communication and public advocacy strategies should be implemented to strengthen the understanding that reporting on travel history facilitates infection screening and prompt treatment, and to decrease the fear of potentially becoming quarantined after reporting. Additionally, social support and policies should be established, and measures should be taken to alleviate stigmatization and discrimination against potential patients and reporters of travel history. Reinforcing the legal accountability of withholding travel history and strengthening systematic community monitoring are the measures that China is currently taking to encourage reporting on travel history to high-risk epidemic regions. These non-pharmaceutical interventions are relevant for countries that are currently facing the spread of the epidemic and those at risk of its potential spread.
Changes in bowel sounds of inpatients undergoing general anesthesia
Authors: Wang Guojing , Wang Mingjun , Liu Hongyun , Zhao Suping , Liu Lu , Wang Weidong 
Published: April 2020

Abstract
Background: General anesthesia can affect intestinal function, but there is no objective, practical and effective indicator to evaluate the inhibition and recovery of intestinal function. The main objectives of this study were to assess whether bowel sounds (BSs) changed before, immediately after and 3 hours after general anesthesia, and whether these changes in BSs are an effective indicator of intestinal function and an accurate guide for post-operative feeding. Methods: We randomly selected 26 inpatients and collected three sets of 5-minute continuous BS data before the operation (Pre-op), immediately after the operation (Pro-op) and three hours after the operation (3h-Pro-op) for each patient. Then the linear and nonlinear characteristic values (CVs) of each EBS were extracted and paired t -tests and rank-sum tests were used to evaluate the changes in the BSs. Results: The differences in CVs, between Pre-op and Pro-op, as well as between Pro-op and 3h-Pro-op, were statistically significant ( p <0.05). However, there is no statistically significant differences between all the CVs between Pre-op and 3h-Pro-op ( p >0.05). Conclusion: BSs changes before and after general anesthesia. Furthermore, the BSs are weakened due to general anesthesia and recover to the pre-op state three hours later. Therefore, the BSs can be an indicator of intestinal function under general anesthesia, so as to provide guidance for postoperative feeding , which is of considerable clinical significance.
Comparison of volume and hemodynamic effects of crystalloid, hydroxyethyl starch, and albumin in patients undergoing major abdominal surgery: a prospective observational study
Authors: Toyoda Daisuke , Maki Yuichi , Sakamoto Yasumasa , Kinoshita Junki , Abe Risa , Kotake Yoshifumi 
Published: April 2020

Abstract
Background
The volume effect of iso-oncotic colloid is supposedly larger than crystalloid, but such differences are dependent on clinical context. The purpose of this study was to compare the volume and hemodynamic effects of crystalloid and colloid during surgical manipulation in patients undergoing major abdominal surgery.
Methods
Subjects undergoing intraabdominal surgery for malignancies with intraoperative goal-directed fluid management enrolled in this observational study. Fluid challenges consisted with 250 ml of either bicarbonate Ringer solution, 6% hydroxyethyl starch or 5% albumin were provided to maintain optimal stroke volume index. Hematocrit derived-plasma volume and colloid osmotic pressure was determined immediately before and 30 min after the fluid challenge. Data were expressed as median (IQR) and statistically compared with Kruskal-Wallis test.
Results
One hundred thirty-nine fluid challenges in 65 patients were analyzed. bicarbonate Ringer solution, 6% hydroxyethyl starch and 5% albumin were administered in 42, 49 and 48 instances, respectively. Plasma volume increased 7.3 (3.6–10.0) % and 6.3 (1.4–8.8) % 30 min after the fluid challenge with 6% hydroxyethyl starch and 5% albumin and these values are significantly larger than the value with bicarbonate Ringer solution (1.0 (-2.7-2.3) %) Colloid osmotic pressure increased 0.6 (0.2–1.2) mmHg after the fluid challenge with 6% hydroxyethyl starch and 0.7(0.2–1.3) mmHg with 5% albumin but decreased 0.6 (0.2–1.2) mmHg after the fluid challenge with bicarbonate Ringer solution. The area under the curve of stroke volume index after fluid challenge was significantly larger after 6% hydroxyethyl starch or 5% albumin compared to bicarbonate Ringer solution.
Conclusions
Fluid challenge with 6% hydroxyethyl starch and 5% albumin showed significantly larger volume and hemodynamic effects compared to bicarbonate Ringer solution during gastrointestinal surgery.
Trial registration:
UMIN Clinical Trial Registry UMIN000017964. Registered July 01, 2015
Association between self-reported walking speed and calcaneal stiffness index in postmenopausal Japanese women
Authors: Tomita Yoshihito , Arima Kazuhiko , Mizukami Satoshi , Tsujimoto Ritsu , Kawashiri Shin-ya , Nishimura Takayuki , Okabe Takuhiro , Tanaka Natsumi , Honda Yuzo , Nakahara Kazumi , Yamamoto Naoko , Ohmachi Izumi , Goto Hisashi , Hasegawa Maiko , Sou Youko , Horiguchi Itsuko , Kanagae Mitsuo , Abe Yasuyo , Nonaka Fumiaki , Tamai Mami , Yamanashi Hirotomo , Nagata Yasuhiro , Kawakami Atsushi , Maeda Takahiro , Aoyagi Kiyoshi 
Published: April 2020

Abstract
Background
Osteoporosis and related fractures, a worldwide public health issue of growing concern, is characterized by compromised bone strength and an increased risk of fracture. Here we show an association between self-reported walking speed and bone mass among community-dwelling postmenopausal Japanese women aged 50 years and older.
Methods
A cross-sectional study was conducted among 1,008 postmenopausal women who underwent a general medical check-up in 2014 and 2016 as recommended by the Japanese government. Self-reported walking speed was ascertained by asking the participants: “Is your walking speed faster than others of the same age and sex?” to which participants responded “yes (faster)” or “no (moderate/slower).” Calcaneal stiffness index was measured.
Results
Women with a faster self-reported walking speed were younger and had a lower BMI, higher stiffness index, and higher grip strength than women with a slower walking speed. Multiple linear regression analysis adjusted for age, body mass index, grip strength, comorbidity, current smoking, and alcohol drinking status showed a significant association between faster self-reported walking speed and higher calcaneal stiffness index (p < 0.001).
Conclusions
Our findings suggest that questionnaires of walking speed may be useful for predicting bone mass and that a fast self-reported walking may benefit bone health in postmenopausal women.
STochastic Optical Reconstruction Microscopy (STORM) reveals the nanoscale organization of pathological aggregates in human brain
Authors: Codron Philippe , Letournel Franck , Marty Serge , Bodin Alexia , Renaud Laurence , Duchesne Mathilde , Verny Christophe , Lenaers Guy , Duyckaerts Charles , Julien Jean-Pierre , Cassereau Julien , Chevrollier Arnaud 
Published: April 2020

Abstract
Background
Histological analysis of brain tissue samples provide valuable information about the pathological processes leading to common neurodegenerative disorders such as Alzheimer’s or Parkinson’s diseases. In particular, high resolution and specific analysis of intra-neuronal lesions is crucial to understand the pathogenesis and progression of these diseases. In this context, the development of novel imaging approaches is a current challenge in neuroscience.
Methods
To this end, we used a recent super-resolutive imaging technique called STochastic Optical Reconstruction Microscopy (STORM) to analyze human brain sections. We combined STORM cell imaging protocols with neuropathological techniques and imaged cryopreserved brain samples from control subjects and patients with neurodegenerative diseases.
Results
This approach allowed us to perform 2D-, 3D- and two-color-STORM in central nervous system tissue sections, and to characterize with a nanometer-scale precision the architecture of physiological and pathological structures in neocortex, white matter and brainstem samples. STORM proved to be particularly effective to visualize the organization of dense protein inclusions, and allowed us to image with unprecedented details Aβ, Tau, α-synuclein and TDP-43 pathological aggregates within the central nervous system of patients with neurodegenerative disorders.
Conclusions
STORM imaging of human brain samples opens further gates to a more comprehensive understanding of the underlying mechanisms responsible for common neurological diseases. The convenience of this technique should open a straightforward extension of its application for super-resolution imaging of the human brain, with promising avenues to current challenges in neuroscience.