bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of an individually targeted multicomponent counseling and home-based rehabilitation program on physical activity and mobility in community-dwelling older people after discharge from hospital: a randomized controlled trial
Authors: Turunen Katri M , Aaltonen-Määttä Laura , Törmäkangas Timo , Rantalainen Timo , Portegijs Erja , Keikkala Sirkka , Kinnunen Marja-Liisa , Finni Taija , Sipilä Sarianna , Nikander Riku 
Published: January 2020

Objectives:The aim of this study is to evaluate the effects of multicomponent rehabilitation on physical activity, sedentary behavior, and mobility in older people recently discharged from hospital.Design:Randomized controlled trial.Setting:Home and community.Participants:Community-dwelling people aged ⩾60 years recovering from a lower limb or back musculoskeletal injury, surgery, or disorder were recruited from local health center hospitals and randomly assigned into an intervention ( n = 59) or a control (standard care, n = 58) group.Intervention:The six-month intervention consisted of a motivational interview, goal attainment process, guidance for safe walking, a progressive home exercise program, physical activity counseling, and standard care.Measurements:Physical activity and sedentary time were assessed using an accelerometer and a single question. Mobility was evaluated with the Short Physical Performance Battery, self-reported use of a walking aid, and ability to negotiate stairs and walk outdoors. Intervention effects were analyzed with generalized estimating equations.Results:Daily physical activity was 127 ± 78 minutes/day and 121 ± 70 at baseline and 167 ± 81 and 164 ± 72 at six months in the intervention and control group, respectively; mean difference of 3.4 minutes (95% confidence interval (CI) = −20.3 to 27.1). In addition, no significant between-group differences were shown in physical performance.Conclusion:The rehabilitation program was not superior to standard care for increasing physical activity or improving physical performance. Mobility-limited older people who had recently returned home from hospital would have needed a longer and more frequently monitored comprehensive geriatric intervention.
Anti-angiogenesis effect and mechanism study of Huangzhi Neiyi capsule in a rat endometriosis model
Authors: Liu Henglian , Sun Xianli , Zhao Yan , Xia Min , Wang Caixia 
Published: January 2020

Objective To investigate the effects and possible mechanism of Huangzhi Neiyi capsule (HZNY) on angiogenesis in rats with endometriosis. Methods Sixty Sprague-Dawley rats were used to establish an endometriosis model by autologous transplantation and were randomly divided into sham operation, model, gestrinone (0.25 g/kg), and HZNY (4.5 and 9 g/kg) groups. All drugs were administered orally for 28 days. At the end of the experiment, all rats were killed by cervical dislocation, and the expression of proliferating cell nuclear antigen (PCNA) and CD31 in ectopic endometrial tissue was assessed by immunohistochemistry. The level of vascular endothelial growth factor (VEGF) in peritoneal fluid was determined by enzyme-linked immunosorbent assay. The mRNA expression of VEGF and hypoxia inducible factor-1α ( HIF1A) in ectopic endometrium was evaluated by reverse transcription-PCR. Results HZNY suppressed the expression of PCNA and CD31 in ectopic endometrium, reduced concentrations of VEGF in peritoneal fluid, and reduced mRNA expression of VEGF and HIF1A in ectopic endometrium. Conclusions HZNY suppressed angiogenesis in endometriosis rats, perhaps by inhibiting expression of VEGF and HIF1A.
Impact of an Electronic Decision-Support System on Nursing Triage Process: A Usability and Workflow Analysis
Authors: Agnihotri Tanya , Fan Mark , McLeod Shelley , Borgundvaag Bjug , Ovens Howard , McCarron Joy , Trbovich Patricia 
Published: January 2020

Purpose To qualitatively contrast emergency department triage workflow using a paper-based triage system and an electronic decision-support tool (electronic Canadian Triage and Acuity Scale (eCTAS)). Methods Triage nurses from a single institution were invited to perform triage assessments of mock patients using a paper-based triage system and eCTAS. These assessments were completed using simulation scenarios, some of which involved facilitators probing triage nurses’ thoughts on the design of the eCTAS system. Participants were asked to “think aloud,” describing their thought patterns as they completed the triage process. Similar patient scenarios with the same Canadian Emergency Department Information System (CEDIS) presenting complaint and triage score were used for comparison between paper-based triage and electronic decision-support tool (eCTAS) conditions. Results Eight participants completed at least two simulation scenarios for each condition and at least one usability scenario with eCTAS. The simulated encounters showed eCTAS provided several advantages to paper-based triage assessment process by shortlisting possible CEDIS complaints and preselecting relevant modifiers. However, usability concerns were identified with eCTAS including challenges related to data entry and eCTAS score overrides. Conclusions Our study highlights several positive features of eCTAS and usability issues that should be addressed to enhance the intended use of eCTAS and support user adoption.
Stressors and Coping Methods of Turkish Adolescents With High and Low Risk of Depression: A Qualitative Study
Authors: Özkul Burcu , Günüşen Neslihan Partlak 
Published: January 2020

Background: Stress and coping skills are essential factors in the etiology of depression. Understanding the stressors and coping strategies of adolescents in Turkey may help determine the content of the country-specific depression prevention program. Aims: The purpose of this study was to understand the stressors of adolescents with a high or low risk of depression and how they coped with these stressors. Method: This descriptive qualitative study was conducted in a high school in western Turkey. The data were collected via semistructured individual interviews. Eleven adolescents with high risk of depression and 10 adolescents with low risk of depression were included in the study. Content analysis technique was used to analyze the data. Results: The stressors of adolescents and their coping were grouped into three themes: stressors, factors affecting coping strategies of adolescents, and coping. Stressors theme consists of three subthemes: family relationship, peer relationship, and telephone/internet usage. The factors affecting coping strategies of adolescents theme consists of four subthemes: cognitive distortions, self-perception, family relationships, and peer relationships. The coping theme consists of two subthemes: engagement coping and disengagement coping. Conclusions: It was determined that adolescents with a high risk of depression had more stressors and used more disengagement-coping techniques. It is recommended that to prevent depression among adolescents, school nurses should take initiatives to strengthen the coping strategies of adolescents with high risk of depression.
Sex Differences in Use of Smoking Cessation Services and Resources: A Real-World Study
Authors: Jayakumar Navitha , Chaiton Michael , Zhang Bo , Selby Peter , Schwartz Robert 
Published: January 2020

Objectives: Smoking cessation interventions with sex considerations have been found to effectively increase cessation rates. However, evidence is limited and weak. This study examined sex differences in the use of smoking cessation services or resources among Ontario adults. Methods: Data are from the Smokers’ Panel, an ongoing online survey of Ontario adult smokers and recent quitters. The analysis included 1009 male and 1765 female participants. Bivariate analysis was used to examine differences in sociodemographic characteristics and smoking-related variables by use of cessation services/resources. Logistic regression was then used to identify sociodemographic characteristics and smoking-related variables associated with the use of cessation services/resources. Results: The analysis shows that there were significant sex differences in the use of individual interventions. Female participants were more likely to use nicotine patch (63% vs 58%; adjusted odds ratio, AOR: 1.39, 95% confidence interval [CI]: 1.16-1.67), varenicline (29% vs 24%; AOR: 1.37, 95% CI: 1.13-1.66), Smokers’ Helpline phone (14% vs 10%; AOR: 1.39, 95% CI: 1.07-1.79), Smokers’ Helpline online (27% vs 21%; AOR 1.43, 95% CI: 1.18-1.74), self-help materials (23% vs 16%; AOR: 1.81 95% CI: 1.46-2.26), and alternative methods (23% vs 19%; AOR: 1.40, 95% CI: 1.14-1.73) compared with male participants, after adjusting for covariates. Conclusion: Consistent with other findings, the study shows sex differences in the use of smoking cessation services or resources among adult smokers. Women are more likely to use recommended cessation resources such as nicotine patch, varenicline, and Smokers’ Helpline than men. Health professionals should use this increased willingness to help female smokers quit. However, men may be underserved and more men-specific interventions need to be developed and evaluated.
Chasing Disparity: Economic Development Incentives and Income Inequality in the U.S. States
Authors: Jansa Joshua M. 
Published: January 2020

AbstractPolitical scientists and policy scholars have traditionally looked at the role of welfare and tax policies in shaping income inequality. Less attention has been paid to the key policy area of economic development. But states spend billions on economic development incentives each year to encourage firms to locate in their state. The few studies that have examined the impact of economic development policy on inequality have found mixed results, and have not considered who shapes and benefits from economic development policy when identifying possible causal mechanisms. I argue that increased incentive spending leads to increased inequality through either a market conditioning effect (incentives disproportionately boost the incomes of top earners prior to taxes) or a redistributive effect (incentives allow wealthy firms, investors, and employees to keep income that would otherwise be taxed and transferred). These mechanisms are tested using data on incentive spending and inequality across the 50 states from 1999 to 2014. The findings demonstrate that incentives increase income inequality via a redistributive effect only. This effect, though, is relatively large, long-lasting, and robust to different measures of incentive spending. Despite using economic development incentives to try to generate greater prosperity, state governments may be inadvertently exacerbating inequality.
A system of radiological criteria for grading and prognosticating temporal lobe contusions
Authors: Nigam Pulak , Krishnan Shyam S , Pande Anil , Vasudevan MC 
Published: January 2020

Introduction Temporal contusions are common in patients with head injuries and require close monitoring due to the propensity of these patients to deteriorate rapidly and fatally. This study attempts to introduce a radiological grading system for temporal lobe contusions and analyse its prognostic value so as to better identify patients at risk of deterioration. Methods The study was conducted as a cross-sectional observational study from April 2011–March 2017 on 42 patients with temporal lobe contusion. Each patients was graded according to the proposed system from a minimum of four to a maximum of 13 and then further grouped in three grades – grade 1 (score = 4), grade 2 (score 5–7) and grade 3 (score > 7) – and their clinical course was closely observed. Results The minimum and maximum scores observed were four and 11 respectively. The proposed grading system has statistically significant correlation to the Glasgow Coma Scale ( p-value < 0.05). All patients in grade 1 (17) could be managed conservatively, while all those in grade 3 (five) needed immediate surgical intervention. Of 20 patients in grade 2, 11 had a score of 5–6 and did not require surgery, whereas nine patients had a score of seven and of these eight required delayed surgical intervention. This correlation was statistically significant ( p-value < 0.05) Conclusion The proposed temporal lobe contusion grading system is a good radiological tool to predict the clinical course of patients and thereby identify patients at higher risk of delayed deterioration.
Mediators of the association of limited English health literacy with medication non-adherence among Singaporean elderly
Authors: Suppiah Sumithra , Tan Yi Wen , Cheng Grand H-L , Tang Wern Ee , Malhotra Rahul 
Published: January 2020

Background: In Singapore, English is predominantly used on prescription medication labels (PMLs). However, many older Singaporeans cannot read English, and among those who read English, their English health literacy (EHL) proficiency varies. It is thus pertinent to examine the link between EHL and medication use outcomes in this population. The present research aims to address this question. Methods: Data from a national survey, on 1167 home-dwelling elderly on ⩾1 prescribed medication was analysed. The validated Health Literacy Test for Singapore was used to determine EHL. Medication non-adherence was self-reported. Path analysis examined the association between limited EHL and medication non-adherence and tested possible mediators. Results: Limited EHL was associated with medication non-adherence (total effect=0.35; p-value: 0.032), and ‘uncertainty in taking medications correctly due to difficulty in understanding written information on PMLs’ was a significant mediator (indirect effect=0.23, 95% confidence interval (0.12–0.39)). Conclusions: Elderly people with limited EHL were significantly more likely than those with adequate EHL to report that they were uncertain about taking medications correctly because they had difficulty understanding the information on PMLs and this misunderstanding contributed to medication non-adherence. Interventions focused on incorporating bilingual text and/or pictograms on PMLs may reduce uncertainty in taking medication correctly and improve medication adherence among the elderly.
Predictors of exercise capacity following septal myectomy in patients with hypertrophic cardiomyopathy
Authors: Smith Joshua R , Layrisse Veronica , Medina-Inojosa Jose R , Berg Jessica D , Ommen Steve R , Olson Thomas P 
Published: January 2020

Aims Patients with hypertrophic obstructive cardiomyopathy (HOCM) have impaired exercise capacity. The gold standard therapy for patients with HOCM is septal myectomy surgery; however, changes in maximum oxygen uptake (VO2peak) following myectomy are variable, with VO2peak decreasing in some patients. Therefore, we evaluated changes in VO2peak following surgical myectomy to determine clinical predictors of those exhibiting decreased VO2peak post-myectomy. Methods HOCM patients ( N = 295) who performed symptom limited cardiopulmonary exercise testing prior to and following surgical myectomy were included for analysis. The VO2peak non-responder group ( n = 128) was defined as <0% change in VO2peak from pre- to post-myectomy. Step-wise regression models using demographics, clinical, and physiologic characteristics were created to determine predictors of hypertrophic cardiomyopathy patients in the VO2peak non-responder group. Results Independent predictors of the VO2peak non-responder group included higher pre-myectomy VO2peak (% predicted), older age, women, history of dyslipidemia, lack of cardiac rehabilitation enrollment, and lower body mass index (all p < 0.03). Forty-three (14.6%) patients reached the primary end-point of all-cause mortality during a median follow up of 11.25 years (interquartile range 6.94 to 16.40). After adjustment for age, sex, beta-blocker use, coronary artery disease history, and body mass index, the VO2peak non-responder group had greater risk of death compared with the VO2peak responder group (adjusted hazard ratio: 1.77, 95% confidence interval: 1.06–3.34, p = 0.01). Conclusion This large hypertrophic cardiomyopathy cohort demonstrated that demographic (i.e. female sex), lack of cardiac rehabilitation enrollment, and cardiovascular risk factors (i.e. history of dyslipidemia) are predictive of those patients that did not exhibit increases in VO2peak following septal myectomy surgery.
High-intensity interval training is effective and superior to moderate continuous training in patients with heart failure with preserved ejection fraction: A randomized clinical trial
Authors: Donelli da Silveira Anderson , Beust de Lima Juliana , da Silva Piardi Diogo , dos Santos Macedo Débora , Zanini Maurice , Nery Rosane , Laukkanen Jari A , Stein Ricardo 
Published: January 2020

Background Heart failure with preserved ejection fraction (HFpEF) is a prevalent syndrome, with exercise intolerance being one of its hallmarks, contributing to worse quality of life and mortality. High-intensity interval training is an emerging training option, but its efficacy in HFpEF patients is still unknown. Design Single-blinded randomized clinical trial. Methods Single-blinded randomized clinical trial with exercise training 3 days per week for 12 weeks. HFpEF patients were randomly assigned to high-intensity interval training or moderate continuous training. At baseline and after 12 week follow-up, patients underwent clinical assessment, echocardiography and cardiopulmonary exercise testing (CPET). Results Mean age was 60 ± 9 years and 63% were women. Both groups ( N = 19) showed improved peak oxygen consumption (VO2), but high-intensity interval training patients ( n = 10) had a significantly higher increase, of 22%, compared with 11% in the moderate continuous training ( n = 9) individuals (3.5 (3.1 to 4.0) vs. 1.9 (1.2 to 2.5) mL·kg−1·min−1, p < 0.001). Ventilatory efficiency and other CPET measures, as well as quality of life score, increased equally in the two groups. Left ventricular diastolic function also improved with training, reflected by a significant reduction in E/e′ ratio by echocardiography (−2.6 (−4.3 to −1.0) vs. −2.2 (−3.6 to −0.9) for high-intensity interval training and moderate continuous training, respectively; p < 0.01). There were no exercise-related adverse events. Conclusions This randomized clinical trial provided evidence that high-intensity interval training is a potential exercise modality for HFpEF patients, being more effective than moderate continuous training in improving peak VO2. However, the two strategies were equally effective in improving ventilatory efficiency and other CPET parameters, quality of life score and diastolic function after 3 months of training.
Positive aging benefits of home and community gardening activities: Older adults report enhanced self-esteem, productive endeavours, social engagement and exercise
Authors: Scott Theresa L , Masser Barbara M , Pachana Nancy A 
Published: January 2020

Objectives: This study examined relationships between home and community gardening and older adults’ self-reported psychosocial and physical well-being, attitudes to aging relative to gardening activities and benefits of membership to a gardening group. Methods: A survey addressing (a) demographic characteristics, (b) gardening interests and sentiments, (c) activities, (d) benefits, (e) self-rated health and quality of life and (f) attitudes to aging was administered online and via mail-out. Results: Participants, 331 gardeners aged 60–95 years from Australia, reported numerous benefits from leisure gardening. According to multiple regression analysis, Restoration and Physical benefits were the strongest explanatory variables of participants’ positive aging self-perceptions. Members of gardening groups reported significantly more social and physical benefits than non-members. Conclusion: The current study provides support for promoting positive aging through gardening. Regardless of ‘doing’ gardening or simply ‘being’ in the garden, having contact with nature was key to attaining positive therapeutic benefits for this sample.
The diagnostic value of IgG index versus oligoclonal bands in cerebrospinal fluid of patients with multiple sclerosis
Authors: Simonsen Cecilia Smith , Flemmen Heidi Øyen , Lauritzen Trine , Berg-Hansen Pål , Moen Stine Marit , Celius Elisabeth Gulowsen 
Published: January 2020

Background Diagnostic criteria for multiple sclerosis have been developed to guide the diagnostic process. In the latest revision of the McDonald criteria, the presence of oligoclonal bands may replace the need for dissemination in time. The aim of this study is to investigate if the less time-consuming analysis of immunoglobulin G index in cerebrospinal fluid can safely predict the findings of oligoclonal bands. Methods This is a retrospective study of patients with multiple sclerosis at three hospitals in South-East Norway where lumbar puncture is performed routinely. We included patients diagnosed with multiple sclerosis after 2005 with known oligoclonal band status and an immunoglobulin G index score. Results Of 1295 patients diagnosed during or after 2005, 93.8% were oligoclonal band positive at diagnosis. Of 842 multiple sclerosis patients with known immunoglobulin G index and oligoclonal band status, 93.3% were oligoclonal band positive and 76.7% had an elevated immunoglobulin G index. The positive predictive value of a high immunoglobulin G index when oligoclonal bands are positive was 99.4% (95% confidence interval 98.4–99.8%). The negative predictive value of a normal immunoglobulin G index when oligoclonal bands are negative was 26.5% (95% confidence interval 23.5–29.9%). Conclusion An immunoglobulin G index >0.7 has a positive predictive value >99% for oligoclonal bands. An elevated immunoglobulin G index adds diagnostic value versus oligoclonal bands and saves time in the diagnostic process.
P-selectin–deficient mice to study pathophysiology of sickle cell disease
Authors: Bennewitz Margaret F. , Tutuncuoglu Egemen , Gudapati Shweta , Brzoska Tomasz , Watkins Simon C. , Monga Satdarshan P. , Pradhan-Sundd Tirthadipa , Sundd Prithu 
Published: January 2020

Key PointsP-selectin–deficient SCD mice are protected from lung vaso-occlusion. P-selectin–deficient SCD mice will be useful in assessing the benefits of anti–P-selectin therapy in diverse complications of SCD.