bluuebunny/crossref_metadata_2025_split huggingface dataset:
Walking meditation versus balance training for improving balance abilities among older adults with history of fall: A randomized controlled trial
Authors: Phoobangkerdphol Chalida , Limampai Patchara , Dasri Sirinuch , Kuptniratsaikul Vilai 
Published: December 2021

Objective To investigate improvement in balance abilities compared between walking meditation and balance training among older adults with history of fall. Interventions Walking meditation or mindfulness meditation whilst standing and moving ( n = 35) or balance training ( n = 33) 20–30 min/day, 5–7 days/week for 24 weeks was performed at home. Main outcomes The primary outcomes were dynamic balance abilities as assessed by Timed Up and Go test (TUGT), and static balance as assessed by Functional Reach Test (FRT) and Single Leg Stance Test (SLST). The secondary outcomes were quality of life as measured by the EuroQOL 5-dimensions 5-levels (EQ-5D-5L), and mental health as evaluated by the Thai Geriatric Mental Health Assessment Tool-15 (TGMHA-15). All outcomes were assessed at baseline, 6 months, and 9 months. Self-reported compliance, adverse events, and patient satisfaction were recorded at 6 and 9 months. Results The mean age was 69 years (range: 60–85). No significant difference was observed between groups for the 3 primary outcome measures. The mean difference (95% confidence interval) between groups was −0.48 (-1.40, 0.44) for TUGT, −1.11 (-3.66, 1.45) for FRT, and 0.82 (-5.03, 6.67) for SLST. The EQ-5D-5L and TGMHA-15 also showed no significant difference between groups. Most participants were in good compliance with the exercise protocol (48.3–68.0%), and no serious adverse events were reported. Conclusion Our results showed walking meditation to be comparable to balance training for improving balance abilities in older adults with history of fall. Walking meditation may be considered an alternative treatment for improving balance abilities in this patient population.
Intensive Care Unit Sedation Practices at a Large, Tertiary Academic Center
Authors: Hofer Mikaela M. , Wieruszewski Patrick M. , Nei Scott D. , Mara Kristin , Smischney Nathan J. 
Published: December 2021

Background Sedatives are frequently administered in an ICU and are often dependent on patient population and ICU type. These differences may affect patient-centered outcomes. Objective Our primary objective was to identify differences in sedation practice among three different ICU types at an academic medical center. Methods This was a retrospective cross-sectional study of adult patients (≥18 years) requiring a continuous sedative for ≥6 h and admitted to a medical ICU, surgical ICU, and medical/surgical ICU at a single academic medical center in Rochester Minnesota from June 1, 2018 to May 31, 2020. We extracted baseline characteristics; sedative type, dose, and duration; concomitant therapies; and patient outcomes. Summary statistics are presented. Results A total of 2154 patients met our study criteria (1010 from medical ICU, 539 from surgical ICU, 605 from medical/surgical ICU). Propofol was the most frequently used sedative in all ICU settings (74.1% in medical ICU, 53.8% in surgical ICU, 68.9% in medical/surgical ICU, and 67.5% in all ICUs). The mortality rate was highest in the medical/surgical ICU (40.2% in medical ICU, 26.0% in surgical ICU, 40.7% in medical/surgical ICU, and 36.8% in all ICUs). 90.7% of all patients required mechanical ventilation (92.9% in medical ICU, 88.5% in surgical ICU, and 89.1% in medical/surgical ICU). Overall, patients spent more time in light sedation than deep sedation, 75% versus 10.3%, during their ICU admission. Patients in the medical ICU spent a greater proportion of time positive for delirium than the other ICU settings (35.7% in medical ICU, 9.8% in surgical ICU, and 20% in medical/surgical ICU). Similar amounts of opioids (morphine milligram equivalents) were used during the continuous sedative infusion between the three settings. Conclusions We observed that patients in the medical ICU spent more time deeply sedated with multiple agents which was associated with a higher proportion of delirium.
Comparative studies of the constitutive models for tungsten heavy alloy (95W-3.5Ni-1.5Fe) at high strain rates
Authors: Lai Xiuwen , Wang Zhanjiang , Qin Na 
Published: December 2021

The plastic behaviors’ description of a tungsten heavy alloy (95W-3.5Ni-1.5Fe) at temperatures of 298–773 K and strain rates of 0.001–11,000 s−1 is systematically studied based on four constitutive models, that is, Zerilli-Armstrong model, modified Zerilli-Armstrong model, Mechanical Threshold Stress model, and modified Mechanical Threshold Stress model. The quasi-static compression experiments using an electronic universal testing machine and the dynamic compression experiments using a split Hopkinson pressure bar apparatus are employed to obtain the true stress–strain curves at a total of three temperatures (298 K, 573 K, and 773 K) and a wide range of strain rates (0.001–11,000 s−1). The parameters of the four constitutive models are obtained by the above fundamental experimental data and Grey Wolf Optimizer. The correlation coefficient and average absolute relative error are used to evaluate the predicted performance of these models. Modified Mechanical Threshold Stress model is found to have the highest predicted performance in describing the flow stress of the 95W-3.5Ni-1.5Fe alloy. Eventually, two compression experiments whose loading conditions are not in the fundamental experiments are conducted to validate the four models.
A Qualitative Exploratory Study of the Effects of Simulation on Nursing Students’ Self-Efficacy Beliefs for Using English for Professional Purposes
Authors: Karaçay Pelin , Zeybekoğlu Zuhal , Chizzo Jacob , Middlebrooks Amy K. 
Published: December 2021

Background The health sector has become more international than ever because of patients’ increased mobility and access to healthcare services. As a result, the ability to communicate in English has become critical for nursing students in countries where English is used as a foreign language. Aim This study aimed to highlight and understand the experiences of nursing students regarding the effect of simulation-based learning on their self-efficacy beliefs for using English for professional purposes. Methods The study was conducted with 28 third-year university nursing students enrolled in a required English course and participating in two nursing simulations conducted in English. Focus groups were conducted using semi-structured interview questions to elicit and understand the self-efficacy beliefs of nursing students for using English for professional purposes. The collected data were analyzed by using content analysis. Results The result of the study emerged under three themes: carrying out nursing duties by using professional discourse, building professional relationships with patients, and maintaining spontaneous conversations with patients. The overall results showed that while the students’ self-efficacy beliefs increased for performing standard nursing duties and establishing rapport with patients, no increase was observed in their self-efficacy beliefs for holding a prolonged conversation with the patient. Conclusion This study’s findings have implications for nursing programs in which English proficiency is considered an important program outcome for nurses who may be expected to work in both their own language and English.
Global Cleft Lip and Palate Outreach: A Google Trends Analysis
Authors: Weissman Joshua P , Reddy Narainsai K , Shah Nikhil D , Gosain Arun K 
Published: December 2021

Understanding patient awareness of cleft lip and/or palate (CL/P) and evaluating demand for necessary procedures may serve to better target future efforts in global outreach. We utilized internet search query data from Google Trends for the terms: “cleft lip,” “cleft palate,” “cleft lip and palate,” “cleft surgery,” and “cleft repair” from January 2004 to January 2021. Relative search volumes (RSV) recorded for the top 5 highest displaying countries and top 3 available regions within those countries were compared against global outreach by Operation Smile and Smile Train, as measured by the number of patients treated. World Health Organization (WHO) indicators were used to validate the RSV values for each country and better understand the current infrastructure and need for cleft care in those countries. Globally, there was an increase in RSV for the terms “cleft lip,” “cleft palate,” “cleft repair,” and “cleft surgery” between 2004 and 2021. For “cleft lip,” the countries with the highest displaying RSVs included: Ghana (100%), Zimbabwe (97%), Nepal (78%), the Philippines (64%), and Kenya (52%). Countries with high RSVs and moderate to high WHO indicators included Ghana, Kenya, India, Nigeria, and Zimbabwe. Countries with high RSVs and poor WHO indicators included Nepal and Pakistan. Some countries had specific regions with high search demand that are not currently targeted for global outreach. Using Google Trends’ data may help find more feasible locations and targeted care for efforts in global outreach with better patient awareness and turnout where demand for CL/P is increasing.
Epidemiological Trends of Breast Cancer in Southern Ethiopia: A Seven-Year Retrospective Review
Authors: Gebretsadik Achamyelesh , Bogale Netsanet , Negera Dereje. G 
Published: December 2021

Introduction African women are affected by cancer at an early age of their productivity. However, the exact prevalence and incidence of cancer, including breast cancer is not known in most sub-Saharan African countries, including Ethiopia because of lack of well-established cancer registry. This study aims to assess the epidemiology of breast cancer at Hawassa University Comprehensive Specialized Hospital (HUCSH), the biggest referral hospital with cancer treatment center serving the southern part of the country. Methods Retrospective review of charts of all patients with a diagnosis of breast cancer between 2013 and 2019 at HUCSH was conducted. A standardized questionnaire was used to collect relevant data that include sociodemographic, symptoms, type of diagnosis, treatment, and outcomes. Data were entered using epidata version 3.1 and analyzed using MS Excel and SPSS version 20. Results Five hundred fifty-nine (18.6%) breast cancer cases were retrieved in 7 years between 2013 and 2019. Of this, 548 (98%) were women. The median ages of the patents were 38 years. Invasive ductal carcinoma was the leading 309 (55.3%) histologic type followed by 185 (33.1%) lobular carcinoma. One hundred seventy-seven (31.7%) were moderately differentiated and 155 (27.7%) were poorly differentiated. Three hundred seventy-two (66.5%) were advanced breast cancer (Stages III and IV). Trends of breast cancer showed the case load is continuously increasing except with a slight reduction of cases in between 2015 and 2016. The majority were advanced breast cancer occurring at an early age by the time diagnosis made. Invasive ductal carcinomas were the predominant one. The trend also showed a continuous increment of cancer case load. Therefore, cancer registration center establishment, community awareness creation, and intensive early detection strategy are mandatory.
Effectiveness and safety of pembrolizumab monotherapy in patients with locally advanced or metastatic non-small-cell lung cancer
Authors: Tamayo-Bermejo Rocio , del Rio-Valencia Juan Carlos , Mora-Rodriguez Beatriz , Muñoz-Castillo Isabel 
Published: December 2021

Introduction Immunotherapy has become a standard treatment for lung cancer; the objective of this study was to evaluate the effectiveness, safety of pembrolizumab monotherapy in patients with advanced or metastatic non-small-cell lung cancer used in real-world clinical practice. Material and methods Retrospective observational study of every patient treated with pembrolizumab in our centre from January 2017 to June 2019. Outcomes collected: sex, age, Eastern Cooperative Oncology Group, programmed death receptor 1 level, previous metastatic line therapies, adverse events and smoking status. Results A total of 62 patients were reviewed. The median age was 62.34 ± 10.62 years, 48 (77.41%) were men and 91.93% of patients had Eastern Cooperative Oncology Group 0. The median dose administered was 170.5 mg (108 – 240 mg) and the median follow-up was 3 months (range: 1 – 38). A median of four cycles of pembrolizumab (range: 1 – 56) were administered as monotherapy. The reason for treatment discontinuation was mainly due to disease progression in 38.70% of patients or death in 30.64%. As first-line pembrolizumab monotherapy, median progression-free survival was 7.7 months (95% CI: 3.66 – 11.73) ( N = 33). With respect to patients who were treated in second–third-line treatment, median progression-free survival was 3.5 months (95% CI: 2.40 – 4.59) ( N=29). As to overall survival, pembrolizumab-treated patients as first-line treatment reached 19 months median OG (95% CI: 13.36 – 24.63) ( N = 33) and those treated in second–third-line treatment got 11 months (95% CI: 3.4 – 18.5). A total of 64.51% of patients presented some adverse events to pembrolizumab however, only, 9.38% of them were grade 3. Conclusion Pembrolizumab represents an effective and feasible alternative in terms of progression-free survival. It is a well-tolerated treatment option.
Post-vaccine COVID-19 in patients with multiple sclerosis or neuromyelitis optica
Authors: Januel Edouard , De Seze Jérôme , Vermersch Patrick , Maillart Elisabeth , Bourre Bertrand , Pique Julie , Moisset Xavier , Bensa Caroline , Maarouf Adil , Pelletier Jean , Vukusic Sandra , Audoin Bertrand , Louapre Céline , Beltran Stéphane , Berger Eric , Bigaut Kevin , Derache Nathalie , Gassama Salimata , Heinzlef Olivier , Kremer Laurent , Kerschen Philippe , Maurousset Aude , Ricigliano Vito A G , Garcia Pierre-Yves , Labauge Pierre 
Published: December 2021

Introduction: Recent studies suggested that anti-CD20 and fingolimod may be associated with lower anti-spike protein-based immunoglobulin-G response following COVID-19 vaccination. We evaluated if COVID-19 occurred despite vaccination among patients with multiple sclerosis (MS) and neuromyelitis optica (NMO), using the COVISEP registry. Case series: We report 18 cases of COVID-19 after two doses of BNT162b2-vaccination, 13 of which treated with anti-CD20 and four with fingolimod. COVID-19 severity was mild. Discussion: These results reinforce the recommendation for a third COVID-19 vaccine dose among anti-CD20 treated patients and stress the need for a prospective clinical and biological study on COVID-19 vaccine efficacy among MS and NMO patients.
Influenza risk groups in Norway by education and employment status
Authors: Klüwer Birgitte , Rydland Kjersti Margrethe , Laake Ida , Todd Megan , Juvet Lene Kristine , Mamelund Svenn-Erik 
Published: December 2021

Aims: This study aimed to estimate the size of the risk group for severe influenza and to describe the social patterning of the influenza risk group in Norway, defined as everyone ⩾65 years of age and individuals of any age with certain chronic conditions (medical risk group). Methods: Study data came from a nationally representative survey among 10,923 individuals aged 16–79 years. The medical risk group was defined as individuals reporting one or more relevant chronic conditions. The associations between educational attainment, employment status, age and risk of belonging to the medical risk group were studied with logistic regression. Results: Nearly a fifth (19.0%) of respondents reported at least one chronic condition, while 29.4% belonged to the influenza risk group due to either age or chronic conditions. Being older, having a low educational level (comparing compulsory education to higher education, odds ratio (OR)=1.4, 95% confidence interval (CI) 1.2–1.8 among women, and OR=1.3, 95% CI 1.1–1.7 among men) and a weaker connection to working life (comparing disability pension to working full-time, OR=6.8, 95% CI 5.3–8.7 among women, and OR=6.5, 95% CI 4.9–8.5 among men) was associated with a higher risk of belonging to the medical risk group for severe influenza. Conclusions: This study indicates that the prevalence of medical risk factors for severe influenza is disproportionally distributed across the socio-economic spectrum in Norway. These results should influence both public funding decisions regarding influenza vaccination and communication strategies towards the public and health professionals.
How to eat, drink and speak on non-invasive ventilation
Authors: Kinnear William , Dring Karah , Kinnear Katherine , Hansel Jane , Sovani Milind 
Published: December 2021

We report our observations on six individuals with non-bulbar neuromuscular disorders using non-invasive ventilation (NIV), who were able to maintain adequate hydration and nutrition orally despite being ventilator-dependant. All had severe respiratory muscle weakness, with a vital capacity less than 500 mL and cough peak flow rate less than 250 L/min. Their median (range) age was 49 (23–64) years; they had been on NIV for 8 (2–24) years. We compared them with an age- and sex-matched normal control. Individuals with neuromuscular disorders needed to chew each mouthful of food significantly more times (median 44, range 18–120 chews) than normal controls (median 15, range 10–20 chews). They took longer to completely swallow a mouthful of food (median 37, range 24–100 s) compared to normal controls (median 14.5, range 10–21 s). Multiple swallows for each mouthful were seen in all neuromuscular individuals, but in only one normal control. Two individuals coughed after swallowing; both these subjects were clinically stable at the time of the study. The median number of NIV breaths associated with chest expansion for each mouthful was 11 (range 5–49). All subjects blocked some NIV breaths whilst eating. Before swallowing, they always waited until the expiratory phase of the NIV breath was complete; no post-swallow expiration was seen, whereas normal subjects invariably exhibited post-swallow expiration. All individuals were able to block several ventilator breaths whilst swallowing un-thickened liquids. The median (range) number of words between breaths was 5 (4–7) for the neuromuscular individuals on NIV, significantly fewer than 11 (8–13) for the matched controls. Eating, drinking and speaking are possible whilst on NIV. Use of cough-assist after eating is recommended, given the likelihood of silent aspiration.
Roads to Success: The Career Attainment Experiences of Lawyers With Visual Impairments in South Korea
Authors: Kwon Chang-kyu , An Soonok 
Published: December 2021

Problem: Disability issues have long been a topic at the margins of HRD research and have rarely been examined outside the United States context or with a focus on a specific disability type. Additionally, largely due to a homogeneous national culture, people with disabilities in South Korea experience unique barriers in career development. Solution: The authors report the findings of a multiple case study on the career attainment experiences of lawyers with visual impairments in South Korea. Data analyzed from interviews with five participants showed that various individual (perseverance, identity as a person with a visual impairment, self-advocacy, and strategic mindset) and social (family and peer support, reasonable accommodation, precedent, and having a leader with a vision for inclusion) factors contributed to their career attainment. Stakeholders: The findings of this study can aid organizational leaders, hiring managers, HRD practitioners in charge of providing reasonable accommodations, and educators of people with disabilities.
The effects of dry needling on the thumb: A case report
Authors: Voss Mitchell R , Donnay Rebecca L , Homa Jennifer K 
Published: December 2021

Introduction Dry needling has been identified as a potential intervention for a variety of diagnoses. Limited evidence exists to support the use of dry needling following surgical intervention of a distal radius fracture. This case report demonstrates the impact of dry needling in the thumb following a distal radius fracture. Methods The patient was a 31-year-old healthy female who sustained a distal radius fracture and required surgical intervention. The patient required a volar plate removal and extensor tenolysis. The patient attended traditional occupational therapy with one session of dry needling to assist in improving range of motion and decreasing pain. Results The patient benefited from the use of dry needling. The patient had no pain with functional grasping and pinching following dry needling and improved on the Kapandji score from eight to nine out of ten. The patient also reported a decrease in overall pain, from seven to two on the Numeric Pain Rating Scale. Discussion The patient benefited from dry needling in the thumb to improve both range of motion and pain symptoms. While the evidence is limited, dry needling may be an appropriate intervention to assist in recovery and reduce thumb pain following distal radius fractures.
Application of artificial intelligence in non-alcoholic fatty liver disease and liver fibrosis: a systematic review and meta-analysis
Authors: Decharatanachart Pakanat , Chaiteerakij Roongruedee , Tiyarattanachai Thodsawit , Treeprasertsuk Sombat 
Published: December 2021

Background: The global prevalence of non-alcoholic fatty liver disease (NAFLD) continues to rise. Non-invasive diagnostic modalities including ultrasonography and clinical scoring systems have been proposed as alternatives to liver biopsy but with limited performance. Artificial intelligence (AI) is currently being integrated with conventional diagnostic methods in the hopes of performance improvements. We aimed to estimate the performance of AI-assisted systems for diagnosing NAFLD, non-alcoholic steatohepatitis (NASH), and liver fibrosis. Methods: A systematic review was performed to identify studies integrating AI in the diagnosis of NAFLD, NASH, and liver fibrosis. Pooled sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and summary receiver operating characteristic curves were calculated. Results: Twenty-five studies were included in the systematic review. Meta-analysis of 13 studies showed that AI significantly improved the diagnosis of NAFLD, NASH and liver fibrosis. AI-assisted ultrasonography had excellent performance for diagnosing NAFLD, with a sensitivity, specificity, PPV, NPV of 0.97 (95% confidence interval (CI): 0.91–0.99), 0.98 (95% CI: 0.89–1.00), 0.98 (95% CI: 0.93–1.00), and 0.95 (95% CI: 0.88–0.98), respectively. The performance of AI-assisted ultrasonography was better than AI-assisted clinical data sets for the identification of NAFLD, which provided a sensitivity, specificity, PPV, NPV of 0.75 (95% CI: 0.66–0.82), 0.82 (95% CI: 0.74–0.88), 0.75 (95% CI: 0.60–0.86), and 0.82 (0.74–0.87), respectively. The area under the curves were 0.98 and 0.85 for AI-assisted ultrasonography and AI-assisted clinical data sets, respectively. AI-integrated clinical data sets had a pooled sensitivity, specificity of 0.80 (95%CI: 0.75–0.85), 0.69 (95%CI: 0.53–0.82) for identifying NASH, as well as 0.99–1.00 and 0.76–1.00 for diagnosing liver fibrosis stage F1–F4, respectively. Conclusion: AI-supported systems provide promising performance improvements for diagnosing NAFLD, NASH, and identifying liver fibrosis among NAFLD patients. Prospective trials with direct comparisons between AI-assisted modalities and conventional methods are warranted before real-world implementation. Protocol registration: PROSPERO (CRD42021230391)