bluuebunny/crossref_metadata_2025_split huggingface dataset:
Occupational Performance Coaching With Parents to Promote Community Participation of Young Children With Developmental Disabilities: Protocol for a Feasibility and Pilot Randomized Control Trial
Authors: Chien Chi-Wen , Lai Yuen Yi Cynthia , Lin Chung-Ying , Graham Fiona 
Published: November 2021

Background: High rates of restricted community participation have been reported in young children with developmental disabilities. Occupational performance coaching (OPC), grounded in self-determination theory, aims to facilitate children's participation in life situations through coaching parents. However, there have been limited randomized controlled trials demonstrating the efficacy of OPC, especially with a specific focus on children's community participation. The proposed study is the first step in evaluating the feasibility and acceptability of conducting a pilot randomized controlled trial of OPC in Hong Kong and testing its initial efficacy (in comparison to parent consultation) in promoting children's community participation.Method/Design: A feasibility and pilot double-blind randomized controlled trial will be undertaken. Fifty children aged 6 years or below with developmental disabilities and their parents will be recruited from early intervention centers and/or through social media in Hong Kong. Parents will be randomly assigned to receive OPC or consultation, and will be blinded to group allocation. Outcomes will be assessed by blinded assessors at baseline, pre-intervention, post-intervention, and follow-up. Predetermined success criteria will be used to assess the feasibility of the trial. Qualitative interviews will be conducted with parents to explore the acceptability and perceived impact of OPC.Discussion: This trial will test whether the study protocol and OPC are feasible and acceptable, as well as assess the initial efficacy of OPC to obtain effect size estimates. The results of the trial will inform future preparations for conducting a full-scale efficacy trial of OPC.Trial Registration:ClinicalTrials.gov, U.S. National Library of Medicine, National Institutes of Health (#NCT04796909), Registered on 15th March 2021.
Hip Involvement in Juvenile Idiopathic Arthritis: A Roadmap From Arthritis to Total Hip Arthroplasty or How Can We Prevent Hip Damage?
Authors: Sorokina Lubov S. , Avrusin Ilia S. , Raupov Rinat K. , Lubimova Natalia A. , Khrypov Sergey V. , Kostik Mikhail M. 
Published: November 2021

Objectives: To describe the clinical characteristics of hip involvement in juvenile idiopathic arthritis (JIA) from arthritis to hip osteoarthritis (HOA) and total hip arthroplasty (THA).Study Design: Seven hundred fifty-three patients aged 2–17 years with JIA were included in the study. The comparison analysis was performed between the following subgroups: (i) JIA without hip involvement (n = 600; 79.7%) vs. JIA with hip involvement without HOA (n = 105; 13.9%), (ii) JIA with hip involvement with HOA, but without THA (n = 32; 4.3%) and JIA with hip involvement with HOA and with THA (n = 16; 2.1%). Clinical, laboratory characteristics and treatment regimens compared.Results: Hip involvement was present in 20.3% of patients. HOA was present in 6.4% (12*1,000 patient-years) of the entire JIA group and 31.4% of patients with hip involvement. Sixteen patients (2.1%; 4.0*1,000 patient-years) required THA. The following factors were associated with HOA: sJIA (OR = 3.6, p = 0.008; HR = 3.0, p = 0.002), delayed remission (OR = 4.2, p = 0.004; HR = 1.4, p = 0.538), delay in biologic therapy initiation (OR = 7.5, p = 0.00001; HR = 6.7, p = 0.002), alkaline phosphatase &lt;165 U\l (OR = 4.1, p = 0.0003; HR = 5.2, p = 0.000004), treatment with corticosteroids (CS) (OR = 2.6, p = 0.008; HR = 1.2, p = 0.670), cumulative corticosteroids &gt;2,700 mg (OR = 4.3, p = 0.032; HR = 1.4, p = 0.527). The following factors were associated with THA: delay in biologic treatment initiation (OR = 1.04, p = 0.0001; HR = 9.1, p = 0.034), delayed hip involvement (OR = 5.2, p = 0.002; HR = 3.0, p = 0.044), and methylprednisolone pulse therapy (OR = 10.8, p = 0.0000001; HR = 5.6, p = 0.002).Conclusion: Both sJIA and systemic CS, impaired calcium-phosphorus metabolism, and delayed hip arthritis are associated with HOA development in JIA. HOA is considered to be a severe adverse event of CS treatment, especially delayed hip involvement.
Relationship Between Cardiovascular Disease Pathology and Fatal Opioid and Other Sedative Overdose: A Post-Mortem Investigation and Pilot Study
Authors: Arab Abdulmalik Zuhair , Conti Aldo Alberto , Davey Fleur , Khan Faisel , Baldacchino Alexander Mario 
Published: November 2021

Introduction: In 2019, Scotland reported the highest number of drug deaths amongst EU countries. Of the 1,264 drug deaths reported in 2019, 94% were related to polysedative use. Studies have proposed a relationship between opioid use and cardiovascular disease. Furthermore, the concomitant use of sedatives and opioids has been associated with lethal cardiopulmonary events. However, evidence is still limited for the relationship between polysedative use and cardiovascular diseases. Thus, the present study aimed to investigate the association between polysedative use and the underlying cardiovascular pathologies in drug deaths.Methods: This study consisted of a post-mortem investigation of 436 drug deaths. Data extracted from post-mortem reports included socio-demographic characteristics (e.g., gender, age), cardiovascular pathologies (e.g., atherosclerosis, atheroma, and inflammation), in addition to the presence of opioids (e.g. methadone, heroin) and other substances (e.g., alcohol, benzodiazepine) in the blood of the deceased. Stepwise multiple regression models were employed to identify which substances predicted cardiovascular pathologies.Results: The presence of opioids, benzodiazepines, and alcohol in the blood of the deceased predicted overall cardiovascular disease (CVD) severity [R2 = 0.33, F (5, 430) = 39.64, p &lt; 0.0001; adjusted R2 = 0.32, f2 = 0.49]. Positive Beta coefficients may indicate an exacerbation of CVD (B = 0.48 95% CI = 0.25, 0.70) due to the presence of opioids in the blood of the deceased. Negative associations may instead indicate a relative protective effect of alcohol (B = −0.2, 95% CI = −0.41, −0.00) and benzodiazepines (B = −0.29, 95% CI = −0.48, −0.09) on CVD.Conclusion: These findings may inform national clinical guidelines on the need to monitor individuals who abuse opioids for presence of cardiovascular disease risk factors pathologies and provide timely interventions to reduce mortality in the population.
Active Flavonoids From Lagotis brachystachya Attenuate Monosodium Urate-Induced Gouty Arthritis via Inhibiting TLR4/MyD88/NF-κB Pathway and NLRP3 Expression
Authors: Ouyang Xiang , Li Na-Zhi , Guo Min-Xia , Zhang Man-Man , Cheng Jie , Yi Li-Tao , Zhu Ji-Xiao 
Published: November 2021

Lagotis brachystachya Maxim is a characteristic herb commonly used in Tibetan medicine. Tibetan medicine records it as an important medicine for the clinical treatment of “Yellow Water Disease,” the symptoms of which are similar to that of arthritis. Our previous study showed that the flavonoid fraction extracted from L. brachystachya could attenuate hyperuricemia. However, the effects of the active flavonoids on gouty arthritis remain elusive, and the underlying mechanism is not understood. In the present study, the effects of the active flavonoids were evaluated in rats or Raw264.7 cells with gouty arthritis induced by monosodium urate (MSU) crystal, followed by the detection of TLR4, MyD88, pNF-κB, and NLR family pyrin domain-containing 3 (NLRP3) expression. The swelling of the ankle joint induced by MSU crystal began to be relieved 6 h post the administration with the active flavonoids. In addition, the active flavonoids not only alleviated MSU crystal-induced inflammation in synovial tissues by histopathological examination but also reduced tumor necrosis factor alpha (TNF-α) and interleukin-1 beta (IL-1β) levels in the joint tissue fluid of MSU crystal-induced rats. Furthermore, Western blot analysis indicated that the active flavonoids reduced the production of these cytokines by inhibiting the TLR4/MyD88/NF-κB pathway and decreasing NLRP3 expression in synovial tissues of rats. More importantly, the inhibition of TLR4/MyD88/NF-κB pathway and NLRP3 expression was also confirmed in MSU-induced Raw264.7 cells. In conclusion, these results indicated that the active flavonoids from L. brachystachya could effectively attenuate gouty arthritis induced by MSU crystal through the TLR4/MyD88/NF-κB pathway and NLRP3 expression in vivo and in vitro, suggesting several potential candidates for the treatment of gouty arthritis.
A Band-Notched Antenna With Two Radiation Zeros Using Grounded Coplanar Waveguide Filter for 2.4/5 GHz WLAN Applications
Authors: Li Min , Xu Feng 
Published: November 2021

In this article, a band-notched dual-polarized crossed dipole antenna is proposed for 2.4/5 GHz WLAN applications. The proposed antenna works on the WLAN 2.4-GHz (2.4–2.48 GHz) and 5-GHz (5.15–5.85 GHz) bands for a VSWR &lt;2 with two radiation zeros within 3.4–3.6 GHz. First, an ultra-wideband crossed dipole antenna with an operating frequency of 2.4–5.8 GHz is designed using the grounded coplanar waveguide (GCPW) feeding structure. Second, a miniaturized defected microstrip structure (DMS) is embedded in the GCPW feeding strip to form a stopband behavior with a radiation zero. Finally, combining with the design of a C-shaped split ring resonator (SRR) on the arms of the dipole antenna, a band notch (3.4–3.6 GHz) with two radiation zeros can be realized. These two radiation zeros can be adjusted independently to achieve a wide stopband performance. As a result, compared with the original ultra-wideband dipole antenna, the realized gains of the proposed antenna in the 3.4–3.6 GHz range are all suppressed from 8 dBi to less than −8 dBi. The proposed antenna can realize the stable unidirectional radiation pattern and a high gain of around 7 dBi in the lower band and 8.5 dBi in the higher band of WLAN. As a demonstration, the proposed antenna is fabricated and measured, and the measurement results are in good agreement with the simulation results.
Mental Health Literacy Levels of Medical Staff in China: An Assessment Based on a Meta-Analysis
Authors: Guo Shengyu , Xiong Jie , Liu Feiyue , Su Yanlin 
Published: November 2021

Background: The awareness rate of mental health knowledge among medical staff is an important evaluation index to assess the service capacity of a country or region, and this indicator in China has not been quantitatively evaluated.Study Design: This study systematically combined pertinent quantitative study data from previous related studies to conclude the awareness rate of mental health knowledge among Chinese medical staff.Methods: Related studies from five electronic databases were searched, and a meta-analysis was conducted to obtain the combined result. The primary outcome of the present study was the awareness rate of medical staff or the sample size and the number of those who can answer the relevant questions correctly. We also performed a hierarchical analysis according to the sample group's region and specialty. The awareness rate of medical staff and corresponding 95% confidence intervals (CIs) were calculated. The heterogeneity was assessed with the I2 test, and Egger's test was used to evaluate publication bias.Results: A total of 15 articles with 11,526 medical staff were included in the present study; the overall awareness rate of mental health knowledge among Chinese medical staff was as low as 81%. The awareness rate of mental health knowledge among medical workers in developed regions is higher than that in developing regions. The awareness rate of mental health among medical staff in the department of psychiatry, non-psychiatry, and community medical staff was 88, 68, and 82%, respectively.Conclusion: The overall awareness rate among medical staff in this country is unsatisfactory, and the awareness rate in developed regions is higher than medical staff in developing regions. Psychiatric hospital staff has a higher awareness rate than community medical staff, and non-psychiatric hospital staff has the lowest awareness rate.
The Effects and Mechanisms of Exercise on the Treatment of Depression
Authors: Xie Yumeng , Wu Zuotian , Sun Limin , Zhou Lin , Wang Gaohua , Xiao Ling , Wang Huiling 
Published: November 2021

Background: It is necessary to seek alternative therapies for depression, because side effects of medications lead to poor adherence and some patients do not achieve a clinical treatment effect. Recently the role of exercise as a low-cost and easy-to-use treatment for depression has gained attention with a number of studies showing that exercise is effective at reducing depressive symptoms and improving body functions such as cardiorespiratory system and cognitive function. Because of the heterogeneity of exercise therapy programs, there is no standardized and unified program. Few studies have summarized the specific properties of exercise programs (type, intensity, duration, and frequency) and clinical prescriptions for exercise are not mentioned in most articles.Aims: This study aimed to investigate the feasibility and efficacy of exercise therapy for patients with depression, in order to appraise the evidence and outline accepted guidelines to direct individualized treatment plans for patients with depression based on their individual situations.Methods: A systematic review of English language literature including papers published from 2010 to present in PubMed was performed. Given the feasibility of prescribing exercise therapy for patients with depression, nearly 3 years of clinical studies on the treatments of depressive symptoms with exercise were first reviewed, comparing the exercise programs utilized.Conclusions: Exercise has therapeutic effects on depression in all age groups (mostly 18–65 years old), as a single therapy, an adjuvant therapy, or a combination therapy, and the benefits of exercise therapy are comparable to traditional treatments for depression. Moderate intensity exercise is enough to reduce depressive symptoms, but higher-dose exercise is better for overall functioning. Exercise therapy has become more widely used because of its benefits to the cardiovascular system, emotional state, and systemic functions.Recommendations: Aerobic exercise/mind-body exercise (3–5 sessions per week with moderate intensity lasting for 4–16 weeks) is recommended. Individualized protocols in the form of group exercise with supervision are effective at increasing adherence to treatment.
The Impact of Violence on the Anxiety Levels of Healthcare Personnel During the COVID-19 Pandemic
Authors: Bitencourt Mariá Romanio , Silva Lincoln Luís , Alarcão Ana Carolina Jacinto , Dutra Amanda de Carvalho , Bitencourt Marcos Rogério , Garcia Giovana Jorge , de Andrade Luciano , Nickenig Vissoci João Ricardo , Pelloso Sandra Marisa , Carvalho Maria Dalva de Barros 
Published: November 2021

Introduction: The COVID-19 pandemic stressed the importance of healthcare personnel. However, there is evidence of an increase in violence against them, which brings consequences, such as anxiety. The aim of this study was to analyze the anxiety levels of health professionals who have or not suffered violence during the COVID-19 pandemic, and verify the variables associated with the risk of starting to take medication for anxiety.Methods: We assessed the anxiety profile of health professionals in Brazil through an online questionnaire, using the Generalized Anxiety Disorder 7-item Scale (GAD-7), in relation to groups of participants who have or not suffered violence during the COVID-19 pandemic. We used Cronbach's alpha reliability coefficient to check the consistency of the responses, and the effect size using the r coefficient. Principal Component Analysis was used to verify the differences in anxiety scores between the two groups. Logistic regression analysis was also used to verify the variables associated with the risk of starting medication for anxiety and considered statistically significant when p &lt; 0.05.Results: A total of 1,166 health professionals participated in the study, in which 34.13% had a normal anxiety profile, 40.14% mild, 15.78% moderate, and 9.95% severe. The mean score of the sum of the GAD-7 was 7.03 (SD 5.20). The group that suffered violence had a higher mean (8.40; SD 5.42) compared to the group that did not (5.70; SD 4.60). In addition, the median between both groups was significantly different (7.0 vs. 5.0; p &lt; 0.01). Approximately 18.70% of the participants reported having started taking medication to treat anxiety during the pandemic. The factors that increased the chances of these professionals starting medication for anxiety p &lt; 0.05 were having suffered violence during the pandemic (OR 1.97; 95% CI 1.42–2.77), being nurses (OR 1.61; 95% CI 1.04–2.47) or other types of health professionals (OR 1.58; 95% CI 1.04–2.38), and having a mild (OR 2.11; 95% CI 1.37–3.34), moderate (OR 4.05; 95% CI 2.48–6.71) or severe (OR 9.08; 95% CI 5.39–15.6) anxiety level.Conclusion: Brazilian healthcare professionals who have suffered violence during the pandemic have higher anxiety scores and higher risk to start taking anxiety medication.
Clinical Features and Outcomes of 124 Italian Patients With Treatment Resistant Depression: A Real-World, Prospective Study
Authors: Perugi Giulio , Calò Paola , De Filippis Sergio , Rosso Gianluca , Vita Antonio , Adami Marina , Ascione Giuseppe , Morrens Joachim , Delmonte Dario 
Published: November 2021

Introduction: Treatment-resistant depression (TRD) is a debilitating condition affecting 20–30% of patients with major depressive disorders (MDD). Currently, there is no established standard of care for TRD, and wide variation in the clinical approach for disease management has been documented. Real-world data could help describe TRD clinical features, disease burden, and treatment outcome and identify a potential unmet medical need.Methods: We analyzed the Italian data from a European, prospective, multicentric, observational cohort study of patients fulfilling TRD criteria by the European Medicine Agency, with moderate to severe major depressive episode, and starting a new antidepressant treatment according to routinary clinical practice. They were followed up for minimum 6 months. Treatments received throughout the study period, disease severity, health-related quality of life and functioning were prospectively recorded and analyzed.Results: The Italian subcohort included 124 TRD patients (30.2% of patients of the European cohort; mean age 53.2 [sd = 9.8], women: 82, 66.1%). At enrollement, the mean (SD) duration of MDD was 16 years (sd = 11.1) and the mean duration of the ongoing major depressive episode (MDE) was 97.5 weeks (sd = 143.5); low scores of quality of life and functioning were reported. The most frequently antidepressant classes started at baseline (data available for 98 subjects) were selective serotonin reuptake inhibitors (SSRI, 42 patients [42.9%]) and serotonin-norepinephrine reuptake inhibitors (SNRI, 32 patients [32.7%]). In terms of treatment strategies, 50 patients (51%) started augmentation therapies, 18 (18.4%) combination therapies and 24 (24.5%) monoterapies (6 patients [6%] started a non-antidepressant drug only). Fourteen patients (11.3%) were treated with a psychosocial approach, including psychotherapy. After 6 months of treatment, clinical assessments were collected for 89 patients: 64 (71.9%) showed no response, 9 (10.1%) response without remission and 16 (18.0%) were in remission; non-responder patients showed lower quality of life and higher disability scores than responder patients.Conclusions: In our sample of TRD patients, we documented substantial illness burden, low perceived quality of life and poor outcome, suggesting an unmet treatment need in TRD care in Italy.Registration Number:ClinicalTrials.gov, number: NCT03373253.
Psychological Impact of the COVID-19 Pandemic on Children and Adolescents With and Without Mental Disorders
Authors: Gilsbach Susanne , Herpertz-Dahlmann Beate , Konrad Kerstin 
Published: November 2021

Background: The previous and current studies highlight the psychological distress caused by coronavirus disease 2019 (COVID-19)-associated restrictions among the general population, especially among children and adolescents; however, few studies have examined children and adolescents with a mental disorder. The current study aimed to explore whether youth with mental disorders show a higher pandemic-associated psychological burden than healthy children and adolescents and to determine which psychiatric diagnoses are particularly associated with a higher distress level.Methods: In this study, 144 children and adolescents between the ages of 6 and 18 years with a mental disorder and 48 children and adolescents within the same age range without a mental disorder, and their caregivers, completed questionnaires assessing the pandemic-associated trauma symptoms (the Child Report of Post-Traumatic Symptoms [CROPS] and the Parents Report of Post-Traumatic Symptoms [PROPS]). Additionally, we asked specific questions about the pandemic-associated stress factors, such as financial problems, prolonged screen times, or loneliness.Results: Children and adolescents with a mental illness showed a significantly higher psychological burden than their mentally healthy peers. Female gender was a risk factor for a higher self-reported psychological burden, and younger age was associated with a more extensive parent-reported psychological burden. The patients with a depressive disorder showed significantly higher levels of psychological distress associated with the COVID-19 pandemic than the patients with an attention deficit and/or a conduct disorder.Conclusions: Children and adolescents with a mental illness, particularly, female children and individuals with a depressive disorder, are at an increased risk of suffering from pandemic-associated psychological distress. Adequate mental health care options, such as telepsychiatry, are indispensable.