bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychological Resilience and Suicide Attempt in Patients With Bipolar Disorder: An Exploratory Study
Authors: Fernández-Rocha María Luisa , García-Izquierdo Mariano , Ríos-Rísquez María Isabel 
Published: October 2021

BACKGROUND: Patients with bipolar affective disorder (BPAD) have a suicide risk of up to 30 times higher than the general population. There is increasing interest in analyzing the effects of resilience in psychiatric diseases and its relationship to other factors such as suicide risk. AIM: The main objective of this study was to analyze the relationship between psychological resilience and suicide attempts, along with other relevant clinical and sociodemographic variables in euthymic patients with BPAD. METHODS: Eighty six outpatients, more than 18 years old, mostly men (60.5%) with BPAD type 1, 2, mixed, and unspecified, in euthymic phase receiving antidepressant and/or euthimizing treatment, participated in the study. Sociodemographic and clinical variables were assessed by means of a questionnaire and psychological resilience by means of Connor-Davidson’s 10-item Resilience Scale. RESULTS: Patients with previous autolytic attempts scored significantly lower in resilience than those who had not attempted suicide ( T = 3.30; p ≤ .001; 20.61 ± 6.58 vs. 26.52 ± 7.29). Patients diagnosed with BPAD scored significantly lower than other samples of university participants, workers, and the unemployed. The number of depressive episodes experienced was negatively and significantly associated with resilience scores ( r = −.28; p < .01). CONCLUSIONS: Patients diagnosed with BPAD who had made autolytic attempts had lower resilience scores than those who had not made them and lower scores than other general nonpsychiatric samples. The promotion of resilience in patients diagnosed with BPAD would facilitate a more adaptive and positive coping with the disease and their recovery process.
The Role of Nutrition in Degenerative Cervical Myelopathy: A Systematic Review
Authors: Partha Sarathi Celine I , Mowforth Oliver D , Sinha Amil , Bhatti Faheem , Bhatti Aniqah , Akhbari Melika , Ahmed Shahzaib , Davies Benjamin M 
Published: October 2021

Introduction: Degenerative cervical myelopathy (DCM) is the commonest cause of adult spinal cord impairment worldwide, encompassing chronic compression of the spinal cord, neurological disability and diminished quality of life. Evidence on the contribution of environmental factors is sparse; in particular, the role of nutrition in DCM is unknown. The objective of this review was to assess the effect of nutrition on DCM susceptibility, severity and surgical outcome. Methods: A systematic review in MEDLINE and Embase was conducted following PRISMA guidelines. Full-text papers in English papers, focussing on cervical myelopathy and nutrition, published before January 2020 were considered eligible. Quality assessments were performed using the GRADE assessment tool. Patient demographics, nutritional factor and DCM outcomes measures were recorded. Relationships between nutritional factors, interventions and disease prognosis were assessed. Results: In total, 5835 papers were identified of which 44 were included in the final analysis. DCM patients with pathological weight pre-operatively were more likely to see poorer improvements post-surgically. These patients experienced poorer physical and mental health improvements from surgery compared to normal weight patients and were more likely to suffer from post-operative complications such as infection, DVT, PE and hospital readmissions. Two trials reporting benefits of nutritional supplements were identified, with 1 suggesting Cerebrolysin to be significant in functional improvement. An unbalanced diet, history of alcohol abuse and malnourishment were associated with poorer post-operative outcome. Conclusion: Although the overall strength of recommendation is low, current evidence suggests nutrition may have a significant role in optimising surgical outcome in DCM patients. Although it may have a role in onset and severity of DCM, this is a preliminary suggestion. Further work needs to be done on how nutrition is defined and measured, however, the beneficial results from studies with nutritional interventions suggest nutrition could be a treatment target in DCM.
Investigating balance, gait, and physical function in people who have undergone thoracic surgery for a diagnosis of lung cancer: A mixed-methods study
Authors: Tough Daniel , Dunning Joel , Robinson Jonathan , Dixon John , Ferguson Jonathan , Paul Ian , Harrison Samantha L 
Published: October 2021

Objectives Symptoms associated with lung cancer and thoracic surgery might increase fall risk. We aimed to investigate: 1) balance, gait and functional status in people post-thoracic surgery compared to healthy controls; 2) perceptions of balance, gait and functional status. Methods Recruitment targeted older adults (≥50 years) who had undergone thoracic surgery for a diagnosis of lung cancer in the previous 3 months, and healthy age-matched controls. Dynamic and static balance, gait velocity, knee-extension strength and physical activity levels were assessed using the BESTest, Kistler force plate, GAITRite system, Biodex System 3 and CHAMPS questionnaire, respectively. Two-part semi-structured interviews were conducted post-surgery. Results Individuals post-surgery ( n = 15) had worse dynamic balance and gait, and lower levels of moderate/vigorous physical activity (MVPA) (all p<0.05) versus healthy controls ( n = 15). Strength did not differ between groups ( p > 0.05). No associations between BESTest and strength or physical activity existed post-surgery ( p > 0.05). Three themes were identified: 1) Symptoms affect daily activities; 2) Functional assessments alter perceptions of balance ability and 3) Open to supervised rehabilitation. Conclusion Balance, gait and MVPA are impaired post-thoracic surgery, yet balance was not viewed to be important in enabling activities of daily living. However, supervised rehabilitation was considered acceptable.
Construct Validity of the Upper-Limb Interlimb Coordination Test in Stroke
Authors: Molad Roni , Levin Mindy F. 
Published: October 2021

Background Coordination impairments are under-evaluated in patients with stroke due to the lack of validated assessments resulting in an unclear relationship between coordination deficits and functional limitations. Objective Determine the construct validity of the new clinical upper-limb (UL) Interlimb Coordination test (ILC2) in individuals with chronic stroke. Methods Thirteen individuals with stroke, ≥40 years, with ≥30° isolated supination of the more-affected (MAff) arm, who could understand instructions and 13 healthy controls of similar age participated in a cross-sectional study. Participants performed synchronous bilateral anti-phase forearm rotations for 10 seconds in 4 conditions: self-paced internally-paced (IP1), fast internally-paced (IP2), slow externally-paced (EP1), and fast externally-paced (EP2). Primary (continuous relative phase-CRP, cross-correlation, lag) and secondary outcome measures (UL and trunk kinematics) were compared between groups. Results Participants with stroke made slower UL movements than controls in all conditions, except EP1. Cross-correlation coefficients were lower (i.e., closer to 0) in stroke in IP1, but CRP and lag were similar between groups. In IP1 and matched-speed conditions (IP1 for healthy and IP2 for stroke), stroke participants used compensatory trunk and shoulder movements. The synchronicity sub-scale and total scores of ILC2 were related to temporal coordination in IP2. Interlimb Coordination test total score was related to greater shoulder rotation of the MAff arm. Interlimb Coordination test scores were not related to clinical scores. Conclusion Interlimb Coordination test is a valid clinical measure that may be used to objectively assess UL interlimb coordination in individuals with chronic stroke. Further reliability testing is needed to determine the clinical utility of the scale.
Predictors of unfavorable outcomes despite substantial reperfusion: Insights from Analysis of Revascularization in Ischemic Stroke With EmboTrap II Study
Authors: Siddiqui Adnan H , Waqas Muhammad , Andersson Tommy , Saver Jeffrey L , Mattle Heinrich P , Bozorgchami Hormozd , Ribó Marc , Zaidat Osama O 
Published: October 2021

Background A considerable proportion of stroke patients have unfavorable outcomes despite substantial reperfusion during mechanical thrombectomy for large vessel occlusion. This study aimed to determine predictors of unfavorable outcomes despite substantial reperfusion (modified thrombolysis in cerebral infarction score of ≥2b). Methods We conducted a post hoc analysis of Analysis of Revascularization in Ischemic Stroke With EmboTrap, a prospective, multicenter study on the efficacy of the EmboTrap revascularization device. We included patients with anterior large vessel occlusion, substantial reperfusion within three passes, and 3-month follow-up. Univariate and multivariate logistic regression analyses were performed to determine independent predictors of dependency or death (modified Rankin Score 3–6) at 90 days. Results Of the 176 patients included in the study, 124 (70.45%) achieved modified Rankin Score of 0–2 at 90 days and 52 (29.6%) had modified Rankin Score of 3–6. On univariate analysis, patient age and initial National Institutes of Health Stroke Scale score were significantly higher in the modified Rankin Score of 3–6 groups (71.4 ± 11.3 years vs. 66.0 ± 13.1 years, 0.01; 18.9 ± 4.13 vs. 14.6 ± 4.36, p < 0.01, respectively). Mean number of passes and symptomatic intracranial hemorrhage were also higher in patients with modified Rankin Score of 3–6 (2.46 ± 1.42 vs. 1.65 ± 0.9, p < 0.01; 13.5% vs. 2.4%, p = 0.008). On multivariate analysis, initial National Institutes of Health Stroke Scale score and mean number of passes and were independent predictors of modified Rankin Score of 3–6 at 90 days. Conclusion More severe initial neurologic deficit and higher number of passes in patients with substantial reperfusion were independent predictors of dependency or death. These findings highlight a reduction in the number of passes required to achieve reperfusion as a therapeutic target to improve the outcome after thrombectomy.
Detection of residual varicose veins with near infrared light in the early period after varicose surgery and near infrared light assisted sclerotherapy
Authors: Kahraman Nail , Yümün Gündüz , Demir Deniz , Özsin Kadir K , Sünbül Sadık A , Gücü Arif , Şeker İbrahim B , Özyaprak Buket , Yavuz Şenol , Göncü Mehmet T 
Published: October 2021

Objectives Varicose veins that cannot be seen with the naked eye can be easily detected with Near Infrared (NIR) light. With a minimally invasive procedure performed with NIR light guided, the need for reoperation is reduced, while optimal treatment of venous insufficiency and symptoms is provided. In this study, the detection of residual varicose veins after varicose vein surgery using NIR light and the results of treatment of sclerotherapy were investigated. Methods In this retrospective study, treatment and clinical outcomes of patients’ who underwent NIR light-guided foam sclerotherapy for Clinical-Etiology-Anatomy-Pathophysiology (CEAP) (C1, C2) stage residual varicose veins after surgical varicose treatment between 2014 and 2017 were examined. Data of patients who underwent foam sclerotherapy with NIR light were collected and analyzed. Results A total of 151 patients and 171 lower extremity varicose veins were treated with surgery. 55 (35.7%) of the patients were male, and 96 (62.3%) were female. Their age ranges from 20 to 64, with an average age of 45.38. 4 (2.6%) of the patients had phlebectomy. 137 of patients (90.7%) had ligation of perforated veins, phlebectomy, and great saphenous vein (GSV) stripping, 10 of patients (6.6%) had GSV stripping, perforating vein ligation, phlebectomy, and small saphenous vein (SSV) surgery. No residual leakage was observed in the controls of GSV, SSV, and perforating veins by duplex ultrasonography (DUS). In the first month after varicose surgery, an average of 1.64 ± 1.05 sessions of sclerotherapy was applied to patients with CEAP C1, C2 stage residual varicose veins. 70 patients had one session of sclerotherapy, 37 patients had two sessions of sclerotherapy, 20 patients had three sessions of sclerotherapy, and 11 patients had four sessions of sclerotherapy administrated. The need for complementary therapy was required for all female patients; 13 of the male patients did not require complementary sclerotherapy. While single-session sclerotherapy was applied to most male patients (32 (58.18%), 10 (18.18%) patients received two sclerotherapy sessions. After completing sclerotherapy, 7 (4.63%) patients had superficial venous thrombosis, and 13 (8.60%) patients had hyperpigmentation. Conclusion Surgical treatment is a safe and effective technique in venous insufficiency. Nevertheless, residual varicose veins may remain, and these can be detected noninvasively with NIR light. Foam sclerotherapy with NIR light is a minimally invasive and safe treatment method for small residual varicose veins after the operation. We think that sclerotherapy with NIR light as a complementary treatment is a practical, reliable, and demanding treatment for clinical improvement, especially in female patients.
SOX2 as a prognostic marker and a potential molecular target in cervical cancer: A meta-analysis
Authors: Yuan Dandan , Wang Jian , Yan Mingyu , Xu Yaohui 
Published: October 2021

Background Sex determining region Y-box 2 (SOX2) has been reported as a potential therapeutic target for cancer. However, the role of SOX2 in cervical cancer remains largely undetermined. This study was performed to evaluate the correlation of SOX2 with clinical characteristics and prognosis in cervical cancer. Methods Multiple databases were systematically searched for eligible publications. The combined odds ratios (ORs) or hazard ratios (HRs) with the corresponding 95% confidence intervals (CIs) were used to assess the effect sizes. Results A total of 17 studies with 1906 participants were identified. SOX2 expression was higher in cervical cancer than in the normal control group (OR = 10.83, 95% CI = 6.64–17.67, P < 0.001), while no significant difference was observed between cervical cancer and cervical intraepithelial neoplasia. SOX2 expression was not associated with age, tumor stage, and lymph node metastasis, but was correlated with tumor grade (grade 2–3 vs. grade 1: OR = 4.59, 95% CI = 2.76–7.62, P < 0.001) and tumor size (≥4 cm vs. ≤4 cm: OR = 1.66, 95% CI = 1.05–2.60, P = 0.028). Based on multivariate Cox analysis, SOX2 expression was not correlated with overall survival, but was closely associated with poor recurrence-free survival (HR = 5.83, 95% CI = 1.35–25.16, P = 0.018) and progress-free survival HR = 2.29, 95% CI = 1.01–5.19, P = 0.046). Conclusion SOX2 may serve as a novel prognostic factor and a promising molecular target for cervical cancer.
The Role of Bone Grafts in Preventing Medication-Related Osteonecrosis of the Jaw: Histomorphometric, Immunohistochemical, and Clinical Evaluation in Animal Model
Authors: da Silva Jonathan Ribeiro , Balbas Maria Cristina de Moraes , Corrêa Caroline Águeda , Zanela Manuella , Okamoto Roberta , Pereira Rodrigo dos Santos , Homsi Nicolas , Hochuli-Vieira Eduardo 
Published: October 2021

Objective:To evaluate the effects of inorganic bovine bone graft (Lumina Bone, Criteria, Brazil) and beta-tricalcium phosphate (β-TCP) graft (ChronOS, Synthes, Brazil) in rats with the risk of developing post-extraction medication-related osteonecrosis of the jaw (MRONJ).Methods:Eighteen male Wistar rats weighing 350 to 450 g were induced to develop MRONJ using zoledronic acid for 5 weeks. In the sixth week, the right maxillary first molar was extracted. The animals in Group I (G1) did not receive bone grafts after tooth extraction, while Group II (G2) animals received inorganic bovine bone grafts, and Group III (G3) animals received beta-tricalcium phosphate (β-TCP) grafts. Clinical evaluation and histomorphometric and immunohistochemical analyses were performed. ANOVA and Tukey’s statistical tests were used and a level of significance was considered to be 5%.Results:In the clinical evaluation, animals from G2 and G3 did not present clinical manifestations of osteonecrosis, unlike the control group (G1) animals, which presented necrotic bone tissue exposure in all samples. In the histomorphometric evaluation, animals in G3 showed greater formation of bone tissue (66%) and less formation of bone lacuna (18%) than animals in G1 (58%/32%) and in G2 (59%/27%) ( P < 0.05). Moderate (++) immunostaining was observed in G2 and G3 for RANKL, TRAP, and OC, while G1 showed moderate (++) labeling for OC and mild (+) immunostaining for TRAP and RANKL.Conclusions:Greater formation of bone tissue and fewer bone lacunae were found in animals treated with β-TCP. In clinical evaluation, bone graft groups presented with the clinical manifestation of MRONJ and showed higher intensity of immunostaining for TRAP and RANKL. Despite the limitations of experimental animal studies, the results of this work may assist in the development of future clinical research for the prevention of MRONJ.
Adherence to diabetes self-care management and associated factors among people with diabetes in Gamo Gofa Zone public health hospitals
Authors: Agidew Eskeziyaw , Wale Mengistu Zelalem , Kerebih Haregewoyin , Yirsaw Mesenbet Terefe , Zewdie Tadiwos Hailu , Girma Meseret , Miskir Abebaw 
Published: October 2021

Introduction: Adherence to diabetes self-care management is a lifestyle modification for people with diabetes which includes; medication, dietary practice and regular physical activity. The objective of this study was to assess the adherence to diabetes self-care management and associated factors among people with diabetes in Gamo Gofa Zone, Southern, Ethiopia, 2018. Methods: Institutional-based cross-sectional study design with a systematic random sampling technique was conducted. A total 635 diabetic participants were involved in this study. Data were collected using structured interviewer administered questionnaire. Data were analyzed using SPSS version 21. Descriptive statistics were employed to describe the study population in relation to the relevant variables. Binary and multivariable logistic regression was conducted to identify factors associated with the outcome variables. P-value < 0.05 with 95% confidence interval was used to declare statistical significance. Results: The prevalence of good adherence toward diabetes self-care management was 341 (53.7%), (95% confidence interval = 46.09, 61.31). Regarding diabetes self-care practices, poor adherence had been detected in blood sugar measurement practice, dietary feeding practice, physical exercise and eye examination practice. The multivariable analysis indicated that government workers [adjusted odds ratio = 2.74 (1.03, 7.30)], training on diabetes self-care practice [adjusted odds ratio = 3.13 (1.89, 5.16)], diabetes’ association membership [adjusted odds ratio = 1.59 (1.01, 2.50)], having personal glucometer at home [adjusted odds ratio = 2.70 (1.37, 5.33)], duration of diabetic illness >10 years [adjusted odds ratio = 9.59 (3.99, 23.05)] and people with diabetes who were not developing complication [adjusted odds ratio = 1.54 (1.01, 2.33)] were significantly associated with good adherence to diabetes self-care management practice. Conclusion: Significant number of diabetes patients had poor adherence to diabetes self-care practice. Special focus should be given to farmers with diabetes, those with diabetic complication and for those with duration of diabetes less than 10 years. Periodical training should be given for people with diabetes on dietary feeding, physical exercise and eye examination practice.
Factors Associated With a Persistent Seronegative Status 1 Year After a SARS-CoV-2 Massive Infection Outbreak in Community Dwellers Living in Rural Ecuador: A Prospective Population-based Study
Authors: Del Brutto Oscar H. , Costa Aldo F. , Recalde Bettsy Y. , Mera Robertino M. 
Published: October 2021

Background The SARS-CoV-2 pandemic is affecting millions of people living in rural areas of Low- and Middle-Income Countries and is causing an already anticipated devastating effect on the health and economics of these populations. More information is needed to modify behaviors that may counterbalance the consequences of mass spread of the virus in these underserved communities. This study aimed to identify factors associated with a persistent SARS-CoV-2 seronegative status 1 year after a massive infection outbreak in middle-aged and older adults living in rural Ecuador. Methods Individuals enrolled in the Atahualpa Project Cohort as of March 2020 received 5 rounds of tests for determination of SARS-CoV-2 antibodies in blood. Individuals who remained seronegative up to April 2021 were considered “persistently seronegative.” An adjusted Poisson regression model was fitted to estimate the incidence risk ratio of factors directly or inversely associated with a persistent seronegative status. Results A total of 673 individuals received baseline tests. Thirty-one declined consent or died and 429 seroconverted, leaving 213 seronegative subjects. Average SARS-CoV-2 incidence rate was 9.87 events (95% C.I.: 8.91-10.83) per 100 person-months of observation. The use of flushing toilet systems (instead of open latrines) increased 1.5 times the possibility of remaining seronegative. Likewise, every additional bedroom in the house increased by 15% the possibility of remaining seronegative. In contrast, every additional person in the house and having high cholesterol levels significantly reduced the possibility of remaining seronegative. Conclusions The use of flushing toilet systems and the number of bedrooms in the house directly influenced the possibility of remaining seronegative among individuals living in this rural setting. Study results also demonstrated a sustained transmission of the virus even after a significant proportion of the population has been infected. Our findings reinforce the mass spread of SARS-CoV-2 in rural communities.
The Necessary Thread of Mindfulness Intervention Fidelity Assurance: Enabling an Organizational Strategy to Promote Health Care Professional Well-Being
Authors: Klatt Maryanna D. , Bawa Rani , Gabram Olivia , Westrick Alexis , Blake Amanda 
Published: October 2021

Purpose A growing waitlist for Mindfulness in Motion (MIM), an evidence-based worksite mindfulness-based intervention, necessitated a training system with built in fidelity assurance to meet program demand. MIM was delivered as part of an organizational strategy in a large academic health center to enhance Health Care Professional (HCP) well-being. In order to ensure that the intervention was being delivered the same way to each cohort, a process to ensure intervention fidelity was developed for MIM. Method The core components of MIM informed the development of a detailed fidelity monitoring system to ensure consistent intervention delivery. Each MIM cohort was conducted with both trained facilitators and trained intervention fidelity monitors. Results Across 11 cohort offerings of MIM, each 8 weeks in length, there was a mean adherence rate of 0.9886, SD = 0.0012. Conclusion The fidelity monitoring system allowed for a reliable expansion of MIM offerings to HCPs and for a seamless pivot to fully virtual MIM delivery, necessitated by COVID-19.