bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neurosurgical Admission Later Than 4 h After the Emergency Call Does Not Result in Worse Long-Term Outcome in Subarachnoid Haemorrhage
Authors: Sonne Asger , Andersen Jesper B. , Eskesen Vagn , Lippert Freddy , Waldorff Frans B. , Siersma Volkert , Lohse Nicolai , Rasmussen Lars S. 
Published: October 2021

Background: Few studies have investigated the importance of the time interval between contact to the emergency medical service and neurosurgical admission in patients with spontaneous subarachnoid haemorrhage. We hypothesised that longer time to treatment would be associated with an increased risk of death or early retirement.Methods: This was a retrospective observational study with 4 years follow-up. Those who reached a neurosurgical department in fewer than 4 h were compared with those who reached it in more than 4 h. Individual level data were merged from the Danish National Patient Register, medical records, the Copenhagen Emergency Medical Dispatch Centre, the Civil Registration System, and the Ministry of Employment and Statistics Denmark. Patients were ≥18 years and had a verified diagnosis of spontaneous subarachnoid haemorrhage. The primary outcome was death or early retirement after 4 years.Results: Two hundred sixty-two patients admitted within a three-and-a-half-year time period were identified. Data were available in 124 patients, and 61 of them were in their working age. Four-year all-cause mortality was 25.8%. No significant association was found between time to neurosurgical admission and risk of death or early retirement (OR = 0.35, 95% confidence interval [CI]: 0.10–1.23, p = 0.10).Conclusion: We did not find an association between the time from emergency telephone call to neurosurgical admission and the risk of death or early retirement.
Physical Activity Levels of Adolescents and Adults With Cerebral Palsy in Urban South Africa
Authors: Salie Roshaan , Eken Maaike M. , Donald Kirsten A. , Fieggen A. Graham , Langerak Nelleke G. 
Published: October 2021

Background: Research in high income countries shows that people with cerebral palsy (CP) are less physically active than typically developing (TD) peers, but less is known regarding physical activity (PA) in those with CP in low-to-middle income countries. The aim of this study was to determine daily step count and levels of PA in adolescents and adults with CP living in urban South Africa, compared to TD peers, and to determine associations with sex, Gross Motor Function Classification System (GMFCS) level, body mass index and socio-economic status.Materials and Methods: This case–control study included 26 adolescents and 22 adults with CP (GMFCS Level I-V) and matched TD peers (25 and 30, respectively). Participants wore an ActiGraph GT3X for 7 consecutive days to determine step count and time (minutes per hour) spent in PA levels, including sedentary (SED), low physical activity (LPA) and moderate to vigorous physical activity (MVPA).Results: The daily step count and PA levels for ambulant adolescents with CP (GMFCS level I-III) were similar to TD peers, while this was less for adolescents classified in GMFCS level IV-V. Daily step count, SED and MVPA were similar for adults classified in GMFCS level I-II compared to TD adults, while all parameters were lower for adults using assistive devices (GMFCS level III) and non-ambulant adults (GMFCS level IV-V) compared to TD peers. Daily step count and PA levels were inversely associated with GMFCS, while no other associations were found.Conclusion: People with CP who were more mobile dependent (higher GMFCS level) were less active. However, adolescents and adults with CP classified as GMFCS levels I-II living in urban South Africa recorded similar step count and PA levels as their TD peers. This was also the case for adolescents using assistive devices, though not for those in the adult group (GMFCS level III). Furthermore, it was apparent that even the ambulant individuals with CP and TD cohorts were relatively inactive. Intervention programs for CP and TD adolescents should be aimed at finding strategies to keep adolescents physically active well into adulthood, in order to promote physical health, social and emotional well-being and independence.
Mood Disturbances, Anxiety, and Impact on Quality of Life in Patients Admitted to Epilepsy Monitoring Units
Authors: Rocamora Rodrigo , Chavarría Beatriz , Pérez Eva , Pérez-Enríquez Carmen , Barguilla Ainara , Panadés-de Oliveira Luisa , Principe Alessandro , Zucca Riccardo 
Published: October 2021

Introduction: The overall combined prevalence of anxiety and depression in patients with epilepsy has been estimated at 20.2 and 22.9%, respectively, and is considered more severe in drug-refractory epilepsy. Patients admitted to epilepsy monitoring units constitute a particular group. Also, patients with psychogenic non-epileptic seizures can reach more than 20% of all admissions. This study aims to characterize these symptoms in a large cohort of patients admitted for evaluation in a tertiary epilepsy center.Materials and Methods: The study was conducted among 493 consecutive patients (age: 38.78 ± 12.7, 57% females) admitted for long-term video EEG from January 2013 to February 2021. Demographic, clinical, and mood disorder patients' data were collected. Anxiety and depression symptoms were assessed through the Hospital Anxiety Depression Scale (HADS-A and HADS-D), the State Trait Anxiety Inventory (STAI), and Beck Depression Inventory (BDI-II). Quality of life was determined using the QOLIE-10. Patients were divided into three groups: patients with epilepsy (n = 395), psychogenic non-epileptic seizures (PNES) (n = 56), and combined (n = 33). A univariate and multivariate regression analysis was performed for variables associated with quality of life.Results: Of 493 patients, 45.0% had structural etiology, and considering epilepsy classification, 43.6% were of temporal lobe origin. In addition, 32.45% of patients had a previous psychiatric history, 49.9% of patients had depressive symptoms in BDI, and 30.9% according to HADS-D; 56.42 and 52.63% of patients presented pathological anxiety scores in STAI-T and STAI-S, respectively; and 44.78% according to HADS-A. PNES and combined groups revealed a higher incidence of pathologic BDI scores (64.29 and 78.79%, p &lt; 0.001) as well as pathologic HADS-A scores (p = 0.001). Anxiety and depression pathologic results are more prevalent in females, HADS-A (females = 50.7%, males = 36.8%; p = 0.0027) and BDI &gt; 13 (females = 56.6%, males = 41.0%; p = 0.0006). QOLIE-10 showed that 71% of the patients had their quality of life affected with significantly higher scores in the combined group than in the epilepsy and PNES groups (p = 0.0015).Conclusions: Subjective anxiety, depression, and reduced quality of life are highly prevalent in patients with refractory epilepsy. These symptoms are more evident when PNES are associated with epilepsy and more severe among female patients. Most of the cases were not previously diagnosed. These factors should be considered in everyday clinical practice, and specific approaches might be adapted depending on the patient's profile.
Stereotactic Body Radiation Therapy for Oligometastatic Breast Cancer: A Retrospective Multicenter Study
Authors: Lemoine Pauline , Bruand Marie , Kammerer Emmanuel , Bogart Emilie , Comte Pauline , Royer Philippe , Thariat Juliette , Pasquier David 
Published: October 2021

IntroductionStereotactic radiotherapy may improve the prognosis of oligometastatic patients. In the literature, there is very little data available that is specific to breast cancer.Materials and MethodsWe conducted a multicenter retrospective study. The primary objective was to estimate progression-free survival after stereotactic body radiotherapy (SBRT) using Cyberknife of breast cancer oligometastases. The secondary objectives were to estimate overall survival, local control, and toxicity. The inclusion criteria were oligometastatic breast cancer with a maximum of five lesions distributed in one to three different organs, diagnosed on PET/CT and/or MRI, excluding brain metastases and oligoprogressions. This was combined with systemic medical treatment.FindingsForty-four patients were enrolled from 2007 to 2017, at three high-volume cancer centers. The patients mostly had one to two lesion(s) whose most widely represented site was bone (24 lesions or 44.4%), particularly in the spine, followed by liver (22 lesions or 40.7%), then pulmonary lesions (six lesions or 11.1%). The primary tumor expressed estrogen receptors in 33 patients (84.6%); the status was HER2+++ in 7 patients (17.9%). The median dose was 40 Gy (min-max: 15-54) prescribed at 80% isodose, the median number of sessions was three (min-max: 3-10). The median D50% was 42 Gy (min max 17-59). After a median follow-up of 3.4 years, progression-free survival (PFS) at one year, two years, and three years was 81% (95% CI: 66-90%), 58% (95% CI: 41-72%), and 45% (95% CI: 28-60%), respectively. The median PFS was 2.6 years (95% CI: 1.3 – 4.9). Overall survival at three years was 81% (95% CI: 63-90%). The local control rate at two and three years was 100%. Three patients (7.3%) experienced G2 acute toxicity, no grade ≥3 toxicity was reported.ConclusionThe PFS of oligometastatic breast cancer patients treated with SBRT appears long, with low toxicity. Local control is high. SBRT for oligometastases is rarely applied in breast cancer in light of the population in our study. Phase III studies are ongoing.
Prognostic Value of Lymphocyte–C-Reactive Protein Ratio in Patients Undergoing Radical Cystectomy for Bladder Cancer: A Population-Based Study
Authors: Zhang Houliang , Wang Yidi , Ni Jinliang , Shi Huajuan , Zhang Tao , Zhang Yifan , Guo Jing , Wang Keyi , Mao Weipu , Peng Bo 
Published: October 2021

PurposeThis study aimed to assess the prognostic value of the lymphocyte–C-reactive protein ratio (LCR) in patients with bladder cancer (BCa) who underwent radical cystectomy (RC).Materials and MethodsBCa patients between 2009 and 2018 were retrieved from our medical center. The predictive value of LCR on survival of BCa patients was evaluated through the Kaplan–Meier survival and receiver operating characteristic (ROC) curves. The multivariate Cox regression results were used for conducting the nomogram, which were further verified by ROC, decision curve analysis (DCA), and calibration curves. Propensity score matching (PSM) was performed to validate our findings.ResultsA total of 201 BCa patients who received RC were included in this study, with 62 (30.8%) patients in the low LCR group and 139 (69.2%) in the high LCR group. Multivariate analysis results revealed that the high LCR group was significantly related to better prognosis and functioned as a prognostic biomarker for overall survival (OS) [hazard ratio (HR) = 0.41, 95% CI, 0.26–0.66; p &lt; 0.001] and disease-free survival (DFS) [HR = 0.40, 95% CI, 0.26–0.66; p &lt; 0.001]. The nomogram processed better predictive capability and accuracy than TNM stage from ROC results (AUC = 0.754 vs. AUC = 0.715), with the confirmation of calibration curves and DCA. The result of PSM confirmed that LCR was significantly correlated with OS and DFS.ConclusionOur finding demonstrates that LCR is a novel, convenient, and effective predictor that may provide vital assistance for clinical decision and individualized therapy in BCa patients after RC.
Self-Reported Health in Patients on or at Risk of Sick Leave Due to Depression and Anxiety: Validity of the EQ-5D
Authors: Sandin Kenneth , Shields Gemma E. , Gjengedal Ragne G. H. , Osnes Kåre , Bjørndal Marianne Tranberg , Hjemdal Odin 
Published: October 2021

Objectives: The EQ-5D is a generic, self-report measure of health that is increasingly used in clinical settings, including mental health. The EQ-5D captures health using five dimensions: Mobility, Self-care, Usual activities, Pain/discomfort, and Anxiety/Depression. The validity of the EQ-5D is previously unexplored in patients on or at risk of sick leave due to depression and anxiety. The study’s aim was to examine its validity in this group of patients.Methods: Baseline data were collected from self-report questionnaires in an observational study (N=890) at a Norwegian outpatient-clinic. Participants were adults on or at risk of sick leave due to depression and anxiety who were referred for treatment by general practitioners. The crosswalk methodology was applied to estimate the EQ-5D value. Validity was assessed by comparing responses on the EQ-5D with the Beck Depression Inventory-II (BDI-II), the Beck Anxiety Inventory (BAI), and Subjective Health Complaints (SHC). An ordinal regression model was used to assess known-groups validity. Convergent validity was assessed using Pearson’s correlation coefficient, and a multivariate regression model that included sociodemographic characteristics.Results: The mean EQ-5D value was 0.631, indicating reduced health status compared to “full health” anchored at 1.0, and patients reported moderate levels of depression and anxiety. Ordinal regression indicated that the EQ-5D could discriminate between different levels of symptom severity for depression and anxiety. The EQ-5D value showed significant correlation with the clinical measures; r=−0.52 for the BDI-II, r=−0.49 for the BAI, and r=−0.44 for SHC. The multivariate regression showed that the clinical variables significantly predicted the EQ-5D value, explaining 40.1% of the variance. Depression and anxiety scores were the largest determinants of EQ-5D value, respectively, whilst sick leave, subjective health complaints, and gender made moderate contributions.Conclusion: The EQ-5D showed indication of validity in patients on or at risk of sick leave due to depression and anxiety in the present study. The EQ-5D value was sensitive to both symptom severity and functional impairment in the form of sick leave. The findings support the EQ-5D as a feasible and relevant measure of health status in these patients.
Efficacy of Group Music Therapy Based on Emotion-Regulation Skills on Male Inpatients With Alcohol Dependence: A Randomized, Controlled Pilot Trial
Authors: Huang Yi , Chen Xu 
Published: October 2021

Objective: This study aimed to determine the benefits and feasibility of using group music therapy based on emotion-regulation skills to treat male inpatients with alcohol dependence (AD).Methods: We recruited male inpatients with alcohol dependence and randomly assigned those eligible for enrollment to either the study group or the control group. The study group received group music therapy along with treatment-as-usual (TAU), while the control group received only treatment-as-usual. Primary outcomes, including anxiety levels, sleep quality, and alcohol craving, were assessed at baseline and after 2 weeks of treatment. Secondary outcomes included feasibility measures such as dropout rates. We evaluated the acceptability of group music therapy based on semi-structured interviews and feedback from patients and therapists.Results: The average attendance rate of the study group patients who underwent group music therapy was 70.77%, and the drop-out rate was 7.69%. Based on intention-to-treat analysis, we found no differences in baseline assessments (p &gt; 0.05). Assessment after 2 weeks of treatment showed that study group patients were less anxious, slept better, and had reduced alcohol cravings than control group patients. However, these differences were not statistically significant. Participants reported that group music therapy made them feel more relaxed and improved their mood.Conclusion: Group music therapy based on emotion-regulation skills is feasible with potential for efficacy and can be used to treat men with alcohol dependence in a closed inpatient environment. Further long-term research is required to gain a better understanding of the efficacy of using group music therapy to treat alcohol dependence.
Teleworking While Sick: A Three-Wave Study of Psychosocial Safety Climate, Psychological Demands, and Presenteeism
Authors: Biron Caroline , Karanika-Murray Maria , Ivers Hans , Salvoni Sandra , Fernet Claude 
Published: October 2021

Introduction: The COVID-19 pandemic has led to a significant increase in the proportion of employees for whom teleworking became mandatory. Presenteeism, or the behavior of working while ill, has hardly been studied in the context of telework. The pandemic forced millions of workers to abruptly transition to working from home for a prolonged period of time, leaving employers often unaware of their health status or work capacity of the workers. This change also eroded the work experience itself, the workplace, and their protective impact on both individual health and work outcomes. This study focused on the longitudinal relationships among psychosocial safety climate (PSC), a lead indicator of workplace conditions, psychological demands, an indicator of quality of work, and presenteeism among a representative sample of teleworkers. PSC was expected to have an indirect impact on presenteeism with psychological demands as a mediator of this impact.Method: We collected the data from a representative sample of teleworkers in the first months (T1: April, T2: June, and T3: December 2020) of the pandemic using a three-wave online survey (n = 275). We tested a model of PSC as a determinant of presenteeism in teleworkers with psychological demands as a mediator. A cross-lagged panel model was estimated to test cross-sectional and longitudinal relationships.Findings: As expected, psychological demands increased over time. Contrary to expectations, the prevalence of presenteeism remained unchanged while PSC increased over time. The data fully supported the mediating effect of psychological demands such that a higher evaluation of PSC at T1 led to lower psychological demands at T2, which led to reduced presenteeism at T3. We also found a reciprocal relationship, with higher psychological demands at T2 leading to decreased evaluation of PSC at T3. These results show that the perception of teleworkers on their organization as giving a high priority to their psychological health is an important determinant of their work experience, ultimately influencing their decision to work while ill. The context of the pandemic has highlighted the importance of a positive workplace climate and working conditions for reducing the behaviors that can be harmful to health and productivity. Implications for theory and practice, beyond the pandemic, are discussed.
Neuromelanin-Sensitive Magnetic Resonance Imaging in Schizophrenia: A Meta-Analysis of Case-Control Studies
Authors: Wieland Lara , Fromm Sophie , Hetzer Stefan , Schlagenhauf Florian , Kaminski Jakob 
Published: October 2021

Background: Psychiatry is in urgent need of reliable biomarkers. Novel neuromelanin-sensitive magnetic resonance imaging (NM-MRI) sequences provide a time-efficient and non-invasive way to investigate the human brain in-vivo. This gives insight into the metabolites of dopaminergic signaling and may provide further evidence for potential dopaminergic alterations in patients with schizophrenia (SCZ). The present systematic review provides a meta-analysis of case-control studies using neuromelanin-sensitive sequences in SCZ vs. healthy controls (HC).Methods: According to predefined search terms and inclusion criteria studies were extracted on PubMed. Meta-analyses with a fixed and random-effects model with inverse variance method, DerSimonian-Laird estimator for τ2, and Cohen's d were calculated. Bias was assessed using funnel plots. The primary study outcome was contrast-to-noise ratio (CNR) in the substantia nigra compared between HC and SCZ.Results: The total sample of k = 6 studies included n = 183 cases and n = 162 controls. Across all studies we found a significant elevation of CNR in the substantia nigra (d = 0.42 [0.187; 0.655], z = 3.521, p &lt; 0.001) in cases compared to controls. We found no significant difference in the control region of locus coeruleus (d = −0.07 [−0.446; 0.302], z = −0.192, p = 0.847), with CNR for the latter only reported in k = 3 studies.Conclusion: CNR in the substantia nigra were significantly elevated in cases compared to controls. Our results support neuromelanin as a candidate biomarker for dopaminergic dysfunction in schizophrenia. Further studies need to assess this candidate marker in large, longitudinal cohorts and address potential effects of disease state, medication and correlations with symptoms.
The Full Mediating Role of Loneliness on the Relationship Between Social Support and Depression Among Rural Family Caregivers of Persons With Severe Mental Illness
Authors: Zhang Baiyang , Lv Xin , Qiao Mutian , Liu Danping 
Published: October 2021

Objective: Depression is a common and overwhelming psychiatric disorder among family caregivers of persons with severe mental illness (SMI). The interrelationships among social support, loneliness, and depression, especially among this relatively vulnerable group, are poorly understood. The aim of the present study was to test the hypothesis that the social support contributes to the alleviation of depression, through its effect on reducing loneliness.Methods: A survey of 256 rural family caregivers of persons with SMI was conducted between December 2017 and May 2018 in Chengdu City, Sichuan Province, China. Social support, loneliness and depression were measured. A series of multiple linear regression models and bootstrapping procedure were performed to examine the mediating effects of loneliness on the association between social support as well as its components and depression.Results: The proportion of family caregivers of persons with SMI who reported significant depressive symptoms was 53.5%. Loneliness fully mediated the negative association between social support and depression. As to three components of social support, subjective support and objective support only had indirect associations with depression mediated by loneliness, while support utilization had both direct and indirect relationships with depression.Conclusion: The current study highlighted that social support and its three components may acted as protective factors by decreasing the feelings of loneliness, which created a beneficial effect on depression among family caregivers of persons with SMI.