bluuebunny/crossref_metadata_2025_split huggingface dataset:
Self‐management training with online intervention process for young adults with chronic conditions: Effects on self‐management, emotion regulation, and occupational balance: A randomized controlled study
Authors: Altuntaş Onur , Özkan Esma 
Published: December 2024

AbstractThe aim of the study was to examine the effects of online self‐management training on self‐management, emotion regulation, and occupational balance in young adults with chronic diseases. Young people participated in this cluster randomized controlled trial (n = 72; mean age, 20.80 ± 2.65 years). Eight sessions of self‐management training were applied in the study group (SG; n = 37), and one session was applied in the control group (CG; n = 35). To evaluate the training, all participants completed the Self Management‐Self Control Scale, Cognitive Emotion Regulation (CERQ), and Occupational Balance Questionnaire at the beginning and end of the training. We performed an analysis of covariance (ANCOVA). In cases where ANCOVA assumptions could not be met, the efficacy of the intervention was determined using the mixed design/split‐plot analysis of variance. Compared to the CG, SG showed a significant increase in self‐management skills. For the CERQ variable, it was observed that there was no significant difference between the study and control group mean differences after the intervention. Occupational balance remained similar between the groups. The self‐management training can have a positive impact on the development of their self‐management, particularly in chronic conditions.
Clinical relevance of immune checkpoint inhibitors for the analgesic effect of opioids: A retrospective propensity score analysis
Authors: Sumimoto Takahiro , Tanaka Ryota , Murakami Yuko , Tatsuta Ryosuke , Itoh Hiroki 
Published: December 2024

AimsThis study aimed to determine the clinical relevance of the influence of coadministration of immune checkpoint inhibitors (ICIs) on the analgesic effects of opioids, focusing on the amount of change in opioid dosage.MethodsThis study used data from patients who used opioids during anticancer therapy at the Oita University Hospital between September 2014 and October 2023. The primary outcome measure was the amount of change in morphine mg equivalent opioid dose during the period of anticancer therapy. Propensity score matching was performed to reduce confounding effects.ResultsThe study enrolled 235 patients; 101 received ICI and 134 received no ICI. Before propensity score matching, there were significant differences between the ICI and non‐ICI groups in lines of anticancer therapy, type of primary cancer, body mass index, maximum opioid dose and the amount of change in opioid dose. Following propensity score matching, 73 patients each were included in the ICI and non‐ICI groups. Analysis of the propensity score‐matched cohort showed a significant increase in the median amount of change in opioid dose in ICI group vs non‐ICI group (22.5 vs. 15.0 morphine mg equivalents, interquartile range; 0.0, 40.0 vs. 0.0, 30.0, P = .044). Multiple regression analysis identified ICI administration and body mass index as significant independent factors associated with the amount of change in opioid dose (P = .014 and .027, respectively).ConclusionsICI administration significantly increased opioid dosage regardless of patient background. Our findings would provide valuable insight into future pain management strategies.
Can Natural Supporters Be Fostered to Support Adults With Intellectual Disabilities to Become Local Volunteers or to Join Mainstream Leisure Groups in Irish Rural Towns and Villages?
Authors: Boland Geraldine , Potter Anne‐Marie , de Paor Eilin , Guerin Suzanne 
Published: December 2024

ABSTRACTBackground/AimsThis study explored supporting the social inclusion of adults with intellectual disabilities living in rural areas, by engaging natural supporters (other than family members and paid staff).MethodsThis qualitative study involved educating and preparing six local connectors—each a member of mainstream volunteering and/or leisure clubs to support six people with intellectual disabilities to join. Qualitative interviews were used to explore the experiences of local connectors.FindingsSix clusters of meaning were identifiable from content analysis including the support provided by local connectors, communication/interaction and supports for continued attendance. Rural local connectors had strong local knowledge and connections that facilitated those with disabilities to make local acquaintances.Conclusions/ImplicationsAs part of a structured programme, natural supporters can be engaged to support people with intellectual disabilities to become known and make connections in their rural neighbourhoods. Implications for practice include sourcing social roles as close as possible to home for rural dwellers and the importance of flexible transport. The characteristics of local connectors and the club ethos/culture that facilitates social inclusion are identified. Policy recommendations include that local authorities offering funding to local clubs develop guidelines and education for members, with a view to embedding diverse membership as a guiding principle.
Spinal Cord Stimulation for Prolonged Disorders of Consciousness: A Study on Scalp Electroencephalography
Authors: Sun Jian , Yan Jiuqi , Zhao Liang , Wei Xiang , Qiu Chang , Dong Wenwen , Luo Bei , Zhang Wenbin 
Published: December 2024

ABSTRACTBackgroundPatients with disorders of consciousness (DOC) undergoing spinal cord stimulation (SCS) for arousal treatment require an assessment of their conscious state before and after the procedure. This is typically evaluated using behavioral scales (CRS‐R), but this method can be influenced by the subjectivity of the physician. Event‐related potentials (ERP) and EEG power spectrum are associated with the recovery of consciousness. This study aims to explore the electrophysiological and behavioral evidence of consciousness recovery in DOC patients after spinal cord stimulation (SCS) and to investigate the role of scalp EEG as a guide for preoperative assessment related to the surgery.MethodsFor the 27 recruited patients, the CRS‐R scale assessment and ERP P300 evaluation were completed before the surgery. At 3 months post‐surgery, all 27 patients underwent the same assessments as preoperatively, and at 6 months post‐surgery, the same evaluations were repeated for the 15 patients who could still be followed up. Between May 2023 and November 2023, resting‐state EEG was collected from 13 patients using a 19‐channel setup, with additional resting‐state EEG recordings taken at 3 months and 6 months after the surgery. The EEG data were processed using EEGLAB to obtain P300‐related metrics and EEG power spectrum. Changes in the CRS‐R scale, ERP, and EEG power spectrum before and after the surgery were compared.ResultsThe Behavioral Scale (CRS‐R) showed significant improvement at 3 months and 6 months post‐surgery compared to preoperative assessments, with statistical significance (p < 0.001). The resting‐state EEG power in the 5–9 Hz frequency band demonstrated statistically significant improvements at the P3 and O1 electrodes; however, this statistical result do not survive FDR correction. In the 9–13 Hz and 20–35 Hz frequency bands, the power spectrum showed statistically significant improvements across most electrodes of the brain, and these results survive FDR correction (p < 0.05). The mean amplitude, peak, and latency of P300 at the Pz electrode showed significant improvements at 3 months and 6 months post‐surgery compared to preoperative values, with statistical significance (p < 0.05).ConclusionOur study shows that SCS can effectively improve the consciousness states of patients with DOC. After surgery, there were positive changes in the EEG power spectrum of the patients, transitioning from type “B” to better types “C” and “D.” The average amplitude, peak, and latency of P300 also demonstrated significant improvements postoperatively. We believe that the “ABCD” model and ERP assessment applied during the preoperative evaluation can effectively enhance the success rate of SCS surgery in promoting awakening.
Evolving Impact of COVID‐19 on Intestinal Transplant Recipients: A Single‐Center Experience
Authors: Powers Colin , Corrente Brielle , Joyce Jennifer , Stein William , Polydor Shelly , Gunabushanam Vikraman , Khanna Ajai , Silveira Fernanda P. , Cruz Ruy J. 
Published: December 2024

ABSTRACTBackgroundThere has been significant concern about coronavirus disease 2019 (COVID‐19) among transplant recipients, particularly those who are highly immunosuppressed. Several studies have analyzed the impact of COVID‐19 on different solid organ transplant patients. However, few isolated case reports of COVID‐19 in intestinal and multivisceral transplant (ITx and MVTx) recipients are available in the literature. We report the first single‐center study evaluating the clinical course and outcome of COVID‐19 in ITx/MVTx recipients.MethodsAdult patients (age ≥ 18 years) with confirmed cases of COVID‐19 between February 2020 and February 2024 were included in this study.ResultsTwelve of the 67 (17.9%) ITx/MVTx recipients followed at our center had COVID‐19. Seven patients (58%) were female, and the median age at diagnosis was 47 years (range: 31–68 years). The average time from transplantation to COVID‐19 was 89 months (range: 14–215 months). Nine patients (75%) required hospitalization; three of them were admitted to the intensive care unit (ICU) and required ventilator support. One patient had COVID‐19 on two different occasions. Treatment modalities consisted of monoclonal antibody treatment (n = 5), of antiviral therapy (n = 4), and steroid monotherapy (n = 1). Three patients received combination therapy. Three patients (25%) developed irreversible respiratory failure and died after prolonged ventilator use.ConclusionsOur data suggested a possible increase in the incidence of COVID‐19 in ITx and MVTx recipients with an unchanged mortality rate despite the use of vaccines and new therapeutic modalities. Further multicenter studies are needed to analyze the real impact of COVID‐19 on this unique population.
Mechanical Circulatory Support for Right Ventricular Primary Graft Dysfunction After Heart Transplant: A Review
Authors: Hart Einar A. , Braithwaite S. A. , Hermens J. A. J. , Kraaijeveld A. O. , Ramjankhan F. , van Laake L. W. , Oerlemans M. I. F. J. , Szymanski M. K. 
Published: December 2024

ABSTRACTPrimary graft dysfunction (PGD) is the most common cause of early mortality following heart transplantation. Although PGD can affect both ventricles, isolated right ventricular dysfunction (RV‐PGD) is observed in nearly half of PGD patients. RV‐PGD requires specific medical management to support the preload, afterload, and function of the failing RV; however, the use of mechanical circulatory support of the RV (RV‐MCS) might be required when optimal medical therapy is insufficient in preventing forward failure and retrograde venous congestion. While RV‐MCS options provide the opportunity to prevent or to recover from circulatory shock states, MCS is associated with a significant risk of complications. As a result of recent developments in short‐term mechanical support devices, less invasive, percutaneous options for RV‐MCS are available. In this review, we discuss the available devices, their advantages and disadvantages, and reported outcomes in RV‐PGD.
A Five‐Year Prospective, Randomized, Open‐Label Study of Standard‐Dose Versus Low‐Dose Prolonged‐Release Tacrolimus With or Without Angiotensin‐Converting Enzyme Inhibitor or Angiotensin II Receptor Blocker Post Kidney Transplantation
Authors: Campbell Patricia M. , Cantarovich Marcelo , Gangji Azim , Houde Isabelle , Jevnikar Anthony M. , Monroy‐Cuadros Felix‐Mauricio , Nickerson Peter W. , Pâquet Michel R. , Prasad G. V. Ramesh , Senécal Lynne , Wolff Jean‐Luc , Schwartz Jason J. , Rush David N. 
Published: December 2024

ABSTRACTIntroductionNovel approaches to improve long‐term outcomes in kidney transplant recipients are required. Here, we present the 5‐year data from a multicenter, prospective, Phase 3b trial evaluating treatment outcomes with standard (STD) or low (LOW) dose prolonged‐release tacrolimus (TAC) combined with ACEi/ARB or other antihypertensive therapy (OAHT) in Canadian kidney transplant recipients.MethodsAdult de novo kidney transplant recipients were randomized 2 × 2 to STD or LOW dose TAC and ACEi/ARB or OAHT. Patients had received a first or second transplant from a living or deceased donor and had ≥ 1 human leukocyte antigen mismatch with their donor.ResultsThere were 281 patients from 13 sites across Canada. Overall patient survival was 95.7% and was comparable between groups. Graft survival at study end was 89.7% in the LOW+OAHT group and 94.4%–97.1% in the other groups and BPAR, and Class II de novo donor‐specific antibodies (dnDSA) were higher in the LOW+OAHT group than in the other groups. However, these differences were not statistically significant. Graft function, blood pressure (BP), and proteinuria were similar between the groups; however, between 2 and 5 years there was a 2‐fold or greater increase in the use of ACEi/ARB in patients randomized initially to OAHT, mostly because of hypertension and proteinuria. There were no unexpected safety findings.ConclusionPatients randomized to LOW TAC with renin‐angiotensin system (RAS) blockade had similar outcomes at 5 years as patients treated with STD TAC with or without RAS blockade, whereas those randomized to LOW TAC without RAS blockade showed a non‐significant trend towards more rejections and dnDSATrial Registration:ClinicalTrials.gov identifier: NCT00933231
A phase I, randomized, placebo‐controlled trial to evaluate the pharmacokinetics, safety, and tolerability of nirsevimab in healthy Chinese adults
Authors: Mao Xiaomeng , Hua Xiaohan , Wu Chengyi , Ge Xiaoyun , Zhang Jie , Wu Xiaojie , Kubiak Robert J. , Wählby Hamrén Ulrika , Villafana Tonya , Christou Georgios , Green Jannine , Takas Therese , Jin Yuwen 
Published: December 2024

AbstractRespiratory syncytial virus (RSV) is the leading cause of lower respiratory tract infection (LRTI) in infants worldwide. Nirsevimab, an extended half‐life monoclonal antibody against RSV, is approved in China for the prevention of RSV lower respiratory tract disease in infants; however, global nirsevimab trials did not enroll Chinese infants. To inform the investigation of nirsevimab for the prevention of RSV LRTI in Chinese infants, this Phase I, randomized, placebo‐controlled trial evaluated the pharmacokinetics (PK) and safety of nirsevimab in healthy Chinese adults. Participants were randomized 3:1 to a single 300 mg intramuscular dose of nirsevimab or placebo and were followed through 150 days post‐dose. Serum nirsevimab concentrations were measured and PK parameters of maximum serum concentration (Cmax), time to maximum concentration (tmax), and area under the concentration‐time curve from time 0 to Day 150 (AUC0–150) were estimated. Treatment emergent adverse events (AEs), clinical laboratory data, and vital signs were evaluated. Overall, 24 participants were randomized to nirsevimab (n = 18) or placebo (n = 6). Nirsevimab geometric mean (coefficient of variation [%CV]) Cmax was 46.9 (21.7) μg/mL, median (range) tmax was 7.0 (4.9, 29.9) days, and geometric mean (%CV) AUC0–150 was 4210.6 (13.6) μg·day/mL. Treatment‐emergent AEs (all Grade 1 or Grade 2 in severity) were reported in 5/18 (27.8%) nirsevimab recipients and 2/6 (33.3%) placebo recipients. No serious AEs, new onset chronic disease, or deaths were reported. Overall, safety and PK outcomes were consistent with those observed in healthy adults in the USA, with no new safety concerns.
The Evaluation of Right Ventricular Synchrony by Two‐Dimensional Speckle Tracking Echocardiography in Connective Tissue Disease‐Associated Pulmonary Arterial Hypertension
Authors: Ma Hong , Wu HongPing , Sun XiaoXuan , Wang Qiang , Zheng YaGuo 
Published: December 2024

AbstractObjectivesNumerous studies have demonstrated impaired right ventricular (RV) synchronicity in pulmonary arterial hypertension (PAH). However, few studies have focused on connective tissue disease (CTD)‐associated PAH. This study evaluates RV dyssynchrony and its prognostic value in CTD‐associated PAH.MethodsOne hundred thirteen CTD patients and 32 healthy controls were consecutively recruited. The patients were further divided into two groups: the CTD‐nonPAH group (sPAP ˂ 36 mmHg, n = 60) and the CTD‐PAH group (sPAP ≥ 36 mm Hg, n = 53). RV dyssynchrony was evaluated by determining the standard deviation of the heart rate–corrected intervals from QRS onset to peak strain for the four segments (RV‐SD4) using 2D speckle‐tracking echocardiography (2D‐STE). All patients were followed up, and the primary endpoint was clinical worsening.ResultsCompared to the health control, the CTD patients exhibited obviously prolonged RV‐SD4 (13.3 ± 6.8 ms vs. 41.2 ± 36.5 ms, p < 0.001). Among 113 CTD patients, the CTD‐PAH patients had longer RV‐SD4 than the CTD‐nonPAH patients (20.8 ± 9.9 ms vs. 64.3 ± 41.6 ms, p < 0.001). RV‐SD4 was moderately positively correlated with RV longitudinal strain (r = 0.632, p < 0.001), sPAP (r = 0.644, p < 0.001), and were negatively correlated with TAPSE (r = –0.547, p < 0.001), and FAC (r = –0.611, p < 0.001). In the follow‐up, 23 patients experienced clinical worsening. The ROC analysis suggested that RV‐SD4 level >60.6 ms predicted clinical worsening with 91.3% sensitivity and 66.7% specificity (AUC = 0.891, p < 0.001). Multivariate Cox analysis showed that TAPSE (HR = 0.739; 95% CI 0.623–0.878; p = 0.001) and RV‐SD4 (HR = 6.148; 95% CI 1.718–22.000; p = 0.005) were independent predictive parameters of clinical worsening.ConclusionCTD patients exhibit impaired RV synchronicity, which is linked to RV function and pulmonary artery pressure. RV dyssynchrony could predict clinical worsening in CTD‐PAH.
Scalp high‐frequency oscillation spatial distribution is consistent over consecutive nights, while rates vary with antiseizure medication changes
Authors: Karatza Panagiota , Cserpan Dorottya , Moser Katharina , Lo Biundo Santo Pietro , Sarnthein Johannes , Ramantani Georgia 
Published: December 2024

AbstractObjectiveThis study aimed to investigate two key aspects of scalp high‐frequency oscillations (HFOs) in pediatric focal lesional epilepsy: (1) the stability of scalp HFO spatial distribution across consecutive nights, and (2) the variation in scalp HFO rates in response to changes in antiseizure medication (ASM).MethodsWe analyzed 81 whole‐night scalp electroencephalography (EEG) recordings from 20 children with focal lesional epilepsy. We used a previously validated automated HFO detector to assess scalp HFO rates (80–250 Hz) during non–rapid eye movement (NREM) sleep. The spatial distribution of HFO rates across consecutive nights was evaluated using Hamming similarity, and changes in ASM were classified as increased, decreased, or stable.ResultsFor each patient, we analyzed 3 ± 1 whole‐night scalp EEG recordings, with a mean duration of 650 ± 215 min per recording. The distribution of HFO remained stable across consecutive nights, with a Hamming similarity of 88% ± 6%. Four patients had at least one ASM dosage decrease, nine patients had both ASM dosage decreases and increases, two patients had only ASM dosage increases, and five patients had no changes in ASM during the study period. A decrease in ASM dosage was associated with increased HFO rates (from .16 ± .32 to .22 ± .36 HFO/min; p = .03), whereas an increase in ASM dosage led to decreased HFO rates (from .32 ± .54 HFO/min to .22 ± .38 HFO/min; p = .005) when comparing the last night to the first.SignificanceThe spatial distribution of scalp HFOs remained consistent across multiple nights, whereas fluctuations in HFO rates correlated with changes in ASM dosage. These findings suggest that scalp HFOs may not only help identify epileptogenic brain tissue but also monitor treatment response.
A Socioecological Approach to Support the Transition to Adult Care for Youth With Medical Complexity: Family Perspectives and Recommendations
Authors: Li Lin , Carter Nancy , Gorter Jan Willem , Till Linda , White Marcy , Strachan Patricia H. 
Published: December 2024

ABSTRACTIntroductionThe transition from paediatric to adult health care (i.e., ‘health care transition’) poses many challenges for youth with medical complexity (YMC) and their families. YMC need specific approaches to supporting transition, tailored to individual youth and family contexts. In this study, we examine the contextual factors influencing families' transition experiences and describe their recommendations for improving the experience.MethodsWe conducted a qualitative explanatory case study in Ontario, Canada. We completed 21 interviews with 17 participants (11 mothers, 2 fathers, 2 YMC, 2 siblings) from 11 families of YMC. Six YMC (55%) were under 18 years of age (pre‐transfer) and five (45%) were aged 18 years and older (post‐transfer). Analytic approaches included reflexive thematic analysis and directed content analysis.FindingsParticipants described how the interplay of personal and environmental factors impacted their transition experiences. Recommendations for health care providers focused on providing instrumental and psychological support, advocacy and care continuity. Families expressed a need for better access to information and support from primary care providers. System‐level recommendations included streamlining transition processes, improving adult health care services and expanding community supports. A socioecological model is presented to guide health care providers and decision makers in assessing and tackling the challenges faced by YMC and their families during transition.ConclusionFindings highlight the complexity and scope of issues surrounding the transition to adult care for YMC in Ontario, with evidence of major gaps in services across multiple sectors and settings. Ongoing efforts are needed to move evidence into practice and advocate for more equitable and responsive care for YMC during the transition and beyond.Patient or Public ContributionThe research team included two parent co‐researchers with lived experience, who contributed to protocol refinement, funding acquisition, recruitment, findings interpretation and ongoing knowledge translation efforts.
Ceramics as alternative solutions for the geological disposal of high‐level radioactive waste: Andra's R&D program
Authors: Debelle Aurélien , Besnard Clémence , Miot Stéphanie , Perret Emilie , Couillaud Samuel , Ganster Patrick , Rossignol Fabrice , German Guillaume , Reine Bénédicte , Pasteau Antoine , Bourbon Xavier , Perrochon Olivier , Bumbieler Frédéric 
Published: December 2024

AbstractThe concept of a safe geological disposal facility designed to manage radioactive waste is on the basis of the multibarrier system comprising both the host rock and various engineered barriers. The robustness of the latter depends directly on the building materials used. With specific regard to high‐level waste, Andra's Cigéo project includes, among others, two barriers, i.e., the disposal container and the microtunnel liner. A scenario was built and shows that safety requirements are satisfied using of low carbon steel for these two components. However, to further increase safety margins and simplify the operation of the facility, Andra decided to study other materials less prone to corrosion. Consequently, Andra launched an R&D program to assess the technical feasibility of a high‐level waste container and a microtunnel liner made from ceramics, with the technical characteristics needed to meet safety requirements. This document describes the current situation for these activities and suggests ways this objective can be met.