bluuebunny/crossref_metadata_2025_split huggingface dataset:
The value of using the Addenbrookes Cognitive Exam-III and the Rookwood Driving Battery to aid fitness-to-drive decisions with people who have dementia or mild cognitive impairment
Authors: Douglas Hazel R , Breckenridge Jenna P , Foster Jane , Douglas Rebekah P , Gemmell Aileen C , Arblaster Emma LH 
Published: December 2024

Introduction: Further evidence is required to support the use of a combination of a generalist cognitive screen Addenbrookes Cognitive Exam-III and a specialist neuropsychological driving screen Rookwood Driving Battery to aid occupational therapists in making fitness-to-drive decisions for people with dementia. Method: An exploratory retrospective study was completed for drivers with dementia or mild cognitive impairment living within Scotland. Data were extracted from patient notes of drivers referred to occupational therapy, who had an ACE-III and RDB completed within a 6-month timeframe. Results: The study sample included 98 participants. A significant negative correlation was identified between both assessments. Lower cut-off scores were identified on the ACE-III below which no participant scored Rookwood Driving Battery <6 (Addenbrookes Cognitive Exam-III cut-off = 65), or the upper Rookwood Driving Battery pass of ⩽10 (Addenbrookes Cognitive Exam-III cut-off = 54). A small subset of participants ( n = 14) sat the on-road test. No participant passed on-road with a score >7 on the Rookwood Driving Battery. Conclusion: The ACE-III is a useful guide for referral to occupational therapy for assessment using the Rookwood Driving Battery and subsequent fitness-to-drive decisions for people with dementia.
Impact of a Culturally Targeted Lifestyle Course on Dietary and Weight Outcomes of Chinese Americans in Texas
Authors: Chen Danhong , Deng Furjen , Sun Helen 
Published: December 2024

Purpose This study aimed to assess the impact of a culturally targeted lifestyle course on the dietary and weight outcomes of Asian Americans. Design This was an observational study of participants for a culturally targeted lifestyle course taught online by a Nutrition Scientist and Board-Certified Holistic Health Practitioner. Setting From 2021 to 2022, 284 participants were recruited through 4 community organizations in Texas and completed the informed consent. Subjects 140 Chinese Americans finished 3 surveys before, after, and 6 months after the course. Measures Participants’ fruit and vegetable consumption was assessed using the questionnaire from the Behavioral Risk Factor Surveillance System and their physical activities were evaluated by the Godin-Shephard Leisure-Time Exercise Questionnaire. Analysis We conducted repeated measures ANOVA to compare participants’ dietary and weight outcomes before, after, and 6 months after the course. Paired t-tests were performed to investigate how the outcomes differed from the baseline. Results The participants’ weights and BMI values at the 6-month follow-up were significantly lower than the baseline, though the changes were not significant immediately after the course. Rice consumption dropped significantly both after the class and at the 6-month follow-up. Participants also significantly reduced their intake of 100% juice and fried potatoes immediately after the class. Conclusion Community-based Participatory Approaches might be used to improve the dietary and weight outcomes of Asian Americans.
Eucalyptol Attenuates Cerebral Ischemia/Reperfusion Injury in Mice
Authors: Wang Yuning , Wu Dan 
Published: December 2024

Background One of the leading causes of acute brain injury is cerebral ischemia/reperfusion (I/R) injury. It is an ailment that occurs when the brain does not receive enough oxygen-rich blood supply, which damages brain cells. Oxidative stress is recognized as a significant mechanism that causes I/R injury and is a critical focal point for therapy. Apoptosis and inflammation are all pathogenic processes underpinning I/R damage. Eucalyptol (EU), a plant-derived substance, protects neuronal damage. We postulate that EU inhibits apoptosis and oxidative stress after focal cerebral I/R damage in mice. Purpose Thus, the present work sought to examine the neurological protective benefits of EU in mice models of cerebral ischemia/reperfusion (CI/R) injury. Methods The measurement of neurological function, infarct volume, and the amount of water in the brain were evaluated subsequently. The brain tissue was examined to assess the activities of oxidative stress, inflammatory cytokines, and matrix metalloproteinases (MMP) levels, and histopathology was determined. Using enzyme-linked immunosorbent assay (ELISA), apoptotic marker expression was used to measure the levels of B-cell lymphoma 2 (Bcl-2), caspase-3, and Bcl-2 associated X-protein (Bax) proteins that exist as indicators of apoptosis. Results EU treatment malondialdehyde (MDA) levels decreased while glutathione (GSH), superoxide dismutase (SOD), A-TOC, and catalase (CAT) activity increased. Following EU therapy dramatically reduced cerebral dysfunction, which was supported by reduced histological damage in I/R injury. Furthermore, with lower levels of MMP-2 and 9, EU treatment could be a novel approach for preventing CI/R injury. EU-treated mice had a notable reduction in cleaved Bax, caspase-3, and increased Bcl-2 protein activities. EU therapy shields the brain against CI/R injury by inhibiting cell death. Conclusion According to the present study’s findings, EU is a promising neuroprotective agent that can be used to treat CI/R injury in mice. By focusing on these aspects, nurses can provide comprehensive care to patients involved in studies on the effects of EU on CI/R injury, promoting better outcomes through careful monitoring, supportive interventions, and education.
The ‘Quartered Head Technique’: a simple, reliable way of maintaining leg length and offset during total hip arthroplasty
Authors: Onafowokan Oluwatobi O , Haruna Muhammad , Bott Alasdair R , Bigsby Ewan , Middleton Rory G , Holt Gavin 
Published: December 2024

Introduction: Various techniques have been described for restoring leg length and offset during total hip arthroplasty (THA). We herein describe a novel “Quartered Head Technique” (QHT) involving a series of femoral osteotomies. Methods: 124 hips were included in the analysis. An anterolateral approach was used in all cases. Leg length, and offset were assessed intraoperatively and reproduced using the QHT. A leg-length discrepancy (LLD) of <6 mm was chosen as acceptable based on previously published literature. Postoperative pelvic radiographs were assessed by two independent observers to ensure inter-observer reliability. Results: The mean absolute postoperative difference in leg length from the contralateral leg was +3.58 mm. 84% of patients had LLD within ±6 mm of the contralateral limb. Mean absolute postoperative difference in offset from the contralateral leg was +3.88 mm. 90% of patients were within ±6 mm offset of the contralateral limb. There was no statistical difference noted between observer measurement. Conclusions: The QHT provides a simple, inexpensive, yet effective method of maintaining femoral leg length and offset during total hip arthroplasty
The Systematic Multi-domain Alzheimer's Risk Reduction Trial (SMARRT) intervention: A personalized approach to dementia risk reduction
Authors: Barnes Deborah E , Balderson Benjamin H , Shulman Lisa , Rosenberg Dori E , Matson Theresa E , Mettert Kayne D , Delaney Kristin , King Deborah , Adams Kristin , Fleckenstein Lynn , Peltz Carrie B , Idu Abisola , Larson Eric B , Yaffe Kristine , Dublin Sascha 
Published: December 2024

Background Addressing modifiable risk factors such as physical inactivity and social isolation could reduce risk of Alzheimer's disease and all-cause dementia, but little is known about which factors individuals are most willing to address or how they prefer to address them. Objective To examine and describe behavior change goals set by participants during the Systematic Multi-domain Alzheimer's Risk Reduction Trial (SMARRT). Methods In SMARRT, older adults worked with a health coach and nurse over 2 years to set incremental, personalized goals to reduce dementia risk. We performed quantitative analyses to summarize the numbers of goals per risk factor and qualitative content analyses of health coach and nurse notes to describe types of goals and useful strategies. Results 82 dementia-free adults (70 to 89 years) with at least two dementia risk factors participated in the SMARRT intervention arm (mean age, 76 ± 5 years; 72% women; 11% Black/African American, 4% Asian, 3% Hispanic, 7% another non-White race). Participants set a median of 12 health coach goals and 1 nurse goals. The risk factors participants chose to work on most frequently were physical activity (95%), hypertension (72%), and cognitive activity (60%). Participants reported that the most useful strategies included support and accountability from the health coach/nurse, setting small goals, and learning to manage setbacks. Conclusions When given support, older adults at increased risk for dementia set a wide range of goals to reduce dementia risk. A flexible, personalized approach that focuses on setting feasible goals and managing setbacks provides a useful framework for dementia risk reduction.
Stepwise identification of prodromal dementia: Testing a practical model for primary care
Authors: Levy Boaz , D'Ambrozio Gianna 
Published: December 2024

Background Prodromal dementia is largely underdiagnosed in primary care. Objective To develop a clinical model for detecting prodromal dementia within the operative boundaries of primary care practice. Methods The study employed the Functional Activities Questionnaire (FAQ) and Montreal Cognitive Assessment (MoCA) to evaluate a “functional-cognitive” step-down screening model, in which the MoCA is administered subsequent to reported symptoms on the FAQ. It classified participants from the Alzheimer's Disease Imaging Initiative to three diagnostic categories: (1) healthy cognition (n = 396), (2) mild cognitive impairment without conversion (n = 430), and (3) prodromal dementia assessed 24 months before diagnosis (n = 164). Results Analyses indicated that the step-down model (Model 1) performed significantly better than an alternative model that applied the FAQ as a single measure (Model 2) and compared well with another model that administered both screening measures to all participants (Model 3). Gradient Boosting Trees classifications yielded the following estimations for Model 1/Model 2/ Model 3, respectively: Sensitivity = 0.87/0.77/0.89, Specificity = 0.68/0.47/0.70, PPV = 0.73/0.40/0.75, NVP = 0.84/0.81/0.87, F1 Score = 0.79/0.52/0.81, AUC = 0.78/0.67/0.79. Conclusions These analyses support the proposed model. The study offers algorithms for validated measures, which were developed from a well characterized clinical sample. Their accuracy will likely improve further with new data from diverse clinical settings. These results can serve primary care in a timely manner in light of the recent advances in pharmacological treatment of dementia and the expected increase in demand for screening.
Real-life reliability of plasma pTau181, Aβ42/Aβ40, and pTau181/Aβ42 measured by Lumipulse G600II in predicting cerebrospinal fluid amyloid status
Authors: Imperiale Daniele , Atzori Cristiana , Angeloro Daniele Pio , Murgioni Amelia , Bagatin Alessia , Secci Valentina , Calcagno Andrea , Capobianco Marco , Coletti Moja Mario , Rota Eugenia , Bongioanni Maria Roberta , Rosso Mara , Godi Laura , Barra Massimo , De Mattei Marco , Bonzanino Massimo , Ferrandi Delfina , Rainero Innocenzo , Lopiano Leonardo , Bozzali Marco 
Published: December 2024

Background Alzheimer's disease (AD) is the most common neurodegenerative dementia, with diagnosis traditionally reliant on clinical criteria. Cerebrospinal fluid (CSF) biomarkers like pTau181 and Aβ42/Aβ40 ratio significantly improve diagnostic accuracy but are invasive. Plasma biomarkers measured by automated assays offer a non-invasive alternative. Objective To evaluate the diagnostic performance of plasma pTau181, Aβ42/Aβ40, and pTau181/Aβ42 ratios in predicting CSF amyloid status in a real-life clinical setting. Methods Data from consecutive patients whose plasma and CSF samples sent to our laboratory between March and October 2022, were retrospectively analyzed. Plasma and CSF pTau181, Aβ42, and Aβ40 levels were measured using the Lumipulse G600II platform. CSF amyloid status was classified as amyloid-positive (A+) or amyloid-negative (A-) based on the Aβ42/Aβ40 ratio. Statistical analyses included Spearman correlation, receiver operating characteristic (ROC) curves, and multivariate logistic regression to evaluate biomarker performance. Results Among 165 individuals (83 females), 29.1% were classified as A+. Significant correlations were found between plasma and CSF biomarkers, with the highest for the pTau181/Aβ42 ratio (ρ=0.620, p < 0.0001). ROC analysis showed the pTau181/Aβ42 ratio had the highest diagnostic performance (AUC 0.818), followed by pTau181 (AUC 0.794) and Aβ42/Aβ40 (AUC 0.775). Combining plasma biomarkers in age-adjusted models improved diagnostic accuracy (AUC up to 0.846). Conclusions Plasma biomarkers measured by the Lumipulse G600II platform show strong potential in predicting CSF amyloid status and possibly reduces the need for lumbar punctures. These findings support the potential use of plasma assays in the early diagnosis of AD. Anyway, further validations in larger multicenter cohorts are mandatory.
Outcomes after critical care admission in people with a learning disability
Authors: Messer Ben , Harrison Emily , Carter Alison , Clement Ian , Gillott Holly , Ho Ching Khai , Ross Thomas , Lane Nicholas , Tedd Hilary 
Published: December 2024

Introduction: People with learning disabilities experience worse healthcare outcomes than the general population. There is evidence that they are more likely to experience avoidable mortality and less likely to receive critical care interventions during an acute illness. Decisions regarding critical care admission or intervention must be based on evidence of whether a patient will receive lasting benefit from a critical care admission. We therefore investigated outcomes from critical care admissions in people with learning disabilities and compared them to general critical care patients. Methods: People with learning disabilities who were admitted to our critical care unit were identified via our coding department, from the Intensive Care National Audit and Research Centre (ICNARC) database and from our local electronic patient record. Mortality and length of stay outcomes for people with learning disabilities were recorded following critical care admission over a 5 years period and compared with the general critical care cohort over the same 5 years period. Longer term survival of patients with learning disabilities was also recorded. Results: 297 critical care admissions in 176 people with learning disabilities were identified. The general critical care cohort included 6224 admissions in 4976 patients. The standardised mortality rate in people with learning disabilities admitted to critical care was 0.59 compared to the general critical care cohort which was 0.98. Mortality outcomes remained better in patients with learning disabilities compared to the general critical care cohort in invasively ventilated patients and in people with profound and multiple learning disability. Critical care length of stay was longer in people with learning disabilities. 12 month mortality was 14.8% in the learning disability cohort. By the end of the study, 23.9% of people with learning disabilities had died after a mean of 482 days following their first critical care admission. Patients who are currently still alive after having survived to hospital discharge following critical care admission have lived an average of 1129 days. After only 7.4% of critical care admissions in people with learning disabilities was there an increase in dependence on assistance in activities of daily living. Discussion: We have shown that people with learning disabilities are more likely to survive following a critical care admission than general critical care patients. This is regardless of whether they were invasively ventilated or whether they had profound and multiple learning disabilities. Critical care admission and invasive ventilation are associated with good short and longer term mortality.
Assessment of stress in mothers of babies admitted to neonatal intensive care unit and the influence of maternal and infant characteristics on the stress levels
Authors: Haribalakrishna Anitha , Utture Alpana , Nanavati Ruchi 
Published: December 2024

Objectives The study was aimed to assess the maternal stress level due to their infant’s neonatal intensive care stay and to understand the factors contributing to it. Method This prospective observational study was conducted in the level III neonatal intensive care unit (NICU) of a tertiary level public hospital in India. Mothers ( N = 100) were interviewed according to the Parental Stress Score (PSS) questionnaire, during days 6–8 of their infant’s admission to the NICU. Results Maternal stress was found to be highest due to sights and sounds in the NICU followed by alteration of the parental role. Stress due to staff behaviour and communication was least stressful followed by baby look and behaviour. The stress due to sights and sounds was significantly higher than stress due to baby’s look and behaviour [(2.7 ± 1.4 vs 1.98 ± 2.02), p = 0.004] and staff behaviour [(2.7 ± 1.4 vs 1.58 ± 1.31), p = 0.00] while was not significantly higher than stress due to parental role [(2.7 ± 1.4 vs 2.29 ± 1.60), p = 0.055]. The stress level due to baby’s look and behaviour was not significantly higher than parental role [(1.98 ± 2.02 vs 2.29 ± 1.60), F = 1.4, p = 0.23] or staff behaviour [(1.98 ± 2.02 vs 1.58 ± 1.31), F = 2.7, p = 0.09]. The demographic characteristics such as maternal age, parity, educational stress, type of delivery, gestation, need of ventilatory support, feed intolerance and kangaroo mother care (KMC) in infants individually did not significantly affect the stress scores. Conclusion The involvement of mothers in neonatal care while the infants were in the NICU, early KMC and involvement of mothers in enteral feeding practices may alleviate her stress levels.
Attitudes and practices surrounding obstetric hemorrhage among patients and providers
Authors: Calderon Joaquin A , Potarazu Savita , Phillips Jaclyn M , Macri Charles J , Ahmadzia Homa K 
Published: December 2024

Background Postpartum hemorrhage is one of the leading causes of maternal morbidity and mortality worldwide and the second most frequent cause of pregnancy related death in the United States. There are discernible differences among healthcare providers in identifying risk factors and managing obstetric hemorrhage. Furthermore, there is limited data on patient’s awareness and attitudes toward hemorrhage risk factors and preventive measures, as well as their involvement in clinical decisions. This project aimed to identify educational gaps for providers and patients in preventing and managing postpartum hemorrhage to optimally reduce maternal morbidity and mortality. Methods Cross-sectional anonymous surveys were distributed among obstetric patients and providers at a single maternity healthcare center from November 2022 to June 2023. Results The study cohort included 629 patients and 22 providers. Most of participants, 84% ( n = 526), lack knowledge or are uncertain about the risk factors associated with postpartum hemorrhage. When participants were asked how likely they would be willing to accept a preventative medication to reduce the risk of postpartum hemorrhage, 55% ( n = 344) responded “very likely” followed by 28% ( n = 176) as “somewhat likely”. Patients are likely to accept preventative medications to reduce the risk of postpartum hemorrhage. The majority of providers, 73% ( n = 16), express confidence in using tranexamic acid for postpartum hemorrhage treatment. Conclusion There is lack of knowledge among pregnant patients about the risk factors for hemorrhage and the standard medications to prevent it. Despite this, most participants are willing to receive preventive medication. Practice patterns regarding the prevention and management of hemorrhage should be part of a shared decision making between patients and providers.
Correlation of predelivery Rotational Thromboelastometry readings with the risk of postpartum hemorrhage during delivery: The ROTEM Study
Authors: Calderon Joaquin A , Ebeid Ahmed M , Lee Sean M , Ahmadzia Homa K 
Published: December 2024

Background Inconsistency in defining postpartum hemorrhage (PPH), and the inability of current tools and approaches to accurately predict PPH have led to the exploration of innovative methods. Rotational thromboelastometry (ROTEM) point-of-care technology provides real-time assessment of the clotting process facilitating time-efficient hemostatic interventions. Our study investigates the utility of ROTEM parameters for predicting individual risk of PPH. Methods This multi-site, prospective observational cohort study recruited 92 women who underwent scheduled cesarean delivery and normal spontaneous vaginal delivery at university-affiliated hospitals from 2018 to 2023. We included women between 18 and 50 years old at ≥34 weeks of gestation. Subjects were approached in the hospital pre-admission testing unit during their routine pre-operative blood draws, typically at least 72 h in advance of their planned cesarean delivery. Participants were also enrolled at the hospital once they arrived for admission a few hours before their procedure. ROTEM parameters EXTEM clotting time (CT), clot formation time (CFT), alpha angle, A10, A20, maximum clot formation (MCF), maximum lysis, were measured preoperative. Results We found significant effects of age, blood loss type, delivery mode, gestational age, and maximum lysis on blood loss. The reduced model predicted that every one-percent increase in maximum lysis was associated with a 44-milliliter increase in blood loss and every one-year increase in age was associated with a 19-milliliter increase in blood loss. On average, cesarean deliveries resulted in 522 more milliliters of blood loss than normal spontaneous vaginal delivery. Conclusion The ROTEM EXTEM maximum lysis parameter has a significant effect on blood loss. Larger prospective clinical trials in conjunction with a prompt definition of the ranges of reference values will strengthen these advances to provide a rapid assessment and guide early interventions to prevent severe obstetric bleeding.