bluuebunny/crossref_metadata_2025_split huggingface dataset:
Racial and ethnic differences in unmet needs among older adults receiving publicly‐funded home and community‐based services
Authors: Fabius Chanee D. , Parikh Romil , Wolf Jack M. , Giordano Stephanie , Fashaw‐Walters Shekinah , Jutkowitz Eric , Shippee Tetyana 
Published: August 2024

AbstractBackgroundUnmet need for home and community‐based services (HCBS) may disparately impact older adults from racial and ethnic minoritized groups. We examined racial and ethnic differences in unmet need for HCBS among consumers ≥65 years using publicly funded HCBS.MethodsWe analyzed the National Core Indicators‐Aging and Disability survey data (2015–2019) from 21,739 community‐dwelling HCBS consumers aged ≥65 years in 23 participating states. Outcome measures included self‐reported unmet need in six service types (i.e., personal care, homemaker/chore, delivered meals, adult day services, transportation, and caregiver support). Racial and ethnic groups included non‐Hispanic Black, Asian, non‐Hispanic White, Hispanic, and multiracial groups. Logistic regression models examined associations between race and ethnicity and unmet need, adjusting for sociodemographic, health, and HCBS program (i.e., Medicaid, Older Americans Act [OAA], Program for All‐Inclusive Care for the Elderly [PACE]) characteristics, and use of specific service types.ResultsAmong 21,739 respondents, 23.3% were Black, 3.4% were Asian, 10.8% were Hispanic, 58.8% were non‐Hispanic White, and 3.7% were multiracial or identified with other races/ethnicities. Asian and Black consumers had higher odds of reporting unmet need in personal care than White consumers (adjusted odds ratio [aOR], 1.45, p value < 0.01; and aOR, 1.25, p < 0.001, respectively). Asian and Black consumers had significantly higher odds of unmet need in adult day services versus White consumers (aOR, 1.94, p < 0.001 and aOR, 1.39, p < 0.001, respectively). Black consumers had higher odds of unmet need versus non‐Hispanic White consumers in meal delivery and caregiver support services (aOR, 1.29; p < 0.01; and aOR 1.26, p < 0.05, respectively). Race and ethnicity were not significantly associated with experiencing unmet need for homemaker/chore or transportation services.ConclusionsFuture research should identify driving forces in disparities in unmet need to develop culturally appropriate solutions.
Qualitative evaluation of the SHARING Choices trial of primary care advance care planning for adults with and without dementia
Authors: Dy Sydney M. , Scerpella Daniel L. , Hanna Valecia , Walker Kathryn A. , Sloan Danetta H. , Green Chase Mulholland , Cotter Valerie , Wolff Jennifer L. , Giovannetti Erin Rand , McGuire Maura , Hussain Naaz , Smith Kelly M. , Saylor Martha Abshire 
Published: August 2024

AbstractBackgroundPrimary care can be an important setting for communication and advance care planning (ACP), including for those with dementia and their families. The study objective was to explore experiences with a pragmatic trial of a communication and ACP intervention, SHARING Choices, in primary care for older adults with and without dementia.MethodsWe conducted qualitative interviews using tailored semi‐structured guides with three groups: ACP facilitators who conducted the intervention; clinicians, managers, and administrators from sites randomized to the intervention; and patients and families who met with ACP facilitators. We used thematic analysis to identify and synthesize emergent themes based on key Consolidated Framework for Implementation Research concepts and Proctor's Implementation Outcomes, triangulating the three groups' perspectives.ResultsWe identified five key themes. For acceptability, perceptions of the intervention were mostly positive, although some components were not generally implemented. For adoption, respondents perceived that ACP facilitators mainly focused on conducting ACP, although facilitators often did not implement the ADRD and family engagement aspects with the ACP. For relational connections, ACP facilitator—practice and clinician communication and engagement were key to how the intervention was implemented. For adaptability, ACP facilitators and health systems adapted how the ACP facilitation component was implemented to local preferences and over time, given the pragmatic nature of the trial. And, for sustainability, ACP facilitators and clinicians/managers/facilitators were positive that the intervention should be continued but noted barriers to its sustainability. Patients and families generally did not recall the intervention.ConclusionsACP facilitators and clinicians, managers, and administrators had positive perceptions of the ACP facilitator component of the intervention in this pragmatic trial with adaptation to local preferences. However, engaging those with dementia and families was more challenging in the implementation of this intervention.
Poration of mitochondrial membranes by amyloidogenic peptides and other biological toxins
Authors: Vassallo Neville 
Published: August 2024

AbstractMitochondria are essential organelles known to serve broad functions, including in cellular metabolism, calcium buffering, signaling pathways and the regulation of apoptotic cell death. Maintaining the integrity of the outer (OMM) and inner mitochondrial membranes (IMM) is vital for mitochondrial health. Cardiolipin (CL), a unique dimeric glycerophospholipid, is the signature lipid of energy‐converting membranes. It plays a significant role in maintaining mitochondrial architecture and function, stabilizing protein complexes and facilitating efficient oxidative phosphorylation (OXPHOS) whilst regulating cytochrome c release from mitochondria. CL is especially enriched in the IMM and at sites of contact between the OMM and IMM. Disorders of protein misfolding, such as Alzheimer's and Parkinson's diseases, involve amyloidogenic peptides like amyloid‐β, tau and α‐synuclein, which form metastable toxic oligomeric species that interact with biological membranes. Electrophysiological studies have shown that these oligomers form ion‐conducting nanopores in membranes mimicking the IMM's phospholipid composition. Poration of mitochondrial membranes disrupts the ionic balance, causing osmotic swelling, loss of the voltage potential across the IMM, release of pro‐apoptogenic factors, and leads to cell death. The interaction between CL and amyloid oligomers appears to favour their membrane insertion and pore formation, directly implicating CL in amyloid toxicity. Additionally, pore formation in mitochondrial membranes is not limited to amyloid proteins and peptides; other biological peptides, as diverse as the pro‐apoptotic Bcl‐2 family members, gasdermin proteins, cobra venom cardiotoxins and bacterial pathogenic toxins, have all been described to punch holes in mitochondria, contributing to cell death processes. Collectively, these findings underscore the vulnerability of mitochondria and the involvement of CL in various pathogenic mechanisms, emphasizing the need for further research on targeting CL‐amyloid interactions to mitigate mitochondrial dysfunction.
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Efficacy of hyaluronic acid in temporomandibular disorders evaluated with diagnostic criteria for temporomandibular disorders (DC/TMD)
Authors: Kukreja Pankaj , Kukreja Bhavna Jha , Marrapodi Maria Maddalena , Ronsivalle Vincenzo , Cicciù Marco , Minervini Giuseppe 
Published: August 2024

AbstractBackgroundThe study aimed to retrospectively assess the efficacy of hyaluronic acid (HA) in managing temporomandibular disorders (TMD) using the diagnostic criteria for temporomandibular disorders (DC/TMD). There has been an ongoing debate regarding the effectiveness of HA as a treatment option for TMD, which necessitated a thorough evaluation.MethodsThe review adhered to PRISMA guidelines conducted across eight different databases, including PubMed, Embase, Web of Science, Cochrane Library, Scopus, ScienceDirect, PsycINFO and CINAHL. The selection criteria included studies that evaluated the efficacy of HA in TMD patients, utilised DC/TMD, and were published in English. Data extraction and quality assessment were performed independently by two reviewers. ROB–2 tool was employed to assess methodological quality of the assessed studies.ResultsA total of 10 studies met the inclusion criteria. They demonstrated that HA was effective in improving various symptoms of TMD, such as pain, mouth opening and joint sounds over control group. But on the other end, platelet‐rich plasma (PRP) was found to be better than HA intervention in alleviation of TMD symptoms. However, the degree of improvement varied across the studies. Some studies reported adverse effects, but these were typically minor and transient. Risk of bias assessment was low in all the included studies.ConclusionThe findings suggest that HA can be an effective treatment for TMD when evaluated with DC/TMD. However, the variation in effectiveness across studies indicates the need for individualised treatment planning and careful monitoring of adverse effects. Further research is needed to refine the treatment protocols and understand the long‐term effectiveness and safety of HA in TMD management.
Changes in Craniofacial Morphology Induced by Unilateral Nasal Obstruction in Mice of Different Ages
Authors: Hu Yun , Li Hegang 
Published: August 2024

ABSTRACTBackgroundNasal obstruction in humans leads to mouth breathing and subsequent hypoxia in the entire body. Furthermore, nasal obstruction in growing children affects craniofacial growth and development.ObjectiveTo investigate the effects of unilateral nasal obstruction (UNO) on craniofacial growth in mice of different ages, particularly on the morphology of the nasomaxillary complex and mandible.MethodsMice aged 3, 6 and 12 weeks were selected as representatives of juvenile, adolescent and adult stages, respectively. A total of 30 male C57BL/6J mice (10 mice each at the ages of 3, 6 and 12 weeks) were used in this study for a 3‐week experiment. The mice in each age stage were randomly and evenly assigned to either the control group (C3+3, C6+3 and C12+3) or the experimental group (E3+3, E6+3 and E12+3). The UNO model in experimental group was constructed by plugging the mouse's left nostril, thereby disrupting its normal nasal breathing pattern and inducing hypoxia. The control group underwent the sham procedure. After 3 weeks, the length, width and height of the cranium, nasomaxillary complex and mandible of each group were measured on two‐dimensional images constructed by micro‐computed tomography. Furthermore, the impact of UNO on mouse growth was evaluated through the measurement of femoral length.ResultsIn juvenile mice, UNO inhibited the growth of cranial width, cranial height and mandibular length. In adolescent mice, UNO impeded the growth of the femoral length, cranial length, nasomaxillary length and mandibular length. In adult mice, no significant negative effects of UNO on craniofacial growth were found.ConclusionReferring to the experimental results, in addition to actively treating nasal obstruction in patients, it is important to monitor the growth of the mandible in juveniles, as well as the nasomaxillary and mandibular growth in adolescents during orthodontic clinical practice.
Self‐efficacy and home dialysis: An integrative review
Authors: D'Souza Nicola A. , Abu‐Qamar Ma'en Zaid , Whitehead Lisa 
Published: August 2024

AbstractBackgroundEnhancing patient confidence in their ability (self‐efficacy) is vital to ensure people are equipped to maintain home dialysis protocols. Bandura's social cognitive theory provided a framework for understanding the role of self‐efficacy in patients managing home dialysis.ObjectivesTo identify self‐reported levels of self‐efficacy, the measurements used to assess self‐efficacy and the effectiveness of interventions to enhance self‐efficacy in patients undergoing home dialysis.DesignAn integrative review approach was employed using Whittemore and Knafl's methodology.MethodsA comprehensive search was conducted to identify literature on self‐efficacy in patients managing home dialysis. Searches were conducted in CINAHL, MEDLINE, Embase and Scopus databases without a date limit. The included literature was critically appraised for methodological quality. Data extraction was conducted to report the study characteristics, measurement tools used and interventions conducted along with the synthesis of findings in a narrative format.ResultsFifteen studies were included in the review were predominantly quantitative examining training programmes promoting self‐efficacy in adults conducting home dialysis. The finding that self‐efficacy builds over time was structured into two themes; gaining skills to develop self‐efficacy and building and maintaining knowledge of self‐efficacy.ConclusionThe findings highlighted the importance of employing multifaceted strategies with support from health professionals including nurses, families and peer support to develop self‐efficacy in patients undergoing home dialysis.
Modified Calcanization of Tibia for Hindfoot Defect Reconstruction: Method and Preliminary Results
Authors: Zhang Rui , Wang Xiaoyu , Liu Shenghe , Qiu Shuo , Ruan Hongjiang , Kang Qinglin 
Published: August 2024

ObjectivesTo introduce our modified technique for calcanization of the tibia in managing massive bony loss of hindfoot and preliminary outcomes.MethodsFrom January 2015 to December 2021, modified calcanization of the tibia were performed in 10 patients with unilateral loss of the calcaneus. Clinical outcomes were assessed based on the American Orthopaedic Foot & Ankle Society score and Symptom Checklist‐90‐Revised questionnaire. Paired two‐group t‐test was applied to compare the parameters.ResultsThe mean lengthened length of the tibia was 77.3 ± 3.0 mm (range, 74–83 mm). The mean external fixation time was 123.7 ± 52.1 days (range, 117–134 days) and the mean external fixation index was 1.601 ± 0.046 days/mm. All patients stuck to the postoperative follow‐up plan with an average follow‐up time of 29.7 ± 3.4 months (range, 24–35 months). Deformities of the injured limbs were well corrected. Based on American Orthopaedic Foot & Ankle Society score, eight good and two fair results were achieved. The mental status of all patients was within the normal range, and several indices of the Symptom Checklist‐90‐Revised questionnaire of each patient were improved after the whole procedure.ConclusionWe demonstrate that the modified calcanization of the tibia is qualified for total loss of calcaneus with limited complications. Early rehabilitation is attainable since external fixation time is shortened due to a simplified procedure.
Efficacy and safety of intravenous ketamine treatment in Japanese patients with treatment‐resistant depression: A double‐blind, randomized, placebo‐controlled trial
Authors: Ohtani Yohei , Tani Hideaki , Nomoto‐Takahashi Kie , Yatomi Taisuke , Yonezawa Kengo , Tomiyama Sota , Nagai Nobuhiro , Kusudo Keisuke , Honda Shiori , Moriyama Sotaro , Nakajima Shinichiro , Yamada Takashige , Morisaki Hiroshi , Iwabuchi Yu , Jinzaki Masahiro , Yoshimura Kimio , Eiro Tsuyoshi , Tsugawa Sakiko , Ichijo Sadamitsu , Fujimoto Yu , Miyazaki Tomoyuki , Takahashi Takuya , Uchida Hiroyuki 
Published: August 2024

AimAlthough the antidepressant effect of ketamine on treatment‐resistant depression (TRD) has been frequently reported in North American and European countries, evidence is scarce among the Asian population. We aimed to evaluate the efficacy and safety of intravenous ketamine in Japanese patients with TRD.MethodsIn this double‐blind randomized placebo‐controlled trial, 34 Japanese patients with TRD were randomized to receive either intravenous ketamine (0.5 mg/kg) or placebo, administered over 40 min, twice a week, for 2 weeks. The primary outcome was the change in the Montgomery Åsberg Depression Rating Scale (MADRS) total score from baseline to post‐treatment. Secondary outcomes included changes in other depressive symptomatology scores and remission, response, and partial response rates. We also examined the association between baseline clinical demographic characteristics and changes in the MADRS total score.ResultsIntention‐to‐treat analysis indicated no significant difference in the decrease in MADRS total score between the groups (−8.1 ± 10.0 vs −2.5 ± 5.2, t[32] = 2.02, P = 0.052), whereas per‐protocol analysis showed a significant reduction in the ketamine group compared to the placebo group (−9.1 ± 10.2 vs −2.7 ± 5.3, t[29] = 2.22, P = 0.034). No significant group differences were observed in other outcomes. Adverse events were more frequent in the ketamine group than in the placebo group, and no serious adverse events were reported. A higher baseline MADRS total score and body mass index were associated with a greater reduction in the MADRS total score.ConclusionIntravenous ketamine outperformed placebo in Japanese patients with TRD who completed the study, suggesting that ketamine could alleviate depressive symptoms of TRD across diverse ethnic populations.
Risk management during times of health uncertainty in Spain: A qualitative analysis of ethical challenges
Authors: Macpherson Ignacio , Guardia Juan J. , Morales Isabel , Zárate Belén , Belda Ignasi , Simon Wendy R. 
Published: August 2024

AbstractThe study examines the reflections of various experts in risk management when asked about uncertainty generated by a health threat and the response to such a threat: what criteria should guide action when potential harm is anticipated, but not known with certainty? The objective of the research is to obtain a holistic perspective of ethical conflicts in risk management, based on experts’ accounts within the Spanish territory. A qualitative study was conducted through semi‐structured interviews with 27 experts from various fields related to health risk management and its ethical implications, following the grounded theory method. The method includes theory generation through an inductive approach, based on the identified categories. The 27 narratives obtained revealed a variety of fundamental issues grouped into 8 subcategories and subsequently grouped into three main categories. The first category focuses on human vulnerability in health matters. The second category explores the agents and instruments for decision‐making that arise from uncertain or traumatic social events. The third category refers to the need for common ethical paradigms for all humanity that implement justice over universal values. A main theory was suggested on the concept of responsibility in a global common good. There is an urgent need to assume this integrative responsibility as an inherent strategy in decision‐making. To achieve this, the involved actors must acquire specific humanistic training, conceptualizing fundamental ethical principles, and emphasizing skills more related to humanistic virtues than technical knowledge.
Hypothermic Peritoneal Perfusion of Cold Oxygenated Perfluorocarbon May Improve the Efficacy of Extracorporeal Oxygenation: A Mathematical Model-Based Analysis
Authors: Rezaei Parham , Leibowitz Joshua L. , KadkhodaeiElyaderani Behzad , Moon Yejin , Awad Morcos , Stachnik Stephen , Sarkar Grace , Shaw Anna E. , Naselsky Warren , Enofe Nosayaba , Stewart Shelby , Culligan Melissa J. , Friedberg Joseph S. , Yu Miao , Hahn Jin-Oh 
Published: August 2024

Abstract
Circulation of perfluorocarbon (PFC) through corporeal cavities has received interest by virtue of its potential to supplement oxygenation via mechanical ventilation. However, the technology is not mature enough for clinical application, due to the knowledge gaps regarding the limiting factors hampering oxygen transport from PFC to blood. In this paper, we investigate a novel hypothesis that hypothermic peritoneal perfusion of cold oxygenated PFC may improve oxygenation of blood by facilitating the diffusion of oxygen from PFC to blood. Our hypothesis originates from physics-inspired insights that both hypothermia and PFC cooling may increase PFC-to-blood oxygen tension gradient: (i) hypothermia may decrease venous oxygen tension while (ii) cooling PFC may increase oxygen tension therein by increasing its oxygen solubility. Using a physics-based mathematical model capable of simulating oxygen tension responses to mechanical ventilation and peritoneal PFC perfusion under normothermic and hypothermic conditions, we analyzed the effect of hypothermic peritoneal cold PFC perfusion on blood oxygenation. The results predicted that peripheral oxygen saturation may be improved by 5–10% by peritoneal perfusion of oxygenated 15 °C PFC at 32 °C body temperature compared with peritoneal perfusion of oxygenated 37.5 °C PFC at 37.5 °C body temperature. The results also predicted that cooling PFC may play a more meaningful role than hypothermia. Pending the investigation of adverse impact of hypothermia and cold PFC on homeostasis, hypothermic cold PFC perfusion may improve peritoneal oxygenation by facilitating diffusion.
Noninvasive Patient Monitoring with Ambient Sensors to Monitor Physical and Cognitive Health for Individuals Living with Alzheimer’s Disease
Authors: Johnson Brian Bradley 
Published: August 2024

Abstract
An estimated 6.2 million Americans aged 65 or older live with Alzheimer’s Disease and Alzheimer’s Disease Related Dementias in the United States, and 55 million globally. Fall detection, prediction, and prevention patient monitoring technology for this population has not been widely adopted as the standard of care because of privacy concerns with artificial intelligent video surveillance and problematic user experience design with wearables. The current standard of care for falls is eyewitness or self-report and therefore highly susceptible to human error. Therefore, solutions need to be scalable, affordable, and clinically effective with broad technology user acceptance.
Despite many prevention and intervention methods that have been tried in past decades, falls remain the number one concern in aging care. The Centers for Medicare and Medicaid Services pay an enormous cost estimated at $50B per year on falls and fall related injuries. Human activity recognition with noninvasive ambient sensors is a versatile approach to patient monitoring as human movement can be translated into activities of daily living with sophisticated algorithms. This method does not use cameras and requires no contact with the body and thus it could be accepted at a higher rate than previous technologies and could therefore be adopted as the standard of care across the continuum.
A Benefit of Late Phase Design Studies: Design Verification Data Lensing
Authors: McLauchlan Arric E. , Patel Rakesh , Hayden David , Gokhale Apurva , Raghupathy Ramesh , Hario Neal , Falk Jeff 
Published: August 2024

Abstract
Process Integration and Design Optimization (PIDO) tools, which can connect and automate a series of computational processes forming an executable workflow with automated data input, analysis execution, and output collection, have an abundance of potential early in the life cycle of a product, but the utilization of these tools and approaches in late-phase programs can be every bit as valuable. One could even argue that the use of these tools to quickly find root causes and optimize final solutions is even more important in the late phases of a program, as the costs at these phases are much higher. PIDO tools and approaches can automate design iterations, allowing more designs to be tested in a shorter amount of time, which can help form a better understanding of the response space, and can in turn help determine the critical parameters of the system. These critical parameters can then be used to lens design verification (DV) data by drawing engineers' focus to the critical relationships of the DV data in order to make statistical observation about these influential factors controlling the system’s response. Potentially, this could be used to find process solutions to product issues without requiring expensive late-phase design changes. This article shows how this very approach was used on a prototype catheter’s hemostasis assembly to troubleshoot a leakage issue prior to locking-in the production tooling design.