bluuebunny/crossref_metadata_2025_split huggingface dataset:
Best practice exercise for emerging depression in multiple sclerosis: A systematic review and meta-analysis
Authors: Ahola Kristiina , Dorstyn Diana , Prideaux Nicole 
Published: July 2024

Objective To examine the effects of instructor-led exercise on depression symptoms in adults with multiple sclerosis, with a focus on moderating factors to treatment response. Data sources Cochrane Library, Embase, PEDro, PsycINFO and PubMed databases were searched until 21 April 2024. Review methods The reporting quality of included studies assessed (PEDro and TESTEX scales). Hedges’ g effect sizes were calculated and pooled using random and mixed-effects modelling. Results Twenty-two independent studies ( k), representing 785 participants with relapsing remitting or progressive MS, were included. Individual studies varied in their reporting quality (PEDro range: 3–8) and did not routinely detail exercise parameters (TESTEX range: 5–13). Nonetheless, exercise reduced core symptoms of depression ( gw = .52, CI: .30–.73, P < .01). Treatment effects were, however, not maintained once training had ceased ( gw = −.53, CI: −.80 to .24, P ≤ .01, k = 5). Both aerobic and non-aerobic exercise groups experienced a significant ( P < .01) reduction in depression scores. Larger gains were noted by those with better ambulation at baseline ( P = .03). Conclusion Regular exercise can help to stabilise mood for people living with multiple sclerosis, regardless of session frequency or duration. Treatment efficacy could be maximised by addressing potential barriers for those with limited mobility, including exercise type, delivery and intensity. Protocol registered on Open Science Framework [ https://osf.io/zfymq/ ].
Considerations for developing complex post-stroke upper limb behavioural interventions: An international qualitative study
Authors: Wingfield Matthew , Hughes Gemma , Fini Natalie A , Brodtmann Amy , Williams Gavin , Hayward Kathryn S 
Published: July 2024

Objective To simultaneously explore the perspectives and opinions of different invested participant groups on the important considerations for development of upper limb behavioural interventions that drive optimal post-stroke upper limb motor recovery. Design A qualitative descriptive study in a constructivist epistemology. Participants Purposively selected participant groups (preclinical research n = 9, clinical research n = 9, clinical experience n = 9 and lived experience n = 10). Setting Research participants were selected from top internationally published authors. Experiential participants were recruited internationally, through networks. Results Four themes were identified with embedded subthemes. Theme 1: ‘Clinical relevance should be the core of a “good” research question’ with two subthemes: ‘Breaking down silos: forging interdisciplinary research teams’, and ‘Beyond the pipeline: bench to bedside and back’; theme 2: ‘Balance restitution and compensation to maximise outcomes’ with three subthemes: ‘Good outcome: going beyond an outcome measure’, ‘Recovery is a puzzle: measure all the pieces’, and ‘Optimising capacity: knowing when and how’; theme 3: ‘Stroke demands personalised solutions’ with two subthemes: ‘Condition-specific considerations’, and ‘Person-specific considerations’; theme 4: ‘Upper limb recovery requires complex interventions’ with four subthemes: ‘Fuelling engagement’, ‘Content is crucial’, ‘Multidimensional dose’, and ‘Therapist sway’. Conclusions This study suggests that post-stroke upper limb motor interventions are the interactions of multiple intervention elements (e.g. dose and content) shaped by different contextual considerations (e.g. stroke and personal factors). Development of such interventions may need to consider both content and context of the intervention to drive optimal recovery.
Predicting cachexia in hepatocellular carcinoma patients: a nomogram based on MRI features and body composition
Authors: Li Xin-xiang , Liu Bing , Zhao Yu-fei , Jiang Yang , Mao Hui , Peng Xin-gui 
Published: July 2024

Background Approximately half of all patients with hepatocellular carcinoma (HCC) develop cachexia during the course of the disease. It is important to be able to predict which patients will develop cachexia at an early stage. Purpose To develop and validate a nomogram based on the magnetic resonance imaging (MRI) features of HCC and body composition for potentially predicting cachexia in patients with HCC. Material and Methods A retrospective two-center study recruited the pretreatment clinical and MRI data of 411 patients with HCC undergoing abdominal MRI. The data were divided into three cohorts for development, internal validation, and external validation. Patients were followed up for six months after the MRI scan to record each patient's weight to diagnose cachexia. Logistic regression analyses were performed to identify independent variables associated with cachexia in the development cohort used to build the nomogram. Results The multivariable analysis suggested that the MRI parameters of tumor size > 5 cm ( P = 0.001), intratumoral artery ( P = 0.004), skeletal muscle index ( P < 0.001), and subcutaneous fat area ( P = 0.004) were independent predictors of cachexia in patients with HCC. The nomogram derived from these parameters in predicting cachexia reached an area under receiver operating characteristic curve of 0.819, 0.783, and 0.814 in the development, and internal and external validation cohorts, respectively. Conclusion The proposed multivariable nomogram suggested good performance in predicting the risk of cachexia in HCC patients.
Phospholipase A2 expression in prostate cancer as a biomarker of good prognosis: A comprehensive study in patients with long follow-up
Authors: Recuero Saulo da Cunha , Viana Nayara I , Reis Sabrina T , Mendes Keith T , Talib Leda L , Gattaz Wagner F , Guimarães Vanessa R , Silva Iran A , Pimenta Ruan C. P , Camargo Juliana A , Nahas Willian C , Srougi Miguel , Leite Katia R. M 
Published: July 2024

Background: Phospholipase A2 (PLA2) is a large family of enzymes involved in the inflammatory process that catalyzes the hydrolysis of membrane phospholipids, leading to the production of free fatty acids and lysophospholipids, starting the arachidonic acid cascade. Their expression has been related to the behavior of several cancers. Our objective is to search for PLA2 expression in prostate cancer (PCa) tissue that correlates with prognosis and survival. Methods: Using qRT-PCR, we analyzed the expression levels of PLA2G1B, PLA2G2A, PLA2G2D, PLA2G4A, PLA2G4B, PLA2G4C, PLA2G4D, PLA2G4E, PLA2G4F, PLA2G6, PLA2G7, PLA2G16, PNPLA1, and PNPLA2 in PCa tissue from 108 patients submitted to radical prostatectomy, followed by a mean time of 163 months. Results: All PLA2 was overexpressed in PCa compared to normal tissue. Interestingly, higher expression of some PLA2 was related to favorable prognostic factors: lower levels of PSA (PLA2G2A, PLA2G4D), lower rates of lymph node metastasis (PLA2G16 and PLA2G1B), and organ-confined disease (PLA2G4A). Most importantly, PLAG4B was independently related to longer disease-free survival. Conclusion: This is the first study exploring comprehensively the expression levels of PLA2 in PCa, showing that the higher expression of some PLA2 should be used as biomarkers of good prognosis and longer disease-free survival.
Prevalence of cutaneous manifestations and myositis-specific antibodies in COVID-19 patients and Anti-PL7 antibodies association with pulmonary radiological severity: A retrospective study
Authors: Oddenino Giorgio Alberto , Canepa Paola , Cozzani Emanuele , Gasparini Giulia , Garlaschi Alessandro , Roccatagliata Luca , Schiavetti Irene , Parodi Aurora 
Published: July 2024

Background Dermatomyositis (DM) is an idiopathic immune-mediated myopathy, and may involve many organs, including muscles, skin and lungs. Myositis-specific autoantibodies (MSAs) are a useful aid in diagnosis DM and identifying its clinical subtype. During the COVID-19 pandemic, several studies found clinical similarities regarding lung involvement in both COVID-19 and DM. Such similarities have prompted speculation of a common pathogenetic mechanism. Indeed, viral infections are well-known triggers of autoimmune diseases. This prompted us to investigate whether circulating MSAs could be markers of the severity of lung involvement and of clinical outcome in COVID-19 patients. Moreover, we investigated the presence of cutaneous signs of DM in COVID-19 patients. Methods We conducted a retrospective cohort study on 178 hospitalized patients affected by COVID-19. The diagnosis was confirmed by naso-pharyngeal swab positivity for SARS-CoV-2. The severity of lung involvement was assessed by assigning to each patient a radiological score ranging from 1 to 4, based on chest imaging (chest X-rays or CT scans). Serum samples were tested for MSAs. Results Anti-PL-7 antibodies were detected in 10.1% of patients and were found to be associated with an increased risk of severe pulmonary involvement ( p = 0.019) and a worse prognosis in COVID-19 patients. Cutaneous lesions were observed in 26.4% of patients. However, none were cutaneous manifestations of DM. Conclusions The detection of anti-PL7 antibodies might predict severe pulmonary involvement and a worse prognosis in COVID-19 patients.
Patterns and Consequences of Delayed Self Care Among Rural Medical Providers
Authors: Terry Danielle L. , Safian Gabrielle , Terry Christopher P. 
Published: July 2024

Purpose The purpose of this study was to (a) examine personal healthcare practices of rural medical providers by issue type (e.g., physical health, social health, or mental health), (b) identify perceived consequences of taking time off and (c) determine whether greater delay in self-care was associated with perceived stress and burnout. Design Electronic surveys were sent to 805 medical providers (response rate = 17.8%, n = 143). Setting The setting was a rural teaching hospital and affiliated community clinics. Subjects Participants included 143 rural medical providers. Measures The survey included demographic information, perceived personal health risk, and questions about delaying health care, and perceived consequences of receiving health care. Results Medical providers delayed mental health care needs significantly more than physical health needs, t131 = 5.13, P < .01, d = .38. Respondents believed that there would be significantly more retaliation against them for taking time off for psychosocial issues, t124 = −3.80, P < .001, d = .25. There was a significant negative association between burnout and physical health self-care (r = −.24, P < .01), psychosocial self-care (r = −.20, P = .01), and mental health self-care (r = −.23, P < .01). Conclusions Our study identified commonly reported consequences related to taking off work for care seeking behavior. Understanding perceived consequences can help guide health care organizations in dismantling these barriers. This study is limited by the generalizability of its sample.
Treatment patterns and preferences of people living with HIV starting or switching antiretroviral therapy: Real-world evidence from Portugal
Authors: Pedro Liliana , Zagalo Alexandra , Tavares Raquel , Pacheco Patrícia , Oliveira Joaquim , Vaz Pinto Inês , Serrão Rosário , Tavares Sandra , Brito Paula , Maltez Fernando , Neves Isabel , Carvalho Alexandre , Teófilo Eugénio , Almeida Joana , Lains Inês 
Published: July 2024

Background There is a lack of up-to-date real-life evidence on antiretroviral therapy (ART) strategies among people living with HIV (PLWH) in Portugal. This study aimed to describe the treatment strategy used in PLWH either initiating or switching ART. Methods Non-interventional, cross-sectional, multicenter study carried out between December 2019 and October 2021 in Portugal. Results A total of 237 PLWH were included in this study, 171 of whom were ART-experienced and 66 were ART-naïve. The study showed that triple regimens were the most common ART strategy and integrase strand transfer inhibitors-based therapy was the most frequently used therapeutic class in both ART-naïve and ART-experienced PLWH. Nevertheless, about a third of PLWH who started a triple regimen transitioned to a dual regimen. Patient-reported outcomes revealed high HIV literacy and similar ART preferences in both groups. Conclusions This real-world study showed that triple regimens were the most widely used ART strategy, even after the European AIDS Clinical Society guidelines introduced the recommendation of a dual regimen for naïve patients. The cohorts of this study presented a high level of HIV literacy at the time of inclusion. Our findings highlighted that taking pills only once a day is considered a very important feature for most patients.
Predictive value of Doppler echocardiography parameters for cardiovascular events in patients with systemic lupus erythematosus
Authors: Lai Li-ping , Wang Liang-qin , Li Shui-ping 
Published: July 2024

Background and objectives This study aimed to assess the utility of Doppler echocardiography in evaluating left ventricular diastolic function, and prognosis in patients with systemic lupus erythematosus (SLE). Patients and methods A total of 286 SLE patients were selected along with 100 age- and gender-matched healthy individuals who underwent physical examinations. Clinical baseline characteristics were collected. Various Doppler echocardiographic parameters were measured and analyzed, including left ventricular posterior wall thickness (LVPWT), interventricular septal diameter (IVSD), left ventricular mass (LVM), LVM index (LVMI), and others. Results Compared to the control group, SLE patients exhibited significantly higher levels of C-reactive protein and lower levels of complement (C) 3 and C4 ( p < .001). Doppler echocardiographic parameters showed significant differences between SLE patients and healthy controls, including increased LVPWT, IVSD, LVM, LVMI, peak A, PWI + Tei, E/e′, TDI-Tei, and decreased e′ and E/A ( p < .001). Subgroup analyses indicated more severe ventricular diastolic dysfunction in patients with higher SLE activity and those who experienced cardiovascular events. Correlation analysis revealed positive associations of PWI + Tei, TDI-Tei, and GLS with SLE activity and cardiovascular events ( p < .01). Multivariate logistic regression analysis identified LVMI, PWI + Tei, TDI-Tei, and GLS as significant predictors of cardiovascular events ( p < .05). Conclusion Doppler echocardiography is a valuable tool for the early diagnosis of left ventricular diastolic dysfunction in SLE patients. Key echocardiographic parameters, including LVMI, PWI + Tei, TDI-Tei, and GLS, are effective in predicting cardiovascular events, underscoring the importance of comprehensive cardiac function assessments in these patients.
Key professional stakeholders roles in promoting older people's autonomy in residential care
Authors: Moilanen Tanja , Suhonen Riitta , Kangasniemi Mari 
Published: July 2024

Background Older people’s autonomy is an ethical and legal principle in everyday residential care, but there is a lack of clarity about the roles and responsibilities of the key professional stakeholder groups involved. Research objectives This study aimed to identify and define the roles and responsibilities of the key professional stakeholder groups involved in promoting older people’s autonomy in residential care settings. Research design We used a Delphi method with two iterative rounds of online group discussions and collected data from experts in older people’s care in Finland in summer 2020. The data were analyzed using deductive-inductive content analysis methods. Ethical considerations According to Finnish legislation, this type of research did not need approval from a research ethics committee. Informed consent from the participants was obtained and they were informed about the voluntary nature and confidentiality of the study and their right to withdraw at any time. Results Key professional stakeholders had different roles and responsibilities, but their shared, integrated goal was to achieve older people’s autonomy in residential care settings. Their combined roles and responsibilities covered all aspects of promoting older people’s autonomy, from care and service planning and daily decision-making to service structures that included ethical competencies and monitoring. Multipronged, variable, coordinated strategies were required to identify, assess, and promote autonomy at different levels of care. Conclusion Key professional stakeholders need to work together to provide an unbroken chain of care that provides older people with autonomy in residential care settings. In future, more knowledge is needed about how to create structures to achieve the shared goal of older people’s autonomy in these settings.
A Study on the Hedging and Safe-Haven Features of Non-fungible Tokens Segments
Authors: James Emiliya , Kayal Parthajit , Maiti Moinak , Balasubramanian G. 
Published: July 2024

This study examines the hedging and safe-haven characteristics across the various segments of non-fungible tokens (NFTs). It adopts the case study approach to blend the key study findings on the risk and return aspects of different NFT segments. The study finds that various segments of NFTs have mixed levels of correlations with traditional financial assets. Online games and metaverse segments of NFTs display a link to the crypto assets. Similarly, only the metaverse segment shows an association with the market sentiment. Art, online games, and collectibles segments within the NFTs space show mixed levels of hedging. However, all NFT segments under consideration show ambiguous safe-haven facets. Overall, the present study highlights some of the important aspects to consider while investing in the different segments of NFTs with respect to portfolio optimization, market dynamics, and risk management. JEL Codes: C12, C13, J64
The Effect of an Educational Intervention on Breast Cancer Screening of Rural Women: Application of the Theory of Planned Behavior
Authors: Kamyab Amirhossein , Mohammadkhah Fatemeh , Asadi Saeedeh , Ghalehgolab Farzaneh , Khani Jeihooni Ali 
Published: July 2024

Background Early diagnosis of breast cancer is a key factor affecting patient survival, so screening can reduce the burden of this disease. The present study aimed to investigate the effect of education based on the theory of planned behavior (TPB) on breast cancer screening in rural women. Methods In this quasi-experimental study, 480 women referring to the health care centers in the cities of Fasa and Shiraz were divided into two groups, intervention (n = 240) and control (n = 240), using cluster random sampling method, in 2021-2022. We randomly selected two health care centers in Shiraz and Fasa and invited them to participate in the study. The demographic information questionnaire and a researcher-made questionnaire based on the TPB were used to collect the data. The intervention included 50-minute sessions on topics such as breast cancer basics, screening methods, barriers to mammography, and the role of peer groups. Data were collected before and 4 months after the intervention. Results The results showed no difference between the two groups in awareness, attitude, perceived behavioral control, subjective norms, behavioral intention, and breast cancer screening performance before the intervention. Four months after the intervention, a significant increase was found in the intervention group in awareness (7.46 ± 1.50 to 18.54 ± 1.20), attitude (28.55 ± 4.62 to 58.69 ± 4.35), perceived behavioral control (22.52 ± 3.32 to 40.88 ± 3.84), and subjective norms (20.37 ± 3.34 to 21.99 ± 3.38). Instead, no significant difference in the mentioned constructs ( P < 0.05) was observed in the control group. Conclusion This study demonstrated that TPB-based education enhanced awareness, attitude, perceived behavioral control, subjective norms, and behavioral intention towards breast cancer screening. The TPB empowers women in rural communities to prioritize their health and seek timely breast cancer screening. Continued efforts and improved access to screening services are crucial for improved outcomes.
Gaining Recovery in Addiction for Community Elders (GRACE) Project: The Impact of Age-Specific Care on Clinical Outcomes and Health Care Resource Utilization in Older Adults With Substance Use Disorder in an Interprofessional Addiction Clinic
Authors: Schachman Kathleen A. , Macomber Catherine A. , Mitchell Matthew L. , Brown Jill M. , Scott Jennifer L. , Darr Rachel L. , Fabbro Mindy A. , Morrone William R. , Peckham Kari A. , Charbonneau-Ivey Trisha K. 
Published: July 2024

Background: The prevalence of substance use disorders (SUDs) in older adults has been increasing, necessitating tailored and effective addiction care for this aging demographic. Aims: The purpose of this study was to assess the impact of age-specific, interprofessional addiction care on clinical outcomes and health care resource utilization in older adults with SUD. Methods: This quasi-experimental study directly compares patients enrolled in the Gaining Recovery in Addiction for Community Elders (GRACE) Project, an interprofessional age-specific addictions treatment program, with age-matched older adults who received conventional “treatment as usual” (TAU). Through retrospective comparative analysis, substance use outcomes, mental and physical health improvements, and inappropriate use of emergency services were examined among 78 older adults with SUD. Results: Clinical outcomes and health care resource utilization were superior for older adults who received age-specific addictions care through the GRACE Project, as compared to mixed-age conventional “TAU.” GRACE patients had improved treatment adherence, fewer relapses, and longer treatment engagement. While both groups exhibited significant reductions in depression and anxiety scores, GRACE patients showed greater improvements. This group demonstrated superior control of both hypertension and diabetes. Importantly, they had fewer inappropriate emergency department visits and avoidable hospitalizations than conventional “TAU.” Conclusions: Addiction treatment delivered by an interprofessional team to meet the unique strengths and needs of older adults has the potential to improve treatment adherence and more favorable long-term outcomes in substance use, mental health, and chronic medical conditions. Nurses are poised to lead interprofessional teams to meet the growing demand for specialized addiction treatment and integrated care for older adults.
Extended-Release Mixed Amphetamine Salts for Comorbid Adult Attention-Deficit/Hyperactivity Disorder and Cannabis Use Disorder: A Pilot, Randomized Double-Blind, Placebo-Controlled Trial
Authors: Levin Frances R. , Mariani John J. , Pavlicova Martina , Choi C. Jean , Basaraba Cale , Mahony Amy L. , Brooks Daniel J. , Brezing Christina A. , Naqvi Nasir 
Published: July 2024

Objective: To determine if treatment of co-occurring adult ADHD and Cannabis Use Disorder (CUD) with extended-release mixed amphetamine salts (MAS-ER) would be effective at improving ADHD symptoms and promoting abstinence. Method: A 12-week randomized, double-blind, two-arm pilot feasibility trial of adults with comorbid ADHD and CUD ( n = 28) comparing MAS-ER (80 mg) to placebo. Main outcomes: ADHD: ≥30% symptom reduction, measured by the Adult ADHD Investigator Symptom Rating Scale (AISRS). CUD: Abstinence during last 2 observed weeks of maintenance phase. Results: Overall, medication was well-tolerated. There was no significant difference in ADHD symptom reduction (MAS-ER: 83.3%; placebo: 71.4%; p = .65) or cannabis abstinence (MAS-ER: 15.4%; placebo: 0%; p = .27). MAS-ER group showed a significant decrease in weekly cannabis use days over time compared to placebo ( p < .0001). Conclusions: MAS-ER was generally well-tolerated. The small sample size precluded a determination of MAS-ER’s superiority reducing ADHD symptoms or promoting abstinence. Notably, MAS-ER significantly reduced weekly days of use over time.