bluuebunny/crossref_metadata_2025_split huggingface dataset:
Translation, Cross-Cultural Adaptation, and Validation of the Fear of Dependency Scale Into European Portuguese
Authors: Pires Patrícia Maria , Carvalho Joana , Pires Telma , Pires Carlos , Ribeiro Oscar 
Published: August 2024

Background: Dependency is defined as a person’s inability to meet basic human needs. In the context of aging, biopsychosocial changes compromise functionality, predisposing older adults to rely on others to perform daily activities. Fear of dependency describes the fear people have of appearing and/or being weak and/or reliant on others. The Fear of Dependency Scale (FDS), developed by Adams-Price and Ralston in 2016, aims to assess the fear of dependency by measuring an individual’s attitudes toward being helped. Objective: This study presents a European Portuguese version of the FDS and examines its psychometric properties (internal consistency reliability and content validity). Methods: The translation and both cultural and linguistic adaptation of the FDS were performed by a panel of experts. A cross-sectional study was then performed to evaluate the psychometric properties (in terms of its reliability and validity) of the translated version of the FDS among a sample of 100 community-dwelling older adults. Results: The European Portuguese version of the FDS exhibited good psychometric properties. The scale’s internal consistency was 0.84. Conclusions: The European Portuguese version of the FDS is a reliable, valid, and practical instrument for assessing the fear of dependency in older adults in the Portuguese population. It can be used in the context of health care provision and research.
Narrow-band and broadband vibration control of double-layer vibration isolation system based on a Youla parameterized adaptive controller
Authors: Pu Huayan , Li Zhentan , Zhu Jiahao , Zhang Chunlin , Bai Ruqing , Li Xueping , Luo Jun , Yuan Shujin 
Published: August 2024

Periodic motion equipment such as motors and pistons will generate broadband and narrow-band vibrations that vary with working conditions, thus reducing the process and measurement accuracy. The traditional control algorithm suppresses the vibration by increasing the broadband open-loop gain, but its effect on narrow-band vibration is limited. The Youla parameterized adaptive controller based on the internal model principle (IMP) is an effective method that can be used to suppress unknown time-varying narrow-band vibrations. However, the existing studies are insufficient for the control of broadband random vibrations. In this paper, a Youla parameterized adaptive controller with an improved central controller is designed to suppress broadband random and unknown narrow-band vibrations in a double-layer vibration isolation system. An optimal linear quadratic Gaussian (LQG) central controller is designed to first suppress the broadband random vibrations. Then, the global stable controllers with the Q parameter are obtained with the Youla parameterization method, and the Q parameter is adjusted online by the adaptive recursive least squares (RLS) algorithm to make the controller converge to the desired controller to suppress the unknown narrow-band vibrations. The results of experiments performed with a double-layer isolator show that the designed adaptive controller not only suppresses the broadband random vibrations to a certain extent but also almost completely eliminates the three unknown time-varying narrow-band vibrations. In practical applications, the controller can suppress the vibrations generated by a motor with varying rotational speeds, achieving an average peak attenuation of 95 dB with a tracking response time within 0.3 s.
Construction of a Prognostic Nomogram for Major Amputation Within 30 Days Postrevascularization in Patients With Acute Lower Limb Ischemia Based on 2D Perfusion Parameters
Authors: Guo Jiandong , Lin Yinsheng , Li Chengzhi , Zhang Yan , Li Wanghai 
Published: August 2024

Purpose: The purpose of the study is to develop a prediction model for major amputation (MA) within 30 days after arterial revascularization in patients with acute lower limb ischemia (ALLI) using 2-dimensional (2D) perfusion imaging parameters. Materials and Methods: A retrospective study was performed in ALLI patients undergoing arterial revascularization between October 2015 and May 2022. Patients were randomly assigned into training and validation cohorts in a ratio of 7:3. Variables were selected using univariate and multivariate logistic regression. A nomogram for the MA risk within 30 days after arterial revascularization in ALLI patients was created. Its discrimination, calibration, and clinical effectiveness were reported. Results: A total of 310 ALLI patients (326 limbs) were included. The MA rate within 30 days after arterial revascularization was 11.6%. Skin speckle, myoglobin, and time-to-peak were independent risk factors, while atrial fibrillation was a protective factor (all p <0.05). The nomogram predicted 30-day MA with satisfactory discriminative ability. The integrated discrimination improvement was 0.279 and 0.379 for the training and validation cohorts, respectively (both p<0.001). Calibration curves were close to the standard curve. The decision curve analysis demonstrated net benefits. Conclusion: This 2D perfusion imaging parameter–based nomogram could accurately predict the risk of MA within 30 days postrevascularization in ALLI patients. Clinical Impact This study introduces a novel nomogram based on 2-dimensional (2D) perfusion imaging that can significantly advance the prognosis prediction in ALLI patients. By calculating the risk of major amputation within 30 days postrevascularization, this nomogram offers an accurate predictive tool and can lead to more informed decision-making on patient management. The innovative aspect of this research lies in its utilization of 2D perfusion parameters, a novel approach that enhances risk assessment accuracy in ALLI patients. This nomogram represents a significant step toward risk stratification and can guide future research for appropriate management on ALLI patients with different risk profiles.
Prediction of Upper Limb Motor Recovery by the PREP2 Algorithm in a Nonselected Population: External Validation and Influence of Cognitive Syndromes
Authors: Millot Sarah , Daghsen Lina , Checkouri Thomas , Wittwer Aymeric , Valabregue Romain , Galanaud Damien , Lamy Jean Charles , Rosso Charlotte 
Published: August 2024

Background Early prediction of poststroke motor recovery is challenging in clinical settings. The Prediction recovery potential (PREP2) algorithm is the most accurate approach for prediction of Upper Limb function available to date but lacks external validation. Objectives (i) To externally validate the PREP2 algorithm in a prospective cohort, (ii) to study the characteristics of patients misclassified by the algorithm, and (iii) to compare the performance according to the presence of cognitive syndromes (aphasia, neglect, cognitive disorders). Methods We enrolled 143 patients with stroke and upper extremity weakness persistent at Day 3. Evaluation to predict the recovery status according to the PREP2 algorithm included age, SAFE and NIHSS scores at Day 3 and transcranial magnetic stimulation to determine the presence of the motor-evoked potential before day seven. Actual recovery (excellent, good, limited, or poor) was defined based on the Action Research Arm test score at 3 months. Accuracy was computed by comparing the predictions of the PREP2 and the actual category of the patient. Additionally, to investigate misclassifications and the impact of cognitive syndromes, we recorded SAFE and NIHSS scores at Day 7, the Montreal Cognitive Assessment (MoCA) score, the presence of aphasia and neglect and Magnetic Resonance Imaging was used to evaluate the corticospinal tract lesion load. Results The PREP2 algorithm showed a very good predictive value with 78% accuracy [95% CI: 71.2%-86.1%], especially for the extreme categories of recovery (EXCELLENT 87.5% [95% CI: 78.9%-96.2%] and POOR 94.9% [95% CI: 87.9%-100%]), and only 46.5% [95% CI: 19.05%-73.25%] for the GOOD category and even worse than chance for the LIMITED category 0%. Pessimistic predictions (false-negative cases) had a drastic improvement in the SAFE score acutely compared to that of well-predicted patients with unfavorable recovery ( P < 001). The predictive value of PREP2 decreased significantly when patients had cognitive disorders (MoCA score <24) versus not (69.4% [95% CI: 52.8%-86.1%] vs 93.1% [95% CI: 83.9%-100%], P = .01). Conclusion Our study provides an external validation of the PREP2 algorithm in a prospective population and underlines the importance of taking into account cognitive syndromes in motor recovery prediction.
Effects of Balance Exercise Interventions on Balance-Related Performance in People With Multiple Sclerosis: A Systematic Review and a Meta-Analysis of Randomized Controlled Trials
Authors: Wallin Andreas , Johansson Sverker , Brincks John , Dalgas Ulrik , Franzén Erika , Callesen Jacob 
Published: August 2024

Background Balance training covers a range of different modalities and complexity levels for people with multiple sclerosis (MS). When evaluating the effects of balance training across different kinds of interventions, determination of the specific intervention content that predict effects are needed. Objective To investigate the effects of balance training on gait and dynamic balance outcomes. Methods Four databases were systematically searched. Randomized controlled trials involving people with MS (Expanded Disability Status Scale [EDSS] score ≤7.5) where at least 50% of the intervention targeted balance control were included. Interventions were categorized based on training types. Risk-of-bias was assessed using the Tool for the Assessment of Study Quality and Reporting in Exercise (TESTEX). Results A total of 18 included studies involved 902 people with MS (EDSS range from 0 to 7.5). Interventions evaluated with a balance composite score or a mobility test showed a moderate effect size (ES = 0.46 [95% confidence interval (CI) = 0.18 to 0.74]; p < .01) and a small overall ES (ES = 0.19 [95% CI = 0.01–0.36]; p = .04), respectively, across different training types. Stepping and gait speed outcomes showed no effect. Cognitive dual-task training showed a significant effect (ES = 0.81 [95% CI = 0.24 to 1.37]) on subgroup level, when evaluated with a mobility outcome measure. The median TESTEX score on study quality and reporting was 11 (maximum score = 15). Conclusions Improvements of balance were found across interventions when measured by balance composite scores and mobility tests, but not when measured by stepping or gait speed outcomes. Large training volume was positively associated with effect on balance. A definition of intensity in balance training is needed for evaluation of its impact on the effect of balance interventions.
Research report: Management of dysphagia using pharyngeal electrical stimulation in the general intensive care population – A service development
Authors: Williams Thomas , Walkden Elizabeth , Patel Karishma , Cochrane Naomi E , McGrath Brendan A , Wallace Sarah 
Published: August 2024

Background: Dysphagia places a substantial burden on the critically ill, affecting 12%–84% of this cohort, and is independently associated with worse outcomes. Pharyngeal electrical stimulation (PES-treatment) is a novel dysphagia therapy with an emerging evidence base. This retrospective observational study describes our dysphagia service and reports the use of PES-treatment as a standard of care in recovering critically ill patients at a single-site tertiary UK hospital. Methods: Patients admitted to Acute or Cardio-Thoracic adult intensive care units between 1st July 2017 and 30th June 2022 were routinely referred to Speech and Language Therapy (SLT) following tracheostomy, or suspected dysphonia/dysphagia. Clinical assessments and direct laryngeal visualisation using Fibreoptic Evaluation of Swallowing (FEES) were performed. Severe dysphagia was defined as Penetration-Aspiration Score of ⩾6 and patients were offered PES-treatment when staffing allowed. Results: Of 289 patients with severe dysphagia, 19 underwent a course of PES-treatment with the remaining patients receiving standard care. PES-treatment patients were significantly less likely to remain nil-by-mouth (11.1% vs 62.5%, Chi2 p < 0.001) or to have an enteral feeding tube in situ at discharge from critical care (27.8% vs 62.5%, p = 0.006) than those receiving standard dysphagia care. Both groups demonstrated an improvement in Penetration-Aspiration Score at repeat FEES: PES-treatment mean difference −2.0 ( p = 0.003); non-PES-treatment −1.68 ( p < 0.001); (61% PES-treatment improved vs 40% non-PES-treatment, p = 0.09). Conclusion: Our observations suggest that PES may be effective in the general critical care population. PES may offer new treatment options for patients and healthcare staff managing severe dysphagia and its significant consequences.
Enhancing health care through medical cognitive virtual agents
Authors: Mishra Sushruta , Chaudhury Pamela , Tripathy Hrudaya Kumar , Sahoo Kshira Sagar , Jhanjhi NZ , Hassan Elnour Asma Abbas , Abdelmaboud Abdelzahir 
Published: August 2024

Objective The modern era of cognitive intelligence in clinical space has led to the rise of ‘Medical Cognitive Virtual Agents’ (MCVAs) which are labeled as intelligent virtual assistants interacting with users in a context-sensitive and ambient manner. They aim to augment users' cognitive capabilities thereby helping both patients and medical experts in providing personalized healthcare like remote health tracking, emergency healthcare and robotic diagnosis of critical illness, among others. The objective of this study is to explore the technical aspects of MCVA and their relevance in modern healthcare. Methods In this study, a comprehensive and interpretable analysis of MCVAs are presented and their impacts are discussed. A novel system framework prototype based on artificial intelligence for MCVA is presented. Architectural workflow of potential applications of functionalities of MCVAs are detailed. A novel MCVA relevance survey analysis was undertaken during March-April 2023 at Bhubaneswar, Odisha, India to understand the current position of MCVA in society. Results Outcome of the survey delivered constructive results. Majority of people associated with healthcare showed their inclination towards MCVA. The curiosity for MCVA in Urban zone was more than in rural areas. Also, elderly citizens preferred using MCVA more as compared to youths. Medical decision support emerged as the most preferred application of MCVA. Conclusion The article established and validated the relevance of MCVA in modern healthcare. The study showed that MCVA is likely to grow in future and can prove to be an effective assistance to medical experts in coming days.
Association of Smaller Intercondylar Notch Size With Graft Failure After Anterior Cruciate Ligament Reconstruction
Authors: Hughes Jonathan D. , Boden Stephanie A. , Belayneh Rebekah , Dvorsky Jenna , Mirvish Asher , Godshaw Brian , Sansone Mikael , Karlsson Jon , Musahl Volker 
Published: August 2024

Background: Smaller intercondylar notch sizes have been consistently associated with a predisposition for primary anterior cruciate ligament tears. Purpose: To evaluate the association between intercondylar notch size, graft size, and postoperative complications, including knee stiffness and return to the operating room, after primary anatomic anterior cruciate ligament reconstruction (ACLR). Study Design: Case-control study; Level of evidence, 3. Methods: This was a retrospective analysis of prospectively collected data from consecutive patients who underwent anatomic single-bundle primary ACLR using a bone-patellar tendon-bone or quadriceps tendon autograft performed by fellowship-trained orthopaedic sports medicine surgeons between April 2009 and August 2019. Graft failure was defined as patient report of instability, pathologic laxity on clinical examination, or graft rerupture confirmed by magnetic resonance imaging and/or subsequent arthroscopy. To ensure the purposeful selection of covariates, univariate analyses were conducted on the list of potential confounders selected a priori, and those with a significance value of P < .10 were considered for the multivariate regression model. Covariates found to be statistically significant with univariate analysis were patient age, notch size, and graft type. After validating all potential covariates, they were added to the regression model and then eliminated in a stepwise fashion. Results: In total, 252 patients were included for analysis (99 bone-patellar tendon-bone and 153 quadriceps tendon autograft; age, 22.2 ± 7.0 years; graft size, 9.8 ± 1.0 mm; time to follow-up, 50.4 ± 28.9 months). Knee stiffness developed in 23 patients (9.1%), and 15 grafts failed (6.0%). Smaller notch size on magnetic resonance imaging was significantly associated with graft failure ( P = .005). There was a significantly higher risk of graft failure with notch size <16 versus ≥16 mm (17.6% vs 2.3%; P = .005) with an odds ratio (OR) of 5.0 (95% CI, 1.7-15.1; P = .004). Notch size <15 mm was associated with the highest risk of graft failure (22.2%; OR, 5.8; 95% CI, 1.6-20.6; P = .006). There was no significant association between notch size or graft–notch size ratio and knee stiffness, meniscal injury, or cartilage damage at the time of ACLR, regardless of graft type. Conclusion: Intercondylar notch size <16 mm was associated with a 5-fold increased risk of graft failure after primary anatomic ACLR.
Beyond the Books: COVID-19's Influence on Future Life Behaviors of Aspiring Medical and Health Professionals
Authors: Gong Zheng , Adu-Amankwaah Joseph , Fu Lu , Qiao Weili , Li Wen , Hou Hongjian , Ma Tongtong , He Mingyu , Cubelo Teodora A. , Sun Hong 
Published: August 2024

BACKGROUND The lifestyle of most people was forced to change due to the COVID-19 pandemic. Perhaps after the pandemic, we will find that these subtle changes in life and from the depths of our hearts are thorough and profound. They may form our conceptual consensus and behavioral habits, becoming part of our long-term personal consciousness. This study explored the impacts of the COVID-19 pandemic on the future life behavior intentions of medical and health-related students studying at universities in China. METHODS Electronic questionnaires were distributed to students studying at 3 universities in China. A total of 251 valid questionnaires were obtained, and the chi-squared test was used to compare the corresponding groups. RESULTS In the future, students plan to pay more attention to wearing masks and maintaining social distance in public places, do more online shopping, have more meals at home or in the canteen, engage in less international travel, and have fewer gatherings with friends. However, compared with Chinese students, more non-Chinese students plan to increase domestic and international travel and reduce online learning. Furthermore, only among non-Chinese students did gender, urban or rural origin, and family economic conditions influence how the COVID-19 pandemic affected their future life behaviors. CONCLUSION The COVID-19 pandemic changed the future life behavior intentions of medical and health-related students. The future behaviors of these students will impact the entire society. This study will help the government and policymakers predict and prepare for general lifestyle changes in our society.
Exploring Symptom Management Experiences Among College Students With Type 1 Diabetes Mellitus Using a Theoretical Framework: A Qualitative Study
Authors: McFadden Ny’Nika T. , Wilkerson Amanda H. , Chaney Beth H. , Carmack Heather J. , Jaiswal Jessica , Stellefson Michael L. , Lovett Kylie 
Published: August 2024

Purpose The purpose of this study was to explore symptom management experiences among college students with type 1 diabetes mellitus (T1DM). Limited qualitative data using a theoretical framework exist that explore the self-care behavior processes for symptom management. Methods A qualitative approach was used for this study. The middle-range theory of self care of chronic illness served as a framework for data collection and analysis procedures. Data collection included distributing a survey to collect participants’ demographic and sociodemographic data and utilizing a semi-structured interview guide to conduct one-on-one interviews with 31 participants. Interviews occurred via Zoom (n = 28) and in person (n = 3). Interview transcripts were uploaded in NVivo for data management. The research team created a codebook using theoretical constructs to assist with thematic analysis. Data are representative of a sample whose characteristics include undergraduate students ages 18 to 23 living with T1DM for 2 years or more who attended large, public, 4-year universities located in the southeastern United States. Results Three main themes were created using theoretical constructs: symptom detection experiences, symptom interpretation experiences, and symptom response experiences. Two subthemes were identified for each theme. Participants engaged in symptom management for blood glucose regulation through detecting changes in their blood glucose physiologically and via technology. Additionally, symptom interpretation involved analyzing blood glucose trends and determining common causes of blood glucose changes. Symptom response included immediately addressing hypoglycemia but delayed responses addressing hyperglycemia. Conclusions Challenges were present responding to hypoglycemia; therefore, additional research is warranted to improve symptom response skills.