bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effect of Inspiratory Muscle Training in Patients With Lung Cancer After Surgery: A Systematic Review
Authors: Nguyen Ngoc-Minh , Latiers Fabien , Aboubakar Nana Frank , Lacroix Valérie , Reychler Gregory 
Published: October 2023

Objective:
The standard of care treatment of potentially resectable lung cancer (LC) is surgery. However, postoperative pulmonary complications (PPCs) and impairments in physical capacity are common. Recently, the effect of inspiratory muscle training (IMT) in postoperative patients with LC (PWLC) was investigated in these outcomes in different studies. The purpose of this systematic review was to synthesize the effect of postoperative IMT (P-IMT) on PPCs and physical capacity in PWLC.

Database:
PubMed, EMBASE, Cochrane, and CINAHL were searched.

Study Selection:
Randomized controlled trials, including control/sham group, IMT as the intervention group, and key measures including PPCs, 6-minute walk test (6MWT), Vo
2peak, maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), quality of life (QoL), physical activity level, hospital length of stay, spirometry.

Data Synthesis:
The quality of the studies was assessed using the Physiotherapy Evidence Database (PEDro) scale. The outcome findings were compared and interpreted.

Results:
Five studies with 249 patients were analyzed. The PEDro scores of studies ranged from 6 to 8. There is no significant difference in PPCs between the groups. The effects of P-IMT on the 6MWT, Vo
2Peak, MIP, MEP, and QoL were ambiguous. No effect of P-IMT on spirometry was reported.

Conclusion:
No effect of P-IMT in PPCs was reported. The effect of P-IMT on physical capacity and respiratory muscle strength was not observed. The level of the effect of P-IMT on hospital length of stay and postoperative physical activity was low. No optimal setting of P-IMT for PWLC with surgery was found. More studies are needed.
Withdrawal-like Symptoms in Problematic Pornography Use: A Scoping Review
Authors: Roza Thiago Henrique , Noronha Lucas Tavares , Shintani Augusto Ossamu , Massuda Raffael , Kessler Felix Henrique Paim , Passos Ives Cavalcante 
Published: October 2023

Objectives
There is still debate whether problematic pornography use (PPU) can be understood as an addictive disorder, and little is known about withdrawal-like symptoms in these patients. Therefore, our aim was to summarize the existing scientific literature about this topic in the format of a scoping review.

Methods
Potentially eligible references were retrieved from 6 databases (MEDLINE/PubMed, Web of Science, Embase, PsycINFO, LILACS, and SciELO) up to February 7, 2023. Studies were included if they reported original data about withdrawal-like symptoms in individuals with PPU. Studies investigating child pornography use, or in which it was not possible to extract data of interest were excluded. Data extracted from included studies and their quality assessment were described narratively.

Results
A total of 937 references were retrieved, and 14 studies were included (n = 31,009 participants). According to our results, cravings were intense in most cases and frequent reasons for relapse. The proportion of participants experiencing other withdrawal-like symptoms (mental, sexual, and physical symptoms) reached up to 72.2% in the cross-sectional studies with this information available. Severity of withdrawal symptoms was associated with severity of PPU and frequency of pornography use. In some studies, measures of withdrawal symptoms were considered central symptoms of PPU and were significantly higher in individuals considering treatment. Masturbation was reported to alleviate withdrawal-like symptoms in some cases.

Conclusions
There is preliminary evidence for the existence of withdrawal-like symptoms in PPU. Future studies should investigate onset, characteristics, duration, and proportion of withdrawal-like symptoms in PPU with robust methodology, also investigating potential confounding variables.
The Effects of Core Stabilization Exercises on Respiratory Muscle Strength, Respiratory Functions, and Postural Control in Children With Hearing Loss: A Randomized Controlled Trial
Authors: Tuncer Deniz , Gurses Hulya Nilgun 
Published: October 2023

Objectives:
To evaluate the effects of core stabilization training on respiratory muscle strength, respiratory functions, and postural control in children with hearing loss.

Design:
We conducted a randomized controlled trial at Bezmialem Vakif University, Faculty of Health Sciences, Division of Physiotherapy and Rehabilitation. Thirty children with hearing loss who were diagnosed with prelingual sensorineural hearing loss were randomly allocated to the study (n = 15, 12.20 ± 1.69 years) and control (n = 15, 11.87 ± 2.20 years) groups. Core stabilization training protocol was performed by the study group for 8 weeks, 5 days/week, whereas the control group received no training. The primary outcome measure was respiratory muscle strength. The secondary outcome measures were: spirometry, postural control tests on Biodex Balance System, and Balance Error Scoring System (BESS). Exercise adherence was recorded via a diary for home sessions. Outcomes were assessed at baseline and the end of the 8 weeks.

Results:
In the study group, a significant improvement was observed in force vital capacity, peak expiratory flow of the spirometry test, maximum inspiratory pressure/expiratory pressure (MEP) of the respiratory muscle strength test; postural stability test except "anterior/posterior stability index", limits of stability test except "backward" and "forward/right", all parameters of the Modified Clinical Test for Sensory Interaction and Balance (mCTSIB) test except “eyes closed firm surface” of the Biodex Balance System, and total score of BESS. Group × time interaction was found in MEP, “overall” stability index in postural stability test, “overall,” “left,” and “backward left” of limits of stability test, all parameters of the mCTSIB, and BESS total.

Conclusions:
Core stabilization exercises were effective in improving respiratory muscle strength, spirometry, and postural control in children with hearing loss.
Challenges and Opportunities in the Elective Management of Diverticulitis: Perspectives from a National Sample of Colorectal Surgeons
Authors: Williamson Andrea J.H. , Cain Brian T. , Hoggan Trevor J. , Larsen Madison W. , Kimball Elisabeth R. , Bloomquist Kennedi , Galyean Patrick , Zickmund Susan , Cohan Jessica N. 
Published: October 2023

BACKGROUND:
Diverticulitis is a complex, heterogeneous disease process which affects a diverse population of patients. In the elective management of this disease, treatment guidelines have shifted toward patient-centered, individualized decision making. It is not known what challenges surgeons face as they approach these nuanced treatment decisions in practice.

OBJECTIVE:
Identify opportunities to support colorectal surgeons in elective diverticulitis treatment.

DESIGN:
This was a qualitative study using standardized, semi-structured interviews to explore the perspectives of 29 colorectal surgeons recruited using a purposive sampling technique. Data were analyzed using an “open-coding” approach.

SETTINGS:
Interviews with a national sample of colorectal surgeons were conducted from a single center using an online video platform.

MAIN OUTCOME MEASURES:
Interviews explored surgeons’ experiences treating diverticulitis in the elective setting, focusing on perceived challenges in providing patient-centered care as well as opportunities to improve treatment decisions.

RESULTS:
Our qualitative analysis identified an overarching challenge in elective diverticulitis management for surgeons: difficulty ensuring adequate patient understanding of the risks and benefits of various treatments. This was thought to be due 1) pre-existing patient expectations about treatment and 2) lack of data regarding long-term treatment outcomes. Surgeons identified two potential opportunities to combat these challenges: 1) patient education and 2) additional research regarding treatment outcomes, with potential for development of diverticulitis-specific decision support tools.

LIMITATIONS:
These results are based on a national sample of colorectal surgeons, but capture qualitative data which is not intended to provide generalizable findings.

CONCLUSIONS:
As surgeons work toward providing individualized care for diverticulitis patients, they find it difficult to adequately counsel patients regarding the patient-specific risks of various treatments. The results of this study identify specific contributors to this problem as well as potential targets for intervention, which can guide future efforts to support surgeons in providing patient-centered care.
Overexpression of Human Soluble Epoxide Hydrolase Exacerbates Coronary Reactive Hyperemia Reduction in Angiotensin-II-Treated Mouse Hearts
Authors: Hanif Ahmad , Edin Matthew L. , Zeldin Darryl C. , Nayeem Mohammed A. 
Published: October 2023

Abstract:
Coronary reactive hyperemia (CRH) is impaired in cardiovascular diseases, and angiotensin-II (Ang-II) exacerbates it. However, it is unknown how Ang-II affects CRH in Tie2-sEH Tr (human-sEH-overexpressed) versus wild-type (WT) mice. sEH-overexpression resulted in CRH reduction in Tie2-sEH Tr versus WT. We hypothesized that Ang-II exacerbates CRH reduction in Tie2-sEH Tr versus WT. The Langendorff system measured coronary flow in Tie2-sEH Tr and WT. The hearts were exposed to 15-second ischemia, and CRH was assessed in 10 mice each. Repayment volume was reduced by 40.50% in WT treated with Ang-II versus WT (7.42 ± 0.8 to 4.49 ± 0.8 mL/g) and 48% in Tie2-sEH Tr treated with Ang-II versus Tie2-sEH Tr (5.18 ± 0.4 to 2.68 ± 0.3 mL/g). Ang-II decreased repayment duration by 50% in WT-treated with Ang-II versus WT (2.46 ± 0.5 to 1.24 ± 0.4 minutes) and 54% in Tie2-sEH Tr treated with Ang-II versus Tie2-sEH Tr (1.66 ± 0.4 to 0.76 ± 0.2 minutes). Peak repayment flow was reduced by 11.2% in WT treated with Ang-II versus WT (35.98 ± 0.7 to 32.11 ± 1.4 mL/g) and 4% in Tie2-sEH Tr treated with Ang-II versus Tie2-sEH Tr (32.18 ± 0.6 to 30.89 ± 1.5 mL/g). Furthermore, coronary flow was reduced by 43% in WT treated with Ang-II versus WT (14.2 ± 0.5 to 8.15 ± 0.8 mL/min/g) and 32% in Tie2-sEH Tr treated with Ang-II versus Tie2-sEH Tr (12.1 ± 0.8 to 8.3 ± 1.2 mL/min/g). Moreover, the Ang-II-AT1-receptor and CYP4A were increased in Tie2-sEHTr. Our results demonstrate that Ang-II exacerbates CRH reduction in Tie2-sEH Tr mice.
Concurrent Medication Adherence in Hypertensive Patients With High-Risk Comorbidities
Authors: Oh Oonjee , Lee Kyoung Suk 
Published: October 2023

Background
Hypertensive patients with high-risk comorbidities require medications for each condition, leading to greater burden. The number of chronic conditions can affect patients' concurrent medication adherence.

Objective
We aimed to compare the characteristics of groups based on their concurrent medication adherence and investigate the association between the number of high-risk comorbidities and concurrent medication adherence for patients with hypertension and high-risk comorbidities.

Methods
A secondary data analysis was performed with the 2018 Korea Health Panel Survey, including 2230 patients with hypertension and at least 1 high-risk comorbidity who were prescribed medications for at least 2 conditions. Using medication adherence for each condition, we identified 3 concurrent medication adherence groups: adherent, suboptimal, and nonadherent groups. Multinominal logistic regression was used to determine the association between the number of high-risk comorbidities and the concurrent medication adherence groups.

Results
Adherent, suboptimal, and nonadherent groups included 85%, 11%, and 4% of the patients, respectively. Whereas having more high-risk comorbidities was associated with belonging to the suboptimal group compared with the adherent group (adjusted odds ratio, 1.46), having fewer high-risk comorbidities was associated with belonging to the nonadherent group compared with the adherent group (adjusted odds ratio, 0.52).

Conclusions
We identified 3 groups based on their concurrent medication adherence. Our results indicated that the relationship of the number of high-risk comorbidities with the concurrent medication adherence group was inconsistent.
Physical Symptoms, Depressive Symptoms, and Quality of Life in Patients With Heart Failure
Authors: Heo Seongkum , Kang JungHee , Shin Mi-Seung , Lim Young-Hyo , Kim Sun Hwa , Kim Sangsuk , An Minjeong , Kim JinShil 
Published: October 2023

Background
Physical and psychological symptoms are prevalent in patients with heart failure (HF) and are associated with poor quality of life (QOL) and high hospitalization rates. Thus, it is critical to identify symptom clusters to better manage patients with high-risk symptom cluster(s) and to reduce adverse effects.

Objective
The aims of this study were to identify clusters of physical HF symptoms (ie, dyspnea during daytime, dyspnea when lying down, fatigue, chest pain, edema, sleeping difficulty, and dizziness) and depressive symptoms and to examine their association with QOL in patients with HF.

Methods
In this secondary analysis of a cross-sectional study, data on physical HF symptoms (Symptom Status Questionnaire), depressive symptoms (Patient Health Questionnaire-9), and general QOL (European Quality of Scale-Visual Analog Scale) were collected. We identified clusters based on the physical HF symptoms and depressive symptoms using 2-step and k-means cluster analysis methods.

Results
Chest pain was removed from the model because of the low importance value. Two clusters were revealed (cluster 1, severe symptom cluster, vs cluster 2, less severe symptom cluster) based on the 7 symptoms. In cluster 1, all of the 7 symptoms were more severe, and QOL was poorer than those in cluster 2 (all Ps < .001). All the mean and median scores of the 7 symptoms in cluster 1 were higher than those in cluster 2.

Conclusions
Patients with HF were clearly divided into 2 clusters based on physical HF symptoms and depressive symptoms, which were associated with QOL. Clinicians should assess these symptoms to improve patient outcomes.
Depression, Anxiety, and Resilience
Authors: Kutcher Anna M. , Byon Ha Do , Esquivel Jill Howie 
Published: October 2023

Background
Engaging in self-care behaviors improves outcomes in patients with heart failure. Identifying psychological factors that affect self-care behaviors and the role of resilience may inform interventions that improve outcomes.

Objectives
The study objective was to determine the relationships among depression, anxiety, resilience, and self-care, including whether resilience mediates or moderates the effects of depression and anxiety on self-care.

Methods
Pearson correlation coefficients were computed to estimate the relationships of depression, anxiety, and resilience with self-care behaviors. Mediating and moderating effects of resilience on the relationships of depression and anxiety with self-care were evaluated using multiple linear regression.

Results
Depression and anxiety were associated with lower self-care. Higher resilience was associated with lower depression and anxiety, but resilience did not mediate or moderate the relationship of depression and anxiety with self-care.

Conclusions
Interventions that foster resilience may improve outcomes by reducing anxiety and depression in patients with heart failure.
Applying the Urgent Maternal Warning Signs Initiative in a Novel Setting
Authors: Jenkins Katherine , Quarshie Evelyn , Phommasathit Crystal , Menegay Michelle , Lorenz Allison , Schneider Patrick , Oza-Frank Reena , Haviland Breanne , Kristofzski-Raizor Heather , Gogan Turner Dyane 
Published: October 2023

ABSTRACT
Symptoms of urgent maternal warning signs (UMWS) may occur during pregnancy or after delivery and may have lasting effects or indicate a life-threatening situation if left untreated. The state department of health sponsored a quality improvement project (QIP) to broaden the reach of UMWS education beyond traditional clinical settings, to public health settings where prenatal and postpartum women are seen. Specifically, the QIP implemented process changes to provide education (written and verbal) and resources to individuals receiving services from Women, Infants, and Children clinics during pregnancy and up to 12 weeks postpartum. Clinics submitted participant-level data although the Research Electronic Data Capture secure data portal. The key results indicated an increase in both written and verbal education. In addition, the project monitored referrals made specific to conditions identified through project-specific data collection and the provision of UMWS education.
Assessing the Reconceptualization of Pain in Graduate-Entry Physiotherapy Students Using the Concept of Pain Inventory for Adults: The University of Technology Sydney Physiotherapy Student Surveys Project
Authors: Pate Joshua W. , Ilhan Emre , Rush Gillian Q. , Kennedy David S. , Verhagen Arianne , Pacey Verity , Stubbs Peter W. 
Published: October 2023

Introduction.
Validly and reliably assessing conceptual change is essential for evaluating the effectiveness of pain science education for physiotherapy students. We aimed to 1) evaluate concept of pain before and after a 14-week pain science education university subject, 2) assess structural validity of the Concept of Pain Inventory for Adults (COPI-Adult) in postgraduate entry-level physiotherapy students, and 3) explore possible relationships between baseline variables and baseline COPI-Adult scores.

Review of Literature.
As the COPI-Adult is a newly developed questionnaire, there is a lack of data regarding its psychometric properties.

Subjects.
Of 129 enrolled students at an Australian university, 124 (96%) and 114 (88%) completed the baseline and follow-up questionnaires, respectively.

Methods.
In this prospective cohort study, students who commenced the degree in 2020 or 2021 completed online questionnaires, including the COPI-Adult, at the start and end of their first semester. This semester included a 14-week pain science education subject and other physiotherapy-related subjects. Higher COPI-Adult scores (range = 0–52) indicate better alignment with contemporary pain science. We 1) compared differences in concept of pain before and after the semester, 2) performed a confirmatory factor analysis on the COPI-Adult, and 3) performed exploratory regression analyses.

Results.
Concept of Pain Inventory for Adults scores increased from baseline (median [interquartile range]: 39 [36–44]) to follow-up (48 [44–51]). The COPI-Adult retained its 1-factor structure, with acceptable internal consistency (Cronbach's alpha = 0.80). Exploratory analysis showed that previously completing a subject on pain was related to higher COPI-Adult baseline scores. Age, gender, and mental health diagnosis did not relate to baseline COPI-Adult scores.

Discussion and Conclusion.
Following a 14-week pain science education subject embedded within a physiotherapy degree, students improved their concept of pain. The COPI-Adult maintains a 1-factor structure in this population. Completing a previous subject on pain was associated with higher COPI-Adult scores.
Olfactory Reference Syndrome
Authors: Tada Koji 
Published: October 2023

Abstract
Olfactory reference syndrome (ORS) is known to have the clinical features of both obsessive-compulsive disorder (OCD) and social anxiety disorder (SAD). However, there has been no clear explanation as to why ORS has the characteristics of two different disorders. In the present study, the comorbidity rates of ORS in patients with SAD (without OCD, n = 83), ORS in patients with OCD (without SAD, n = 42), and patients with SAD and OCD comorbidity (n = 17) were compared. Of all 142 patients studied, 11 were diagnosed with ORS. The comorbidity rate of ORS in comorbid SAD/OCD group was significantly higher than those in both SAD and OCD groups. Logistic regression analysis of 100 cases of SAD and selected 69 cases of generalized SAD showed that the risk of ORS was significantly higher in patients with OCD and bulimia nervosa. Of 59 cases with OCD, the risk of ORS was significantly higher in patients with SAD. The results of the present study suggest that the comorbidity of SAD and OCD most likely explains the development of ORS.
Treatment of primary cancer in metastatic hormone-sensitive prostate cancer
Authors: Lim Kylie Y.-Y. , Alberto Matthew , Ranasinghe Weranja 
Published: October 2023

Purpose of review
Recently, there has been emerging interest in the treatment of primary tumours in metastatic prostate cancer based on major trials that have provided evidence for radiation therapy and cytoreductive radical prostatectomy. Preclinical studies have further established the molecular features of metastatic disease that provide a rationale for primary treatment.

Recent findings
Several randomised controlled trials and other prospective studies have demonstrated a benefit in overall survival, predominantly in low-volume disease. Advancements in precision medicine also offer insight into improving selection, staging and monitoring.

Summary
In this review, the authors highlight and review recent data on emerging and established treatment options and shift towards personalised medicine for hormone-sensitive metastatic prostate cancer.
Balance and Gait
Authors: Conceição Aline S.G.G. , Sant´Ana Lívea F.G. , Mattar Guilherme P. , de Fátima R. Silva Maria , Ramos Andressa R. , Oliveira Alexandra M. , Carvalho Claudia L. , Gonçalves Octavio R. , Varotto Bruna L.R. , Martinez Luana D. , Leduc Vinícius , Fonseca Luciana M. , Forlenza Orestes V. 
Published: October 2023

Background:
Atypical aging in Down syndrome (DS) is associated with neuropathological characteristics consistent with Alzheimer disease. Gait abnormalities have been shown to be associated with an increased risk of dementia for the general population. The aim of this study was to determine whether gait disorders are associated with worse cognitive performance and dementia in adults with DS.

Methods:
We evaluated 66 individuals with DS (≥20 y of age), divided into 3 groups: stable cognition, prodromal dementia, and dementia (presumed Alzheimer disease). Each individual was evaluated with the Performance-Oriented Mobility Assessment (POMA), Timed Up and Go test, and Cambridge Examination for Mental Disorders of Older People with Down’s Syndrome and Others with Intellectual Disabilities (CAMDEX-DS), in addition to a comprehensive clinical protocol to ascertain the occurrence of medical or psychiatric comorbidities.

Results:
The score on the POMA-Gait subscale score and body mass index were found to be independent predictors of prodromal dementia and dementia (P<0.001 for both). With the exception of perception, all cognitive domains correlated with the POMA-Total score (P<0.05).

Conclusion:
A lower POMA-Gait score increases the chance of prodromal dementia and dementia in adults with DS. Unlike other research, in this study higher body mass index was also found to increase the chance of prodromal dementia and dementia. In those individuals, applying the POMA could facilitate the early diagnosis of dementia, help identify fall risks, and promote the adoption of geriatric interventions focused on improving functional mobility.