bluuebunny/crossref_metadata_2025_split huggingface dataset:
Feasibility of home dose optimization of apomorphine sublingual film in Parkinson’s disease patients with OFF episodes: results from the dose-optimization phase of an open-label, randomized crossover study
Authors: Kassubek Jan , Stocchi Fabrizio , Martinez Ernest Balaguer , Pahwa Rajesh , Ondo William , Zhang Yi , Bowling Alyssa , Pappert Eric , Isaacson Stuart , Wu Stacy ,   for the CTH-302 Study Investigators*
Published: November 2023

Background: Dose optimization of sublingual apomorphine (SL-APO), a dopamine agonist for the treatment of OFF episodes in patients with Parkinson’s disease (PD), has been performed under clinical supervision in clinical trials. SL-APO may be a candidate for home dosing optimization which would be less burdensome for patients. Objectives: To evaluate the feasibility and safety of home optimization of SL-APO in patients with PD and OFF episodes. Design: A multicenter, randomized, crossover study comparing SL-APO with subcutaneous apomorphine was conducted, comprising an open-label dose-optimization phase and a treatment phase. This non-comparative analysis focuses on the outcomes of the dose-optimization phase with SL-APO only. Methods: Patients with PD and OFF episodes received SL-APO at an initial dose of 10 mg in the clinic (open-label). Further optimization could continue at home in 5 mg increments during subsequent OFF episodes (maximum dose of 30 mg). Optimization and tolerability were assessed daily by patient-reported feedback via telephone. Patients reporting a FULL ON returned to the clinic for a dose-confirmation visit (DCV). In patients with inadequate response as determined during the DCV, the dose could be further optimized at home. Results: Home optimization was continued by 81.4% (83/102) of patients. Of these, 80.7% identified an effective, tolerable dose. Mean time between initial clinic visit and DCV 1 was 6.8 days, and the final optimized dose of SL-APO was 30 mg (mode). In total, 62.7% of patients reported ⩾1 adverse event; the most common included nausea (31.4%), dizziness (9.8%), somnolence (8.8%), dyskinesia (7.8%), and fatigue (5.9%). The safety profile in this study in which most patients performed home dose optimization was consistent with the study utilizing clinic-based optimization. Conclusion: After the first clinic dose, home dose optimization of SL-APO appears feasible in patients with PD and OFF episodes, with most patients identifying their optimal SL-APO dose at home. Trial registration: This study is registered with EudraCT (2016-003456-7): Clinical Trials register – Search for eudract_number:2016-003456-70.
Results From a Virtual Clinic for the Follow-up of Patients Using the Advanced Hybrid Closed-Loop System
Authors: Gómez Medina Ana María , Henao Carrillo Diana Cristina , Silva León Julio David , Gómez González Javier Alberto , Muñoz Velandia Oscar Mauricio , Conde Brahim Lucia , Mecón Prada Guillermo Andrés , Rondón Sepúlveda Martin 
Published: November 2023

Background: Evidence regarding the implementation of medium-term strategies in advanced hybrid closed-loop (AHCL) system users is limited. Therefore, this study aimed to describe the efficacy and safety of the AHCL system in patients with type 1 diabetes (T1D) on a six-month follow-up in a virtual diabetes clinic (VDC). Method: A prospective cohort of adult patients with T1D treated using the AHCL system (Mini Med 780G; Medtronic, Northridge, California) in a VDC follow-up. Standardized training and follow-up were conducted virtually. Clinical data and metabolic control outcomes were reported at baseline, and at three and six months. Results: Sixty-four patients (mean age = 42 ± 14.6 years, 65% men, 54% with graduate education) were included. Percentage time in range (%TIR) increased significantly regardless of prior therapy with intermittently scanned continuous glucose monitoring + multiple daily injections and sensor-augmented pump therapy with predictive low-glucose management after starting AHCL and persisted during the follow-up period with no hypoglycemic events. The %TIR 70 to 180 mg/dL according to socioeconomic strata was 73.4% ± 5.3%, 78.1% ± 8.1%, and 84.2% ± 7.5% for the lower, middle, and upper strata, respectively. The sensor was used more frequently in the population with a higher education level. Adherence to sensor use and SmartGuard retention were higher in patients who underwent the VDC follow-up. Conclusions: Medium-term follow-up of users of AHCL systems in a VDC contributes to safely achieving %TIR goals. Virtual diabetes clinic follow-up favored adherence to sensor use and continuous SmartGuard use. Socioeconomic strata were associated with a better glycemic profile and education level was associated with better adherence to sensor use.
Synergistic effect of albuminuria on atherosclerosis in patients with primary aldosteronism
Authors: Kao Ting-Wei , Liao Che-Wei , Tsai Cheng-Hsuan , Chang Yi-Yao , Pan Chien-Ting , Chang Chin-Chen , Lee Bo-Ching , Huang Wei-Chieh , Huang Kuo-How , Lu Ching-Chu , Lai Tai-Shuan , Chan Chieh-Kai , Chueh Jeff S. , Wu Vin-Cent , Hung Chi-Sheng , Chen Zheng-Wei , Lin Yen-Hung 
Published: November 2023

Background: Primary aldosteronism (PA) has been associated with atherosclerosis beyond the extent of essential hypertension, but the impact of albuminuria remains unknown. Objective: To investigate the effect of concomitant albuminuria on arterial stiffness in PA. Design: Prospective cohort study. Methods: A prospective cohort study was conducted to evaluate the association of albuminuria (>30 mg/g in morning spot urine) with arterial stiffness, as measured non-invasively by pulse wave velocity (PWV) in patients with PA. Propensity score matching (PSM) with age, sex, diabetes, systolic and diastolic blood pressure, creatinine, potassium, number of antihypertensive medications, and hypertension history was used to balance baseline characteristics. The effects of albuminuria on PWV before and 1 year after treatment were analyzed. Results: A total of 840 patients with PA were enrolled, of whom 243 had concomitant albuminuria. After PSM, there were no significant differences in baseline demographic parameters except alpha-blocker and spironolactone use. PWV was greater in the presence of albuminuria ( p = 0.012) and positively correlated with urine albumin–creatinine ratio. Multivariable regression analysis identified albuminuria, age, body weight, systolic blood pressure, and calcium channel blocker use as independent predictors of PWV. As for treatment response, only PA patients with albuminuria showed significant improvements in PWV after PSM ( p = 0.001). The magnitude of improvement in PWV increased with urine albumin–creatinine ratio and reached plateau when it exceeded 100 mg/g according to restricted cubic spline analysis. Conclusion: Concomitant albuminuria in PA was associated with greater arterial stiffness and more substantial improvement after targeted treatment. Both the baseline and the improved extent of PWV increased in correlation with rising urine albumin–creatinine ratio levels, reaching a plateau when the urine albumin–creatinine ratio surpassed 100 mg/g.
Acceptability rate and barriers to COVID-19 vaccination among healthcare workers in Chukwuemeka Odumegwu Ojukwu University Teaching Hospital, Amaku-Awka, Nigeria
Authors: Joe-Ikechebelu Ngozi Nneka , Umeh Uche Marian , Eleje George Uchenna , Igbodike Emeka Philip , Ogbuefi Emmanuel Okwudili , Akanwa Angela Oyilieze , Echendu Sylvia Tochukwu , Ngene Williams Onyeka , Okpala Augusta Nkiruka , Okolo Onyinye Chigozie , Okechukwu Chidubem Ekpereamaka , Akabuike Josephat Chukwudi , Agu Helen Obioma , Okpala Vincent Ogochukwu , Nwazor Onyinye Chinenye , Nnedum Anthony Obiajulu Ugochukwu , Esimone Chinyere Celestina , Agwaniru Hephzibah Ngozi , Ezeabasili Ethel Ifeoma , Joe-Ikechebelu Belusochi Blessing 
Published: November 2023

Background: Healthcare workers were at the forefront of the COVID-19 pandemic. The acceptability and uptake of COVID-19 vaccines among healthcare workers was an important strategy in halting the spread of the virus as well as the antecedent implications on global health and the world economy. Objectives: This study aims to determine the acceptability rate and barriers to COVID-19 vaccination of frontline healthcare workers in Awka, Nigeria. Design: This is an analytical cross-sectional study. Methods: An online cross-sectional survey was conducted from February 2022 to April 2022 to obtain the data for this study. One hundred healthcare workers were studied. Acceptability rate and barriers to uptake of COVID-19 vaccination were outcome measures. Results: The COVID-19 vaccination rate was 45.0% among healthcare workers in study area of Awka metropolis. Ages 30–39 years had the highest acceptance rate of COVID-19 vaccination, 19 (47.5%; p = 0.262) with a more female preponderance of COVID-19 vaccine acceptance compared to males [26 (41.3%) vs 16 (42.2%), p = 0.721]. The place of residence of respondents (urban vs rural) and their marital status (married vs single) appeared not to influence the acceptance of COVID-19 vaccination [(38 (42.2%) vs 3 (33.3%); p = 0.667; 25 (36.8% vs 17 (54.8%); p = 0.433)]. Years of work experience (<10 years vs >10 years) significantly affected COVID-19 vaccine acceptance [27 (45.8%) vs 12 (52.2%); p = 0.029]. Educational status and monthly income appeared not to influence vaccine uptake ( p > 0.05, for both). A significant number of respondents were not sure why they should or should not take the COVID-19 vaccine [49 (92.5%) vs 35 (83.3%); p = 0.001]. Conclusion: The COVID-19 vaccination rate is still poor among healthcare workers in Awka metropolis. The majority of respondents do not know why they should or should not take COVID-19 vaccine. We therefore recommend robust awareness campaigns that will explain in clear terms the essence and efficacy of COVID-19 vaccination in order to improve vaccine acceptance.
Quality of life of stroke survivors in Bangladesh
Authors: Sarkar Shimu , Rahman Ayesha , Islam Nashid , Emran Md Ali , Biswas Jheelam 
Published: November 2023

Objective: In Bangladesh, the factors that contribute to the reduced quality of life were not systematically investigated in long-term stroke survivors, and only a few studies have used preference-based measures to assess the quality of life. We sought to assess the quality of life in stroke survivors who comprise physical health status, psychological state, social relationship, and surrounding environment of the stroke patients. Methods: The quality of life among stroke patients was assessed with a semi-structured questionnaire using the validated Bangla Version of the World Health Organization, Quality-of-Life scale among the patients who survived beyond 28 days of first-ever stroke occurrence presenting in the Department of Physical Medicine and Rehabilitation, Bangabandhu Sheikh Mujib Medical University in the period between November 2020 and October 2021. Results: Of the 77 patients who were identified as post-stroke patients, the mean score of overall quality of life (as assessed by Q1 and scored in a range of 1–5) was 3.14 ± 1.08. The mean scores of quality of life were highest for the psychological domain (51.18 ± 19.73) followed by environmental (52.08 ± 13.13), social (45.62 ± 22.73), and physical domains (37.18 ± 18.56). According to the classification of the Bangla Version of the World Health Organization, Quality-of-Life, 75.3% had a low physical quality of life, 37.7% had a low psychological quality of life, 53.2% had a low social quality of life, and 53.2% had a moderate environmental quality of life. The average scores for the physical, psychological, social, and environmental domains were notably lower in stroke survivors with comorbid chronic conditions such as hypertension, diabetes, heart disease, asthma or chronic obstructive pulmonary disease, obesity, and ischemic heart disease in comparison to those without such conditions. Conclusion: In our study, post-stroke patients with lower quality of life were associated with factors such as female gender, lower level of education, urban dwellers, and chronic diseases.
Promoting patient self-management following cardiac rehabilitation using a web-based application: A pilot study
Authors: Stamm-Balderjahn Sabine , Bernert Sebastian , Rossek Susanne 
Published: November 2023

Background The use of health-related mobile apps has become an important component of healthcare. Patients can use a range of tools to strengthen their health literacy and promote disease management. The aim of the project was to develop a web-based application for use on smartphones, tablets and computers for patients with cardiovascular diseases (cardio-app). Methods A semi-standardized written survey was conducted among rehabilitation patients with cardiovascular diseases ( n = 158). The usability of the cardio-app was assessed using the System Usability Scale (SUS). The usage behaviour was conducted with a self-developed questionnaire. Results The study enrolled 158 eligible rehabilitation patients. The SUS of the cardio-app determined was 74.4 (SD ± 17.4). For 86%, the menu navigation was self-explanatory and logical. The visual presentation appealed to 92% of respondents. The content of the texts used in the app was understandable for 95%, and 93% found the technical terms used in the glossary well explained. For 57%, the app was helpful in planning their physical activities. 83% of the rehabilitation patients would recommend the app to others. The main criticisms of the app were the lack of synchronization options with other apps. Of those who did not use the app, the following reasons for non-use were most frequently cited: too much effort (43%), lack of time (29%) and pandemic-related reasons (29%). Conclusions The cardio-app revealed high agreement values. Whether the use of the app is associated with improved clinical state and outcome would have to be verified in further studies.
Telemedicine in nursing homes: Insights on the social acceptance and ethical acceptability of telemedical consultations
Authors: Offermann Julia , Ziefle Martina , Sira Nataliya , Groß Dominik ,   Optimal@NRW Research Group, Wilhelmy Saskia 
Published: November 2023

Introduction The increasing number of older adults in need of care, the resulting rise in demand for care services and the shortage of nursing staff are major challenges for society. In these situations, the use of telemedicine seems promising – especially in nursing homes when the focus is on rapid support in acute medical cases. However, in addition to the medical and technical potential, the acceptability and usability of the use of telemedical consultations are crucial for a sustainable implementation and acceptance. Our research aims at a holistic identification of socially and ethically relevant parameters for the evaluation of telemedical consultations in nursing homes. Methods Presentation of the empirical approach of an interdisciplinary cooperation that combines social and ethical research perspectives during an entire research project. Qualitative analysis of social and ethical aspects based on an interview study with care personnel (N = 14) who have experiences with telemedical consultations in nursing homes, as an example of this interdisciplinary collaboration and to show first insights. Results The results of the interview study show a slightly positive evaluation of the use of telemedical consultations in nursing homes. Six main categories were identified to capture and differentiate ethically and socially relevant perceived benefits and barriers (contact with physicians, general, personnel-related, residents-related, technical, and organizational aspects). Conclusion The study results allow initial recommendations for the implementation of telemedicine consultations in nursing homes considering socially and ethically relevant aspects. These recommendations can be used to inform medical and technical experts in the field of telemedicine. In addition, the presentation of the interdisciplinary collaboration shows that the close integration of social and ethical aspects in research enables a holistic dimension of the use of telemedicine.
Cross-cultural adaptation and preliminary validation of the Arabic version of the Rosenbaum Concussion Knowledge and Attitudes Survey - Student Version (RoCKAS-ST-A)
Authors: Almutairi Anwar B. , Albous Jouzah , Almutairi Madhawi , Alenezi Nourah , Alfadhli Shaikah , Aldhafeeri Shouq 
Published: November 2023

Objective to cross-culturally adapt the Rosenbaum Concussion Knowledge and Attitudes Survey - Student Version (RoCKAS-ST) into Arabic (RoCKAS-ST-A), and to evaluate its psychometric properties (i.e., face validity, internal consistency and test-retest reliability) of the Arabic version 16 of the RoCKAS-ST (RoCKAS-ST-A). Design cross-cultural and preliminary validation of the of the Arabic version of the Rosenbaum Concussion Knowledge and Attitudes Survey - Student Version (RoCKAS-ST-A). Setting youth clubs and after-school activities centers around Kuwait. Participants Adolescent and young adults, aged 13–20 years old, both sexes. Independent Variables age, sex, and type of sport (if any). Main Outcome measure RoCKAS-ST-A questionnaire answers and demographics of participants. Results Two hundred and thirty-four adolescent and young adults ( n = 234) participated in this study (mean age = 15.95, SD = 1.92). More than half of the participants were males ( n = 163, 69.66%). The internal consistency for the concussion knowledge index (CKI) and concussion attitude index (CAI) ranged between fair and good (α = 0.31 & 0.97, respectively). The test-retest reliability of CKI score was 0.79 (95% CI = 0.42–0.92, P < 0.05) and of CAI was 0.86 (95% CI =0.66–0.94, P < 0.05). The average time between the 2 tests was 9.35 ± 2.44 days. Conclusion RoCKAS-ST-A is a reliable, valid, and feasible tool to examine the knowledge about and attitudes toward sport-related concussions (SRC) in adolescents and young adults with Arabic as their first language. Decreased knowledge and unsafe attitudes toward SRC was exhibited among adolescents and young adults in Kuwait.
Long-Term Results of Minimally Invasive Transforaminal Lumbar Interbody Fusion in Elderly Patients: A 5-Year Follow-Up Study
Authors: Goh Graham S. , Tay Adriel You Wei , Zeng Gerald J. , Soh Reuben Chee Cheong 
Published: November 2023

Study Design Retrospective review of prospective data. Objectives Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) may be beneficial for elderly patients due to decreased surgical morbidity and faster postoperative recovery. This study compared the clinical and radiological outcomes of MIS-TLIF in elderly patients and younger controls at minimum 5-year follow-up. Methods There were 120 patients who underwent single-level MIS-TLIF for degenerative spondylolisthesis. Elderly patients (≥70 years; n = 30) and controls (<70 years; n = 90) were matched 1:3 for demographics, comorbidities and preoperative patient-reported outcomes (PROs). The Oswestry Disability Index (ODI), 36-Item Short-Form Physical (SF-36 PCS) and Mental Component Summary (SF-36 MCS), Visual Analogue Scale (VAS) back pain, and VAS leg pain were compared at 6 months, 2 years and 5 years. Radiographic fusion, adjacent segment degeneration (ASD) and revision rates were assessed at mean 7.2 ± 2.0 years. Results Elderly patients had longer length of stay (4.7 ± 5.8 vs 3.3 ± 1.4 days, P = .035) and more readmissions (10% vs 1%, P = .019), but there was no difference in operative time, transfusions, complications or discharge disposition. All PROs were comparable at 5 years and satisfaction rates were similar (93% elderly vs 91% controls, P = .703). The rates of radiographic fusion in the control group and elderly group were similar (94% vs 97%, P = .605), as were the rates of ASD (40% vs 33%, P = .503). There were 3 revisions (3.3%) in the control group (2 for ASD, 1 for screw loosening) but none in the elderly group ( P = .311). Conclusions Elderly patients undergoing MIS-TLIF achieved similar improvements in pain, disability and quality of life that were sustained at 5 years. Level of Evidence: Level III, retrospective cohort study
Effect of Age and Femoral Tunnel Drilling Technique on the Prevalence of Intra-articular Pathology at Both Primary and Revision ACL Reconstruction
Authors: Brown Michael J.C. , Klemm Haydn J. , Webster Kate E. , Feller Julian A. 
Published: November 2023

Background: Studies have shown that meniscal and chondral lesions are more common at the time of revision anterior cruciate ligament reconstruction (ACLR) compared with primary surgery; however, few have evaluated the same patients through both primary and revision surgery. Purpose: To describe the prevalence of meniscal and chondral lesions at the time of primary and subsequent revision ACLR and to determine the effect of age and femoral tunnel drilling technique on the development of intra-articular pathology over time. Study Design: Case series; Level of evidence, 4. Methods: All patients who had primary and subsequent revision ACLR in the same knee between 1997 and 2022 were identified from a prospectively collated database. The grading of chondral surfaces in each compartment, the presence of any meniscal tears, and treatment performed were recorded. Patients were grouped according to age and femoral tunnel drilling technique to allow subgroup analysis. Results: Overall, 262 patients were included. Median age at primary surgery was 20.2 years. Lateral meniscal tears were more prevalent than medial tears at both primary (34.7% vs 28.2%; P = .11) and revision surgery (44.3% vs 40.8%; P = .43). Chondral lesions were most frequently found on the patella (8.8%) and the medial femoral condyle (MFC; 8.0%) at primary surgery. Between surgeries, new lesions developed most commonly on the MFC (13.0%) and the lateral femoral condyle (LFC; 11.1%). It was significantly more common for lateral meniscal tears treated with repair or left in situ at primary surgery to be healed at the time of revision surgery than medial tears ( P = .01). Significantly more patients who had transtibial drilling of the femoral tunnel had a new meniscal tear at revision surgery ( P = .001). Age did not have a significant influence on the prevalence of meniscal pathology. Conclusion: The prevalence of intra-articular pathology increased between primary and revision ACLR. Lateral meniscal tears were more prevalent than medial tears at both surgeries. At revision surgery, new chondral lesions were more commonly found on the MFC than the LFC. The higher incidence of new meniscal tears observed in the transtibial group may reflect the more vertical graft orientation with this technique and its inferior ability to control rotation.