bluuebunny/crossref_metadata_2025_split huggingface dataset:
Wrist Extensor Muscle Fatigue During a Dual Task With Two Muscular and Cognitive Load Levels in Younger and Older Adults
Authors: Wagenblast Florestan , Läubli Thomas , Seibt Robert , Rieger Monika A. , Steinhilber Benjamin 
Published: December 2023

Objective To examine the effect of concurrent physical and cognitive demands as well as age on indicators of muscle fatigue at the wrist. Background There are few studies examining risk indicators for musculoskeletal disorders associated with work-related physical and cognitive demands that often occur simultaneously in the workplace. Methods Twenty-four gender-balanced older and 24 gender-balanced younger (mean age 60 and 23 years) participants performed four 30 min dual tasks. Tasks differed by the muscular load level during force tracking: 5% and 10% of maximum voluntary contraction force (MVC) and concurrent cognitive demands on the working memory: easy and difficult. Muscle fatigue was assessed by MVC decline and changes in surface electromyography (increased root mean square: RMS, decreased median frequency: MF) at the extensor digitorum (ED) and extensor carpi ulnaris (EU). Results A decline in MVC was found in all participants when tracking was performed at 10% MVC (mean ± SD: 137.9 ± 49.2 – 123.0 ± 45.3 N). Irrespective of age, muscular, or cognitive load, RMS increased (ED 12.3 ± 6.5 – 14.1 ± 7.0% MVE, EU 15.4 ± 7.6 – 16.9 ± 8.6% MVE) and MF decreased (ED 85.4 ± 13.6 – 83.2 ± 12.8 Hz, EU 107.2 ± 17.1 – 104.3 ± 16.7 Hz) in both muscles. However, changes in MF of EU tended to be more pronounced in the older group at higher cognitive and lower muscular load, without reaching statistical significance. Conclusion Maximum voluntary contraction indicated no interaction between muscle fatigue, cognitive load, or age. However, the tendencies toward altered muscle activity due to an increase in cognitive load and older age suggest muscular adaptations while maintaining tracking performance during the onset of fatigue signs in the sEMG signal. Application If the tendencies in muscle activity are confirmed by further studies, ergonomic assessments in industrial workplaces should consider cognitive load and age when describing the risk of musculoskeletal disorders.
Hope, resilience and subjective happiness among general population of Paraguay in the post COVID-19 pandemic
Authors: Torales Julio , Barrios Iván , Melgarejo Osvaldo , Ruiz Díaz Noelia , O’Higgins Marcelo , Navarro Rodrigo , Amarilla Diego , Almirón-Santacruz José , González-Urbieta Israel , Caycho-Rodríguez Tomás , Castaldelli-Maia João Mauricio , Ventriglio Antonio 
Published: December 2023

Background: Positive mental health includes not only the absence of mental disorders but also the presence of subjective well-being, good coping strategies for life stress, and strategies for adapting to community life. It is well known that the COVID-19 pandemic has challenged mental health in general population worldwide. However, research has not measured protective factors for mental health in the general population after the declared end of pandemic by the World Health Organization. Methods: This observational, cross-sectional study surveyed 591 Paraguayan participants aged ⩾18 years, who were recruited through an online survey. Demographic characteristics, socioeconomic status were collected as well as mental health and validated tools for hope, resilience, subjective happiness were administered. Results: Of the participants, 81.6% were women, 54% were married or in a relationship and 90.7% reported an university education. The main source of stress was economic issues (30.3%). A total of 22.7% had been previously diagnosed with a mental disorder, 22.2% had consulted a mental health professional and 10.8% had consumed prescription drugs. 42.6% reported flourishing, 36.2% reported moderate and 21.2% reported languishing mental health. Conclusions: This large survey has shown that most of participants reported a flourishing mental health with high ratings at hope, resilience, and subjective happiness scales. Also, the main sources of stress were economic issues, not consequently related to the pandemic. This may add evidences to the international debate on the long term effects of the global pandemic and probably suggests that recovery processes have been collectively adopted in Paraguay.
Mixed methods, single case design, feasibility trial of a motivational conversational agent for rehabilitation for adults with traumatic brain injury
Authors: Hocking Judith , Maeder Anthony , Powers David , Perimal-Lewis Lua , Dodd Beverley , Lange Belinda 
Published: December 2023

Objective Rehabilitation for adults with traumatic brain injury (TBI) incorporates client-centred goal-setting and motivational support to achieve goals. However, face-to-face rehabilitation is time-limited. New therapy approaches which leverage care are warranted. Conversational agents (CAs) offer a human–computer interface with which a person can converse. This study tested the feasibility, usability and acceptability of using a novel CA – RehabChat – alongside brain injury rehabilitation. Design Mixed methods, single case design, feasibility pilot trial. Setting Ambulatory and community brain injury rehabilitation. Participants Adults with TBI receiving brain injury rehabilitation and clinicians providing this care. Intervention Following 1:1 training, client–clinician dyads used RehabChat for two weeks alongside usual care. Main measures Pre-post clinical measures (Motivation for Traumatic Brain Injury Rehabilitation Questionnaire, Rehabilitation Therapy Engagement Scale, Brain Injury Rehabilitation Trust Motivation Questionnaire-Relative, Brain Injury Rehabilitation Trust Motivation Questionnaire-Self) repeated measures (Hospital Anxiety and Depression Scale, researcher-developed wellbeing screening questions); and post-intervention (System Usability Scale (SUS), semi-structured 1:1 interview). Results Six participants (two clients and four clinicians) completed training. Two client–clinician dyads completed the intervention. Two other clinicians used RehabChat in a mock client–clinician session. SUS scores indicated good usability. Client well-being did not deteriorate. No adverse events were experienced. Interviews indicated RehabChat was feasible, acceptable and easy to use; and supported motivation, goal-setting and completing practice activities. Conclusions RehabChat was feasible and acceptable to use alongside usual ambulatory and community brain injury rehabilitation, had good usability and supported client needs. Further testing of RehabChat with a larger cohort for longer duration is warranted.
Healthcare professionals’ experiences of delivering a stroke Early Supported Discharge service – An example from Ireland
Authors: O Connor Elaine , Dolan Eamon , Horgan Frances , Galvin Rose , Robinson Katie 
Published: December 2023

Objective To explore healthcare professionals’ experiences of the development and delivery of Early Supported Discharge for people after stroke, including experiences of the COVID-19 pandemic. Design Qualitative descriptive study using one-to-one semi-structured interviews. Data were analysed using reflexive thematic analysis. Setting Nine Early Supported Discharge service sites in Ireland. Participants Purposive sampling identified 16 healthcare professionals. Results Five key themes were identified (1) Un-coordinated development of services, (2) Staff shortages limit the potential of Early Supported Discharge, (3) Limited utilisation of telerehabilitation post COVID-19 pandemic, (4) Families need information and support, and (5) Early Supported Discharge involves collaboration with people after stroke and their families. Conclusions Findings highlight how Early Supported Discharge services adapted during the COVID-19 pandemic and how gaps in the service impacts on service delivery. Practice implications include the need to address staff recruitment and retention issues to prevent service shortages and ensure consistent access to psychology services. Early Supported Discharge services should continue to work closely with families and address their information and support needs. Future research on how telerehabilitation can optimally be deployed and the impact of therapy assistants in Early Supported Discharge is needed.
Abuse potential assessment of the dual orexin receptor antagonist daridorexant in rats
Authors: Steiner Michel A , Toeroek-Schafroth Michael , Giusepponi Maria Elena , Dacome Lisa , Tessari Michela 
Published: December 2023

Background: Drugs that act on the central nervous system (CNS) and have sedative effects can lead to abuse in humans. New CNS-active drugs often require evaluation of their abuse potential in dedicated animal models before marketing approval. Daridorexant is a new dual orexin receptor antagonist (DORA) with sleep-promoting properties in animals and humans. It was approved in 2022 in the United States and Europe for the treatment of insomnia disorder. Aims: Nonclinical evaluation of abuse potential of daridorexant using three specific rat models assessing reinforcement, interoception, and withdrawal. Methods: Reinforcing effects of daridorexant were assessed in an operant rat model of intravenous drug self-administration. Similarity of interoceptive effects to those of the commonly used sleep medication zolpidem was tested in an operant drug discrimination task. Withdrawal signs indicative of physical dependence were evaluated upon sudden termination of chronic daridorexant treatment. Rat experiments were conducted at a dose range resulting in daridorexant plasma concentrations equaling or exceeding those achieved at the clinically recommended dose of 50 mg in humans. Results: Daridorexant had no reinforcing effects, was dissimilar to zolpidem in the drug discrimination task, and did not induce any withdrawal-related signs upon treatment discontinuation that would be indicative of physical dependence. Outcomes: Daridorexant showed no signs of abuse or dependence potential in rats. Our data indicate that daridorexant, like other DORAs, has a low potential for abuse in humans.
Increased FGFR3 is involved in T-2 toxin-induced lesions of hypertrophic cartilage associated with endemic osteoarthritis
Authors: Zhang Ying , Fang Qian , Liu Yinan , Zhang Dan , He Ying , Liu Fei , Sun Kun , Chen Jinghong 
Published: December 2023

This study evaluated the effect of fibroblast growth factor receptor 3 (FGFR3) on damaged hypertrophic chondrocytes of Kashin–Beck disease (KBD). Immunohistochemical staining was used to evaluate FGFR3 expression in growth plates from KBD rat models and engineered cartilage. In vitro study, hypertrophic chondrocytes were pretreated by FGFR3 binding inhibitor (BGJ398) for 24 h before incubation at different T-2 toxin concentrations. Differentiation -related genes (Runx2, Sox9, and Col Ⅹ) and ECM degradation -related genes (MMP-13, Col Ⅱ) in the hypertrophic chondrocytes were analyzed using RT-PCR, and the corresponding proteins were analyzed using western blotting. Hypertrophic chondrocytes death was detected by the Annexin V/PI double staining assay. The integrated optical density of FGFR3 staining was increased in knee cartilage of rats and engineered cartilage treated with T-2 toxin. Both protein and mRNA levels of Runx2, Sox9, Col Ⅱ, and Col Ⅹ were decreased in a dose-dependent manner when exposed to the T-2 toxin and significantly upregulated by 1 μM BGJ398. The expression of MMP-1, MMP-9, and MMP-13 increased in a dose-dependent manner when exposed to T-2 toxin and significantly reduced by 1 μM BGJ398. 1 μM BGJ398 could prevent early apoptosis and necrosis induced by the T-2 toxin. Inhibiting the FGFR3 signal could alleviate extracellular matrix degradation, abnormal chondrocytes differentiation, and excessive cell death in T-2 toxin-induced hypertrophic chondrocytes.
The efficacy of part-time patching treatment for intermittent exotropia on different age groups
Authors: Alkharashi Maan , Aldokhayel Fares , Alekrish Yazeed , Alotaibi Mohammed , Almazyad Laith Mazyad , Bajeaifer Yazen 
Published: December 2023

Background Intermittent exotropia (IXT) is one of the most common forms of strabismus usually seen in the pediatric age group, the prevalence of IXT is higher in Africa and the Middle East. IXT treatment strategies include both surgical and non-surgical methods, non-surgical management is preferred in general as it is less invasive and avoids the risks associated with surgery and anesthesia. Aims This study aims to determine the effectiveness of patching therapy for the treatment of IXT in different age groups and to compare the success of patching therapy in preventing surgery in IXT patients in different age groups. Methodology A retrospective chart review was conducted from September 2022 until February 2023 at King Abdulaziz University Hospital in Riyadh. The data was collected retrospectively from electronic medical records from 2016 to 2021 of all patients diagnosed with IXT and were managed by patching therapy fitting the inclusion criteria. Results A total of 76 patients with IXT enrolled in the study with 56.5% of the participants were older than 7 years old. Overall, there was no improvement in the angle of deviation but 34% of patients had improved control over the follow-up period. 55.3% of the participants didn't require surgery. Younger age, longer duration of patching per month, and good compliance were significantly associated with treatment success. Conclusion Younger age groups were more likely to benefit from patching therapy than older age groups, and good compliance to patching therapy is an important factor in preventing the need for surgery.
Unpacking and unpicking the challenge of 600 hours of preschool attendance
Authors: Harrison Linda J , Redman Tracy , Brown Judith E , Lavina Leanne , Davis Belinda , Degotardi Sheila , Fordham Loraine , Hadley Fay , Jones Catherine , Waniganayake Manjula , Wong Sandie 
Published: December 2023

The Australian Government’s (2022) Preschool Reform Funding Agreement and initiatives by state governments aim to lift enrolment and maximise the benefits of early childhood education (ECE) in the year before school. The Agreement is particularly relevant for children and families from vulnerable and disadvantaged backgrounds, many of whom do not utilise the annual attendance target of 600 hours available to every child. Children’s enrolment and daily attendance records are key to understanding participation in ECE, but few studies or government reports have examined this information in detail. Drawing on administrative records provided by 19 long day care and preschool centres/schools in areas of socio-economic disadvantage, we analysed weekly attendance for 971 preschool-aged children over four 10-week terms. Results for the ‘percentage of enrolled days’ attended (M = 88%) and ‘total hours’ attended (M = 576 h) approached the target but differed for children enrolled in preschool versus long day care.
Influence of Previous Arthroscopic Meniscectomy on Midterm to Long-term Outcomes After Medial Open-Wedge High Tibial Osteotomy
Authors: Kim Daean , Kim Kang-II , Kim Jun-Ho , Lee Sang Hak , Ko Taeyoung 
Published: December 2023

Background: Few studies have evaluated the clinical and radiological outcomes of medial open-wedge high tibial osteotomy (MOWHTO) in patients who had previously undergone arthroscopic meniscectomy. Purpose: To verify whether previous arthroscopic meniscectomy affects the clinical and radiological outcomes of MOWHTO. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 183 consecutive knees that underwent MOWHTO and had a minimum 5 years of follow-up were retrospectively reviewed. We compared the preoperative and postoperative clinical and radiological data of 32 knees with a history of meniscectomy (previous meniscectomy group) to 151 control knees without a history of meniscectomy. Cartilage status was also compared at first- and second-look arthroscopic surgery according to the International Cartilage Repair Society grading system. Failure was defined as conversion to total knee arthroplasty or revision MOWHTO. On subgroup analysis, the previous meniscectomy group was divided into 2 subgroups based on the time from meniscectomy to MOWHTO (<3 vs ≥3 years). Results: The mean age at the time of surgery was 55.9 years (range, 38-70 years), and the mean follow-up period was 86.2 months (range, 60-164 months). The mean time between meniscectomy and MOWHTO was 48.9 months (range, 5-156 months), and all meniscectomy procedures were performed on the medial side. Preoperative patient characteristics were similar between the study groups. Clinical and radiological outcomes were not significantly different between the groups at the latest follow-up, and no significant between-group differences were observed regarding postoperative cartilage status on arthroscopic examination. One knee in the control group underwent conversion to total knee arthroplasty at 7 years postoperatively for arthritic progression. Subgroup analysis of the previous meniscectomy group indicated no significant differences in clinical outcomes based on the time from meniscectomy to MOWHTO. Conclusion: Based on the results, a history of meniscectomy did not adversely affect the midterm to long-term outcomes of MOWHTO. Furthermore, the time between previous meniscectomy and MOWHTO was not associated with the clinical outcomes of MOWHTO.
Medical Students’ Attitudes Toward AI in Medicine and their Expectations for Medical Education
Authors: Kimmerle Joachim , Timm Jasmin , Festl-Wietek Teresa , Cress Ulrike , Herrmann-Werner Anne 
Published: December 2023

Objectives Artificial intelligence (AI) is used in a variety of contexts in medicine. This involves the use of algorithms and software that analyze digital information to make diagnoses and suggest adapted therapies. It is unclear, however, what medical students know about AI in medicine, how they evaluate its application, and what they expect from their medical training accordingly. In the study presented here, we aimed at providing answers to these questions. Methods In this survey study, we asked medical students about their assessment of AI in medicine and recorded their ideas and suggestions for considering this topic in medical education. Fifty-eight medical students completed the survey. Results Almost all participants were aware of the use of AI in medicine and had an adequate understanding of it. They perceived AI in medicine to be reliable, trustworthy, and technically competent, but did not have much faith in it. They considered AI in medicine to be rather intelligent but not anthropomorphic. Participants were interested in the opportunities of AI in the medical context and wanted to learn more about it. They indicated that basic AI knowledge should be taught in medical studies, in particular, knowledge about modes of operation, ethics, areas of application, reliability, and possible risks. Conclusions We discuss the implications of these findings for the curricular development in medical education. Medical students need to be equipped with the knowledge and skills to use AI effectively and ethically in their future practice. This includes understanding the limitations and potential biases of AI algorithms by teaching the sensible use of human oversight and continuous monitoring to catch errors in AI algorithms and ensure that final decisions are made by human clinicians.
Computer-aided detection thresholds for digital chest radiography interpretation in tuberculosis diagnostic algorithms
Authors: Vanobberghen Fiona , Keter Alfred Kipyegon , Jacobs Bart K.M. , Glass Tracy R. , Lynen Lutgarde , Law Irwin , Murphy Keelin , van Ginneken Bram , Ayakaka Irene , van Heerden Alastair , Maama Llang , Reither Klaus 
Published: December 2023

ObjectivesUse of computer-aided detection (CAD) software is recommended to improve tuberculosis screening and triage, but threshold determination is challenging if reference testing has not been performed in all individuals. We aimed to determine such thresholds through secondary analysis of the 2019 Lesotho national tuberculosis prevalence survey.MethodsSymptom screening and chest radiographs were performed in participants aged ≥15 years; those symptomatic or with abnormal chest radiographs provided samples for Xpert MTB/RIF and culture testing. Chest radiographs were processed using CAD4TB version 7. We used six methodological approaches to deal with participants who did not have bacteriological test results to estimate pulmonary tuberculosis prevalence and assess diagnostic accuracy.ResultsAmong 17 070 participants, 5214 (31%) had their tuberculosis status determined; 142 had tuberculosis. Prevalence estimates varied between methodological approaches (0.83–2.72%). Using multiple imputation to estimate tuberculosis status for those eligible but not tested, and assuming those not eligible for testing were negative, a CAD4TBv7 threshold of 13 had a sensitivity of 89.7% (95% CI 84.6–94.8) and a specificity of 74.2% (73.6–74.9), close to World Health Organization (WHO) target product profile criteria. Assuming all those not tested were negative produced similar results.ConclusionsThis is the first study to evaluate CAD4TB in a community screening context employing a range of approaches to account for unknown tuberculosis status. The assumption that those not tested are negative – regardless of testing eligibility status – was robust. As threshold determination must be context specific, our analytically straightforward approach should be adopted to leverage prevalence surveys for CAD threshold determination in other settings with a comparable proportion of eligible but not tested participants.
Contribution of pressure and flow changes to resistance reduction after pulmonary arterial hypertension treatment: a meta-analysis of 3898 patients
Authors: Farmakis Ioannis T. , Baroutidou Amalia , Patsiou Vasiliki , Arvanitaki Alexandra , Doundoulakis Ioannis , Hobohm Lukas , Zafeiropoulos Stefanos , Konstantinides Stavros V. , D'Alto Michele , Badagliacca Roberto , Giannakoulas George 
Published: December 2023

BackgroundPulmonary arterial hypertension (PAH)-targeted therapies exert significant haemodynamic changes; however, systematic synthesis is currently lacking.MethodsWe searched PubMed, CENTRAL and Web of Science for studies evaluating mean pulmonary artery pressure (mPAP), cardiac index/cardiac output (CI/CO) and pulmonary vascular resistance (PVR) of PAH-targeted therapies either in monotherapy or combinations as assessed by right heart catheterisation in treatment-naïve PAH patients. We performed a random-effects meta-analysis with meta-regression.ResultsWe included 68 studies (90 treatment groups) with 3898 patients (age 47.4±13.2 years, 74% women). In studies with small PVR reduction (<4 WU), CI/CO increase (R2=62%) and not mPAP reduction (R2=24%) was decisive for the PVR reduction (p<0.001 and p=0.36, respectively, in the multivariable meta-regression model); however, in studies with large PVR reduction (>4 WU), both CI/CO increase (R2=72%) and mPAP reduction (R2=35%) contributed significantly to the PVR reduction (p<0.001 and p=0.01, respectively). PVR reduction as a percentage of the pre-treatment value was more pronounced in the oral+prostanoid intravenous/subcutaneous combination therapy (mean difference −50.0%, 95% CI −60.8– −39.2%), compared to oral combination therapy (−41.7%, −47.6– −35.8%), prostanoidi.v./s.c.monotherapy (−31.8%, −37.6– −25.9%) and oral monotherapy (−21.6%, −25.4– −17.8%). Changes in haemodynamic parameters were significantly associated with changes in functional capacity of patients with PAH as expressed by the 6-min walking distance.ConclusionCombination therapies, especially with the inclusion of parenteral prostanoids, lead to remarkable haemodynamic improvement in treatment-naïve PAH patients and may unmask the contribution of mPAP reduction to the overall PVR reduction in addition to the increase in CO.