bluuebunny/crossref_metadata_2025_split huggingface dataset:
Aerobic physical exercise versus dual-task cognitive walking in cognitive rehabilitation of people with stroke: a randomized clinical trial
Authors: Maeneja Reinaldo , Silva Cláudia R. , Ferreira Inês S. , Abreu Ana Maria 
Published: October 2023

IntroductionStroke is a neurological deficit caused by an acute focal injury to the central nervous system due to vascular injury that can result in loss of neurological function, lasting brain damage, long-term disability and, in some cases, death. The literature reports that aerobic physical exercise, as well as dual-task cognitive walking, are used for the cognitive recovery of people with stroke. We aimed to assess whether aerobic physical exercise influences post-stroke cognitive recovery, namely performance on selective and sustained attention. We tested the hypothesis that post-stroke aerobic physical exercise leads to more significant gains than post-stroke dual-task cognitive walking.MethodsWe used a Randomized Clinical Trial, single-blind, parallel group, to verify the existence of differences between two groups. A total of 34 patients with subacute to chronic stroke were divided into two groups to train three times a week for 12 weeks: the aerobic physical exercise (PE) group engaged in 20 min on a treadmill, 20 min on a stationary bicycle and 5 min on a desk bike pedal exerciser per session; the dual-task (DT) gait exercise group walked for 45 min while simultaneously performing cognitive tasks per session. All participants were assessed on cognitive functioning with the Mini-Mental State Examination (MMSE) and d2 Test of Attention before acute interventions and post interventions. We have also applied a Visual Analog Scale to monitor the participants’ perceived difficulty, pre-, post-acute, and post-chronic interventions. Participants also responded to a Borg Scale of perceived exertion following the acute and the final session of chronic training.ResultsA mixed model ANOVA revealed a significant interaction effect with a large effect size for most of the cognitive variables under study. The variables associated with the d2 Test of Attention showed significant differences between the groups, mainly from T0 to T2. Also for MMSE, an ANOVA revealed a significant interaction effect with significant improvements from T0 to T2. Our results strongly suggest that aerobic physical exercise is more beneficial than dual-task cognitive-gait exercise since in the PE group, cognitive attention scores increase, and cognitive impairment and perception of exertion decrease, compared to the DT group.ConclusionThese findings support that PE provides more significant benefits for patients post-stroke when compared to DT.
Hard-to-treat or hard-to-catch? Clinical features and therapeutic outcomes of help-seeking foster care youths with mood disorders
Authors: Benarous Xavier , Lahaye Hélène , Pellerin Hugues , Consoli Angèle , Cohen David , Labelle Réal , Renaud Johanne , Gérardin Priscille , El-Khoury Fabienne , van der Waerden Judith , Guilé Jean-Marc 
Published: October 2023

IntroductionThe high level of emotional problems in youths placed in foster care contrasts with the limited use of evidence-based treatments. This study aims to better characterize the clinical features and therapeutic outcomes of foster care youths with mood disorders.MethodsA secondary analysis of data collected in the context of a French-Canadian clinical research network on pediatric mood disorders in four sites was conducted to compare three groups of patients with depressive or bipolar disorder: those without exposure to child welfare intervention (WCWI, n = 181), those who received non-placement psychosocial intervention (NPI, n = 62), and those in placement interventions (PI, n = 41).ResultsWe observed a very high rate of academic problems in patients in the groups NPI/PI compared to those in the WCWI group. Patients in the PI group had more disruptive behavioral disorders (OR = 6.87, 95% CI [3.25–14.52]), trauma-related disorders (OR = 3.78, 95% CI [1.6–8.94]), and any neurodevelopmental disorders (OR = 2.73, 95% CI [1.36–5.49]) compared to the other groups (NPI/WCWI). Among inpatients, the Clinical Global Impression-Improvement scale and the change in the Children Global Assessment Scale during the hospital stay did not differ across the three groups. We observed a higher prescription rate of antipsychotics in the PI group compared to the NPI/WCWI groups, but no significant difference for antidepressants and mood stabilizers.DiscussionThese findings support the view that, when provided with dedicated support, fostered inpatient youths can improve in a range comparable to other inpatients. Undetected neurodevelopmental disorders and academic problems are likely important contributors of the burden of mood disorders in these youths.
“Surrounded, detached”: the relationship between defensive peripersonal space and personality
Authors: Biggio Monica , Escelsior Andrea , Murri Martino Belvederi , Trabucco Alice , Delfante Federico , da Silva Beatriz Pereira , Bisio Ambra , Serafini Gianluca , Bove Marco , Amore Mario 
Published: October 2023

IntroductionPersonality shapes the cognitive, affective, and behavioral interactions between individuals and the environment. Defensive peripersonal space (DPPS) is the projected interface between the body and the world with a protective function for the body. Previous studies suggest that DPPS displays inter-individual variability that is associated with psychiatric symptoms, such as anxiety. However, DPPS may share a link with personality traits.MethodsFifty-five healthy participants were assessed with the Personality Inventory for DSM-5 (PID-5)–Adult to evaluate personality dimensions. Subjects underwent the Hand Blink Reflex (HBR) task that estimates the DPPS limits by assessing the modulation of blink intensity in response to the median nerve stimulation. Data of the HBR was analyzed with Bayesian multilevel models, while the relationship between DPPS and personality traits was explored using network analysis.ResultsHBR was best modeled using a piecewise linear regression model, with two distinct slope parameters for electromyographic data. Network analyzes showed a positive correlation between the proximal slope and detachment personality trait, suggesting that individuals with higher scores in the detachment trait had an increased modulation of HBR, resulting in a larger extension of the DPPS.DiscussionFeatures of the detachment personality trait include avoidance of interpersonal experiences, restricted affectivity, and suspiciousness, which affect interpersonal functioning. We suggest that DPPS may represent a characteristic feature of maladaptive personality traits, thus constitute a biomarker or a target for rehabilitative interventions.
Degeneracy and disordered brain networks in psychiatric patients using multivariate structural covariance analyzes
Authors: Paunova Rositsa , Ramponi Cristina , Kandilarova Sevdalina , Todeva-Radneva Anna , Latypova Adeliya , Stoyanov Drozdstoy , Kherif Ferath 
Published: October 2023

IntroductionIn this study, we applied multivariate methods to identify brain regions that have a critical role in shaping the connectivity patterns of networks associated with major psychiatric diagnoses, including schizophrenia (SCH), major depressive disorder (MDD) and bipolar disorder (BD) and healthy controls (HC). We used T1w images from 164 subjects: Schizophrenia (n = 17), bipolar disorder (n = 25), major depressive disorder (n = 68) and a healthy control group (n = 54).MethodsWe extracted regions of interest (ROIs) using a method based on the SHOOT algorithm of the SPM12 toolbox. We then performed multivariate structural covariance between the groups. For the regions identified as significant in t term of their covariance value, we calculated their eigencentrality as a measure of the influence of brain regions within the network. We applied a significance threshold of p = 0.001. Finally, we performed a cluster analysis to determine groups of regions that had similar eigencentrality profiles in different pairwise comparison networks in the observed groups.ResultsAs a result, we obtained 4 clusters with different brain regions that were diagnosis-specific. Cluster 1 showed the strongest discriminative values between SCH and HC and SCH and BD. Cluster 2 had the strongest discriminative value for the MDD patients, cluster 3 – for the BD patients. Cluster 4 seemed to contribute almost equally to the discrimination between the four groups.DiscussionOur results suggest that we can use the multivariate structural covariance method to identify specific regions that have higher predictive value for specific psychiatric diagnoses. In our research, we have identified brain signatures that suggest that degeneracy shapes brain networks in different ways both within and across major psychiatric disorders.
Stakeholders’ perception of factors influencing adoption of a pediatric weight management intervention: a qualitative study
Authors: Sierra-Velez Desiree , Gundewar Anisha , Persaud Alicia , Simione Meg , Castro Ines , Perkins Meghan , Lindros Jeanne , Salmon Jeremiah , Smith Justin D. , Taveras Elsie M. , Fiechtner Lauren 
Published: October 2023

BackgroundChildhood obesity is highly prevalent in the United States and disproportionately impacts communities of color and low-income populations; these disparities have worsened during the COVID-19 pandemic. Adoption of effective pediatric weight management interventions (PWMIs) that have been evaluated among low-income diverse populations is needed. The Healthy Weight Clinic PWMI, a package co-developed by the American Academy of Pediatrics and Massachusetts General Hospital, helps health centers establish multidisciplinary Healthy Weight Clinics based on previous randomized controlled trials which demonstrated effectiveness. We sought to identify the factors influencing successful adoption of this PWMI and understand adaptations needed prior to implementation in new sites.MethodsWe interviewed 20 stakeholders, 10 from two health centers in Mississippi where the Healthy Weight Clinic PWMI will be piloted (pre-implementation sites) and 10 from health centers that have previously implemented it (sites in maintenance stages). Separate interview guides informed by the Consolidated Framework for Implementation Research (CFIR) were developed for the pre-implementation sites and those in maintenance stages, including questions related to adaptations of the PWMI in response to the COVID-19 pandemic. Qualitative data analysis was conducted using directed content analysis based on CFIR constructs. Adaptations in response to the pandemic were categorized using Framework for Reporting Adaptations and Modifications-Expanded (FRAME).ResultsIn pre-implementation sites, an inner setting facilitator mentioned was a positive learning climate. Characteristics of individuals that can facilitate adoption include staff willingness to learn, valuing evidence-based care for childhood obesity, and culturally and weight-sensitive staff. In terms of patient needs and resources (outer setting), social drivers of health are barriers to adoption, but creative solutions were suggested to mitigate these. Other facilitators related to the intervention included its multidisciplinary model and adaptability. Similar themes were elicited from sites in maintenance stages; adaptations brought on by the pandemic, such as telehealth visits and content modification to align with distancing guidelines and the effects of social isolation were also described.ConclusionUnderstanding the factors influencing adoption of an evidence-based PWMI informs necessary adaptations and implementation strategies required to facilitate nationwide dissemination of PWMIs, with the goal of reaching the populations most at-risk.
The costs and financing needs of delivering Kenya’s primary health care service package
Authors: Olago Agatha , Suharlim Christian , Hussein Salim , Njuguna David , Macharia Stephen , Muñoz Rodrigo , Opuni Marjorie , Castro Hector , Uzamukunda Clarisse , Walker Damian , Birse Sarah , Wangia Elizabeth , Gilmartin Colin 
Published: October 2023

IntroductionFor many Kenyans, high-quality primary health care (PHC) services remain unavailable, inaccessible, or unaffordable. To address these challenges, the Government of Kenya has committed to strengthening the country’s PHC system by introducing a comprehensive package of PHC services and promoting the efficient use of existing resources through its primary care network approach. Our study estimated the costs of delivering PHC services in public sector facilities in seven sub-counties, comparing actual costs to normative costs of delivering Kenya’s PHC package and determining the corresponding financial resource gap to achieving universal coverage.MethodsWe collected primary data from a sample of 71 facilities, including dispensaries, health centers, and sub-county hospitals. Data on facility-level recurrent costs were collected retrospectively for 1 year (2018–2019) to estimate economic costs from the public sector perspective. Total actual costs from the sampled facilities were extrapolated using service utilization data from the Kenya Health Information System for the universe of facilities to obtain sub-county and national PHC cost estimates. Normative costs were estimated based on standard treatment protocols and the populations in need of PHC in each sub-county.Results and discussionThe average actual PHC cost per capita ranged from US$ 9.3 in Ganze sub-county to US$ 47.2 in Mukurweini while the normative cost per capita ranged from US$ 31.8 in Ganze to US$ 42.4 in Kibwezi West. With the exception of Mukurweini (where there was no financial resource gap), closing the resource gap would require significant increases in PHC expenditures and/or improvements to increase the efficiency of PHC service delivery such as improved staff distribution, increased demand for services and patient loads per clinical staff, and reduced bypass to higher level facilities. This study offers valuable evidence on sub-national cost variations and resource requirements to guide the implementation of the government’s PHC reforms and resource mobilization efforts.
Exploring the factors that contribute to the successful implementation of antimicrobial resistance interventions: a comparison of high-income and low-middle-income countries
Authors: Graells Tiscar , Lambraki Irene A. , Cousins Melanie , Léger Anaïs , Henriksson Patrik J. G. , Troell Max , Carson Carolee A. , Parmley Elizabeth Jane , Majowicz Shannon E. , Wernli Didier , Jørgensen Peter Søgaard 
Published: October 2023

IntroductionAntimicrobial resistance (AMR) is a challenge to modern medicine. Interventions have been applied worldwide to tackle AMR, but these actions are often not reported to peers or published, leading to important knowledge gaps about what actions are being taken. Understanding factors that influence the implementation of AMR interventions and what factors are relevant in low-middle-income countries (LMICs) and high-income countries (HICs) were the key objectives of this exploratory study, with the aim to identifying which priorities these contexts need.MethodsA questionnaire was used to explore context, characteristics, and success factors or obstacles to intervention success based on participant input. The context was analyzed using the AMR-Intervene framework, and success factors and obstacles to intervention success were identified using thematic analysis.ResultsOf the 77 interventions, 57 were implemented in HICs and 17 in LMICs. Interventions took place in the animal sector, followed by the human sector. Public organizations were mainly responsible for implementation and funding. Nine themes and 32 sub-themes emerged as important for intervention success. The themes most frequently reported were ‘behavior’, ‘capacity and resources’, ‘planning’, and ‘information’. Five sub-themes were key in all contexts (‘collaboration and coordination’, ‘implementation’, ‘assessment’, ‘governance’, and ‘awareness’), two were key in LMICs (‘funding and finances’ and ‘surveillance, antimicrobial susceptibility testing and preventive screening’), and five were key in HICs (‘mandatory’, ‘multiple profiles’, ‘personnel’, ‘management’, and ‘design’).ConclusionLMIC sub-themes showed that funding and surveillance were still key issues for interventions, while important HIC sub-themes were more specific and detailed, including mandatory enforcement, multiple profiles, and personnel needed for good management and good design. While behavior is often underrated when implementing AMR interventions, capacity and resources are usually considered, and LMICs can benefit from sub-themes captured in HICs if tailored to their contexts. The factors identified can improve the design, planning, implementation, and evaluation of interventions.
Remote data collection speech analysis in people at risk for Alzheimer's disease dementia: usability and acceptability results
Authors: Gregory Sarah , Harrison John , Herrmann Janna , Hunter Matthew , Jenkins Natalie , König Alexandra , Linz Nicklas , Luz Saturnino , Mallick Elisa , Pullen Hannah , Welstead Miles , Ruhmel Stephen , Tröger Johannes , Ritchie Craig W. 
Published: October 2023

IntroductionDigital cognitive assessments are gathering importance for the decentralized remote clinical trials of the future. Before including such assessments in clinical trials, they must be tested to confirm feasibility and acceptability with the intended participant group. This study presents usability and acceptability data from the Speech on the Phone Assessment (SPeAk) study.MethodsParticipants (N = 68, mean age 70.43 years, 52.9% male) provided demographic data and completed baseline and 3-month follow-up phone based assessments. The baseline visit was administered by a trained researcher and included a spontaneous speech assessment and a brief cognitive battery (immediate and delayed recall, digit span, and verbal fluency). The follow-up visit repeated the cognitive battery which was administered by an automatic phone bot. Participants were randomized to receive their cognitive test results acer the final or acer each study visit. Participants completed acceptability questionnaires electronically acer each study visit.ResultsThere was excellent retention (98.5%), few technical issues (n = 5), and good interrater reliability. Participants rated the assessment as acceptable, confirming the ease of use of the technology and their comfort in completing cognitive tasks on the phone. Participants generally reported feeling happy to receive the results of their cognitive tests, and this disclosure did not cause participants to feel worried.DiscussionThe results from this usability and acceptability analysis suggest that completing this brief battery of cognitive tests via a telephone call is both acceptable and feasible in a midlife-to-older adult population in the United Kingdom, living at risk for Alzheimer's disease.
Expanding access to evidence-based psychotherapy in VA settings: implementation of the brief cognitive behavioral therapy for depression program
Authors: Mignogna Joseph , Boykin Derrecka , Gonzalez Raquel D. , Robinson Andrew , Zeno Darrell , Sansgiry Shubhada , Broderick-Mcdaniel Jennifer , Roberson Richard B. , Sorocco Kristen , Cully Jeffrey A. 
Published: October 2023

IntroductionEvidence-based psychotherapies (EBPs) are effective for mental health conditions, but access to these services remains limited and rural Veterans are particularly underserved. Specialized implementation and dissemination programs are needed to improve access to known EBPs.MethodsThe current project sought to improve access to a known EBP—brief Cognitive Behavioral Therapy for depression (Brief CBT). Diverse Veterans and those from rural settings were a focus of this work. Aligned with the RE-AIM framework, a multifaceted implementation program was used to train and support VHA providers in their use of Brief CBT in VHA mental health settings, with specific outreach efforts made to providers at VHA Community-Based Outpatient Clinics (CBOCs) where rural Veterans often receive care. Evaluation included all facets of RE-AIM with a particular focus on adoption, effectiveness, and maintenance.ResultsDuring the first two years, over 40 VHA facilities adopted the program across four regional networks. Eighty-three providers were approached, and 54 (65.1%) providers completed the training and are delivering the intervention. A total of 688 Veterans, 174 rural (25.7%), received 2,186 sessions (average of 3.5 sessions per Veteran). Veterans receiving Brief CBT with elevated depression scores who completed three or more sessions were found to have significant symptom reductions of 4.6 points (first to last available evaluations).DiscussionImplementation efforts of Brief CBT resulted in rapid uptake and significant clinical impact on Veterans. Rural outreach efforts, including targeted training for CBOC providers and use of tele-mental health, enhanced availability of EBP services for rural Veterans.
Learning about What? Non-Confessional Religious Education after the Dissolution of the Binary Categories ‘Religion’ and ‘Secular’
Authors: Thalén Peder 
Published: October 2023

The binary division between ‘religion’ and ‘secular’ as an analytical tool has long been criticised within the research field of ‘critical religion’ in religious studies. There has also been a parallel critique in the academic discussion about post-secularity. Recently, sociologists have picked up and deepened this criticism, as expressed in Mitsutoshi Horii’s book ‘Religion’ and ‘Secular’ Categories in Sociology: Decolonizing the Modern Myth (2021). Based on a critical processing of Horii’s application to sociology, the aim of this article is to discuss the challenges for non-confessional religious education (RE) that the ongoing dismantling of this binary division entails. In particular, it looks at how a non-confessional RE could be designed that transcends the binary division and how powerful knowledge could be understood in a non-binary context.
Sudden Spurt in Pediatric Patients with AKI in Uzbekistan: A Call for International Drug Quality Control and Pharmaceutical Legislation
Authors: Murtalibova Nodira , Sethi Sidharth Kumar , Raina Rupesh , Mamatkulov Bahrom , Mustakimov Alisher 
Published: October 2023

Key Points

These outbreaks serve as a reminder of the difficulties faced in less resourced nations for improvement in regulation and enforcement of quality control procedures in the pharmaceutical industry.With the rise in the number of drug manufacturers, monitoring of drug supply in developing countries is extremely important.