bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of a monitored home-based exercise program combined with a behavior change intervention and a smartphone app on walking distances and quality of life in adults with peripheral arterial disease: the WalkingPad randomized clinical trial
Authors: Silva Ivone , Moreira Célia Sofia , Pedras Susana , Oliveira Rafaela , Veiga Carlos , Moreira Luís , Santarém Daniel , Guedes Daniel , Paredes Hugo 
Published: November 2023

AimsInvestigate whether a Home-based Exercise Therapy (HBET) program for patients with Peripheral Arterial Disease (PAD) and Intermittent Claudication (IC) with a behavior change intervention, supported by a smartphone application, is effective in improving walking distances and performance, and quality of life (QoL) over 6 months.Methods and resultsThis was a single-center, prospective, two-arm, single-blinded randomized controlled trial including 73 patients with PAD and IC, and three assessment moments: baseline, 3, and 6 months. Participants were randomized to receive a walking exercise prescription, with the support (n = 38) or without the support (n = 35) of the WalkingPad app, between January 2021 and July 2022. Both groups received two face-to-face behavior change sessions and 12 structured and targeted reinforcement phone calls over 6 months. Primary outcomes were between-group differences in pain-free walking distance (PFWD), functional walking distance (FWD), maximal walking distance (MWD), and 6-min walk distance (6 MWD) at 3 and 6 months. Secondary outcomes were QoL and walking impairment. Seventy-three patients (mean age 64 ± 7.2 years, 88% men) participated in this study, 60 of whom completed the three assessment moments. The whole sample significantly improved all primary outcomes in the first 3 months; that is, the average PFWD (151.1 m), FWD (175.2 m), MWD (171.1 m), and 6 MWD (30.8 m) increased from T1 to T2. Only MWD exhibited a significant average increase (35.0 m). Secondary outcomes also increased from baseline to 3 and 6 months. There were no between-group differences, except for MWD, which showed a greater increase at 6 months in the group that used the app, excluding patients with weak walking ability and extreme anxiety symptoms at baseline.ConclusionThe intervention improved distances and walking skills as well as the physical, mental, and disease-related quality of life among adults with PAD and IC. The group that used the WalkingPad app improved their MWD in 6 months compared to the control group, except for patients with poor walking ability and extreme anxiety symptoms, which suggests the effectiveness of the WalkingPad app for patients with high walking ability and no severe anxiety symptoms. More research is needed to determine the durability of these findings and to explore what app functionality might promote the other outcomes.
Clinical Trial Registrationhttps://clinicaltrials.gov (NCT04749732).
Effectiveness of a heart disease blended learning program in physiotherapy students: a prospective study
Authors: Marques-Sule Elena , Hernández-Guillén David , Cezón-Serrano Natalia , Arjona-Tinaut Laura , Sillero-Sillero Amalia , Sánchez González Juan Luis , Cobos-Rincón Ana , Juárez-Vela Raúl , Muñoz-Gómez Elena 
Published: November 2023

BackgroundIn recent years, novel teaching methodologies have been emerging with the aim of improving student learning. One of them is known as Blended Learning. BL allows educators to integrate elements of traditional face-to-face teaching with tailored online learning modalities, integrating the distinct strengths of both methodologies.PurposeTo determine the effectiveness of a heart disease blended learning program in undergraduate physiotherapy students.Methods124 participants (average age 21.20 ± 4.67 years, 58.87% female) performed an 8-week heart disease blended learning program that included face-to-face classes and online resources. Knowledge was assessed at baseline, at 4, 8, 12 and 20 weeks. Motivation and engagement were assessed at 4 and 8 weeks. Design of the instructions and learning behaviors were measured at 8 weeks. Finally, 108 subjects completed the studyResultsKnowledge significantly increased mid-program (p = 0.02), at the end of the program (p &lt; 0.001), at 12 weeks (p &lt; 0.001) and 20 weeks (p = 0.001). After the intervention, a high intrinsic motivation was shown (5.60 ± 0.80)) over 7), whilst extrinsic motivation scored 4.24 ± 0.97 over 7.Finally, engagement (3.98 ± 0.52) over 5), design of the instructions (4.15 ± 0.62) over 5) and learning behaviors (70.51 ± 36.08) downloads, 28.97 ± 16.09) topics visited, and online questionnaires scored 7.67 ± 1.60) over 10) reported adequate scores.ConclusionThis program seems to be an appropriate methodology in future physiotherapists, since it improved knowledge and participants exhibited a high motivation and an adequate engagement, design of the program instructions and learning behaviors.
Plasma interleukin responses as predictors of outcome stratification in patients after major trauma: a prospective observational two centre study
Authors: Jones Matthew Allan , Hanison James , Apreutesei Renata , Allarakia Basmah , Namvar Sara , Ramaswamy Deepa Shruthi , Horner Daniel , Smyth Lucy , Body Richard , Columb Malachy , Nirmalan Mahesan , Nirmalan Niroshini 
Published: November 2023

Background and objectivesThere is a need to develop objective risk stratification tools to define efficient care pathways for trauma patients. Biomarker-based point of care testing may strengthen existing clinical tools currently available for this purpose. The dysregulation of pro- and anti-inflammatory cytokines in the pathogenesis of organ failure is well recognised. This study was carried out to evaluate whether blood concentrations of IL-6, IL-10, and IL-6:IL-10 ratios in the early stages of the illness are significantly different in patients with worsening organ function.Materials and methodsIn this prospective observational cohort study, plasma concentrations of IL-6 and IL-10 on days 1, 3 and 5 were measured in 91 major trauma patients using a multiplexed cytometric bead array approach. A composite measure of adverse outcome - defined as SOFA ≥ 2 or mortality at 7 days, was the primary outcome. IL-6 and IL-10 concentrations in early samples (days 1, 3 &amp; 5) in patients who developed SOFA ≥ 2 on day 7 were compared against those who did not. Similar composite outcome groups at day 5 and in groups with worsening or improving SOFA scores (ΔSOFA) at days 7 and 5 were undertaken as secondary analyses.ResultsStratification on day 7, 44 (48%) patients showed adverse outcomes. These adverse outcomes associated with significantly greater IL-6 concentrations on days 1 and 5 (Day 1: 47.65 [23.24-78.68] Vs 73.69 [39.93 – 118.07] pg/mL, P = 0.040 and Day 5: 12.85 [5.80-19.51] Vs 28.90 [8.78-74.08] pg/mL; P = 0.0019). Similarly, IL-10 levels were significantly greater in the adverse outcome group on days 3 and 5 (Day 3: 2.54 [1.76-3.19] Vs 3.16 [2.68-4.21] pg/mL; P = 0.044 and Day 5: 2.03 [1.65-2.55] Vs 2.90 [2.00-5.06] pg/mL; P &lt;0.001). IL-6 and IL-10 concentrations were also significantly elevated in the adverse outcome groups at day 3 and day 5 when stratified on day 5 outcomes. Both IL-6 and IL-6:IL-10 were found to be significantly elevated on days 1 and 3 when stratified based on ΔSOFA at day 5. This significance was lost when stratified on day 7 scores.ConclusionsEarly IL-6 and IL-10 concentrations are significantly greater in patients who develop worsening organ functions downstream. These differences may provide an alternate biomarker-based approach to strengthen risk stratification in trauma patients.
Lateral impact response of circular hollow steel tubes with mid-span localized penetrating notches
Authors: Huang Xiaoli , Wang Yulin 
Published: November 2023

In this study, 32 numerical models of CHST columns were established in the ABAQUS program to evaluate the effect of mid-span local defects on the impact resistance of circular hollow steel tube (CHST) columns. The simulation studies were conducted from three aspects: notch length, notch angle, and impact energy. The results showed that under a lateral impact load, the mid-span of the CHST column presented global bending failure patterns accompanied by local indentation deformation in the impact region and local buckling deformation at the bottom of the fixed end. Compared with the mid-span indentation displacement of the non-notch model, when the impact velocities were 30 km/h and 60 km/h, the horizontal notch model surpassed the maximum by 29.3% and 36.3%, the oblique notch model surpassed the maximum by 47.8% and 115.6%, and the vertical notch model only increased by 9.7% and 1.1%. The local damage area and impact force time-history curves of the vertical notch model agreed well with those of the non-notch model. Among the three notch angles, the impact plateau values of the vertical notch model and the global bending displacement in the mid-span were least affected by the notch length, notch location, and impact energy. The energy absorption of the CHST column was mainly due to indentation deformation in the mid-span, and the global bending deformation was auxiliary. Compared with the energy absorption ratio (EAR) of the non-notch model, with increased impact energy, the EAR of the vertical notch model increased by 20.2%, 13.5%, and 17.3% on average. The horizontal and oblique notch models decreased by 28.2%, 61.0%, 42.4%, and 29.1%, 62.7%, and 49.3%, respectively. The Rd of all notch models showed an overall upward trend as the impact energy increased, and the Rd of the horizontal notch model increased the most. According to the parametric analysis results, the dynamic flexural capacity prediction formula of the CHST columns section was obtained, considering the influence of notch length, notch angle, and impact energy within the parameter range of this study.
Real-world national trends and influencing factors preference of non-vitamin K antagonist oral anticoagulants in China
Authors: Zhu Shaojing , Li Mengjie , Wang Lujun , Hou Lu , Li Dandan , Liu Jiuhong , Lu Yanxia 
Published: November 2023

BackgroundsNon-vitamin K antagonist oral anticoagulants (NOACs) have been recommended as the first choice over warfarin for non-valvular atrial fibrillation (AF). However, there is limited data about their usage in mainland China.MethodsPrescriptions of patients diagnosed with AF and containing OACs were extracted from Hospital Prescription Cooperation Project from January 2016 to March 2021. The primary outcome was the changing percentage of different OACs. The secondary outcomes were frequencies as well as factors with the choice of different OACs and dosage of NOACs. Univariate and Multivariate logistic regressions were conducted to explore possible factors. All statistical analyses were performed using SAS software (Version 9.4).ResultsAmong the 220,083 distinct prescriptions diagnosed with AF and prescribed with OACs, the percentage of NOACs increased over years, exceeding warfarin in 2018. Until March 2021, 83.53% of included patients were prescribed with NOACs. Rivaroxaban (62.25%) and dabigatran (37.65%) were the most commonly prescribed NOACs. Low dosage was common for NOACs (44.54%), this was mainly driven by rivaroxaban, 67.98% of which were low dosage. Multivariate logistic regression indicated that several factors were positively associated with the preference of low dosage, including outpatients (OR 1.32, 95% CI 1.26–1.39), patients with hypertension (OR 1.49, 95% CI 1.40–1.58), acute coronary syndrome (OR 1.17, 95% CI 1.12–1.22), stroke (OR 1.42, 95% CI 1.33–1.52), and kidney disease (OR 1.63, 95% CI 1.34–1.97), as well as concomitantly using antiplatelet agents (OR 1.52, 95% CI 1.40–1.66), and steroids (OR 1.76, 95% CI 1.50–2.07). On the contrary, they were less common in health insurance holder (OR 0.79, 95% CI 0.75–0.84), patients taking apixaban (vs. rivaroxaban, OR 0.39, 95% CI 0.18–0.81), dabigatran (vs. rivaroxaban, OR 0.01, 95% CI 0.01–0.01), edoxaban (vs. rivaroxaban, OR 0.36, 95% CI 0.23–0.55), diagnosed with heart failure (OR 0.87, 95% CI 0.81–0.93), deep vein thrombosis (OR 0.36, 95% CI 0.29–0.46), pulmonary embolism (OR 0.35, 95% CI 0.28–0.43), and peripheral artery disease (OR 0.68, 95% CI 0.55–0.85).ConclusionThe usage of OACs for AF was overall complying with updated guidelines. Low dosage was common for NOACs, further studies were warranted to verify its effectiveness and explore the underlying mechanism.
The effectiveness and safety of one-stage iStent-based micro-invasive glaucoma surgery—A retrospective study
Authors: Hajduga-Szewczyk Marta , Smedowski Adrian , Filipecka Iwona , Mrukwa-Kominek Ewa 
Published: November 2023

PurposeMicro-invasive glaucoma surgery involves a group of treatment methods associated with a low rate of side effects and good effectiveness outcomes. One of the most frequently performed procedures belonging to this group is iStent microstent implantation. The aim of this study was to perform a retrospective evaluation of the safety and efficacy of a combined procedure involving cataract phacoemulsification and single iStent microstent implantation, performed simultaneously.Materials and methodsThe complete medical records of 62 patients (91 eyes) were analyzed retrospectively, including the best corrected visual acuity, intraocular pressure, the mean defect of visual fields, and the number of active substances used in eye drops. The follow-up times were 1, 3, 6, 9, and 12 months after the surgical procedure.ResultsA significant improvement in the best corrected visual acuity and a reduction of the intraocular pressure were achieved after the surgery. On average, after 12 months, the best corrected visual acuity improved from 0.70 (0.25) to 0.91 (0.18; p = 0.001), the intraocular pressure reduced from 17.76 (3.95) to 14.91 (3.04; p = 0.0001), and the number of active substances used in eye drops reduced from 2.07 (1.08) to 0.70 (0.06; p = 0001). In addition, we found that patients who initially showed higher intraocular pressure values did not benefit from surgery in the aspect of the number of active substances used in their eye drops. Intraoperative and postoperative adverse events were transient and ultimately did not affect the outcomes.ConclusionSimultaneous cataract phacoemulsification with single iStent implantation in patients with open-angle glaucoma is a safe and effective method for reducing intraocular pressure and the number of topical medications that must be used. Having initially higher intraocular pressure values may limit the beneficial effects of iStent implantation by subordinating patients from topical treatment; thus, single iStent implantation may not be the most favorable choice in uncontrolled glaucoma cases.
Case report: Uncommon presentation of Salmonella Dublin infection as a large paravertebral abscess
Authors: An Kang , Wu Zengxiang , Zhong Cejun , Li Shuangqing 
Published: November 2023

BackgroundSalmonella Dublin is a zoonotic pathogen that is associated with invasive infections and high morbidity and mortality rates. Here we present the case of a 78-year-old man with a rare manifestation of a paravertebral abscess in the thoracolumbar spine caused by Salmonella Dublin.Case presentationThe patient had a history of spinal tuberculosis and poorly controlled diabetes. The abscess was successfully managed by drainage, and a 12-week course of moxifloxacin resulted in complete recovery. Salmonella Dublin was identified using culture-based serotyping. The patient resided in an environment where cattle farming is common; he consumed raw beef and unpasteurized milk, suggesting a potential source of infection.DiscussionIncreasing the awareness of Salmonella Dublin as a potential cause of spinal abscesses is important, particularly in patients with structural spinal abnormalities. The timely initiation of appropriate antimicrobial therapy based on susceptibility testing is recommended. This case highlights the pathogenic potential of Salmonella Dublin and emphasizes the importance of effectively managing invasive Salmonella infections.
Perioperative management for elderly patients undergoing day surgery: evidence-based practice for nursing care and day surgery
Authors: Wu Mei , Xia Lu , Zhang Li , Xu Yamin , Cheng Yun , Zhang Xiaoju , Chen Long 
Published: November 2023

IntroductionIt is necessary to explore the evidence-based practice of perioperative management of elderly patients undergoing ambulatory surgery, to optimize the clinical workflow and improve the quality of nursing care.MethodsBased on the best evidence obtained from the previous study, the perioperative management model and examination index of elderly patients undergoing day surgery were established, and the evidence of best practice was obtained by using the evidence-based methodology. Then, we integrated evidence into clinical practice and improved the process. We made a comparative analysis of the effect before and after the implementation of the evidence.ResultsThis study summarized 26 pieces of evidence of perioperative management of elderly patients undergoing day surgery and transformed the evidence into 7 items and 11 items of examination index. After the application of the best evidence, knowledge, belief, and practice of perioperative management of nurses for elderly patients in the day operation ward reached 100%, and the rate of reaching the standard of most indicators increased after the application of evidence. The length of waiting for admission and waiting for operation and returning to the ward to discharge of elderly patients decreased significantly, and the difference was statistically significant (All p &lt; 0.05).ConclusionEvidence-based perioperative management of elderly patients undergoing day surgery improves the nursing practice of clinical nurses and shortens the waiting time and hospitalization time of elderly patients undergoing day surgery, which should be promoted in clinical nursing care.
Assessing the reach, effectiveness, adoption, implementation, and maintenance of the ProACTIVE SCI physical activity counseling intervention among physiotherapists and SCI peer coaches during the transition from rehabilitation to community
Authors: Olsen Kenedy , Martin Ginis Kathleen A. , Lawrason Sarah , McBride Christopher B. , Walden Kristen , Le Cornu Levett Catherine , Colistro Regina , Plashkes Tova , Bass Andrea , Thorson Teri , Clarkson Ryan , Bitz Rod , Ma Jasmin K. 
Published: November 2023

IntroductionPhysical Activity (PA) levels for individuals with spinal cord injury (SCI) peak during rehabilitation and sharply decline post-discharge. The ProACTIVE SCI intervention has previously demonstrated very large-sized effects on PA; however, it has not been adapted for use at this critically understudied timepoint. The objective is to evaluate the reach, effectiveness, adoption, implementation, and maintenance of the ProACTIVE SCI intervention delivered by physiotherapists and SCI peer coaches during the transition from rehabilitation to community.MethodsA single-group, within-subjects, repeated measures design was employed. The implementation intervention consisted of PA counseling training, champion support, prompts and cues, and follow-up training/community of practice sessions. Physiotherapists conducted counseling sessions in hospital, then referred patients to SCI peer coaches to continue counseling for 1-year post-discharge in the community. The RE-AIM Framework was used to guide intervention evaluation.ResultsReach: 82.3% of patients at the rehabilitation hospital were reached by the intervention. Effectiveness: Interventionists (physiotherapists and SCI peer coaches) perceived that PA counseling was beneficial for patients. Adoption: 100% of eligible interventionists attended at least one training session. Implementation: Interventionists demonstrated high fidelity to the intervention. Intervention strategy highlights included a feasible physiotherapist to SCI peer coach referral process, flexibility in timepoint for intervening, and time efficiency. Maintenance: Ongoing training, PA counseling tracking forms, and the ability to refer to SCI peer coaches at discharge are core components needed to sustain this intervention.DiscussionThe ProACTIVE SCI intervention was successfully adapted for use by physiotherapists and SCI peer coaches during the transition from rehabilitation to community. Findings are important for informing intervention sustainability and scale-up.
Evaluation of taVNS for extreme environments: an exploration study of health benefits and stress operationality
Authors: Le Roy Barbara , Martin-Krumm Charles , Gille Adèle , Jacob Sandrine , Vigier Cécile , Laborde Sylvain , Claverie Damien , Besnard Stéphane , Trousselard Marion 
Published: November 2023

IntroductionLong-duration space missions will be a real challenge for maintaining astronauts' adaptability. Research on transcutaneous vagus nerve stimulation (taVNS) is expanding rapidly, and its modalities constitute a major research challenge. A growing number of reviews stress the need to validate biomarkers for monitoring effects to enhance our understanding of the processes by which taVNS acts. Heart rate variability (HRV) appears to be a relevant candidate that informs on the autonomic nervous system (ANS). This is a promising technique to minimize the pathogenic effects of such large-scale missions and thus might be a relevant countermeasure. This study aimed to investigate the impact of taVNS on cognitive, psychological, and physiological functioning, including ANS functioning, and the benefits of increasing the number of taVNS sessions.MethodA total of 44 healthy participants were randomly assigned to one of the two cross-over protocols: a single session protocol (one taVNS and one sham simulation) or a repeated session protocol (three taVNS and three sham simulations). Cognitive, psychological, and physiological measures were performed before (pre) and after (post) each intervention. Sleep monitoring was only recorded before the first and after the last intervention in each protocol. For the repeated session protocol only, participants were allocated to two groups according to their parasympathetic activation gain during the three interventions: high parasympathetic delta (HPd) and low parasympathetic delta (LPd).ResultsParticipants in the repeated session protocol increased their HRV, cognitive performance, and sleep efficiency. In particular, taVNS induced higher parasympathetic activation and cardiac flexibility compared to the sham simulation in the repeated session protocol. Nevertheless, the perception of stress may indicate a nocebo effect of the repeated session. The HPd profile had higher interoceptive awareness, HRV highlighted by non-linear measures, and cognitive performance, but presented a decrease in some indicators of sleep efficiency compared to the LPd profile.ConclusiontaVNS seems to induce positive health outcomes, especially when the stimulation is repeated three times per week. Our findings highlight the benefits of parasympathetic activation during taVNS on psychophysiological and cognitive functioning. Further research is needed to validate these results on a large sample, using longitudinal measures over several months. This intervention appears promising as a countermeasure to extreme missions and occupations.