bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of immersive virtual reality on sensory overload in a random sample of critically ill patients
Authors: Naef Aileen C. , Gerber Stephan M. , Single Michael , Müri René M. , Haenggi Matthias , Jakob Stephan M. , Jeitziner Marie-Madlen , Nef Tobias 
Published: October 2023

BackgroundSensory overload and sensory deprivation have both been associated with negative health outcomes in critically ill patients. While there is a lack of any clear treatment or prevention strategies, immersive virtual reality is a promising tool for addressing such problems, but which has not been repetitively tested in random samples. Therefore, this study aimed to determine how critically ill patients react to repeated sessions of immersive virtual reality.MethodsThis exploratory study was conducted in the mixed medical–surgical intermediate care unit of the University Hospital of Bern (Inselspital). Participants (N = 45; 20 women, 25 men; age = 57.73 ± 15.92 years) received two immersive virtual reality sessions via a head-mounted display and noise-canceling headphones within 24 h during their stay in the unit. Each session lasted 30-min and showed a 360-degree nature landscape. Physiological data were collected as part of the participants’ standard care, while environmental awareness, cybersickness, and general acceptance were assessed using a questionnaire designed by our team (1 = not at all, 10 = extremely).ResultsDuring both virtual reality sessions, there was a significant negative linear relationship found between the heart rate and stimulation duration [first session: r(43) = −0.78, p &lt; 0.001; second session: r(38) = −0.81, p &lt; 0.001] and between the blood pressure and stimulation duration [first session: r(39) = −0.78, p &lt; 0.001; second session: r(30) = −0.78, p &lt; 0.001]. The participants had a high comfort score [median (interquartile range {IQR}) = 8 (7, 10); mean = 8.06 ± 2.31], did not report being unwell [median (IQR) = 1 (1, 1); mean = 1.11 ± 0.62], and were not aware of their real-world surroundings [median (IQR) = 1 (1, 5); mean = 2.99 ± 3.22].ConclusionThe subjectively reported decrease in environmental awareness as well as the decrease in the heart rate and blood pressure over time highlights the ability of immersive virtual reality to help critically ill patients overcome sensory overload and sensory deprivation. Immersive virtual reality can successfully and repetitively be provided to a randomly selected sample of critically ill patients over a prolonged duration.
More than medications: a patient-centered assessment of Parkinson’s disease care needs during hospitalization
Authors: Shurer Jessica , Golden Shannon L. S. , Mihas Paul , Browner Nina 
Published: October 2023

BackgroundParkinson’s disease (PD) increases the risk of hospitalization and complications while in the hospital. Patient-centered care emphasizes active participation of patients in decision-making and has been found to improve satisfaction with care. Engaging in discussion and capturing hospitalization experience of a person with PD (PwP) and their family care partner (CP) is a critical step toward the development of quality improvement initiatives tailored to the unique hospitalization needs of PD population.ObjectivesThis qualitative study aimed to identify the challenges and opportunities for PD patient-centered care in hospital setting.MethodsFocus groups were held with PwPs and CPs to capture first-hand perspectives and generate consensus themes on PD care during hospitalization. A semi-structured guide for focus group discussions included questions about inpatient experiences and interactions with the health system and the clinical team. The data were analyzed using inductive thematic analysis.ResultsA total of 12 PwPs and 13 CPs participated in seven focus groups. Participants were 52% female and 28% non-white; 84% discussed unplanned hospitalizations. This paper focuses on two specific categories that emerged from the data analysis. The first category explored the impact of PD diagnosis on the hospital experience, specifically during planned and unplanned hospitalizations. The second category delves into the unique needs of PwPs and CPs during hospitalization, which included the importance of proper PD medication management, the need for improved hospital ambulation protocols, and the creation of disability informed hospital environment specific for PD.ConclusionPD diagnosis impacts the care experience, regardless of the reason for hospitalization. While provision of PD medications was a challenge during hospitalization, participants also desired flexibility in ambulation protocols and an environment that accommodated their disability. These findings highlight the importance of integrating the perspectives of PwPs and CPs when targeting patient-centered interventions to improve hospital experiences and outcomes.
Transcranial Doppler during the first week after cardiac arrest and association with 6-month outcomes
Authors: Reichenbach Antje , Alteheld Lars , Henriksen Julia , Nakstad Espen Rostrup , Andersen Geir Øystein , Sunde Kjetil , Šaltytė Benth Jūratė , Lundqvist Christofer 
Published: October 2023

BackgroundEarly prediction of outcomes in comatose patients after out-of-hospital cardiac arrest is challenging. Prognostication tools include clinical examination, biomarkers, and neuroradiological and neurophysiological tests. We studied the association between transcranial Doppler (TCD) and the outcome.MethodsThis was a pre-defined sub-study of the prospective observational Norwegian Cardiorespiratory Arrest Study. Patients underwent standardized post-resuscitation care, including target temperature management (TTM) to 33°C for 24 h. TCD was performed at days 1, 3, and 5–7. The primary endpoint was cerebral performance category (CPC) at 6 months, dichotomized into good (CPC 1–2) and poor (CPC 3–5) outcomes. We used linear mixed modeling time-series analysis.ResultsOf 139 TCD-examined patients, 81 (58%) had good outcomes. Peak systolic velocity in the middle cerebral artery (PSV) was low during TTM (Day 1) and elevated after rewarming (Day 3). Thereafter, it continued to rise in patients with poor, but normalized in patients with good, outcomes. At days 5–7, PSV was 1.0 m/s (95% CI 0.9; 1.0) in patients with good outcomes and 1.3 m/s (95% CI 1.1; 1.4) in patients with poor outcomes (p &lt; 0.001)ConclusionElevated PSV at days 5–7 indicated poor outcomes. Our findings suggest that serial TCD examinations during the first week after cardiorespiratory arrest may improve our understanding of serious brain injury.
Narrow band green light effects on headache, photophobia, sleep, and anxiety among migraine patients: an open-label study conducted online using daily headache diary
Authors: Lipton Richard B. , Melo-Carrillo Agustin , Severs Mark , Reed Michael , Ashina Sait , Houle Timothy , Burstein Rami 
Published: October 2023

BackgroundNarrow band green light (NbGL) has been shown to relieve headache in small numbers of subjects but large-scale real-world assessments are lacking. The goal of this prospective, observational, open-label, real world study was to determine whether treatment with NbGL during the ictal phase of migraine, improves patients' perception of their headache, photophobia, anxiety and same-night sleep.MethodsThe study was conducted in purchasers of the NbGL Lamp in two phases. In Phase I purchasers of the Lamp completed a survey and were asked to participate in a 6-week diary study. In Phase 2 participants completed daily diaries for 6 weeks. Specifically, they were asked to use their judgement/impression/perception when choosing between headache-improved or headache-unimproved after using the NbGL during acute attacks. Diary outcomes of interest included rates of attacks improve in responders (≥50%), non-responders (&lt;50%), super-responders (≥75%), and super non-responders (&lt;30%).ResultsOf 3,875 purchasers of the Lamp for migraine, 698 (18%) agreed to participate, filled out a pre-study survey, and agreed to a 6-week daily headache diary. Complete data were provided by 181 (26%) participants. Using criteria above, 61, 39, 42, and 27% of participants were classified responder, non-responder, super-responder and super non-responder, respectively. Headache improved in 55% of all 3,232 attacks, in 82% of the 1,803 attacks treated by responders, and in 21% of the 1,429 attacks treated by non-responders. Photophobia improved in 53% of all attacks, 68% of the attacks in responders and in 35% of the attacks in non-responders. Anxiety improved in 34% of all attacks, 46% of the responders' attacks, and 18% of the non-responders' attacks. Sleep improved in 49% of all attacks, 59% of the responders' attacks, and 36% of the non-responders' attacks.ConclusionThis open-label real world study suggests that 2 h of treatment with the lamp during migraine attacks is associated with relief of pain and photophobia, reduction in anxiety, and improved sleep. The absence of rigorous diagnosis and a blinded contemporaneous control group limits the rigor of this interpretation. Improvement in photophobia, anxiety and sleep among the responders may be secondary to the improvement in the headache itself.Clinical trial registrationClinicalTrial.gov (NCT04841083).
A novel untrained SSVEP-EEG feature enhancement method using canonical correlation analysis and underdamped second-order stochastic resonance
Authors: Chen Ruiquan , Xu Guanghua , Zhang Huanqing , Zhang Xun , Li Baoyu , Wang Jiahuan , Zhang Sicong 
Published: October 2023

ObjectiveCompared with the light-flashing paradigm, the ring-shaped motion checkerboard patterns avoid uncomfortable flicker or brightness modulation, improving the practical interactivity of brain-computer interface (BCI) applications. However, due to fewer harmonic responses and more concentrated frequency energy elicited by the ring-shaped checkerboard patterns, the mainstream untrained algorithms such as canonical correlation analysis (CCA) and filter bank canonical correlation analysis (FBCCA) methods have poor recognition performance and low information transmission rate (ITR).MethodsTo address this issue, a novel untrained SSVEP-EEG feature enhancement method using CCA and underdamped second-order stochastic resonance (USSR) is proposed to extract electroencephalogram (EEG) features.ResultsIn contrast to typical unsupervised dimensionality reduction methods such as common average reference (CAR), principal component analysis (PCA), multidimensional scaling (MDS), and locally linear embedding (LLE), CCA exhibits higher adaptability for SSVEP rhythm components.ConclusionThis study recruits 42 subjects to evaluate the proposed method and experimental results show that the untrained method can achieve higher detection accuracy and robustness.SignificanceThis untrained method provides the possibility of applying a nonlinear model from one-dimensional signals to multi-dimensional signals.
Mapping of the supplementary motor area using repetitive navigated transcranial magnetic stimulation
Authors: Kern Giulia , Kempter Miriam , Picht Thomas , Engelhardt Melina 
Published: October 2023

BackgroundThe supplementary motor area (SMA) is important for motor and language function. Damage to the SMA may harm these functions, yet tools for a preoperative assessment of the area are still sparse.ObjectiveThe aim of this study was to validate a mapping protocol using repetitive navigated transcranial magnetic stimulation (rnTMS) and extend this protocol for both hemispheres and lower extremities.MethodsTo this purpose, the SMA of both hemispheres were mapped based on a finger tapping task for 30 healthy subjects (35.97 ± 15.11, range 21–67 years; 14 females) using rnTMS at 20 Hz (120% resting motor threshold (RMT)) while controlling for primary motor cortex activation. Points with induced errors were marked on the corresponding MRI. Next, on the identified SMA hotspot a bimanual finger tapping task and the Nine-Hole Peg Test (NHPT) were performed. Further, the lower extremity was mapped at 20 Hz (140%RMT) using a toe tapping task.ResultsMean finger tapping scores decreased significantly during stimulation (25.70taps) compared to baseline (30.48; p &lt; 0.01). Bimanual finger tapping led to a significant increase in taps during stimulation (28.43taps) compared to unimanual tapping (p &lt; 0.01). Compared to baseline, completion time for the NHPT increased significantly during stimulation (baseline: 13.6 s, stimulation: 16.4 s; p &lt; 0.01). No differences between hemispheres were observed.ConclusionThe current study validated and extended a rnTMS based protocol for the mapping of the SMA regarding motor function of upper and lower extremity. This protocol could be beneficial to better understand functional SMA organisation and improve preoperative planning in patients with SMA lesions.
Identification and validation of PCSK9 as a prognostic and immune-related influencing factor in tumorigenesis: a pan-cancer analysis
Authors: Sun Chao , Zhu Guoji , Shen Conghuan , Huang Shungen , Li Ruidong , Li Jianhua , Ma Zhenyu , Wang Zhengxin 
Published: October 2023

IntroductionProprotein convertase subtilisin/kexin-9 (PCSK9) has been primarily studied in the cardiovascular field however, its role in cancer pathophysiology remains incompletely defined. Recently, a pivotal role for PCSK9 in cancer immunotherapy was proposed based on the finding that PCSK9 inhibition was associated with enhancing the antigen presentation efficacy of target programmed cell death-1 (PD-1). Herein, we provide results of a comprehensive pan-cancer analysis of PCSK9 that assessed its prognostic and immunological functions in cancer.MethodsUsing a variety of available online cancer-related databases including TIMER, cBioPortal, and GEPIA, we identified the abnormal expression of PCSK9 and its potential clinical associations in diverse cancer types including liver, brain and lung. We also validated its role in progression-free survival (PFS) and immune infiltration in neuroblastoma.ResultsOverall, the pan-cancer survival analysis revealed an association between dysregulated PCSK9 and poor clinical outcomes in various cancer types. Specifically, PCSK9 was extensively genetically altered across most cancer types and was consistently found in different tumor types and substages when compared with adjacent normal tissues. Thus, aberrant DNA methylation may be responsible for PCSK9 expression in many cancer types. Focusing on liver hepatocellular carcinoma (LIHC), we found that PCSK9 expression correlated with clinicopathological characteristics following stratified prognostic analyses. PCSK9 expression was significantly associated with immune infiltrate since specific markers of CD8+ T cells, macrophage polarization, and exhausted T cells exhibited different PCSK9-related immune infiltration patterns in LIHC and lung squamous cell carcinoma. In addition, PCSK9 was connected with resistance of drugs such as erlotinib and docetaxel. Finally, we validated PCSK9 expression in clinical neuroblastoma samples and concluded that PCSK9 appeared to correlate with a poor PFS and natural killer cell infiltration in neuroblastoma patients.ConclusionPCSK9 could serve as a robust prognostic pan-cancer biomarker given its correlation with immune infiltrates in different cancer types, thus potentially highlighting a new direction for targeted clinical therapy of cancers.
Evaluation of IL-6, FoxP3 Treg lymphocytes, intestinal barrier biomarkers and the use of synbiotics in obese adolescents: a pilot study
Authors: Aziz Cylmara , Morales Armando , Pinto Walter , Fanchini Vanessa , Dell Aquila Luis , Sangaleti Carine , Elias Rosilene , Dalboni Maria 
Published: October 2023

AimThis prospective pilot study evaluated inflammatory and intestinal barrier biomarkers and the effects of a synbiotic in obese adolescents.MethodsEighteen obese and 20 eutrophic adolescents were evaluated for body composition using bioimpedance analysis (BIA), body mass index (BMI), IL-6 and lipopolysaccharide (LPS) serum levels, CD4 and FoxP3 Treg lymphocytes and monocytes. Synbiotic supplementation for 60 days was also evaluated for these parameters only in obese adolescents.ResultsWe observed an increase in CD4 lymphocyte (18.0 ± 12.4 vs. 8.9 ± 7.5; p &lt; 0.01), IL-6 (0.30 ± 0.06 vs. 0.20 ± 0.06; p = 0.02) and LPS (0.18 ± 0.15 vs. 0.08 ± 0.05; p &lt; 0.01) levels in obese compared to eutrophic adolescents. After synbiotic supplementation, FoxP3 Treg lymphocytes increased (14.0 ± 6.7 vs. 9.9 ± 5.4; p = 0.02) in obese adolescents.ConclusionsObese adolescents presented a state of microinflammation and intestinal barrier breakdown, and synbiotic supplementation increased the expression of FoxP3 Treg lymphocytes, an anti-inflammatory regulator. Whether the increase in FoxP3 Treg lymphocytes may have an impact on inflammation and outcomes in obese adolescents deserves further evaluation.
TRPA1-dependent and -independent activation by commonly used preservatives
Authors: Mager Maximilian L. , Ciotu Cosmin I. , Gold-Binder Markus , Heber Stefan , Fischer Michael J. M. 
Published: October 2023

Background and purpose: Addition of preservatives ensures microbial stability, especially in multidose containers of parenterally administered pharmaceuticals. These compounds can cause side effects, and particularly at the site of application, might elicit or facilitate pain. TRPA1 is a cation channel expressed in peripheral neurons which contributes to pain and inflammation and is sensitive to many irritants. The most commonly used preservatives, in particular with a focus on parenteral formulations, were investigated for their potential to activate TRPA1.Experimental approach: Sixteen preservatives were screened for mediating calcium influx in human TRPA1-transfected HEK293t cells. Untransfected cells served as control, results were further validated in mouse sensory neurons. In addition, proinflammatory mediators serotonin, histamine and prostaglandin E2 were co-administered to probe a potential sensitisation of preservative-induced TRPA1 activation.Key results: Butylparaben, propylparaben, ethylparaben, bronopol, methylparaben, phenylethyl alcohol and phenol induced a TRPA1-dependent calcium influx in transfected HEK293t cells at concentrations used for preservation. Other preservatives increased calcium within the used concentration ranges, but to a similar degree in untransfected controls. Serotonin, histamine, and prostaglandin enhanced TRPA1 activation of phenylethyl alcohol, bronopol, ethylparaben, propylparaben and butylparaben.Conclusion and implications: Systematic screening of common preservatives applied for parenterally administered drugs resulted in identifying several preservatives with substantial TRPA1 channel activation. This activation was enhanced by the addition of proinflammatory meditators. This allows selecting a preservative without TRPA1 activation, particularly in case of pharmaceuticals that could act proinflammatory.
The positive impact of mindfulness interventions on the explicit and implicit affective attitudes toward vegetarian foods
Authors: Winkelmair Annica , Jansen Petra 
Published: October 2023

ObjectivesThe main goal of our intervention study was to investigate whether two conceptually different mindfulness interventions positively impacted the explicit and implicit affective evaluations of vegetarian foods. We included possible mediating variables (e.g., wellbeing) and related our results to the stage model of self-regulated behavioral change (SSBC).MethodsWe implemented a compassion and caring-based mental training (N = 31) and an adapted MBSR course (N = 34) as mindfulness interventions, and a stress-reduction course (N = 26) as the active control group. The curriculums consisted of 12 weekly group sessions á 75 min. All participants were tested pre- and post-intervention and 3 months after the last intervention session, answered questionnaires (mindfulness, compassion, wellbeing, items of the SSBC) and completed an explicit affective evaluation task and an affective priming task.ResultsThere was an improvement in the explicit attitudes toward vegetarian foods regardless of the intervention group. In the SSBC, we found a link between the explicit attitudes toward vegetarian foods and the indicated stage in the model. Multiple regression analysis revealed social and personal norms and a vegetarian/vegan diet as the only significant predictors for goal intention in the SSBC.ConclusionThe results of our study suggest that both conceptually different mindfulness interventions, as well as a stress-reduction program, have a positive impact on explicit affective attitudes toward vegetarian foods. We highlight the meaning of inner dimensions and transformation for change processes for a more sustainable diet and the role of social and personal norms.
Beyond borders: exploring the impact of augmented reality on intercultural competence and L2 learning motivation in EFL learners
Authors: Liu Song , Gao Shengbing , Ji Xiaoyan 
Published: October 2023

IntroductionThis mixed-methods study investigates the impact of augmented reality (AR) on the development of intercultural competence and L2 (second language) learning motivation among Chinese English as a Foreign Language (EFL) learners. The research comprised forty-eight intermediate-level learners who were randomly assigned to either an experimental group, receiving AR-based language instruction, or a control group, receiving traditional instruction.MethodsBoth groups underwent pre- and post-tests to assess their intercultural competence and L2 learning motivation. The experimental group engaged with an AR application, which exposed learners to a variety of cultural scenarios, customs, and norms.ResultsThe results indicate that the experimental group, exposed to AR-based instruction, demonstrated significantly higher levels of intercultural competence and L2 learning motivation in comparison to the control group.DiscussionQualitative data analysis further elucidated that AR-based instruction enhanced learners’ engagement, motivation, and deepened their cultural understanding. This study highlights the potential of augmented reality as a powerful tool for fostering the development of intercultural competence and L2 learning motivation within the EFL context, suggesting promising opportunities for innovative pedagogical approaches in language education.