bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Different Durations and Frequencies of Vestibular Rehabilitation in Patients With Residual Symptoms After Benign Paroxysmal Positional Vertigo Repositioning
Authors: Cui Qingjia , Wen Cheng , Yan Jin , Wang Rui , Han Renjie , Huang Lihui 
Published: November 2023

Objectives: This study aimed to explore the effects of different duration and daily frequency of vestibular rehabilitation (VR) in patients with residual symptoms after benign paroxysmal positional vertigo (BPPV) successful repositioning. Method: Patients with successful BPPV repositioning (n = 118) were divided into 3 groups according to VR duration and frequency: group A (n = 30; 15 minutes, 3 times/day), group B (n = 30; 30 minutes, 3 times/day), group C (n = 28; 15 minutes, 6 times/day), and control group D (n = 30; no VR). All patients completed the dizziness handicap inventory (DHI) and vestibular rehabilitation benefit questionnaire (VRBQ) at baseline and after 2 and 4 weeks. Results: The emotional scores and the proportion of severe dizziness disability in the DHI scores were significant differences between VR groups A to C and control group D after 2 and 4 weeks (all P < .05). There were significant differences in total DHI and VRBQ scores among the VR groups A to C after 2 and 4 weeks (all P < .05). Interestingly, emotion scores were not significantly different in group A ( P = .385), group B ( P = .569), and group C ( P = .340) between 2 and 4 weeks. Meanwhile at 2 weeks, the difference in motion-provoked dizziness score between group A and B was statistically significant ( P = .02). Conclusions: A total VR duration over 4 weeks can reduce dizziness and improve VR benefits in routine therapy in patients with residual dizziness after successful BPPV repositioning. Emotional improvement can be observed after 2 weeks. VR may help to relieve motion-provoked dizziness earlier if patients are willing to consider increasing the duration to more than 15 minutes.
Relationships between COVID-related health literacy, mental health and workload of school leaders
Authors: Kristensen Rune Müller , Dadaczynski Kevin , Okan Orkan , Simovska Venka 
Published: November 2023

Objective: Studies have shown that school leaders’ health literacy is key to supporting health development in school. During the COVID-19 pandemic, the importance of school leaders’ health literacy became evident, as school leadership was characterised with uncertainty and demanded high levels of alertness to the need to implement rapidly changing health-related measures at short notice. This study sought to explore school leaders’ health literacy, mental health and work-related characteristics in Danish public primary and lower secondary schools during the pandemic. Methods: Selecting schools from the national Danish register of institutions a sample of 220 complete responses was achieved in a cross-sectional survey. School leaders or a member of the school management team completed a self-administered version of the COVID-HL: School Principals Survey, which assessed health literacy, three domains of mental health, sense of coherence and workload. Data were analysed using chi-square tests and logistic regression. Results: The majority of school leaders (71.4%) demonstrated a sufficient level of health literacy. However, there was a significant difference in workload increase between those with sufficient (66.0%) and insufficient (81.6%) health literacy. A high general workload was associated with lower well-being, while an increase in workload during the COVID-19 pandemic was linked to psychosomatic complaints. Sense of coherence explained variations in well-being, emotional exhaustion and psychosomatic complaints. Conclusion: This study highlights the importance of enhancing the health literacy of Danish school leaders, enabling them to deal effectively with complex health-related information and make informed decisions during health crises. Strengthening health literacy is crucial to promoting overall health and well-being in schools under normal circumstances, as well as navigating health crises.
Make Microfinance Great Again: Can Flexibility in Repayments Improve Business Outcomes in North India?
Authors: Sangwan Navjot 
Published: November 2023

Classic microfinance loan contracts characterised by rigid weekly repayment schedules used by most microfinance institutions (MFIs) offer little flexibility—and little benefit—to borrowers who are poor and have seasonal income. Previous research has also shown that such contracts can negatively affect the economic well-being of poor borrowers leading to underinvestment of capital, selling of productive assets, over-indebtedness through cross-financing from informal sources, reductions in consumption and income, and in some cases, a deterioration in borrowersʼ mental health arising from stress and worry. If lenders offered more flexibility in loan repayment schedules, would it help to overcome some of these problems? To explore this, we tested whether clientsʼ business outcomes were sensitive to various repayment schedules using primary data collected from the clients of three MFIs, a cooperative society and a few local traders specialising in business lending in a village in North India. We analysed alternatives to the rigid contract model, focussing on the degree of flexibility and the length of gap between repayments in the loan schedule. This study finds that clients repaying their loans monthly invested more in their businesses and earned higher income, compared both to those who repaid weekly and to those with an irregular payment schedule. JEL Codes: G12, D12, O16, O12
Effect of accelerated weathering on the properties of poly(lactic acid)/poly(butylene adipate-co-terephthalate) blend and composite containing wood flour and wollastonite
Authors: Chuayjuljit Saowaroj , Leejarkpai Thanawadee , Chaiwutthinan Phasawat 
Published: November 2023

The objective of the present work was to explore the effects of accelerated weathering test on properties of poly(lactic acid) (PLA)/poly(butylene adipate- co-terephthalate) (PBAT) blend and PLA)/PBAT/wood flour (WF)/wollastonite (WT) composite. The 70/30 (wt%/wt%) PLA/PBAT blend and its composite with 25 phr WF and 5 phr WT were prepared on a twin screw extruder and injection molding machine. Resulted blend and hybrid composite were exposed to accelerated weathering conditions of UV-irradiation and moisture cycles at 63°C in a laboratory Xenon Weather-Ometer chamber for various periods (250, 500, 750, and 1000 h). The alterations in the surface quality (color change), chemical structure, surface morphology, tensile properties, thermal behaviors, and thermal stability of the specimens were evaluated by spectrocolorimetry, Fourier-transform infrared spectroscopy, scanning electron microscopy (SEM), universal testing machine, differential scanning calorimetry and thermogravimetric analysis, respectively. The photo- and hydrolytic degradations were found to occur during the weathering exposure time. Both blend and composite showed a continuous increase in the total color change with prolonged exposure time, which was mainly due to the degradation of PLA and wood components, especially lignin. The SEM images also confirmed their degradations by illustrating roughness, voids, and cavities on the specimen surfaces after accelerated weathering. Meanwhile, the tensile and thermal properties of both blend and composite were found to decrease. Thus, this study can be used for quality control and material certification.
Covered Stents vs Bare Metal Stents for Aortoiliac Arterial Diseases: A Systematic Review and Meta-Analysis
Authors: Zeng Chenlin , Wu Zhaoyu , Lei Jiahao , Pu Hongji , Qiu Peng , Peng Zhaoxi , Liu Yijun , Ye Kaichuang , Lu Xinwu 
Published: November 2023

Purpose: Covered stents and bare metal stents (BMS) have been regarded as viable treatment options for aortoiliac arterial diseases. We performed this systematic review and meta-analysis to compare the efficacy of covered stents with BMS for aortoiliac arterial diseases. Materials and Methods: The Cochrane Library, Embase, and Medline databases were searched by 2 authors (C.Z. and Z.W.) to retrieve all studies comparing the outcomes of covered stents vs BMS for aortoiliac arterial diseases. The Cochrane tool and the Newcastle–Ottawa scale were used to assess the risk of bias in randomized controlled trials and observational studies, respectively. The outcomes at the same stage reported in at least 2 studies were pooled together. The fixed effects model combined the data when I2<50%, otherwise the random effects model was applied. The results for dichotomous variables were presented as odds ratio (OR) or risk difference and 95% confidence interval (CI); continuous variables were reported as mean difference and 95% CI. Results: Herein, 10 studies with a total of 1695 limbs were included. The covered stents significantly increased the freedom from target lesion revascularization (OR 2.85, 95% CI: 1.28–6.33, p=0.010) compared to the BMS during a 24-month follow-up. However, no statistically significant difference was found in the technical success, primary patency, secondary patency, major adverse events (MAEs), ankle-brachial index (ABI) improvement, limb salvage, and survival between the two groups. Conclusion: Compared to BMS, covered stents appear to have similar technical success, primary patency, secondary patency, MAEs, ABI improvement, limb salvage, and survival but may have advantages in reducing target lesion revascularization. More well-designed, prospective studies are warranted to determine such findings. Clinical Impact Covered stents may increase freedom from target lesion revascularization (TLR) compared to bare metal stents (BMS) in the treatment of aortoiliac arterial diseases. However, technical success, primary patency, secondary patency, major adverse events (MAEs), ABI improvement, limb salvage, and survival were similar. The aforementioned results are still not sufficient to draw a solid conclusion about the selection of stents for aortoiliac arterial diseases. More well-designed, prospective studies are warranted to determine such findings.
Systematic Review and Meta-Analysis of the Effect of Anticoagulation on Outcomes After Endovascular Aneurysm Repair
Authors: Kontopodis Nikolaos , Galanakis Nikolaos , Ioannou Christos V. , Antoniou George A. 
Published: November 2023

Purpose: Our objective was to investigate whether patients who receive anticoagulation therapy have different outcomes after endovascular aneurysm repair (EVAR) from those who do not. Materials and Methods: We conducted a systematic review of studies that compared outcomes of EVAR in patients who were on therapeutic anticoagulation vs those who were not. We developed and reported the review in accordance with the PRISMA guidelines with a registered protocol (CRD42022375894). The Ovid interface was used to search Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica Database (EMBASE), and Cochrane Central Register of Controlled Trials (CENTRAL) up to November 2022. The quality of studies was assessed with the Newcastle-Ottawa Scale (NOS) (maximum score=9), and the evidence was appraised with the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework. The hazard ratio (HR) and 95% confidence interval (CI) was the effect estimate in time-to-event meta-analyses, calculated using the inverse-variance statistical method and random-effects models. Results: Sixteen studies qualified for inclusion reporting a total of 35 739 individuals. Anticoagulated patients had a statistically significantly higher hazard of death (HR=1.93, 95% CI=1.03-3.63), endoleak (HR=2.13, 95% CI=1.55-2.93), reintervention (HR=1.79, 95% CI=1.27-2.52), and aneurysm sac expansion (HR=2.72, 95% CI=1.57-4.72) than patients not receiving anticoagulation therapy. The median score on the NOS was 7 (range=4-9). The certainty of evidence was very low for mortality and reintervention and low for endoleak and sac expansion. Conclusions: Anticoagulation is a poor prognostic factor after standard EVAR and should be considered in decision-making, consent processes, and surveillance strategies. Clinical Impact The number of individuals who take anticoagulation treatment has been rapidly increasing over the recent years. We aimed to investigate the effect of such treatment on outcomes after endovascular aneurysm repair (EVAR). Anticoagulated patients were found to have increased mortality, endoleak, and reintervention rates after EVAR compared to their non-anticoagulated counterparts. Anticoagulation therapy has a prognostic role in EVAR and should be considered in decision making and EVAR surveillance. Anticoagulated patients need to be informed of the higher failure rates of EVAR, and intensified surveillance strategies may need to be implemented in this patient cohort.
A case series of image-guided percutaneous drainage of abdominal aortic graft infection as bridge therapy
Authors: Baffoe-Bonnie Helena , Alnahhal Khaled I , Englund Kristin , Baker Mark E , Kirksey Lee 
Published: November 2023

Introduction Aortic graft infection (AGI) is a rare complication following endovascular aneurysm repair and is associated with substantial morbidity and mortality. The traditional management of AGI is intravenous antibiotic therapy and surgical explantation. In this case series, percutaneous drainage was used as a bridge therapy in the treatment of AGI. Methods We report two cases, 78-year-old male and 57-year-old female, in whom image-guided percutaneous drainage was used to treat AGI in two contrasting contexts. Informed consent was obtained from both cases/relatives for publication. Results Both cases underwent successful percutaneous drainage of AGI utilized as a bridge therapy before definitive surgical reconstruction and graft explantation. Each patient had a different outcome. In the first case, the patient’s comorbidities and severe disease state could not be overcome, resulting in his death. The second patient benefitted from the percutaneous drainage by allowing her more time ameliorate her malnutrition before definitive surgery. Conclusion Data on the outcomes of percutaneous drainage of AGI is limited. The successful procedure described in this case series emphasizes the need to conduct more research to evaluate the safety and efficacy of this treatment approach before the surgical explantation.
Conflict with children, psychological depression, and problematic internet use among Chinese older adults: The moderating effect of sociability and living situation
Authors: Liu Tianyuan , Jia Yu , Yang Yang , Chen Qinyu 
Published: November 2023

Introduction Problematic internet use among the elderly is an emerging area as previous studies focused more among the young people. Only a few studies focused on problematic internet use at the level of individual characteristics of older adults or on mitigating factors at the level of the older adult's family, ignoring family-level disruptive factors. Objective The purpose of study is to investigate the relationship between conflict with children and problematic internet use among the elderly, as well as the mediating mechanisms and boundary conditions of the relationship. Methods The valid sample of study composed of 428 older adults from 39 different villages and communities in central China. Data analyses were conducted by SPSS, MPLUS, and SmartPLS software. To test our hypotheses, we implement several quantitative methods, including confirmatory factor analysis (CFA), correlations analysis, and ordinary least squares (OLS) regression. Also, we employed partial least square structural equation modeling (PLS-SEM) for robustness testing. Results The results indicated that conflict with children was positively associated with problematic internet use of old people; psychological depression mediated the relationship between conflict with children and old adults’ problematic internet use; sociability moderated the effect of conflict with children on psychological depression; and living situation moderated the effect of psychological depression on problematic internet use among the elderly. Conclusion The current research improved the understanding of the mechanisms that produce problematic internet use among the elderly and helped prevent or reduce problematic internet use in older adults in terms of family support systems and individual ability characteristics.
Teledermatology in remote Indigenous populations: Lessons learned and paths to explore, an experience from Canada (Québec) and Australia
Authors: Nguyen Alex , Zhu Catherine K , O’Brien Elizabeth 
Published: November 2023

Objective Recent introduction of a provincially funded and administered teledermatology platform in Quebec presents a major opportunity to improve healthcare delivery to rural Indigenous communities where healthcare is suboptimal. In this study, we assessed approaches, challenges, solutions, and outcomes in implementing teledermatology in rural Indigenous communities of Australia and Canada. Methods A narrative review was performed using journal articles and grey literatures to assess challenges encountered in Canadian and Australian teledermatology programs in rural Indigenous communities. We then conducted a focused search to identify solutions and outcomes to these challenges. We identified four main areas of focus for implementing teledermatology: financial, cultural, legal, and provider competency. Results Main financial concerns included identifying the cost-to-benefit ratio of teledermatology and financial benefits of the store-and-forward system compared to videoconferencing. Delivery of teledermatology through culturally considerate services is crucial to mend the mistrust felt by Indigenous people toward mainstream health services. From a legal standpoint, patient confidentiality and physician liability must be considered. A uniform teledermatology platform and physician competency in both telemedicine and dermatology are needed to ensure standard of care. Conclusion Teledermatology initiatives represent great opportunities to improve healthcare services to rural Indigenous populations.
Efficacy of Allograft Versus Bioactive Glass-Ceramic Cage in Anterior Cervical Discectomy and Fusion: A Randomized Controlled Study
Authors: Liu Yanting , Park Chan Woong , Pholprajug Phattareeya , Suvithayasiri Siravich , Kim Jung Hoon , Lee Chorong , Kim Eun , Kim Jin-Sung 
Published: November 2023

Study design A randomized controlled trial. Objective The aim of this study is to compare the efficacy of allografts and bioactive glass-ceramic (BG) cages for anterior cervical discectomy and fusion (ACDF) in treating cervical degenerative disc disease. Methods We conducted a single-center, randomized controlled trial between August 2017 and August 2022. Participants were randomized into two groups, and consecutive patients requiring ACDF were randomly assigned to receive either the allograft cage or the BG cage. The surgical outcomes measured included pain levels, neck disability, surgical details, and radiological assessments. Results Of the 45 assessed, 40 participants were included, with 18 in the allograft cage group and 22 in the BG cage group. By the 12-month follow-up, both groups exhibited significant improvements in pain levels and disability scores, with no notable intergroup differences. Over 85% of patients in both groups were satisfied with their outcomes. Radiological assessments revealed stability in the cervical spine with both cage types post intervention. Although both materials showed a trend toward increased subsidence over time, the difference between them was not statistically significant. Fusion rates were comparable between the groups at 12 months, with BG cage showing a slightly higher early fusion rate at 6 months. No significant differences were observed between the two groups in terms of complications. Conclusions Both allograft and BG cages are effective in ACDF surgeries for cervical degenerative disc disease, with both contributing to substantial postoperative improvements. Differences in disc height, interspinous motion, and subsidence were not significant in the last follow-up, indicating both materials' suitability for clinical use. Future research with a larger cohort and longer follow-up is needed to confirm these preliminary findings.
CAR T-cell therapy in multiple myeloma: mission accomplished?
Authors: Rasche Leo , Hudecek Michael , Einsele Hermann 
Published: November 2023

Abstract
B-cell maturation antigen (BCMA) chimeric antigen receptor (CAR) T cells are the most potent treatment against multiple myeloma (MM). Here, we review the increasing body of clinical and correlative preclinical data that support their inclusion into firstline therapy and sequencing before T-cell–engaging antibodies. The ambition to cure MM with (BCMA-)CAR T cells is informed by genomic and phenotypic analysis that assess BCMA expression for patient stratification and monitoring, steadily improving early diagnosis and management of side effects, and advances in rapid, scalable CAR T-cell manufacturing to improve access.
Use of infection control measures in people with chronic lung disease: mixed methods study
Authors: Jones Arwel W. , King Bill E. , Cumella Andrew , Hopkinson Nicholas S. , Hurst John R. , Holland Anne E. 
Published: November 2023

BackgroundThe introduction of community infection control measures during the COVID-19 pandemic was associated with a reduction in acute exacerbations of lung disease. We aimed to understand the acceptability of continued use of infection control measures among people with chronic lung disease and to understand the barriers and facilitators of use.MethodsAustralian adults with chronic lung disease were invited to an online survey (last quarter of 2021) to specify infection control measures they would continue themselves post-pandemic and those they perceived should be adopted by the community. A subset of survey participants were interviewed (first quarter of 2022) with coded transcripts deductively mapped to the COM-B model and Theoretical Domains Framework.Results193 people (COPD 84, bronchiectasis 41, interstitial lung disease 35, asthma 33) completed the survey. Physical distancing indoors (83%), handwashing (77%), and avoidance of busy places (71%) or unwell family and friends (77%) were measures most likely to be continued. Policies for the wider community that received most support were those during the influenza season including hand sanitiser being widely available (84%), wearing of face coverings by healthcare professionals (67%) and wearing of face coverings by the general population on public transport (66%). Barriers to use of infection control measures were related to physical skills, knowledge, environmental context and resources, social influences, emotion, beliefs about capabilities and beliefs about consequences.ConclusionsAdults with chronic lung diseases in Australia are supportive of physical distancing indoors, hand hygiene, and avoidance of busy places or unwell family and friends as long-term infection control measures.