bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health-related quality of life improvement by adalimumab therapy in patients with rheumatoid arthritis in Taiwan: A nationwide prospective study
Authors: Hsieh Song-Chou , Tsai Ping-Han , Kuo Chang-Fu , Cheng Tien-Tsai , Lai Ning-Sheng , Lin Jing-Chi , Lin Liang-Hung , Tsai Chang-Youh 
Published: January 2023

Background:
To determine the effects of adalimumab on health-related quality of life (HRQoL) in Taiwanese patients with moderate-to-severe rheumatoid arthritis (RA) (NCT02616380).

Methods:
During a 24-week observational period, 100 biologic-naive patients with RA received 40 mg adalimumab subcutaneously, every 2 weeks. The primary endpoint was a change in Health Assessment Questionnaire–Disability Index (HAQ-DI) score at 24 weeks. The secondary endpoints included change in HAQ-DI at week 12, number and percentage of patients achieving a meaningful improvement in HAQ-DI at weeks 12 and 24, and changes in the 36-Item Short Form Health Survey (SF-36), EuroQol 5-dimension 3-level version (EQ-5D-3L) index, and Work Productivity and Activity Impairment (WPAI) questionnaire scores at weeks 12 and 24.

Results:
At weeks 12 and 24, mean changes in HAQ-DI from baseline were −0.34 ± 0.46 and −0.44 ± 0.59 (both p < 0.001), and clinically meaningful improvement in HAQ-DI was achieved by 60.4% and 59.6% of patients, respectively. SF-36, EQ-5D-3L index, and WPAI scores significantly improved (p < 0.001) from baseline to weeks 12 and 24. Exploratory analyses showed diabetes was significantly associated with changes in HAQ-DI, EQ-5D-3L, and WPAI scores whereas peptic ulcer correlated with changes in the SF-36 physical component summary T-score.

Conclusion:
HRQoL improved after initiation of adalimumab therapy in Taiwanese patients with moderate-to-severe RA.
Impact of Type D Personality, Role Strain, and Diabetes Distress on Depression in Women With Type 2 Diabetes: A Cross-Sectional Study
Authors: CHEN Shi-Yu , HSU Hui-Chun , HUANG Chiu-Ling , CHEN Yi-Hsuan , WANG Ruey-Hsia 
Published: January 2023

ABSTRACT

Background
Women with diabetes face a significantly elevated risk of developing depression. Clarifying the factors associated with depression is critical to designing more timely interventions for this vulnerable population.

Purpose
This study was developed to examine the impact of Type D personality, diabetes-care-related role strain, and diabetes-related distress on depression in women with Type 2 diabetes.

Methods
A cross-sectional design was used. Convenience sampling was used to recruit 298 women aged 20–64 years who had been diagnosed with Type 2 diabetes for over 6 months from three outpatient endocrine clinics in Taiwan. Demographic and disease characteristics and Type D personality (negative affectivity and social inhibition), diabetes-care-related role strain, and diabetes-related distress and depression status information were collected using self-reported questionnaires and medical records. The important factors of influence on depression were examined using hierarchical multiple regression.

Results
On the basis of the results of the hierarchical multiple regression analysis, age, negative affectivity, diabetes-care-related role strain, and diabetes-related distress were identified as significantly associated with depression, with negative affectivity explaining most (43.4%) of the variance in depression, followed by diabetes-care-related role strain and diabetes-related distress, which respectively explained 3% and 2.5% of the variance.

Conclusions/Implications for Practice
The negative affectivity associated with the Type D personality was shown to be more significantly associated with depression than diabetes-related psychosocial factors such as diabetes-related distress and diabetes-care-related role strain. Timely assessment of negative affectivity and the provision of brief mindfulness intervention to reduce negative affectivity may be useful in preventing depression in women with Type 2 diabetes, whereas addressing diabetes-related distress and diabetes-care-related role strain should not be neglected when providing comprehensive depression-preventing interventions to young women with diabetes.
An Outpatient-Based Training Program Improves Family Caregivers' Preparedness in Caring for Persons With Mild Cognitive Impairment: A Randomized Controlled Trial
Authors: TUNG Yi-En , KUO Li-Min , CHEN Min-Chi , HSU Wen-Chuin , SHYU Yea-Ing Lotus 
Published: January 2023

ABSTRACT

Background
Little is known regarding the effects of training programs on family caregivers of older persons with mild cognitive impairment because of the significant differences in outcome variables measured in the various studies in the literature.

Purpose
This study was designed to examine the effects of an outpatient-based caregiver training program on the preparedness, health-related quality of life, and depressive symptoms of participants responsible for caring for older persons with mild cognitive impairment.

Methods
A randomized clinical trial was implemented. Of the 54 family caregiver participants who provided complete and valid data, 28 and 26 were assigned to the experimental and control groups, respectively. The experimental group participated in a researcher-developed training program that provided information on mild cognitive impairment, strategies for maintaining and promoting cognitive function in persons with mild cognitive impairment, managing their own and their care recipients' healthcare, and managing their own emotional support and stress. Outcomes (caregiver preparedness, health-related quality of life, and depressive symptoms) were assessed before the start of the training program (baseline) and at 1, 3, and 6 months after completion of the program.

Results
After controlling for baseline cognitive function of the care recipients and of caregiver preparedness, the experimental group was shown to be significantly less prepared than the control group at baseline (β = −1.41, p = .031) and better prepared than the control group at all three posttests (group differences: 1.3, 1.53, and 4.24, respectively), with the difference at the third posttest (6 months) reaching statistical significance (p = .008). No impact of the intervention on caregiver depressive symptoms or health-related quality of life was found at posttest.

Conclusions
The training intervention in this study was found to increase the perceived preparedness of the family caregiver participants to handle various aspects of providing care to persons with mild cognitive impairment. However, no changes were found in depressive symptoms or health-related quality of life.
Six-Minute walk distance predicts outcomes in liver transplant candidates
Authors: Cox-Flaherty Katherine , Moutchia Jude , Krowka Michael J. , Al-Naamani Nadine , Fallon Michael B. , DuBrock Hilary , Forde Kimberly A. , Krok Karen , Doyle Margaret F. , Kawut Steven M. , Ventetuolo Corey E. 
Published: January 2023

A 6-minute walk test is a simple tool for assessing submaximal exercise capacity. We sought to determine whether a 6-minute walk distance (6MWD) predicts outcomes in patients with cirrhosis. The Pulmonary Vascular Complications of Liver Disease 2 study is a multicenter, prospective cohort study that enrolled adults with portal hypertension during liver transplantation evaluation. We excluded subjects with an incident or prevalent portopulmonary hypertension. The 6-minute walk test was performed using standardized methods. Cox proportional hazards modeling and multivariable linear regression analysis were performed to determine the relationship between baseline 6MWD and outcomes. The study sample included 352 subjects. The mean 6MWD was 391±101 m. For each 50-meter decrease in 6MWD, there was a 25% increase in the risk of death (HR 1.25, 95% CI [1.11, 1.41], p < 0.001) after adjustment for age, gender, body mass index, MELD-Na, and liver transplant as a time-varying covariate. In a multistate model, each 50-meter decrease in 6MWD was associated with an increased risk of death before the liver transplant (p < 0.001) but not after the transplant. 6MWD was similar to MELD-Na in discriminating mortality. Each 50-meter decrease in 6MWD was associated with an increase in all-cause (p < 0.001) and transplant-free hospitalizations (p < 0.001) in multivariable models for time-to-recurrent events. Shorter 6MWD was associated with worse Short Form-36 physical (p < 0.001) and mental component scores (p = 0.05). In conclusion, shorter 6MWD is associated with an increased risk of death, hospitalizations, and worse quality of life in patients evaluated for liver transplantation. The 6-minute walk distance may be a useful adjunct for risk assessment in patients undergoing liver transplant evaluation.
Identifying the Distinct Profiles of Transition Readiness in Chinese Pediatric Cancer Survivors
Authors: Cheng Lei , Mao Xiaorong , Chen Qiurong , Pu Huarong , Yu Ling 
Published: January 2023

Background
Transition readiness is important for pediatric cancer survivors who need to move from pediatric to adult medical care. However, their transition readiness profiles merit further exploration.

Objectives
The aim of this study was to use a person-centered approach to identify transition readiness profiles of Chinese pediatric cancer survivors aged 12 to 18 years, diagnosed at least 6 months before the study.

Methods
Transition readiness was assessed using the Chinese TRANSITION-Q Scale, and latent class analysis was performed to identify the transition readiness profiles as well as demographic and clinical factors associated with profile classification and to examine how self-efficacy and quality of life may differ between these profiles.

Results
A total of 139 pediatric cancer survivors were included. Three different transition readiness profiles were identified: high transition readiness, medium transition readiness, and low transition readiness. Age, treatment status, and parental working status were significantly associated with the transition readiness profile classifications. Those who were in the low transition readiness profile were likely to have lower self-efficacy and mobility scores than those in the high or medium transition readiness profiles.

Conclusions
Three distinct transition readiness profiles existed in a sample of Chinese pediatric cancer survivors, indicating significant heterogeneity in their transition readiness.

Implications for Practice
Knowledge of transition readiness profiles can assist clinicians in screening pediatric cancer survivors for their profile memberships and provide targeted interventions for those with a low transition profile.
Effects of a Virtual Reality-Based Meditation Intervention on Anxiety and Depression Among Patients With Acute Leukemia During Induction Chemotherapy
Authors: Zhang Bixia , Jin XiaoHuan , Kuang Xiaolin , Shen Biyu , Qiu Dingrong , Peng Jinrui , Chen Erhui , Dai Xiping , Chen Xiaoling , Wong Cho Lee 
Published: January 2023

BackgroundEmerging evidence supports that virtual reality (VR)–based meditation interventions may improve anxiety and depression among patients with cancer. However, empirical studies involving patients with acute leukemia during induction chemotherapy are limited.ObjectiveThis study aimed to examine the effects of VR-based meditation intervention on alleviating anxiety and depression and improving the quality of life among patients with acute leukemia during induction chemotherapy.MethodsThis randomized controlled trial recruited 63 patients newly diagnosed with acute leukemia. Participants were randomly assigned to an intervention group (received VR-based meditation for 20 min daily for 14 days) and a control group. Anxiety, depression, and quality of life were measured using the State Anxiety Inventory, the Center for Epidemiological Studies Depression Scale, and the Functional Assessment of Cancer Therapy-Leukemia Questionnaire, respectively. All outcomes were measured at baseline and post-intervention.ResultsCompared with patients in the control group, those in the intervention group demonstrated a significantly greater reduction in anxiety (P= .04) and improvement in quality of life (P= .04). However, no significant difference was noted in depression levels between groups (P= .09), although a decreasing trend was observed in the intervention group.ConclusionVirtual reality–based meditation intervention effectively alleviated anxiety and improved the quality of life among acute leukemia patients during induction chemotherapy. Future randomized controlled trials with larger sample sizes and longer follow-up periods are warranted.Implication for PracticeVirtual reality–based meditation can be applied in clinical practice virtually anytime and anywhere to provide a convenient intervention for anxiety reduction for acute leukemia patients during induction chemotherapy.
Perceptions of Authentic Nurse Leader Attributes Among Clinical Nurses and Nurse Leaders
Authors: Giordano-Mulligan Marie , Moran-Peters Judith Ann , Eckardt Sarah 
Published: January 2023

OBJECTIVE
This study aimed to develop and validate a tool to measure authentic nurse leadership (ANL) from the perspective of nurse leaders.

BACKGROUND
The COVID-19 pandemic heightened the need for ANL to establish healthy work environments (HWE) that promote positive outcomes.

METHODS
A nonexperimental design and exploratory psychometric analysis developed and validated the Authentic Nurse Leadership Questionnaire for Nurse Leaders (ANLQ-NL) instrument. Relationships were explored between ANLQ-NL and HWE, as measured by the Areas of Worklife Survey (AWS). The Marlowe-Crowne Social Desirability Scale (MC-SDS) was used to measure the nurse leaders' tendency to produce socially desirable responses. The sample consisted of 188 nurse leaders from several US hospitals.

RESULTS
The ANLQ-NL instrument was found to be valid and highly reliable. Each of the constructs aligned with the ANL conceptual framework.

CONCLUSION
The ANL conceptual framework and instruments (ANLQ and ANLQ-NL) can be used for educational programs aimed at developing ANL attributes among nurses.
Retaining the Best
Authors: Sweeney Cynthia Divens , Wiseman Rebecca 
Published: January 2023

OBJECTIVE
The purpose of this study was to identify what meaningful recognition is to nurses in a postpandemic healthcare landscape.

BACKGROUND
The COVID pandemic has exacerbated the critical need to retain our nursing workforce. Meaningful recognition as a component of a healthy work environment can be a strategy to retain nurses. Identifying what is considered meaningful recognition to nurses will optimize organizational use of it.

METHODS
A descriptive correlational design was used. Members of Sigma Theta Tau in the state of Maryland were asked to respond to an online survey consisting of demographic data and questions exploring meaningful recognition and the healthy work environment using tools with established reliability and validity. Deidentified data from 163 respondents were collected.

RESULTS
Meaningful recognition strategies that meant the most to nurses in this study were: 1) reasonable payment for level of service provided; 2) public recognition within the organization and the profession; and 3) opportunities for professional development. Trends in desired meaningful recognition varied across ethnic/racial and gender groups.

CONCLUSIONS
Meaningful recognition to nurses is as diverse as the nursing population. It is important that instruments be developed to capture the rich cultural and ethnic differences in relation to what is considered meaningful recognition to the nursing workforce. Although pay, public recognition, and opportunities for advancement were seen in this study as important forms of meaningful recognition, a deeper exploration across ethnic, racial, and gender groups is needed. This study underscored that one size of meaningful recognition does not fit all.
“Could this be cancer?” Addressing diagnostic delay disparities in adolescents and young adults with cancer through targeted awareness and mitigation of barriers to help-seeking behaviors
Authors: Larsen Lorna L. V. 
Published: January 2023

Abstract
Adolescents and young adults (AYAs) with cancer worldwide face unique challenges throughout the course of their disease. Disproportionately long diagnostic delays have been identified as one of the disparities in their care. Decreasing delays in diagnosis requires a multifaceted approach targeting a number of stakeholders including well AYAs and ultimately AYAs with cancer not yet diagnosed. Identifying help-seeking barriers and taking steps to mitigate them has the potential to reduce diagnostic intervals and improve outcomes. AYAs need to understand their cancer risk and early cancer warning signs and be reassured about high cure rates for early cancer. Effective health promotion approaches designed to reach AYAs with symptoms and early detection messages help reduce help-seeking barriers and empower AYAs to ask the question “Could this be cancer?” Upstream cancer awareness and education strategies have the potential to expedite time to diagnosis and treatment, decrease distress, improve patient outcomes, and reduce survivorship disparities.
Concomitant occurrence of acute motor axonal neuropathy in systemic lupus erythematosus
Authors: Lee Mirim , Lee Chang Hee , Ko Jun Young , Kim Aram 
Published: January 2023

Abstract
Few case reports exist on the association of acute motor axonal neuropathy (AMAN), a subtype of the Guillain–Barre syndrome (GBS), with systemic lupus erythematosus (SLE). Standard therapeutic guidelines for concomitant AMAN and SLE in the acute phase are not established, and no studies have reported physical medicine and rehabilitation perspective management in the plateau and recovery phases. A 50-year-old woman with SLE presented with upper- and lower-limb weakness that progressed to an inability to walk. Neurological examination, radiologic evaluation, serologic analysis, and electrodiagnostic study were conducted, and she was diagnosed with AMAN. Subsequently, intravenous immunoglobulin therapy was administered. She complained of residual upper and lower extremity weakness and an inability to walk 3 months after symptom onset. She underwent an intensive inpatient rehabilitation program for 6 weeks, and showed remarkable recovery in muscle strength and functional status (Berg balance scale, modified Barthel index, and GBS disability scale). To our knowledge, this is the first reported case that focused on the functional outcomes after the rehabilitation program in AMAN with a history of SLE. This case report emphasizes the need for rehabilitation intervention for functional recovery in the plateau and recovery phases.
Emerging Challenges to Cellular Therapy of Cancer
Authors: Lulla Premal D. , Brenner Malcolm 
Published: January 2023

AbstractCellular immunotherapy of cancer in the form of chimeric antigen receptor–modified T-cell therapy has become a standard treatment for lymphoid and more recently plasma cell malignancies. Although their successes in these cancers represent a breakthrough for adoptive cell therapy, there are several challenges to their continued growth in the field of cancer medicine. In this review, we discuss the progress made thus far toward achieving “off-the-shelf” accessibility of cell therapies that has the potential to greatly offset the costs associated with the current practice of making patient-specific products. We also review the innovations under investigation that attempt to make cellular therapy applicable to solid tumors as well.
Transcription Factors and Cancer
Authors: Shiah Jamie V. , Johnson Daniel E. , Grandis Jennifer R. 
Published: January 2023

Abstract
Cancer is defined by the presence of uncontrollable cell growth, whereby improper proliferative signaling has overcome regulation by cellular mechanisms. Transcription factors are uniquely situated at the helm of signaling, merging extracellular stimuli with intracellular responses. Therefore, this class of proteins plays a pivotal role in coordinating the correct gene expression levels for maintaining normal cellular functions. Dysregulation of transcription factor activity unsurprisingly drives tumorigenesis and oncogenic transformation. Although this imparts considerable therapeutic potential to targeting transcription factors, their lack of enzymatic activity renders intervention challenging and has contributed to a sense that transcription factors are “undruggable.” Yet, enduring efforts to elucidate strategies for targeting transcription factors as well as a deeper understanding of their interactions with binding partners have led to advancements that are emerging to counter this narrative. Here, we highlight some of these approaches, focusing primarily on therapeutics that have advanced to the clinic.
Streamlining and Consistency in Surgery: Lean-Six-Sigma to Improve Operating Room Efficiency
Authors: Tanna Neil , Clappier Mona , Barnett Sarah L. , Talamini Mark A. , Coppa Gene F. , Cifu Kelly , Bianculli Andrea R. , Drummond Donna , Bello Stephen , Smith Mark L. 
Published: January 2023

Introduction:
Improving peri-operative efficiency helps reduce unnecessary surgical expenditure, increase operating room (OR) throughput, improve patient safety, and enhance staff and patient satisfaction. Lean Six-Sigma (LSS) is a quality improvement model that has been successfully applied to eliminate inefficiencies in the business sector but has not yet been widely adopted in medicine. This study investigates the adaptation of LSS to improve operative efficiency for plastic surgery procedures.

Methods:
The authors followed the Define, Measure, Analyze, Improve, and Control (DMAIC) phases to implement LSS. The key outcome measures gathered were operative times, including the cut-to-close time and the total time the patient spent in the operating room.

Results:
The study included a total of 181 patients who underwent immediate bilateral DIEP flap breast reconstruction between January 2016 and December 2019. The LSS interventions were associated with a decrease in total operative time from 636.36 minutes to 530.35 minutes, and a decrease in the time between incision to closure from 555.16 minutes to 458.85 minutes for a bilateral mastectomy with immediate DIEP flap breast reconstruction.

Conclusion:
This study demonstrates that Lean-Six-Sigma is useful to improve peri-operative efficiency during complex plastic surgery procedures. The workflow of the procedure was improved by determining the optimal spatial positioning and distinct roles for each surgeon and preparing surgeon-specific surgical trays. Two process maps were developed to visualize the positioning of the surgeons during each stage of the procedure and depict the parallel workflow that helped improve intraoperative efficiency.