bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effects of exercise interventions on physical performance and activities of daily living in oldest-old and frail older adults: a review of the literature
Authors: Lau Lay Khoon , Tou Nien Xiang , Abdul Jabbar Khalid , Tang Jia Ying , Gao Jonathan , Ding Yew Yoong , Ng Yee Sien 
Published: April 2023

Abstract
This review examined and compared the effects of exercise interventions using portable exercise equipment on muscle strength, balance, and ability to perform activities of daily living (ADL) in the oldest-old and frail. We also examined the differences in the intervention characteristics between these two groups. The CINAHL, MEDLINE and COCHRANE databases were searched using specific text words and MeSH for randomised controlled trials published from 2000 to 2021, which involved exercise interventions for either oldest-old (≥75 years old) or physically frail (reduced muscular strength, endurance and physiological function) older adults. A total of 76 articles were included in this review, in which 61 studies involved oldest-old adults and 15 studies examined frail adults. Subgroup reviews of community dwelling and institutionalized adults were performed. The empirical evidence suggests that single-component and multicomponent exercise interventions, produced positive effects for both older adult groups on muscle strength and balance, respectively. The effects of multicomponent interventions on muscular strength could be dependent on the number of exercise components per session. The effects of exercises on ADL enhancement were less clear. We advocate for single intervention resistance training in all oldest-old and frail seniors to improve strength, if compliance to exercise duration is an issue.
Clinical and Electrophysiological Characteristics of Very Early Guillain–Barré Syndrome
Authors: Kumar Mritunjai , Dhar Nikita , Tiwari Ashutosh , Singh Jagbir , Jatale Vinayak 
Published: April 2023

Purpose:
This study compared the clinical and electrodiagnostic (EDX) features and long-term outcomes of patients with very early Guillain–Barré syndrome (VEGBS, duration of illness ≤4 days) and those with early/late (>4 days)-presenting GBS.

Methods:
One hundred patients with GBS were clinically evaluated and categorized into VEGBS and early/late GBS groups. Electrodiagnostic studies were performed on the bilateral median, ulnar, and fibular motor nerves and the bilateral median, ulnar, and sural sensory nerves. Admission and peak disability were assessed using the 0 to 6 Guillain–Barré Syndrome Disability Scale (GBSDS). The primary outcome was disability at 6 months, which was categorized as complete (GBSDS ≤1) or poor (GBSDS ≥2). The secondary outcomes were frequencies of abnormal electrodiagnostic findings, in-hospital progression, and mechanical ventilation (MV).

Results:
Patients with VEGBS had higher peak disability (median 5 vs. 4; P = 0.02), frequent in-hospital disease progression (42.9% vs. 19.0%, P < 0.01), needed MV (50% vs. 22.4%; P < 0.01), and less frequent albuminocytologic dissociation (52.4% vs. 74.1%; P = 0.02) than those with early/late GBS. Thirteen patients were lost to follow-up at 6 months (nine patients with VEGBS and four patients with early/late GBS). The proportion of patients with complete recovery at 6 months was comparable (60.6% vs. 77.8%; P = ns). Reduced d-CMAP was the most common abnormality, noted in 64.7% and 71.6% of patients with VEGBS and early/late GBS, respectively (P = ns). Prolonged distal motor latency (≥130%) was more common in early/late GBS than in VEGBS (36.2% vs. 25.4%; P = 0.02), whereas absent F-waves were more frequent in VEGBS (37.7% vs. 28.7%; P = 0.03).

Conclusions:
Patients with VEGBS were more disabled at admission than those with early/late GBS. However, 6 month's outcomes were similar between the groups. F-wave abnormalities were frequent in VEGBS, and distal motor latency prolongation was common in early/late GBS.
Changes in Inpatient Electroconvulsive Therapy Utilization Between 2019 and 2020
Authors: Luccarelli James , Henry Michael E. , Smith Felicia , Beach Scott R. , McCoy Thomas H. 
Published: April 2023

Objectives
Electroconvulsive therapy (ECT) is an essential procedure for a range of psychiatric conditions. Multiple single-center studies have documented reduction in ECT administration in 2020 because of the coronavirus disease 2019 pandemic, but there have been little nationally representative data from the United States. The aim of this study was to examine the demographics of patients receiving ECT in 2019 and 2020 and to characterize temporal and regional variations in ECT utilization.

Methods
The 2019 and 2020 National Inpatient Sample, an administrative database of inpatient hospitalizations in the United States, was queried for hospitalizations involving the delivery of ECT based on procedural codes. Overall number of ECT procedures was calculated based on the overall number of ECT procedural claims.

Results
In the 2019 NIS, 14,230 inpatient hospitalizations (95% confidence interval, 12,936–15,524) involved the use of ECT, with a cumulative 52,450 inpatient ECT procedures administered. In 2020, the number of inpatient hospitalizations with ECT decreased to 12,055 (95% confidence interval, 10,878–13,232), with a 10.0% reduction in overall procedures to 47,180. Whereas January and February ECT hospitalizations were comparable in both years, ECT hospitalizations decreased by more than 25% in March through May 2020 relative to 2019 volume. There was regional variability in the change in ECT utilization between 2019 and 2020.

Conclusions
Electroconvulsive therapy use among general hospital inpatients declined between 2019 and 2020, with regional variability in the magnitude of change. Further study is warranted into the root causes and optimal responses to these changes.
ApoA-I Protects Pancreatic β-cells from Cholesterol-induced Mitochondrial Damage and Restores their Ability to Secrete Insulin
Authors: Manandhar Bikash , Pandzic Elvis , Deshpande Nandan , Chen Sing-Young , Wasinger Valerie , Kockx Maaike , Glaros Elias , Ong Kwok Leung , Thomas Shane R. , Wilkins Marc R. , Whan Renee M. , Cochran Blake J. , Rye Kerry-Anne 
Published: April 2023

ABSTRACTObjective:High cholesterol levels in pancreatic β-cells cause oxidative stress and decrease insulin secretion. β-cells can internalize apolipoprotein (apo) A-I, which increases insulin secretion. This study asks whether internalization of apoA-I improves β-cell insulin secretion by reducing oxidative stress.Approach:Ins-1E cells were cholesterol-loaded by incubation with cholesterol-methyl-β-cyclodextrin. Insulin secretion in the presence of 2.8 or 25 mM glucose was quantified by radioimmunoassay. Internalization of fluorescently labelled apoA-I by β-cells was monitored by flow cytometry. The effects of apoA-I internalization on β-cell gene expression was evaluated by RNA sequencing. ApoA-I binding partners on the β-cell surface were identified by mass spectrometry. Mitochondrial oxidative stress was quantified in β-cells and isolated islets with MitoSOX and confocal microscopy.Results:An F1-ATPase β-subunit on the β-cell surface was identified as the main apoA-I binding partner. β-cell internalization of apoA-I was time-, concentration-, temperature-, cholesterol- and F1-ATPase β-subunit-dependent. β-cells with internalized apoA-I (apoA-I+cells) had higher cholesterol and cell surface F1-ATPase β-subunit levels than β-cells without internalized apoA-I (apoA-I−cells). The internalized apoA-I co-localized with mitochondria and was associated with reduced oxidative stress and increased insulin secretion. The ATPase inhibitory factor 1, IF1, attenuated apoA-I internalization and increased oxidative stress in Ins-1E β-cells and isolated mouse islets. Differentially expressed genes in apoA-I+and apoA-I−Ins-1E cells were related to protein synthesis, the unfolded protein response, insulin secretion and mitochondrial function.Conclusions:These results establish that β-cells are functionally heterogeneous and apoA-I restores insulin secretion in β-cells with elevated cholesterol levels by improving mitochondrial redox balance.
Use of genetic correlations to examine selection bias
Authors: Shapland Chin Yang , Gkatzionis Apostolos , Hemani Gibran , Tilling Kate 
Published: April 2023

AbstractObservational studies are rarely representative of their target population, because there are known and unknown factors that affect an individual’s choice to participate (known as the selection mechanism). Selection can cause bias in a given analysis, if the outcome is related to selection (conditional on the other variables in the model). However, the selection mechanism usually cannot be detected from the observed data if we have no data on the non-selected sample - for example, when the selected sample is participants in a research study. Here, we develop methods to examine the selection mechanism by comparing correlations among variables in the selected sample to those expected under no selection. We examine the use of four hypothesis tests to identify induced associations between genetic variants in the selected sample. We evaluate these approaches with Monte Carlo simulations. Finally, these approaches are demonstrated with an applied example, using data from UK Biobank (UKBB), with alcohol intake as exposure to test the presence of selection bias. The proposed tests have identified selection due to alcohol intake into UKBB, and the subsample of individuals with weekly alcohol intake. Analyses in UKBB with alcohol consumption as exposure or outcome may be biased by this selection.
Incidence and Pattern of Childhood Cancer in Addis Ababa, Ethiopia (2012 - 2017)
Authors: Belay Amanuel , Ali Ahmed , Ayele Wondimu , Assefa Mathewos , Jemal Ahmedin , Kantelhardt Eva J. 
Published: April 2023

AbstractBackgroundCancer is becoming a major public health problem and a leading cause of death in children worldwide. However, little is known about the epidemiology of childhood cancer in Ethiopia. This study, therefore, assessed childhood cancer incidence patterns in Addis Ababa using the Addis Ababa city population-based cancer registry data from 2012-2017.MethodsInvasive cancer cases diagnosed in ages 0-14 years from 2012-2017 were obtained from the Addis Ababa City population-based Cancer Registry. Cases were grouped according to the International Classification of Childhood Cancer, 3rd edition (ICCC-3) based on morphology and primary anatomic site. Age-standardized incidence rates (ASR) were calculated by the direct method using the world standard population.ResultsThe overall average annual incidence rate during 2012-2017 in children was 84.6 cases per million, with rates higher in boys (98.97 per million) than in girls (69.7 per million). By age, incidence rates per million increased from 70.8 cases in ages 0-4 years to 88.4 cases in ages 5-9 years to 110.0 cases 10-14 years. Leukemia was the most common childhood cancer in both boys (29.1%) and girls (26.8%), followed by lymphoma in boys (24.7%) and renal tumours (13.1%) in girls. The overall cancer incidence rate decreased from 87.02 per million in 2012 to 51.07 per million in 2017.ConclusionThe burden of childhood cancer is considerably high in Addis Ababa, and its profile is generally similar to those from other parts of sub-Saharan Africa except that renal tumour is the 2ndmost commonly diagnosed cancer in girls in Addis Ababa. Future studies should examine risk factors for the occurrence of childhood cancer in Addis Ababa and other parts of Ethiopia.
EFFICACY AND SAFETY OF NICORANDIL IN ACUTE CORONARY SYNDROME: A META-ANALYSIS
Authors: Dani Avichal , Raithatha Shubh , Desai Dev 
Published: April 2023

AbstractBackgroundNicorandil acts as a potassium channel opener, however its cardio protective benefit is still uncertain. This meta-analysis was conducted with the objective of evaluating the efficacy of nicorandil in improving cardiovascular outcomes in acute coronary syndrome.Main BodyA total of 24 RCTs with 1640 patients in the nicorandil group and 1592 patients in the control group were identified following PRISMA guidelines till November 2019 and were matched for inclusion and exclusion criteria. The following search strings and MESH terms were used: “nicorandil”, “ACS”, “MACE”. Following this, nicorandil was evaluated for its efficacy and safety outcomes. RevMan 5.3 was used for appropriate statistical tests. Fixed and Random Effect Model Test were used and p<0.05 was considered statistically significant.ResultsAdministration of nicorandil was found to be associated with a significant decrease in MACE (RR = 0.686, 95% CI = 0.509-0.925, p=0.013), no-reflow phenomenon (RR =0.395, 95% CI = 0.266-0.588, p<0.001) and worsening of HF (RR =0.441, 95% CI = 0.221-0.882, p=0.021). It was also associated with significant improvement in LVEF (SMD= 0.637, 95% CI= 0.0972 to 1.177, p=0.021) and significant lowering of cTFC (SMD= -0.216, 95% CI= -0.428 to -0.0041, p=0.046)ConclusionsNicorandil does indeed exert a cardio protective effect by improving cardiovascular outcomes. There is a significant decrease in occurrences of MACE and worsening of HF. There is also significant improvement in LVEF.
Direct and indirect impact of the COVID-19 pandemic on the survival of kidney transplant recipients: a national observational study in France
Authors: Leye Elhadji , Delory Tristan , Karoui Khalil El , Espagnacq Maude , Khlat Myriam , Coeur Sophie Le , Lapidus Nathanaël , Hejblum Gilles 
Published: April 2023

AbstractBackgroundDuring the pandemic period, healthcare systems were substantially reorganized for managing COVID-19 cases. The corresponding changes on the standard care of persons with chronic diseases and the potential consequences on their outcomes remain insufficiently documented. This observational study investigates the direct and indirect impact of the pandemic period on the survival of kidney transplant recipients (KTR), in particular in those not hospitalized for COVID-19.MethodsWe conducted a cohort study using the French national health data system which contains all healthcare consumptions in France. Incident persons with end stage kidney disease between January 1, 2015 and December 31, 2020 who received a kidney transplant were included and followed-up from their transplantation date to December 31, 2021. The survival of KTR during the pre-pandemic and pandemic periods was investigated using Cox models with time-dependent covariates, including vaccination and hospitalization events.FindingsThere were 10,637 KTR included in the study, with 324 and 430 deaths observed during the pre-pandemic (15,115 person-years of follow-up) and pandemic periods (14,657 person-years of follow-up), including 127 deaths observed among the 659 persons with a COVID-19-related hospitalization. In multivariable analyses, the risk of death during the pandemic period was similar to that observed during the pre-pandemic period (hazard ratio (HR) [95% confidence interval]: 0 ·92 [0·77–1·11]), while COVID-19-related hospitalization was associated with an increased risk of death (HR: 10 ·62 [8·46–13·33]). In addition, pre-emptive kidney transplantation was associated with a lower risk of death (HR: 0·71 [0·56–0·89]), as well as a third vaccine dose (HR: 0·42 [0·30– 0·57]), while age, diabetes and cardiovascular diseases were associated with higher risks of death.InterpretationConsidering persons living with a kidney transplant with no severe COVID-19-related hospitalization, the pandemic period was not associated with a higher risk of death.FundingInitiative Économie de la Santé de Sorbonne Université (Idex Sorbonne Université, programmes Investissements d’Avenir); Ministère de la Solidarité et de la Santé (PREPS 20-0163).
Identification of probable child maltreatment using prospectively recorded information between 5 months and 17 years in a longitudinal cohort of Canadian children
Authors: Scardera Sara , Langevin Rachel , Collin-Vezina Delphine , Comtois Cabana Maude , Pinto Pereira Snehal M , Côté Sylvana , Ouellet-Morin Isabelle , Geoffroy Marie-Claude 
Published: April 2023

AbstractBackgroundBoth prospective and retrospective measures of child maltreatment predict mental health problems, despite their weak concordance. Research remains largely based on retrospective reports spanning the entire childhood due to a scarcity of prospectively completed questionnaires targeting maltreatment specifically.ObjectiveWe developed a prospective index of child maltreatment in the Québec Longitudinal Study of Child Development (QLSCD) using prospective information collected from ages 5 months to 17 years and examined its concordance with retrospective maltreatment.Participants and SettingThe QLSCD is an ongoing population-based cohort that includes 2,120 participants born from 1997-1998 in the Canadian Province of Quebec.MethodsAs the QLSCD did not have maltreatment as a focal variable, we screened 29,600 items completed by multiple informants (mothers, children, teachers, home observations) across 14 measurement points (0-17 years). Items that could reflect maltreatment were first extracted. Two maltreatment experts reviewed these items for inclusion and determined cut-offs for possible child maltreatment. Retrospective maltreatment was self-reported at 23 years.ResultsIndicators were derived across preschool, school-age and adolescence periods and by the end of childhood and adolescence, including presence (yes/no), chronicity (re-occurrence), extent of exposure and cumulative maltreatment. Across all developmental periods, the presence of maltreatment was as follows: physical abuse (16.3-21.8%), psychological abuse (3.3-21.9%), emotional neglect (20.4-21.6%), physical neglect (15.0-22.3%), supervisory neglect (25.8-44.9%), family violence (4.1-11.2%) and sexual abuse (9.5% in adolescence only).ConclusionsIn addition to the many future research opportunities offered by these prospective indicators of maltreatment, this study offers a roadmap to researchers wishing to undertake a similar task.HighlightsIn this longitudinal cohort, maltreatment experts retained 251 of 29,600 items availableProbable maltreatment indicators were derived: presence, chronicity, extent of exposure, and cumulative maltreatmentPrevalence rates vary from 3.3% and 44.9% across developmental periods, and 16.5-67.3% by the end of adolescenceProspective and retrospective maltreatment identify different groups of individualsAs most studies use retrospective data, findings suggest that the representation of child maltreatment is incomplete and retrospective reports should be complimented by prospective data, whenever possible
Deep Learning Using High-Resolution Images of Forearm Predicts Fracture
Authors: Chapurlat Roland , Ferrari Serge , Li Xiaoxu , Peng Yu , Xu Min , Bui Min , Sornay-Rendu Elisabeth , lespessailles Eric , Biver Emmanuel , Seeman Ego 
Published: April 2023

AbstractImportanceFragility fractures are a public health problem. Over 70% of women having fractures have osteopenia or normal BMD, but they remain unidentified and untreated because the definition of ‘osteoporosis’, a bone mineral density (BMD) T-Score ≤ -2.5SD, is often used to signal bone fragility.ObjectiveAs deep learning facilitates investigation of bone’s multi-level hierarchical structure and soft tissue, we tested whether this approach might better identify women at risk of fracture before fracture.DesignWe pooled data from three French and Swiss prospective population-based cohorts (OFELY, QUALYOR, GERICO) that collected clinical risk factors for fracture, areal BMD and distal radius measurements with high resolution peripheral quantitative tomography (HRpQCT). Using only three-dimensional images of the distal radius, ulna and soft tissue acquired by HRpQCT, an algorithm, a Structural Fragility Score-Artificial Intelligence (SFS-AI), was trained to distinguish 277 women having fractures from 1401 remaining fracture-free during 5 years and then was tested in a validation cohort of 422 women.SettingEuropean postmenopausal womenParticipantsWe have studied postmenopausal women considered as representative of the general population, who were followed for a median 9.4 years in OFELY, 5.4 years in QUALYOR and 5.7 years in GERICO.Main outcome and measureAll types of incident fragility fracturesResultsWe used data from 2666 postmenopausal women, with age range of 42-94. In women ≥ 65 years having ‘All Fragility Fractures’ or ‘Major Fragility Fractures’, SFS-AI generated an AUC of 66-70%, sensitivities of 60-68% and specificity of 71%. Sensitivities were greater than achieved by the fracture risk assessment (FRAX) with BMD or BMD (6.7-26.7%) with lower specificities than these diagnostics (∼95%).Conclusion and relevanceThe SFS-AI is a holistic surrogate of fracture risk that pre-emptively identifies most women needing prompt treatment to avert a first fracture.Key PointsQuestionCan a deep learning model (DL)° based on high resolution images of the distal forearm predict fragility fractures?FindingsIn the setting of 3 pooled population-based cohorts, the DL model predicted fractures substantially better than areal bone mineral density and FRAX, especially in women ≥65 years.MeaningOur DL model may become an easy to use way to identify postmenopausal women at risk for fracture to improve fracture prevention.
Digitally managing depression: a fully remote randomized attention-placebo controlled trial
Authors: Kandola Aaron , Edwards Kyra , Muller Marie AE , Dührkoop Bettina , Hein Bettina , Straatman Joris , Hayes Joseph F 
Published: April 2023

AbstractBackgroundDepression is a common and disabling condition. Digital apps may augment or facilitate care, particularly in under-served populations. We tested the efficacy of juli, a digital self-management app for depression in a fully remote randomized controlled trial.MethodsWe completed a pragmatic single-blind trial of juli for depression. We included participants aged over 18 who self-identified as having depression and scored 5 or more on the Patient Health Questionnaire-8 (PHQ-8). Participants were randomly assigned (1:1) to receive juli for 8 weeks or a limited attention-placebo control version of the app. Our primary outcome was the difference in PHQ-8 scores at 8 weeks. Secondary outcomes were remission, minimal clinically important difference, worsening of depression, and health-related quality of life. Analyses were per protocol (primary) and modified intention-to-treat (secondary). The trial was registered at the ISRCTN registry (ISRCTN12329547).ResultsBetween May 2021 and January 2023, we randomised 908 participants. 662 completed the week 2 outcome assessment and were included in the modified intention-to-treat analysis, and 456 completed the week 8 outcome assessments (per protocol). The mean baseline PHQ-8 score was consistent with a diagnosis of moderately severe depression. In the per-protocol analysis, the juli group had a lower mean PHQ-8 score (10.78, standard deviation 6.26) than the control group (11.88, standard deviation 5.73) by week 8 (baseline adjusted β-coefficient -0.94, 95%CI -1.87 to -0.22, p=0.045). Remission and minimal clinically important difference were increased in the juli group at 8 weeks (adjusted odds ratio 2.22, 95%CI 1.45-3.39, p<0.001 and adjusted odds ratio 1.56, 95%CI 1.08 to 2.27, p=0.018). There were no between-group differences in health-related quality of life physical or mental component scores or worsening of depression.ConclusionUse of juli reduced symptoms of depression at 8 weeks compared with an attention-placebo control. The juli app is a digital self-management tool that could increase accessibility of evidence-based depression treatments.