bluuebunny/crossref_metadata_2025_split huggingface dataset:
Commercial exergames for rehabilitation of physical health and quality of life: a systematic review of randomized controlled trials with adults in unsupervised home environments
Authors: Rüth Marco , Schmelzer Mona , Burtniak Kateryna , Kaspar Kai 
Published: June 2023

BackgroundCommercial exergames are widely available tools that can support physical rehabilitation at home. However, the effects of the unsupervised use of commercial exergames in home environments are not yet clear. Hence, we provide a systematic review on the effects of unsupervised commercial exergaming at home on adults' physical health (RQ1) and quality of life (RQ2). We also scrutinize adults' experiences with exergaming at home regarding participant support, adherence, and adverse outcomes (RQ3).MethodsWe searched Web of Science, PsycINFO, PubMed, Embase, and CINAHL for peer-reviewed randomized controlled trials with adults in need of rehabilitation. Overall, 20 studies (1,558 participants, 1,368 analyzed) met our inclusion criteria. The quality of evidence was assessed with the Cochrane risk of bias tool.ResultsEffects of unsupervised commercial exergaming at home on physical health were higher in seven studies and similar in five studies regarding the respective comparison or control conditions; eight studies reported non-significant findings. Of the 15 studies that also examined effects on quality of life, improvements were higher in seven studies and similar in two studies regarding the respective comparison or control conditions; results were non-significant in six studies. Participant support consisted of setup of the exergaming system, instructions, training, and contact with participants. Adherence was high in eight studies, moderate in six studies, and low in one study. Adverse outcomes related to exergaming were found in four studies and were at most moderate. Concerning the quality of evidence, six studies were related to a high risk of bias due to outcome reporting bias or ceiling effects in the primary outcome. Additionally, 10 studies yielded some concerns, and four studies were related to a low risk of bias.DiscussionThis systematic review summarizes promising evidence that the unsupervised use of commercial exergames can support and complement rehabilitation measures in home environments. Still, future studies based on larger samples and using more recent commercial exergames are needed to obtain more high-quality evidence on the effects of different exercise prescriptions. Overall, considering the necessary precautions, the unsupervised use of commercial exergames at home can improve the physical health and quality of life in adults with needs for physical rehabilitation.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022341189, identifier: PROSPERO, Registration number: CRD42022341189.
Do toddlers’ levels of cortisol and the perceptions of parents and professional caregivers tell the same story about transition from home to childcare? A mixed method study
Authors: Drugli May Britt , Nystad Kathrin , Lydersen Stian , Brenne Anne Synnøve 
Published: June 2023

IntroductionEnrolling in childcare represents the first transition in toddlers’ lives and lays the foundation for their well-being in childcare centers going forward. Child cortisol levels may be an indicator of how toddlers themselves experience their introduction to childcare. In the present study, we explored changes in toddler cortisol levels during their first month in childcare and at a 3-month follow-up, as well as the perceptions of parents and professional caregivers regarding the toddlers’ settling-in process during the same period.MethodThis study used a mixed-method design. Saliva samples were collected from 113 toddlers and their cortisol levels analyzed. Qualitative notes were collected from parents (n = 87) and professional caregivers (n = 101). The data were analyzed using linear mixed model and thematic analyses, respectively.ResultsChanges in toddler cortisol levels and their parents’ and professional caregivers’ perceptions of the transition process fit well. Both data sources indicated an easy start in childcare when parents were present, while the first weeks separated from parents seemed quite demanding. After 3 months, the cortisol levels returned to a low level, while child well-being was perceived as high.DiscussionToddlers need time to adapt to childcare settings. Even if they are well taken care of by their keyworkers during the day, many toddlers are tired and exhausted in the evenings at home, particularly in the first weeks of separation from their parents. Both professional caregivers and parents should be aware of toddlers’ need for emotional support during their transition to childcare.
Cost-effectiveness of peer-supported self-management for people discharged from a mental health crisis team: methodological challenges and recommendations
Authors: Le Novere Marie , Johnson Sonia , Lloyd-Evans Brynmor , Marston Louise , Ambler Gareth , Clarke Caroline S. , Osborn David , Lamb Danielle , Hunter Rachael Maree 
Published: June 2023

BackgroundMental health acute crisis episodes are associated with high inpatient costs. Self-management interventions may reduce readmission by enabling individuals to manage their condition. Delivery of such interventions by Peer Support Workers (PSWs) may be cost-effective. CORE, a randomized control trial of a PSW self-management intervention compared to usual care, found a significant reduction in admissions to acute mental healthcare for participants receiving the intervention. This paper aims to evaluate the cost-effectiveness of the intervention over 12 months from a mental health service perspective. Analysis methods of increasing complexity were used to account for data missingness and distribution.MethodsParticipants were recruited from six crisis resolution teams in England from 12 March 2014 to 3 July 2015 (trial registration ISRCTN: 01027104). Resource use was collected from patient records at baseline and 12 months. The EQ-5D-3L was collected at baseline and 4 and 18 months, and linear interpolation was used to calculate 12-month values for quality-adjusted life-years (QALYs). The primary analysis of adjusted mean incremental costs and QALYs for complete cases are calculated separately using OLS regression. Secondly, a complete-case non-parametric two-stage bootstrap (TSB) was performed. The impacts of missing data and skewed cost data were explored using multiple imputation using chained equations and general linear models, respectively.ResultsFour hundred and forty-one participants were recruited to CORE; 221 randomized to the PSW intervention and 220 to usual care plus workbook. The probability that the PSW intervention was cost-effective compared with the workbook plus usual care control at 12 months varied with the method used, and ranged from 57% to 96% at a cost-effectiveness threshold of £20,000 per QALY gained.DiscussionThere was a minimum 57% chance that the intervention was cost-effective compared to the control using 12-month costs and QALYs. The probability varied by 40% when methods were employed to account for the relationship between costs and QALYs, but which restricted the sample to those who provided both complete cost and utility data. Caution should therefore be applied when selecting methods for the evaluation of healthcare interventions that aim to increase precision but may introduce bias if missing data are heavily unbalanced between costs and outcomes.
Aberrant brain entropy in posttraumatic stress disorder comorbid with major depressive disorder during the coronavirus disease 2019 pandemic
Authors: Fu Shishun , Liang Sipei , Lin Chulan , Wu Yunfan , Xie Shuangcong , Li Meng , Lei Qiang , Li Jianneng , Yu Kanghui , Yin Yi , Hua Kelei , Li Wuming , Wu Caojun , Ma Xiaofen , Jiang Guihua 
Published: June 2023

AimPreviously, neuroimaging studies on comorbid Posttraumatic-Major depression disorder (PTSD-MDD) comorbidity found abnormalities in multiple brain regions among patients. Recent neuroimaging studies have revealed dynamic nature on human brain activity during resting state, and entropy as an indicator of dynamic regularity may provide a new perspective for studying abnormalities of brain function among PTSD-MDD patients. During the COVID-19 pandemic, there has been a significant increase in the number of patients with PTSD-MDD. We have decided to conduct research on resting-state brain functional activity of patients who developed PTSD-MDD during this period using entropy.MethodsThirty three patients with PTSD-MDD and 36 matched TCs were recruited. PTSD and depression symptoms were assessed using multiple clinical scales. All subjects underwent functional magnetic resonance imaging (fMRI) scans. And the brain entropy (BEN) maps were calculated using the BEN mapping toolbox. A two-sample t-test was used to compare the differences in the brain entropy between the PTSD-MDD comorbidity group and TC group. Furthermore, correlation analysis was conducted between the BEN changes in patients with PTSD-MDD and clinical scales.ResultsCompared to the TCs, PTSD-MDD patients had a reduced BEN in the right middle frontal orbital gyrus (R_MFOG), left putamen, and right inferior frontal gyrus, opercular part (R_IFOG). Furthermore, a higher BEN in the R_MFOG was related to higher CAPS and HAMD-24 scores in the patients with PTSD-MDD.ConclusionThe results showed that the R_MFOG is a potential marker for showing the symptom severity of PTSD-MDD comorbidity. Consequently, PTSD-MDD may have reduced BEN in frontal and basal ganglia regions which are related to emotional dysregulation and cognitive deficits.
Bundle management strategy in reducing hospital-acquired pneumonia in hospitalized patients with mental disorders
Authors: Han Jingjing , Li Dan , Rao Yan , Wang Gaohua 
Published: June 2023

IntroductionThe incidence of hospital-acquired pneumonia (HAP) is high in the medical setting for mental disorders. To date, effective measurements for preventing HAP in hospitalized mental disorder patients are unavailable.MethodsThis study was conducted at the Large-Scale Mental Health Center of Renmin Hospital of Wuhan University (Wuhan, China) in two phases: baseline phase (January 2017–December 2019) and intervention phase (May 2020–April 2022). In the intervention phase, the HAP bundle management strategy was implemented in the Mental Health Center, and the data on HAP were collected continuously for analysis.ResultsA total of 18,795 and 9,618 patients were included in the baseline and intervention phases, respectively. The age, gender, ward admitted to, type of mental disorder, and Charlson comorbidity index did not differ significantly. After intervention, the rate of HAP occurrence decreased from 0.95 to 0.52% (P &lt; 0.001). Specifically, the HAP rate decreased from 1.70 to 0.95% (P = 0.007) in the closed ward and from 0.63 to 0.35% (P = 0.009) in the open ward. The HAP rate in the subgroups was higher in patients with schizophrenia spectrum disorders (1.66 vs. 0.74%) and organic mental disorders (4.92 vs. 1.41%), and in those ≥65 years old (2.82 vs. 1.11%) but decreased significantly after intervention (all P &lt; 0.05).ConclusionThe implementation of the HAP bundle management strategy reduced the occurrence of HAP in hospitalized patients with mental disorders.
Non-suicidal self-injury function: prevalence in adolescents with depression and its associations with non-suicidal self-injury severity, duration and suicide
Authors: Shen Ying , Hu Yingzi , Zhou Yongjie , Fan Xiwang 
Published: June 2023

BackgroundGiven that adolescents with depression are at the highest risk for non-suicidal self-injury (NSSI), a thorough understanding of their NSSI functions, as well as associations between functions and severe behavioral consequences, is essential for risk assessment and invention development.MethodsAdolescents with depression from 16 hospitals across China, for whom data was available regarding their NSSI function, frequency, number of methods used, time characteristics, and suicide history were included. Descriptive statistical analyses were performed to determine the prevalence of NSSI functions. Regression analyses were conducted to explore the relationship between NSSI functions and behavioral characteristics of NSSI and suicide attempts.ResultsAffect regulation was the primary function of NSSI and followed by anti-dissociation in adolescents with depression. Females recognized automatic reinforcement functions more frequently than males, while males had a higher prevalence of social positive reinforcement functions. Automatic reinforce functions played the prominent role in associations between NSSI functions and all the severe behavioral consequences. Specifically, functions of anti-dissociation, affect regulation, and self-punishment were all associated with NSSI frequency, while higher levels of endorsements for anti-dissociation and self-punishment were linked to more NSSI methods, and greater level of endorsement for anti-dissociation was related to longer NSSI duration. Only the increase in endorsement of self-punishment was associated with a greater hazard of suicide attempts.ConclusionThe dominant functions of NSSI in adolescents with depression was automatic reinforcement, specifically affect regulation. And prevalence of NSSI function differed between males and females. Anti-dissociation and self-punishment seemed to be the most risky factors as they were linked to severe NSSI or suicide behaviors. More attention should be given to these functions in risk evaluation, and the targeted interventions should be developed accordingly in a timely manner.
Historical developments, hotspots, and trends in tardive dyskinesia research: a scientometric analysis of 54 years of publications
Authors: Baminiwatta Anuradha , Correll Christoph U. 
Published: June 2023

BackgroundSince being recognized as an important drug-induced clinical entity during the 1960s, tardive dyskinesia (TD) has generated an extensive body of research seeking to understand its clinical characteristics, epidemiology, pathophysiology and management. Modern scientometric approaches allow interactive visualization of large bodies of literature to identify trends and hotspots within knowledge domains. This study thus aimed to provide a comprehensive scientometric review of the TD literature.MethodsWeb of Science was searched for articles, reviews, editorials and letters with the term “tardive dyskinesia” in the title, abstract, or keywords through 12/31/2021. A total of 5,228 publications and 182,052 citations were included. Annual research output, prominent research areas, authors, affiliations and countries were summarized. VOSViewer and CiteSpace were used for bibliometric mapping and co-citation analysis. Structural and temporal metrics were used to identify key publications in the network.ResultsTD-related publications peaked in the 1990s, gradually declined after 2004, and showed a further small increase after 2015. The most prolific authors were Kane JM, Lieberman JA, and Jeste DV overall (1968–2021), and Zhang XY, Correll CU and Remington G in the last decade (2012–2021). The most prolific journal was the Journal of Clinical Psychiatry overall, and the Journal of Psychopharmacology in the last decade. Knowledge clusters in the 1960–1970s dealt with clinical and pharmacological characterization of TD. In the 1980s, epidemiology, clinical TD assessment, cognitive dysfunction and animal models predominated. During the 1990s, research diverged into pathophysiological studies, especially oxidative stress, and clinical trials on atypical antipsychotics, with a focus on clozapine and bipolar disorder. In the 1990–2000s, pharmacogenetics emerged. More recent clusters include serotonergic receptors, dopamine-supersensitivity psychosis, primary motor abnormalities of schizophrenia, epidemiology/meta-analyses, and advances in TD treatment, particularly vesicular monoamine transporter-2 inhibitors since 2017.ConclusionThis scientometric review visualized the evolution of scientific knowledge on TD over more than five decades. These findings will be useful for researchers to find relevant literature when writing scientific articles, choosing appropriate journals, finding collaborators or mentors for research, and to understand the historical developments and emerging trends in TD research.
Gender differences in the relationship between loneliness and health-related behavioral risk factors among the Hakka elderly in Fujian, China
Authors: Chang Huajing , Ruan Wenqian , Chen Yating , Cai Longhua , Liu Xiaojun 
Published: June 2023

IntroductionTo explore gender differences in the relationship between loneliness and health-related behavioral risk factors (BRFs) among the Hakka elderly.MethodsLoneliness was measured by the UCLA Loneliness Scale Short-form (ULS-8). Seven BRFs were examined. Mann–Whitney U, Kruskal-Wallis, and post hoc tests were conducted to compare the differences in ULS-8 scores among the Hakka elderly with different BRFs. Generalized linear regression models were employed to examine the associations of specific BRF and its number with the ULS-8 scores among the Hakka elderly in male, female, and total samples.ResultsPhysical inactivity (B = 1.96, p &lt; 0.001), insufficient leisure activities participation (B = 1.44, p &lt; 0.001), unhealthy dietary behavior (B = 1.02, p &lt; 0.001), and irregular sleep (B = 2.45, p &lt; 0.001) were positively correlated with the ULS-8 scores, whereas drinking (B = −0.71, p &lt; 0.01) was negatively associated with the ULS-8 scores in the total sample. In males, insufficient leisure activities participation (B = 2.35, p &lt; 0.001), unhealthy dietary behavior (B = 1.39, p &lt; 0.001), and irregular sleep (B = 2.07, p &lt; 0.001) were positively associated with the ULS-8 scores. In females, physical inactivity (B = 2.69, p &lt; 0.001) and irregular sleep (B = 2.91, p &lt; 0.001) was positively correlated with the scores of ULS-8, while drinking (B = −0.98, p &lt; 0.05) was negatively associated with the ULS-8 scores. More BRFs were significantly related to greater loneliness (p &lt; 0.001).ConclusionThere are gender differences in the relationship between loneliness and BRFs among the Hakka elderly, and individuals with more BRFs were more likely to feel loneliness. Therefore, the co-occurrence of multiple BRFs requires more attention, and integrated behavioral intervention strategies should be adopted to reduce the loneliness of the elderly.
In silico clinical trial evaluating lisdexamfetamine’s and methylphenidate’s mechanism of action computational models in an attention-deficit/hyperactivity disorder virtual patients’ population
Authors: Gutiérrez-Casares José Ramón , Quintero Javier , Segú-Vergés Cristina , Rodríguez Monterde Pilar , Pozo-Rubio Tamara , Coma Mireia , Montoto Carmen 
Published: June 2023

IntroductionAttention-deficit/hyperactivity disorder (ADHD) is an impairing psychiatric condition with the stimulants, lisdexamfetamine (LDX), and methylphenidate (MPH), as the first lines pharmacological treatment.MethodsHerein, we applied a novel in silico method to evaluate virtual LDX (vLDX) and vMPH as treatments for ADHD applying quantitative systems pharmacology (QSP) models. The objectives were to evaluate the model’s output, considering the model characteristics and the information used to build them, to compare both virtual drugs’ efficacy mechanisms, and to assess how demographic (age, body mass index, and sex) and clinical characteristics may affect vLDX’s and vMPH’s relative efficacies.Results and DiscussionWe molecularly characterized the drugs and pathologies based on a bibliographic search, and generated virtual populations of adults and children-adolescents totaling 2,600 individuals. For each virtual patient and virtual drug, we created physiologically based pharmacokinetic and QSP models applying the systems biology-based Therapeutic Performance Mapping System technology. The resulting models’ predicted protein activity indicated that both virtual drugs modulated ADHD through similar mechanisms, albeit with some differences. vMPH induced several general synaptic, neurotransmitter, and nerve impulse-related processes, whereas vLDX seemed to modulate neural processes more specific to ADHD, such as GABAergic inhibitory synapses and regulation of the reward system. While both drugs’ models were linked to an effect over neuroinflammation and altered neural viability, vLDX had a significant impact on neurotransmitter imbalance and vMPH on circadian system deregulation. Among demographic characteristics, age and body mass index affected the efficacy of both virtual treatments, although the effect was more marked for vLDX. Regarding comorbidities, only depression negatively impacted both virtual drugs’ efficacy mechanisms and, while that of vLDX were more affected by the co-treatment of tic disorders, the efficacy mechanisms of vMPH were disturbed by wide-spectrum psychiatric drugs. Our in silico results suggested that both drugs could have similar efficacy mechanisms as ADHD treatment in adult and pediatric populations and allowed raising hypotheses for their differential impact in specific patient groups, although these results require prospective validation for clinical translatability.
Promoting and supporting breastfeeding in a protracted emergency setting—Caregivers' and health workers' perceptions from North-East Nigeria
Authors: Amat Camacho Nieves , Chara Abdullahi , Briskin Emily , Pellecchia Umberto , Kyi Htet Aung , de Rubeis Maria Livia , Hussain Faisal , Ahmed Tasneem , Ogundipe Oluwakemi F. , Burzio Chiara , Kamis Uba , Bukar Lawan M. , Von Schreeb Johan , Kolokotroni Ourania , Della Corte Francesco , Sunyoto Temmy 
Published: June 2023

BackgroundBreastfeeding (BF) should be protected, promoted, and supported for all infants in humanitarian settings. The re-establishment of exclusive BF is also a central part of the management of acutely malnourished infants under 6 months (&lt;6 m). Médecins Sans Frontières (MSF) runs a nutrition project in Maiduguri, a protracted emergency setting in North-East Nigeria. This study aimed to explore caregivers' (CGs) and health workers' (HWs) perceptions of BF practice, promotion, and support among CGs with infants &lt;6 m in this setting.MethodsWe conducted a qualitative study using in-depth interviews and focus group discussions combined with non-participant observations. Participants included CGs of young infants enrolled in MSF nutritional programs or who attended health promotion activities in a displacement camp. MSF HWs were involved at different levels in BF promotion and support. Data were collected involving a local translator and analyzed using reflexive thematic analysis directly from audio recordings.ResultsParticipants described how feeding practices are shaped by family, community, and traditional beliefs. The perception of breastmilk insufficiency was common and led to early supplementary feeding with inexpensive but unsuitable products. Participants often linked insufficient breastmilk production with poor maternal nutrition and stress, in a context shaped by conflict and food insecurity. BF promotion was generally well received but could be improved if tailored to address specific barriers to exclusive BF. Interviewed CGs positively valued BF support received as part of the comprehensive treatment for infant malnutrition. One of the main challenges identified was the length of stay at the facility. Some participants perceived that improvements in BF were at risk of being lost after discharge if CGs lacked an enabling environment for BF.ConclusionThis study corroborates the strong influence of household and contextual factors on the practice, promotion, and support of BF. Despite identified challenges, the provision of BF support contributes to improvements in BF practice and was positively perceived by CGs in the studied setting. Greater attention should be directed toward providing support and follow-up for infants &lt;6 m and their CGs in the community.