bluuebunny/crossref_metadata_2025_split huggingface dataset:
Socioeconomic Disparities in Cognitive Functioning Trajectories Among Older Filipinos: Applying the Characteristics Approach
Authors: Vicerra Paolo Miguel Manalang , Estanislao Juniesy M. 
Published: February 2023

Health functioning declines with age, but there are disparities in its progression with regard to socioeconomic status, particularly education attainment, income, and wealth. This paper focused on the use of the characteristics approach to present the trajectories of cognitive performance among older adults with different education and wealth levels in the Philippines. Using an analytical sample of 5209 adults aged at least 60 years, extracted from the first wave of the 2018 Longitudinal Study on Ageing and Health in the Philippines, it was observed that having higher levels of education delayed lower cognitive performance, whereby men had further gains than women. Greater wealth and income were also shown to slow diminishing cognitive performance, and women gained more in this regard. Viewing health only from an age perspective is limiting; and the results show that the older population is heterogeneous and social gradients exhibit disparities in health performance at later ages.
Resilience during the COVID-19 pandemic among people living with HIV: A cross-sectional study
Authors: Kıllı Nesrin Ecem , Bakır Çiçek Nur , Canbaz Ata Alpay , Karabulut Kardelen , Mutlu Ali , Karataşlı Şeyhmus , Tekin Süda , Kayı İlker 
Published: February 2023

Background This study aims to investigate the factors shaping resilience during the COVID-19 pandemic among people living with HIV (PLWH). Methods A total of 341 participants were included in this cross-sectional study. The online survey included scales of resilience, depression & anxiety, loneliness, social support, COVID-19 fear, stress, and sociodemographic information. Results Logistic regression test results showed loneliness (OR = 2.548, 95% CI = 1.251, 5.189), social support (OR = 2.217, 95% CI = 1.148, 4.279), income (OR = 2.581, 95% CI = 1.217, 5.472), sexual orientation (OR = 2.707, 95% CI = 1.004, 7.300), age (OR = 1.044, 95% CI = 1.006, 1.083) and COVID-19 fear (OR = 0.891, 95% CI = 0.840, 0.944) were statistically significant factors associated with resilience among PLWH. Conclusion In conclusion, reducing COVID-19 fear by providing the correct information about the COVID-19 pandemic, fortifying the level of social support satisfaction, as well as minimising the level of loneliness have the potential to improve psychological resilience among PLWH.
Shared and unique risk factors for readmission exist following upper and lower extremity arthroplasty in the 30-day postoperative period
Authors: Scholten Donald J , Gwam Chukwuweike U , Recker Andrew J , Plate Johannes F , Waterman Brian R 
Published: February 2023

Purpose Joint arthroplasty has become increasingly more common in the United States, and it is important to examine the patient-based risk factors and surgical variables associated with hospital readmissions. The purpose of this study was to identify stratified rates and risk factors for readmission after upper extremity (shoulder, elbow, and wrist) and lower extremity (hip, knee, and ankle) arthroplasty. Methods All patients undergoing upper and lower extremity arthroplasty from 2008–2018 were identified using the National Surgical Quality Improvement Program dataset. Patient demographics, medical comorbidities and surgical characteristics were examined utilizing uni- and multi-variate analysis for significant predictors of 30-days hospital readmission. Results A total of 523,523 lower and 25,215 upper extremity arthroplasty patients were included in this study. A number of 22,183 (4.2%) lower and 1072 (4.4%) upper extremity arthroplasty patients were readmitted within 30 days of discharge. Significant risk factors for 30-days readmission after lower extremity arthroplasty included age, Body Mass Index (BMI), operative time, dependent functional status, American Society of Anesthesiologists (ASA) score ≥3, increased length of stay, and various medical comorbidities such as diabetes, tobacco dependency, and chronic obstructive pulmonary disease (COPD). An overweight BMI was associated with a lower odds of 30-days readmission when compared to a normal BMI for lower extremity arthroplasty. Analysis for upper extremity arthroplasty revealed similar findings of significant risk factors for 30-days hospital readmission, although diabetes mellitus was not found to be a significant risk factor. Conclusion Nearly one in 25 patients undergoing upper and lower extremity arthroplasty experiences hospital readmission within 30-days of index surgery. There are several modifiable risk factors for 30-days hospital readmission shared by both lower and upper extremity arthroplasty, including tobacco smoking, COPD, and hypertension. Optimization of these medical comorbidities may mitigate the risk short-term readmission following joint arthroplasty procedures and improve overall cost effectiveness of perioperative surgical care.
The Burden of having to Wonder: Hospice Caregiving Experiences of LGBTQ+ Cancer Family Caregivers
Authors: Cloyes Kristin G. , Reynaga Miranda , Vega Marilisa , Thomas Hebdon Megan C. , Thompson Casidee , Rosenkranz Susan J. , Tay Djin , Reblin Maija , Ellington Lee 
Published: February 2023

Background and Objectives LGBTQ+ people are more likely to be caregivers for family and friends with life-limiting illnesses than non-LGBTQ+ people. LGBTQ+ caregivers may also experience stigma, bias, and discrimination, in addition to caregiving stress. Yet few studies have elicited LGBTQ+ family caregivers’ perspectives on their end-of-life (EOL) experiences of home hospice. Research Design and Methods We conducted semi-structured interviews with LGBTQ+ family caregivers of home hospice patients (N = 20). Following an interpretive descriptive approach, interview data were audio recorded, transcribed, and iteratively coded, and themes were developed and synthesized. Results The burden of having to wonder expressed caregivers’ uncertainty and concern about whether their negative experiences were common to all EOL caregivers or stemmed from cultural stigma and provider bias. Participants described how invisibility vs. risks of disclosure, anticipatory anxiety, perceived microaggressions, and protective vigilance increased stress and complicated caregiver-provider communication. Navigating EOL universalities vs. minority realities depicted underlying tensions between commonly assumed universalities of EOL caregiving and LGBTQ+-specific experiences. Providers’ discomfort, awkward communication, lack of access to culturally competent EOL support resources, and broader structural and cultural discrimination eroded their sense of connectedness and safety. Together, these themes characterized the impact of minority stress at EOL. Discussion and Implications Our findings suggest that LGBTQ+ hospice caregivers are at risk for minority stress in addition to more common sources of EOL caregiving pressures and thus have specific support and communication needs. Providers must understand this to deliver effective EOL care for all families.
Tunneled central venous catheters for hemodialysis—unfairly condemned? Catheter-related complications in a university hospital setting
Authors: Buckenmayer Anna , Möller Bianca , Ostermaier Claudia , Hoyer Joachim , Haas Christian S 
Published: February 2023

Background: Central venous catheters (CVCs) provide an immediate hemodialysis access but are considered to be of elevated risk for complications. It remains unclear, if CVCs per se have relevant impact on clinical outcome. We provide an assessment of CVC-associated complications and their impact on mortality. Methods: In a single center retrospective study, CVC patients between JAN2015-JUN2021 were included. Data on duration of CVC use, complications and comorbidities was collected. Estimated 6-month mortality was compared to actual death rate. Results: About 478 CVCs were analyzed. Initiation of dialysis was the main reason for CVC implantation. Death was predominant for termination of CVC use. Infections were rare (0.6/1000 catheter days), complications were associated with certain comorbidities. Actual 6-month mortality was lower than predicted (14.3% vs 19.6%). Conclusion: (1) CVCs are predominantly implanted for initiation of hemodialysis; (2) serious complications are rare; (3) complications are associated with certain comorbidities; and (4) CVC patients survive longer than predicted.
The roles and ethics of psychosocial support workers in integrated health services for sexual and gender-based violence survivors
Authors: Kasherwa Amani Clovis , Alexandre Ali Bitenga , Mugisho Gilbert Mubalama , Foussiakda Agino Cecilia , Balegamire Juvenal Bazilashe 
Published: February 2023

Summary Mental Health and Psychosocial Support are integral components of the multisectoral programs addressing wartime sexual violence. In the Democratic Republic of Congo, an integrated framework known as the one-stop centre model was implemented at Panzi Hospital for delivering medical, legal, psychosocial, and socioeconomic support services for wartime sexual violence survivors. While recent developments broadly described this model with more focus on its medical pillar, there is limited knowledge on how its psychosocial support component can be harnessed in addressing wartime sexual violence. This article explored the roles and ethics of psychosocial support in integrated health services based on the research data from 11 in-depth interviews with the psychosocial support workers and desk reviews. Findings The findings of this study indicated that the roles and ethics of psychosocial workers in addressing wartime sexual violence are limited by the lack of adequately trained staff members, low professional status, and complex ethical challenges. In this case, psychosocial support draws more from virtue ethics and moral constructivism and less from professional utilitarianism and deontology. While both approaches are integral to providing support services, combining them is necessary for the complementarity and consistency of therapeutic processes. The study's findings also demonstrated the lack of professional social work and mental health interventions in the Congo and suggested coordinated actions engaging social work education, policy, and research developments. Applications We conclude that the roles and ethics of psychosocial support should be of serious concern to decision-makers, practitioners, and educators.
A systematic review of the treatment of primary acromioclavicular joint osteoarthritis
Authors: Welch Matthew , Rankin Sally , How Saw Keng Matthew , Woods David 
Published: February 2023

Background This systematic review aims to comprehensively summarise and present the available evidence for the treatment of primary acromioclavicular joint (ACJ) osteoarthritis (OA). Methods Five databases were searched for studies investigating the management of ACJ OA. Included were studies with participants with clinical/radiological signs of primary ACJ OA, an intervention and included a functional outcome measure. Results Forty-eight studies were included. Treatments consisted of physiotherapy (n = 1 study), medical only (n = 11) and operative management (n = 36). Operative studies included five comparative trials – physiotherapy versus surgery (n = 1) and open versus arthroscopic resection (n = 4). A total of 1902 shoulders were treated for ACJ OA, mean age (51 years), 58% male and mean follow-up (28.5 months). Treatment with injection showed a mean improvement of 50% in pain levels at follow-up (mean = 7.5 months). The commonest surgical procedure was arthroscopic excision of the distal clavicle and operative studies averaged 6 months of conservative management and a mean functional outcome of 87.8%. Conclusion Studies varied in indication, intervention and quality but it did not provide evidence that both non-operative and operative interventions are effective. There was no significant difference between open or arthroscopic distal clavicle excision (DCE). Participants having between 0.5 and 2 cm of clavicle excised had good outcomes and those requiring concomitant shoulder procedures had similarly good outcomes.
Enhancing distress tolerance to uplift motivation in recovery: Results from an open development trial
Authors: Bhuptani Prachi H. , Block Amanda , Jiménez Muñoz Paola , Bello Mariel S. , Ramsey Susan , Ranney Megan , Carey Kate , Rich Josiah , Langdon Kirsten 
Published: February 2023

Objective This open pilot study examines the feasibility, acceptability, and qualitative outcomes of an interactive web- and text message-delivered personalized feedback intervention aimed at cultivating motivation and tolerance of distress for adults initiating outpatient buprenorphine treatment. Methods Patients ( n = 10) initiating buprenorphine within the past 8 weeks first completed a web-based intervention focused on enhancing motivation and providing psychoeducation on distress tolerance skills. Participants then received 8 weeks of daily personalized text messages that provided reminders of salient motivational factors and recommended distress tolerance-oriented coping skills. Participants completed self-report measures to assess intervention satisfaction, perceived usability, and preliminary efficacy. Additional perspectives were captured via qualitative exit interviews. Results In total, 100% of retained participants ( n = 9) engaged with the text messages throughout the entire 8-week period. Mean scores of 27 (SD  = 5.05) on the Client Satisfaction Questionnaire at the end of 8-week period indicated a high degree of satisfaction with the text-based intervention. The average rating on the System Usability Scale was 65.3 at the end of the 8-week program, suggesting that the intervention was relatively easy to use. Participants also endorsed positive experiences with the intervention during qualitative interviews. Clinical improvements were observed across the intervention period. Conclusions Preliminary findings from this pilot suggest that the content and delivery method of this combined web- and text message-based personalized feedback intervention is perceived by patients as feasible and acceptable. Leveraging digital health platforms to augment buprenorphine has potential for high scalability and impact to reduce opioid use, increase adherence/retention to treatment, and prevent future incidence of overdose. Future work will evaluate the efficacy of the intervention in a randomized clinical trial design.
Associations of improved air quality with lung function growth from childhood to adulthood: the BAMSE study
Authors: Yu Zhebin , Merid Simon Kebede , Bellander Tom , Bergström Anna , Eneroth Kristina , Georgelis Antonios , Hallberg Jenny , Kull Inger , Ljungman Petter , Klevebro Susanna , Stafoggia Massimo , Wang Gang , Pershagen Göran , Gruzieva Olena , Melén Erik 
Published: February 2023

BackgroundThe beneficial effect of improving air quality on lung function development remains understudied. We assessed associations of changes in ambient air pollution levels with lung function growth from childhood until young adulthood in a Swedish cohort study.MethodsIn the prospective birth cohort BAMSE (Children, Allergy, Environment, Stockholm, Epidemiology (in Swedish)), spirometry was conducted at the 8-year (2002–2004), 16-year (2011–2013) and 24-year (2016–2019) follow-ups. Participants with spirometry data at 8 years and at least one other measurement in subsequent follow-ups were included (1509 participants with 3837 spirometry measurements). Ambient air pollution levels (particulate matter with diameter ≤2.5 μm (PM2.5), particulate matter with diameter ≤10 μm (PM10), black carbon (BC) and nitrogen oxides (NOx)) at residential addresses were estimated using dispersion modelling. Linear mixed effect models were used to estimate associations between air pollution exposure change and lung function development.ResultsOverall, air pollution levels decreased progressively during the study period. For example, the median (interquartile range (IQR)) level of PM2.5decreased from 8.24 (0.92) μg·m−3during 2002–2004 to 5.21 (0.67) μg·m−3during 2016–2019. At the individual level, for each IQR reduction of PM2.5the lung function growth rate increased by 4.63 (95% CI 1.64–7.61) mL per year (p<0.001) for forced expiratory volume in 1 s and 9.38 (95% CI 4.76–14.00) mL per year (p<0.001) for forced vital capacity. Similar associations were also observed for reductions of BC and NOx. Associations persisted after adjustment for potential confounders and were not modified by asthma, allergic sensitisation, overweight, early-life air pollution exposure or dietary antioxidant intake.ConclusionsLong-term reduction of air pollution is associated with positive lung function development from childhood to young adulthood.
Obstructive sleep apnoea and long-term risk of incident diabetes in the middle-aged and older general population
Authors: Siddiquee Ali T. , Kim Soriul , Thomas Robert J. , Lee Min-Hee , Ku Lee Seung , Shin Chol 
Published: February 2023

BackgroundObstructive sleep apnoea (OSA) is associated with increased risk of type 2 diabetes. However, results from large population-based prospective cohort studies are rare. The main aim of the present study was to investigate the relative risk of 8-year incident type 2 diabetes in relation to OSA severity in a prospective cohort study of middle-aged and older adults.MethodsA total of 2918 participants (mean age 59 years) of the Korean Genome and Epidemiology Study (KoGES), who underwent home-based overnight polysomnography at baseline examination between 2011 and 2014, were followed up 4-yearly between 2015–2018 and 2019–2021. A total of 1697 participants were present in both follow-ups. After excluding participants who had diabetes at baseline (n=481), a total of 1216 participants were eligible for the analyses.ResultsOSA at baseline was categorised by apnoea–hypopnoea index levels as non-OSA (0–4.9 events·h−1), mild OSA (5.0–14.9 events·h−1) and moderate–severe OSA (≥15.0 events·h−1). Incident type 2 diabetes was identified at each follow-up. Compared with non-OSA, participants with moderate–severe OSA had 1.5 times higher risk of developing type 2 diabetes at the end of the 8-year follow-up after adjusting for potential covariates (relative risk 1.50, 95% CI 1.02–2.21). In the same analytical models for 4-year relative risk of incident type 2 diabetes, none of the OSA groups were at significantly higher risk compared with the non-OSA group.ConclusionModerate–severe OSA, a modifiable risk factor, poses a higher risk of incident type 2 diabetes compared with non-OSA over an 8-year period in general middle-aged and older adults.
A randomised, controlled, feasibility trial of an online, self-guided breathlessness supportive intervention (SELF-BREATHE) for individuals with chronic breathlessness due to advanced disease
Authors: Reilly Charles C. , Maddocks Matthew , Chalder Trudie , Bristowe Katherine , Higginson Irene J. 
Published: February 2023

IntroductionSELF-BREATHE is a complex, transdiagnostic, supportive, digital breathlessness intervention co-developed with patients. SELF-BREATHE seeks to build capacity and resilience within health services by improving the lives of people with chronic breathlessness using nonpharmacological, self-management approaches. This study aimed to determine whether SELF-BREATHE is feasible to deliver and acceptable to patients living with chronic breathlessness.MethodsA parallel, two-arm, single-blind, single-centre, randomised controlled, mixed-methods feasibility trial with participants allocated to 1) intervention group (SELF-BREATHE) or 2) control group (usual National Health Service (NHS) care). The setting was a large multisite NHS foundation trust in south-east London, UK. The participants were patients living with chronic breathlessness due to advanced malignant or nonmalignant disease(s). Participants were randomly allocated (1:1) to an online, self-guided, breathlessness supportive intervention (SELF-BREATHE) and usual care or usual care alone, over 6 weeks. Thea prioriprogression criteria were ≥30% of eligible patients given an information sheet consented to participate; ≥60% of participants logged on and accessed SELF-BREATHE within 2 weeks; and ≥70% of patients reported the methodology and intervention as acceptable.ResultsBetween January 2021 and January 2022, 52 (47%) out of 110 eligible patients consented and were randomised. Of those randomised to SELF-BREATHE, 19 (73%) out of 26 logged on and used SELF-BREATHE for a mean±sd(range) 9±8 (1–33) times over 6 weeks. 36 (70%) of the 52 randomised participants completed and returned the end-of-study postal questionnaires. SELF-BREATHE users reported it to be acceptable. Post-intervention qualitative interviews demonstrated that SELF-BREATHE was acceptable and valued by users, improving breathlessness during daily life and at points of breathlessness crisis.ConclusionThese data support the feasibility of moving to a fully powered, randomised controlled efficacy trial with minor modifications to minimise missing data (i.e.multiple methods of data collection: face-to-face, telephone, video assessment and by post).
Micro-Sized Pinhole Inspection with Segmented Time Reversal and High-Order Modes Cluster Lamb Waves Based on EMATs
Authors: Zhou Jinjie , Hu Yang , Li Xiang , Zheng Yang , Yang Sanhu , Liu Yao 
Published: February 2023

AbstractPinhole corrosion is difficult to discover through conventional ultrasonic guided waves inspection, particularly for micro-sized pinholes less than 1 mm in diameter. This study proposes a new micro-sized pinhole inspection method based on segmented time reversal (STR) and high-order modes cluster (HOMC) Lamb waves. First, the principle of defect echo enhancement using STR is introduced. Conventional and STR inspection experiments were conducted on aluminum plates with a thickness of 3 mm and defects with different diameters and depths. The parameters of the segment window are discussed in detail. The results indicate that the proposed method had an amplitude four times larger than of conventional ultrasonic guided waves inspection method for pinhole defect detection and could detect micro-sized pinhole defects as small as 0.5 mm in diameter and 0.5 mm in depth. Moreover, the segment window location and width (5−10 times width of the conventional excitation signal) did not affect the detection sensitivity. The combination of low-power and STR is more conducive to detection in different environments, indicating the robustness of the proposed method. Compared with conventional ultrasonic guided wave inspection methods, the proposed method can detect much smaller defect echoes usually obscured by noise that are difficult to detect with a lower excitation power and thus this study would be a good reference for pinhole defect detection.