bluuebunny/crossref_metadata_2025_split huggingface dataset:
Informal carers’ information needs in managing behavioural and psychological symptoms of people with dementia and related mHealth applications: a systematic integrative review to inform the design of an mHealth application
Authors: Jagoda Thilanka , Dharmaratne Samath , Rathnayake Sarath 
Published: May 2023

ObjectiveTo review and synthesise the evidence on informal carers’ information needs in managing behavioural and psychological symptoms of dementia (BPSD) of their care recipients and related mobile health (mHealth) applications to inform the design of an mHealth application.DesignThis is a systematic integrative review guided by Whittemore and Knafl’s five-stages framework. Six databases were searched: Cochrane, CINAHL, Embase, MEDLINE, ProQuest and PsycINFO. The key concepts included ‘dementia’, ‘behavioural and psychological symptoms’, ‘informal carers’ and (‘information need’ or ‘mHealth application’). Peer-reviewed full-text articles published in English from 2000 to 2022 were included. The methodological rigour of studies was analysed using the Mixed Methods Appraisal Tool V.2018. Preferred Reporting Items for Systematic Reviews and Meta-Analyses-2020 reporting guidelines were followed.ResultsThis review included 34 studies, including quantitative (n=13), qualitative (n=17) and mixed-method (n=4) studies. Four major themes emerged from the reported studies: the need for addressing information needs on managing BPSD, the role of support systems in managing BPSD, self-care for carers and the role of mHealth applications in providing education and support for carers. In managing BPSD, carers seek knowledge about dementia and BPSD, the roles of the carers and misconceptions about BPSD. One study reported an mHealth application to monitor the behavioural issues of people with dementia.ConclusionInformal carers of people with dementia face a number of challenges when providing care for BPSD of their care recipients. The lack of knowledge on managing BPSD is a significant challenge. Support systems such as professional, social, residential, legal and eHealth have a significant role in managing the BPSD of people with dementia in the community. mHealth interventions are sparse to support BPSD management. These findings can be used in designing an mHealth application that addresses needs related to managing BPSD of informal carers of people with dementia.PROSPERO registration numberCRD42021238540.
Survey of emergency medicine doctors in London physical activity characteristics, awareness of guidelines and prescribing behaviours
Authors: Koch Kai , Tillet Eleanor , Loosemore Michael 
Published: May 2023

ObjectiveTo determine London emergency medicine (EM) doctors’ physical activity (PA) characteristics, awareness of PA guidelines and PA prescription practice from London emergency departments (EDs).MethodsAn anonymous online survey of EM doctors working in London over 6 weeks between 27 April 2021 and 12 June 2021. Inclusion criteria included EM doctors of any grade currently working in London EDs. Exclusion criteria were non-EM doctors, other healthcare professionals and those working outside London EDs. The Emergency Medicine Physical Activity Questionnaire created consisted of two parts: part 1, on basic demographic data and the Global Physical Activity Questionnaire and part 2, focused questions around awareness of guidelines and prescribing characteristics.Results122 participants attempted the survey, of which 75 (61.5%) met the inclusion criteria. 61.3% (n=46) were aware of and 77.3% (n=58) achieved minimum recommended aerobic PA guidelines. However, only 33.3% (n=25) were aware of and 48% (n=36) achieved muscle strengthening (MS) guidelines. The mean sedentary behaviour time/day was 5 hours. 75.3% (n=55) of EM doctors thought it was important to prescribe PA, yet only 41.8% (n=23) prescribed PA.ConclusionsMost London EM doctors are aware of and achieve minimum aerobic PA guidelines. Encouraging MS awareness and activities, as well as PA prescribing, should be areas of focus. Larger studies should take place to assess EM doctors’ characteristics in UK regions and data using accelerometers to determine PA more precisely. Further research should also look at patient perceptions of PA.
Tolerability and beneficial effects of sacubitril/valsartan on systemic right ventricular failure
Authors: Nederend Marieke , Kiès Philippine , Regeer Madelien V , Vliegen Hubert W , Mertens Bart JA , Robbers-Visser Daniëlle , Bouma Berto J , Tops Laurens F , Schalij Martin J , Jongbloed Monique R M , Egorova Anastasia D 
Published: May 2023

ObjectivePatients with a systemic right ventricle (sRV) in the context of transposition of the great arteries (TGA) after atrial switch or congenitally corrected TGA (ccTGA) are prone to sRV dysfunction. Pharmacological options for sRV failure remain poorly defined. This study aims to investigate the tolerability and effects of sacubitril/valsartan on sRV failure in adult patients with sRV.MethodsIn this two-centre, prospective cohort study, all consecutive adult patients with symptomatic heart failure and at least moderately reduced sRV systolic function were initiated on sacubitril/valsartan and underwent structured follow-up.ResultsData of 40 patients were included (40% female, 30% ccTGA, median age 48 (44–53) years). Five patients discontinued therapy during titration. Median follow-up was 24 (12–36) months. The maximal dose was tolerated by 49% of patients. No episodes of hyperkalaemia or renal function decline occurred. Six-minute walking distance increased significantly after 6 months of treatment (569±16 to 597±16 m, p=0.016). Serum N-terminal-prohormone brain natriuretic peptide (NT-proBNP) levels decreased significantly after 3 months (567 (374–1134) to 404 (226–633) ng/L, p<0.001). Small, yet consistent echocardiographic improvements in sRV function were observed after 6 months (sRV global longitudinal strain: −11.1±0.5% to −12.6±0.7%, p<0.001, and fractional area change: 20% (16%−24%) to 26% (19%−30%), p<0.001). The linear mixed-effects model illustrated that after first follow-up moment, no time effect was present for the parameters.ConclusionsTreatment with sacubitril/valsartan was associated with a low rate of adverse effects in this adult sRV cohort. Persisting improvement in 6-minute walking test distance, NT-proBNP levels and echocardiographic parameters of sRV function was observed in an on-treatment analysis and showed no differential response based on sex or anatomy.
Clinical consequences of off-label reduced dosing of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation: a systematic review and meta-analysis
Authors: Joosten Linda P T , van Maanen Rosanne , van den Dries Carline J , Rutten Frans H , Hoes Arno W , Granger Christopher B , Hemels Martin E W , Geersing Geert-Jan , van Doorn Sander 
Published: May 2023

ObjectivePostmarketing observational studies report that a substantial percentage of patients with atrial fibrillation (AF) receive a reduced non-vitamin K antagonist oral anticoagulant (NOAC) dose without a clear indication. Recently, increasing evidence has become available to explore the clinical consequences of such off-label reduced dosing (OLRD). This study aims to systematically review and meta-analyse observational studies that report clinical outcomes associated with OLRD of NOACs compared with on-label non-reduced dosing (OLNRD) of NOACs in patients with AF.Methods and analysisWe performed a systematic literature review and meta-analysis of observational studies reporting clinical outcomes in AF patients with OLRD of an NOAC compared with AF patients with OLNRD of an NOAC. Using random effects meta-analyses, we estimated the risk of stroke/thromboembolism, bleeding and all-cause mortality.ResultsWe included 19 studies with a total of 170 394 NOAC users. In these studies, the percentage of OLRD among patients with an indication for an on-label non-reduced NOAC dose ranged between 9% and 53%. 7 of these 19 studies met the predefined criteria for meta-analysis (n=80 725 patients). The pooled HR associated with OLRD of NOACs was 1.04 (95% CI 0.83 to 1.29; 95% prediction interval (PI) 0.60 to 1.79) for stroke/thromboembolism, 1.10 (95% CI 0.95 to 1.29; 95% PI 0.81 to 1.50) for bleeding and 1.22 (95% CI 0.81 to 1.84; 95% PI 0.55 to 2.70) for all-cause mortality.ConclusionThis meta-analysis shows no statistically significant increased risk of stroke/thromboembolism, nor a decreased bleeding risk, nor a difference in risk of all-cause mortality in patients with OLRD of NOACs. Future research may focus on differences between NOACs.
Insignificant influence of the intertransverse process block for major breast cancer surgery: a randomized, blinded, placebo-controlled, clinical trial
Authors: Nielsen Martin Vedel , Tanggaard Katrine , Hansen Lone Bak , Hansen Christian Kruse , Vazin Mojgan , Børglum Jens 
Published: May 2023

IntroductionThe intertransverse process (ITP) block mimics the thoracic paravertebral block and allegedly ameliorates hemithoracic postoperative pain. However, concerning major reconstructive breast cancer surgery the modality has never been tested against placebo in a randomized clinical trial. We aimed to assess the efficacy of the multiple-injection ITP block and hypothesized that the blockade would reduce postoperative opioid consumption.MethodsWe screened 58 patients with breast cancer scheduled for unilateral subpectoral implant-based primary breast reconstruction, involving mastectomy with complete fascial dissection of the major pectoral muscle. A randomization procedure allowed for the allocation of 36 patients to receive either unilateral multiple-injection active ITP block (0.5% ropivacaine 3×10 mL) or placebo ITP block (isotonic saline 3×10 mL) at T2, T4, T6 in a prospective, blinded, clinical trial. The primary outcome was total opioid consumption within the first 24 postoperative hours. Secondary outcomes included opioid consumption at 4-hour intervals, postoperative pain, patient satisfaction with block application, time to first opioid, ambulation and discharge, opioid-related side effects, and quality of recovery.ResultsOpioid consumption within the first 24 postoperative hours showed no significant reduction when comparing the active and placebo group median (IQR): 75.0 mg (45–135) vs 62.5 mg (30–115), p=0.5, respectively. We did not find any consequential clinically relevant results of the secondary outcomes.ConclusionsFollowing major reconstructive breast cancer surgery, a preoperative multiple-injection ITP block neither reduces 24-hour opioid consumption postoperatively nor promotes substantial clinical positive outcomes.Trial registration numberEudraCT2019-001016-35.
Comparison of the incidence of intravascular injection using the Tuohy and Quincke needles during ultrasound-guided caudal epidural block: a prospective randomized controlled study
Authors: Kim Ji Yeong , Lee Jong Seok , Kim Ji Young , Baek Ji Won , Kim Hye Su , Kim Do-Hyeong 
Published: May 2023

IntroductionIntravascular injection of a local anesthetic can lead to life-threatening complications, such as deficits in neurological function after caudal epidural block. This study aimed to determine whether the intravascular injection rate of the Tuohy needle is lower than that of the Quincke needle during an ultrasound-guided caudal block.MethodsTwo-hundred and thirty patients were randomized into the Quincke (n=115) and the Tuohy (n=115) needle groups. The randomly selected needle was introduced at a 45° angle until it penetrated the sacrococcygeal ligament under ultrasound guidance, and intravenous injections were analyzed using contrast-dyed digital subtraction angiography. The relationship between the incidence of intravascular injection and independent variables, including needle type, patient demographics, history of lumbosacral surgery, use of anticoagulants, anatomic variables of the sacrum, presence of bony contact during the procedure, and the number of needle repositioning under ultrasound guidance, were examined.ResultsIntravascular uptake of contrast medium was surveyed in 25/230 (10.9%) caudal blocks using digital subtraction angiography (DSA). The incidence of intravascular uptake was 13.9% (16/115) using the Quincke needle and 7.8% (9/115) using the Tuohy needle (p=0.14). Although the needle tip type was not associated with the rate of intravascular injection, the occurrence of bony contact during the procedure demonstrated a relationship with the intravenous injection (p<0.01).ConclusionsThe overall incidence of inadvertent intravascular injections during ultrasound-guided caudal block confirmed using DSA was 10.9%. Tuohy needles did not reduce intravascular injection rates during the ultrasound-guided caudal block.Trial registration numberNCT05504590.
Accumulation and health risk of major and trace elements in a soil–medicinal plant system: a case study of the Chinese herbaceous peony (
Paeonia Lactiflora
Pall.) grown in Bozhou, China
Authors: Wang Jie , Zhang Xin , Hu Yunfei 
Published: May 2023

To investigate the interrelationships between metal elements in soil–medicinal plant systems, 51 pairs of soil and Chinese herbaceous peony samples were collected from Bozhou City, China. Our results revealed that the major and trace elements in soils and Chinese herbaceous peony samples were in descent order as: Al > Fe > Mn > Cr > Zn > Cu > Pb > As > Cd for soil samples, and Al > Fe > Zn > Mn > Cu > Cr > Pb > As > Cd for peony samples. The pollution indices of enrichment factor and Nemerow integrated pollution index both indicated that Cr was the priority pollutant in soils and the other elements (Mn, As, Fe, Cd, Pb, Cu and Zn) were slightly elevated. In general, the pollution load index indicated that the studied soils were slightly contaminated by the nine elements. Furthermore, there existed a significant relationship between the Cr content in peony samples and that in soils, and soil pH (
P
< 0.01), indicating that the main source of Cr in Chinese herbaceous peony was probably from soils. Additionally, the Cr content in peony samples displayed the highest hazard quotient value, followed by As, Cu, Al, Fe, Zn, Mn, Cd and Pb. Although the hazard quotient for all elements and hazard index were lower than 1, which indicated no adverse health effects for adults, it was necessary to strengthen the control of soil Cr content in the process of peony planting.

Thematic collection:
This article is part of the Geochemical processes related to mined, milled, or natural metal deposits collection available at:
https://www.lyellcollection.org/topic/collections/geochemical-processes-related-to-mined-milled-or-natural-metal-deposits
Contribution of Previously Unrecognized RNA Splice-Altering Variants to Congenital Heart Disease
Authors: Jang Min Young , Patel Parth N. , Pereira Alexandre C. , Willcox Jon A.L. , Haghighi Alireza , Tai Angela C. , Ito Kaoru , Morton Sarah U. , Gorham Joshua M. , McKean David M. , DePalma Steven R. , Bernstein Daniel , Brueckner Martina , Chung Wendy K. , Giardini Alessandro , Goldmuntz Elizabeth , Kaltman Jonathan R. , Kim Richard , Newburger Jane W. , Shen Yufeng , Srivastava Deepak , Tristani-Firouzi Martin , Gelb Bruce D. , Porter George A. , Seidman Christine E. , Seidman Jonathan G. 
Published: May 2023

Background:Known genetic causes of congenital heart disease (CHD) explain <40% of CHD cases, and interpreting the clinical significance of variants with uncertain functional impact remains challenging. We aim to improve diagnostic classification of variants in patients with CHD by assessing the impact of noncanonical splice region variants on RNA splicing.Methods:We tested de novo variants from trio studies of 2649 CHD probands and their parents, as well as rare (allele frequency, <2×10−6) variants from 4472 CHD probands in the Pediatric Cardiac Genetics Consortium through a combined computational and in vitro approach.Results:We identified 53 de novo and 74 rare variants in CHD cases that alter splicing and thus are loss of function. Of these, 77 variants are in known dominant, recessive, and candidate CHD genes, includingKMT2DandRBFOX2. In 1 case, we confirmed the variant’s predicted impact on RNA splicing in RNA transcripts from the proband’s cardiac tissue. Two probands were found to have 2 loss-of-function variants for recessive CHD genesHECTD1andDYNC2H1. In addition, SpliceAI—a predictive algorithm for altered RNA splicing—has a positive predictive value of ≈93% in our cohort.Conclusions:Through assessment of RNA splicing, we identified a new loss-of-function variant within a CHD gene in 78 probands, of whom 69 (1.5%; n=4472) did not have a previously established genetic explanation for CHD. Identification of splice-altering variants improves diagnostic classification and genetic diagnoses for CHD.Registration:URL:https://clinicaltrials.gov; Unique identifier: NCT01196182.
VR Dance Training System Capable of Human Motion Tracking and Automatic Dance Evaluation
Authors: Esaki Kazuhiro , Nagao Katashi 
Published: May 2023

Abstract
In this paper, a method for 3D human body tracking using multiple cameras and an automatic evaluation method using machine learning are developed to construct a virtual reality (VR) dance self-training system for fast-moving hip-hop dance. Dancers’ movement data are input as time-series data of temporal changes in joint point positions and rotations and are categorized into instructional items that are frequently pointed out by coaches as areas for improvement in actual dance lessons. For automatic dance evaluation, contrastive learning is used to obtain better expression vectors with less data. As a result, the accuracy when using contrastive learning was 0.79, a significant improvement from 0.65 without contrastive learning. In addition, since each dance is modeled by a coach, the accuracy was slightly improved to 0.84 by using, as input, the difference between the expression vectors of the model's and the user's movement data. Eight subjects used the VR dance training system, and results of a questionnaire survey confirmed that the system is effective.
Dubbing in Practice: A Large Scale Study of Human Localization With Insights for Automatic Dubbing
Authors: Brannon William , Virkar Yogesh , Thompson Brian 
Published: May 2023

Abstract
We investigate how humans perform the task of dubbing video content from one language into another, leveraging a novel corpus of 319.57 hours of video from 54 professionally produced titles. This is the first such large-scale study we are aware of. The results challenge a number of assumptions commonly made in both qualitative literature on human dubbing and machine-learning literature on automatic dubbing, arguing for the importance of vocal naturalness and translation quality over commonly emphasized isometric (character length) and lip-sync constraints, and for a more qualified view of the importance of isochronic (timing) constraints. We also find substantial influence of the source-side audio on human dubs through channels other than the words of the translation, pointing to the need for research on ways to preserve speech characteristics, as well as transfer of semantic properties such as emphasis and emotion, in automatic dubbing systems.
Efficacy of zinc supplementation for the treatment of dysmenorrhoea: a double-blind randomised controlled trial
Authors: Obiagwu Hillary I. , Eleje George U. , Obiechina Nworah J.A. , Nwosu Betrand O. , Udigwe Gerald O. , Ikechebelu Joseph I. , Ugboaja Joseph O , Okoro Chukwuemeka C. , Okonkwo Ifeanyi O. , Okwuosa Ayodele O. , Oguejiofor Charlotte B. , Chigbo Chisom G. , Ogabido Chukwudi A. , Okafor Chidinma Charity , Okafor Chigozie G. 
Published: May 2023

Objectives To determine the efficacy of zinc sulfate supplementation in managing dysmenorrhoea. Methods In total, 103 high school students were randomised into an experimental arm (52 students) and a control arm (51 students) and received 40-mg zinc sulfate or placebo, respectively, over three cycles. Primary outcome measures were the mean Visual Analogue Scale score, which measured pain over three cycles, and the frequency of nausea and vomiting. Secondary outcomes were the use of additional analgesics and the frequency of allergic reactions. Results Fifty participants were analysed in each group. Mean pain scores were not significantly different between the groups before administering zinc sulfate therapy. Following the intervention, the mean pain scores for the treatment (2.80 ± 2.28) and placebo (3.48 ± 2.85) groups were not significantly different in the first cycle; however, scores in the treatment group were significantly better in the second (2.56 ± 1.97 vs 3.80 ± 2.77) and third (1.95 ± 1.72 vs 3.95 ± 2.82) cycles. No significant differences were observed between the groups in the nausea and vomiting incidence and the requirement for additional analgesics. Conclusions Zinc sulfate reduces dysmenorrhoea severity with minimal or no adverse effects, especially with more than one cycle of usage. Trial Registration Number: PACTR202105843292338. The trial is publicly available and was registered at www.pactr.org on 25 May 2021.
Resolution of Sleep Disturbance and Improved Functional Outcomes After Rotator Cuff Repair
Authors: Zheng Evan T. , Lowenstein Natalie A. , Collins Jamie E. , Matzkin Elizabeth G. 
Published: May 2023

Background: Most patients experience sleep disturbances before rotator cuff repair, with these symptoms largely improving postoperatively. However, the relationship between the resolution or persistence of sleep disturbance and patient-reported outcomes after rotator cuff repair remains unknown. Purpose: To compare outcomes after rotator cuff repair between patients who reported a preoperative sleep disturbance and those who did not. Outcomes at various time points after surgery were also assessed in relation to the persistence or resolution of sleep disturbance. Study Design: Case-control study; Level of evidence, 3. Methods: Patients undergoing primary arthroscopic rotator cuff repair at a tertiary academic center were prospectively enrolled in a registry database. Patient characteristics were obtained preoperatively and validated patient-reported outcome measures (PROMs) were obtained pre- and postoperatively, including the visual analog scale for pain, American Shoulder and Elbow Surgeons score, Single Assessment Numeric Evaluation, Simple Shoulder Test, and Veterans RAND 12-Item Health Survey Physical and Mental components. Sleep disturbance was evaluated via responses to Simple Shoulder Test question 2. Patients with and without sleep disturbance were compared before and after surgery. Results: In total, 293 patients were prospectively enrolled. A total of 262 (89.8%) patients reported a sleep disturbance preoperatively. Of these, 221 (84.4%) reported a resolution of sleep disturbance by 2 years postoperatively. After adjustment for age, workers’ compensation status, and Cofield tear size, patients with a preoperative sleep disturbance reported significantly worse baseline PROMs, apart from the Veterans RAND 12-Item Health Survey Mental component, before surgery. However, postoperatively, these patients had greater improvement in PROMs, and no significant remaining differences were seen at follow-up between patients with and without preoperative sleep disturbance. Among patients who reported a preoperative sleep disturbance, those whose symptoms resolved postoperatively had superior PROM scores as well as significantly greater improvements from preoperative baseline values compared with patients with persistent sleep disturbances after surgery. Conclusion: Patients with preoperative sleep disturbances reported worse baseline functional scores before rotator cuff repair compared with patients without sleep disturbance. These disturbances largely resolved after surgery, with postoperative outcomes comparable with those of patients who reported no preoperative sleep concerns. Patients whose sleep disturbances resolved postoperatively also reported superior PROM scores compared with patients whose sleep disturbances persisted postoperatively.