bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fucoidan Attenuated Kidney and Bone Damage Caused by CKD-MBD in Mice by Upregulating Klotho
Authors: Lu Tao , Dou Mang , Yang Chengyi , Hu Qiangyan , Wang Yin’e , Pan Suxia 
Published: July 2023

Background Fucoidan is a phosphorylated polysaccharide extracted from seaweed that has a renal protective effect. However, whether Fucoidan can be used to prevent chronic kidney disease with mineral and bone disorders (CKD-MBD) is still a mystery and thus becomes the target of this research. Materials and Methods CKD-MBD mouse models were constructed, and the effects of Fucoidan and Klotho on CKD-MBD were determined through treatment of Fucoidan (100 mg/kg or 200 mg/kg) by gavage or tail vein injection of Klotho specific to small interfering RNA (siKlotho). The biochemical indicators related to renal function and bone metabolism in serum were detected by an automatic biochemical analyzer or enzyme-linked immunosorbent assay. Bone density was measured by X-ray. The effect of Fucoidan or siKlotho on kidney damage was tested by hematoxylin and eosin (H&E) staining or Elastica Masson-Goldner (EMG) staining. The expressions of Klotho, Runt-related transcription factor 2 (Runx2), and α-smooth muscle actin (α-SMA) in kidney tissue after Fucoidan treatment and/or siKlotho injection were quantified by quantitative reverse transcription-polymerase chain reaction (qRT-PCR), immunohistochemistry, or Western blot. Results Fucoidan treatment inhibited the levels of blood urea nitrogen (BUN), creatinine, alkaline phosphatase (ALP), phosphorus, intact parathyroid hormone (iPTH), and fibroblast growth factor 23 (FGF23), while promoting 1,25 (OH)2D3 levels in serum. Fucoidan also increased bone density in mice, alleviated kidney damage and fibrosis of kidney tissue, promoted the expression of Klotho and Runx2, and inhibited the expression of α-SMA in kidney tissue. However, the above-mentioned therapeutic effects of Fucoidan were all reversed by siKlotho. Conclusion Fucoidan prevents CKD-MBD by up-regulating Klotho levels.
Circulating biomarkers of cardiovascular disease are related to aneurysm volume in abdominal aortic aneurysm
Authors: Bouwens Elke , Vanmaele Alexander , Hoeks Sanne E , Verhagen Hence JM , Fioole Bram , Moelker Adriaan , ten Raa Sander , Hussain Burhan , Oliveira-Pinto José , Bastos Gonçalves Frederico , Ijpma Arne S , Hoefer Imo E , van Lier Felix , Akkerhuis K Martijn , Majoor-Krakauer Danielle F , Boersma Eric , Kardys Isabella 
Published: July 2023

Background: Surveillance programs in abdominal aortic aneurysms (AAA) are mainly based on imaging and leave room for improvement to timely identify patients at risk for AAA growth. Many biomarkers are dysregulated in patients with AAA, which fuels interest in biomarkers as indicators of disease progression. We examined associations of 92 cardiovascular disease (CVD)-related circulating biomarkers with AAA and sac volume. Methods: In a cross-sectional analysis, we separately investigated (1) 110 watchful waiting (WW) patients (undergoing periodic surveillance imaging without planned intervention) and (2) 203 patients after endovascular aneurysm repair (EVAR). The Cardiovascular Panel III (Olink Proteomics AB, Sweden) was used to measure 92 CVD-related circulating biomarkers. We used cluster analyses to investigate protein-based subphenotypes, and linear regression to examine associations of biomarkers with AAA and sac volume on CT scans. Results: Cluster analyses revealed two biomarker-based subgroups in both WW and EVAR patients, with higher levels of 76 and 74 proteins, respectively, in one subgroup versus the other. In WW patients, uPA showed a borderline significant association with AAA volume. Adjusting for clinical characteristics, there was a difference of −0.092 (−0.148, −0.036) loge mL in AAA volume per SD uPA. In EVAR patients, after multivariable adjustment, four biomarkers remained significantly associated with sac volume. The mean effects on sac volume per SD difference were: LDLR: −0.128 (−0.212, −0.044), TFPI: 0.139 (0.049, 0.229), TIMP4: 0.110 (0.023, 0.197), IGFBP-2: 0.103 (0.012, 0.194). Conclusion: LDLR, TFPI, TIMP4, and IGFBP-2 were independently associated with sac volume after EVAR. Subgroups of patients with high levels of the majority of CVD-related biomarkers emphasize the intertwined relationship between AAA and CVD. ClinicalTrials.gov Identifier: NCT03703947.
A Retrospective Cohort Study of Racial/Ethnic and Socioeconomic Disparities in Initiation and Meaningful Use of Continuous Glucose Monitoring Among Youth With Type 1 Diabetes
Authors: Tremblay Elise Schlissel , Bernique Allison , Garvey Katherine , Astley Christina M. 
Published: July 2023

Background: Continuous glucose monitor (CGM) use improves type 1 diabetes (T1D) outcomes, yet children from diverse backgrounds and on public insurance have worse outcomes and lower CGM utilization. Using novel CGM data acquisition and analysis of two T1D cohorts, we test the hypothesis that T1D youth from different backgrounds experience disparities in meaningful CGM use following both T1D diagnosis and CGM uptake. Methods: Cohorts drawn from a pediatric T1D program were followed for one year beginning at diagnosis ( n = 815, 2016-2020) or CGM uptake ( n = 1392, 2015-2020). Using chart and CGM data, CGM start and meaningful use outcomes between racial/ethnic and insurance groups were compared using median days, one-year proportions, and survival analysis. Results: Publicly compared with privately insured were slower to start CGM (233, 151 days, P < .01), had fewer use-days in the year following uptake (232, 324, P < .001), and had faster first discontinuation rates (hazard ratio [HR] = 1.61, P < .001). Disparities were more pronounced among Hispanic and black compared with white subjects for CGM start time (312, 289, 149, P = .0013) and discontinuation rates (Hispanic HR = 2.17, P < .001; black HR = 1.45, P = .038), and remained even among privately insured (Hispanic/black HR = 1.44, P = .0286). Conclusions: Given the impact of insurance and race/ethnicity on CGM initiation and use, it is imperative that we target interventions to support universal access and sustained CGM use to mitigate the potential impact of provider biases and systemic disadvantage and racism. By enabling more equitable and meaningful T1D technology use, such interventions will begin to alleviate outcome disparities between youth with T1D from different backgrounds.
Hierarchy of Evidence: An Appraisal Tool for Weighting the Evidence in Healthcare Design Research Based on Internal Validity
Authors: Jamshidi Saman , Pati Debajyoti 
Published: July 2023

Purpose: This inquiry aims to develop an appraisal tool to offer greater granularity in weighing evidence in the field of healthcare design research. Background: In evidence-based design (EBD), the goal is to implement interventions that result in a meaningful and optimal effect based on current best evidence. Although multiple appraisal tools (many adopted from medical disciplines) have been instrumental in evaluating studies in the field of healthcare design research to identify the best evidence, they do not necessarily consider the unique contexts of healthcare design research, and methodologies appropriate to the field. Methods: Five basic types of studies are ranked based on the level of confidence that they offer regarding the estimate of an effect: (1) meta-analysis studies, (2) causal studies, (3) correlational studies, (4) descriptive studies, and (5) anecdotal evidence. Causal studies are further divided into four levels based on the interaction of two factors: (1) type of intervention and (2) groups’ equivalency and extraneous variable control. Results: An eight-level hierarchy of evidence for healthcare design research is proposed that is expected to improve upon previous hierarchies in three major ways: (a) including research methods that are more relevant to healthcare design research, (b) enhancing evaluation accuracy and reliability by providing a clearer definition of studies based on their key components rather than using study labels alone, and (c) distinguishing different levels of evidence, particularly in causal studies. Conclusions: The proposed appraisal tool is developed specifically for EBD by reflecting on the unique context of healthcare design research and practice.
Factors Associated With Awareness, Adoption, and Implementation of Anterior Cruciate Ligament Injury Prevention in Youth Sports
Authors: MacFarlane Alexander J. , Whelan Timothy , Weiss-Laxer Nomi S. , Haider Mohammad N. , Dinse Scott A. , Bisson Leslie J. , Marzo John M. 
Published: July 2023

Background: Anterior cruciate ligament (ACL) injuries are among the most common injuries in adolescent athletes and result in significant financial and physical morbidity. Evidence-based programs designed to prevent ACL injury are effective. However, their adoption remains low. We sought to evaluate the awareness, evidence-based implementation, and barriers to implementation of ACL injury prevention programs (ACL-IPP) among youth athletic coaches. Hypothesis: Higher education level of the coach, higher level of training, number of teams coached, and coaching female teams would be associated with ACL-IPP implementation. Study Design: Cross-sectional survey Level of Evidence: Level 4. Methods: We conducted an email survey sent to all 63 school districts within Section VI of the New York State Public High School Athletic Association. We employed descriptive statistics and tests of correlation to identify factors associated with ACL-IPP implementation. Results: A total of 73% of coaches said they were aware of ACL-IPP, and only 12% of coaches implemented ACL-IPP according to best evidence. Coaches of higher competitive levels were more likely to adopt ACL-IPP ( P = 0.01), more likely to use them multiple times per week ( P = 0.03), and for ≥1 seasons ( P = 0.02). Coaches of multiple teams were more likely to adopt ACL-IPP ( P = 0.01). There were no differences in evidence-based implementation of ACL-IPP with gender coached or level of education of the coach. Conclusion: Overall awareness, adoption, and evidence-based implementation of ACL-IPP remain low. These results suggest that coaches at higher levels of play and multiple teams tend to use ACL-IPP more often. Gender coached and level of education do not appear to be associated with awareness or implementation. Clinical Relevance: Evidence-based ACL-IPP implementation remains low. Targeting coaches of younger athletes and fewer teams with local outreach programs and ACL-IPP may increase the implementation of ACL-IPP.
Towards multimodal boosting of motivation for fall-preventive physical activity in seniors: An iterative development evaluation study
Authors: Revenäs Å. , Ström L. , Cicchetti A. , Ehn M. 
Published: July 2023

Background Many seniors need to increase their physical activity (PA) and participation in fall prevention exercise. Therefore, digital systems have been developed to support fall-preventive PA. Most of them lack video coaching and PA monitoring, two functionalities that may be relevant for increasing PA. Objective To develop a prototype of a system to support seniors’ fall-preventive PA, which includes also video coaching and PA monitoring, and to evaluate its feasibility and user experience. Methods A system prototype was conceived by integrating applications for step-monitoring, behavioural change support, personal calendar, video-coaching and a cloud service for data management and co-ordination. Its feasibility and user experience were evaluated in three consecutive test periods combined with technical development. In total, 11 seniors tested the system at home for four weeks with video coaching from health care professionals. Results Initially, the system's feasibility was non-satisfactory due to insufficient stability and usability. However, most problems could be addressed and amended. In the third (last) test period, both seniors and coaches experienced the system prototype to be fun, flexible and awareness-raising. Interestingly, the video coaching which made the system unique compared to similar systems was highly appreciated. Nonetheless, even the users in the last test period highlighted issues due to insufficient usability, stability and flexibility. Further improvements in these areas are needed. Conclusions Video coaching in fall-preventive PA can be valuable for both seniors and health care professionals. High reliability, usability and flexibility of systems supporting seniors are essential.
Wearable devices in palliative care for people 65 years and older: A scoping review
Authors: Sandic Spaho Rada , Uhrenfeldt Lisbeth , Fotis Theofanis , Kymre Ingjerd Gåre 
Published: July 2023

Objective The objective of this scoping review is to map existing evidence on the use of wearable devices in palliative care for older people. Methods The databases searched included MEDLINE (via Ovid), Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Google Scholar, which was included to capture grey literature. Databases were searched in the English language, without date restrictions. Reviewed results included studies and reviews involving patients aged 65 years or older who were active users of non-invasive wearable devices in the context of palliative care, with no limitations on gender or medical condition. The review followed the Joanna Briggs Institute's comprehensive and systematic guidelines for conducting scoping reviews. Results Of the 1,520 reports identified through searching the databases, reference lists, and citations, six reports met our inclusion criteria. The types of wearable devices discussed in these reports were accelerometers and actigraph units. Wearable devices were found to be useful in various health conditions, as the patient monitoring data enabled treatment adjustments. The results are mapped in tables as well as a Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) chart. Conclusions The findings indicate limited and sparse evidence for the population group of patients aged 65 years and older in the palliative context. Hence, more research on this particular age group is needed. The available evidence shows the benefits of wearable device use in enabling patient-centred palliative care, treatment adjustments and symptom management, and reducing the need for patients to travel to clinics while maintaining communication with healthcare professionals.
Using a complexity science approach to evaluate the effectiveness of just-in-time adaptive interventions: A meta-analysis
Authors: Xu Zhan , Smit Eline 
Published: July 2023

Objective Just-in-time adaptive interventions (JITAIs), which allow individuals to receive the right amount of tailored support at the right time and place, hold enormous potential for promoting behavior change. However, research on JITAIs’ implementation and evaluation is still in its early stages, and more empirical evidence is needed. This meta-analysis took a complexity science approach to evaluate the effectiveness of JITAIs that promote healthy behaviors and assess whether key design principles can increase JITAIs’ impacts. Methods We searched five databases for English-language papers. Study eligibility required that interventions objectively measured health outcomes, had a control condition or pre-post-test design, and were conducted in the real-world setting. We included randomized and non-randomized trials. Data extraction encompassed interventions’ features, methodologies, theoretical foundations, and delivery modes. RoB 2 and ROBINS-I were used to assess risk of bias. Results The final analysis included 21 effect sizes with 592 participants. All included studies used pre- and post-test design. A three-level random meta-analytic model revealed a medium effect of JITAIs on objective behavior change ( g = 0.77 (95% confidence interval (CI); 0.32 to 1.22), p < 0.001). The summary effect was robust to bias. Moderator analysis indicated that design principles, such as theoretical foundations, targeted behaviors, and passive or active assessments, did not moderate JITAIs’ effects. Passive assessments were more likely than a combination of passive and active assessments to relate to higher intervention retention rates. Conclusions This review demonstrated some evidence for the efficacy of JITAIs. However, high-quality randomized trials and data on non-adherence are needed.
Relaxation Methods to Reduce Occupational Stress
Authors: Williams-Southers TaShana 
Published: July 2023

Background: Healthcare providers putting their patient’s health before their own has negative consequences. Utilizing evidence-based research, nurse leaders can implement practices to positively affect employee health. This project assessed the utilization of a workplace relaxation room to reduce occupational stress. Method: Multiple methods were used to recruit participants. Participants completed pre/post surveys (demographic, PSS-10, GallupQ12, and open-ended questions) via email. The relaxation room contained stress reducing items for staff to utilize while at work. Data was collected using Qualtrics Survey software. Findings: Data from the PSS-10 and GallupQ12 did not reveal statistically significant results. The participants responses to the open-ended questions did indicate a positive impact. Conclusions/Application to Practice: While the aims of the project were not met during the intervention, the open-ended responses indicated that for the employees who participated in the project, the intervention was a positive addition to the workplace.
Authentic Leadership and Its Role in Registered Nurses’ Mental Health and Experiences of Workplace Bullying
Authors: Al-Hassan Nadira Salman , Rayan Ahmad Hussien , Baqeas Manal Hassan , Hamaideh Shaher H. , Khrais Huthaifah 
Published: July 2023

Introduction Bullying is a widespread problem in healthcare organizations, resulting in nurses’ poor mental health. Effective leadership, such as authentic leadership, may help to overcome this problem. Objective To examine the relationship between authentic leadership, workplace bullying, and nurses’ mental health, controlling for demographic characteristics. Methods A descriptive correlational design was utilized with a sample of 170 nurses. Nurses were recruited from four private hospitals in Jordan and completed a survey about their perception of managers’ authentic leadership, their experience of workplace bullying, and their mental health. Results About 48.8%, 25.9%, and 25.3% were categorized as “not bullied,” “occasionally bullied,” and “severely bullied,” respectively. Participant nurses had mild depression ( m = 12.11) and moderate anxiety ( m = 10.92). Workplace bullying was higher among nurses who earn less than 600 Jordanian dinars and nurses working in the smallest hospital, with 130 beds. Authentic leadership explains 6% of the variance of workplace bullying, 3% of anxiety, 7% of stress, and 7% of depression above and beyond the variance explained by other variables. Conclusions Healthcare organizations are facing a challenge in providing a healthy work environment. Employing authentic leadership in the workplace could be one of the factors that could help in addressing this issue.
Student Employment Models for Undergraduate Nurses and Midwives in Australia: A Scoping Review
Authors: Lindsay David J. , Ahern Tracey A. , Pardon Madelyn K. , McAuliffe Marie T. , Rannard Sam G. 
Published: July 2023

Introduction Evidence has shown that throughout their undergraduate years, many nursing and midwifery students obtain paid employment in a wide variety of clinical and non-clinical positions. Across Australia, inconsistencies exist in the models of clinical employment available to these student groups. Previous Australian studies have described the employment of undergraduate nursing and midwifery students in regulated and unregulated clinical roles. No studies have reported on the various regulated roles available to both student nurses and midwives in Australia. The purpose of this scoping review is to identify and synthesize evidence related to nursing and/or midwifery students employed in regulated and unregulated clinical roles in Australia. Methods This scoping review utilized published recommendations for data screening, abstraction, and synthesis. One of the authors, a librarian, undertook systematic searches in CINAHL Complete (1937–present), Emcare on Ovid (1995–present), Scopus (1969–present), and Ovid MEDLINE(R) (including Epub Ahead of Print, In-Process, and In-Data-Review & Other Non-Indexed Citations, 1946–present). The initial searches were completed in April 2019 and repeated in March 2021 and May 2022 to identify any new literature. Manual searching of reference lists in the included papers was also undertaken, together with selected organizational websites. The extracted data included the lead author, date, title, study design, study sample and location, and key findings. Results From the 53 items retrieved, 23 peer-reviewed studies met the inclusion criteria and were included in the review. All items were published between 2011 and 2022. Only four of the studies focused upon student midwives. Undergraduate nursing and midwifery students in Australia obtain paid employment in a variety of regulated and unregulated clinical roles. Conclusion The literature reported here demonstrates that there are differing models, nomenclature, educational requirements, and pay scales in place for student employment in clinical roles across Australian states and territories.
Family Nurse Practitioner Students’ Readiness for Board Certification Utilizing a Full Board Review Course and Simulation
Authors: Wolf Lindsay , Buschini Laurie , Logsdon Roberta 
Published: July 2023

Background The aim of this project was to determine if the implementation of a three-tiered model consisting of a full board review course, round table case analysis, and on call scenarios in the final clinical course of the Family Nurse Practitioner Doctor of Nursing Practice program improved readiness for board certification testing for graduating students. Methods An anonymous pre- and post-survey design was utilized. Institutional Review Board (IRB) approval was obtained prior to implementation. A full board review course, including a predictor exit exam component, was utilized in this cohort's final clinical course. Additionally, in-class case review and “on-call” scenarios were facilitated by the faculty to simulate critical decision-making scenarios. A 58% survey response rate was elicited. Prior to the full board review, 16% of respondents felt ready to answer general board-style questions as compared to 100% following the review. Thirty three percent of respondents felt ready to prescribe and provide evidence-based care prior to the project, following the project, 100% of respondents felt ready. Open-ended questions revealed positive feedback for the course and simulated scenarios, however students did feel overwhelmed by the amount of work the course entailed over the course the semester. Conclusions Quantitative and Qualitative results indicated positive outcomes and provide support for adoption of the full board review, case-based simulation, and on-call scenarios for all practicum courses at the university. Adjustment of the time requirement and expectations should be reviewed prior to further implementation. In addition, limitations included a small cohort of students in this study; additional studies should be implemented before generalization can occur.