bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract B030: Sustainability plan for Wellness Rx: A community-led initiative to reduce disparities and improve healthy lifestyles in an under-resourced Black community
Authors: Salinas Manisha , Albertie Monica 
Published: January 2023

Abstract
Background: Wellness Rx is a community-academic partnership program developed through a community engagement and participatory model (CEP) framework, to improve health disparities in an under-resourced predominantly Black community. This program addresses health disparities in chronic disease and social determinants of health through interactive health education, empowerment, and neighborhood support. This program aims to increase access to resources, increase capacity and strengthen relationships with local organizations for sustainable health outcomes. Wellness Rx ran in the community for 4 years with financial and logistical support from an academic medical center. In year 5, the community participated in sustainability training to shift and transfer ownership to community members. Methods: A sustainability training program was developed and delivered to community members to allow for Wellness Rx to be community-led and self-directed. A core group of 12 community members volunteered to serve as the taskforce that would ultimately lead and direct Wellness Rx after the sustainability training. This training included Information sharing of program materials, key partnership contacts, resource lists, skills training on program implementation, volunteer management, grant writing, partnership development and leadership. Results: Since the adoption of the training program, the community has tailored the Wellness Rx to meet their needs and priorities, and encompasses topics within and outside of behavioral health. As leaders of the program, they have expanded their partnerships beyond existing networks and have secured funding for activities. Conclusion: Wellness Rx demonstrates the potential for a program to become self-directed after initial support from an academic medical center. Core components of Wellness Rx can be replicated and implemented as a power-sharing model for long-term sustainability.
Citation Format: Manisha Salinas, Monica Albertie. Sustainability plan for Wellness Rx: A community-led initiative to reduce disparities and improve healthy lifestyles in an under-resourced Black community [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B030.
Zonally Asymmetric Multidecadal Variability of the North Pacific Subtropical Fronts
Authors: Wu Baolan , Xu Lixiao 
Published: January 2023

Abstract
The North Pacific Subtropical Fronts (STFs), accompanied by the eastward-flowing subtropical countercurrent, stretch from the western Pacific Ocean to the north of Hawaii. Previous work has detected different trends of the frontal position and strength between the western STF (WSTF; west of 180°) and the eastern STF (ESTF; east of 180°) in the past 40 years. However, whether the basin-scale STFs have zonally asymmetric variability on multidecadal time scales and what drives that change remain to be quantified. Our recent work has shown that the multidecadal variability of the WSTF is controlled by the Atlantic multidecadal oscillation via the subtropical mode water variability. The present study proposes that the variability of ESTF is modulated by the Pacific decadal oscillation (PDO) via the central mode water (CMW) variability, quasi synchronously on multidecadal time scales. During a PDO positive phase, the enhanced midlatitude westerly winds in the central North Pacific increase the local surface buoyancy loss and deepen the winter mixed layer, which enlarges the CMW formation and thus increases its volume. Meanwhile, accompanied by the southward-migrated outcropping zone, the main body of CMW shifts equatorward. In response to such CMW changes, the ESTF strengthens and shifts equatorward correspondingly. Conversely, during a PDO negative phase, the weakened midlatitude westerly winds in the central North Pacific decrease the local surface buoyancy loss and shallow the winter mixed layer, which reduces the CMW formation and thus decreases its volume. Meanwhile, accompanied by northward-migrated outcropping zone, the main body of CMW shifts poleward. In response to such CMW changes, the ESTF weakens and shifts poleward correspondingly. Our results reveal that the dominant factor controlling the low-frequency variability of the WSTF and ESTF is different, which renews the conventional picture that all of the STFs behave symmetrically, with important implications for the North Pacific climate variability.
Dynamic Changes and Relevant Factors of Perioperative Deep Vein Thrombosis in Patients with Thoracolumbar Fractures Caused by High-Energy Injuries
Authors: Lv Bing , Wang Haiying , Zhang Zipeng , Li Weifeng , Han Gefeng , Liu Xiangdong , Zhang Cheng 
Published: January 2023

Objective To investigate the dynamic changes and relevant factors of deep vein thrombosis (DVT) in patients with thoracolumbar fractures caused by high-energy injuries. Methods From January 2016 to June 2021, a total of 655 patients with thoracolumbar fractures who underwent surgical treatment in our hospital were retrospectively analyzed. The patients were examined by preoperative and postoperative ultrasonography, and divided into thrombus growth group, thrombus invariant group, and thrombus regression group according to the preoperative and postoperative ultrasonographic results. Medical record data, including demographic data, surgical data, and laboratory results, were collected and the differences in various factors among the groups were compared. Results DVT was found in 99 patients (15.1%, 99/655) before surgery, including 79 cases of distal thrombus, 7 cases of proximal thrombus, and 13 cases of mixed thrombus. The incidence of postoperative DVT increased to 20.6% (134/655), including 96 cases of distal thrombus, 15 cases of proximal thrombus, and 23 cases of mixed thrombus. Among them, 39.7% had thrombus growth, 49.3% had thrombus basically unchanged and 11.0% had thrombolysis. There were significant differences in age, lower extremity muscle strength, time from trauma to surgery, operation time, blood loss, blood transfusion, and post 3-D-dimer among the three groups. Conclusions In patients with thoracolumbar fractures caused by high-energy injuries, the majority of patients with DVT do not change or grow after surgery, and only a few of them have thrombolysis. Younger age, lower extremity motor, and fewer blood transfusion contribute to thrombolysis. Delayed surgical intervention, longer operation time, and higher blood loss can lead to thrombosis growth. Post 3-D-dimer is closely related to the dynamic changes of thrombus.
Validation of the 2018 FIGO Staging System for Predicting the Prognosis of Patients With Stage IIIC Cervical Cancer
Authors: Long Xingtao , He Misi , Yang Lingling , Zou Dongling , Wang Dong , Chen Yuemei , Zhou Qi 
Published: January 2023

Background: Risk stratification of patients with cervical cancer accompanied by positive lymph nodes (stage IIIC) (the 2018 International Federation of Gynecology and Obstetrics [FIGO] new staging system) yields a clinically heterogeneous group. In this study, we investigated the prognostic performance of the 2018 FIGO staging system for stage IIIC cervical cancer. Methods: The study included patients with stage III cervical cancer based on the 2018 FIGO staging system, who visited Chongqing University Cancer Hospital between January 2011 and December 2014. Kaplan-Meier curves were generated to evaluate overall survival (OS), which was compared using the log-rank test. The Cox proportional hazard regression model was used for multivariable analysis. Results: A total of 418 patients were eligible for analysis. The 5-year OS was 54.1% for stage IIIC1, 43.3% for stage IIIA, 40.6% for stage IIIB, and 23.1% for stage IIIC2 ( P < .001). Multivariable analysis revealed that compared with stages IIIA (hazard ratio [HR] 1.432, 95% confidence interval [CI] 0.867-2.366, P = .161) and IIIB (HR 1.261, 95% CI 0.871-1.827, P = .219), stage IIIC1 cancer was not significantly associated with an increased mortality risk. Stage IIIC2 was independently associated with an increased mortality risk compared with stages IIIA (HR 2.958, 95% CI 1.757-4.983, P < .001) and IIIB (HR 2.606, 95% CI 1.752-3.877, P < .001). We stratified patients with stage IIIC1 based on the T stage. The 5-year OS was significantly longer in patients with stage IIIC1 (T1) than in those with stage IIIA ( P = .004) or IIIB ( P < .001). Analysis of multiple factors revealed that the mortality risk was 2.75-fold higher in patients with stage IIIC1pN>2 than in patients with stage IIIC1pN1-2 (HR 2.753, 95% CI 1.527-4.965, P = .001). Conclusions: Patients with stage IIIC1 cervical cancer showed heterogeneous clinical characteristics that reflected variable prognoses, depending on the T stage and the extent of pelvic lymph node metastases.
Tight control in patients with rheumatoid arthritis treated with targeted therapies across the COVID-19 pandemic era
Authors: Luppino Angela Flavia , Cincinelli Gilberto , Orenti Annalisa , Boracchi Patrizia , Favalli Ennio Giulio , Caporali Roberto , Ingegnoli Francesca 
Published: January 2023

Objectives To analyze the impact of different patterns of healthcare delivery on remission of rheumatoid arthritis (RA) patients treated with targeted therapies during the first wave (2020) and second/third waves (2021) of the pandemic compared to the pre-pandemic period (2019). Methods In this observational real-life study, data from RA patients treated with biologic or targeted synthetic drugs were extracted from a longitudinal registry. Clinical Disease Activity Index (CDAI) was analyzed in the same period from the 22nd of February to the 18th of May for three consecutive years. These three periods were characterized by different patterns of healthcare delivery: (1) before the pandemic (2019) only in-person visits, (2) during the first wave (2020) both in-person visits and telehealth, and (3) during the second/third waves (2021) only in-person visits. A generalized linear model with the binomial error was fitted to evaluate the difference in the proportion of patients in CDAI remission. Quantile regression was used to compare the median of CDAI in difficult-to-treat (D2T) patients. Results In the three periods, we included 407, 450, and 540 RA patients respectively. The percentages of patients in CDAI remission were similar in the three periods (prevalence ratio 1.07, p value 0.423 between 2020 and 2019, and 1.01, p-value 0.934 between 2021 and 2019). The CDAI remission rate was 40.55% ( N = 163), 43.18% ( N = 155) and 40.82% ( N = 220) in 2019, 2020 and 2021, respectively. Among our cohort of D2T patients, CDAI remission was similar across the three periods ( N = 30, 22.22%; N = 27, 23.68%; and N = 34, 21.52% respectively). Conclusion Although the pandemic has imposed changes in our healthcare delivery, these different strategies seem to be effective in ensuring satisfactory management of RA treated with targeted therapies. The approaches modulated in the context of the different periods have been a feasible compensation for ensuring disease control even in D2T patients.
Fe3O4/SiO2/polymer hybrid biosorbent based on an etch-fill strategy for heavy metal ion adsorption
Authors: Tao Jin , Zhu Ying , Huang Tao , Zhang Jishu , Wu Jianbing , Liu Leigen 
Published: January 2023

Heavy metal contamination is a serious concern worldwide. In order to remove heavy metal ions from wastewater efficiently, multifunctinoal biomass-based material have been utilized. Herein, hyperbranched polymer modified cellulose biomass (HBP-CB) derived from textile waste materials ramie fibers was successfully developed by construction of Fe3O4/SiO2/polymer multiple structure through an etch-fill strategy. Specifically, Fe3O4 and SiO2 particles were introduced to the oxidation etching cellulose surface, and subsequently modified by hyperbranched polymer The adsorption behavior of the adsorbent toward two classes of heavy metal ions was investigated. The results indicated that HBP-CB owned excellent adsorption capacities for chromium and Cu(II) with maximum 123.5 mg/g and 149.0 mg/g and magnetic recovery performance in aqueous medium. These are owing to the oxidization etching biomass matrix with a higher BET surface area of 4.61 m2/g and the hybrid multiple structure modified by functional hyperbranched polymer with high dense adsorptive sites on the matrix. The adsorption behavior was well described by pseudo-second-order kinetic model and Langmuir isotherm model, revealing a rapid surface adsorption and monolayer spontaneous chemical adsorption. For recycling, 81% of adsorption capacity could be retained after five recovery cycles. These demonstrate that the hybrid multiple structure based on biomass, nanomaterials and polymer could provide sustainable and high-performance adsorption property for wastewater treatment.
Gait-Adaptability Training in People With Hereditary Spastic Paraplegia: A Randomized Clinical Trial
Authors: van de Venis Lotte , van de Warrenburg Bart , Weerdesteyn Vivian , Geurts Alexander C. H. , Nonnekes Jorik 
Published: January 2023

Background and objectives In people with hereditary spastic paraplegia (HSP), reduced gait adaptability is common and disabling. Gait impairments result from lower extremity spasticity, muscle weakness, and impaired proprioception. The aim of this study was to assess the efficacy of a 5-week gait-adaptability training in people with pure HSP. Method We conducted a randomized clinical trial with a cross-over design for the control group, and a 15-week follow-up period after training. Thirty-six people with pure HSP were randomized to 5 weeks of (i) gait-adaptability training (10 hours of C-Mill training—a treadmill equipped with augmented reality) or (ii) a waiting-list control period followed by 5 weeks gait-adaptability training. Both groups continued to receive usual care. The primary outcome was the obstacle subtask of the Emory Functional Ambulation Profile. Secondary outcome measures consisted of clinical balance and gait assessments, fall rates, and spatiotemporal gait parameters assessed via 3D motion analysis. Results The gait-adaptability training group (n = 18) did not significantly decrease the time required to perform the obstacle subtask compared to the waiting-list control group (n = 18) after adjusting for baseline differences (mean: −0.33 seconds, 95% CI: −1.3, 0.6). Similar, non-significant results were found for most secondary outcomes. After merging both groups (n = 36), the required time to perform the obstacle subtask significantly decreased by 1.3 seconds (95% CI: −2.1, −0.4) directly following 5 weeks of gait-adaptability training, and this effect was retained at the 15-week follow-up. Conclusions We found insufficient evidence to conclude that 5 weeks of gait-adaptability training leads to greater improvement of gait adaptability in people with pure HSP.
Embolization of a duplicated femoral vein for treatment of lower extremity deep venous insufficiency: A case report
Authors: Sun Chun , Zheng Wei , Wang Sheng , Wu Yingfeng 
Published: January 2023

Background Lower extremity deep venous insufficiency (DVI) occurs secondary to structural or functional abnormalities of deep venous valves in the affected extremities. The effectiveness of surgical treatment for improvement of the hemodynamic status in these patients remains controversial in clinical practice. Method In this case report, we describe a patient who presented with severe right lower extremity edema and liposclerosis and underwent venography, which suggested a variation in the number of femoral veins. The valve within the duplicated femoral vein was significantly incompetent; however, the valve of the main trunk of the femoral vein showed normal function. We performed embolization of the duplicated femoral vein. Results The patient tolerated the procedure well without recurrent symptoms. Conclusions Individualized assessment based on venography findings is useful to establish the therapeutic approach in patients with DVI.
Staff Low Back Injury Risk During Assisted Falls Virtual Reality Simulations
Authors: Broderick Vianna , Barrett Blake , Phillips Samuel , Cowan Linda , Friedman Yvonne , McKinney Andrea , Chavez Margeaux , Lind Jason , Bradley Sarah , Kaplan Howard , Bulat Tatjana 
Published: January 2023

Background: Assisted falls occur when staff try to minimize the impact of falls by slowing a patient’s descent. Assisting a patient fall may decrease patient injury risk, but biomechanical risk of injury to staff has not been evaluated. Assisted falls virtual reality (VR) simulations were conducted to examine staff low back injury risk during common assisted falls scenarios. Methods: VR simulations of a toilet to wheelchair transfer were developed with a male patient avatar for three assisted falls scenarios: standing up from toilet, sitting down on wheelchair, and ambulation. Patient avatar weight was modified to reflect normal, underweight, and overweight adult patients. The average spinal compression force at L5/S1 was calculated for each participant with five trials per three scenarios while utilizing physical ergonomic techniques and compared to the safe spinal compression limit of 3,400 Newtons (N). Findings: Six staff participants completed 90 VR simulations in total. The average calculated spinal compression force ranged from 7,132 N to 27,901 N. All participant trials exceeded the safe spinal compression limit of 3,400 N for every assisted falls scenario and avatar weight despite application of ergonomic techniques including wide stance, knees bent, and backs straight. Conclusions/Application to Practice: Staff are at risk for low back injury if they assist falls regardless of the adult patient weight and application of ergonomic techniques. Safer alternatives like the implementation of mobility screening tools and safe patient handling and mobility technology are needed to help prevent assisted falls to decrease injury risk to both patients and staff.
Boosting ICU capacity during the COVID-19 pandemic in the western Balkan region, The Republic of Srpska experience
Authors: Kovacevic Pedja , Djajic Vlado , Momcicevic Danica , Zlojutro Biljana , Jandric Milka , Kovacevic Tijana , Latinovic Milan , Seranic Alen , Bokonjic Dejan , Skrbic Ranko , Dragic Sasa 
Published: January 2023

Background: Response to the outbreak of poliomyelitis in mid-1950 led to recognition and consequent development of critical care. Seventy years later the humankind was struck by COVID-19, another major challenge for critical care medicine which was especially big in Low-Resources-Settings where more than two thirds of the world population live, including the population of the Republic of Srpska (RS). Design and methods: The main aim was to show an overview of all interventions in order to boost hospitals’ capacities to the level which is sufficient to manage high amount of critically ill COVID-19 patients in the RS. A before-after cohort study design was conducted to evaluate the effects of interventions for increase in preparedness and capacity of ICUs for admission and treatment of COVID-19 critically ill patients in nine hospitals in the RS. Results: Following interventions, the biggest and university affiliated hospital in the RS has increased ICU capacities: total number of ICU beds increased by 38% and number of ventilators by 114%. Availability of machines for veno-venous extracorporeal membrane oxygenation (vvECMO) increased by 100%. Number of doctors who were involved in treatment of critically ill patients increased by 47% and nurse/patient’s ratio reached 1:2.5. Similarly, all other hospitals experienced boosting of ICU beds by 189% and ventilators by 373% while number of doctors increased by 108% and nurse/patient’s ratio reached 1:4. Conclusion: All interventions implemented during COVID-19 pandemic outbreak in the RS resulted in increasing capacity for treatment of critically ill patients, but the education of health care professionals was identified as the most important conducted intervention.
Adrenal Insufficiency Associated with Low High-Density Lipoprotein (HDL) in Patients of Chronic Liver Disease
Authors: Singh Satender Pal , Mondia Nitisha 
Published: January 2023

Introduction Adrenal insufficiency is noted in patients of cirrhosis, mainly in critically ill patients. Cirrhosis characterized with low synthetic functions has multiple indirect markers for severity. Methodology 100 decompensated cirrhosis patients were hospitalized to Lady Hardinge Medical College in New Delhi as part of an observational cohort research from October 2014 to June 2016. Adrenocorticotrophic hormone stimulation test was done with 250 mcg, basal cortisol, and cortisol after 60 minutes of stimulation was noted. We investigated the relationship between blood HDL levels and adrenal insufficiency. Results Insufficient adrenal function was detected in 28% of the patients. INR, serum total bilirubin, serum creatinine, low high-density lipoprotein (HDL), child score, MELD score, plasma renin activity level, and renal resistive index were all associated with patients with adrenal insufficiency on univariate analysis. Multivariate analysis showed in patients with adrenal insufficiency, MELD score had odds ratio of 1.5 with AUC 0.724 (0.622-0.825), Bilirubin with odds ratio of 5.6 and AUC of 0.676 (0.679-0.882). Serum HDL with odds ratio of 6.1 (3.3-9.2) and AUC 0.822 (0.724-0.828) with P value <0.001, cut off calculated was 26 mg/dL with sensitivity of 81% and specificity of 85% predicts adrenal insufficiency. Patients with adrenal insufficiency had higher mortality. Conclusion Cirrhosis is associated with adrenal insufficiency, more with advanced liver disease. Low HDL level in blood can be taken as an indirect marker for adrenal insufficiency.
Unraveling the COVID-19 hospitalization dynamics in Spain using Bayesian inference
Authors: Aleta Alberto , Blas-Laína Juan Luis , Tirado Anglés Gabriel , Moreno Yamir 
Published: January 2023

Abstract
Background
One of the main challenges of the COVID-19 pandemic is to make sense of available, but often heterogeneous and noisy data. This contribution presents a data-driven methodology that allows exploring the hospitalization dynamics of COVID-19, exemplified with a study of 17 autonomous regions in Spain from summer 2020 to summer 2021.

Methods
We use data on new daily cases and hospitalizations reported by the Spanish Ministry of Health to implement a Bayesian inference method that allows making short-term predictions of bed occupancy of COVID-19 patients in each of the autonomous regions of the country.

Results
We show how to use the temporal series for the number of daily admissions and discharges from hospital to reproduce the hospitalization dynamics of COVID-19 patients. For the case-study of the region of Aragon, we estimate that the probability of being admitted to hospital care upon infection is 0.090 [0.086-0.094], (95% C.I.), with the distribution governing hospital admission yielding a median interval of 3.5 days and an IQR of 7 days. Likewise, the distribution on the length of stay produces estimates of 12 days for the median and 10 days for the IQR. A comparison between model parameters for the regions analyzed allows to detect differences and changes in policies of the health authorities.

Conclusions
We observe important regional differences, signaling that to properly compare very different populations, it is paramount to acknowledge all the diversity in terms of culture, socio-economic status, and resource availability. To better understand the impact of this pandemic, much more data, disaggregated and properly annotated, should be made available.