bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Physical Therapy on Joint Pain, Joint Range of Motion, Joint Health, Strength, and Mobility in Patients with Hemophilia: A Systematic Review and Meta-Analysis
Authors: Chen Chien-Min , Lin Chia-Hung , Kung Kuan-Yu 
Published: February 2023

ABSTRACT

Objective
This study investigated the effects of physical therapy (PT), including exercise, manual therapy, and physical agent modality, on joints, muscle strength, and mobility of patients with hemophilia.

Methods
PubMed, Embase, MEDLINE, Cochrane Central Register of Controlled Trials, Web of Science, and Scopus were searched from inception to September 10, 2022. Randomized controlled trials (RCTs) comparing pain, range of motion (ROM), and health of joints, as well as muscle strength and mobility (timed up and go test [TUG]) between PT and control groups were included.

Results
Fifteen RCTs with 595 male patients with hemophilia were included. In comparisons between PT and control groups, PT significantly reduced joint pain (standardized mean difference [SMD] = −0.87; 95% confidence interval [CI], −1.14 to −0.60), increased joint ROM (SMD = 0.24; 95% CI, 0.14–0.35), enhanced joint health (SMD = −1.08; 95% CI, −1.38 to −0.78), improved muscle strength (SMD = 1.42; 95% CI, 1.16–1.69) and TUG performance (SMD = −1.25; 95% CI, −1.89 to −0.60). The comparisons demonstrate moderate to high evidentiary quality grades.

Conclusions
PT is effective in reducing pain, increasing joint ROM, and enhancing joint health, as well as improving muscle strength and mobility in patients with hemophilia.
The SETPACE Trial: Stroke Survivors Impressions of the Education and Teaching Provided Regarding Physical Activity, and Patient Confidence Regarding Exercise
Authors: Wavell Christopher , Marrocco Stephanie , Lee Fiona Jih-Hsien , Momen Rozhan , Macaluso Steven 
Published: February 2023

ABSTRACT

Objective
Investigate the association between patient self-efficacy, impression of exercise education and physical activity among stroke survivors. We hypothesized low self-efficacy and/or poor impressions of exercise education following stroke would be associated with reduced exercise participation.

Design
Cross-sectional investigation of patients’ post-stroke with physical activity as the primary outcome variable. Physical activity was measured with The Physical Activity Scale for Individuals with Physical Disabilities (PASIPD). Self-efficacy was measured with the Self-Efficacy for Exercise questionnaire (SEE). Impression of exercise education measured by the Exercise Impression Questionnaire (EIQ).

Results
Low but significant correlation between SEE and PASIPD: r (66) = .272, p = .012. Insignificant correlation between EIQ and PASIPD: r (66) = .174, p = .078. Low but significant correlation between age and PASIPD: r (66) = -.269, p = .013. No correlation between sex and PASIPD: r (66) = .051, p = .339. Age, sex, EIQ and SEE predicts 17.1% of PASIPD variance (R2 = 0.171).

Conclusion
Self-efficacy was the strongest predictor of physical activity participation. There was a lack of association between the impressions of exercise education and physical activity. Addressing patient confidence to complete exercise has the potential to improve exercise participation in patients following stroke.
Determinants of male involvement in antenatal care at Palabek Refugee Settlement, Lamwo district, Northern Uganda
Authors: Irene Auma , Dinah Nabaweesi , Sam Orech , Alege John Bosco , Komakech Allan 
Published: February 2023

AbstractBackgroundIn 2014, Uganda launched the National Male Involvement Strategy in Maternal and Child Health. In 2020, the District Health Management Information System report for Lamwo district, where Palabek Refugee Settlement is located, indicated a 10% male involvement in antenatal care (ANC). We investigated determinants of male involvement in ANC in Palabek Refugee Settlement to inform programs on improvement of male involvement in ANC in a refugee setting.MethodologyWe conducted a community-based cross-sectional analytical study among a proportionate sample of mothers in Palabek Refugee Settlement from October-December 2021. Using a standardized questionnaire, we collected information on demographics and the constructs of the socio-ecological model where consent was given. We summarized data in tables and figures. We used Pearson chi-square test to determine significance of independent variables at bivariate level. A multivariable logistic regression model was run for all variables found significant at bivariate analysis to determine association between the different independent variables and male involvement in ANC.ResultsWe interviewed 423 mothers. The mean age of their male partners was 31 years, SD 7. Eighty-one percent (343/423) of male partners had formal education, with 13% (55/423) having a source of income and 61% (257/423) having access to ANC information during their pregnancy. The level of male involvement in ANC in Palabek Refugee Settlement was 39% (164/423). Male involvement in ANC was positively associated with access to information on ANC (AOR 3.0; 95%Cl: 1.7-5.4) and frequent couple discussion on ANC (AOR 10.1; 95%Cl: 5.6-18.0). However, it was negatively associated with distance ≥3km to the health facility (AOR 0.6 ;95%Cl: 0.4-1.0).ConclusionsApproximately one in three male partners in Palabek Refugee Settlement were involved in ANC. Male partners who had access to information during ANC and those who had frequent discussions were more likely to get involved in ANC. Men who lived ≥3 kilometers from the health facility were less likely to be involved in ANC. We recommend intensified awareness creation on importance of male involvement in ANC and implementation of integrated community outreaches to reduce distance to the health facility.
Racial Differences and Contributory Cardiovascular and Non-cardiovascular Risk Factors Towards Chronic Kidney Disease Progression In Young To Middle-Aged Black And White American Adults
Authors: Choi Yuni , Jacobs David R , Kramer Holly J. , Shroff Gautam R. , Chang Alexander R. , Duprez Daniel A 
Published: February 2023

AbstractBackgroundThe progression of chronic kidney disease (CKD) is higher in Black than in White Americans but studies have mainly focused on racial differences within advanced CKD. We evaluated CKD progression in Black and White participants over 20 years and the contribution of conventional cardiovascular and non-traditional risk factors to racial disparities in CKD progression.MethodsThis study was based on 2,175 Black and 2,207 White adults in the Coronary Artery Risk Development in Young Adults (CARDIA) study. Both estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (UACR) were measured at study year 10 (age 27-41y) and every five years for 20 years. The outcome was CKD progression through No CKD into Low, Moderate, High, or Very High Risk that was based on categories of eGFR and UACR in combination. The association between race and CKD progression as well as the contribution of risk factors to racial differences were assessed in multivariable-adjusted Cox proportional hazards models.ResultsBlack participants had higher CKD transition probabilities than White participants and more prevalent risk factors during the 20-year period studied. Hazard ratios for CKD transition for Black (vs White participants) were 1.38 from No CKD into ≥ Low Risk, 2.25 from ≤ Low Risk into ≥ Moderate Risk, and 4.49 for from ≤ Moderate Risk into ≥ High Risk. Racial differences in CKD progression from No CKD into ≥ Low Risk were primarily explained by forced vital capacity (54.8%), hypertension (30.9%), and obesity (20.8%). Similar findings were observed for the race difference in transition from ≤ Low Risk into ≥ Moderate Risk, but little of the race difference in transition ≤ Moderate Risk into ≥ High Risk was explained.ConclusionsIn this longitudinal study, Black compared to White participants had a higher risk of CKD progression, and this discrepancy may be partly explained by conventional cardiovascular and non-traditional risk factors.Clinical PerspectiveWhat Is New?▪In 20 years of follow-up, young Black American adults had higher risk of chronic kidney disease (CKD) progression than their White counterparts, and the differences were larger in transitions to more advanced categories.▪Additionally, Black individuals had more conventional cardiovascular and non-traditional characteristics known to increase risk of CKD.What Are the Clinical Implications?▪Periodic screening for elevated albuminuria and eGFR would be helpful, particularly among young Black individuals.▪Future studies should evaluate if regular monitoring of eGFR and albuminuria in young Black individuals is helpful in preventing progression in CKD.
Biomonitoring of perfluoroalkyl and polyfluoroalkyl substances (PFAS) from the Survey of the Health of Wisconsin (SHOW) 2014-2016 and comparison with the National Health and Nutrition Examination Survey (NHANES)
Authors: Schultz Amy , Stanton Noel , Pomazal Rachel , Lange Meshel , Irving Roy , Meiman Jonathan , Shelton Brandon , Malecki Kristen CM 
Published: February 2023

AbstractBackgroundPer- and polyfluoroalkyl substances (PFAS) are a growing class of manufactured chemical compounds found in a variety of consumer products. PFAS have become ubiquitous in the environment and were found in many humans sampled in the United States (U.S.). Yet, significant gaps in understanding statewide level exposures to PFAS remain.ObjectiveThe goals of this study are to establish a baseline of exposure at the state level by measuring PFAS serum levels among a representative sample of Wisconsin residents and compare to United States National Health and Nutrition Examination Survey (NHANES).MethodsThe study sample included 605 adults (18+ years of age) selected from the 2014-2016 sample of the Survey of the Health of Wisconsin (SHOW). Thirty-eight PFAS serum concentrations were measured using high-pressure liquid chromatography coupled with tandem mass spectrometric detection (HPLC-MS/MS) and geometric means presented. Weighted geometric mean serum values of eight PFAS analytes from SHOW were compared to U.S. national levels from the NHANES 2015-2016 sample (PFOS, PFOA, PFNA, PFHxS, PFHpS, PFDA, PFUnDA), and the 2017-2018 sample for Me-PFOSA, PFHPS using the Wilcoxon rank-sum test.ResultsOver 96% of SHOW participants had positive results for PFOS, PFHxS, PFHpS, PFDA, PFNA, and PFOA. In general, SHOW participants had lower serum levels across all PFAS when compared to NHANES. Serum levels increased with age and were higher among males and whites. These trends were seen in NHANES, except non-whites had higher PFAS levels at higher percentiles.SignificanceWisconsin residents may have a lower overall body burden of some PFAS compounds compared to those seen by a nationally representative sample. Additional testing and characterization may be needed in Wisconsin, particularly among non-whites and low socioeconomic status, for which the SHOW sample had less representation compared to NHANES.Impact StatementThe present study conducts biomonitoring of 38 PFAS in the state of Wisconsin and suggests that while most residents of Wisconsin have detectable levels of PFAS in their blood serum, they may have a lower body burden of some PFAS compared to a nationally representative sample. Older adults, males, and whites may have a higher body burden of PFAS relative to other groups both in Wisconsin and the wider United States.
A digital score of peri-epithelial lymphocytic activity predicts malignant transformation in oral epithelial dysplasia
Authors: Bashir Raja Muhammad Saad , Shephard Adam J , Mahmood Hanya , Azarmehr Neda , Raza Shan E Ahmed , Khurram Syed Ali , Rajpoot Nasir M 
Published: February 2023

AbstractOral squamous cell carcinoma (OSCC) is amongst the most common cancers worldwide, with more than 377,000 new cases worldwide each year. OSCC prognosis remains poor, related to cancer presentation at a late stage indicating the need for early detection to improve patient prognosis. OSCC is often preceded by a premalignant state known as oral epithelial dysplasia (OED), which is diagnosed and graded using subjective histological criteria leading to variability and prognostic unreliability. In this work, we propose a deep learning approach for the development of prognostic models for malignant transformation and their association with clinical outcomes in histology whole slide images (WSIs) of OED tissue sections. We train a weakly supervised method on OED (n= 137) cases with transformation (n= 50) status and mean malignant transformation time of 6.51 years (±5.35 SD). Performing stratified 5-fold cross-validation achieves an average AUROC of ∼0.78 for predicting malignant transformations in OED. Hotspot analysis reveals various features from nuclei in the epithelium and peri-epithelial tissue to be significant prognostic factors for malignant transformation, including the count of peri-epithelial lymphocytes (PELs) (p< 0.05), epithelial layer nuclei count (NC) (p< 0.05) and basal layer NC (p< 0.05). Progression free survival using the Epithelial layer NC (p< 0.05, C-index = 0.73), Basal layer NC (p< 0.05, C-index = 0.70) and PEL count (p< 0.05, C-index = 0.73) shown association of these features with a high risk of malignant transformation. Our work shows the application of deep learning for prognostication and progression free survival (PFS) prediction of OED for the first time and has a significant potential to aid patient management. Further evaluation and testing on multi-centric data is required for validation and translation to clinical practice.
Generative AI as a Tool for Environmental Health Research Translation
Authors: Anderson Lauren B. , Kanneganti Dhiraj , Houk Mary Bentley , Holm Rochelle H. , Smith Ted 
Published: February 2023

AbstractGenerative artificial intelligence, popularized by services like ChatGPT, has been the source of much recent popular attention for publishing health research. Another valuable application is in translating published research studies to readers in non-academic settings. These might include environmental justice communities, mainstream media outlets, and community science groups. Five recently published (2021-2022) open-access, peer-reviewed papers, authored by University of Louisville environmental health investigators and collaborators, were submitted to ChatGPT. The average rating of all summaries of all types across the five different studies ranged between 3 and 5, indicating good overall content quality. ChatGPT’s general summary request was consistently rated lower than all other summary types. Whereas higher ratings of 4 and 5 were assigned to the more synthetic, insight-oriented activities, such as the production of a plain language summaries suitable for an 8thgrade reading level and identifying the most important finding and real-world research applications. This is a case where artificial intelligence might help level the playing field, for example by creating accessible insights and enabling the large-scale production of high-quality plain language summaries which would truly bring open access to this scientific information. This possibility, combined with the increasing public policy trends encouraging and demanding free access for research supported with public funds, may alter the role journal publications play in communicating science in society. For the field of environmental health science, no-cost AI technology such as ChatGPT holds the promise to improve research translation, but it must continue to be improved (or improve itself) from its current capability.
Estimation of the Variation in Glomerular Filtration Rate Based on Glycosylated Hemoglobin, Serum Creatinine and Age, in Type 2 Diabetic Patients with or Without Chronic Kidney Disease
Authors: Aguirre-Quispe Wilfor , Arana-Calderón Cesar Alejandro 
Published: February 2023

ABSTRACTObjectiveThe methods currently used to calculate GFR underestimate this measurement in the population of diabetic patients, so there is a need to look for more accurate methods of estimating GFR in this specific population. This study aims to evaluate a predictive model based on the use of HbA1c to estimate the variability of GFR in diabetic patients with or without CKD.MethodsWe analyzed data from diabetic patients belonging to a cohort of prospective follow-up of a renal health surveillance program attached to a Peruvian hospital. The following factors were included in the multiple linear regression model: age, sex, diastolic blood pressure (DBP), systolic blood pressure (SBP), body mass index (BMI), cholesterol, triglycerides, HDL, LDL, serum creatinine, Urinary creatinine, microalbuminuria, hemoglobin, basal glycemia and HbA1c.Results122 patients were included in the analysis. The final multivariate model, which included variation of HbA1c, age and creatinine variation, was very significant (p <0.0001) with an adjusted R2 of 80%. The other variables analyzed were not significant to predict the variation of the GFR despite showing some correlation.ConclusionsThe study shows that HbA1c, age and creatinine variation significantly predict the variation of GFR in diabetic patients with or without CKD and opens the possibility of use as a prognostic tool for this specific population.
Identifying COPD subtypes using multi-trait genetics
Authors: Ziyatdinov Andrey , Hobbs Brian D. , Kanaan-Izquierdo Samir , Moll Matthew , Sakornsakolpat Phuwanat , Shrine Nick , Chen Jing , Song Kijoung , Bowler Russell P. , Castaldi Peter J. , Tobin Martin D. , Kraft Peter , Silverman Edwin K. , Julienne Hanna , Aschard Hugues , Cho Michael H. 
Published: February 2023

AbstractChronic Obstructive Pulmonary Disease (COPD) has a simple physiological diagnostic criterion but a wide range of clinical characteristics. The mechanisms underlying this variability in COPD phenotypes are unclear. To investigate the potential contribution of genetic variants to phenotypic heterogeneity, we examined the association of genome-wide associated lung function, COPD, and asthma variants with other phenotypes using phenome-wide association results derived in the UK Biobank. Our clustering analysis of the variants-phenotypes association matrix identified three clusters of genetic variants with different effects on white blood cell counts, height, and body mass index (BMI). To assess the potential clinical and molecular effects of these groups of variants, we investigated the association between cluster-specific genetic risk scores and phenotypes in the COPDGene cohort. We observed differences in steroid use, BMI, lymphocyte counts, chronic bronchitis, and differential gene and protein expression across the three genetic risk scores. Our results suggest that multi-phenotype analysis of obstructive lung disease-related risk variants may identify genetically driven phenotypic patterns in COPD.
How appropriate is use of antiplatelet medications in patients with transient ischemic attacks and stroke: an analysis of 9132 patients over eight years
Authors: Naveed Hiba , Akhtar Naveed , Al-Jerdi Salman , Uy Ryan Ty , Joseph Sujatha , Morgan Deborah , Babu Blessy , Shanthi Shobana , Shuaib Ashfaq 
Published: February 2023

AbstractBackground and purposeGuidelines recommend patients with high-risk TIAs and minor stroke presenting within 1-3 days from onset be offered dual antiplatelet therapy (DAPT). There is little data on real-world adherence to these recommendations. We evaluated the appropriateness of DAPT use in TIA and stroke patients in a prospective Database.MethodsThe Qatar Stroke Database began enrollment of patients with TIAs and acute stroke in 2014 and currently has ∼ 16,000 patients. For this study we evaluated the rates of guideline-adherent use of antiplatelet treatment at the time of discharge in patients with TIAs and stroke. TIAs were considered high-risk with ABCD2 score of ⍰ 4 and minor stroke was defined as NIHSS ⍰ 3. Patient demographics, clinical features, risk factors, previous medications, imaging and laboratory investigations, final diagnosis, discharge medications, and discharge and 90-day modified Rankin Scale (mRS) were analyzed.ResultsAfter excluding patients with ICH, mimics and rare secondary causes, 8082 patients available for final analysis (TIAs: 1357;stroke 6725). In high-risk TIAs, 282 of 666 (42.3%) patients were discharged on DAPT. In patients with minor stroke, 1207 of 3572 (33.8%) patients were discharged on DAPT. DAPT was inappropriately offered to 238 of 691 (34.4%) of low-risk TIAs and 809 of 3153 (25.7%) of non-minor stroke patients.ConclusionsThis large database of prospectively collected patients with TIAs and stroke shows that, unfortunately, despite several guidelines, a large majority of patients with TIAs and stroke are receiving inappropriate antiplatelet treatment at discharge from hospital. This requires urgent attention and further investigation.
Sex differences in atrial myocardial fibrosis and degeneration: evaluation using left atrial low-voltage areas during catheter ablation of atrial fibrillation
Authors: Masuda Masaharu , Matsuda Yasuhiro , Uematsu Hiroyuki , Sugino Ayako , Ooka Hirotaka , Kudo Satoshi , Fujii Subaru , Asai Mitsutoshi , Iida Osamu , Okamoto Shin , Ishihara Takayuki , Nanto Kiyonori , Tsujimura Takuya , Hata Yosuke , Toyoshima Taku , Higashino Naoko , Nakao Sho , Mano Toshiaki 
Published: February 2023

AbstractBackgroundAtrial myocardial degeneration predisposes to atrial fibrillation (AF), ischemic stroke, and heart failure. Studies suggest the presence of sex differences in atrial myocardial degeneration. This study aimed to delineate sex differences in the prevalence, predictors, and prognostic impact of left atrial low-voltage areas (LVAs).MethodsThis observational study included 1,488 consecutive patients undergoing initial ablation for AF. Voltage mapping was performed after pulmonary vein isolation during sinus rhythm. LVAs were defined as regions where bipolar peak-to-peak voltage was < 0.50 mV. Results: LVA prevalence was higher in women (37.6%) than in men (16.0%). High age, persistent form of AF, diabetes mellitus, and a large left atrium were shown to be common predictors in both sex categories. Heart failure and history of stroke/thromboembolic events were men-specific predictors of LVA existence. Women experienced more AF recurrence than men (31.1% vs. 25.7%, p = 0.027). LVA existence was significantly associated with increased AF recurrence in each sex category, with a respective hazard ratio, 95% confidence interval and p value of 2.45, 1.87-3.22, and < 0.0001 in men and 1.82, 1.33-2.49, and < 0.0001 in women.ConclusionsLVA was more frequent in women than men, and predicted frequent AF recurrence irrespective of sex category.