bluuebunny/crossref_metadata_2025_split huggingface dataset:
Applying the Generalizability Theory to Identify the Sources of Validity Evidence for the Quality of Communication Questionnaire
Authors: Del Castanhel Flávia , Fonseca Fernanda R. , Bonnassis Burg Luciana , Maia Nogueira Leonardo , Rodrigues de Oliveira Filho Getúlio , Grosseman Suely 
Published: September 2023

Effective doctor-patient-family communication is an integral and sensitive part of health care, assessing its quality is essential to identify aspects needing disclosure and, if necessary, improvement. Cross-sectional study aimed to analyze the sources of evidence of validity and the number of participants needed to reliably apply the Quality of Communication Questionnaire (QoC) through Generalizability Theory (GT). The mean age of the 150 patients hospitalized at the end of life was 50.5 (SD = 13.8) years, the mean hospital length of stay was 7.5 (SD = 10.2) days, 56.9% were male. Regarding the 105 patients’ family members of patients whose mean length of hospital stay was 9.5 (SD = 9.1) days, their mean age was 42.2 (SD = 14.7) years, 69.5% were female. GT was used to quantify the minimum number of questionnaires needed, with the aim of reaching a reliable estimate of QoC with G-coefficients. To reach a reliability of .90, there is a need for 25 for the Eρ2 questionnaires and 35 for the Φ. The exact estimation identified the minimum number of questionnaires required for the evaluation of physicians by patients. To obtain a reliability of .90, there is a need for 30 and 40 questionnaires for the G-coefficients. A practical and fast application makes it possible to use QoC in its entirety or alone to evaluate general communication or communication about palliative care. Furthermore, based on these results, it was possible to identify which aspects were effective or ineffective in these contexts.
Endovascular Thrombus Removal for Treating Post-Partum Iliofemoral Deep Vein Thrombosis: A Single-Centre Retrospective Cohort Study
Authors: Zheng Xuexun , Xue Ming , Zhou Yadong , Guan Yunbiao 
Published: September 2023

Objective To evaluate the safety and efficacy of percutaneous thrombectomy for treating postpartum iliofemoral vein thrombosis. Methods A retrospective analysis was performed on patients with continuous postpartum acute symptomatic iliofemoral deep vein thrombosis who were treated in our center, including all patients who underwent pharmacomechanical thrombolysis (PMT) or only catheter-directed thrombolysis (CDT) (study group), and patients that received simple anticoagulation treatment (control group). We evaluated the incidence of lower extremity postthrombotic syndrome, recanalization rate of lower extremity veins, and complications in the study and control groups. Results Overall, 72 postpartum women were included in this study, including the PMT combined with CDT group (14 cases, 15 limbs), CDT alone group (26 cases, 27 limbs), and anticoagulant therapy alone group (32 cases, 34 limbs). The thrombectomy group completed the treatment with a technical success rate of 100%, and no serious bleeding complications occurred. The patency rate of lower limb veins in the thrombectomy group was 85.09 ± 16.51% after treatment and 82.60 ± 21.45% after 1 year. At the 1-year follow-up, the Villalta score in the study group was lower (1.90 ± 2.45 vs 8.50 ± 5.33, P < .001), and the incidence of postthrombotic syndrome was significantly different between the groups (17.50% in the study group vs 68.75% in the anticoagulant group, P < .001). Conclusions Lower extremity venous thrombectomy is a safe and effective treatment for postpartum iliofemoral venous thrombosis. It can improve the patency rate of lower extremity veins and reduce the incidence of postthrombotic syndrome compared with anticoagulation alone.
Screening for ADHD in Adult Patients With Epilepsy: Prevalence of Symptoms and Challenges to Diagnosis
Authors: Nguyen Trung , Xiao Emily , Clark Allison , Shamim Afroz , Maheshwari Atul 
Published: September 2023

Objective: Given the complex nature of seizure disorders and their treatments, ADHD may be underdiagnosed in this population. We hypothesized that a higher percentage of patients presenting to a seizure clinic would endorse ADHD symptoms compared to rates reported in the general population and that formal screening for ADHD symptoms would identify patients with previously undiagnosed comorbid ADHD. Methods: In this study, we surveyed 312 adults in a seizure clinic using the Adult ADHD Self-Report Scale (ASRS-v1.1). Results: We found that 90 patients (28.8%) screened positive with the ASRS-v1.1, but only nine of these patients were able to complete neuropsychological testing,. Out of these patients, only one was diagnosed with possible ADHD. Conclusion: Through this process, we identified many challenges to making a new ADHD diagnosis in this population, including attention deficits due to other medical or psychiatric diagnoses, a positive urine drug screen, lack of collateral report/information about developmental history, and barriers to neuropsychological evaluation.
The Exeter-Trident THA with ceramic-on-ceramic-bearings: 10-year outcomes in 275 total hip arthroplasties
Authors: McHale Stephen K , Whitehouse Sarah L , Howell Jonathan R , Hubble Matthew JW , Timperley A John , Wilson Matthew J 
Published: September 2023

Aims: This study reports on the Exeter-Trident total hip arthroplasty (THA) using an alumina ceramic-on-ceramic bearing with 10-year clinical and radiographic follow-up. Patients and methods: Between January 2001 and January 2006, 275 THAs were performed. Mean age at surgery was 52.7 (17–86) years, with 84 patients (33.6%) aged <50 years. The primary outcome was all-cause construct survival at minimum 10 years. Secondary outcomes included functional and noise scores. Radiographs were compared between baseline and latest follow-up and assessed for component loosening, migration and lysis. Results: No patient was lost to follow-up. Mean follow-up for surviving patients was 12.5 (9.5–15.6) years. Kaplan-Meier survival for all-cause revision was 94.0% (95% CI, 90.5–97.5) at 14.3 years. 2 patients had a femoral component fracture. All scores improved significantly at latest follow-up. HSS-NQ for 247 hips (90.2%) at mean 9.1 (7.0–14.4) years post implantation showed most hips (93.1%) reported no more than occasional noise. At minimum 5 years, radiolucency around the acetabular component was observed in 2 hips (0.8%), and lysis at the interface in 1 hip (0.4%). On the femoral side, endosteal lysis was observed in 7 hips. Conclusions: The Exeter-Trident THA with alumina ceramic-on-ceramic bearings performed well in this population. Patients are at low risk of revision in the first decade. However, there is a small risk of stem fracture as a late complication and some patients experience significant noise.
Development and vulnerability across the lifecourse
Authors: Zittoun Tania , Gillespie Alex , Bernal Marcos Marcos José 
Published: September 2023

What is it that develops in adult life? Development through work and family life have been documented and theorised in detail, but much less is known about what is learned beyond these domains, through people’s engagements in hobbies or when out of work (e.g., unemployed, retired). We argue that adult development can be addressed in general terms, beyond domain specificity; drawing on our sociocultural psychology framework, and assuming an open-system perspective, we highlight the two processes of progressive differentiation and psychological distancing in diverse domains of activity. To address development over time, we explore 20 years of people’s lives through the longitudinal analysis of online diaries. A combination of quantitative and qualitative analysis enables us to identify people’s experiences of rupture and transitions, the diversity of their domains of interests, and how these change over time. Based on a case-study, we show that, if the general direction of development does entail progressive differentiation and distanciation, these processes can also be hindered by the cumulation of vulnerabilising events. Finally, we show that some domains, such as the long-standing activity of diary writing, can itself be used as resource for adult development.
“I guess you can interpret it in a number of ways like kind of a milder or the mildest form of dementia?”: Multi-stakeholder perceptions of cognitive impairment
Authors: Yemm H , Peel E , Brooker D 
Published: September 2023

Introduction Mild cognitive impairment (MCI) has a high prevalence and is a risk factor for dementia. Furthering understanding of MCI has been identified as a public health priority. This research aimed to explore views about the causes of cognitive impairment and identify associations between cognitive impairment, dementia, and normative ageing. Method Semi-structured qualitative interviews were conducted with 22 participants with different stakeholder perspectives on the area of MCI in England, and analysed thematically. Results Our analysis focuses on two main themes: 1) causes of cognitive impairment, and 2) ageing, dementia, and dying. Most participants viewed cognitive impairment as a transitional state between normative ageing and dementia. Participants expressed their fear of cognitive impairment and dementia, and made clear links between cognitive impairment and dying. Participants also showed an awareness of the links between lifestyle factors and cognitive health. However, linkage between lifestyle and cognition was discussed only when explicitly asked, suggesting that this was not especially salient for participants when considering the causes and risk factors for cognitive impairment. Conclusion The results of this study highlight key areas for future public health initiatives, such as a focus on the multitude of benefits offered by adopting a healthy diet and physical exercise in reducing risk of cognitive impairment.
Metformin treatment of juvenile mice potentiates innate immune response to bacterial lipopolysaccharide in males
Authors: Sun Yujie , Zhu Yun , Bartke Andrzej , Lin Lin , Yuan Rong 
Published: September 2023

Objective: Metformin is a widely used drug, with a good safety profile, for treatment of type 2 diabetes. Recently, it has been found to also exhibit immunomodulatory potential. We aim to preliminarily explore the potential role of metformin in regulating innate immunity using UM-HET3 mice. Methods: In this study, we treated juvenile UM-HET3 mice with metformin and investigated the alteration of the innate immune response. Peripheral blood of HET3 mice was treated with ex-vivo lipopolysaccharide (LPS) stimulation to induce a leukocyte inflammatory response, which was detected by analyzing the expression of LPS receptors TLR4 and CD14 on leukocytes with flow cytometry. Furthermore, cytokine release induced by LPS was measured in isolated cell culture supernatants with ELISA. Results: In this study LPS treatment triggered a downregulation of TLR4 as well as an upregulation of CD14 expressed on the cell surface. Besides, it enhanced the secretion of pro-inflammatory cytokines TNF-α, IL-1β and IL-6. The results showed that metformin treatment led to a significant ( p < .05) increase in the expression of CD14 and pro-inflammatory cytokines, including IL-1β and IL-6, as well as increased proportion of TLR4 downregulation on the cell surface in response to LPS, specifically in males. Conclusions: This study indicates that treating juvenile mice with metformin enhances the innate immune response to bacterial endotoxin in males, but not in females.
Distal radial fractures: a nationwide register study on corrective osteotomies after malunion
Authors: Raudasoja Leena , Vastamäki Heidi , Aspinen Samuli , Ryhänen Jorma , Hulkkonen Sina 
Published: September 2023

The aim of the present study was to explore the incidence of corrective osteotomies after conservatively treated distal radial fracture and the risk for late correction depending on the patient’s age. Based on data from the Finnish National Care Register of Health Care, Specialist Care, on all corrective osteotomies carried out in Finland during 2015–2019 in adults aged ≥20 years, we calculated the mean annual incidence rates per 100,000 person-years, standardized with the European Standard Population 2013. Using multivariable logistic regression, we calculated the risk of corrective osteotomies in various age groups. In total, 41,418 distal radial fractures were identified. Of those, 10,577 received surgical treatment in the acute phase. The incidence rate of primary operations for distal radial fractures was 47.9 per 100, 000 person-years. A total of 321 conservatively treated fractures needed corrective osteoteomy, with a surprisingly low mean annual incidence rate of 1.5 per 100,000 person-years. The risk for this was highest in patients in their fourth or fifth decade. Level of evidence: III
Environmental crisis or an act of contemporary racism? A flint effect on maternal health disparities
Authors: Henderson Kionna L. , Shortridge Ashton , Sadler Richard C. 
Published: September 2023

Background Racial injustices, both within the social and environmental aspect, are increasingly in national discussions due to impacts from the COVID-19 pandemic and persistent violence perpetrated by police against Black civilians that resulted in tragic deaths. An ongoing environmental injustice that began in 2014 is the Flint Water Crisis (FWC). The purpose of this study is to conduct a quasi-experimental research design to compare Flint to a sociodemographically similar city to determine what effect, if any, the FWC had on maternal health from 2012 to 2017 across three time periods: pre-during-and-post-FWC. Methods The Centers for Disease Control and Prevention (CDC)'s 21 severe maternal morbidity (SMM) rates severed as indicators of maternal health status and were collected from the Michigan Inpatient Database. Differences between non-Hispanic Black and non-Hispanic White race codes determined the maternal health disparity gap. R-statistical software and k-mean analysis were used to analyze cities that were comparable to Flint. Difference-in-difference methodology was used to compare the difference in SMM rates for Flint and a sociodemographically comparable city. Results On average, non-Hispanic Black women had a higher odds of experiencing a SMM across all three time periods: pre-FWC = 1.29, during-FWC = 1.2, and post-FWC = 1.05. Conclusions Maternal health outcomes observed in Flint during the FWC are significantly influenced by race. The study showed that regardless of a woman giving birth in a predominantly Black city, an environmental hazard, and her age range, maternal health disparities are still present if that woman identifies as Black.
A web-based care assistant for caregivers of the elderly: Development and pilot study
Authors: Jeon Hwawoo , Choi Yong Suk , Lim Yoonseob 
Published: September 2023

Background The aging population in Korea has driven a surge in demand for elderly care services, leading to significant growth in elderly welfare facilities, particularly Adult Daycare Centers (ADCs). However, despite advancements in care facilities, caregivers continue to face challenges in providing suitable elderly care due to difficulties arising from gaps in the latest information on the elderly and their coping abilities. Objective The objective of this study is to develop and evaluate the effectiveness of the elderly care assistant system, which facilitates the sharing of information and knowledge necessary for elderly care among caregivers. Methods The ECA system was designed to support knowledge sharing through a knowledge management system based on an ontological knowledge model, with a web-based user interface for improved accessibility. A field trial was conducted at ADC in Seoul from August 17 to September 21, with eight caregivers participating. A mixed-methods approach, involving both surveys and interviews, was employed to gauge the ECA system's effectiveness. Results The study found that the use of the ECA was beneficial in promoting knowledge sharing among caregivers. Additionally, caregivers noted the potential benefits of using the ECA in conjunction with family caregivers, who can offer additional information and perspectives on elderly care. Conclusions This study presents preliminary evidence of the potential benefits of a care knowledge sharing system among various caregivers in elderly care. Although the elderly care assistant effectively promotes knowledge sharing, more research is needed to fully understand its impact on elderly care outcomes.
Safety and Efficacy of Bone Marrow–Derived Mesenchymal Stem Cells for Chronic Patellar Tendinopathy (With Gap >3 mm) in Patients: 12-Month Follow-up Results of a Phase 1/2 Clinical Trial
Authors: Soler Robert , Rodas Gil , Rius-Tarruella Joan , Alomar Xavier , Balius Ramon , Ruíz-Cotorro Ángel , Masci Lorenzo , Maffulli Nicola , Orozco Lluís 
Published: September 2023

Background: In a previous study, the authors found that at 6 months after treatment with a 20 × 106 dose of bone marrow–derived mesenchymal stem cells (BM-MSCs), patients showed improved tendon structure and regeneration of the gap area when compared with treatment using leukocyte-poor platelet-rich plasma (Lp-PRP). The Lp-PRP group (n = 10), which had not seen tendon regeneration at the 6-month follow-up, was subsequently offered treatment with BM-MSCs to see if structural changes would occur. In addition, the 12-month follow-up outcomes of the original BM-MSC group (n = 10) were evaluated. Purpose: To evaluate the outcomes of all patients (n = 20) at 12 months after BM-MSC treatment and observe if the Lp-PRP pretreated group experienced any type of advantage. Study Design: Cohort study; Level of evidence, 2. Methods: Both the BM-MSC and original Lp-PRP groups were assessed at 12 months after BM-MSC treatment with clinical examination, the visual analog scale (VAS) for pain during daily activities and sports activities, the Victorian Institute of Sport Assessment–Patella score for patellar tendinopathy, dynamometry, and magnetic resonance imaging (MRI). Differences between the 2 groups were compared with the Student t test. Results: The 10 patients originally treated with BM-MSCs continued to show improvement in tendon structure in their MRI scans ( P < .0001), as well as in the clinical assessment of their pain by means of scales ( P < .05). Ten patients who were originally treated with Lp-PRP and then with BM-MSCs exhibited an improvement in tendon structure in their MRI scans, as well as a clinical pain improvement, but this was not significant on the VAS for sports ( P = .139). Thus, applying Lp-PRP before BM-MScs did not yield any type of advantage. Conclusion: The 12-month follow-up outcomes after both groups of patients (n = 20) received BM-MSC treatment indicated that biological treatment was safe, there were no adverse effects, and the participants showed a highly statistically significant clinical improvement ( P < .0002), as well as an improvement in tendon structure on MRI ( P < .0001). Preinjection of Lp-PRP yielded no advantages.
Jordanian Community People's Knowledge of and Attitudes Toward Dementia
Authors: Abdalrahim Asem , Alamoush Khaled Mohammad , ALBashtawy Mohammed , Hamaideh Shaher H. , Mohammad Khitam Ibrahem , Alkhawaldeh Abdullah , Alazzam Manar , Alhroub Nisser , Suliman Mohammad , ALBashtawy Bayan 
Published: September 2023

Introduction Limited research exists on the knowledge and attitudes of Jordanian community residents toward people with dementia (PwD). As the prevalence of dementia is anticipated to increase, there is a critical need for informed knowledge and positive attitudes toward dementia in the Jordanian community. Objectives This study aimed to evaluate people's knowledge of and attitudes toward PwD and identify the predictors of dementia knowledge and attitudes. Methods The study employed a cross-sectional research design and utilized a self-administered questionnaire as the primary data collection method. The study employed the Alzheimer's Disease Knowledge Scale (ADKS) to evaluate the knowledge of the participants, and the Dementia Attitudes Scale (DAS) was utilized to assess their attitudes in the Jordanian community. Multiple regression analysis was performed to find relevant factors influencing knowledge of and attitude toward dementia. Results The study's 346 participants revealed limited knowledge about dementia, with an average ADKS score of 17.21 out of 30. However, participants showed a positive attitude toward dementia, as evidenced by a mean DAS score of 88 out of 140. Statistical analysis demonstrated significantly higher knowledge scores among employed individuals ( P < .05), while females exhibited significantly higher attitude scores ( P < .05). Participants with experience in geriatric clinical practice, dementia education or training, informal caregiving experience, and a desire to learn more about dementia also exhibited significantly higher knowledge and attitude scores ( P < .05). Conclusion The study offers preliminary insights into the knowledge and attitudes toward dementia in the Jordanian population. The findings underscore the importance of continuing education and training to increase knowledge and understanding of dementia. Improving dementia care and support in Jordan requires enhancing knowledge and attitudes toward dementia. The study findings were presented to policymakers, with recommendations for strategic planning and the development of awareness programs. Future research can build upon these findings and promote evidence-based practices in dementia care and community awareness programs.