bluuebunny/crossref_metadata_2025_split huggingface dataset:
Self-Reported Measures Have a Stronger Association With Dizziness-Related Handicap Compared With Physical Tests in Persons With Persistent Dizziness
Authors: Kristiansen Lene , Magnussen Liv H. , Wilhelmsen Kjersti T. , Maeland Silje , Nordahl Stein Helge G. , Hovland Anders , Clendaniel Richard , Boyle Eleanor , Juul-Kristensen Birgit 
Published: July 2022

BackgroundAssociations between dizziness-related handicap and a variety of self-reported measures have been reported. However, research regarding associations between dizziness-related handicap and aspects of functioning that includes both physical tests and self-reported measures is scarce.ObjectiveThe purpose of the study was to describe the variations in signs and symptoms in people with persistent dizziness using physical tests and self-reported outcomes across three severity levels of the Dizziness Handicap Inventory (DHI) and investigate their associations with the DHI.MethodParticipants with persistent dizziness (n = 107) were included in this cross-sectional study. The participants underwent (1) physical tests (gait tests, grip strength, body flexibility, and movement-induced dizziness) and completed questionnaires regarding (2) psychological measures (Mobility Inventory of Agoraphobia, Body Sensation Questionnaire, Agoraphobic Cognitions Questionnaire, and Hospital Depression and Anxiety Questionnaire), and (3) fatigue, dizziness severity, and quality of life (Chalders Fatigue Scale, Vertigo Symptom Scale-Short Form, and EQ visual analog scale), in addition to the DHI. Data were presented by descriptive statistics for three DHI severity levels (mild, moderate, and severe). A multiple linear backward regression analysis was conducted for each group of measures in relation to the DHI total score, with additional analyses adjusting for age and sex. Based on these results, significant associations were tested in a final regression model.ResultsWith increasing severity levels of DHI, the participants demonstrated worse performance on most of the physical tests (preferred and fast gait velocity, dizziness intensity after head movements), presented with worse scores on the self-reported measures (avoidance behavior, fear of bodily sensation, fear of fear itself, psychological distress, fatigue, dizziness severity, quality of life). After adjusting for age and sex, significant associations were found between total DHI and avoidance behavior, psychological distress, dizziness severity, and quality of life, but not with any of the physical tests, explaining almost 56% of the variance of the DHI total score.ConclusionThere was a trend toward worse scores on physical tests and self-reported measurements with increasing DHI severity level. The DHI seems to be a valuable tool in relation to several self-reported outcomes; however, several signs and symptoms may not be detected by the DHI, and thus, a combination of outcomes should be utilized when examining patients with persistent dizziness.
Non-Linear Association Between Serum Alkaline Phosphatase and 3-Month Outcomes in Patients With Acute Stroke: Results From the Xi'an Stroke Registry Study of China
Authors: Guo Weiyan , Liu Zhongzhong , Lu Qingli , Liu Pei , Lin Xuemei , Wang Jing , Wang Yuanji , Chang Qiaoqiao , Wang Fang , Wu Songdi 
Published: July 2022

BackgroundAlkaline phosphatase (ALP) is associated with an increased risk of cardiovascular events and is closely related to adverse outcomes after stroke. However, the regional investigation into the associations of ALP with acute stroke (AS) outcomes is limited. This study aimed to identify the association between serum ALP levels and clinical outcomes 3 months after AS in the Xi'an district of China.MethodsWe enrolled all patients with AS from 4 hospitals in the Xi'an district from January to December 2015. ALP levels and related patient information were collected at admission, and the events of stroke outcomes were followed up 1 and 3 months after diagnosis. ALP levels were analyzed as continuous variables and quartiles (Q1–Q4). The outcomes included all-cause mortality, recurrent stroke, and poor functional outcomes (modified Rankin Scale score of 3–6) within 3 months. A multivariate logistic regression and interaction analyses were performed to evaluate the independent association between serum ALP level and 3-month stroke outcomes.ResultsOverall, 2,799 patients with AS were enrolled in this study. The mean age was 63.9 ± 12.5 years. In the Q4 (≥93.0 U/L) group, the incidences of all-cause mortality, recurrent stroke, and poor functional outcomes were 7.8, 2.7, and 24.9%, respectively. After being adjusted for confounding variables, patients in Q4 (≥93.0 U/L) were related to an increased risk of all-cause mortality [odds ratio (OR) = 2.17, 95% CI: 1.19–3.96; P = 0.011] and patients in Q3 (76.8–92.9 U/L) were related to a lower risk of recurrent stroke (OR = 0.37, 95% CI: 0.14–0.97; P = 0.043) at the 3-month time point, compared to those in Q2 (63.0–76.7 U/L). The optimal range of ALP for all-cause mortality was seen in Q2, with a nadir level of 70 U/L. However, differences were statistically insignificant between ALP levels and poor functional outcomes (P &gt; 0.05). Moreover, there was no significant interaction between ALP levels and age, gender, drinking status, smoking status, or pneumonia (P &gt; 0.05) for all outcomes.ConclusionNon-linear associations were observed between serum ALP levels and 3-month outcomes in patients with AS. It might be beneficial to reduce the risk of all-cause mortality and recurrent stroke by maintaining ALP at optimal ranges.
Adjunctive Treatment With Eslicarbazepine Acetate for Adults and Children With Focal-Onset Epilepsy: A Meta-Analysis
Authors: Fei Yanqing , Shi Ruting , Song Zhi 
Published: July 2022

BackgroundThe efficacy and tolerability of eslicarbazepine acetate (ESL) in adults and children with focal-onset epilepsy (FOE) according to the dose remain to be validated. A meta-analysis based on randomized controlled trials (RCTs) was therefore conducted as a summary.MethodsRelevant RCTs were collected by systematic searching the electronic databases of PubMed, Cochrane's Library, Embase, Wanfang and CNKI from inception to May 16, 2022. The random-effect model was adopted to pool the results by incorporating the possible heterogeneity. Efficacy outcomes including responsive rate and effective rate, defined as cases with 50 and ≥75% reduction in seizure frequency compared to baseline, were determined, respectively. Incidence of severe adverse events (AE) leading to drug discontinuation was also evaluated.ResultsTen studies including 2,565 people with epilepsy contributed to the meta-analysis. For adults, ESL 400 mg/d did not improve the response rate or the effective rate; ESL 800 mg/d was associated with improved response rate (odds ratio [OR] 2.16, 95% confidence interval [CI]: 1.65–2.83, p &lt; 0.001) and effective rate (OR 2.16, 95% CI: 1.41–3.30, p &lt; 0.001) without significantly increased severe AE (OR 1.58, 95% CI: 0.90–2.78, p = 0.11); ESL 1,200 mg/d improved response rate (OR 2.49, p &lt; 0.001) and effective rate (OR 3.09, p = 0.04), but significantly increased severe AE (OR 3.72, p &lt; 0.001). For children, ESL also did not significantly improve the response rate (OR 1.76, p = 0.22) or the effective rate (OR 2.17, p = 0.13).ConclusionESL 800 mg/d is effective and well-tolerated as adjuvants for adults with FOE. Efficacy of ESL in children with FOE should be further evaluated.
Cisplatin-Induced Anorexia and Pica Behavior in Rats Enhanced by Chronic Stress Pretreatment
Authors: Guo Zhijun , Duan Jingjing , Chen Yitian , Cai Weijia , Yang Chenghua , Yang Zhen , Liu Xiufeng , Xu Feng 
Published: July 2022

Background: Chemotherapy-induced nausea and vomiting severely impairs the treatment and prognosis of cancer patients. Depressive mood disorder might aggravate nausea and vomiting in cancer patients; however, the role of neurotransmitters and receptors involved in the mediation of emesis and nausea is still not well elaborated.Methods: The study was carried out based on the chronic unpredictable mild stress–induced depression-like phenotype rat model and cisplatin-induced pica rat model establishment. Forty male Sprague–Dawley rats were randomized into the non-treated control group and the chronic stress group, which were exposed to 8 weeks of stress. Each group was then sub-divided into vehicle subgroups (n = 10) and cisplatin subgroups (n = 10) which were given cisplatin to induce pica behavior. Kaolin and food intake were recorded after administration. The medulla oblongata and ileum tissues were obtained. Neurotransmitters involved in the mediation of emesis and nausea (5-HT, DA, SP, and AEA) were detected using an ELISA kit. Vomit-related receptors (5-HT3R, DA2R, NK1R, and CB1R) in tissues were assayed for mRNA and protein expression by RT-qPCR and Western blotting.Results: Behavioral test and sucrose preference validated that depression-like phenotype rat models were established successfully. The kaolin consumption test confirmed that chronic stress pretreatment aggravated anorexia and pica behavior. Vomiting-related molecules’ data showed that chronic stress exposure increased 5-HT and SP levels in the medulla oblongata. Vomiting-related receptor expression data showed that chronic stress pretreatment upregulated 5-HT3R, DA2R, and NK1R expressions and downregulated the CB1R expression in the medulla oblongata. However, chronic stress pretreatment downregulated 5-HT3R, DA2R, and NK1R expressions and upregulated the CB1R expression in the ileum.Conclusion: Chronic stress pretreatment aggravates anorexia and vomiting progress, which might be via altering neurotransmitters and receptors involved in the mediation of emesis and the nausea level and expression in the central nervous system.
Elevated plasma syndecan-1 as glycocalyx injury marker predicts unfavorable outcomes after rt-PA intravenous thrombolysis in acute ischemic stroke
Authors: Zhao Fangfang , Wang Rongliang , Huang Yuyou , Li Lingzhi , Zhong Liyuan , Hu Yue , Han Ziping , Fan Junfen , Liu Ping , Zheng Yangmin , Luo Yumin 
Published: July 2022

Purpose: We aimed to examine the prognostic value of syndecan-1 as a marker of glycocalyx injury in patients with acute ischemic stroke (AIS) receiving rt-PA intravenous thrombolysis.Methods: The study included 108 patients with AIS treated with rt-PA intravenous thrombolysis and 47 healthy controls. Patients were divided into unfavorable and favorable prognosis groups based on modified Rankin Scale scores. Univariate and multivariate logistic regression analyses were used to determine risk factors affecting prognosis. Risk prediction models presented as nomograms. The predictive accuracy and clinical value of the new model were also evaluated.Results: Plasma levels of syndecan-1 were significantly higher in patients with AIS than in controls (p &lt; 0.05). Univariate analysis indicated that higher levels of syndecan-1 were more frequent in patients with poor prognosis than in those with good prognosis (t = −4.273, p &lt; 0.001). Syndecan-1 alone and in combination with other factors predicted patient outcomes. After adjusting for confounding factors, syndecan-1 levels remained associated with poor prognosis [odds ratio, 1.024; 95% confidence interval (CI), 1.010–1.038]. The risk model exhibited a good fit, with an area under the receiver operating characteristic curve of 0.935 (95% CI, 0.888–0.981). The categorical net reclassification index (NRI) and continuous NRI values were &gt;0. The integrated discrimination improvement value was 0.111 (95% CI, 0.049–0.174, p &lt; 0.001). Decision curve analysis indicated that the model incorporating syndecan-1 levels was more clinically valuable than the conventional model.Conclusion: Plasma syndecan-1 levels represent a potential marker of prognosis of AIS following intravenous thrombolysis. Adding syndecan-1 to the conventional model may improve risk stratification.
Muscle Deoxygenation Rates and Reoxygenation Modeling During a Sprint Interval Training Exercise Performed Under Different Hypoxic Conditions
Authors: Solsona Robert , Deriaz Roméo , Borrani Fabio , Sanchez Anthony M. J. 
Published: July 2022

This study compared the kinetics of muscle deoxygenation and reoxygenation during a sprint interval protocol performed under four modalities: blood flow restriction at 60% of the resting femoral artery occlusive pressure (BFR), gravity-induced BFR (G-BFR), simulated hypoxia (FiO2≈13%, HYP) and normoxia (NOR). Thirteen healthy men performed each session composed of five all-out 30-s efforts interspaced with 4 min of passive recovery. Total work during the exercises was 17 ± 3.4, 15.8 ± 2.9, 16.7 ± 3.4, and 18.0 ± 3.0 kJ for BFR, G-BFR, HYP and NOR, respectively. Muscle oxygenation was continuously measured with near-infrared spectroscopy. Tissue saturation index (TSI) was modelled with a linear function at the beginning of the sprint and reoxygenation during recovery with an exponential function. Results showed that both models were adjusted to the TSI (R2 = 0.98 and 0.95, respectively). Greater deoxygenation rates were observed in NOR compared to BFR (p = 0.028). No difference was found between the conditions for the deoxygenation rates relative to sprint total work (p &gt; 0.05). Concerning reoxygenation, the amplitude of the exponential was not different among conditions (p &gt; 0.05). The time delay of reoxygenation was longer in BFR compared to the other conditions (p &lt; 0.05). A longer time constant was found for G-BFR compared to the other conditions (p &lt; 0.05), and mean response time was longer for BFR and G-BFR. Finally, sprint performance was correlated with faster reoxygenation. Hence, deoxygenation rates were not different between the conditions when expressed relatively to total sprint work. Furthermore, BFR conditions impair reoxygenation: BFR delays and G-BFR slows down reoxygenation.
Uptake of and Motivational Responses to Mental Health-Promoting Practices: Comparing Relaxation and Mindfulness Interventions
Authors: Beattie Marguerite M. , Hankonen Nelli E. , Konttinen Hanna M. , Volanen Salla-Maarit 
Published: July 2022

BackgroundComparative analyses of alternative interventions within the same trial enable acceptability and fidelity of each to be investigated more critically. In addition, whereas so far studies have focused on efficacy evaluations, more understanding is needed on motivational factors influencing the uptake of mental health-promoting practices rather than solely their effects.PurposeThis study investigates whether the motivational responses to a mindfulness intervention are different from a relaxation intervention. We compare social cognitions outlined by the reasoned action approach and their roles in practice uptake, self-reported reasons for non-practice, and experienced benefits.MethodsIn a cluster-randomized trial (ISRCTN18642659; N = 3134), 12–15-year-old participants were given a 9-week intervention and followed up to 52 weeks. Main statistical analyses included t-tests, mixed ANOVAs, path models, and chi-square tests.ResultsSocial cognitions in the mindfulness arm were slightly more positive immediately post-intervention, but recipients mostly responded similarly to the two interventions in the longer term. While attitudes, norms, intention, and self-efficacy were relatively high post-intervention, most of them slightly decreased by 26 weeks. Main reasons for non-practice in both arms included not finding the exercises helpful, no felt need, boringness of exercises and forgetting. The most common benefits experienced by practicing respondents were stress management and concentration ability. Better sleep was a more frequently reported benefit in the relaxation arm, but no other major differences emerged.ConclusionThis study offers an example of comparing motivational responses to experimental and active control arm interventions, a potentially helpful approach in improving intervention adherence.
Therapeutic Suggestions During General Anesthesia Reduce Postoperative Nausea and Vomiting in High-Risk Patients – A Post hoc Analysis of a Randomized Controlled Trial
Authors: Nowak Hartmuth , Wolf Alexander , Rahmel Tim , Oprea Guenther , Grause Lisa , Moeller Manuela , Gyarmati Katharina , Mittler Corinna , Zagler Alexandra , Lutz Katrin , Loeser Johannes , Saller Thomas , Tryba Michael , Adamzik Michael , Hansen Ernil , Zech Nina 
Published: July 2022

Postoperative nausea and vomiting (PONV) are one of the most adverse events after general anesthesia, a distressing experience, and pose a risk to the patient. Despite advances in drug prophylaxis and PONV treatment, the incidence remains high and additional non-pharmacological treatments are needed. In this post hoc analysis of a recently published double-blind multicenter randomized controlled trial on the efficacy of intraoperative therapeutic suggestions on postoperative opioid dosage, we analyzed the effects of intraoperative therapeutic suggestions on PONV. We focus on patients with a high risk of PONV (Apfel risk score of 3–4) and distinguished early (first two postoperative hours) and delayed PONV (2–24 h). A total of 385 patients with a moderate or high risk for PONV were included. The incidence of early and delayed PONV was reduced (22.7–18.3 and 29.9–24.1%, respectively), without statistical significance, whereas in high-risk patients (n = 180) their incidence was nearly halved, 17.2 vs. 31.2% (p = 0.030) and 20.7 vs. 34.4% (p = 0.040), corresponding to a number needed to treat of 7 to avoid PONV. In addition, there was a significant reduction in PONV severity. In a multivariate logistic regression model, assignment to the control group (OR 2.2; 95% CI: 1.1–4.8) was identified as an independent predictor of the occurrence of early PONV. Our results indicate that intraoperative therapeutic suggestions can significantly reduce the incidence of PONV in high-risk patients. This encourages the expansion of therapeutic suggestions under general anesthesia, which are inexpensive and virtually free of side effects.Clinical Trial Registration: German Clinical Trials Register, https://drks.de, registration number: DRKS00013800.
Characteristics in Initial Sandplay of Optimal and Non-optimal Family Functioning Among High School Students
Authors: Qiu-qiang Zheng , Guang-zhi Zhuo , Qi-zhe Zhang 
Published: July 2022

ObjectiveThe purpose of this study is to explore the characteristics of the initial sandplay of high school students with poor family function, by studying the initial sandplay of high school students with different levels of family function, so as to provide the basics for the psychological assessment and intervention of high school students.SignificanceTo provide data support for high school students' mental health education and sandplay therapy, and to apply sandplay as an intervention method to play a healing role in high school mental health work.MethodsHigh school students (N = 345) were divided into 11 groups and participated in a sandplay experiment for 8 weeks from February to March 2021. Each group completed the Chinese version of the Epstein et al. Family Assessment Device. Samples with scores of one standard deviation below and above the sample mean were placed in the low family functioning group (n = 30; 15 girls) or high family functioning group (n = 30; 15 girls), respectively. The initial sandplay was evaluated on multiple dimensions using an established coding system.ResultsSamples with low family functioning used fewer animal figurines in their sandplay (t = 2.176, p &lt; 0.05); had more family scenes (χ2 = 4.356, p &lt; 0.05); fewer rural scenes (χ2 = 4.344, p &lt; 0.05); and fewer healing themes (t = −2.336, p &lt; 0.05). In particular, there were fewer examples of connected healing themes (χ2 = 7.500, p &lt; 0.05); in-depth healing themes (χ2 = 5.455, p &lt; 0.05); and more hindered trauma themes (χ2 = 4.812, p &lt; 0.05). Logistic regression analysis was conducted using the sandplay characteristics as predictors of group membership. Using forward stepwise selection, themes of hindered trauma (B = −2.030) and connected healing (B=1.765) were shown to be significant predictors of group membership (F = 17.784, P &lt; 0.01, ΔR2 = 0.214).ConclusionStudents who reported high and low family functioning showed significant differences in their sandplay characteristics. We propose sandplay characteristics can help identify low family functioning of adolescents during psychological evaluations.
Cognitive Behavioral Therapy and Acceptance and Commitment Therapy (CBT-ACT) vs. Standard Care After Critical Illness Due to COVID-19: Protocol for a Pilot Randomized Controlled Trial
Authors: Håkansson Anders , Cronhjort Maria , Lidin-Darlington Pernilla , Lilja Gisela , Nilsson Anna , Schandl Anna , Friberg Hans 
Published: July 2022

BackgroundPost-covid syndrome is an emerging condition involving a wide range of symptoms, including high rates of poor mental health. The diagnostic relevance and clinical severity of these symptoms are largely unknown, and evidence for treatment of post-covid mental health symptoms is lacking. This protocol describes a pilot randomized clinical trial, primarily aiming to assess feasibility, participant adherence and satisfaction in a novel phycho-therapeutic intervention on post-covid anxiety and depression symptoms ≥1 year after critically ill COVID-19. Whether the intervention may generate improvements in post-covid depression, anxiety, post-traumatic stress and health-related quality of life (HRQoL) will be addressed in a following larger trial.MethodsA multicenter, investigator-initiated randomized controlled trial (Clinical Trial Identifier number NCT05119608) including Intensive Care Unit (ICU)-treated COVID-19 survivors, who display symptoms of anxiety and/or depression at follow-up 12 months after hospitalization (Hospital Anxiety and Depression Scale ≥8 for depression or anxiety). Eligible individuals are referred to a psychiatrist for structured diagnostic assessment and inclusion in the trial. Participants will be randomized to either a 10-week cognitive behavioral therapy intervention with added acceptance and commitment therapy (CBT-ACT) or standard care (primary care referral). Primary study outcome measure is feasibility and patient adherence, defined as the proportion of participants who consent to randomization and remain in the study including follow-up. Secondary outcome measures include reduced symptoms in the HADS depression/anxiety subscales, post-traumatic symptoms, HRQoL and user satisfaction at 3 months after the intervention.DiscussionThis protocol describes a pilot trial to assess feasibility and preliminary effects of a structured psycho-therapeutic intervention to ameliorate mental health in a population severely affected by COVID-19, where evidence for structured psycho-therapy is lacking.