bluuebunny/crossref_metadata_2025_split huggingface dataset:
Recruitment Strategies to Engage Newcomer Mothers of African Descent in Maternal Mental Health Research in Canada
Authors: Baiden Deborah , Evans Marilyn 
Published: April 2022

Introduction: Newcomer mothers of African descent are at risk for maternal mental stress because of inadequate social support, newcomer status, and stress of motherhood. Limited participation of newcomer African mothers in mental health research contributes to a knowledge gap in this area further impacting culturally competent health services. This article reports recruitment strategies to better engage African newcomer women in maternal mental health research. Methods: In-depth discussion of recruitment strategies, used in a qualitative descriptive study conducted with Black African newcomer mothers in Canada. Results: Ten African newcomer mothers were successfully recruited using recruitment strategies such as engagement with religious organizations, snowballing, and the use of social media. Discussion: Cultural beliefs on motherhood, resilience, and mental illness may account for hesitancy to engage in maternal mental health research. Recruitment strategies could help overcome the challenges and potentially diversify maternal mental health research in Canada through the engagement of African newcomer mothers.
Risk and Prognostic Factors for Small Bowel Adenocarcinoma: A Multicenter Retrospective Observational Study in China
Authors: Wei Xin , Chen Ke , Li Dong-chang , Li He , Zhu Liang , Wang Zheng-guang 
Published: April 2022

Background: Small bowel adenocarcinoma (SBA) is a rare malignancy that accounts for 3% of all gastrointestinal tumors. We evaluated the clinical characteristics, outcomes, and prognostic factors of primary SBAs. Methods: We retrospectively analyzed the clinicopathological features and clinical outcomes of 300 patients with SBA from three institutions in China between January 2003 and July 2020. Overall survival (OS) was analyzed using the Kaplan–Meier method and it was statistically compared using the log-rank test. Single-variable and multivariate analyses were used to identify the significant correlates of OS. Results: The primary tumor was on the duodenal papilla in 156 patients (52%), in the duodenum in 60 patients (20%), and in the jejunum–ileum in 84 patients (28%). The median OS of the entire cohort was 32.5 months (range, 0-213 months), with a 1-year OS rate of 78.0%. For jejunoileal adenocarcinoma, advanced age, advanced T stage, advanced N stage, more positive lymph nodes, distant metastasis, high carcinoembryonic antigen (CEA), and lymphocyte-to-monocyte ratio < 2.32 predicted worse survival on single-variable analysis. Multivariate analysis showed that advanced age, advanced tumor node metastases (TNM) stage, high CEA level, high alpha fetoprotein (AFP) level, and low prealbumin level were independent prognostic factors for non-ampullary SBA. The independent prognostic factors for duodenal papilla adenocarcinoma included TNM Stage III, nerve invasion, low platelet/lymphocyte ratio, and high CA19-9. Conclusion: We found different independent prognostic factors for tumors at different locations. This finding warrants further investigation to ensure more effective management strategies for SBA.
Improvement in walking impairment following surgical and endovascular revascularization: Insights from VOYAGER PAD
Authors: Hogan Shea E , Nehler Mark R , Anand Sonia , Patel Manesh R , Debus Sebastian , Jackson Matthew T , Buchanan Cullen , King R Wilson , Hess Connie , Muehlhofer Eva , Haskell Lloyd P , Bauersachs Rupert M , Berkowitz Scott D , Hsia Judith , Bonaca Marc P 
Published: April 2022

Background: Peripheral artery disease (PAD) affects 200 million people worldwide and is associated with impaired quality of life, increased morbidity, and mortality. Supervised exercise therapy (SET) and lower-extremity revascularization (LER) are both proven strategies to improve patient symptoms. Short and long-term functional outcomes after LER for symptomatic PAD in a large, international cohort have not previously been described. Methods: The VOYAGER PAD trial (ClinicalTrials.gov identifier: NCT02504216) enrolled subjects after LER for symptomatic PAD (Rutherford category 2–6). Participants completed the Walking Impairment Questionnaire (WIQ) at baseline, 1, 3 and 6 months, and every 6 months thereafter. The primary outcome analysis was degree of difficulty walking two blocks at each of the aforementioned time points. Difficulty walking three blocks and climbing one flight of stairs at these time points was also analyzed. Data about supervised and home exercise therapy before or after revascularization were not collected in the VOYAGER PAD trial. Results: Of the 5614 VOYAGER PAD participants completing the WIQ at baseline, three-quarters presented with claudication and one-quarter with critical limb ischemia. Of these, the majority (62% with claudication and 74% with CLI) reported inability or much difficulty walking two blocks prior to LER. Walking improved after LER regardless of revascularization strategy, but one-fifth with claudication and one-third with CLI reported continued inability or much difficulty walking two blocks 1 month after LER. Participants who reported improved walking ability 1 month after LER experienced a durable functional result out to 3 years. Although the proportion of participants reporting significant baseline difficulty climbing one flight of stairs or walking three blocks differed, the trend in immediate and sustained improvement after LER was similar to that observed for walking two blocks. Conclusion: In this large, international cohort undergoing LER for symptomatic PAD, nearly two-thirds reported inability or much difficulty walking two blocks at baseline. Although many participants reported improved walking ability after LER, a substantial proportion remained severely disabled. These observations may help motivate providers, patients, and medical systems to improve awareness and engagement in SET referral after LER.
Incidence of Procedure-Related Complications in Patients Treated With Atherectomy in the Femoropopliteal and Tibial Vessels in the Vascular Quality Initiative
Authors: Sanon Omar , Carnevale Matthew , Indes Jeffrey , Gao Qi , Lipsitz Evan , Koleilat Issam 
Published: April 2022

Purpose: To compare procedural complications in patients undergoing atherectomy plus angioplasty (A+A) and plain balloon angioplasty (POBA). Materials and Methods: Patients in the Vascular Quality Initiative (VQI) registry undergoing first-time peripheral vascular intervention (PVI) were included. Those undergoing aortoiliac or pedal interventions, primary stenting, or hybrid procedures were excluded. Patients were stratified by lesion location (femoropopliteal [FP] or tibial [TIB]). The primary outcomes were target vessel dissection, distal embolization, and provisional stent placement. Secondary outcomes included postoperative complications and the need for subsequent interventions. Results: 12 499 patients undergoing FP (49.6% A+A) and 6736 patients undergoing TIB (17.0% A+A) interventions were identified. In the FP group, A+A was associated with greater intraoperative target vessel dissection (4.5% vs 2.6%, p<0.001), distal embolization (1.5% vs 0.7%, p =0.001), and provisional stent placement (1.5% vs 0%, p<0.001); and greater postoperative target vessel dissection (4.2% vs 2.0%, p<0.001) and distal embolization (0.9% vs 0.4%, p=0.034). In the TIB group, A+A was associated with fewer intraoperative vessel dissection (0.8% vs 2.3%, p=0.011) but greater provisional stent placement (0.3% vs 0%, p<0.001). TIB A+A was also associated with higher rates of technical success (97.6% vs 95.1%, p<0.001). Conclusions: Atherectomy was associated with increased procedural-related complications in femoropopliteal, but not in tibial vessels. Future studies addressing lesion morphology, device design, and technique may help define its role in peripheral vascular interventions.
Occupational Therapy Interventions for Poststroke Fatigue: A Scoping Review
Authors: Smetheram Tatyana , Amiama Maria Emilia , Hébert Debbie , Law Geoff , Dawson Deirdre R. 
Published: April 2022

Introduction: Fatigue after stroke can negatively affect the survivors’ well-being. Despite the high prevalence and consequences of poststroke fatigue (PSF), there is no specific guidance for occupational therapy practitioners (OTPs) to address this symptom. Objectives: The objectives of the study were to identify and describe the research on potential occupational therapy (OT) interventions for PSF. Method: Three databases were searched using scoping review methodology. Two authors completed a title and abstract and full-text review. Study characteristics, participant characteristics, qualities of interventions, and outcome measures were extracted and synthesized. Results: Eight studies met selection criteria. Studies were conducted with stroke and traumatic brain injury patients in outpatient, inpatient, and community settings. Interventions included psychoeducation and behavior change, multicomponent programs, and mindfulness-based stress reduction therapies. The Fatigue Severity Scale and the Mental Fatigue Scale were commonly used. Conclusion: Evidence for OT interventions targeting PSF is limited. Recommendations for future research are provided.
Obesity negatively affects outcomes following arthroscopic rotator cuff repair at four-year follow-up
Authors: Parnes Nata , Scanaliato John P , Dunn John C , Fink Walter A , Sandler Alexis , Fares Austin B 
Published: April 2022

Introduction The purpose is to evaluate the influence of obesity (BMI 30 to 39.9 kg/m 2 ) on surgical outcomes following arthroscopic rotator cuff repair surgery. Materials and Methods A retrospective review was performed examining the outcomes of arthroscopic rotator cuff repair in both a normal weight (BMI 18.5 to 24.9 kg/m2) and an obese (BMI 30 to 39.9 kg/m2) patient population, specifically looking at functional outcomes and range of motion. Secondary variables analyzed were surgical time, complications, and medical comorbidities. Results 52 normal weight patients (mean BMI 23.7 ± 2.1) and 59 obese patients (mean BMI 34.0 ± 2.4) were included. Both groups demonstrated statistically significant improvements in VAS, SANE and ASES scores (P < 0.0001), however there were significantly better outcomes in the normal weight group in VAS (0.56 ± 0.96 vs 1.42 ± 2.22; P = 0.0108), ASES (96.1 ± 5.8 vs 90.6 ± 15.6; P = 0.0192), and internal rotation (9.2 ± 3.0 vs 10.9 ± 2.3; P = 0.0010). Additionally, the obese cohort had more complications, longer surgical times, and a greater comorbid background. Conclusions Obesity is associated with significantly more comorbid conditions, surgical complications, longer surgical time, and worse patient reported outcomes than normal weight patients undergoing arthroscopic rotator cuff repair.
Long-Term Prediction of Blood Glucose Levels in Type 1 Diabetes Using a CNN-LSTM-Based Deep Neural Network
Authors: Jaloli Mehrad , Cescon Marzia 
Published: April 2022

Background: In this work, we leverage state-of-the-art deep learning–based algorithms for blood glucose (BG) forecasting in people with type 1 diabetes. Methods: We propose stacks of convolutional neural network and long short-term memory units to predict BG level for 30-, 60-, and 90-minute prediction horizon (PH), given historical glucose measurements, meal information, and insulin intakes. The evaluation was performed on two data sets, Replace-BG and DIAdvisor, representative of free-living conditions and in-hospital setting, respectively. Results: For 90-minute PH, our model obtained mean absolute error of 17.30 ± 2.07 and 18.23 ± 2.97 mg/dL, root mean square error of 23.45 ± 3.18 and 25.12 ± 4.65 mg/dL, coefficient of determination of 84.13 ± 4.22% and 82.34 ± 4.54%, and in terms of the continuous glucose-error grid analysis 94.71 ± 3.89% and 91.71 ± 4.32% accurate predictions, 1.81 ± 1.06% and 2.51 ± 0.86% benign errors, and 3.47 ± 1.12% and 5.78 ± 1.72% erroneous predictions, for Replace-BG and DIAdvisor data sets, respectively. Conclusion: Our investigation demonstrated that our method achieved superior glucose forecasting compared with existing approaches in the literature, and thanks to its generalizability showed potential for real-life applications.
Smartphone movement sensors for the remote monitoring of respiratory rates: Technical validation
Authors: Valentine Sophie , Cunningham Adam C. , Klasmer Benjamin , Dabbah Mohammad , Balabanovic Marko , Aral Mert , Vahdat Dan , Plans David 
Published: April 2022

Background Mobile health (mHealth) offers potential benefits to both patients and healthcare systems. Existing remote technologies to measure respiratory rates have limitations such as cost, accessibility and reliability. Using smartphone sensors to measure respiratory rates may offer a potential solution to these issues. Objective The aim of this study was to conduct a comprehensive assessment of a novel mHealth smartphone application designed to measure respiratory rates using movement sensors. Methods In Study 1, 15 participants simultaneously measured their respiratory rates with the app and a Food and Drug Administration-cleared reference device. A novel reference analysis method to allow the app to be evaluated ‘in the wild’ was also developed. In Study 2, 165 participants measured their respiratory rates using the app, and these measures were compared to the novel reference. The usability of the app was also assessed in both studies. Results The app, when compared to the Food and Drug Administration-cleared and novel references, respectively, showed a mean absolute error of 1.65 ( SD  =  1.49) and 1.14 (1.44), relative mean absolute error of 12.2 (9.23) and 9.5 (18.70) and bias of 0.81 (limits of agreement = –3.27 to 4.89) and 0.08 (–3.68 to 3.51). Pearson correlation coefficients were 0.700 and 0.885. Ninety-three percent of participants successfully operated the app on their first use. Conclusions The accuracy and usability of the app demonstrated here in individuals with a normal respiratory rate range show promise for the use of mHealth solutions employing smartphone sensors to remotely monitor respiratory rates. Further research should validate the benefits that this technology may offer patients and healthcare systems.
Can digital engagement improve outcomes for total joint replacements?
Authors: Milliren Carly E , Lindsay Bill , Biernat Lisa , Smith Todd A , Weaver Betsy 
Published: April 2022

BackgroundPatient activation and engagement can improve outcomes of medical and surgical care by increasing involvement of patients in their care plan. We designed a digital engagement tool to improve surgical cancellation and post-surgical outcomes for adult patients undergoing total joint replacements by providing patient education materials via email or text, in small increments throughout the perioperative period.MethodsWe assessed the tool's impact using a quasi-experimental design comparing patients scheduled for surgery January–June 2017 (pre-intervention) versus January–June 2018 (post-intervention). Post-intervention patients with digital contact information in the medical record were automatically enrolled. We extracted de-identified administrative data for all patients during both time periods and utilized an intent-to-treat approach including all post-intervention patients regardless of enrollment. Surgical cancellation and post-surgical outcomes (length of stay, discharge to home and revisits and readmissions) were compared between periods using adjusted regression models. We also examined associations between measures of engagement with the intervention and outcomes.ResultsA total of 2027 joint replacement patients were included (720 hip replacements; 1307 knee replacements). Adjusting for gender, age and insurance type, both hip and knee patients in the post-intervention group were more likely to have a cancelled surgery, but cancellations were less likely to be on the day of surgery compared to pre-intervention patients. Post-intervention patients were also less likely to have length of stay >2 days. Forty- three per cent of hip and 47% of knee patients in the post-period received the intervention and most were highly engaged. Higher engagement was associated with lower odds of surgical cancellation, shorter stays and higher odds of discharge home.ConclusionFindings suggest that utilization of a digital patient engagement tool translates into improved hospital efficiency and patient outcomes, particularly for those highly engaged.
Early vs. late treatment initiation in multiple sclerosis and its impact on cost of illness: A register-based prospective cohort study in Sweden
Authors: Karampampa Korinna , Gyllensten Hanna , Murley Chantelle , Alexanderson Kristina , Kavaliunas Andrius , Olsson Tomas , Manouchehrinia Ali , Hillert Jan , Friberg Emilie 
Published: April 2022

Background Early treatment with disease modifying therapies (DMTs) for multiple sclerosis (MS) has been associated with lower disability progression; the aim was to explore its association with cost of illness (COI) in MS. Methods All people with relapsing-remitting MS in the Swedish MS register, aged 20–57 years and receiving their first MS DMT in 2006–2009, were followed in nationwide registers for 8 years. Healthcare costs (in- and outpatient healthcare, DMTs and other prescribed drugs), and productivity losses (sickness absence and disability pension) of individuals receiving therapy in ≤6 months after diagnosis (early treatment group) were compared to those receiving therapy >6 months (late treatment group). Using Poisson regressions, the mean COI per patient per year, and per group, was estimated, adjusted for disability progression. Results The early treatment group comprised 74% of the 1562 individuals included in the study. The early treatment group had lower productivity losses over time. Both groups had similar healthcare costs, which first increased and then decreased over time. Conclusions Early DMT in MS could result in lower productivity losses possibly through maintained work capacity. COI serves as an objective measure showing the advantage of early vs. late treatment initiation in MS.
Autonomous Spinal Robotic System for Transforaminal Lumbar Epidural Injections: A Proof of Concept of Study
Authors: Margalit Adam , Phalen Henry , Gao Cong , Ma Justin , Suresh Krishna V. , Jain Punya , Farvardin Amirhossein , Taylor Russell H. , Armand Mehran , Chattre Akhil , Jain Amit 
Published: April 2022

Study Design Phantom study Objective The aim of our study is to demonstrate in a proof-of-concept model whether the use of a marker less autonomous robotic controlled injection delivery system will increase accuracy in the lumbar spine. Methods Ideal transforaminal epidural injection trajectories (bilateral L2/3, L3/4, L4/5, L5/S1 and S1) were planned out on a virtual pre-operative planning software by 1 experienced provider. Twenty transforaminal epidural injections were administered in a lumbar spine phantom model, 10 using a freehand procedure, and 10 using a marker less autonomous spinal robotic system. Procedural accuracy, defined as the difference between pre-operative planning and actual post-operative needle tip distance (mm) and angular orientation (degrees), were assessed between the freehand and robotic procedures. Results Procedural accuracy for robotically placed transforaminal epidural injections was significantly higher with the difference in pre- and post-operative needle tip distance being 20.1 (±5.0) mm in the freehand procedure and 11.4 (±3.9) mm in the robotically placed procedure ( P < .001). Needle tip precision for the freehand technique was 15.6 mm (26.3 – 10.7) compared to 10.1 mm (16.3 – 6.1) for the robotic technique. Differences in needle angular orientation deviation were 5.6 (±3.3) degrees in the robotically placed procedure and 12.0 (±4.8) degrees in the freehand procedure ( P = .003). Conclusion The robotic system allowed for comparable placement of transforaminal epidural injections as a freehand technique by an experienced provider, with additional benefits of improved accuracy and precision.
Validity and reliability test of ENDOCARE questionnaire adoption on endometriosis patients in Indonesia
Authors: Harzif Achmad Kemal , Pradana Agatha , Muharam Raden , Maidarti Mila , Pratama Gita , Sumapraja Kanadi , Charilda Fistyanisa Elya , Andyra Azizah Fitriayu 
Published: April 2022

Background: Endometriosis is a health problem that causes various biological, psychological, and social problems. Patient-centered care is the best standard of care in endometriosis cases. ENDOCARE is an questionnaire assessing all dimensions of patient-centered endometriosis care. However, there has been no adoption of this questionnaire in Indonesia. Aim: To determine the validity and reliability of the Indonesian version of the ENDOCARE questionnaire. Method: This study is a cross-sectional study conducted on patients with endometriosis on Dr. Cipto Mangunkusumo, Jakarta, Indonesia from July 2020 to December 2020. Patients with communication problems were excluded from the study. The English version of the ENDOCARE questionnaire was translated into Indonesian and back into English by sworn translators and specialists in obstetrics and gynecology. Analysis of the validity and reliability of ENDOCARE was carried out. Result: There were 108 respondents who were included in the study. Percentage of negative experience (PNP), mean important score (MIS), and patient-centered care (PCS) score were analyzed. Validity and reliability tests were performed. There were 38 questions covering 10 dimensions in the Indonesian version of the ENDOCARE questionnaire Conclusion: The Indonesian version of the ENDOCARE questionnaire is a valid and reliable questionnaire in assessing patient-centered care of endometriosis.
An Indicator of environmental enrichment to measure physical, social and cognitive activities in human daily life
Authors: Flores-Ramos Mónica , Yoldi-Negrete María , Guiza-Zayas Rodrigo , Ramírez-Rodríguez Gerardo-Bernabé , Montes-Castrejón Adolfo , Fresán Ana 
Published: April 2022

Abstract
Background
The concept of environmental enrichment (EE) encompasses complex physical, social, cognitive, motor, and somatosensory stimuli to which individuals are differentially exposed. An indicator of EE comprising these elements would facilitate the study of the impact of EE in diverse clinical settings by allowing an easy and comparable measurement. This study aimed to create and test such an EE indicator based on the Florida Cognitive Activities Scale (FCAS), the Multidimensional Social Integration in Later Life Scale (SILLS), and the International Physical Activity Questionnaire (IPAQ).

Methods
Participants with major depression and control subjects were recruited in this cross-sectional comparative study. Depressive symptom severity was assessed with the Hamilton Depression Rating Scale (HAM-D). The EE indicator was used to evaluate cognitive, social, and physical activity. We divided the sample into three levels of cognitive and social activities to construct an EE indicator and compared the obtained scores between participants with major depression and control subjects.
Results: 40 patients suffering from major depression and 50 control subjects were included. Higher HAM-D scores were associated with lower EE levels. Cognitive and social items exhibited adequate reliability. Control subjects reported higher scores in all three activities evaluated, except for some items of physical activities. This indicator of EE clearly differentiated between participants with major depression from control subjects.

Conclusions
FCAS, SILLS, and IPAQ used together are valid to evaluate EE. This EE indicator may be a useful tool during clinical practice. The cross-sectional design and the small sample size are limitations of the present study.