bluuebunny/crossref_metadata_2025_split huggingface dataset:
Personality traits as mediators of the relationship between childhood trauma and depression severity in bipolar disorder: A structural equation model
Authors: Wrobel Anna L , Russell Samantha E , Jayasinghe Anuradhi , Kavanagh Bianca E , Lotfaliany Mojtaba , Turner Alyna , Dean Olivia M , Cotton Sue M , Diaz-Byrd Claudia , Yocum Anastasia K , Duval Elizabeth R , Ehrlich Tobin J , Marshall David F , Berk Michael , McInnis Melvin G 
Published: August 2022

Background: Childhood trauma is negatively associated with depression severity in bipolar disorder; however, the underlying mechanisms remain unclear. We investigated whether personality traits (neuroticism, extraversion, openness, agreeableness, conscientiousness) mediate the relationship between childhood trauma and the severity of bipolar depression. Methods: Data from 209 individuals with bipolar disorder recruited for the Prechter Longitudinal Study of Bipolar Disorder were analysed. Using structural equation modelling, we examined the direct and indirect associations between childhood trauma (Childhood Trauma Questionnaire) and depression severity (Hamilton Depression Rating Scale) – with the personality traits (NEO Personality Inventory–Revised) as mediators. Results: The direct effect of childhood trauma on depression severity (standardised β = 0.32, 95% bootstrap confidence interval [CI] = 0.20–0.45, p < 0.001) and the indirect effect via neuroticism (standardised β = 0.03, 95% bootstrap CI [0.002, 0.07], p = 0.039) were significant; supporting a partial mediation model. The indirect effect accounted for 9% of the total effect of childhood trauma on depression severity (standardised β = 0.09, 95% bootstrap CI [0.002, 0.19], p = 0.046). The final model had a good fit with the data (comparative fit index = 0.96; root mean square error of approximation = 0.05, 90% CI = [0.02, 0.07]). Conclusion: Personality traits may be relevant psychological mediators that link childhood trauma to a more severe clinical presentation of bipolar depression. Consequently, a person’s personality structure may be a crucial operative factor to incorporate in therapeutic plans when treating individuals with bipolar disorder who report a history of childhood trauma.
Risk Factors Affecting the Survival Rate of Collagen Meniscal Implant for Partial Meniscal Deficiency: An Analysis of 156 Consecutive Cases at a Mean 10 Years of Follow-up
Authors: Lucidi Gian Andrea , Grassi Alberto , Agostinone Piero , Di Paolo Stefano , Dal Fabbro Giacomo , D’Alberton Chiara , Pizza Nicola , Zaffagnini Stefano 
Published: August 2022

Background: Collagen meniscal implant (CMI) is a biologic scaffold that can be used to replace meniscus host tissue after partial meniscectomy. The short-term results of this procedure have already been described; however, little is known about risk factors for failure. Purpose: To determine the factors that predict failure of meniscal scaffold implantation in a large series of patients treated at a single institution and to better define the indications for surgery. Study Design: Case-control study; Level of evidence, 3. Methods: The analysis included 186 consecutive patients with a minimum 5-year follow-up who underwent CMI scaffold implantation or combined procedures. Patients’ characteristics and details of the surgery were obtained via chart review. Patients with a Lysholm score <65 were considered to have experienced clinical failure. Surgical failure was defined as partial or total scaffold removal. Results: The final analysis included 156 patients (84%) at a mean follow-up of 10.9 ± 4.3 years. The patients’ mean age at surgery was 42.0 ± 11.1 years, and the survival rate was 87.8%. Subgroup analysis identified Outerbridge grade 3-4 (Hazard ratio [HR], 3.8; P = .004) and a lateral meniscal implant (HR, 3.2; P = .048) as risk factors for failure. The survival rate was 90.4% for medial implants and 77.4% for lateral implants. An Outerbridge grade 3-4 (HR, 2.8; P < .001) and time from meniscectomy to scaffold >10 years (HR, 2.8; P = .020) were predictive of surgical or clinical failure. Conclusion: CMI for partial meniscal deficiency provided good long-term results, with 87.8% of the implants still in situ at a mean 10.9 years of follow-up. Outerbridge grade 3-4, lateral meniscal implants, and longer time from the meniscectomy to implantation of the CMI were identified as risk factors for clinical and surgical failure.
Why Australia should move towards nationally consistent mental health legislation?
Authors: Tosson Daniel , Lam Danny , Raeburn Toby 
Published: August 2022

Objective Mental Health Acts (MHAs) are important pieces of legislation which include essential definitions of mental illness and mental disorder and are used to guide decision-making regarding treatment, including involuntary admissions. In Australia, responsibility for reviewing this legislation falls under the jurisdiction of State and Territory Governments, resulting in interstate variations of legislative definitions and care requirements. In this paper, we outline some of the main differences between MHAs, and argue that it is time for Australia to enact nationally consistent Mental Health Legislation. Conclusions Substantial divergence exists between definitions of mental illness and mental disorder, differing criteria for involuntary treatment and discrepancies between treatment requirements for Indigenous Australians. While variations between MHAs are understandable considering the historical context, in an increasingly integrated society, it is time for Australia to enact nationally consistent mental health legislation.
Impact of the Post-Thrombotic Syndrome on the Arterial Wall of the Lower Limbs
Authors: Lu Mingshu , Qi Xiangbin , Bi Jingpeng , Li Yunhui 
Published: August 2022

Objective Deep vein thrombosis of the lower limbs is a common disease in vascular surgery. Approximately 20–50% of deep vein thrombosis patients develop post-thrombotic syndrome, which can severely affect the patient's quality of life. However, the precise science of the pathophysiology of the progression of the post-thrombotic syndrome remains unclear. Studies have demonstrated that patients with post-thrombotic syndrome of the lower limbs have impaired arterial wall endothelial function. Nevertheless, there is little research on the different impacts of post-thrombotic syndrome on the arterial wall endothelial function between the affected limbs and the healthy limbs. This study aims to assess this difference. Methods A total of 60 patients treated for the post-thrombotic syndrome of the lower limbs were included. The flow-mediated dilation (FMD%) and nitroglycerin-mediated dilation (NMD%) were measured to assess the different endothelial function alterations of the common femoral arterial wall between the affected limb and the healthy limb. Results No significant differences in the common femoral artery diameter between the affected limbs and the healthy limbs were discovered (8.94  ±  0.92 mm vs 8.75  ±  1.0 mm, P = 0.710). The flow-mediated dilation of the common femoral artery of the affected limbs were significantly lower compared to the healthy limbs (FMD%: 3.21  ±  1.07% vs 5.19  ±  1.35%, P  =  0.001). However, there was no significant difference in the nitroglycerin-mediated dilation of the common femoral artery between the affected limbs and the healthy limbs（ NMD%: 13.37  ±  1.78% versus 14.45  ±  2.14%, P = 0.083). Conclusions Our results demonstrated the association between post-thrombotic syndrome and deteriorated endothelial functional properties of the arterial wall of the lower limbs. Endothelial dysfunction of the arteries wall was more severe in the affected lower limbs with the post-thrombotic syndrome than in the healthy limbs. The mentioned findings may partly explain the pathophysiology of the progression post-thrombotic syndrome of the lower limbs. Highlights tudies have demonstrated that patients with post-thrombotic syndrome of the lower limbs have impaired arterial wall endothelial function. Our results demonstrated the endothelial dysfunction of the arteries wall was more severe in the affected lower limbs with the post-thrombotic syndrome than in the healthy limbs. Our findings may partly explain the pathophysiology of the progression post-thrombotic syndrome of the lower limbs.
Sex differences in appropriate insertion depth for intraosseous access in adults: An exploratory radiologic single-center study
Authors: Miller Clemens , Nardelli Paul , Hell Tobias , Glodny Bernhard , Putzer Gabriel , Paal Peter 
Published: August 2022

Background: Intraosseous access is a recommended alternative to venous access in emergencies. For its application, knowledge of the correct insertion depth is indispensable. We aimed to determine sex-specific differences on the appropriate insertion depth for intraosseous access in adults at the insertion sites most frequently used, namely the proximal and distal tibia and the proximal humerus. Methods: In this exploratory retrospective study, we measured thickness of soft tissue cover, cortex and cancellous bone along the puncture line on magnetic resonance images or computed tomography scans. Inclusion criteria were both sexes, 18–90 years of age and appropriate image quality. Primary outcome was the appropriate insertion depth to reach the cancellous bone for each sex. This was defined as the corridor between (i) the sum of the soft tissue cover and the cortex and (ii) the sum of (i) plus the diameter of the cancellous bone. Secondary outcomes were the differences in thickness of each layer between sexes. Results: In 179 females and males, the appropriate insertion depth was 32.5–45.5 mm and 20.5–42.0 mm in the proximal tibia, 14.5–30.5 mm and 16.5–34.5 mm in the distal tibia, and 27.5–52.5 mm and 26.0–56.5 mm in the proximal humerus. Although females had a thicker soft tissue cover (+6.8 mm [95% CI 3.7–10.1], p < 0.01) in the proximal tibia, extrapolation by correlation analysis showed no clinically relevant difference between the sexes. Conclusion: In adults, there are no sex-specific differences in the appropriate insertion depth for intraosseous access in the proximal or distal tibia or in the proximal humerus.
Barriers to Enrollment in Post-Stroke Brain Stimulation in a Racially and Ethnically Diverse Population
Authors: Hodics Timea , Cohen Leonardo G. , Pezzullo John C. , Kowalske Karen , Dromerick Alexander W. 
Published: August 2022

Background and Purpose Brain stimulation is an adjuvant strategy to promote rehabilitation after stroke. Here, we evaluated the influence of inclusion/exclusion criteria on enrollment in a transcranial direct current stimulation (tDCS) trial in the context of a racially/ethnically diverse acute stroke service at University of Texas Southwestern (UTSW). Methods 3124 (59.7 ± 14.5 years) racially/ethnically diverse (38.4% non-Hispanic white, (W), Hispanic (H) 22%, African American (AA) 33.5%, Asian (A) 2.3%) patients were screened in the acute stroke service at UTSW. Demographics, stroke characteristics, and reasons for exclusion were recorded prospectively. Results 2327 (74.5%) patients had a verified stroke. Only 44 of them (1.9%) were eligible. Causes for exclusion included in order of importance: (1) magnitude of upper extremity (UE) motor impairment, (2) prior strokes (s), (3) hemorrhagic stroke, (4) psychiatric condition or inability to follow instructions, and (5) old age, of these (2) and (4) were more common in AA patients but not in other minorities. 31 of the 44 eligible individuals were enrolled (W 1.68%, H 1.37%, AA .77%, A 3.774%). 90.5% of verified stroke patients did not exhibit contraindications for stimulation. Conclusions 3 main conclusions emerged: (a) The main limitations for inclusion in brain stimulation trials of motor recovery were magnitude of UE motor impairments and stroke lesion characteristics, (b) most stroke patients could be stimulated with tDCS without safety concerns and (c) carefully tailored inclusion criteria could increase diversity in enrollment. Clinical Trial Registration-URL: http://clinicaltrials.gov . Unique identifier: NCT01007136.
Evaluation of Clinical and Genetic Determinants of Treatment OutCome In EGFR Mutation Positive Advanced Lung Adenocarcinoma
Authors: Jokic Vera , Savic-Vujovic Katarina , Spasic Jelena , Bukumiric Zoran , Marinkovic Mladen , Radosavljevic Davorin , Cavic Milena 
Published: August 2022

Background The aim of this research was to evaluate clinical and low-cost genetic determinants of treatment outcome in EGFR mutation positive advanced lung adenocarcinoma patients. Material and Methods EGFR mutation testing and EGFR 181946C>T genotyping were performed in 101 advanced lung adenocarcinoma patients using qRT-PCR and PCR-RFLP, respectively. Progression-free survival was defined as the time from the start of TKI therapy to date of progression, and overall survival as the time from diagnosis to death from any cause. Pain level was evaluated using a Numerical Rating Scale and the Verbal Descriptor Scale. Statistical significance was considered for P < .05. Results Patients were treated with EGFR-TKIs for a period of 1–39months (median 9), with a median PFS of 12.0 months (10.4-13.6, CI 95%), and a median OS of 19.0 months (15.1-22.7, CI 95%). The presence of pain was significantly correlated with the existence of bone ( P < .001) and adrenal glands metastases ( P = .029). Genetic factors did not have a direct impact on pain management but had a significant effect on the response to TKIs leading to pain alleviation. Conclusions EGFR mutation subtype and the EGFR 181946 C>T SNP had a significant effect on the response to TKI inducing an indirect anti-dolorous effect.
The second randomized controlled ENhanced Control of Hypertension ANd Thrombectomy strokE stuDy (ENCHANTED2): Protocol and progress
Authors: Song Lili , Yang Pengfei , Zhang Yongwei , Zhang Xiaoxi , Chen Xiaoying , Li Yunke , Shen Hongjian , Zhang Lei , Li Zifu , Zhang Yongxin , Xing Pengfei , Zhang Ping , Zhou Yihan , Ren Xinwen , Billot Laurent , Wang Xia , Parsons Mark W , Butcher Ken , Campbell Bruce , Robinson Thompson , Goyal Mayank , Dippel Diederik , Roos Yvo , Majoie Charles , Liu Jianmin , Anderson Craig S ,   for ENCHANTED-MT Investigators
Published: August 2022

Background: Uncertainty exists over the optimal level of blood pressure (BP) after mechanical thrombectomy (MT) for acute ischemic stroke (AIS). Objectives: We aim to determine the effectiveness and safety of intensive BP-lowering following MT reperfusion of large-vessel occlusion (LVO)-related AIS. Design: The second ENhanced Control of Hypertension ANd Thrombolysis strokE stuDy (ENCHANTED2) is an investigator-initiated, multicenter, prospective, randomized, open, blinded-endpoint (PROBE) trial of intensive systolic BP (SBP) control in reperfused (extended treatment in cerebral infarction (eTICI) classification 2b/2c/3) LVO-AIS patients with persistent hypertension (SBP ⩾ 140 mmHg) at 60+ sites in China, and Australia and the United Kingdom. Eligible patients are centrally randomly allocated to more- (target SBP ⩽ 120 mmHg within 1 h) or less-intensive (target SBP 140–180 mmHg) BP management, to be maintained for 72 h. Primary outcome is an ordinal shift analysis of scores on the modified Rankin scale (mRS) at 90 days. Sample size of 2257 patients provides 90% power to detect a 6.5% absolute reduction in poor outcome from more-intensive BP-lowering using ordinal logistic regression. Progress: Recruitment started in China in July 2020. At a meeting of the independent Data and Safety Monitoring Board in March 2022 to review primary outcome data available for 347 patients, they recommended suspension of recruitment due to safety concerns in the more-intensive group; which was implemented by the Trial Steering Committee (TSC) with 817 randomized patients only in China. The TSC then stopped recruitment after the safety concerns persisted on further review of the data in June 2022. The TSC will make a decision on restarting the trial with modification of the protocol when the results are made public. Discussion: ENCHANTED2 will provide further randomized evidence on the role of intensive BP-lowering after reperfusion in MT-treated AIS patients. Trial registration: ClinicalTrials.gov NCT04140110; registered 25 October 2019.
Analysis of Factors Historically Affecting Innovation in Hospital Building Design
Authors: Moslehian Anahita Sal , Tucker Richard , Kocaturk Tuba , Andrews Fiona 
Published: August 2022

Purpose: This article aims to complement the historical literature on the evolution of hospital buildings via a holistic analysis of the contextual factors triggering hospital design innovation over the past 100 years. Background: Innovation in hospital building design should be considered as a complex ecosystem with a heterogeneous set of actors. Methods: A novel hybrid research design to the Mixed Grounded Theory methodology, with Charmaz’s constructivist paradigm, was developed to explore, construct, and interpret concepts and the interconnections between them. Results: Six hundred seventeen interconnections between 146 factors, classified across 14 categories, were developed to explain the individual and combined impacts of all components of the design innovation ecosystem. Conclusions: This study provides hospital building designers, researchers, policy makers, and stakeholders with a systemic understanding of the innovation ecosystem and their potential role in this system. This knowledge suggests the need for interdisciplinary education to address complex and quickly evolving real-world building design problems.
Digital health transformation in Saudi Arabia: A cross-sectional analysis using Healthcare Information and Management Systems Society’ digital health indicators
Authors: Al-Kahtani Nouf , Alrawiai Sumaiah , Al-Zahrani Bnan Mohammed , Abumadini Rahaf Ali , Aljaffary Afnan , Hariri Bayan , Alissa Khalid , Alakrawi Zahra , Alumran Arwa 
Published: August 2022

Background The digital revolution has had a huge impact on healthcare around the world. Digital technology could dramatically improve the accuracy of diagnosis, treatment, health outcomes, efficiency of care, and workflow of healthcare operations. Using health information technology will bring major improvements in patient outcomes. Purpose This study aims to measure the readiness for digital health transformation at different hospitals in the Eastern Province, Saudi Arabia in relation to Saudi Vision 2030 based on the four dimensions adopted by the Healthcare Information and Management Systems Society: person-enabled health, predictive analytics, governance and workforce, and interoperability. Methods The study was conducted with a cross-sectional design using data collected through an online questionnaire from 10 healthcare settings, the questionnaire consists of the four digital health indicators. The survey was developed by Healthcare Information and Management Systems Society for the purpose of assessing the level of digital maturity in healthcare settings. Results Ten healthcare facilities in the Eastern Province, both private and governmental, were included in the study. The highest total scores for digital health transformation were reported in private healthcare facilities (median score for private facilities = 77, public facilities = 71). The ‘governance and workforce’ was the most implemented dimension among the healthcare facilities in the study (median = 80), while the dimension that was least frequently implemented was predictive analytics (median score = 70). In addition, tertiary hospitals scored the least in digital transformation readiness (median = 74) compared to primary and secondary healthcare facilities in the study. Conclusion The results of the study show that private healthcare facilities scored higher in digital health transformation indicators. These results will be useful for promoting policymakers’ understanding of the level of digital health transformation in the Eastern Province and for the creation of a strategic action plan.
Profiling Authentic Self-Development: Associations With Basic Need Satisfaction in Emerging Adulthood
Authors: Lopez Frederick G. , Rice Kenneth G. , Durán Barbara S. , Hong Jihee 
Published: August 2022

Research on dispositional authenticity has accelerated in recent years. Using the Authenticity Scale and drawing upon Self-Determination Theory, we conducted a Latent Profile Analysis to determine whether two or more distinct classes of authentic self-development were identifiable across separate samples (Ns = 344 and 378) of emerging adults (18–22 year olds). We also tested whether multidimensional perfectionism and attachment insecurity were correlated with the classes of authentic self-development, and examined the association between class membership and levels of psychological need satisfaction and frustration. Our findings supported the presence of a 3-class configuration which we respectively labelled “Consolidated Authenticity,” “Unintegrated Authenticity,” and “Pre-Emergent Authenticity.” This class structure was replicated in a separate, independent sample. Results highlighted relevant variation in authentic self-development across the identified classes and yielded support for our model involving hypothesized influences on, as well as contemporary outcomes associated with, participants’ class membership.
Body mass index increase: a risk factor for forced expiratory volume in 1 s decline for overweight and obese adults with asthma
Authors: Bermúdez Barón Nicolás , Kankaanranta Hannu , Hedman Linnea , Andersson Martin , Stridsman Caroline , Lindberg Anne , Rönmark Eva , Backman Helena 
Published: August 2022

BackgroundWith increasing prevalence of overweight and obesity, it is important to study how body mass index (BMI) change may affect lung function among subjects with asthma. There are few prospective studies on this topic, especially with separate analyses of those with normal and high BMI. The aim of the present study was to prospectively study the association between annual BMI change and annual lung function decline, separately among those with normal initial BMI and overweight/obesity, in an adult asthma cohort.MethodsA population-based adult asthma cohort was examined at study entry between 1986 and 2001 and at follow-up between 2012 and 2014 (n=945). Annual BMI change was analysed in association with annual decline in forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and FEV1/FVC separately in those with normal weight (BMI 18.5–24.9) and overweight/obese subjects (BMI ≥25) at study entry. Regression models were used to adjust for sex, age, smoking, inhaled corticosteroids use and occupational exposure to gas, dust or fumes.ResultsOverweight/obese subjects had lower FEV1and FVC but slower annual FEV1and FVC decline compared to those with normal weight. After adjustment through regression modelling, the association between BMI change with FEV1and FVC decline remained significant for both BMI groups, but with stronger associations among the overweight/obese (FEV1B[Overweight/obese]=−25 mLversusB[normal weight]=−15 mL). However, when including only those with BMI increase during follow-up, the associations remained significant among those with overweight/obesity, but not in the normal-weight group. No associations were seen for FEV1/FVC.ConclusionsBMI increase is associated with faster FEV1and FVC decline among overweight and obese adults with asthma in comparison with their normal-weight counterparts.