bluuebunny/crossref_metadata_2025_split huggingface dataset:
Digital intervention promoting physical activity among obese people (DIPPAO) randomised controlled trial: study protocol
Authors: Mazéas Alexandre , Chalabaev Aïna , Blond Marine , Pereira Bruno , Duclos Martine 
Published: June 2022

IntroductionPhysical inactivity and excessive sedentary behaviours are major preventable causes in both the development and the treatment of obesity and type 2 diabetes mellitus (T2DM). Nevertheless, current programmes struggle to engage and sustain physical activity (PA) of patients over long periods of time. To overcome these limitations, the Digital Intervention Promoting Physical Activity among Obese people randomised controlled trial (RCT) aims to evaluate the effectiveness of a group-based digital intervention grounded on gamification strategies, enhanced by social features and informed by the tenets of the self-determination theory and the social identity approach.Methods and analysisThis trial is a two-arm parallel RCT testing the effectiveness of the Kiplin digital intervention on obese and patients with T2DM in comparison to the usual supervised PA programme of the University Hospital of Clermont-Ferrand, France. A total of 50 patients will be randomised to one of the two interventions and will follow a 3-month programme with a 6-month follow-up postintervention. The primary outcome of the study is the daily step count change between the baseline assessment and the end of the intervention. Accelerometer data, self-reported PA, body composition and physical capacities will also be evaluated. To advance our understanding of complex interventions like gamified and group-based ones, we will explore several psychological mediators relative to motivation, enjoyment, in-group identification or perceived weight stigma. Finally, to assess a potential superior economic efficiency compared with the current treatment, we will conduct a cost–utility analysis between the two conditions. A mixed-model approach will be used to analyse the change in outcomes over time.Ethics and disseminationThe research protocol has been reviewed and approved by the Local Human Protection Committee (CPP Ile de France XI, No 21 004-65219). Results will inform the Kiplin app development, be published in scientific journals and disseminated in international conferences.Trial registration numberNCT04887077.
Association between purpose in life and healthcare use among women and men in Germany: cross-sectional analysis of the nationally representative German Socio-Economic Panel (GSOEP) study
Authors: Hajek André , König Hans-Helmut 
Published: June 2022

ObjectivesIt remains almost unknown whether purpose in life is associated with healthcare use (HCU) in general. Therefore, the goal of this study was to examine the association between purpose in life and HCU (in terms of frequency of outpatient physician visits and hospitalisation) stratified by sex.DesignCross-sectional study.Setting and participantsA representative sample of the general adult population in Germany (n=1238; collected from September 2020 to February 2021); taken from the innovation sample of the German Socio-Economic Panel.Outcome measuresThe frequency of outpatient physician visits in the past 3 months was used as first outcome measure. Hospitalisation in the last 12 months was used as the second outcome measure. Purpose in life was quantified by means of the subscale ‘purpose in life’ of the six-factor model of psychological well-being. Covariates were selected based on the Andersen model.ResultsAverage purpose in life equaled 4.5 (SD: 0.8; ranging on a scale from 1 to 6, with higher values indicating higher purpose in life). Adjusting for various potential confounders, regressions revealed that higher purpose in life was associated with an increased frequency of outpatient physician visits in the past 3 months among women (IRR 1.16, 95% CI:1.03 to 1.30), but not men (IRR 0.96, 95% CI 0.87 to 1.07). In contrast, higher purpose in life was associated with in an increased likelihood of hospitalisation among men (OR 1.40, 95% CI 1.02 to 1.93), but not women (OR 1.03, 95% CI 0.79 to 1.34).ConclusionEven after adjusting for various potential confounders, there was still a gender-specific association between higher purpose in life and increased HCU. This knowledge may assist in addressing individuals at risk for underuse or overuse of healthcare services.
Systematic review and narrative synthesis of the impact of Appreciative Inquiry in healthcare
Authors: Merriel Abi , Wilson Amie , Decker Emily , Hussein Julia , Larkin Michael , Barnard Katie , O’Dair Millie , Costello Anthony , Malata Address , Coomarasamy Arri 
Published: June 2022

BackgroundAppreciative Inquiry is a motivational, organisational change intervention, which can be used to improve the quality and safety of healthcare. It encourages organisations to focus on the positive and investigate the best of ‘what is’ before thinking of ‘what might be’, deciding ‘what should be’ and experiencing ‘what can be’. Its effects in healthcare are poorly understood. This review seeks to evaluate whether Appreciative Inquiry can improve healthcare.MethodsMajor electronic databases and grey literature were searched. Two authors identified reports of Appreciative Inquiry in clinical settings by screening study titles, abstracts and full texts. Data extraction, in duplicate, grouped outcomes into an adapted Kirkpatrick model: participant reaction, attitudes, knowledge/skills, behaviour change, organisational change and patient outcomes.ResultsWe included 33 studies. One randomised controlled trial, 9 controlled observational studies, 4 qualitative studies and 19 non-controlled observational reports. Study quality was generally poor, with most having significant risk of bias. Studies report that Appreciative Inquiry impacts outcomes at all Kirkpatrick levels. Participant reaction was positive in the 16 studies reporting it. Attitudes changed in the seventeen studies that reported them. Knowledge/skills changed in the 14 studies that reported it, although in one it was not universal. Behaviour change occurred in 12 of the 13 studies reporting it. Organisational change occurred in all 23 studies that reported it. Patient outcomes were reported in eight studies, six of which reported positive changes and two of which showed no change.ConclusionThere is minimal empirical evidence to support the effectiveness of Appreciative Inquiry in improving healthcare. However, the qualitative and observational evidence suggests that Appreciative Inquiry may have a positive impact on clinical care, leading to improved patient and organisational outcomes. It is, therefore, worthy of consideration when trying to deliver improvements in care. However, high-quality studies are needed to prove its effects.PROSPERO registration numberCRD42015014485.
Quality of end-of-life nursing home care in dementia: relatives’ perceptions
Authors: Vandenbogaerde Isabel , De Vleminck Aline , van der Heide Agnes , Deliens Luc , Van den Block Lieve , Smets Tinne 
Published: June 2022

ObjectivesOnly a few studies have investigated the quality of end-of-life care provided to nursing home residents with dementia as perceived by their relatives. We aim to investigate the quality of end-of-life care as perceived by relatives and to investigate which characteristics of nursing home residents with dementia, their relatives and the care they received are associated with the evaluation the quality of end-of-life care as perceived by the relatives.MethodsData used were from two cross-sectional studies performed in Flanders in 2010 and 2015. Questionnaires were sent to bereaved relatives of nursing home residents with dementia and 208 questionnaires were returned. The quality of end-of-life care as perceived by the relatives was measured with the End-of-Life with Dementia–Satisfaction With Care scale (scores ranging 10–40).ResultsIn total, 208 (response rate2010: 51.05%, response rate2015=60.65%) bereaved relatives responded to the questionnaire. The quality of end-of-life care as perceived by them was positively associated with the nursing home resident being male (b=1.78, p<0.05), relatives receiving information on palliative care (b=2.92, p<0.01) and relatives receiving information about medical care from care providers (b=2.22, p<0.01).ConclusionThis study suggests that relatives need to be well informed about palliative and medical care. Future end-of-life care interventions in nursing homes should focus on how to increase the information exchange and communication between nursing home staff and relatives.
Global quality of life in breast cancer: systematic review and meta-analysis
Authors: Javan Biparva Akbar , Raoofi Samira , Rafiei Sima , Pashazadeh Kan Fatemeh , Kazerooni Mitra , Bagheribayati Farzaneh , Masoumi Maryam , Doustmehraban Maryam , Sanaei Mohaddeseh , Zarabi Farnaz , Raoofi Neda , Beiramy Chomalu Zahra , Ahmadi Behrooz , Seyghalani Talab Fatemeh , Sadat Hoseini Batool , Asadollahi Elnaz , Mir Maryam , Deylami Sama , Zareei Mahsa , Sanaei Hadis , Dousti nia Kakavand Fateme , Koohestani Hooman , Nasiri Mahmoud , Vali Negin , Ghashghaee Ahmad 
Published: June 2022

BackgroundBreast cancer (BC) is the most common cancer among women worldwide. We conducted a systematic review and meta-analysis to cover the existing research gap and contribute to existing knowledge to provide both researchers and clinicians with a better profile on the topic and consequently help improve the quality of life (QoL) of patients with BC.MethodsA comprehensive review of original articles published in English from January 2000 to October 2021 from databases including Embase, Scopus, PubMed and Web of Science was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.ResultsBased on the meta-regression which examined a total of 9012 patients with BC, the QoL score calculated by EORTC QLQ-C30 was 64.72 (95% CI 59.24 to 70.20), while the score obtained from FACT-B was 84.39 (95% CI 64.24 to 104.54) and the scores from QLQ-BR23 and SF-36 were 66.33 (95% CI 62.76 to 69.90) and 57.23 (95% CI 47.65 to 66.82), respectively. A meta-analysis affirmed a significant direct relationship between the QoL score of patients with BC and their age (p=0.03). The results also revealed that the QoL scores of patients who had completed treatment were higher than those who were currently under treatment.ConclusionThe present systematic review identified several factors that affect the QoL of women with BC worldwide and provided several implications for developing policy interventions to effectively improve the QoL of women with BC. In this way, clinicians can sufficiently give advice to their patients with the purpose of improving their QoL.PROSPERO registration numberCRD42022309791.
Remote Patient Monitoring in the Management of Chronic Obstructive Pulmonary Disease
Authors: Chalupsky Megan R , Craddock Krystal M , Schivo Michael , Kuhn Brooks T 
Published: June 2022

Remote patient monitoring allows monitoring high-risk patients through implementation of an expanding number of technologies in coordination with a healthcare team to augment care, with the potential to provide early detection of exacerbation, prompt access to therapy and clinical services, and ultimately improved patient outcomes and decreased healthcare utilization. In this review, we describe the application of remote patient monitoring in chronic obstructive pulmonary disease including the potential benefits and possible barriers to implementation both for the individual and the healthcare system.
Direct to angiosuite strategy versus standard workflow triage for endovascular therapy: systematic review and meta-analysis
Authors: Galecio-Castillo Milagros , Vivanco-Suarez Juan , Zevallos Cynthia B , Dajles Andres , Weng Julie , Farooqui Mudassir , Ribo Marc , Jovin Tudor G , Ortega-Gutierrez Santiago 
Published: June 2022

BackgroundReducing stroke workflow times when performing endovascular thrombectomy is associated with improvement in clinical outcomes. We compared outcomes among large vessel occlusion (LVO) stroke patients following the direct to angiosuite (DTAS) strategy versus standard workflow (SW) when undergoing endovascular therapy.MethodsWe conducted a systematic review and meta-analysis to compare rates of functional outcomes, reperfusion, symptomatic intracranial hemorrhage (sICH) and stroke workflow metrics. We included observational studies and clinical trials that compared the DTAS strategy versus SW, and at least one outcome of interest was assessed. Clinical, methodological and statistical heterogeneity were measured, and a random-effects model was used.Results12 studies were included in the systematic review and 8 in the meta-analysis (n=2890). The DTAS strategy was associated with significant higher odds of good functional outcome at 90 days (47.3% vs 34.9%; OR 1.58, 95% CI 1.16 to 2.14) and a significant average reduction of door-to-puncture (mean differences (MD) −35.09, 95% CI −49.76 to −20.41) and door-to-reperfusion times (MD –32.88, 95% CI –50.75 to –15.01). We found no differences in sICH (OR 0.80, 95% CI 0.53 to 1.20), mortality (OR 1.00, 95% CI 0.60 to 1.67) or successful reperfusion rates (OR 1.37, 95% CI 0.82 to 2.29). Moreover, the DTAS strategy was associated with greater odds of dramatic clinical improvement at 24 hours (OR 1.79, 95% CI 1.15 to 2.79).ConclusionPatients undergoing the DTAS strategy had a significant reduction in door-to-puncture and door-to-reperfusion times. This resulted in an increased rate of early neurological and 90-day functional recovery without compromising safety in LVO patients undergoing endovascular thrombectomy.
Preprocedural determination of an occlusion pathomechanism in endovascular treatment of acute stroke: a machine learning-based decision
Authors: Baek Jang-Hyun , Kim Byung Moon , Kim Dong Joon , Heo Ji Hoe , Nam Hyo Suk , Kim Young Dae , Rho Myung Ho , Chung Pil-Wook , Won Yu Sam , Chung Yeongu 
Published: June 2022

ObjectiveTo evaluate whether an occlusion pathomechanism can be accurately determined by common preprocedural findings through a machine learning-based prediction model (ML-PM).MethodsA total of 476 patients with acute stroke who underwent endovascular treatment were retrospectively included to derive an ML-PM. For external validation, 152 patients from another tertiary stroke center were additionally included. An ML algorithm was trained to classify an occlusion pathomechanism intoembolicorintracranial atherosclerosis. Various common preprocedural findings were entered into the model. Model performance was evaluated based on accuracy and area under the receiver operating characteristic curve (AUC). For practical utility, a decision flowchart was devised from an ML-PM with a few key preprocedural findings. Accuracy of the decision flowchart was validated internally and externally.ResultsAn ML-PM could determine an occlusion pathomechanism with an accuracy of 96.9% (AUC=0.95). In the model, CT angiography-determined occlusion type, atrial fibrillation, hyperdense artery sign, and occlusion location were top-ranked contributors. With these four findings only, an ML-PM had an accuracy of 93.8% (AUC=0.92). With a decision flowchart, an occlusion pathomechanism could be determined with an accuracy of 91.2% for the study cohort and 94.7% for the external validation cohort. The decision flowchart was more accurate than single preprocedural findings for determining an occlusion pathomechanism.ConclusionsAn ML-PM could accurately determine an occlusion pathomechanism with common preprocedural findings. A decision flowchart consisting of the four most influential findings was clinically applicable and superior to single common preprocedural findings for determining an occlusion pathomechanism.
Effectiveness of Acapella along with institutional based chest physiotherapy techniques on pulmonary functions and airway clearance in post-operative CABG patients
Authors: Jage Bhagyashree , Thakur Anuprita 
Published: June 2022

Background: Patients undergoing Coronary Artery Bypass Graft (CABG) surgery often develop pulmonary complications in the early post-operative period as result of decreased lung function and impaired cough. Conventional physiotherapy in early post-operative period aims at increasing lung volumes and airway clearance.Objective: This study aimed to determine the effectiveness of the addition of Acapella to conventional chest physiotherapy in improving lung volumes and secretion clearance in early post-operative CABG patients.Methods: Twenty patients of both genders (40–70 years) who had undergone CABG and were in Phase I of Cardiac Rehabilitation were involved in this pilot randomized control trial (9 control, 11 experimental). Post-surgery intervention commenced on post-operative day 2 (POD 2) and continued till POD 6. Patients in the control group were given conventional physiotherapy that included breathing exercises, incentive spirometry and manual techniques. Patient in the experimental group used an Acapella device along with the conventional intervention. Outcome measures considered were pulmonary function parameters (FVC, FEV1 & PEFR) and amount of sputum expectorated.Results: A significant increase in lung volumes was observed in both the groups on POD 6 as compared to POD 2 ([Formula: see text]). However, the increase was significantly greater on POD 6 in experimental group than the control group [mean difference (95% CI) FVC: 0.44[Formula: see text]L (0.24–0.63), FEV1: 0.43[Formula: see text]L (0.19–0.66), PEFR: 0.86[Formula: see text]L/s (0.57–1.14)]. The amount of sputum expectoration significantly greater in the experimental group as compared to the control group [2.71[Formula: see text]mL (0.53–4.90)].Conclusion: The addition of Acapella enhanced the effect conventional physiotherapy in improving lung volumes and airway clearance in the early post-operative period for CABG patients.
New field observations on the Quaternary geology and vertebrate palaeontological occurrences in the Narsinghpur region of Narmada valley (central India)
Authors: Lal Ravish , Padhan Tosabanta , Jangra Bharti , Chauhan Parth R. , Sahu Shivam , Patnaik Rajeev 
Published: June 2022

Abstract
Since the beginning of the nineteenth century, the Narmada River Valley has been well known for discoveries of abundant vertebrate fossil localities, a wide range of prehistoric archaeological assemblages and the first-known hominin fossil site in India at Hathnora. The fossil and archaeological remains are found in various sedimentary contexts: boulder conglomerate, pebble-rich sand, cross-bedded, coarse-to-fine sand and reddish brown clay in the Early to Late Pleistocene deposits. Our preliminary field investigations in the Narsinghpur region of the basin mark the presence of 26 individual localities within a stretch of 70 km of the Narmada River and adjoining tributaries. Each location was documented by GPS and the geological details were recorded while collecting the fossils. Past and current palaeontological research has revealed that a variety of fauna adapted to the sub-humid climate of both aquatic and terrestrial landscapes that thrived in this area during the Pleistocene period. One of our long-term goals is to understand the reasons for the high number of palaeontological occurrences compared with other parts of India and use such information to predict the locations of new occurrences, including hominin fossils. Various taphonomic processes in this region are responsible for the preservation and destruction of fossil assemblages in different geological formations: soil type, climatic conditions, rich calcium carbonate presence, encrustation, patination and modern anthropogenic activities (among others). Most of the fossil localities are found at an elevation range of 310–350 m above mean sea level (AMSL). The Narmada Basin was inhabited by prehistoric human populations and a variety of fauna, as evidenced by the ample lithic and fossil assemblages across the region. There are definitive contextual patterns of occurrences of the Quaternary vertebrate fossils and archaeological assemblages in the landscape, which require detailed investigations and mapping to understand the spatial distribution pattern and nature of associated sedimentary environments. In addition, this uniquely fossil-rich area requires proper protection and long-term preservation as it is heavily impacted by modern anthropogenic factors such as agriculture, sand mining and other activities.
Understanding contaminant transport in Chalk from petroleum hydrocarbon and chlorinated solvent contamination investigations
Authors: Dent V. , Dewhurst R. E. , Dottridge J. 
Published: June 2022

Abstract
The Chalk is a strategically important aquifer in the UK, but it is at risk of contamination, with impacts on abstractions, because of extensive outcrop. Assessments of the risk of contamination impacting water supply are commonly based on bulk aquifer parameters, usually reported for abstraction wells, and do not consider the macro- and micro-scale variation at the site and within the Chalk succession. The presence of less permeable layers is significant in restricting contaminant entry into the aquifer, pushing the contaminants into fractures and voids, where their flow is limited by density differences that cause hydrocarbons to smear into micro-fractures. Dense solvents flowing to depth are further impacted by the presence of lower permeability layers within the Chalk, while horizontal flow is affected by fractures and faults. Porewater concentrations of contaminants are limited, by pore throat size and limited connectivity, to low concentrations of the most soluble compounds, but are characterized by electron acceptors that are observed as reduced and oxidized species.
The combination of macro- and micro-scale physical structures, combined with natural attenuation, means that initial risk assessments for hydrocarbons and solvents in Chalk can be highly conservative and should be supported by further targeted investigation.
Photodynamic Therapy–Induced Cell Surface Expression and Release of Heat Shock Proteins: Relevance for Tumor Response
Authors: Korbelik Mladen , Sun Jinghai , Cecic Ivana 
Published: June 2022

AbstractAlmost instantaneously after the treatment of mouse SCCVII tumor cells with Photofrin-based photodynamic therapy (PDT), a fraction (15-25%) of total cellular heat shock protein 70 (HSP70) became exposed at the cell surface. The level of this surface-expressed HSP70 then remained unchanged for the next 6 hours and persisted at lower levels even at 18 hours after PDT. A similar induction of surface HSP70 expression was found with PDT-treated human umbilical vein endothelial cells. The same analysis for several other HSPs revealed the induced surface expression of HSP60 and GRP94, but not GRP78, on PDT-treated SCCVII cells. A fraction of total HSP70 existing in SCCVII cells at the time of PDT treatment was promptly (within 1 hour) released from cells after high treatment doses, whereas even lower PDT doses induced a substantial HSP70 release at later time intervals. Macrophages coincubated with PDT-treated SCCVII cells displayed elevated levels of both HSP70 and GRP94 on their surface and were stimulated to produce tumor necrosis factor α, whose production was inhibited by the presence of antibodies against either HSP70, Toll-like receptors 2 and 4, or specific NF-κB inhibitor in the coincubation medium. The induction of cell surface expression and release of HSPs by PDT may represent an important event in the response of tumors to this treatment modality with a critical role in the induced inflammatory and immune responses that contribute to the therapeutic outcome.