bluuebunny/crossref_metadata_2025_split huggingface dataset:
Brazilian-Portuguese version of the Friendship Scale to assess social isolation: cross-cultural adaptation and psychometric properties
Authors: Alves Natália Christina Moura , Almeida Paulo André , Ferreira Paulo Henrique , Ferreira Lucas Calais , Teixeira Salmela Luci Fuscaldi , Leite Hércules Ribeiro , Oliveira Vinicius Cunha 
Published: September 2022

Aim: To translate, cross-cultural adapt and investigate the measurement properties of the 25-point Friendship Scale to Brazilian-Portuguese. Methods: Translation and adaptation of the 25-point Friendship Scale to Brazilian-Portuguese was conducted at first. Then, the new version was administered to 160 Brazilians to investigate test-retest reliability, internal consistency, standard error of the measurement (SEM), minimal detectable change (MDC), ceiling and floor effects, and concurrent validity. To investigate concurrent validity, the Brazilian–Portuguese version of the 0-100 EuroQol Visual Analog Scale (EQ VAS) was used to assess people’s self-reported health status. Results: The Brazilian-Portuguese version has good to excellent reliability (ICC of 0.76, 95% CI 0.61 – 0.85) and had moderate internal consistency (Cronbach’s alpha value of 0.78, 95% CI: 0.73 – 0.83). To avoid measurement error and to exceed variability, scores need to be greater than 1.33 (SEM) and 3.69 (MDC) on the 25-point scale, respectively. There was no ceiling and floor effects. For concurrent validity, there was a small positive correlation between the Friendship Scale and the EQ VAS (Spearman rs = 0.24; p<0.01). Conclusions: The new Brazilian–Portuguese version of the Friendship Scale has acceptable measurement properties to assess people over 18 years old’s perception of social isolation.
Diagnostic and prognostic value of serum soluble suppression of tumorigenicity-2 in heart failure with preserved ejection fraction: A systematic review and meta-analysis
Authors: Shi Yujiao , Liu Jiangang , Liu Chunqiu , Shuang Xiong , Yang Chenguang , Qiao Wenbo , Dong Guoju 
Published: September 2022

BackgroundHeart failure (HF) with preserved ejection fraction (HFpEF) is a growing public health burden, with mortality and rehospitalization rates comparable to HF with reduced ejection fraction (HFrEF). The evidence for the clinical usefulness of soluble suppression of tumorigenicity 2 (sST2) in HFpEF is contradictory. Therefore, we conducted the following systematic review and meta-analysis to assess the diagnostic and prognostic value of serum sST2 in HFpEF.MethodsPubMed and Scopus were searched exhaustively from their inception until March 15, 2022. In diagnostic analysis, we compared the diagnostic value of serum sST2 in HFpEF to NT pro-BNP. We separately pooled the unadjusted and multivariate-adjusted hazard ratios (HRs) and the corresponding 95% confidence intervals (CIs) in prognostic analysis.ResultsA total of 16 publications from 2008 to 2021 were examined. The results of this analysis were as follow: Firstly, compared with NT pro-BNP, sST2 obtains poor diagnostic performance in independently identifying HFpEF from healthy controls, hypertensive patients, and HFrEF patient. Nevertheless, it may provide incremental value to other biomarkers for diagnosing HFpEF and deserves further investigation. Secondly, log sST2 was independently associated with adverse endpoints on multivariable analysis after adjusting for variables such as age, sex, race, and NYHA class. Per log unit rise in sST2, there was a 2.76-fold increased risk of all-cause death [HR:2.76; 95% CI (1.24, 6.16); p = 0.516, I2 = 0%; P = 0.013] and a 6.52-fold increased risk in the composite endpoint of all-cause death and HF hospitalization [HR:6.52; 95% CI (2.34, 18.19); p = 0.985, I2 = 0%; P = 0.000]. Finally, the optimal threshold levels of serum sST2 need further determined.ConclusionsHigher sST2 was strongly linked to an increased risk of adverse outcomes in HFpEE. Especially, log sST2 independently predicted all-cause death and the composite endpoint of all-cause death and HF hospitalization. However, prospective and multicenter studies with large-sample and extended follow-up periods are required to validate our results due to limitations in our research.
Role of digital health insurance management systems in scaling health insurance coverage in low- and Middle-Income Countries: A case study from Nigeria
Authors: Okuzu Okey , Malaga Ross , Okereafor Kenneth , Amos Ujulu , Dosunmu Afolabi , Oyeneyin Abiodun , Adeoye Victor , Sambo Mohammed Nasir , Ebenso Bassey 
Published: September 2022

BackgroundIncreasing global commitment to Universal Health Coverage (UHC) in the past decade has triggered UHC-inspired reforms and investments to expand health service coverage in many Low- and Middle-Income Countries (LMICs). UHC aims to ensure that all people can access quality health services, safeguard them from public health risks and impoverishment from out-of-pocket payments for healthcare when household members are sickAimThis paper reviews the role of health insurance as a policy tool to address health financing as a contributory mechanism for accelerating the achievement of UHC in LMICs. We focus on Nigeria's legal framework for health insurance coverage for its whole population and the role of technology in facilitating enrollment to health insurance schemes.MethodsFrom May to July 2022, we adopted a cross-sectional case study design combining: (i) a literature review of the effects of UHC with (ii) document analysis of health insurance systems in Nigeria, and (iii) secondary analysis of health insurance datasets to understand experiences of deploying MedStrat, a locally-developed digital health insurance management system, and its features that support the administration of health insurance schemes in multiple states of Nigeria. We drew on contemporary technology adoption models to triangulate diverse data analyzed from literature and documents reviews and from health insurance datasets to identify: (i) enablers of adoption of digital insurance schemes, (ii) the contribution of digital technology to expanding access to health insurance, and (iii) further scalability of digital insurance intervention.ResultsPreliminary findings suggests that digital insurance management systems can help to increase the number of enrollees for insurance especially among poor households. Three contextual enablers of adoption of digital insurance schemes were a favourable policy environment, public-private-partnerships, and sustained stakeholder engagement and training.Discussion and conclusionKey elements for successful scaling of digital health insurance schemes across Nigeria and similar contexts include: (i) ease of use, (ii) existing digital infrastructure to support electronic insurance systems, and (iii) trust manifested via data encryption, maintaining audit trails for all data, and in-built fraud prevention processes. Our findings affirm that digital health technology can play a role in the attainment of UHC in LMICs.
Distribution patterns of microplastics in subtidal sediments from the Sado river estuary and the Arrábida marine park, Portugal
Authors: Rodrigues Diana , Antunes Joana , Pais Joana , Pequeno João , Caetano Paulo Sá , Rocha Fernando , Sobral Paula , Costa Maria Helena 
Published: September 2022

Understanding local accumulation patterns of microplastics in subtidal sediments is crucial to assess how available such particles are for ingestion by benthic feeders and to identify the potential pollution sources in the region upon which is urgent to act. The coastal urban centers of Setúbal and Sesimbra (Portugal) and the multiple activities taking place at the contiguous Sado estuary and in the sheltered waters of Professor Luiz Saldanha Marine Park make this a relevant case study about MPs pollution in the seabed. Here, a short-term investigation assessed the spatiotemporal distribution, abundance, and composition of MPs on the nearshore seabed. Sediment samples were monthly collected from summer 2018 to winter 2019, in six stations. Despite the differences observed in rainfall between campaigns, no distinct patterns were detected in the accumulation of MPs throughout the sampled months. Yet, strong variations occurred among stations. The abundance of MPs in the Sado estuary (1042.8 ± 430.8 items kg−1) was higher in comparison to all the stations located along the marine park (52.9 ± 31.9 items kg−1). Fragments comprised 70% of particles found in estuarine sediments, while fibers were the predominant type in marine sediments. The majority of MPs collected in the estuary shared the same size class as the best represented grain size fraction: 0.250–0.500 mm. On average, the ratio between the abundance of MPs and the abundance of meiofauna organisms was higher in the estuary, suggesting more encounter rates, by both meiofauna and their predators, with MPs. The distribution of MPs throughout the study area was moderately correlated with sediment sorting and organic matter content. Also, the distinct mineralogical content of each station indicates a reduced sediment transit between stations and consequently a weak exportation of MPs from the estuary. The majority of the polymers identified by Fourier Transform Infrared Spectroscopy was denser than seawater. Polyethylene terephthalate represented 41% of the items analyzed and was mostly assigned to fibers and fiber bundles. Unveiling the distribution patterns of MPs along this segment of the Portuguese west coast enabled to identify a high-risk area where the implementation of preventive measures is urgent.
Characterization of the immune system of Ellegaard Göttingen Minipigs - An important large animal model in experimental medicine
Authors: Pernold Clara P.S. , Lagumdzic Emil , Stadler Maria , Mair Kerstin H. , Jäckel Sven , Schmitt Michael W. , Ladinig Andrea , Knecht Christian , Dürlinger Sophie , Kreutzmann Heinrich , Martin Vera , Sawyer Spencer , Saalmüller Armin 
Published: September 2022

Interest in Ellegaard Göttingen Minipigs (EGMs) as a model in experimental medicine is continuously growing. The aim of this project is to increase the knowledge of the immune system of EGMs as information is still scarce. Therefore, we studied the postnatal maturation of their immune system from birth until 126 weeks of age. For the first 26 weeks of the study, animals were kept under pathogen-reduced conditions (SPF) and afterwards under conventional housing conditions. The development of the immune system was analyzed by monitoring changes in total numbers of leukocytes and lymphocytes of ten individuals and the composition of leukocyte populations by multi-color flow cytometry (FCM). We followed the presence of monocytes using monoclonal antibodies (mAbs) against CD172a+and CD163+and B cells based on the expression of CD79a. NK cells were distinguished as CD3-CD16+CD8α+/dimcells and further subdivided using NKp46 (CD335) expression into NKp46-, NKp46+, and NKp46highNK cells. T-cell receptor (TCR) γδ T cells were defined by the expression of TCR-γδ and different subsets were determined by their CD2 and perforin expression. TCR-αβ T cells were classified by their CD8β+or CD4 expression. For monitoring their differentiation, expression of CD27 and perforin was investigated for CD8β++T cells and CD8α together with CD27 for CD4+T cells. We clearly detected a postnatal development of immune cell composition and identified phenotypes indicative of differentiation within the respective leukocyte subsets. Examination of the development of the antigen-specific immune system after transfer to different distinct housing conditions and after vaccination against common porcine pathogens such as porcine circovirus 2 (PCV2) revealed a markedly increased presence of more differentiated CD8+and CD4+T cells with central and effector memory T-cell phenotypes. To complement the findings, a PCV2 vaccine-specific antigen was used forin vitrorestimulation experiments. We demonstrated antigen-specific proliferation of CD4+CD8α+CD27+central and CD4+CD8α+CD27-effector memory T cells as well as antigen-specific production of TNF-α and IFN-γ. This study of postnatal immune development defines basic cellular immune parameters of EGMs and represents an important milestone for the use of EGMs for immunological questions in experimental medicine.
Impact of a sensory stimulation program conducted by family members on the consciousness and pain levels of ICU patients: A mixed method study
Authors: Adineh Mohammad , Elahi Nasrin , Molavynejad Shahram , Jahani Simin , Savaie Mohsen 
Published: September 2022

BackgroundThe results of several studies show the different effects of a balanced sensory stimulation program (SSP) on patients with brain injury admitted to the intensive care unit (ICU), but these effects have been less studied based on mixed and comprehensive methods.MethodThis mixed-method study involved 66 patients with brain injury admitted to the ICU who were allocated into intervention (n= 33) and control (n= 33) groups using random stratified sampling. Patients in the intervention group received a sensory stimulation program from family members for 1 h daily during ICU hospitalization, while the control group received only routine care. Patients' level of consciousness and pain intensity were measured immediately before and after the intervention using Glasgow Coma Scale (GCS) and Behavioral Pain Scale (BPS), respectively. In-depth unstructured interviews were conducted with the patients in the intervention group 3 months after discharge from the ICU. These interviews were analyzed following Graneheim and Lundman (2004) conventional content analysis method.ResultsA significant difference was found between the study groups in terms of the mean difference of GCS (P=0.001) and BPS score (P= 0.001) before and after intervention. Patients in the intervention group had a higher mean GCS and a lower mean BPS than did patients in the control group. The main themes extracted from the qualitative analysis confirmed the results obtained from the quantitative phase of the study.ConclusionThe combination of the quantitative and qualitative findings suggested that amidst the many hardships and sufferings brain injury patients go through in the ICU, a sensory stimulation program offered by family members may have many benefits such as increased level of consciousness and reduced pain for these patients. Therefore, it is necessary to formulate a framework for this program and provide the needed facilities in order to benefit more from the capacity of such programs for ICU patients.
Head-shaking-induced nystagmus reflects dynamic vestibular compensation: A 2-year follow-up study
Authors: Striteska Maja , Valis Martin , Chrobok Viktor , Profant Oliver , Califano Luigi , Syba Jaroslav , Trnkova Katerina , Kremlacek Jan , Chovanec Martin 
Published: September 2022

PurposeWe aimed to assess the ability of a head-shaking test (HST) to reflect vestibular compensation in patients after unilateral peripheral vestibular loss and to provide missing evidence and new insights into the features of head-shaking-induced nystagmus (HSN) over a 2-year follow-up.BackgroundHSN may occur after a prolonged sinusoidal oscillation of the head. HSN is frequently observed in subjects with vestibular function asymmetry; it usually beats toward the functionally intact or “stronger” ear and can be followed by a reversal of its direction.Study designA prospective observational case-control study.SettingsA tertiary academic referral center.MethodsA total of 38 patients after acute unilateral vestibular loss (22 patients with vestibular neuronitis and 16 patients after vestibular neurectomy) and 28 healthy controls were followed for four consecutive visits over a 2-year period. A complex vestibular assessment was performed on all participants, which included spontaneous nystagmus (SPN), the caloric test, the head-shaking test (HST), the video head impulse test (vHIT), the Timed Up and Go (TUG) test, and the Dizziness Handicap Inventory (DHI) questionnaire. We established the criteria for the poorly compensated group to assess different compensatory behaviors and results.ResultsWe found a time-related decrease in HSN (ρ &lt; −0.84, p &lt; 0.001) after unilateral vestibular loss. After 2 years of follow-up, HSN intensity in compensated patients reached the level of the control group; TUG and DHI also improved to normal; however, the caloric and vHIT tests remained abnormal throughout all follow-ups, indicating a chronic vestibular deficit. Besides, poorly compensated patients had a well-detectable HSN throughout all follow-ups; TUG remained abnormal, and DHI showed at least a moderate deficit.ConclusionsOur study showed that, after a unilateral peripheral vestibular loss, the intensity of HSN decreased exponentially over time, reflecting an improvement in dynamic ability and self-perceived deficit. HSN tended to decline to the value of the control group once vestibular compensation was satisfactory and sufficient for a patient's everyday life. In contrast, well-detectable HSN in poorly compensated patients with insufficient clinical recovery confirmed the potential of HSN to reflect and distinguish between adequate and insufficient dynamic compensation. HSN could serve as an objective indicator of stable unilateral vestibular loss.
Impact of type of oral anticoagulants in patients with cerebral microbleeds after atrial fibrillation-related ischemic stroke or TIA: Results of the NOACISP-LONGTERM registry
Authors: Wagner Benjamin , Hert Lisa , Polymeris Alexandros A. , Schaedelin Sabine , Lieb Johanna M. , Seiffge David J. , Traenka Christopher , Thilemann Sebastian , Fladt Joachim , Altersberger Valerian L. , Zietz Annaelle , Dittrich Tolga D. , Fisch Urs , Gensicke Henrik , De Marchis Gian Marco , Bonati Leo H. , Lyrer Philippe A. , Engelter Stefan T. , Peters Nils 
Published: September 2022

BackgroundCerebral microbleeds (CMBs) may have a differential impact on clinical outcome in stroke patients with atrial fibrillation (AF) treated with different types of oral anticoagulation (OAC).MethodsObservational single-center study on AF-stroke-patients treated with OAC. Magnetic-resonance-imaging was performed to assess CMBs. Outcome measures consisted of recurrent ischemic stroke (IS), intracranial hemorrhage (ICH), death, and their combined analysis. Functional disability was assessed by mRS. Using adjusted logistic regression and Cox proportional-hazards models, we assessed the association of the presence of CMBs and OAC type (vitamin K antagonists [VKAs] vs. direct oral anticoagulants [DOACs]) with clinical outcome.ResultsOf 310 AF-stroke patients treated with OAC [DOACs: n = 234 (75%); VKAs: n = 76 (25%)], CMBs were present in 86 (28%) patients; of these, 66 (77%) received DOACs. In both groups, CMBs were associated with an increased risk for the composite outcome: VKAs: HR 3.654 [1.614; 8.277]; p = 0.002; DOACs: HR 2.230 [1.233; 4.034]; p = 0.008. Patients with CMBs had ~50% higher absolute rates of the composite outcome compared to the overall cohort, with a comparable ratio between treatment groups [VKAs 13/20(65%) vs. DOACs 19/66(29%); p &lt; 0.01]. The VKA-group had a 2-fold higher IS [VKAs:4 (20%) vs. DOACs:6 (9%); p = 0.35] and a 10-fold higher ICH rate [VKAs: 3 (15%) vs. DOACs: 1 (1.5%); p = 0.038]. No significant interaction was observed between type of OAC and presence of CMBs. DOAC-patients showed a significantly better functional outcome (OR 0.40 [0.17; 0.94]; p = 0.04).ConclusionsIn AF-stroke patients treated with OAC, the presence of CMBs was associated with an unfavorable composite outcome for both VKAs and DOACs, with a higher risk for recurrent IS than for ICH. Strokes were numerically higher under VKAs and increased in the presence of CMBs.Clinical trial registrationhttp://www.clinicaltrials.gov, Unique identifier: NCT03826927.
Incidence of stroke in the first year after diagnosis of cancer—A systematic review and meta-analysis
Authors: Lun Ronda , Roy Danielle Carole , Hao Yu , Deka Rishi , Huang Wen-Kuan , Navi Babak B. , Siegal Deborah M. , Ramsay Tim , Fergusson Dean , Shorr Risa , Dowlatshahi Dar 
Published: September 2022

BackgroundPatients newly diagnosed with cancer represent a population at highest risk for stroke. The objective of this systematic review and meta-analysis was to estimate the incidence of stroke in the first year following a new diagnosis of cancer.MethodsWe searched MEDLINE and EMBASE from January 1980 to June 2021 for observational studies that enrolled adults with a new diagnosis of all cancers excluding non-melanoma skin cancer, and that reported the incidence of stroke at 1 year. PRISMA guidelines for meta-analyses were followed. Two reviewers independently extracted data and appraised risk of bias. We used the Dersimonian and Laird random effects method to pool cumulative incidences after logit transformation, and reported pooled proportions as percentages. Statistical heterogeneity was assessed using the I2 statistic.ResultsA total of 12,083 studies were screened; 41 studies were included for analysis. Data from 2,552,121 subjects with cancer were analyzed. The cumulative incidence of total stroke at 1 year was 1.4% (95% CI 0.9–2.2%), while the pooled incidence of ischemic stroke was 1.3% (95% CI 1.0–1.8%) and 0.3% (95% CI 0.1–0.9%) for spontaneous intracerebral hemorrhage (ICH), with consistently high statistical heterogeneity (&gt;99% I2).ConclusionThe estimated incidence of stroke during the first year after a new diagnosis of cancer is 1.4%, with a higher risk for ischemic stroke than ICH. Cancer patients should be educated on the risk of stroke at the time of diagnosis. Future studies should evaluate optimal primary prevention strategies in this high-risk group of patients.Systematic review registrationhttps://osf.io/ucwy9/.