bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors and outcomes in primary depression care (POKAL) – a research training group develops an innovative approach to collaborative care
Authors: Gensichen J , Lukaschek K , Jung-Sievers C , Falkai P , Schmitt A , Henningsen P , Dreischulte T , Pitschel-Walz G , Krcmar H , Böhm M , Prommegger B , Linde K , Drescher A , Schönweger P , Haas C , Brand C , Younesi P , Vukas J , Brisnik V , Schillok H , Raub J , Kaupe L , Biersack K , Gökce F , Eder J , Hattenkofer L , Reindl-Spanner Ph , von Schrottenberg V , Teusen C , Sterner Ph , Bühner M , Schneider A ,   for the POKAL group, Schillock Hannah , von Nessen-Lapp Regina Wehrstedt , Lochbühler Kirsten 
Published: December 2022

Abstract
Background
The interdisciplinary research training group (POKAL) aims to improve care for patients with depression and multimorbidity in primary care.
POKAL includes nine projects within the framework of the Chronic Care Model (CCM). In addition, POKAL will train young (mental) health professionals in research competences within primary care settings. POKAL will address specific challenges in diagnosis (reliability of diagnosis, ignoring suicidal risks), in treatment (insufficient patient involvement, highly fragmented care and inappropriate long-time anti-depressive medication) and in implementation of innovations (insufficient guideline adherence, use of irrelevant patient outcomes, ignoring relevant context factors) in primary depression care.

Methods
In 2021 POKAL started with a first group of 16 trainees in general practice (GPs), pharmacy, psychology, public health, informatics, etc. The program is scheduled for at least 6 years, so a second group of trainees starting in 2024 will also have three years of research-time. Experienced principal investigators (PIs) supervise all trainees in their specific projects. All projects refer to the CCM and focus on the diagnostic, therapeutic, and implementation challenges.

Results
The first cohort of the POKAL research training group will develop and test new depression-specific diagnostics (hermeneutical strategies, predicting models, screening for suicidal ideation), treatment (primary-care based psycho-education, modulating factors in depression monitoring, strategies of de-prescribing) and implementation in primary care (guideline implementation, use of patient-assessed data, identification of relevant context factors). Based on those results the second cohort of trainees and their PIs will run two major trials to proof innovations in primary care-based a) diagnostics and b) treatment for depression.

Conclusion
The research and training programme POKAL aims to provide appropriate approaches for depression diagnosis and treatment in primary care.
Regional differences regarding the occurrence of falls and associated factors in two populations of Brazilian longevous people
Authors: Silva Jaíza M. M. , da Silva Freitas Javanna Lacerda Gomes , Nóbrega Júlia Cristina Leite , Medeiros Juliana Barbosa , Simões Raisa Fernandes Mariz , Olinda Ricardo , de Ferreira Santos Jair Lício , de Oliveira Duarte Yeda Aparecida , Zatz Mayana , Matheson David , Santos Silvana , Menezes Tarciana Nobre 
Published: December 2022

AbstractBackgroundFew studies have explored regional asymmetries and their implications for health policies regarding episodes of falls among the population of ≥80 years old in continental and developing countries like Brazil with deep inequalities and sociocultural differences.ObjectiveTo evaluate the occurrence of falls and their association with functional capacity and nutritional status in the longest oldest-old living in two municipalities in the Northeast and Southeast of Brazil.MethodsThis is a cross-sectional study, with primary data collection in which were included in the research seniors aged 80 years or more, of both sexes, belonging to two Brazilian municipalities of discrepant socioeconomic aspects. The dependent variable was the occurrence of falls in the last year. The independent variables were grouped into demographic aspects, functional capacity and nutritional status. To identify variables that contribute to the occurrence of falls, the multiple logistic regression model, adopts a significance level of 5%.ResultsThe sample was composed of 415 oldest-old adults. From the total, 32.3% reported having fallen in the last year, 24.7% in Brejo dos Santos and 37.8% in São Paulo. Among the former population, the mean value of walking speed for those who had falls was 0.27 m/s and for those who had no occurrence of falls was 0.33 m/s; and, among the seniors from São Paulo, the mean values were 0.51 m/s and 0.58 m/s, respectively. Significant correlations between walking speed and falls were verified for both populations, showing that the lower the walking speed, the higher the predisposition to falls. In the final regression model, the occurrence of falls was associated with moderate balance (OR = 5.28; CI: 1.11–25.18) among the longevous people Brejo dos Santos and with very poor functional performance (OR = 16.09; CI:1.46–177.06) among those from São Paulo.ConclusionThe results pointed out a lower prevalence of falls in longevous people from Brejo dos Santos than in those from São Paulo and differences regarding the associated factors, showing heterogeneity between the two populations; indicating the need for public policies and effective programmes aimed at preventing falls based on the maintenance or increase of functional capacity.
Targeting integrated stress response with ISRIB combined with imatinib treatment attenuates RAS/RAF/MAPK and STAT5 signaling and eradicates chronic myeloid leukemia cells
Authors: Dudka Wioleta , Hoser Grazyna , Mondal Shamba S. , Turos-Korgul Laura , Swatler Julian , Kusio-Kobialka Monika , Wołczyk Magdalena , Klejman Agata , Brewinska-Olchowik Marta , Kominek Agata , Wiech Milena , Machnicki Marcin M. , Seferynska Ilona , Stoklosa Tomasz , Piwocka Katarzyna 
Published: December 2022

AbstractThe integrated stress response (ISR) facilitates cellular adaptation to unfavorable conditions by reprogramming the cellular response. ISR activation was reported in neurological disorders and solid tumors; however, the function of ISR and its role as a possible therapeutic target in hematological malignancies still remain largely unexplored. Previously, we showed that the ISR is activated in chronic myeloid leukemia (CML) cells and correlates with blastic transformation and tyrosine kinase inhibitor (TKI) resistance. Moreover, the ISR was additionally activated in response to imatinib as a type of protective internal signaling. Here, we show that ISR inhibition combined with imatinib treatment sensitized and more effectively eradicated leukemic cells both in vitro and in vivo compared to treatment with single agents. The combined treatment specifically inhibited the STAT5 and RAS/RAF/MEK/ERK pathways, which are recognized as drivers of resistance. Mechanistically, this drug combination attenuated both interacting signaling networks, leading to BCR-ABL1- and ISR-dependent STAT5 activation. Consequently, leukemia engraftment in patient-derived xenograft mice bearing CD34+ TKI-resistant CML blasts carrying PTPN11 mutation responsible for hyperactivation of the RAS/RAF/MAPK and JAK/STAT5 pathways was decreased upon double treatment. This correlated with the downregulation of genes related to the RAS/RAF/MAPK, JAK/STAT5 and stress response pathways and was associated with lower expression of STAT5-target genes regulating proliferation, viability and the stress response. Collectively, these findings highlight the effect of imatinib plus ISRIB in the eradication of leukemic cells resistant to TKIs and suggest potential clinical benefits for leukemia patients with TKI resistance related to RAS/RAF/MAPK or STAT5 signaling. We propose that personalized treatment based on the genetic selection of patients carrying mutations that cause overactivation of the targeted pathways and therefore make their sensitivity to such treatment probable should be considered as a possible future direction in leukemia treatment.
Magnitude and associated factors of delirium among patients attending emergency department at Jimma medical center, Jimma, southwest Ethiopia, 2022
Authors: Sileshy Bethelhem , Hailesilasiie Hailemariam , Tesfaye Yonas , Ababu Henok 
Published: December 2022

Abstract
Background
Delirium is a severe neuropsychiatric condition that occurs frequently in all medical settings. It has been associated to serious consequences like higher mortality, institutionalization, and longer hospital stays. Delirium is missed in emergency rooms in 57% to 83% of patients, despite its frequent incidence and detrimental repercussions.

Objectives
The purpose of this study was to determine the prevalence and contributing causes of delirium in patients who visited the emergency room at Jimma Medical Center in Jimma, southwest Ethiopia, in 2022.

Methods
From August 1 through September 30, 2022, a cross-sectional study was undertaken at a hospital. The study enrolled 422 participants, who were chosen through a systematic random sampling. The Richmond Agitation Sedation Scale (RASS) was used to evaluate different subtypes of delirium and level of arousal. The Confusion Assessment Method (CAM) was used to determine the presence or absence of delirium. Epi Data V3.1 was used to enter the data, and Version 20 of the Statistical Package for Social Scientists was used to export it (SPSS V20). Bivariate and multivariable logistic regressions were performed to identify the related factors. Variables with a p-value of less than 0.05 were considered to be significant.

Result
26.6% of participants (n = 107) were found to have delirium. Alcohol use (AOR = 3.6, 95% CI (2.5–8.1), visual impairment (AOR = 2.34, 95% CI (1.89–3.68), frequent admission (AOR = 3.47, 95% CI (1.24–7.34), bladder catheterization (AOR = 1.4, 95% CI (1.21–2.89), and benzodiazepine exposure (AOR = 1.5, 95% CI (1.01–2.3) had a significant association with delirium.

Conclusion
According to this study, delirium was very common among patients in the emergency room. Benzodiazepine exposure, numerous admissions, visual impairment, current alcohol consumption, bladder catheterization, and frequent admissions all significantly increased the risk of delirium. To address identifiable causes and enhance patients’ health outcomes, early recognition is crucial.
Sociodemographic and morbidity characteristics of people on long-term sick leave
Authors: Oancea Corina , Capraru Rodica Simona , Stanescu Ana Maria Alexandra , Gherman Despina Mihaela 
Published: December 2022

Abstract
Background
Certifying long-term sick leave and coordinating complex rehabilitation programs are essential activities of social insurance doctors. These doctors have a role in preventing the decreased work capacity of employees that may lead to leaving the labour market and the transition of these employees to other social insurance benefits, such as a work disability pension.

Objectives
Analysis of long-term sick leaves (over 183 days) to identify risk factors and population groups with low potential for work capacity rehabilitation.

Method
We conducted a cross-sectional study between September 2019 and September 2020. The information was collected from the National Institute of Medical Assessment and Work Capacity Rehabilitation Bucharest registers and the EXPMED application. The data were statistically analysed using PSPP software.

Results
The highest rehabilitation percentage was achieved in cases of traumatic injuries (73.17%), followed by musculoskeletal diseases (70.06%). We noticed lower recovery in cases of nervous system diseases (50.56%) and cardiovascular diseases (44.23%). In the group that summed up the other pathologies, the recovery percentage was 58.37%. People who regained their work capacity were significantly younger (mean age 47.87 y ± 8.93) than those who turned to other forms of social benefits, such as a disability pension or an old-age pension (mean age 53.16 y ± 8.43).

Conclusion
Most of the subjects (72%) regained their work capacity and did not need a disability pension. We identified the sociodemographic and morbidity characteristics of people on long-term sick leave along with target groups requiring intensive intervention measures.
Effect of aquatic physical therapy on chronic low back pain: a systematic review and meta-analysis
Authors: Ma Ji , Zhang Teng , He Yapeng , Li Xin , Chen Haoyang , Zhao Qian 
Published: December 2022

Abstract
Background
Chronic low back pain is a common musculoskeletal disease. With the increasing number of patients, it has become a huge economic and social burden. It is urgent to relieve the burden of patients. There are many common rehabilitation methods, and aquatic physical therapy is one of them. The purpose of this systematic review and meta-analysis is to summarize the existing literature and analyze the impact of aquatic physical therapy on pain intensity, quality of life and disability of patients with chronic low back pain.

Methods
Through 8 databases, we searched randomized controlled trials on the effect of aquatic physical therapy on patients with chronic low back pain. These trials published results on pain intensity, quality of life, and disability. This review is guided by Cochrane Handbook for systematic reviews of interventions version 5.1.0. The level of evidence was assessed through GRADE.

Results
A total of 13 articles involving 597 patients were included. The results showed that compared with the control group, aquatic physical therapy alleviated the pain intensity (Visual Analogue Scale: SMD = -0.68, 95%CI:-0.91 to -0.46, Z = 5.92, P < 0.00001) and improved quality of life (physical components of 36-Item Short Form Health Survey or Short-Form 12: SMD = 0.63, 95%CI:0.36 to 0.90, Ζ = 4.57, P < 0.00001; mental components of 36-Item Short Form Health Survey or Short-Form 12: SMD = 0.59, 95%CI:0.10 to 1.08, Ζ = 2.35, P = 0.02), and reduced disability (Roland Morris Disability Questionnaire: SMD = -0.42, 95%CI:-0.66 to -0.17, Ζ = 3.34, P = 0.0008; Oswestry Disability Index or Oswestry Low Back Pain Disability Questionnaire: SMD = -0.54, 95%CI:-1.07 to -0.01, Ζ = 1.99, P = 0.05). However, aquatic physical therapy did not improve patients' pain at rest (Visual Analogue Scale at rest: SMD = -0.60, 95%CI:-1.42 to 0.23, Ζ = 1.41, P = 0.16). We found very low or low evidence of effects of aquatic physical therapy on pain intensity, quality of life, and disability in patients with chronic low back pain compared with no aquatic physical therapy.

Conclusions
Our systematic review showed that aquatic physical therapy could benefit patients with chronic low back pain. However, because the articles included in this systematic review have high bias risk or are unclear, more high-quality randomized controlled trials are needed to verify.
State-wide implementation of patient-reported outcome measures (PROMs) in specialized outpatient palliative care teams (ELSAH): A mixed-methods evaluation and implications for their sustainable ﻿use
Authors: Seipp Hannah , Haasenritter Jörg , Hach Michaela , Becker Dorothée , Schütze Dania , Engler Jennifer , Bösner Stefan , Kuss Katrin 
Published: December 2022

AbstractBackgroundSuch patient-reported outcome measures (PROMs) and patient-centered outcome measures as the Integrated Palliative Care Outcome Scale (IPOS), Phase of Illness, and IPOS Views on Care (IPOS VoC), facilitate patient-centered care and help improve quality. To ensure sustainability, implementation and usage should be adapted according to setting. When settings involve several distinct teams that differ in terms of views and working practices, it is more difficult to integrate outcome measures into daily care. The ELSAH study aimed to learn how health professionals working in specialized outpatient palliative care (SOPC) viewed the use of these outcome measures in daily care, and what they express is needed for successful sustainable, state-wide application.MethodsWe used a parallel mixed-methods design involving three focus groups (n = 14) and an online-survey based on normalization process theory (n = 76). Most participants were nurses and physicians from 19 SOPC-teams in Hesse, Germany. We used a triangulation protocol including convergence coding matrices to triangulate findings.ResultsThe majority of health professionals were able to integrate the outcome measures into their working lives and said that it had become a normal part of their day-to-day work. To ensure their sustainable integration into daily care, the motivation and concerns of health professionals should be taken into consideration. Health professionals must clearly recognize how the measures help improve daily care and quality evaluation.ConclusionsTo implement the outcome measures in a number of teams, it will be necessary to take individual team characteristics into account, because they influence motivation and concerncs. Further, it will be necessary to offer opportunities for them to engage in peer support and share information with other teams. The sustainable use of outcome measures in SOPC will require continuous support within each team as well as across teams. When several distinct teams are working in the same setting, a cross-team coordination unit can help to coordinate their work efficiently.Trial registrationGerman Clinical Trials Register DRKS-ID: DRKS00012421;www.germanctr.de/DRKS00012421
Barriers to uptake of cervical cancer screening services in low-and-middle-income countries: a systematic review
Authors: Petersen Z. , Jaca A. , Ginindza T. G. , Maseko G. , Takatshana S. , Ndlovu P. , Zondi N. , Zungu N. , Varghese C. , Hunting G. , Parham G. , Simelela P. , Moyo S. 
Published: December 2022

AbstractObjectivesLow-and-middle-income countries (LMICs) bear a disproportionate burden of cervical cancer mortality. We aimed to identify what is currently known about barriers to cervical cancer screening among women in LMICs and propose remedial actions.DesignThis was a systematic review using Medical Subject Headings (MeSH) terms in Google Scholar, PubMed, Scopus, and Web of Science databases. We also contacted medical associations and universities for grey literature and checked reference lists of eligible articles for relevant literature published in English between 2010 and 2020. We summarized the findings using a descriptive narrative based on themes identified as levels of the social ecological model.SettingWe included studies conducted in LMICs published in English between 2010 and 2020.ParticipantsWe included studies that reported on barriers to cervical cancer screening among women 15 years and older, eligible for cervical cancer screening.ResultsSeventy-nine articles met the inclusion criteria. We identified individual, cultural/traditional and religious, societal, health system, and structural barriers to screening. Lack of knowledge and awareness of cervical cancer in general and of screening were the most frequent individual level barriers. Cultural/traditional and religious barriers included prohibition of screening and unsupportive partners and families, while social barriers were largely driven by community misconceptions. Health system barriers included policy and programmatic factors, and structural barriers were related to geography, education and cost. Underlying reasons for these barriers included limited information about cervical cancer and screening as a preventive strategy, poorly resourced health systems that lacked policies or implemented them poorly, generalised limited access to health services, and gender norms that deprioritize the health needs of women.ConclusionA wide range of barriers to screening were identified across most LMICs. Urgent implementation of clear policies supported by health system capacity for implementation, community wide advocacy and information dissemination, strengthening of policies that support women’s health and gender equality, and targeted further research are needed to effectively address the inequitable burden of cervical cancer in LMICs.
Trends and factors contributing to health facility delivery among adolescent women in Ethiopia: multivariate decomposition analysis
Authors: Gebeyehu Asaye Alamneh , Damtie Dejen Gedamu , Yenew Chalachew 
Published: December 2022

Abstract
Background
Although an increase in health facility delivery in Ethiopia over time, adolescent women giving birth at health facilities is still low. Health facility delivery is crucial to improving the health of women and their newborns' health by providing safe delivery services. We aimed to examine the trend change and identify factors contributing to health facility delivery in Ethiopia.

Methods
We analyzed the data on adolescent women obtained from three Ethiopian Demographic and Health Surveys. A total of weighted samples were 575 in 2005, 492 in 2011, and 378 in 2016. Data management and further statistical analysis were done using STATA 14. Trends and multivariate decomposition analysis were used to examine the trends in health facility delivery over time and the factors contributing to the change in health facility delivery.

Results
This study showed that the prevalence of health facility delivery among adolescent women in Ethiopia increased significantly from 4.6% (95% CI 3.2–6.7) in 2005 to 38.7% (95% CI 33.9–43.7) in 2016. Decomposition analysis revealed that around 78.4% of the total change in health facility delivery over time was due to the changes in the composition of adolescent women and approximately 21.6% was due to the changes in their behavior. In this study, maternal age, place of residency, wealth index, maternal education, frequency of ANC visits, number of living children, and region were significant factors contributing to an increase in health facility delivery over the study periods.

Conclusion
The prevalence of health facility delivery for adolescent women in Ethiopia has increased significantly over time. Approximately 78.4% increase in health facility delivery was due to adolescent women’s compositional changes. Public health interventions targeting rural residents and uneducated women would help to increase the prevalence of health facility delivery.