bluuebunny/crossref_metadata_2025_split huggingface dataset:
Demonstration experiment of telemedicine using ultrasonography and telerehabilitation with 5G communication system in aging and depopulated mountainous area
Authors: Saeki Masaomi , Oyama Shintaro , Yoneda Hidemasa , Shimoda Shingo , Agata Tsukasa , Handa Yutaka , Kaneda Satoshi , Hirata Hitoshi 
Published: October 2022

Objective The challenges of an aging population worldwide are the increased number of people needing medical and nursing care and inadequate medical resources. Information and communication technologies have progressed remarkably, leading to innovations in various areas. 5G communication systems are capable of high-capacity, high-speed communication with low latency and are expected to transform medicine. We aimed to report a demonstration experiment of telerehabilitation and telemedicine using a mobile ultrasound system in a depopulated area in a mountainous terrain, where 32% of the population are 65 years or older. Methods At the core hospital, a physician or physical therapist remotely performed ultrasonography or rehabilitation on a subject in a clinic. Five general residents participated in the telerehabilitation as subjects. The delay time and video quality transmitted with 5G and long-term evolution (LTE) communication systems were compared. The physician or physical therapist subjectively evaluated the quality and delay of the transmitted images and subject acceptability. Results Of seven physical therapists, six and three responded that the video quality was “good” for telerehabilitation with 5G/4K resolution and LTE, respectively. Five physical therapists and one physical therapist reported that the delay time was “acceptable” with 5G/4K resolution and LTE, respectively. For telemedicine using a mobile ultrasound system, the responses for 5G were “the delay was acceptable” and “rather acceptable.” In contrast, both respondents’ responses for LTE were “not acceptable.” Conclusions Multiple high-definition images can be transmitted with lower latency in telerehabilitation and telemedicine using mobile ultrasound imaging systems with a 5G communication system. These differences affected the subjective evaluation of the doctors and physical therapists.
An Observational Cross-Sectional Survey Exploring the Indications for and Responses to Medical Marijuana Use in Certified Patients in Pennsylvania
Authors: Kimless Debra , Caloura Matthew , Markos Virginia , Ryan Jennie , Abbonizio Sally , Janicki Sharon 
Published: October 2022

Introduction/Objectives: Medical cannabis programs across the country vary and differ in their qualifying conditions for medical cannabis use. This has led to a gap in knowledge regarding the specific needs of cannabis patients, including the most common reason patients seek medical cannabis. The purpose of this study was to examine the current needs of medical cannabis patients in order to better inform future research, and to evaluate potential needs in policy changes in states with more restrictive qualifying conditions for medical cannabis use. Methods: A cross-sectional survey study was administered (n = 207) at a Laurel Harvest Labs dispensary in Pennsylvania. Participants were qualified medical cannabis users and were recruited as a convenience sample when entering the dispensary. The survey asked questions regarding participant demographics, medical cannabis qualifying conditions, usage, methods of administration, adverse effects, tolerance, and impact of medical cannabis on medication, alcohol, and tobacco use. Chi-squared or Fisher’s exact tests were conducted for analyses involving categorical data. Results: The mean age of respondents was 36.7 years (SD = 12.8), and the majority were male (61.4%) and white (84.7%). Respondents self-reported that anxiety disorder was the most common qualifying medical condition and the most common comorbid condition (50.1%; 69.3%) for medical cannabis use. Additionally, approximately 95% of users reported having no adverse effects from using medical cannabis, and 90% of users preferred inhalation through vaporization as the preferred method of consumption. More than 50% of participants reported an improvement in their symptoms where only 20% of users reported being tolerant to their current dose. More than 70% of respondents reported that obtaining medical cannabis was “easy” and 54% of users reported that the cost of medical cannabis was not a barrier to access. Conclusions: Anxiety disorder is a prevalent condition for which medical cannabis is used; however, many states do not recognize anxiety disorder as a qualifying condition for medical cannabis. Further research on medical cannabis use for anxiety disorders is needed to evaluate proper dosing and responses to treatment.
Reported dietary habits and lifestyle behaviors of students before and during COVID-19 lockdown: A cross-sectional survey among university students from Ghana
Authors: Kanyiri Gaa Patience , Sulley Shafaw , Boahen Sylvia , Bogobiri Sumaya , Mogre Victor 
Published: October 2022

Background: COVID-19 lockdowns involved precautions and social rules that resulted in drastic changes to daily life activities in every setting. University students were not left out as their education was affected and they had to resort to online learning from their homes. The lockdowns did not only affect their education but also potentially affected their dietary habits and lifestyle behaviors. We evaluated the reported dietary habits and lifestyle behaviors of students from a Ghanaian University before and during the COVID-19 lockdown. Materials and Methods: Following a cross-sectional design, 220 students were recruited from the University for Development Studies in Ghana. Data was collected by means of an online questionnaire. Chi-square test ( χ2) analysis was used to examine associations among variables. Results: About 59% of the students skipped meals before COVID-19 whereas 47.8% skipped meals during the COVID-19 lockdown. While 64.1% consumed homemade meals before the COVID-19, 82.3% consumed homemade meals during the COVID-19 lockdown. In addition, there was a significant increase in the consumption of homemade food ( p < 0.001), level of healthy foods choices ( p = 0.029), and a reduced skipping of meals (0.014) during the COVID-19 lockdown. Again, 56.4% of the students engaged in exercise before the lockdown while 45% participated in exercise during the lockdown. Conclusions: The lockdown had an impact on some of the dietary and lifestyle habits of the students. University students should be supported with appropriate nutrition education and counseling programs to help them adopt healthy dietary and lifestyle habits.
1-year mortality in lung cancer in France according to key timepoints of care pathways
Authors: Rivière Axelle , Lecuyer Anne Isabelle , Laurent Emeline , Lefebvre Carole , Lecomte Thierry , Olivier Elodie , Carmier Delphine , Plantier Laurent , Grammatico-Guillon Leslie 
Published: October 2022

BackgroundIt is unclear whether delays in care affect prognosis of patients with lung cancer. The primary objective of this study was to describe the care pathway of patients diagnosed with lung cancer in a French region. Secondary objectives were to identify markers associated with 1) time from imaging to treatment and 2) with 1-year survival.MethodsIn a retrospective cohort study, clinical data from multidisciplinary team meetings for all incident lung cancer cases discussed in 2018 in one French region were matched with medico-administrative data from the National Health Insurance Database. Care pathway time intervals were estimated for small cell lung cancer (SCLC), resected nonsmall cell lung cancer (NSCLC) and unresected NSCLC. Factors associated with delay in the care pathway were identified using linear regression; 1-year survival was analysed using Cox modelling.ResultsA total of 685 patients were included. Median time between imaging and treatment was 49 days (interquartile range: 33–73), and was lower in cases of metastatic disease, SCLC and private care. At 1 year, 48% had died (resected NSCLC 12%). In unresected NSCLC, time from diagnostic imaging to first treatment <49 days was associated with a higher risk of death. Time intervals were similar in patients with squamous cell carcinomaversusadenocarcinoma or undifferentiated carcinoma.DiscussionTime intervals in the care pathways of lung cancer were similar to previous reports, confirming the robustness of retrospective databases. In unresectable NSCLC, rapid care was not associated with better survival.
Multidisciplinary rehabilitation in intensive care for COVID-19: randomised controlled trial
Authors: Carvalho Ana Cristina , Moreira Jorge , Cubelo Pedro , Cantista Pedro , Aguiar Branco Catarina , Guimarães Bruno 
Published: October 2022

Coronavirus disease 2019 (COVID-19) has led to an increasing number of patients in intensive care units (ICUs). The size of this post-ICU cohort will be unprecedented, with many patients vulnerable to post-intensive care syndrome. We analysed the respiratory and functional effects of a multidisciplinary rehabilitation programme on functional performance, in patients hospitalised in the ICU due to COVID-19.We conducted a randomised controlled clinical trial. 96 patients who fulfilled the eligibility criteria were randomised into control or intervention group. The control group received standard of care in the ICU, and the intervention group received a functional and respiratory rehabilitation protocol that included medical, nursing, physiotherapy and occupational therapy interventions.At discharge, the intervention group showed significantly better muscular strength and respiratory capacity, and significantly fewer days of hospitalisation (12.90±5.8versus15.60±6.7 days, p=0.037). At the 4- and 12-week follow-up, we applied our main outcome measure, the 6-min walk test (6MWT). The intervention group had significantly better results than the control group on the 6MWT at the 4-week follow-up (604±67versus571±57 m, p=0.018) and at the 12-week follow-up (639±53versus611±67 m, p=0.025).These results support the role of a multidisciplinary rehabilitation programme in COVID-19 patients hospitalised in the ICU and adds evidence that the implementation of rehabilitation programmes in ICUs could result in beneficial outcomes for critically ill patients.
Neighbourhood disadvantage impacts on pulmonary function in patients with sarcoidosis
Authors: Goobie Gillian C. , Ryerson Christopher J. , Johannson Kerri A. , Keil Spencer , Schikowski Erin , Khalil Nasreen , Marcoux Veronica , Assayag Deborah , Manganas Hélène , Fisher Jolene H. , Kolb Martin R.J. , Chen Xiaoping , Gibson Kevin F. , Kass Daniel J. , Zhang Yingze , Lindell Kathleen O. , Nouraie S. Mehdi 
Published: October 2022

BackgroundThis multicentre, international, prospective cohort study evaluated whether patients with pulmonary sarcoidosis living in neighbourhoods with greater material and social disadvantage experience worse clinical outcomes.MethodsThe area deprivation index and the Canadian Index of Multiple Deprivation evaluate neighbourhood-level disadvantage in the US and Canada, with higher scores reflecting greater disadvantage. Multivariable linear regression evaluated associations of disadvantage with baseline forced vital capacity (FVC) or diffusing capacity of the lung for carbon monoxide (DLCO) and linear mixed effects models for associations with rate of FVC orDLCOdecline, and competing hazards models were used for survival analyses in the US cohort, evaluating competing outcomes of death or lung transplantation. Adjustments were made for age at diagnosis, sex, race and smoking history.ResultsWe included 477 US and 122 Canadian patients with sarcoidosis. Higher disadvantage was not associated with survival or baseline FVC. The highest disadvantage quartile was associated with lower baselineDLCOin the US cohort (β = −6.80, 95% CI −13.16 to −0.44, p=0.04), with similar findings in the Canadian cohort (β = −7.47, 95% CI −20.28 to 5.33, p=0.25); with more rapid decline in FVC andDLCOin the US cohort (FVC β = −0.40, 95% CI −0.70 to −0.11, p=0.007;DLCOβ = −0.59, 95% CI −0.95 to −0.23, p=0.001); and with more rapid FVC decline in the Canadian cohort (FVC β = −0.80, 95% CI −1.37 to −0.24, p=0.003).ConclusionPatients with sarcoidosis living in high disadvantage neighbourhoods experience worse baseline lung function and more rapid lung function decline, highlighting the need for better understanding of how neighbourhood-level factors impact individual patient outcomes.
Estimating the effect size of a hidden causal factor between SNPs and a continuous trait: a mediation model approach
Authors: Ding Zhuoran , Ritchie Marylyn D. , Voight Benjamin F. , Hwang Wei-Ting 
Published: October 2022

Abstract
Background
Observational studies and Mendelian randomization experiments have been used to identify many causal factors for complex traits in humans. Given a set of causal factors, it is important to understand the extent to which these causal factors explain some, all, or none of the genetic heritability, as measured by single-nucleotide polymorphisms (SNPs) that are associated with the trait. Using the mediation model framework with SNPs as the exposure, a trait of interest as the outcome, and the known causal factors as the mediators, we hypothesize that any unexplained association between the SNPs and the outcome trait is mediated by an additional unobserved, hidden causal factor.

Results
We propose a method to infer the effect size of this hidden mediating causal factor on the outcome trait by utilizing the estimated associations between a continuous outcome trait, the known causal factors, and the SNPs. The proposed method consists of three steps and, in the end, implements Markov chain Monte Carlo to obtain a posterior distribution for the effect size of the hidden mediator. We evaluate our proposed method via extensive simulations and show that when model assumptions hold, our method estimates the effect size of the hidden mediator well and controls type I error rate if the hidden mediator does not exist. In addition, we apply the method to the UK Biobank data and estimate parameters for a potential hidden mediator for waist-hip ratio beyond body mass index (BMI), and find that the hidden mediator has a large effect size relatively to the effect size of the known mediator BMI.

Conclusions
We develop a framework to infer the effect of potential, hidden mediators influencing complex traits. This framework can be used to place boundaries on unexplained risk factors contributing to complex traits.
Differential associations between simple physical performance tests with global and specific cognitive functions in cognitively normal and mild cognitive impairment: a cross-sectional cohort study of Asian community-dwelling older adults
Authors: Ng Ted Kheng Siang , Han Madeline Fu Yun , Loh Ping Yeap , Kua Ee Heok , Yu Junhong , Best John R. , Mahendran Rathi 
Published: October 2022

Abstract
Background
Physical performance declines and executive dysfunctions are predictors of dementia. However, their associations are not well understood in Asian older adults without dementia (cognitively normal [CN] and mild cognitive impairment [MCI]), especially in a single study.

Objective
Examine the associations between physical performance measures with executive function (EF)-based and non-EF-based neurocognitive tests and whether preclinical dementia cognitive status i.e., CN and MCI, moderated these associations.

Methods
We examined cross-sectional cohort of 716 community-dwelling older adults without dementia (CN = 562 and MCI = 154) using multivariable linear regression models. We associated three simple physical performance measures, namely timed-up-and-go (TUG), fast gait speed (FGS), and 30-s chair stand test (30 s-CST), with a comprehensive neurocognitive test battery measuring EF and non-EF cognitive functions. Moderating effects of cognitive status on the associations were examined. In all models, we controlled for pertinent covariates, including age, education, medical and psychiatric status.

Results
Upon controlling for covariates, TUG was most strongly and positively associated with multiple EF-based neurocognitive tests, followed by FGS, with 30 s-CST having the weakest associations. For all physical performance measures, no significant associations with non-EF-based neurocognitive tests were detected. Cognitive status significantly moderated the associations between all physical measures and several neurocognitive tests, with stronger associations in the MCI than CN.

Conclusion
Compared to FGS and 30 s-CST, TUG had the most robust associations with multiple EF-based cognitive functions. Given their differential associations with global and detailed neurocognitive tests and significant moderating effects of cognitive status, findings highlight a need to carefully consider the choices of simple physical performance tests when using these tests with a heterogenous group of community-dwelling older adults without dementia.
Feasibility, acceptability, and preliminary effectiveness of the adapted Namaste Care program delivered by caregivers of community-dwelling older persons with moderate to advanced dementia: a mixed methods feasibility study
Authors: Yous Marie-Lee , Ploeg Jenny , Kaasalainen Sharon , McAiney Carrie , Fisher Kathryn 
Published: October 2022

Abstract
Background
Caregivers have considerable responsibilities in supporting persons in advanced stages of dementia, however they receive little education. Namaste Care is a multisensory program originally designed to be delivered by healthcare providers in long-term care homes for persons with advanced dementia. The program has not yet been adapted and evaluated for use by caregivers of persons with moderate to advanced dementia living at home. The purpose of this feasibility study is to determine the feasibility, acceptability and preliminary effectiveness of the adapted Namaste Care program for use by caregivers of community-dwelling older persons with moderate to advanced dementia.

Methods
This feasibility study, with a one-group before-after design and interviews, was part of a larger study using a multiphase mixed methods design. A total of 12 caregivers delivered the program over three months. Caregivers completed questionnaires on caregiver quality of life, perceptions of caregiving, self-efficacy, and burden at baseline and 3-month follow-up. Caregivers participated in interviews at the 3-month follow-up to explore acceptability and perceived benefit. Descriptive statistics and paired t-tests were used to analyze quantitative data. A secondary analysis used multiple imputation to explore the impact of missing data. Experiential thematic analysis was used in analyzing qualitative data.

Results
The adapted Namaste Care program was judged to be feasible, given that all caregivers used it at least twice a week over the 3-month period. The retention rate of caregivers was 83% (10 of 12). Caregivers perceived that the program was practical, enhanced the wellbeing of persons with dementia, and brought them closer in their relationships with persons with dementia. There were no statistically significant changes for quality of life, perceptions of caregiving, self-efficacy, or burden outcomes. Multiple imputation results revealed promising findings for an improvement in caregiver wellbeing related to quality of life.

Conclusions
The adapted Namaste Care program for use by caregivers of community-dwelling older persons with moderate to advanced dementia was feasible and acceptable. The program has the potential to enhance the quality of life and other outcomes of caregivers, however there is a need to conduct a larger trial that is adequately powered to detect these effects.
Rusty pipe syndrome: a case report and review of the literature
Authors: Tang Huanna , Zhu Wenting , Chen Jianpeng , Zhang Dan 
Published: October 2022

Abstract
Background
Painless bloody nipple discharge is often classified as pathological due to its association with malignant lesions. However, it can also be a completely harmless condition. Rusty pipe syndrome is a rare cause of benign, self-limiting bloody nipple discharge during late pregnancy and early lactation. Given that rusty pipe syndrome is not described in conventional textbooks, we thought it would be appropriate to bring this benign disease to the notice of readers.

Case presentation
A 31-year-old G1P1 female delivered an infant with a birth weight of 3000 g via cesarean section at 39 weeks of gestation. The baby was admitted to the pediatric intensive care unit for a suspected oblique inguinal hernia. The mother had bilateral painless bloody nipple discharge when she started to express milk. A physical examination uncovered no signs of inflammation, engorgement, palpable mass, tenderness, cracks or ulcers. A breast ultrasound and cytological analysis revealed no signs of a neoplasm. Without any medical intervention, the color of the rusty milk changed from dark brown to light brown during hospitalization and finally resolved six days postpartum.

Conclusion
Rusty pipe syndrome is a self-limiting benign condition that should be considered in the differential diagnosis of bloody nipple discharge. Awareness of this rare disease by medical professionals would be extremely beneficial for avoiding unneeded examinations and discontinuity of exclusive breastfeeding.
A dyadic survey study of partner engagement in and patient receipt of guideline-recommended colorectal cancer surveillance
Authors: Veenstra Christine M. , Ellis Katrina R. , Abrahamse Paul , Ward Kevin C. , Morris Arden M. , Hawley Sarah T. 
Published: October 2022

Abstract
Background
We investigated whether partner (spouse or intimate partner) engagement in colorectal cancer (CRC) surveillance is associated with patient receipt of surveillance.

Methods
From 2019 to 2020 we surveyed Stage III CRC survivors diagnosed 2014–2018 at an academic cancer center, a community oncology practice and the Georgia SEER registry, and their partners. Partner engagement was measured across 3 domains: Informed about; Involved in; and Aware of patient preferences around surveillance. We evaluated bivariate associations between domains of partner engagement and independent partner variables. Analysis of variance and multivariable logistic regression were used to compare domains of engagement with patient-reported receipt of surveillance.

Results
501 patients responded (51% response rate); 428 had partners. 311 partners responded (73% response rate). Partners were engaged across all domains. Engagement varied by sociodemographics. Greater partner involvement was associated with decreased odds of receipt of composite surveillance (OR 0.67, 95% CI 0.48–0.93) and trended towards significance for decreased odds of receipt of endoscopy (OR 0.60, 95% CI 0.34–1.03) and CEA (OR 0.75, 95% CI 0.55–1.04). Greater partner awareness was associated with increased odds of patients’ receipt of endoscopy (OR 2.18, 95% CI 1.15–4.12) and trended towards significance for increased odds of receipt of composite surveillance (OR 1.30, 95% CI 0.91–2.04).

Conclusion
Partners are engaged (informed, involved, and aware) in CRC surveillance. Future research to develop dyadic interventions that capitalize on the positive aspects of partner engagement may help partners effectively engage in surveillance to improve patient care.