bluuebunny/crossref_metadata_2025 huggingface dataset:
Medication Assisted Recovery: A Social Ecological Approach to Understanding How Stigma Shapes Effective Use
Authors: Fry Melissa S. , Shircliff Katie , Benham Mariah , Duncan Tessa , Ladd Kevin , Gilbert Misty Kannapel , Rattermann Mary Jo , Cyders Melissa A.
Published: April 2023

Stigma is a well-documented barrier to effective individual and community response to mental illness and, in recent years, is a recognized impediment to prevention and treatment of substance use disorders (SUDs). This study uses focus group data to explore stigmatizing views of medication assisted recovery (MAR) among those in recovery and the people, organizations, and communities that surround them, with attention to implications for long-term recovery. Across groups, we find consistent themes that MAR simply trades one drug for another, MAR should be used only as a stepping-stone to full abstinence, and that long-term use of MAR indicates ineffectiveness or treatment failure. Data suggest the prevalence of these perceptions leads those in recovery and providers to see MAR as a last resort treatment, encourages individuals to discontinue MAR before they are ready, and as result increases risk of relapse and overdose.
Analyzing communication skills of Dentistry Post Graduate Residents with Geriatric Patients in Clinical Encounter by using Video Recordings
Authors: Zafar Raja Hina , Kamran Rizwana , Farid Muhammad , Saleem Muhammad Nasir , Mumtaz Maryam , Tufail Shazia , Sarfaraz Khan Junaid
Published: April 2023

Background:

An effective communication between the doctor and patient is the foremost factor in establishing good interpersonal relationships. This comprises of both verbal and non-verbal communicators. Particularly in the geriatric population, communication can be hindered due to physiological and psychological deterioration. This study was designed to assess the communication skills of dentistry postgraduate residents (PGRs), with their geriatric patients and provide a baseline for the shortcomings and improvements.

Methods:

Four postgraduate residents of both genders were selected to take clinical interviews of geriatric patients. Audio-video recordings were made by an expert and reviewed by all researchers. The interviews were transcribed individually and thematic analysis was done. Open and axial coding was done for data organization under themes and subthemes.

Results:

Data transcription led to initial generation of 61 codes. These codes were categorized under nine codes through axial coding and grouping of similar codes. Persistent overlapping of content was found in data transcription, which may indicate data saturation.

Conclusion:

Workshop-trained postgraduate students of dentistry demonstrated relatively instrumental communication skills at their clinical encounter with geriatric patients. However, the professional demeanor demands further finesse in soft skills, which can be achieved through its regular practice.
“Spiritually Dynamic but Ecclesially Deviant”: African Immigrant Christianity and New Ecumenical Terrain in the West
Authors: Krabill Matthew J.
Published: April 2023

This article argues that the presence of African immigrant Christianity in the West presents a critical, yet largely overlooked and unexplored arena for exploring ecumenical relations. The article draws on research among African immigrant Mennonites in the US and contends that their presence in homegrown Mennonite spaces poses unprecedented challenges and opportunities to the potential for shared ecclesial life. The article identifies and assesses several key challenges and areas of misalignment and argues that from the African immigrant perspective, the encounter with homegrown Christianity proves to be one of its formidable and intractable ecclesial challenges.
New Generations, New Mission: Intergenerational Faith Transmission and the Missionary Function of African Immigrant Faith Communities
Authors: Norton Allison L. , Nyanni Caleb Opoku
Published: April 2023

In the last decade, African-led churches in North America and Europe have seen tremendous growth due to the growing number of second- and third-generation children who are now coming of age. Utilizing perspectives from the United States and the United Kingdom, this article explores the intersection of two related concerns: (1) the transmission of faith across generations, and (2) evangelism that crosses racial, ethnic, and national boundaries. As such, we utilize a mixed-method approach to explore innovation and evangelism as the next generation creates spaces of their own within their intergenerational congregations.
Sensing weather and climate: Phenomenological and ethnographic approaches
Authors: Hepach Maximilian Gregor , Lüder Catharina
Published: April 2023

In light of the increasing tendency to view extreme weather events as experiences of climate change, we revisit how weather and climate are measured and experienced, contributing to an ongoing dialogue on the atmospheric between phenomenology, media studies and geography. We make use of and complicate the concept of sensing to make sense of the heterogeneous modes of experiencing and measuring weather. First, we detail the history and phenomenology of weather between experience and measurement. Providing evidence for our theoretical account, we go through two ethnographic examples of weather-sensing, looking at the work of meteorologists and a weather-machine. From weather-sensing, we extrapolate the possibility of climate-sensing to aid in the comprehension of climate change. Sensing, we conclude, promises to reconnect weather and climate, the measured and experienced, the proximate and remote, the bodily and abstract.
CNMNC guidelines for the nomenclature of polymorphs and polysomes
Authors: Hatert Frédéric , Mills Stuart J. , Pasero Marco , Miyawaki Ritsuro , Bosi Ferdinando
Published: April 2023

New guidelines for the nomenclature of polymorphs and polysomes have been approved by the the Commission on New Minerals, Nomenclature and Classification of the International Mineralogical Association (IMA–CNMNC). Several cases can be distinguished. (i) Polymorphs with different crystal systems are distinguished by the prefixes cubo- (cubic), hexa- (hexagonal), tetra- (tetragonal), trigo- (trigonal), ortho- (orthorhombic), clino- (monoclinic) and anortho- (triclinic). (ii) Polymorphs with different crystal systems but showing a pseudosymmetry should show the prefix ‘pseudo-’. (iii) Polymorphs with the same crystal system but different space groups are distinguished by the prefix ‘para-’. If three or more polymorphs show the same crystal system but different space groups, the space group notation may be added as a suffix, though such a nomenclature should be avoided if possible. (iv) Polymorphs with the same space group are distinguished by the prefix ‘para-’. (v) Minerals with polymorph suffixes but with different chemical compositions cannot be considered as true polymorphs, so we recommend using the prefix ‘meta-’, which indicates a close but significantly different chemical composition. (vi) Polysomatic symbols should be placed as a suffix, which indicates the number and types of modules that alternate in the structure, such as in the högbomite supergroup, or as prefixes as in the sartorite homologous series. These recommendations have to be applied for future new mineral proposals, when the authors decide to use structural prefixes or suffixes, however modifications of historical and well-established names have to pass through the CNMNC for approval. In order to be consistent with the new guidelines, 25 mineral names are now modified: domeykite-β becomes trigodomeykite; fergusonite-(Y)-β becomes clinofergusonite-(Y); fergusonite-(Ce)-β becomes clinofergusonite-(Ce); fergusonite-(Nd)-β becomes clinofergusonite-(Nd); ice-VII becomes cubo-ice; roselite-β becomes anorthoroselite; sulphur-β becomes clinosulphur; mertieite-II becomes mertieite; mertieite-I becomes pseudomertieite; uranophane-α becomes uranophane; uranophane-β becomes parauranophane; gersdorffite-P213 becomes gersdorffite; gersdorffite-Pa3 becomes paragersdorffite; gersdorffite-Pca21 becomes orthogersdorffite; betalomonosovite becomes paralomonosovite; lammerite-β becomes paralammerite; nováčekite-I becomes hydronováčekite; nováčekite-II becomes nováčekite; halloysite-7Å becomes halloysite; halloysite-10Å becomes hydrohalloysite; metauranocircite-I becomes metauranocircite; taimyrite-I becomes taimyrite; uranocircite-II becomes uranocircite; andorite IV becomes quatrandorite; and andorite VI becomes senandorite.
Tuberculosis: current challenges and beyond
Authors: Villar-Hernández Raquel , Ghodousi Arash , Konstantynovska Olha , Duarte Raquel , Lange Christoph , Raviglione Mario
Published: April 2023

Despite being a preventable and curable disease, tuberculosis (TB) is still a major global health threat and the second leading cause of death due to an infectious agent worldwide. All the efforts invested to end TB have resulted overall in rather slow decreases in TB incidence and mortality rates, which have been further negatively affected by the ongoing coronavirus disease 2019 (COVID-19) pandemic. While the majority of targets of the End TB Strategy remain off track, and we have not yet overcome the disruptions caused by the COVID-19 pandemic, recent conflicts such as the ongoing war in Ukraine are threatening the decrease of the burden of TB even further. To get back on track and get closer to ending TB, we need urgent, global, well-structured and committed multi-sectoral actions that go beyond national and global TB programmes with the support of deep investments in research and facilitation of equitable and rapid implementation of innovation worldwide.
Time Synchronous Averaging Based on Cross-power Spectrum
Authors: Wang Ling , Hu Minghui , Ma Bo , Jiang Zhinong
Published: April 2023

Periodic components are of great significance for fault diagnosis and health monitoring of rotating machinery. Time synchronous averaging is an effective and convenient technique for extracting those components. However, the performance of time synchronous averaging is seriously limited when the separate segments are poorly synchronized. This paper proposes a new averaging method capable of extracting periodic components without external reference and an accurate period to solve this problem. With this approach, phase detection and compensation eliminate all segments' phase differences, which enables the segments to be well synchronized. The effectiveness of the proposed method is validated by numerical and experimental signals.
Migraine symptoms, healthcare resources utilization and disease burden in a large Polish migraine cohort
Authors: Waliszewska-Prosół Marta , Straburzyński Marcin , Czapińska-Ciepiela Ewa K. , Nowaczewska Magdalena , Gryglas-Dworak Anna , Budrewicz Sławomir
Published: April 2023

Background

The Migraine in Poland study is the first large scale nationwide cross-sectional online survey of symptoms, approaches to management, treatment patterns, quality of life, and sociodemographic characteristics of the Polish migraine patients’ cohort, conducted from August 2021 to June 2022.

Methods

A cross-sectional online survey was designed based on the American Migraine Prevalence and Prevention (AMPP) Study. Participants were recruited through broad advertisement through various channels. The survey included questions allowing for the diagnosis of migraine without aura (MwoA) based on the third edition of the International Classification of Headache Disorders (ICHD-3). Moreover, the questionnaire assessed sociodemographic and headache features, comorbidities, consultation rates with medical professionals, as well as the use of abortive or preventive treatment, including non-pharmacological methods, psychological symptoms and the burden of migraine.

Results

A structured online questionnaire was submitted by 3225 respondents aged 13 to 80 (mean age 38.9, 87.1% women). In this group 1679 (52.7%) of participants fulfilled ICHD-3 diagnostic criteria for MwoA, which was in most cases (88.3%) confirmed by a medical professional in the past. In this group the average number of monthly headache days was 4.7, while 47.8% of participants had at least 4 migraine days per month. Mean Migraine Disability Assessment score was 42.65 (median 32).

Among MwoA respondents, 1571 (93.6%) had consulted their headache with a medical professional in the past – mostly neurologists (n = 1450 (83.4%) and primary care physicians (n = 1393 (82.9%). In the MwoA cohort, 1553 (92.5%) of participants declared the current use of some form of treatment, although only 193 (11.5%) respondents were currently on preventive medications. The most prevalent comorbidities included: chronic rhinitis (37.1%), allergies (35.9%) and low blood pressure (26.9%). Anxiety (20.4%) and depression (21.3%) were highly prevalent among participants.

Conclusions

People with migraine in Poland face similar difficulties as their peers in other countries. Despite relatively high access to neurologist consultations and good diagnosis accuracy, migraine still poses diagnostic and therapeutic difficulties. In this context, migraine undertreatment in Polish population must be underlined, especially in context of high disease burden.
Current patterns of care at adult emergency department in Ethiopian tertiary university hospital
Authors: Tarkie Kibur , Altaye Kassaye Demeke , Berhe Yophtahe Woldegerima
Published: April 2023

Background

The complexity and demands of emergency healthcare service are continuously increasing, and it is important to regularly track the patterns of care at the emergency department (ED).

Methodology

A retrospective study was conducted at the ED of the University of Gondar Comprehensive Specialized Hospital (UoGCSH) from April 1 to June 30, 2021. Ethical approval was obtained from the Emergency and Critical Care Directorate of UoGCSH. Data was collected from the emergency registry and descriptive analysis was performed.

Results

A total of 5232 patients have visited and triaged at the ED. All patients who visited the ED have received triage service within 5 min of arrival. The average length of stay at the ED was 3 days. About 79.1% of patients have stayed at the ED beyond 24 h, and the unavailability of beds at admission areas was responsible for 62% of delays. Mortality rate at the ED was 1.4%, and male to female ratio of death was 1.2 to 1. Shock (all types combined), pneumonia with/without COVID-19, and poisoning were the leading causes of death at the ED which were responsible for 32.5%, 15.5%, and 12.7% of deaths respectively.

Conclusions

Triage has been done within the recommended time after patient arrival. However, many patients were staying at the ED for an unacceptably prolonged time. Unavailability of beds at the admission areas, waiting long for senior clinicians’ decisions, delays in investigation results, and lack of medical equipment were the causes of delayed discharge from the ED. Shock, pneumonia, and poisoning were the leading causes of death. Healthcare administrators should address the lack of medical resources, and clinicians should provide timely clinical decision and investigation results.
A novel inflammatory marker for extensive ulcerative colitis; Endocan
Authors: Albayrak Bulent , Sebin Engin
Published: April 2023

Background & aims

Ulcerative colitis (UC) is an inflammatory bowel disease characterized by mucosal inflammation. Endocan, a proteoglycan secreted by endothelial cells in response to inflammatory cytokines, has been reported to be overexpressed in inflammatory conditions. In this study, we aimed to evaluate the utility of endocan level in determining the extent and severity of disease in patients with ulcerative colitis and to determine whether it can be a candidate marker for noninvasive evaluation and monitoring since there is not enough data in the literature.

Materials and methods

Sixty-five people were included in the study, including thirty-five with ulcerative colitis and thirty in the control group. Patients with first diagnosed ulcerative colitis clinically, endoscopically, and histopathologically, without any treatment, and with normal liver and kidney tests were included in the study. Endoscopic scoring of all patients was performed according to the Mayo endoscopic scoring (MES) system. Blood samples for CRP (C-reactive protein) and endocan were taken from the patients simultaneously.

Results

There was a significant statistical difference between all patients with ulcerative colitis and the control group in both endocan level and CRP level (p < 0.001). There was a statistically significant difference between endocan levels and CRP levels between the left-distal group and pancolitis (diffuse colitis) patients, but there was no statistical difference between age and MES.

Conclusion

Serum endocan level can be useful in determining the extent of ulcerative colitis and planning treatment.
Seizure semiology and predictors of outcomes in Chinese patients with glutamic acid decarboxylase antibody-associated neurological syndrome
Authors: Lin Nan , Bai Lin , Liu Qing , Chen Jianhua , Ren Haitao , Guan Hongzhi , Lu Qiang
Published: April 2023

Background

In the current study, seizure semiology and potential predictive factors of seizure outcomes in glutamic acid decarboxylase antibody (GAD Ab)-associated neurological syndrome were investigated.

Methods

In this study, 32 Chinese patients with GAD Ab-associated neurological syndrome who presented with seizures at Peking Union Medical College Hospital from January 2017 to October 2022 were reviewed; 30 had a follow-up duration of more than 1 year.

Results

Among the 32 patients, 10 presented with epilepsy alone. Concomitant neurological syndromes were observed in 22 patients, including limbic encephalitis (n = 20), stiff-person syndrome (SPS, n = 1), and cerebellar ataxia (n = 1). Bilateral tonic–clonic seizures were observed in 21 patients (65.6%). Focal seizures occurred in 27 patients (84.4%); 17 had focal motor seizures and 18 focal non-motor seizures. Among 30 patients with long-term follow-up, 11 (36.7%) were seizure-free. Acute/subacute onset (p = 0.049) and comorbidity of limbic encephalitis with epilepsy (p = 0.023) led to better seizure outcomes. Patients with persistent epilepsy were more likely to have focal seizure (p = 0.003) and higher frequency of seizure (p = 0.001). Furthermore, these patients tended to have longer intervals from onset to immunomodulatory treatments. Early immunotherapy (within 6 months from onset) was administered in 81.8% of seizure-free patients but only in 42.1% of patients with persistent seizures. However, steroid and immunosuppressant duration did not differ in the two groups. Repeated serum GAD Ab tests during the follow-up showed no association with seizure outcomes.

Conclusions

The seizure manifestations are diverse and variable. Approximately one third of patients achieved seizure remission during long-term follow-up. The type and frequency of seizures may influence the seizure outcomes. Early immunotherapy, especially within 6 months, may lead to better seizure outcomes.
A systematic review and narrative synthesis of fathers’ (including migrant fathers’) experiences of pregnancy and childbirth
Authors: Mprah Andy , Haith-Cooper Melanie , Duda-Mikulin Eva , Meddings Fiona
Published: April 2023

Objective

The purpose of this review was to consider factors that influence the experiences of pregnancy and childbirth by fathers including migrant fathers.

Method

A systematic review and narrative synthesis were conducted as per the PRISMA guidelines. The spider tool was used to build a search strategy which was used to conduct literature search in eight identified electronic databases: ASSIA, CINAHL, EMBASE, MEDLINE, PsycINFO, PUBMED, Sage and Scopus. Grey literature was searched through the King’s Fund Library database, Ethos, The North Grey Literature Collection, Social Care Online and other charity websites such as the Refugee Council and Joseph Rowntree Foundation. The search was conducted across all the databases in the week commencing January 7, 2019, and restricted to studies published in the English language.

Results

The search across all the eight electronic databases identified 2564 records, 13 records through grey literature databases/websites and an additional 23 records identified through hand-searching/forward citation. The number of records after duplicates were removed was 2229. Record screening based on titles and abstracts identified 69 records for full text screening. Dual screening of these full text records identified 12 full records from 12 separate studies, eight of which were qualitative studies, three of which were quantitative studies and one mixed method study.

Findings

This review has revealed three main themes: influence of society and health professionals; adjustment to a new life of fatherhood; and involvement in maternity care. However, the literature has focused on non-migrant father’s experiences of pregnancy and childbirth, with little attention paid to fathers who may be migrants.

Key conclusion and implications for practice

This review has exposed a dearth of research on migrant fathers’ experiences of pregnancy and childbirth in an era of increasing globalisation and migration between countries. Midwives and other health professionals should be alert to the needs of any father when providing maternity care. More research is needed which considers experiences of migrants and how choosing to move to a new country or being forced to move could influence migrant father’s experiences and therefore their needs.
Delayed cystic fibrosis diagnosis due to presumed celiac disease-A case report from Syria
Authors: Ranjous Yahia , Al Balkhi Abdulrahman , Alahmad Nazir , Asaad Ali , Ali Ayman
Published: April 2023

Background

This case report describes a cystic fibrosis case after 7 years of a presumed diagnosis of celiac disease without confirming laboratory tests and biopsies. Both cystic fibrosis and celiac disease cause malnutrition, malabsorption, and failure to thrive. Also, the occurrence of cystic fibrosis in celiac disease patients is higher than in the normal population. Therefore, the differentiation between the two diseases might be challenging. This article highlights the reason for the confusion between cystic fibrosis and celiac disease and emphasizes the importance of not skipping the necessary investigations no matter how difficult it is to perform them.

Case presentation

This report details the case history of a patient presumed to have celiac disease for 7 years without confirming investigations. He developed multiple respiratory infections and weight loss throughout the 7 years but was only diagnosed with cystic fibrosis after hospitalization for gradual abdominal distension and productive cough. Chest CT showed atelectasis in the right upper lobe, tree-in-bud sign on both sides, and right periumbilical mass with several enlargements in the mediastinal nodes. Ascites paracentesis revealed a high SAAG gradient and low-protein fluid. The sweat chloride test resulted in a chloride level of 90 mEq/L, which confirmed the cystic fibrosis diagnosis. Subsequent genetic testing revealed the rare G85E mutation.

Conclusion

This report highlights the potential for diagnostic confusion between cystic fibrosis and celiac disease. Also, it reminds physicians about the importance of taking a detailed medical history and performing the essential investigations no matter how difficult it is to do them. Finally, it emphasizes the need to verify the patient’s previous medical history in case there is no official documentation of his case. This should be considered particularly in rural areas in low-income countries where the possibility of medical malpractice should not be forgotten.
Clinical characteristics and potential association to Parkinson’s disease and dementia with Lewy bodies in patients with major depressive disorder who received maintenance electroconvulsive therapy: a retrospective chart review study
Authors: Kudo Shun , Uchida Takahito , Nishida Hana , Takamiya Akihiro , Kikuchi Toshiaki , Yamagata Bun , Mimura Masaru , Hirano Jinichi
Published: April 2023

Background

Maintaining remission after electroconvulsive therapy (ECT) is clinically relevant in patients with depression, and maintenance ECT has been introduced in patients who fail to maintain remission after ECT. However, the clinical characteristics and biological background of patients who receive maintenance ECT are poorly understood. Thus, this study aimed to examine the clinical background of patients who underwent maintenance ECT.

Methods

Patients with major depressive disorder who underwent ECT followed by maintenance ECT (mECT group) and those who did not (acute ECT [aECT] group) were included. Clinical characteristics, including the results of neuroimaging examinations for Parkinson’s disease (PD) and dementia with Levy body (DLB) such as myocardial 123I-metaiodobenzylguanidine (MIBG) scintigraphy and dopamine transporter imaging single-photon emission computerized tomography (DaT-SPECT), were compared between the groups.

Results

In total, 13 and 146 patients were included in the mECT and aECT groups, respectively. Compared to the aECT group, the mECT group showed a significantly higher prevalence of melancholic features (92.3% vs. 27.4%,p < 0.001) and catatonic features (46.2% vs. 9.6%,p = 0.002). Overall, 8 of the 13 patients in the mECT group and 22 of the 146 patients in the aECT group underwent neuroimaging examinations for PD/DLB. The rate of patients examined is significantly higher in the mECT group than in the aECT group (61.5% vs. 11.2%,p < 0.001). Among the groups examined, 7/8 patients in the mECT group and 16/22 patients in the aECT group showed relevant neuroimaging findings for PD/DLB; the positive rate was not significantly different between the two groups (87.5% vs. 72.7%,p = 0.638).

Conclusions

Patients who receive acute and maintenance ECT may have underlying neurodegenerative diseases, including PD/DLB. Investigating the neurobiology of patients who receive maintenance ECT is important for developing appropriate treatments for depression.
The association between fatty liver index and onset of diabetes: secondary analysis of a population-based cohort study
Authors: Zhu Yanqiong , Hu Haofei , Wu Yumei , Rao Yinhua , Li Qixiang , Duan Xuehui , Yao Guopeng , Yin Hekun , Luo Ziyi
Published: April 2023

Background

According to research, the fatty liver index (FLI) is associated with diabetes. However, few studies have been conducted to investigate the relationship between FLI and diabetes risk from various perspectives. This study comprehensively investigated the relationship between FLI and incident diabetes in a large Japanese population.

Methods

This retrospective cohort study included 14,280 participants from Murakami Memorial Hospital in Japan from 2004 to 2015. The independent and dependent variables are FLI and risk of type 2 diabetes mellitus (T2DM), respectively. To examine the link between FLI and incident T2DM, Cox proportional-hazards regression was employed. In addition, we performed a number of sensitivity studies to guarantee the validity of the results. Moreover, we conducted subgroup analyses.

Results

After adjusting covariates, the results showed that FLI was positively associated with the risk of T2DM (HR = 1.019, 95%CI: 1.012, 1.025). Additionally, the sensitivity analysis showed how reliable the outcomes were. And a stronger association between FLI and incident T2DM was observed in the regular exercisers (HR = 1.036, 95%CI: 1.019–1.053, P < 0.0001) and the population without ethanol consumption (HR = 1.028, 95%CI: 1.017–1.039, P < 0.0001). Besides, receiver operating characteristic (ROC) curve analysis showed that FLI was better than waist circumference, triglycerides, body mass index, and gamma-glutamyl transferase in predicting incident T2DM.

Conclusion

FLI is positively associated with incident T2DM.
The Thai version of the COVID-19 Yorkshire Rehabilitation Scale: a valid instrument for the psychometric assessment of the community members in Bangkok, Thailand
Authors: Partiprajak Suphamas , Krongthaeo Suphanna , Piaseu Noppawan , Wongsathikun Jatuporn , Kongsuwan Anon
Published: April 2023

Background

Coronavirus disease 2019 (COVID-19) can develop into a long-term COVID in some cases, which can have a major impact on various health systems requiring appropriate treatment involving multi-disciplinary healthcare. The COVID-19 Yorkshire Rehabilitation Scale (C19-YRS) is a standardized tool widely used for screening the symptoms and severity of long-term COVID. Translation of the English version of the C19-YRS into the Thai language and testing it is essential for the psychometric evaluation of the severity of the long-term COVID syndrome prior to providing rehabilitation care for community members.

Methods

Forward-and back-translations including cross-cultural aspects were conducted in order to develop a preliminary Thai version of that tool. Five experts evaluated the content validity of the tool and produced a highly valid index. A cross-sectional study was then conducted on a sample of 337 Thai community members recovering from COVID-19. Assessment of internal consistency and individual item analyses were also performed.

Results

The content validity resulted in valid indices. The analyses showed that 14 items had acceptable internal consistency, based on the corrected item correlations. However, five symptom severity items and two functional ability items were deleted. The Cronbach’s alpha coefficient of the final C19-YRS was 0.723, indicating acceptable internal consistency and reliability of the survey instrument.

Conclusions

This study indicated that the Thai C19-YRS tool had acceptable validity and reliability for the evaluation and testing of the psychometric variables in a Thai community population. The survey instrument also had acceptable validity and reliability for screening the symptoms and severity of long-term COVID. Further studies are warranted in order to standardize the various applications of this tool.
Caregivers perception of common neonatal illnesses and their management among rural dwellers in Enugu state, Nigeria: a qualitative study
Authors: Chime Onyinye H , Eneh Chizoma I. , Asinobi Isaac N , Ekwochi Uchenna , Ndu Ikenna Kingsley , Nduagubam Obinna C , Amadi Ogechukwu F , Osuorah Donatus Chidiebere
Published: April 2023

Background

Neonatal mortality continues to be a challenge in Nigeria, where low-quality care, caregivers’ ignorance of signs of neonatal illnesses, and prevalent use of unorthodox alternatives to health care predominate. Misconceptions originating and propagating as traditional practices and concepts can be linked to adverse neonatal outcomes and increased neonatal mortality. This study explores the perceptions of causes and management of neonatal illness among caregivers in rural communities in Enugu state, Nigeria.

Methods

This was a cross-sectional qualitative study among female caregivers of children residing in rural communities in Enugu state. A total of six focus group discussions (FGDs) were conducted; three in each of the communities, using an FGD guide developed by the researchers. Using pre-determined themes, thematic content analysis was used to analyze the data.

Results

The mean age of respondents was 37.2 ± 13.5 years. Neonatal illnesses were reportedly presented in two forms; mild and severe forms. The common causes of the mild illnesses reported were fever, jaundice, eye discharge, skin disorders, and depressed fontanelle. The severe ones were convulsion, breathlessness/difficulty or fast breathing, draining pus from the umbilicus, and failure-to-thrive. The caregivers’ perceptions of causes and management of each illness varied. While some believed these illnesses could be managed with unorthodox treatments, others perceived the need to visit health centers for medical care.

Conclusions

Caregivers’ perception on the causes and management of common neonatal illnesses in these communities is poor. Obvious gaps were identified in this study. There is a need to design appropriate interventions to dispel the myths and improve the knowledge of these caregivers on neonatal illnesses towards adopting good health-seeking behaviours.
Effectiveness of family-centred sexual health education and HPV self-sampling in promoting cervical cancer screening among hard-to-reach indian women in rural and tribal areas: a community-based pilot study
Authors: Vahabi Mandana , Mishra Gauravi , Pimple Sharmila , Wong Josephine Pui-Hing , Khan Momina , Prakash Vijayshree , Anand Kavita , Narushima Miya , Lofters Aisha K.
Published: April 2023

Background

While cervical cancer deaths have declined steeply in high-income countries due to the widespread use of the Papanicolaou test (Pap test), the same trend has not emerged in low or middle-income countries (LMICs). Access to screening in LMICs like India is limited due to barriers such as limited healthcare infrastructures, lack of sexual health education, and stigma demarcating sexually transmitted infections (STIs). HPV self-sampling (HPV-SS), a woman–centered and at-home method for screening, can be utilized as a unique screening tool to overcome some of these barriers. Our study examined the effectiveness of HPV-SS, supported by family-centred arts-based sexual health literacy on the uptake of cervical cancer screening among hard-to-reach women in rural and remote areas in India.

Methods

Our community-based mixed methods pilot study recruited 240 participants (120 women and 120 male partners or family members) through female Accredited Social Health Activists (ASHA) across 3 Indian villages of Shirgoan, Khodala, and Jamsar in Palghar district. Inclusion criteria included women ages 30–69 who were under or never screened (UNS) and their male partners/family members aged 18 or over. Knowledge and attitudes about cervical cancer and screening and their perceived stigma surrounding STI were assessed using validated scales prior to and after attending a 2-hour arts-based sexual health education (SHE). In addition, participants’ uptake of cervical cancer screening was assessed after attendance in SHE.

Findings

Results revealed significant improvement in knowledge and attitudes about cervical cancer and screening, and a reduction in the STI stigma after participation in SHE sessions (overall mean difference in Knowledge: z = 6.1 ± 2.4, P < 0.001; attitudes about Pap-test and VIA: z = 2.2 ± 8.4, P < 0.001 and z = 2.9 ± 8.2, P < 0.001; STI stigma: z = 2.8 ± 12.4, P < 0.001). 118 out of 120 female participants chose to be screened and 115 opted for HPV-SS.

Conclusions

The implementation of HPV-SS coupled with family-centered arts-based and culturally appropriate SHE is highly promising in promoting cervical cancer screening among hard-to-reach women. Evidence from our study can be used to advance public health policies and inform the scale-up of similar initiatives in other villages and states across rural India and other LMICs.
Perspectives of older women in the Netherlands: identifying motivators and barriers for healthy lifestyles and determinants of healthy aging
Authors: Sialino L. D. , Wijnhoven H. A.H. , van Oostrom S. H. , Picavet H. S.J. , Verschuren W. M.M. , Visser M. , Vader S. , Schaap L. A.
Published: April 2023

Background

Women have a higher life expectancy than men but experience more years with physical disabilities in daily life at older ages, especially women with a migration background. This pinpoints older women as an important target group for strategies that stimulate healthy lifestyle, which benefits healthy aging. Our study investigates motivators and barriers for healthy lifestyles and perspectives on determinants of healthy aging of older women. This provides essential information for developing targeted strategies.

Methods

Data was collected by semi-structured digital interviews from February till June 2021. Women aged 55 years and older living in the Netherlands (n = 34) with a native Dutch (n = 24), Turkish (n = 6) or Moroccan (n = 4) migration background were included. Two main subjects were investigated: (1) motivators and barriers on their current lifestyles regarding smoking, alcohol consumption, physical activity, diet and sleep and (2) perspectives on determinants of healthy aging. Interviews were analyzed using Krueger’s framework.

Results

Personal health was the most common motivator for a healthy lifestyle. In addition, peer pressure and being outdoors were specific motivators for physical activity. Bad weather conditions and personal dislike to be active were specific barriers. The social environment, personal preferences and personal belief to compensate with other healthy lifestyle behaviors were barriers for low alcohol consumption. Personal preferences (liking unhealthy food and not making time) were the main barriers for a healthy diet. Sleep was not perceived as a form of lifestyle behavior, but rather as a personal trait. Since there were no smokers, specific barriers were not mentioned. For Turkish-Dutch and Moroccan-Dutch women, additional barriers and motivators were culture and religion. These were strong motivators to abstain from alcohol consumption and smoking, but a barrier for a healthy diet. With regard to perspectives on determinants of healthy aging, positive views on aging and being physically active were perceived as most important. Women often wanted to increase their physical activity or healthy diet to stimulate healthy aging. Among Turkish-Dutch and Moroccan-Dutch women, healthy aging was also perceived as something in the hands of God.

Conclusions

Although motivators and barriers for a healthy lifestyle and perspectives on healthy aging vary for distinct lifestyles, personal health is a common motivator across all lifestyles. Having a migration background added culture and religion as distinct barriers and motivations. Strategies to improve lifestyle among older women should therefore have a tailored, culture sensitive approach (if applicable) for distinct lifestyle factors.
Short Telomere Syndrome presenting with pulmonary fibrosis, liver cirrhosis and hepatopulmonary syndrome: a case report
Authors: Baird Andrew , Gomes Marcio , Souza Carolina A. , Magner Kate , Alvarez Gonzalo
Published: April 2023

Background

Idiopathic pulmonary fibrosis is thought to result from aberrant post-injury activation of epithelial cells leading to fibroblast proliferation and activation. A number of genetic aetiologies have been implicated in this disease process, including, among others, the short telomere syndromes. Short telomere syndromes follow an autosomal dominant pattern of inheritance resulting in shortened telomere length, which consequently leads to accelerated cell death. Organs with rapid cell turnover are most affected.

Case presentation

We describe a case of a 53-year-old man with a chief complaint of cough and dyspnea on exertion. His presentation was otherwise significant for features of accelerated aging, including a history of osteoporosis and early greying, and a family history of pulmonary fibrosis in his father. Pulmonary function testing revealed a restrictive pattern with severely reduced diffusion capacity and high resolution CT of the chest showed diffuse lung disease with mild fibrosis, in pattern suggesting an alternative diagnosis to IPF. Biopsy of the lung was in keeping with chronic fibrosing interstitial pneumonia. Imaging of the abdomen showed splenomegaly, hepatic cirrhosis and portal hypertension. Transthoracic contrast echocardiogram showed intrapulmonary shunting consistent with hepatopulmonary syndrome. Given the constellation of early aging, idiopathic pulmonary fibrosis, cryptogenic cirrhosis and a family history of pulmonary fibrosis in this patient, the Short Telomere Syndrome was suspected. Peripheral blood was sent for Flow-cytometry FISH, which demonstrated granulocyte telomere length below the 10th percentile for the patient’s age, consistent with a diagnosis of Short Telomere Syndrome in this clinical context. Targeted genetic testing of mutations known to be associated with short telomere was negative though it was acknowledged that the full spectrum of disease-causing mutations remains unknown. Given the extensive fibrosis on biopsy and his progressive hypoxemia he was treated with mycophenolate and prednisone. Ultimately, he developed progressive respiratory failure and underwent double lung and concurrent liver transplant 18 months after the initial diagnosis was made.

Conclusions

Short Telomere Syndrome is a rare cause of end stage organ disease and testing lacks sensitivity making diagnosis challenging. Organ transplant is still the mainstay of treatment. Nevertheless, disease identification is important because of implications for family member screening and the possibility of future treatment options.
Xanthogranulomatous pyelonephritis with polycystic kidney disease as a mimic of cystic renal cell carcinoma: a case report
Authors: Yi Mei , Liu Yong , Chen Qi
Published: April 2023

Background

Xanthogranulomatous pyelonephritis (XGP) is a rare chronic pyelonephritis that often mimics other renal diseases, when combined with autosomal dominant polycystic kidney disease(ADPKD), preoperative diagnosis is exceedingly difficult. It is important for clinicians to be aware of an XGP with ADPKD since a misdiagnosis can lead to unnecessary surgical intervention.

Case presentation

Here, we report a case of a 66-year-old female with a history of bilateral ADPKD and urinary tract infection admitted to our hospital due to right flank pain, feeble, and low-grade fever. Contrast-enhanced ultrasound revealed a malignant mass of the right kidney suspected to be a cystic renal cell carcinoma with polycystic kidney disease. In addition, contrast-enhanced computed tomography (CT) and fluorine 18 fluorodeoxyglucose PET/CT (18F FDG PET/CT) showed similar results. Subsequently, the patient underwent a right radical nephrectomy, but histopathological examination revealed XGP with ADPKD. On the follow-up, the patient's symptoms were relieved.

Conclusions

XGP should be kept in mind during the differential diagnosis of renal masses with ADPKD even in the absence of characteristic clinical symptoms and imaging manifestations.
Exploring patient perspectives on the secondary use of their personal health information: an interview study
Authors: Dobson Rosie , Wihongi Helen , Whittaker Robyn
Published: April 2023

Background

The increased digitalisation of health records has resulted in increased opportunities for the secondary use of health information for advancing healthcare. Understanding how patients want their health information used is vital to ensure health services use it in an appropriate and patient-informed manner. The aim of this study was to explore patient perceptions of the use of their health information beyond their immediate care.

Methods

Semi-structured in-depth interviews were conducted with current users of health services in Aotearoa New Zealand. Different scenarios formed the basis of the discussions in the interviews covering different types of information use (current practice, artificial intelligence and machine learning, clinical calculators, research, registries, and public health surveillance). Transcripts were analysed using thematic analysis.

Results

Twelve interviews were conducted with individual’s representative of key ethnicity groups and rural/urban populations, and at the time of recruitment, had been accessing a diverse range of health services. Participants ranged from high users of health care (e.g., weekly dialysis) through to low users (e.g., one-off presentation to the emergency department). Four interrelated overarching themes were identified from the transcripts describing the main issues for participants: helping others, sharing of data is important, trust, and respect.

Conclusions

People currently engaging with health services are supportive of their health information being used to help others, advance science, and contribute to the greater good but their support is conditional. People need to be able to trust the health service to protect, care for, and respect their health information and ensure no harm comes from its use. This study has identified key considerations for services and researchers to reflect on when using patient health information for secondary purposes to ensure they use it in a patient-informed way.

Trial registration

NA.
Diagnosis of autism in a rare case of tyrosine hydroxylase deficiency: a case report
Authors: Reyes Zoe Maria Dominique , Lynch Emma , Henry Julia , De Simone Lenika Marina , Sobotka Sarah A.
Published: April 2023

Background

Tyrosine hydroxylase deficiency (THD) is a rare movement disorder with broad phenotypic expression caused by bi-allelic mutations in the TH gene, which encode for tyrosine hydroxylase (TH) protein. Some patients with THD have improvement in dystonia with carbidopa–levodopa, a synthetic form of dopamine typically used in Parkinson’s disease, and are considered to have dopa-responsive THD. THD has been found in 0.5–1 per million persons, although due to overlapping symptoms with other disorders and the need for genetic testing, prevalence is likely underestimated. Existing literature describes some patients with THD having intellectual disability, but comorbid autism spectrum disorder (ASD) has not been reported.

Case presentation

A nearly 3-year-old boy was referred to pediatric neurology due to hypotonia, delayed motor milestones, and expressive speech delay. Whole exome sequencing confirmed tyrosine hydroxylase deficiency, detecting a novel variant p.S307C first reported here. The child was treated with carbidopa–levodopa with an excellent response, resulting in improved balance, fewer falls, and improved ability to jump, run and climb stairs. He was determined to have dopa-responsive THD. Due to his delays in expressive speech, the boy also had an assessment with a developmental and behavioral pediatrician, who identified a pattern of social pragmatic speech delay, sensory sensitivities, and restricted interests, and determined that he met criteria for a diagnosis of ASD.

Conclusions

While ASD can stand alone as a clinical diagnosis, it is also a cardinal feature of other genetically-based neurological disorders. To our knowledge, this is the first case that describes a patient with both disorders. Perhaps THD may be among the genetic disorders linked with ASD.
Expression of TFRC helps to improve the antineoplastic effect of Ara-C on AML cells through a targeted delivery carrier
Authors: Wu Xinzhou , Jiao Zhouguang , Zhang Junying , Li Feng , Li Yuhua
Published: April 2023

Background

Currently, high doses of cytarabine arabinoside (Ara-C)-based combined chemotherapy are commonly used in acute myeloid leukemia (AML) therapy, but severe adverse effects and poor suppression effects in leukemia cells limit the clinical therapeutic efficiency of Ara-C-based chemotherapy due to a lack of targeting selectivity. To improve the therapeutic effect of Ara-C in AML, here, since we confirmed that transferrin receptor 1 (TFRC) expression in AML cells was constant, we generated Ara-C@HFn by encapsulating free Ara-C into self-assembled heavy ferritin chain (HFn, the ligand of TFRC) nanocages.

Results

The analysis of clinically relevant data suggested that the high expression levels of TFRC from AML cells would not decrease significantly after treatment with Ara-C. Ara-C@HFn can be efficiently internalized by leukemia cells, showing stronger cytotoxic effects in vitro and reducing the burden of leukemia in AML mice more effectively in vivo than free Ara-C. Ara-C@HFn treatment showed no acute toxicity in visceral organs of mice. Moreover, the analysis of clinically relevant data also suggested that there are several drugs (such as tamibarotene and ABT199) that would not cause significant expression down-regulation of TFRC in AML cells (after treatment).

Conclusion

The above results suggested that TFRC can be used as a constant and effective target for drug targeting delivery of AML cells. Thus Ara-C@HFn treatment can become a safe and efficient strategy for AML therapy by specifically delivering Ara-C to AML cells. Besides, the HFn nanocages are promising for improving antineoplastic effect of other AML-related therapy drugs that do not cause downregulated expression of TFRC in AML cells.

Graphical Abstract