bluuebunny/crossref_metadata_2025_split huggingface dataset:
Migraine, attention deficit hyperactivity disorder and screen time in children attending a Sri Lankan tertiary care facility: are they associated?
Authors: Attygalle Udena Ruwindu , Hewawitharana Gemunu , Wijesinghe Champa Jayalakshmie 
Published: July 2020

Abstract
Background
Headache and Attention Deficit Hyperactivity Disorder (ADHD) are two relatively common, neuropsychiatric conditions seen in children. Recent studies have shown an association between these two disorders, which are otherwise distinct conditions. This study aims to assess the association between migraine and ADHD, as well as the association between screen-time and these two conditions, among children attending a Sri Lankan tertiary care facility. Possible associations will have important implications in the clinical management of these conditions.

Methods
This was a comparative cross-sectional study of 226 children aged 5–14 years, attending clinics at a tertiary care hospital in Galle, Sri Lanka. Of them, 141 had a diagnosis of migraine and 85 did not have migraine. The presence or absence of ADHD and the use of screen-time among the two groups was analysed. Chi-square test and Mann-Whitney U test was used to assess the associations between these variables.

Results
Approximately 5% of the children with migraine had clinically diagnosed ADHD, compared to 3.5% of those without migraine (p = 0.862). The median SNAP-IV scores (inter-quartile range) of the children with migraine and without migraine were 0.60 (0.27–1.00) and 0.44 (0.16–0.80) respectively (p = 0.014). There was no significant difference in screen-time hours per day between children with and without clinically diagnosed ADHD. However, a significant difference in median screen-time (hours per day) was observed between children with and without migraine (2.0 h and 1.0 h respectively; p = 0.012).

Conclusions
Our findings suggest that children with migraine are more likely to show features of hyperactivity/impulsivity and inattentiveness than those without migraine. While no association was found between clinically diagnosed ADHD and screen-time, migraine was associated with longer daily screen use. Screening for ADHD in children diagnosed with migraine may be of benefit. Further studies are required to understand the possible benefits of reducing screen-time in children with migraine.
Cornea Verticillata in classical Fabry disease, first from Sri Lanka: a case report
Authors: Hewavitharana Hasani , Jasinge Eresha , Abeysekera Hiranya , Wanigasinghe Jithangi 
Published: July 2020

Abstract
Background
Fabry disease is a rare inborn error of metabolism with profound clinical consequences if untreated. It is caused by the deficiency of α galactosidase A enzyme and is the only lysosomal storage disorder with an X linked inheritance. Confirmation requires genetic analysis of Galactosidase Alpha (GLA) Gene, which is often a challenge in resource-poor settings. Despite these technological limitations, specific clinical features in this condition can establish the diagnosis.

Case presentation
We report on a 13-year old male who presented with an afebrile convulsion with a background history of chronic burning sensation of hands and feet and anhidrosis for 2 years duration with a similar history of episodic acroparesthesia in the other male sibling. The early clinical diagnosis was based on the history and detection of Cornea Verticillata on eye examination. Biochemical confirmation was established with detection of low α galactosidase A enzyme levels and a missense mutation of the Galactosidase Alpha (GLA) Gene (c.136C > T) established the genetic confirmation.

Conclusion
This is the first case of Fabry disease reported in Sri Lanka. Awareness of specific clinical features aided clinical diagnosis long before access to genetic confirmation was available.
The prevalence and risk factors for mental distress among Syrian refugees in Germany: a register-based follow-up study
Authors: Borho Andrea , Viazminsky Andre , Morawa Eva , Schmitt Gregor Martin , Georgiadou Ekaterini , Erim Yesim 
Published: July 2020

AbstractBackgroundMental disorders among refugees as well as their risk factors are already well documented in cross-sectional reports. However, longitudinal follow-up designs are widely lacking. Therefore, the aim of this study was to examine the change of the prevalence of mental disorders among Syrian refugees with German residence permission, taking into account their increasing length of stay in Germany, and to uncover the change in their relationship to pre- and post-migration risk factors.MethodsThis study formed part of a register-based follow-up study with two measurement points in Erlangen (Germany). At the first time of recruitment in 2017, 200 of the 518 Syrian refugees with residence permission living in Erlangen took part. During the second survey timeframe 1.5 years later, in 2019, 108 of the former 200 Syrian refugees participated again and formed the total sample for this follow-up study. The survey instruments included demographics, migration-related variables and symptoms of post-traumatic stress (Essen Trauma Inventory, ETI), depression (Patient Health Questionnaire - PHQ-9) and generalized anxiety disorder (GAD-7).ResultsAt the time of the first survey, 26.9% of the participants exceeded the cut-off for a clinically relevant depression diagnosis, 16.7% for an anxiety disorder and 13.9% for a PTSD diagnosis. At the second measurement point, it was 30.6% for depression, 15.7% for an anxiety disorder and 13.0% for PTSD. No significant changes between the measurement points were found for any of the disorders. In multiple linear regression analyses, higher perceived discrimination, a higher number of traumatic experiences and a shorter duration of residence permission were shown to be the most important pre- and post-migration predictors of psychological stress independent of the time of measurement.ConclusionsThere is strong empirical evidence that the prevalence rates of mental distress among refugees are significantly higher compared to the overall population. However, it has not yet become clear how these prevalence rates change with an increasing length of stay in the host countries. The results of our study indicate that the psychological burden on this refugee population remains consistently high over time, despite partly improved living conditions, and confirm the importance of therapeutic interventions.
The actual and anticipated effects of a menthol cigarette ban: a scoping review
Authors: Cadham Christopher J. , Sanchez-Romero Luz Maria , Fleischer Nancy L. , Mistry Ritesh , Hirschtick Jana L. , Meza Rafael , Levy David T. 
Published: July 2020

AbstractBackgroundThe United States (US) Food and Drug Administration (FDA), under the 2009 Family Smoking Prevention and Tobacco Control Act, banned characterizing flavors in cigarettes; however, mentholated tobacco products were exempt. Since 2009, over 20 US jurisdictions and numerous countries around the world have extended this restriction to menthol. Currently, the FDA is reconsidering its position on a nation-wide menthol cigarette ban. However, the effects of such a ban remain unclear. We conducted a scoping review to explore the impact of a menthol cigarette ban on individual behaviors (initiation, cessation, and product switching), sales, and compliance.MethodsWe conducted a search of the international literature using PubMed, EBSCO, and Web of Science (to November 25, 2019). We retrieved articles relevant to the impacts of an implemented or hypothetical menthol ban. We also included studies of flavored tobacco product bans due to their potential relevance in gauging compliance and product substitutability.ResultsThe search identified 493 articles, of which 24 were included. Studies examined the effects of implemented menthol bans (n = 6), hypothetical menthol bans (n = 12) and implemented flavor bans that exclude menthol (n = 6). Menthol bans were found to reduce sales and increase smoking cessation with only partial substitution for non-menthol cigarettes. US smokers’ reactions to a hypothetical ban indicate that about 25–64% would attempt to quit smoking and 11–46% would consider switching to other tobacco products, including 15–30% to e-cigarettes. Flavor ban studies indicate reductions in initiation of 6%. Ban compliance was high, but studies indicate that the tobacco industry and retailers have attempted to circumvent their impact via packaging changes and online sales.ConclusionOur review finds that extending the US cigarette flavor ban to menthol products would promote smoking cessation and reduce initiation. This evidence supports further action by the FDA towards mentholated tobacco products. However, few studies have been conducted in the vaping era.
From long-term sickness absence to disability retirement: diagnostic and occupational class differences within the working-age Finnish population
Authors: Salonen Laura , Blomgren Jenni , Laaksonen Mikko 
Published: July 2020

Abstract
Background
It is well documented that sickness absence is strongly associated with disability retirement. A long-term sickness absence (LTSA) in particular increases the risk of disability retirement, but little is known about the variation of this risk across diagnostic causes. Further, as occupational classes differ in their diagnostic profiles, it is likely that the role of diagnosis in the pathway from LTSA to disability retirement varies between occupational classes. We examined how LTSA of different diagnostic causes predicts all-cause disability retirement and disability retirement due to the same diagnostic group or due to some other diagnostic group than that which caused the LTSA spell in different occupational classes.

Methods
Cox proportional hazards models were used to analyse a 70% random sample of all employed Finns aged 25–62 Finns in 2006 (N = 1,458,288). Disability retirement was followed from 2007 to 2014. The risk of disability retirement was compared between occupational classes with at least one LTSA spell due to musculoskeletal diseases, mental disorders, respiratory diseases, or circulatory diseases and those who had no LTSA spells due to these diagnostic groups during 2005.

Results
Those who had LTSA due to musculoskeletal diseases or mental disorders transferred more often to disability retirement due to same diagnostic group, whereas those who had LTSA due to respiratory or circulatory diseases transferred more often to disability retirement due to some other diagnostic group. The largest occupational class differences in all-cause disability retirement were found among those with LTSA due to mental disorders. For men, the hazard ratios (HR) varied from HR 5.70 (95% confidence interval (CI) 5.00–6.52) in upper non-manual employees to 2.70 (95% CI 2.50–2.92) in manual workers. For women, the corresponding HRs were 3.74 (95% CI 3.37–4.14) in upper non-manual employees and 2.32 (95% 2.17–2.50) in manual workers.

Conclusions
The association between LTSA and disability retirement varies between diagnostic groups, and the strength of this association further depends on the person’s occupational class and gender.
Paradoxical embolism after surgery for breast cancer: a case report
Authors: Yu Zhimin , Deng Heran , Wang Jie , Xu Junyao 
Published: July 2020

Abstract
Background
Paradoxical embolism (PDE) presented with concomitant pulmonary embolism (PE) and renal artery embolism (RAE) which occurred to breast cancer patient after breast-conserving therapy, has never been reported.

Case presentation
A 55-year-old female with breast cancer exhibited unexplained hypoxemia, followed with vomiting, diarrhea, unilateral flank pain and abdominal pain after lumpectomy 12 h. The urgent multi-detector row computed tomography (MDCT) confirmed the diagnosis of PE and RAE. Confusingly, the patient had no history of intracardiac defect, cardiac valvular diseases, atrial fibrillation or other cardiovascular disease and the definite cause was still unclear. However, after 10 days of prompt anticoagulant therapy in ICU, she was discharged in good condition.

Conclusion
Breast cancer patients after surgery suffering from unexplained hypoxemia, abdominal pain, vomiting and diarrhea should be highly suspicious of PE or RAE, even PDE. Any clinical presentation on these postoperative patients should be given much more attention to make accurate diagnosis and appropriate interventions.
A quasi-experimental approach using telemetry to assess migration-strategy-specific differences in the decision-making processes at stopover
Authors: Schmaljohann Heiko , Klinner Thomas 
Published: July 2020

AbstractBackgroundMigrant birds travel between their breeding areas and wintering grounds by alternating energetically and physiologically demanding flights with periods of rest and fuelling, so-called stopovers. An important intrinsic factor influencing the decision to resume migration is the amount of energy stores available for the next flight. Correlative studies with free-flying birds and experimental studies with caged birds have shown that the amount of energy stores affects the day-to-day, within-day and the directional decision of departure. The methodological advantages of both the correlative and experimental approach are combined when radio-tagging many individuals on the same day and subsequently determining the departure decisions at a high spatiotemporal resolution. Making use of such a quasi-experimental approach with an automated radio-tracking system at stopover, we studied the effect of energy stores on departure decisions and whether they vary between species of different migration strategies experiencing contrasting time constraints. For this, we chose a long-distance migrant, the common redstart (Phoenicurus phoenicurus), and a medium-distance migrant, the European robin (Erithacus rubecula), because the former has to travel at relatively higher speed to reach its wintering ground in a reasonable time at the expense of relatively higher energetic costs for travelling than the latter.ResultsCommon redstarts with higher energy stores were more likely to resume migration than their conspecifics with lower energy stores, whereas this pattern was absent in the European robins. The amount of energy stores significantly affected the timing of departure within the day, with large energy stores yielding early departures in both species. Departure directions from the stopover site during the first night after capture were oriented towards the seasonally appropriate direction but were not affected by variation in energy stores.ConclusionsWe demonstrate the importance of variation in energy stores on the departure decisions and that it may affect species with different migration strategies dissimilarly in autumn. Nevertheless, knowledge of other intrinsic factors, such as feeding conditions, health status and physiological consequences of previous flights, is additionally required to better understand the departure decisions of migrants, as this is the key to providing an overall assessment of the decision-making process.
Sociodemographic factors associated with HbA1c variability in type 2 diabetes: a prospective exploratory cohort study
Authors: Mellergård Emelia , Johnsson Per , Eek Frida 
Published: July 2020

AbstractBackgroundThe associations between sociodemographic factors and HbA1c variability in type 2 diabetes are not yet established. Examining group differences in HbA1c variability may help identify patient characteristics related to diabetes management. The present study examined differences in baseline HbA1c and HbA1c variability between groups with regard to sex, level of education, civil status, age, and BMI, in a sample of individuals with type 2 diabetes.MethodsThe study was a prospective exploratory cohort study. Differences in HbA1c variability between sociodemographic groups were analyzed in 158 individuals. HbA1c variability was assessed as the standard deviation (SD) and coefficient of variation (CV) over five measured points, and a questionnaire was used to assess sociodemographic factors.ResultsThe results showed significantly higher HbA1c variability in men compared to women (mean difference 1.44 mmol/mol [95% CI: 0.58 to 2.31]), and significantly higher HbA1c variability in individuals with a BMI characterized as obese compared to individuals with a BMI characterized as normal weight (mean difference 1.56 mmol/mol [95% CI: 0.25 to 2.88]). There were no significant associations between HbA1c variability and civil status or education.ConclusionsMen and individuals with obesity may be more vulnerable to future diabetic complications than other groups, since they have greater long-term glycemic variability.
Massage perceptions and attitudes of undergraduate pre-professional health sciences students: a cross-sectional survey in one U.S. university
Authors: Munk Niki , Church Abby , Nemati Donya , Zabel Samantha , Comer Amber R. 
Published: July 2020

Abstract
Background
Attitudes and beliefs about massage therapy have been explored among health professionals and health profession students, but not for undergraduate preprofessional health sciences students.

Methods
This cross-sectional survey sought to determine pre-professional health students’ attitudes and perceptions toward massage therapy and determine the extent demographic variables such as age, gender, race, along with lifetime massage experience are associated with neutral/negative perceptions.

Results
N = 129 undergraduate students completed the Attitudes Toward Massage scale and 7 supplemental items pertaining to sexuality and therapist gender preference along with questions regarding lifetime massage utilization. Prevalence of massage therapy utilization was 35.6% (lifetime) and 18.6% (last 12-months). Overall, positive attitudes towards massage therapy was observed with participants reporting massage experience expressing more positive massage attitudes (lifetime; p = 0.0081, the past 12 months; p = 0.0311). Participants with no massage experience were more likely to report neutral/negative attitudes toward massage (p = 0.04). Men were more likely to prefer their massage therapist to be of the opposite sex (38.9%) compared to women (2.1%) (p = < 0.0001). Men were less confident than women in their concern of becoming sexually aroused during massage (p = 0.0001) and in the belief that massage is sexually arousing (p = 0.048). Both genders expressed comfort with female and/or male massage therapists, but if given a choice, both prefer a female massage therapist.

Conclusions
Undergraduate pre-professional health sciences students have generally positive attitudes towards massage therapy however more research is needed regarding implicit gender bias and/or preferences. This work should inform future research designs examining the impact of attitudes and beliefs on patient referrals to massage therapy.
A novel instrument of cognitive and social congruence within peer-assisted learning in medical training: construction of a questionnaire by factor analyses
Authors: Loda Teresa , Erschens Rebecca , Nikendei Christoph , Giel Katrin , Junne Florian , Zipfel Stephan , Herrmann-Werner Anne 
Published: July 2020

Abstract
Background
Peer-assisted learning is effective due to cognitive and social congruence. Cognitive congruence is created by sharing a similar knowledge base between students and student tutors. Social congruence is defined as having similar social roles. A questionnaire of these concepts was newly constructed, and this study explored the factor analysis of the instrument.

Methods
In a cross-sectional method design cognitive and social congruence were operationalised by exploratory and confirmatory factor analyses. Cognitive and social congruence were assessed by validated questionnaires and through self-developed items that were collected through semi-structured interviews.. The questionnaire consisted of 26 items that were rated on a five-point Likert scale, from 0 = I strongly disagree to 4 = I strongly agree.

Results
676 medical students participated in the study. Exploratory factor analysis for students resulted in a two-factor solution with cognitive and social congruence as confirming factors. New findings showed that the items “non-judgmental learning atmosphere” and “informal communication” were associated to cognitive congruence, “effectiveness” and “comprehensible explanations” belonged to social congruence. Confirmatory factor analysis for student tutors confirmed the resulting two-factor solution.

Conclusions
As one of the largest investigation of cognitive and social congruence, this study investigated the underlying mechanisms of effective PAL using factor analysis. Cognitive congruence was created by sharing the same knowledge. Knowledge transfer might play a relevant role in cognitive congruence. Social congruence focused on the relationship between student tutors and students, which might impact the content level. Practical recommended actions (using the same language) could be implemented.
Development of an algorithm to detect and reduce complexity of drug treatment and its technical realisation
Authors: Wurmbach Viktoria S. , Schmidt Steffen J. , Lampert Anette , Frick Eduard , Metzner Michael , Bernard Simone , Thürmann Petra A. , Wilm Stefan , Mortsiefer Achim , Altiner Attila , Sparenberg Lisa , Szecsenyi Joachim , Peters-Klimm Frank , Kaufmann-Kolle Petra , Haefeli Walter E. , Seidling Hanna M. 
Published: July 2020

Abstract
Background
The increasing complexity of current drug therapies jeopardizes patient adherence. While individual needs to simplify a medication regimen vary from patient to patient, a straightforward approach to integrate the patients’ perspective into decision making for complexity reduction is still lacking. We therefore aimed to develop an electronic, algorithm-based tool that analyses complexity of drug treatment and supports the assessment and consideration of patient preferences and needs regarding the reduction of complexity of drug treatment.

Methods
Complexity factors were selected based on literature and expert rating and specified for integration in the automated assessment. Subsequently, distinct key questions were phrased and allocated to each complexity factor to guide conversation with the patient and personalize the results of the automated assessment. Furthermore, each complexity factor was complemented with a potential optimisation measure to facilitate drug treatment (e.g. a patient leaflet). Complexity factors, key questions, and optimisation strategies were technically realized as tablet computer-based application, tested, and adapted iteratively until no further technical or content-related errors occurred.

Results
In total, 61 complexity factors referring to the dosage form, the dosage scheme, additional instructions, the patient, the product, and the process were considered relevant for inclusion in the tool; 38 of them allowed for automated detection. In total, 52 complexity factors were complemented with at least one key question for preference assessment and at least one optimisation measure. These measures included 29 recommendations for action for the health care provider (e.g. to suggest a dosage aid), 27 training videos, 44 patient leaflets, and 5 algorithms to select and suggest alternative drugs.

Conclusions
Both the set-up of an algorithm and its technical realisation as computer-based app was successful. The electronic tool covers a wide range of different factors that potentially increase the complexity of drug treatment. For the majority of factors, simple key questions could be phrased to include the patients’ perspective, and, even more important, for each complexity factor, specific measures to mitigate or reduce complexity could be defined.