bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perceptions and experiences of the public regarding the COVID-19 pandemic in Nepal: a qualitative study using phenomenological analysis
Authors: Bhatt Navin , Bhatt Bandana , Gurung Soniya , Dahal Suresh , Jaishi Amrit Raj , Neupane Bandana , Budhathoki Shyam Sundar 
Published: December 2020

ObjectivesPerceptions of people regarding COVID-19 influences their health behaviour in terms of seeking public health services. This helps the government in planning appropriate public health strategies. Therefore, this study intends to explore the perceptions of people towards COVID-19 and their experiences during the pandemic in Nepal.Design, setting and participantsThis qualitative study was conducted among the public in Kathmandu, Kanchanpur, Bajura and Jhapa districts of Nepal. Eight focus group discussions and 40 in-depth interviews were conducted by using a maximum variation sampling method.ResultsThe findings were organised into the following themes: General understanding of COVID-19, Disease prevention, Source of information and misconceptions, Expectation and challenges; and Personal and societal consequences of COVID-19, social distancing and lockdown. There was a good general understanding among respondents about COVID-19, personal preventive measures and population-level strategies. They responded that the use of masks, sanitisers, handwashing and proper lockdown would help to prevent the disease. The respondents acknowledged the vital role of media in increasing awareness. Participants also expressed concerns over the misleading news spread by some media. The lack of social interaction, isolation and loss of income were raised as pertinent issues by the participants as potentially leading to psychological consequences. Health workers and public both raised concerns over inadequate Personal Protective Equipment, under-prepared health system, unorganised public quarantine centres, and public violation of lockdownConclusionsThis study reports participants’ views on disease prevention measures such as maintaining personal hygiene, adhering to physical distancing, and using personal protective equipments. Additionally, it illuminates the confusion among public due to conflicting public health messages from different sources of information which was deemed as misleading by the participants. This research sheds light on people’s perspectives and experiences that can inform population-targeted policies in the future.
Processing of positive newborn screening results: a qualitative exploration of current practice in England
Authors: Chudleigh Jane , Chinnery Holly , Holder Pru , Carling Rachel S , Southern Kevin , Olander Ellinor , Moody Louise , Morris Stephen , Ulph Fiona , Bryon Mandy , Simpson Alan 
Published: December 2020

ObjectiveTo explore current communication practices for positive newborn screening results from the newborn bloodspot screening (NBS) laboratory to clinicians to highlight differences, understand how the pathways are implemented in practice, identify barriers and facilitators and make recommendations for future practice and research.DesignA qualitative exploratory design was employed using semi-structured interviews.SettingThirteen NBS laboratories in England.ParticipantsSeventy-one clinicians; 22 NBS laboratory staff across 13 laboratories and 49 members of relevant clinical teams were interviewed.ResultsAssurance of quality and consistency was a priority for all NBS laboratories. Findings indicated variation in approaches to communicating positive NBS results from laboratories to clinical teams. This was particularly evident for congenital hypothyroidism and was largely influenced by local arrangements, resources and the fact individual laboratories had detailed standard operating procedures for how they work. Obtaining feedback from clinical teams to the laboratory after the child had been seen could be challenging and time-consuming for those involved. Pathways for communicating carrier results for cystic fibrosis and sickle cell disease could be ambiguous and inconsistent which in turn could hamper the laboratories efforts to obtain timely feedback regarding whether or not the result had been communicated to the family. Communication pathways for positive NBS results between laboratories and clinical teams could therefore be time-consuming and resource-intensive.ConclusionThe importance placed on ensuring positive NBS results were communicated effectively and in a timely fashion from the laboratory to the clinical team was evident from all participants. However, variation existed in terms of the processes used to report positive NBS results to clinical teams and the people involved. Variant practice identified may reflect local needs, but more often reflected local resources and a more consistent ‘best practice’ approach is required, not just in the UK but perhaps globally.Trial registration numberISRCTN15330120.
Development and validation of the VitaL CLASS score to predict mortality in stage IV solid cancer patients with septic shock in the emergency department: a multi-center, prospective cohort study
Authors:   on behalf of the Korean Shock Society (KoSS) Investigators, Kim Youn-Jung , Kang Jihoon , Kim Min-Ju , Ryoo Seung Mok , Kang Gu Hyun , Shin Tae Gun , Park Yoo Seok , Choi Sung-Hyuk , Kwon Woon Yong , Chung Sung Phil , Kim Won Young 
Published: December 2020

Abstract
Background
Clinical decision-making of invasive high-intensity care for critically ill stage IV cancer patients in the emergency department (ED) is challenging. A reliable and clinically available prognostic score for advanced cancer patients with septic shock presented at ED is essential to improve the quality of intensive care unit care. This study aimed to develop a new prognostic score for advanced solid cancer patients with septic shock available early in the ED and to compare the performance to the previous severity scores.

Methods
This multi-center, prospective cohort study included consecutive adult septic shock patients with stage IV solid cancer. A new scoring system for 28-day mortality was developed and validated using the data of development (January 2016 to December 2017; n = 469) and validation sets (January 2018 to June 2019; n = 428). The developed score’s performance was compared to that of the previous severity scores.

Results
New scoring system for 28-day mortality was based on six variables (score range, 0–8): vital signs at ED presentation (respiratory rate, body temperature, and altered mentation), lung cancer type, and two laboratory values (lactate and albumin) in septic shock (VitaL CLASS). The C-statistic of the VitaL CLASS score was 0.808 in the development set and 0.736 in the validation set, that is superior to that of the Sequential Organ Failure Assessment score (0.656, p = 0.01) and similar to that of the Acute Physiology and Chronic Health Evaluation II score (0.682, p = 0.08). This score could identify 41% of patients with a low-risk group (observed 28-day mortality, 10.3%) and 7% of patients with a high-risk group (observed 28-day mortality, 73.3%).

Conclusions
The VitaL CLASS score could be used for both risk stratification and as part of a shared clinical decision-making strategy for stage IV solid cancer patients with septic shock admitting at ED within several hours.
Assessment of sleep disorders and use of psychoactive drugs among Polish students
Authors: Piotrowski Patryk , Babicki Mateusz , Maślanka Paulina , Kotowicz Kamila , Marciniak Dominik , Rymaszewska Joanna 
Published: December 2020

Cel pracyZaburzenia snu pod postacią bezsenności czy nadmiernej senności w ciągu dnia mają swoje konsekwencje zdrowotne i społeczne. Celem pracy była ocena częstości zaburzeń snu, jakości życia oraz wzorca stosowania substancji psychoaktywnych wśród studentów polskich uczelni wyższych w badaniu internetowym metodą CAVI.MetodaPosłużono się Ateńską Skalą Bezsenności, Skalą Senności Epworth oraz Manchesterską Krótką Oceną Jakości Życia.WynikiWśród respondentów (N=5342) dominowały kobiety (74%). Stwierdzono wysoki odsetek (>51%) zaburzeń snu z przewagą ich występowania u kobiet. Senność w ciągu dnia występowała u 28% respondentów co korelowało z zaburzeniami snu. Stosowanie środków psychoaktywnych jest bardzo powszechne (94%) wśród polskich studentów obu płci, które (poza alkoholem) w istotny sposób wpływają negatywnie na jakość życia (p=0.000). Studenci uczelni o profilu medycznym jedynie nieznacznie różnią się od studentów innych kierunków w ocenie wzorca stosowania używek. Jakość życia osób dotkniętych zaburzeniami snu oceniana jest dużo niżej niż u zdrowej populacji studentów.WnioskiDuża skala zjawiska zaburzeń snu oraz stosowania środków psychoaktywnych wśród polskich studentów wymaga dalszej eksploracji ze szczególnym naciskiem na działania prewencyjne oraz terapeutyczne.
Assessing effects of diet alteration on selected parameters of chronically mentally ill residents of a 24-hour Nursing Home. Part I: Effects of diet modification on carbohydrate-lipid metabolism
Authors: Friedrich Mariola , Fugiel Joanna , Bruszkowska Magda 
Published: December 2020

Cel pracyCelem badań była ocena czy i na ile możliwe jest wdrożenie prawidłowego żywienia u przewlekle psychicznie chorych, objętych całodobową opieką Domu Pomocy Społecznej.MetodaW badaniu udział wzięły 52 osoby, przebywające w całodobowym Domu Pomocy Społecznej (DPS) dla osób przewlekle psychicznie chorych. Badania prowadzono metodą prospektywną z wykorzystaniem badań ankietowych, wywiadu żywieniowego, badań antropometrycznych i analizy wybranych wskaźników biochemicznych krwi. Korekta diety, której towarzyszyła prowadzona równolegle prozdrowotna edukacja żywieniowa, polegała na zbilansowaniu jej wartości energetycznej i odżywczej odpowiednio dla płci, wieku, z uwzględnieniem choroby głównej i chorób współistniejących oraz zmianie źródeł podstawowych składników odżywczych, tj. białek, węglowodanów i lipidów, na bardziej zalecane lub prozdrowotne.WynikiStwierdzono, tak u kobiet jak i u mężczyzn, statystycznie istotne zmniejszenie spożycia energii, wynikające przede wszystkim z istotnego zmniejszenia spożycia lipidów i węglowodanów prostych. Zmiany zachowań żywieniowych znalazły swoje odbicie w statystycznie istotnym wzroście spożycia witamin i składników mineralnych oraz płynów w postaci wody. Zmiany składu diety przełożyły się na pozytywne zmiany wartości stężenia glukozy, triacylogliceroli, cholesterolu całkowitego i jego frakcji HDL- C. i LDL-C. u wielu z badanych pacjentów.WnioskiStwierdzono, że również u pacjentów przewlekle psychicznie chorych możliwe jest wdrożenie, przy ich pełnej akceptacji i współudziale, zasad prawidłowego żywienia. Zmiany w sposobie żywienia znalazły swoje odzwierciedlenie w poprawie wielu funkcji organizmu, w tym w poprawie wartości wskaźników przemian węglowodanowo – lipidowych, także u chorych na schizofrenię, leczonych neuroleptykami.
Cognitive and emotional impairment in patients with migraine and signs of leukoencephalopathy during preventive therapy
Authors: Pozhidaev K. A. , Parfenov V. A. 
Published: December 2020

Patients with migraine and signs of leukoencephalopathy are frequently found to have cognitive impairment (CI), the pathogenesis of which is not entirely clear. The dynamics of CI in these patients during preventive therapy has been little studied.Patients and methods. A six-month follow-up study was conducted in 50 patients (8 men and 42 women; mean age, 41.9±11.9 years) with migraine (mainly chronic one) and signs of cerebral leukoencephalopathy according to magnetic resonance imaging (MRI). A control group consisted of 40 healthy individuals (13 males and 27 females) aged 20 to 64 years (mean age, 42.6±12.0 years). Neuropsychological examinations (the 12-word recall test; the test of literal and categorical associations; the Benton visual retention test, the Munsterberg test; the Montreal Cognitive Assessment (MoCA), the trail making test; the forward and backward digit recall test; the digit-symbol coding test; and the Stroop color test) and studies of emotional disorders (the Beck Depression Inventory (BDI), the Center for Epidemiological Studies Depression Scale (CES-D); the Hospital Anxiety and Depression Scale (HADS), and the Spielberger-Khanin Scale) were performed at baseline, and at 3 and 6 months of preventive therapy for migraine.Results and discussion. The patients with migraine versus the control group were observed to have lower scores of the MoCA (p=0.004), the 12- word recall test (p=0.0003), and the tests of literal (p=0.001) and categorical (p=0.0002) associations. No significant relationship was found between the volume of MRI cerebral white matter lesions and the severity of CI. There was a moderate inverse correlation (correlation coefficient R=-0.41) between the number of headache (HA) days per month and the MoCA score (p<0.05). The patients with migraine were found to have the signs of depression on the Hospital Depression Scale (p=0.04), the BDI (p=0.003), and the CES-D Scale (p=0.0001) and increased anxiety on the HADS (p=0. 0001) and the Spielberger–Khanin Scale (p=0.0001). There was a significant association between the degree of depression and the MoCA score (p=0.007). During 6-month preventive therapy, there was a decline in the incidence of HA from 19.4±2.9 to 12.6±4.4 days per month (p<0.05), a significant reduction in the severity of emotional disorders, and an improvement in cognitive functions by most neuropsychological tests (the MoCA, the 12-word recall test, the Munsterberg test, and the trail making test Part B) compared to the baseline data.Conclusion. During preventive treatment for migraine, there was a reduction in the frequency of HA attacks and in the severity of emotional and cognitive impairment. The preventive treatment of migraine and related emotional disorders seems to be the most effective way to improve cognitive functions.
Effects of canagliflozin are mostly observed at first follow-up, within 6 months of commencement: results for the ABCD canagliflozin audit
Authors: Crabtree Thomas SJ , Winocour Peter , Darzy Ken , Phillips Suzanne , Evans Alison , Rohilla Anurita , Raghavan Rajeev , Sennik Devesh , Bickerton Alex , Idris Iskandar , Yadagiri Mahender , Ryder Robert EJ , Canagliflozin Audit Contributors ABCD 
Published: December 2020

Introduction: Canagliflozin was initially approved for use in the UK in March 2013. Randomised control trial evidence has demonstrated multiple beneficial effects. Many of these are present at initial follow-up and within 26 weeks of randomised control trial data. Our aim was to assess whether the beneficial effects of canagliflozin on multiple clinical and biochemical parameters occurred prior to first follow-up and, if so, whether these continued to improve or simply persisted at second follow-up.Methods: Data were extracted from the ABCD nationwide canagliflozin audit to include a minimum dataset of a baseline value and one (or two) follow-ups for each value.Results: A total of 1,214 patient datasets were identified and used in the analysis: mean±SD age 60.1±10.6 years; median duration of diabetes 8 (IQR 2.4–12.6 years); baseline HbA1c 75.1±17.4 mmol/mol (9.0±1.59%) and weight 97.8±22.0 kg. 68.3% of the patients were Caucasian where this was known (n=183). At first follow-up (median 0.7 years) from baseline: change in HbA1c −9.3 mmol/mol (95% CI −8.2 to −10.4; p<0.0001), weight −2.3 kg (95% CI −1.9 to −2.5; p<0.0001); BMI −0.7 kg/m2 (95% CI −0.6 to −0.8; p<0.0001); alanine aminotransferase −2 U/L (95% CI −1.3 to −2.7; p<0.0001); eGFR −0.9 mL/min/1.73 m2 (95% CI −0.4 to −1.4; p<0.001); systolic blood pressure (BP) −2.6 mmHg (95% CI −1.6 to −3.5; p<0.0001) and diastolic BP −0.9 mmHg (95% CI −0.2 to −1.6; p<0.001). Significant differences persisted comparing second follow-up (median 1.2 years) to baseline, but no further significant changes were noted between first follow-up and second follow-up other than in weight and BMI with further change in weight −0.65 kg (95% CI −0.2 to −1.1; p=0.047).Conclusion: The improvements following canagliflozin in this real-world cohort seem to occur within the first 0.7 years of treatment, which is similar to randomised controlled trial data. These improvements seem to be maintained over the next 6 months, with significant further weight loss occurring between 0.7 years and 1.2 years, although the mechanism of this is unclear and might be due to confounders. More evidence on this point is needed.
Glycaemic benefit of structured diabetes education in Nepal, a resource limited environment
Authors: Pradhan Jaya , Rajbhandari Satyan M 
Published: December 2020

Introduction: Structured diabetes education is a key element in the management of type 2 diabetes, but this is challenging to deliver in settings where resources are limited.Methods: We conducted a randomised evaluation of a single 90-minute session of structured diabetes education added to the local standard of diabetes care compared with a control group (standard diabetes care only) in 150 patients with recently diagnosed type 2 diabetes in Nepal. The level of knowledge about diabetes was low.Results: Follow-up 6 months after the intervention showed that the reduction in mean (SD) fasting plasma glucose was significantly larger in the education group (from 8.6 (2.9) mmol/L to 6.7 (1.2) mmol/L) compared with the control group (from 8.1 (1.8) mmol/L to 7.0 (1.8) mmol/L) (p=0.029 for comparison between groups). A significant reduction in postprandial plasma glucose also occurred in the education group (from 11.7 (3.7) mmol/L to 8.3 (1.2) mmol/L) compared with the control group (from 11.5 (4.0) mmol/L to 9.7 (2.3) mmol/L) (p=0.005 between groups). A trend to reduced HbA1c was seen for the education versus the control group at 6 months (p=0.06). There were no significant changes in lipids or blood pressure. Overall energy intake and the proportion of energy intake from fat was lower at 6 months compared with baseline for the education group but not for the control group, although there were no significant changes in anthropometric parameters.Conclusion: Our results suggest that a single session of structured diabetes education may provide glycaemic benefits in newly-diagnosed type 2 diabetes patients, and that this may be a pragmatic means of improving diabetes self-care in resource-limited countries such as Nepal.
Type 2 diabetes is an independent predictor of weight loss in Tier 3 Weight Assessment and Management Services
Authors: Prihartadi* Aliya Syahreni , Licastro* Giovanna Impelliziere , Deshmukh Harshal , Benamer Sufyan , Linn Kyaw , Shah Najeeb , Sathyapalan Thozhukat , Mohammed Kamrudeen 
Published: December 2020

Introduction: A specialist weight management service provides an effective treatment option for severe obesity; however, there are limited data exploring the baseline predictors of response and effect on HbA1c following engagement with the service.Methods: We used prospective data from the regional weight management services within the Hull University Teaching Hospitals NHS Trust Tier 3 Obesity Programme. Data were available for 249 patients referred to the service. T-tests were used for univariate baseline characteristics of those with and without 5% weight loss after engagement with the service. Logistic regression analysis was used to identify independent predictors of weight loss at 12 months.Results: A total of 309 patients were referred to the Tier 3 adult weight management service, of which 249 (80.6%) participated in the programme and had at least one follow-up. The median age of the study population was 46 years (range 36–55) and consisted of 66% females with a median baseline body mass index of 44 kg/m2 (range 42–45). The prevalence of type 2 diabetes was 31%, hypertension was 35%, gastro-oesophageal reflux disease was 34% and osteoarthritis was 29%. The median baseline weight on enrolment in the programme was 126 kg (range 115–138). During the follow-up period of 1 year, the median weight fell to 120.5 kg at 3 months, 119.6 kg at 6 months, 117.7 kg at 9 months and 117.5 kg at 12 months. The median HbA1c fell from a baseline of 60.25 mmol/mol to 54.4 mmol/mol during the follow-up period. Sixty-four patients had a baseline HbA1c of >53 mmol/mol (7% HbA1c), which fell to <53 mmol/mol in 21% of patients during the follow-up period. In the logistic regression model, higher age (OR 1.05, p=0.0001), type 2 diabetes (OR 2.54, p=0.002) and dyslipidaemia (OR 2.21, p=0.03) were independently associated with more than 5% weight loss at 12 months follow-up.Conclusion: Engagement with Tier 3 adult weight management is associated with significant weight loss and improvement in glycaemic control in a large proportion of patients at one year. Higher age, diabetes and dyslipidaemia at baseline are independent predictors of weight loss on the Tier 3 weight management service.
KCNN4 Expression Is Elevated in Inflammatory Bowel Disease: This Might Be a Novel Marker and Therapeutic Option Targeting Potassium Channels
Authors: Süss Christoph , Broncy Lucile , Pollinger Kirstin , Kunst Claudia , Gülow Karsten , Müller Martina , Wölfel Gisela 
Published: December 2020

Background and Aims: The K + channel KCNN4 is involved in many inflammatory diseases. Previous work has shown that this channel is involved in epithelial ion transport and intestinal restitution. In inflammatory bowel diseases (IBD) a defective epithelial barrier can lead to typical symptoms like secretory diarrhea and the formation of intestinal ulcers. We compared surgical samples from patients with IBD, diverticulitis and controls without inflammation to determine the potential role of KCNN4 as a diagnostic marker and/or therapeutic target.
Methods: mRNA-levels of KCNN4 and a control K + channel were determined in intestinal epithelial cells (IEC) from patients with IBD, diverticulitis and controls. In addition, we performed a Western blot analysis of KCNN4 and a respective control K + channel in IEC from patients with IBD. Furthermore, we determined epithelial barrier integrity by measuring the flux of fluorescent-labeled dextran beads across a cell monolayer upon incubation with interferon-γ.
Results: KCNN4 mRNA and protein levels were elevated in IEC from patients with Crohn`s disease (CD) and ulcerative colitis (UC). Of note, KCNN4 was not elevated in non-IBD intestinal inflammatory conditions e.g. diverticulitis. Of clinical relevance, pharmacological KCNN4 channel openers stabilized epithelial barrier function in vitro. Thus, KCNN4 may have a protective role in IBD and constitute a therapeutic target.
Conclusions: Our data demonstrate elevated KCNN4 both at mRNA and protein level in IEC specifically from patients with IBD. Therefore, we conclude that KCNN4 could be used as a novel marker for IBD, especially for the establishment of initial diagnosis. Of therapeutic consequence, we show that pharmacological KCNN4 openers stabilize the epithelial barrier. Thus, KCNN4 might be a novel target to diagnose and treat IBD.