bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient disease knowledge, attitudes and behaviours related to non-alcoholic fatty liver disease: a qualitative study
Authors: Tincopa Monica A , Wong Jane , Fetters Michael , Lok Anna S 
Published: June 2021

ObjectiveDespite clear evidence that weight loss via nutritional and physical activity changes improves histological outcomes in non-alcoholic fatty liver disease (NAFLD), many patients struggle to implement and maintain these health behaviour changes. The aim of this study was to characterise disease knowledge, attitudes and behaviours among persons with NAFLD and to identify the factors driving these health behaviours and perceptions.DesignWe conducted semistructured interviews among patients with NAFLD. We used purposeful sampling to enroll equivalent percentages based on age and sex, and enrolled approximately one-third of patients with cirrhosis to capture those perspectives. Interviews were conducted until thematic saturation was achieved. Transcripts were coded using NVivo software to identify themes and subthemes.ResultsA total of 29 patient interviews were completed. Ambiguity about the diagnosis and aetiology of their liver disease was a key theme, though the vast majority of patients were aware that weight loss via nutrition and exercise was the primary therapy. Most patients were asymptomatic, diagnosed incidentally, and reported low level of concern regarding their diagnosis. The primary barriers and facilitators to health behaviour change were the presence of social support, competing medical comorbidities and low motivation to change behaviours.ConclusionsAlthough patients are aware that lifestyle interventions are the primary therapy for NAFLD, there is a gap in knowledge about the condition. The presence of social support and competing medical comorbidities were the most consistent facilitators and barriers to lifestyle change. Tailoring treatment recommendations to provide relevant disease education, specific nutrition and exercise regimens, and personalised approaches based on specific individual barriers and facilitators will likely aid in uptake and maintenance of first-line therapy for NAFLD.
Higher adenoma detection, sessile serrated lesion detection and proximal sessile serrated lesion detection are associated with physician specialty and performance on Direct Observation of Procedural Skills
Authors: Telford Jennifer , Gondara Lovedeep , Pi Steven , Gentile Laura , Enns Robert 
Published: June 2021

ObjectiveAdenoma detection rate (ADR) and sessile serrated lesion detection rate (SSLDR) vary among physicians. We sought to determine physician characteristics associated with ADR and SSLDR in a population-based colon screening programme.DesignRetrospective study of 50–74 year olds with positive faecal immunochemical test and colonoscopy from 15/11/2013 to 31/12/2018. Physician characteristics included: gender, specialty, year and country of medical school graduation, colonoscopy volume and Direct Observation of Procedural Skills (DOPS) performance. Multivariable regression was performed on the following dependent variables: ADR, advanced ADR, proximal and distal ADR, SSLDR, proximal and distal SSLDR.Results104 326 colonoscopies were performed by 261 physicians. A higher ADR was associated with gastroenterology (OR for general surgery 0.87, 95% CI 0.80 to 0.95; OR for general/family/internal medicine 0.70, 95% CI 0.55 to 0.88), fewer years since graduation (OR for graduation>2000 10.48, 95% CI 1.30 to 1.69 compared with <1980) and DOPS performance (OR for lowest DOPS performance 0.64, 95% CI 0.50 to 0.82 compared with highest DOPS performance). SSLDR was associated with gastroenterology (OR for general surgery 0.89, 95%, CI 0.81 to 0.97; OR for general/family/internal medicine 0.67, 95% CI 0.49 to 0.92) and DOPS performance (OR for lowest DOPS performance 0.71, 95% CI 0.51 to 0.99 compared with highest DOPS performance). Proximal SSLDR was associated with gastroenterology (OR for general surgery 0.90, 95% CI 0.82 to 0.99; OR for general/family/internal medicine 0.69, 95% CI 0.50 to 0.97) and DOPS performance (OR for lowest DOPS performance 0.68, 95% CI 0.47 to 0.99).ConclusionHigher ADR, SSLDR and proximal SSLDR was associated with gastroenterology specialty and improved performance on DOPS.
Improving pathways to care through interventions cocreated with communities: a qualitative investigation of men’s barriers to tuberculosis care-seeking in an informal settlement in Blantyre, Malawi
Authors: Phiri Mackwellings Maganizo , Makepeace Effie , Nyali Margaret , Kumwenda Moses , Corbett Elizabeth , Fielding Katherine , Choko Augustine , MacPherson Peter , MacPherson Eleanor Elizabeth 
Published: June 2021

IntroductionMen have a higher prevalence of undiagnosed tuberculosis (TB) than women and can spend up to a year longer contributing to ongoing transmission in the community before receiving treatment. Health outcomes are often worse for patients with TB living in informal settlements especially men. This study aimed to understand the barriers preventing men from seeking care for TB and cocreate interventions to address these barriers.MethodsWe used qualitative research methods including in-depth interviews and participatory workshops. Researchers worked with women and men living in Bangwe, an informal settlement in Blantyre, Malawi to develop interventions that reflected their lived realities. The study took place over two phases, in the first phase we undertook interviews with men and women to explore barrier to care seeking, in the second phase we used participatory workshops to cocreate interventions to address barriers and followed up on issues emerging from the workshops with further interviews. In total, 30 interviews were conducted, and 23 participants joined participatory workshops. The team used a thematic analysis to analyse the data.ResultsThree interconnected thematic areas shaped men’s health TB seeking behaviour: precarious socioeconomic conditions; gendered social norms; and constraints in the health system. Insecurity of day labour with no provision for sick leave; pressure to provide for the household and a gendered desire not to appear weak and a severely under-resourced health system all contributed to men delaying care in this context. Identified interventions included improved patient–provider relations within the health-system, improved workers’ health rights and broader social support for households.ConclusionImproving mens’ pathways to care requires interventions that consider contextual issues by addressing individual level socioeconomic factors but also broader structural factors of gendered social dynamics and health systems environment.
Italian version of the short 10/66 dementia diagnostic schedule: a validation study
Authors: Ibnidris Aliaa , Piumatti Giovanni , Carlevaro Fabio , Fadda Marta , Magno Francesca , Magistro Daniele , Albanese Emiliano 
Published: June 2021

ObjectivesTo determine the criterion and concurrent validity of the Italian version of the short 10/66 Dementia Diagnostic Schedule and algorithm in a sample of Italian native speakers, older adults.DesignA cross-sectional, validation study.SettingThe study was conducted with older adults living in the community and in nursing homes in the Canton of Ticino, Switzerland, and the Piedmont region in Italy between March and August 2019.ParticipantsA convenience sample of 229 participants (69% females) were recruited. The eligibility criteria were being ≥60 years old and having an informant. The final sample included 74 participants (32%) with a previous clinical diagnosis of dementia and 155 (68%) cognitively healthy older adults.Primary and secondary outcome measuresThe short version of 10/66 Dementia Diagnostic Schedule consists of the Community Screening Instrument for Dementia, the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) 10-word list learning task with delayed recall and the depression scale, Euro-Depression (EURO-D) scale. Disability was measured using the WHO Disability Assessment Schedule (WHO-DAS II).ResultsThe Italian version of the short 10/66 Dementia Diagnostic Schedule showed fair sensitivity (87%), specificity (61%) and agreement with the clinical diagnosis of dementia (kappa=0.40, area under the receiver operating characteristics curve=0.74). Older adults with dementia living in nursing homes had higher disability scores (WHO-DAS II mean=23.14, SE=1.29) than those living in the community (WHO-DAS II mean=7.08, SE=0.66). WHO-DAS II was positively correlated with the short version of the 10/66 dementia diagnosis (β=5.23, 95% CI 2.05 to 8.41).ConclusionsIn settings where lengthy diagnostic procedures are not feasible, the short 10/66 is a practical tool to identify dementia in older adults. Our findings extend evidence on the validity of the 10/66 dementia diagnostic algorithm to high-income countries, where epidemiological evidence on dementia and its impact is outdated.
Restoring invisible and abandoned trials of gabapentin for neuropathic pain: a clinical and methodological investigation
Authors: Mayo-Wilson Evan , Chen Xiwei , Qureshi Riaz , Dickinson Stephanie , Golzarri-Arroyo Lilian , Hong Hwanhee , Görg Carsten , Li Tianjing 
Published: June 2021

IntroductionGabapentin (Neurontin) is prescribed widely for conditions for which it has not been approved by regulators, including certain neuropathic pain conditions. There is limited evidence that gabapentin is safe and effective for the treatment of neuropathic pain. Published trial reports, and systematic reviews based on published trial reports, mislead patients and providers because information about gabapentin’s harms has been published only partly. We confirmed that trials conducted by the drug developer have been abandoned, and we plan to conduct a restoration with support from the Restoring Invisible and Abandoned Trials Support Centre (https://restoringtrials.org/).Methods and analysisIn this study, we will analyse and report the harms that were observed in six trials of gabapentin, which have not been reported publicly (eg, in journal articles). We will use clinical study reports and individual participant data to identify and report the harms observed in each individual trial and to summarise the harms observed across all six trials. We will report all adverse events observed in the included trials by sharing deidentified data and summary tables on the Open Science Framework (https://osf.io/w8puv/). Additionally, we will produce a summary report that describes differences between the randomised groups in each trial and across trials for prespecified harms outcomes.Ethics and disseminationWe will use secondary data. This study was determined to be exempt from Institutional Review Board (IRB) review (protocol #1910607198).
Challenges of enforcing cellphone use while driving laws among police in the USA: a cross-sectional analysis
Authors: Rudisill Toni Marie , Zhu Motao 
Published: June 2021

ObjectivesResearch suggests that cellphone use while driving laws may be difficult for police to enforce in the USA, but this is unknown. A national survey of police officers was conducted to determine whether barriers to enforcing these laws exist, what aspects of laws make them easier to enforce and ways to discourage the behaviour among drivers.DesignCross-sectional survey.SettingUSA.ParticipantsIndividuals >18 years of age employed as a law enforcement officer from all 50 states were recruited via convenience sampling through multiple modalities from November 2019 to April 2020. Officers (N=353) from 31 states participated.Primary and secondary outcome measuresDescriptive statistics and multi-level logistic regression analyses were run to assess the responses.ResultsThe most common barriers to enforcing texting bans (ie, the most prevalent law) were drivers concealing their phone use (78%) and the officer not being able to determine what the driver was doing on their phone (65%). If a universal hand-held cellphone ban was in effect in their state, officers were 77% less likely (adjusted OR=0.23; 95% CI 0.08 to 0.70) to report that a texting ban was difficult to adjudicate. The majority of officers (86%) agreed that having one general law that prohibits any type of hand-held cellphone use would aid with enforcement, and that laws must be a primary offence (87%), and be applicable to all licensed drivers (91%). Most officers felt that driver education is needed.ConclusionsWhile numerous barriers to enforcement were identified, opportunities exist to improve current legislation to aid enforcement efforts and to prevent the behaviour among drivers.
Post-acute sequelae of SARS-CoV-2 infection (PASC): a protocol for a multidisciplinary prospective observational evaluation of a cohort of patients surviving hospitalisation in Sao Paulo, Brazil
Authors: Busatto Geraldo Filho , de Araújo Adriana Ladeira , Duarte Alberto José da Silva , Levin Anna Sara , Guedes Bruno Fukelmann , Kallas Esper Georges , Pinna Fabio Rezende , de Souza Heraldo Possolo , da Silva Katia Regina , Sawamura Marcio Valente Yamada , Seelaender Marilia , Imamura Marta , Garcia Michelle Louvaes , Forlenza Orestes Vicente , Nitrini Ricardo , Damiano Rodolfo Furlan , Rocha Vanderson Geraldo , Batisttella Linamara Rizzo , Carvalho Carlos Roberto Ribeiro de ,   on behalf of the HCFMUSP PASC Initiative
Published: June 2021

IntroductionCOVID-19 may lead to persistent and potentially incapacitating clinical manifestations (post-acute sequelae of SARS-CoV-2 infection (PASC)). Using easy-to-apply questionnaires and scales (often by telephone interviewing), several studies evaluated samples of COVID-19 inpatients from 4 weeks to several months after discharge. However, studies conducting systematic multidisciplinary assessments of PASC manifestations are scarce, with thorough in-person objective evaluations restricted to modestly sized subsamples presenting greatest disease severity.Methods and analysesWe will conduct a prospective observational study of surviving individuals (above 18 years of age) from a cohort of over 3000 subjects with laboratory-confirmed COVID-19 who were treated as inpatients at the largest academic health centre in Sao Paulo, Brazil (Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo). All eligible subjects will be consecutively invited to undergo a 1–2-day series of multidisciplinary assessments at 2 time-points, respectively, at 6–9 months and 12–15 months after discharge. Assessment schedules will include detailed multidomain questionnaires applied by medical research staff, self-report scales, objective evaluations of cardiopulmonary functioning, physical functionality and olfactory status, standardised neurological, psychiatric and cognitive examinations, as well as diagnostic laboratory, muscle ultrasound and chest imaging exams. Remaining material from blood tests will be incorporated by a local biobank for use in future investigations on inflammatory markers, genomics, transcriptomics, peptidomics and metabolomics.Ethics and disseminationAll components of this programme have been approved by local research ethics committees. We aim to provide insights into the frequency and severity of chronic/post-COVID multiorgan symptoms, as well as their interrelationships and associations with acute disease features, sociodemographic variables and environmental exposures. Findings will be disseminated in peer-reviewed journals and at scientific meetings. Additionally, we aim to provide a data repository to allow future pathophysiological investigations relating clinical PASC features to biomarker data extracted from blood samples.Trial registration numberRBR-8z7v5wc; Pre-results.
Pro-inflammatory cytokine profile is present in the serum of Mexican patients with different stages of diabetic retinopathy secondary to type 2 diabetes
Authors: Quevedo-Martínez Jonathan Uriel , Garfias Yonathan , Jimenez Joanna , Garcia Osvaldo , Venegas Diana , Bautista de Lucio Victor Manuel 
Published: June 2021

AimIt’s been reported that pro-inflammatory cytokines are elevated in patients with diabetic retinopathy (DR); this may contribute to the pathophysiology of the disease. The aim of this study is to measure the concentration of various inflammatory cytokines from the main CD4+ T helper inflammatory responses in blood serum from Mexican patients with DR in different stages using cytometric bead array (CBA) technology and correlate them with the presence and severity of DR in order to find possible DR biomarkers that serve as diagnostic or therapeutic predictors.Methods64 subjects were included in the study, 16 in the control group, 16 in the type 2 diabetes mellitus no DR (NDR) group, 16 in the non-proliferative DR (NPDR) group and 16 in the proliferative DR (PDR) group. Cytokine concentrations of interleukin (IL) 1ß, IL‐2, IL‐4, IL‐6, IL‐8, IL‐10, IL‐12, IL‐17A, tumour necrosis factor alpha (TNFα) and interferon-gamma in serum samples were measured using Human Inflammatory and TH1/TH2/TH17 CBA Kit.ResultsIL-6, IL-12, IL-17a and TNFα were significantly higher in the patients with DR compared with the control group. The PDR group showed a slightly lower concentration of serum cytokines IL-6, IL-12 and IL-17a. TNFα showed a higher concentration compared with healthy controls, NDR and NPDR subjects. We also found a positive statistical correlation between the presence and severity of DR with the clinical parameters haemoglobin A1c, body mass index and serum creatinine and the concentration of serum cytokines IL-6 and TNFα.ConclusionOur findings suggest that patients with diabetes and DR have a stronger chronic inflammatory profile compared with non-diabetic subjects.
IFN-γ- and IL-17-producing CD8+ T (Tc17-1) cells in combination with poly-ICLC and peptide vaccine exhibit antiglioma activity
Authors: Ohkuri Takayuki , Kosaka Akemi , Ikeura Maki , Salazar Andres M , Okada Hideho 
Published: June 2021

BackgroundWhile adoptive transfer of T-cells has been a major medical breakthrough for patients with B cell malignancies, the development of safe and effective T-cell-based immunotherapy for central nervous system (CNS) tumors, such as glioblastoma (GBM), still needs to overcome multiple challenges, including effective homing and persistence of T-cells. Based on previous observations that interleukin (IL)-17-producing T-cells can traffic to the CNS in autoimmune conditions, we evaluated CD8+ T-cells that produce IL-17 and interferon-γ (IFN-γ) (Tc17-1) cells in a preclinical GBM model.MethodsWe differentiated Pmel-1 CD8+ T-cells into Tc17-1 cells and compared their phenotypic and functional characteristics with those of IFN-γ-producing CD8+ T (Tc1) and IL-17-producing CD8+ T (Tc17) cells. We also evaluated the therapeutic efficacy, persistence, and tumor-homing of Tc17-1 cells in comparison to Tc1 cells using a mouse GL261 glioma model.ResultsIn vitro, Tc17-1 cells demonstrated profiles of both Tc1 and Tc17 cells, including production of both IFN-γ and IL-17, although Tc17-1 cells demonstrated lesser degrees of antigen-specific cytotoxic activity compared with Tc1 cells. In mice-bearing intracranial GL261-Quad tumor and treated with temozolomide, Tc1 cells, but not Tc17-1, showed a significant prolongation of survival. However, when the T-cell transfer was combined with poly-ICLC and Pmel-1 peptide vaccine, both Tc1 and Tc17-1 cells exhibited significantly prolonged survival associated with upregulation of very late activation antigen−4 on Tc17-1 cells in vivo. Glioma cells that recurred following the therapy lost the susceptibility to Pmel-1-derived cytotoxic T-cells, indicating that immuno-editing was a mechanism of the acquired resistance.ConclusionsTc17-1 cells were equally effective as Tc1 cells when combined with poly-ICLC and peptide vaccine treatment.
СТАН СИСТЕМИ ГІДРОГЕН СУЛЬФІДУ ПЕЧІНКИ ЩУРІВ ПРИ ЕКСПЕРИМЕНТАЛЬНІЙ НЕФРОПАТІЇ ЗА УМОВ ВВЕДЕННЯ МЕЛАТОНІНУ
Authors: Коляник І. О. , Геруш І. В. 
Published: June 2021

Резюме. Метаболічні порушення, що виникають при нефропатії, супроводжуються продукцією вільних радикалів, що призводить до структурно-функціональних порушень клітинних мембран різних органів і систем, у тому числі й печінки. Гідроген сульфід (H2S) – це газотрансмітер і важлива сигнальна молекула, що регулює безліч фізіологічних та патофізіологічних процесів. Мелатонін, як гормон епіфіза, володіє імуностимулюючими, детоксикаційними та антиоксидантними властивостями. Однак залишаються нез’ясованими всі механізми дії мелатоніну, зокрема його вплив на систему гідроген сульфіду при нефропатії.
Мета дослідження – з’ясувати вплив мелатоніну на стан системи гідроген сульфіду в печінці щурів за умов експериментальної нефропатії.
Матеріали і методи. Експеримент проведено на 84 нелінійних щурах-самцях масою 0,16–0,18 кг. Експериментальну нефропатію моделювали за допомогою одноразового внутрішньочеревного введення фолієвої кислоти в дозі 250 мг/кг маси тіла. Мелатонін вводили інтрагастрально упродовж 7-ми днів після моделювання нефропатії в дозі 10 мг/кг. У постмітохондріальній фракції печінки щурів визначали продукцію та концентрацію гідроген сульфіду, а також активність H2S-генеруючих ензимів: цистатіонін-γ-ліази (CSE), цистатіонін-β-синтази (СBS) та цистеїнамінотрансферази (САТ).
Результати. При експериментальній нефропатії встановлено зниження продукції та концентрації H2S на 27,9 % і 45,2 % відповідно, а також зниження активності H2S-продукуючих ензимів: CSE – на 31,7 %, СBS – на 32,1 % та САТ – на 32,7 % відповідно порівняно з групою контрольних тварин. Введення мелатоніну сприяло підвищенню H2S-продукції та концентрації на 20,9 % і 33,0 %, а також активності H2S-продукуючих ензимів СBS та САТ на 23,7 % і 25,4 % відповідно, порівняно з показниками тварин із нефропатією, але все ще достовірно відрізнялося від показників контрольних тварин.
Висновки. Нефропатія призводить до зниження концентрації та продукції Н2S у печінці щурів, через пригнічення H2S-продукуючої активності ензимів, що генерують Н2S. Введення мелатоніну сприяло підвищенню вмісту гідроген сульфіду як за рахунок підвищення активності СВS та САТ, так, ймовірно, і за рахунок безпосередньої участі мелатоніну в знешкодженні вільних радикалів та зниженні окиснювальної модифікації протеїнів, зокрема і досліджуваних ензимів.