bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validation of the intolerance of uncertainty scale as a screening tool for perinatal anxiety
Authors: Furtado Melissa , Frey Benicio N. , Green Sheryl M. 
Published: December 2021

Abstract
Background
To date, there is a significant lack of research validating clinical tools for early and accurate detection of anxiety disorders in perinatal populations. Intolerance of uncertainty was recently identified as a significant risk factor for postpartum anxiety symptoms and is a key trait of non-perinatal anxiety disorders. The present study aimed to validate the Intolerance of Uncertainty Scale (IUS) in a perinatal population and evaluate its use as a screening tool for anxiety disorders.

Methods
Psychiatric diagnoses were assessed in a sample of perinatal women (n = 198), in addition to completing a self-report battery of questionnaires. Psychometric properties including internal consistency and convergent and discriminant validity were assessed. Determination of an optimal clinical cut-off score was measured through a ROC analysis in which the area under the curve, sensitivity, specificity, as well as positive and negative predictive values were calculated.

Results
The IUS demonstrated excellent internal consistency (α = 0.95) and an optimal clinical cut-off score of 64 or greater was established, yielding a sensitivity of 89%. The IUS also demonstrated very good positive (79%) and negative (80%) predictive values.

Conclusions
These findings suggest that the IUS represents a clinically useful screening tool to be used as an aid for the early and accurate detection of perinatal anxiety.
The psychological impact of paediatric burn injuries: a systematic review
Authors: Woolard Alix , Hill Nicole T. M. , McQueen Matthew , Martin Lisa , Milroy Helen , Wood Fiona M. , Bullman Indijah , Lin Ashleigh 
Published: December 2021

Abstract
Objective
To review and synthesise qualitative literature regarding the psychological outcomes following paediatric burn injuries, and to determine if children and adolescents who experience a burn injury have elevated risk of psychopathology following the injury.

Design
Systematic review of quantitative and qualitative studies.

Data sources
Informit health, Medline, Embase, and PsycINFO were searched from January 2010 to December 2020.

Data extraction and synthesis
Two reviewers screened articles, and one reviewer extracted data (with cross-checking from another reviewer) from the included studies and assessed quality using an established tool. Narrative synthesis was used to synthesise the findings from the quantitative studies, and thematic synthesis was used to synthesise the findings of included qualitative studies.

Results
Searches yielded 1240 unique titles, with 130 retained for full-text screening. Forty-five studies from 17 countries were included. The psychological outcomes included in the studies were mental health diagnoses, medication for mental illness, depression, anxiety, stress, fear, post-traumatic stress, post-traumatic growth, emotional issues, self-harm, self-esteem, self-concept, stigmatisation, quality of life, level of disability, resilience, coping, and suicidality.

Conclusions
Our findings highlight paediatric burn patients as a particularly vulnerable population following a burn injury. Studies suggest elevated anxiety and traumatic stress symptoms, and higher rates of psychopathology in the long-term. Further research is recommended to determine the psychological outcomes in the other mental health domains highlighted in this review, as findings were mixed.
Clinical care teams responsible for the aftercare of burn patients should involve psychological support for the children and families to improve outcomes.
Tetrandrine alleviates podocyte injury via calcium-dependent calpain-1 signaling blockade
Authors: Ding Yin , Tang Xuanli , Wang Yuhui , Yu Dongrong , Zhu Caifeng , Yu Jin 
Published: December 2021

Abstract
Background
Podocytes have become a crucial target for interventions in proteinuric kidney diseases. Many studies have reported that overexpression of transient receptor potential cation channel protein 6 (TRPC6) in podocyte injury upregulates intracellular Ca2+ influx and stimulates Ca2+-dependent protease calpain-1 signaling. The traditional Chinese drug, tetrandrine, a nonselective Ca2+ channel blocker, has long been used to treat chronic kidney disease. This research aimed to explore the possible mechanisms underlying the anti-proteinuric properties of tetrandrine.

Methods
We investigated the involvement of tetrandrine in Ca2+ dependent calpain-1 signaling in mouse podocytes and adriamycin-induced nephropathy rats. Cyclosporine A (CsA) and U73122 were used as positive controls. Cell viability, cytotoxicity, Ca2+ concentration, calpain activity, and mRNA and protein expression levels of calpain-1 signaling pathways were examined. The clinical and pathological changes were measured.

Results
Tetrandrine decreased intracellular Ca2+ influx in cultured TRPC6-overexpressing podocytes. In both in vitro and in vivo studies, the administration of tetrandrine downregulated calpain activity and the expression of calpain-1 and restored the expression of downstream Talin-1 and nephrin. Compared to CsA, tetrandrine treatment exhibited superior inhibitory effects on calpain activity and calpain-1 expression.

Conclusions
Tetrandrine has therapeutic potential in podocyte damage by blocking Ca2+-dependent activation of the calpain-1 signaling pathway. Tetrandrine reduced proteinuria, improved renal function, and alleviate renal pathological damage.
Protein expression of the tear film of domestic cats before and after inoculation with Toxoplasma gondii
Authors: Guedes Paula Elisa Brandão , Veloso Jéssica Fontes , Lacerda Luciana Carvalho , Santana Juliano Oliveira , Mora-Ocampo Irma Yuliana , Pirovani Carlos Priminho , Cruz Rebeca Dalety Santos , Munhoz Alexandre Dias , Carlos Renata Santiago Alberto 
Published: December 2021

Abstract
Background
Tear film (TF) helps maintain and protect ocular function against damage to the ocular surface. Proteins are one of its main constituents, whose expression pattern can be used as a biomarker of ocular changes and systemic diseases. The aim of this study was to evaluate the expression of proteins in the TF of domestic cats before and after infection with Toxoplasma gondii, in the phases of acute infection and chronicity. Twelve healthy cats received orally homogenized brain matter obtained from mice inoculated with T. gondii oocysts, strain ME49. Cat feces were collected daily from the third day after infection to assess the release of oocysts. TF samples were obtained from cats, by Schirmer’s Tear Test 1, on day 0 (before infection), day 5 after infection (acute phase of infection, with maximum peak release of oocysts in feces) and on day 21 after infection (start of chronic phase, 7 days after total absence of oocyst release in feces). Tear samples were also submitted to proteomic analysis in a Q-Tof-Premier mass spectrometer.

Results
A total of 37 proteins with scores equal to or greater than 100 were identified on D0, followed by 36 on D5 and 42 on D21. Of these, 27 were common to D0 and D5, 33 to D0 and D21, 27 to D5 and D21, and 26 were common to the three groups, totaling 54 proteins. The most abundant proteins were lipocalin allergen Fel d, serum albumin, aldehyde dehydrogenase, lactoperoxidase and lactotransferrin. There was no significant difference in the abundance of proteins found on D0 and D5, but there was a statistical difference between D0 and D21 for ACT1_AEDAE, CERU_HUMAN and GELS_HUMAN. Regarding D5 and D21, there were significant differences for KV1_CANLF, LAC_PIG, TRFL_PIG, ACT1_AEDAE, CERU_HUMAN, GELS_HUMAN and OVOS2_HUMAN.

Conclusions
The main proteins identified in the TF of domestic cats are similar to those found in humans and other animal species. Most are part of the ocular surface defense system against injuries. The most expressed proteins in animals in the chronic phase of T. gondii infection are associated with the immune response to the parasite.
Prevalence and associated factors of gender based violence among Baso high school female students, 2020
Authors: Mingude Alemu Basazin , Dejene Tadesse Mamo 
Published: December 2021

AbstractBackgroundGender-based violence (GBV) is a common reproductive health problem, especially in developing countries. It is still the first research priority area in Africa that is identified by World Health Organization. The main aim of this study was to identify the prevalence and determinants of Gender Based Violence among Baso high school female students in Debre Berhan town, Ethiopia.MethodsAn institutional based cross-sectional study was conducted in Debre Berhan, Ethiopia. A total of 350 female students were selected by stratified sampling technique. A self-administered structured questionnaire was used to collect the data. Each independent variable was fitted separately into bivariate logistic analysis, and Variables with p-values less than 0.25 in bivariable model were fitted into multivariate logistic regression analysis to evaluate the degree of association with gender-based violence. The significance level was obtained with 95% CI and p-value < 0.05.ResultThe prevalence of GBV during the lock- down was 36.2% (95% CI 0.3, 0.4), and the lifetime prevalence of GBV was 47.2% (95% CI 0.4, 0.5). The prevalence of life time sexual violence and physical violence were found to be 27.99% (95% CI 0.2, 0.3), and 37.99% (95% CI 0.3, 0.4), respectively. Sexual violence and physical violence during the lockdown were found to be 21.3% and 17.8%, respectively. Respondents educational performance (AOR = 4.5; 95% CI 1.8, 11.3), monthly pocket money received from their parents (AOR = 3; 95% CI 1.6, 5.6), free discussion about reproductive issue (AOR = 2.7; 95% CI 1.4, 5.2), and experience of sexual intercourse (AOR = 13.2; 95% CI 4.8, 36.4) were found to be associated factors of gender based violence.Conclusion and recommendationGender Based Violence is still a significant sexual and reproductive health issue in Ethiopia. Governmental and non-governmental organizations should give due attention to this problem. Moreover, further large-scale studies are needed to estimate the national figure of GBV and to identify route causes.
Transmission of synovial sarcoma from a single multi-organ donor to three transplant recipients: case report
Authors: Zhang Jian , Yang Yang , Tian Ye , Xu Ruifang , Lin Jun 
Published: December 2021

Abstract
Background
Transmission of malignancy is a notable problem that cannot always be absolutely predicted at the time of transplantation. In particular, donor-derived transmission of synovial sarcoma in solid-organ transplantation is a rare but catastrophic event.

Case presentation
We are the first to report three cases of synovial sarcoma transmitted from a single multi-organ donor in China. The donor died of respiratory failure caused by an intrathoracic tumor, which was diagnosed as benign at the time of donation. All three recipients developed synovial sarcoma 3–13 months after transplantation; all three cases were confirmed to be donor transmitted. The liver transplant recipient died of tumor metastasis after partial-allograft hepatectomy. The two renal-transplant recipients survived after comprehensive therapy, including allograft nephrectomy, withdrawal of immunosuppressants and targeted therapy with anlotinib.

Conclusions
This report highlights the importance of detailed donor assessment, close follow-up and timely treatment of unexpected donor-transmitted malignancy. Although pathology is the most important evidence for the exclusion of donors for malignant potential, it should be combined with tumor type, tumor size and speed of growth. Organs from donors with malignant potential should be discarded. Allograft nephrectomy should be considered after confirmation of renal-allograft synovial sarcoma. Anlotinib for synovial sarcoma seems to be effective and well tolerated during long-term follow-up.
Prevalence of breastfeeding in a baby-friendly pediatric practice in Trieste, Italy: follow up to 36 months of age
Authors: Milinco Mariarosa , Cattaneo Adriano , Macaluso Anna , Materassi Paola , Di Toro Nicola , Ronfani Luca 
Published: December 2021

Abstract
Background
A breastfeeding-friendly physician’s office that applies the 13 recommendations of the Academy of Breastfeeding Medicine can help increase the exclusivity and duration of breastfeeding. Having already published the results up to five months of age of this intervention in our pediatric practice, we now report on the follow up to 36 months.

Methods
A cohort of 252 newborn infants was enrolled with our pediatric office in Trieste, Italy, between 1 January 2016 and 31 December 2016. The office implemented baby-friendly pediatric practices and a biological nurturing approach to the support of breastfeeding. In addition to the services offered by two pediatricians, support was provided by a peer counselor. Data on breastfeeding were collected at periodic healthy child visits up to 36 months of age. The outcome of interest for this follow up was the rate of any breastfeeding, defined as the percentage of infants and children who had received breastmilk in the previous 24 h.

Results
The rates of any breastfeeding at discharge and at 1, 3 and 5 months (n = 252) were 95.2, 95.8, 89.3 and 86.5%, respectively. At 8, 12, 18, 24 and 36 months of age, the rates of breastfeeding were 70.6% (163/231), 59% (135/229), 35% (78/224), 24.6% (55/224) and 7.2% (16/224), respectively.

Conclusions
The rates of any breastfeeding recorded in our pediatric practice up to age 36 months, are much higher than those reported elsewhere in high income countries and are likely to be associated with our baby-friendly and biological nurturing approach.
Multidisciplinary approach to screening and management of children with Fabry disease: practice at a Tertiary Children’s Hospital in China
Authors: Shen Qian , Liu Jialu , Chen Jing , Zhou Shuizheng , Wang Yi , Yu Lifei , Sun Li , Wang Liuhui , Wu Bingbing , Liu Fang , Cao Yun , Huang Ying , Wang Jianshe , Yang Chenhao , Zhu Daqian , Ma Yangyang , Xu Zhengmin , Lu Wei , Fu Lili , Zhou Wenhao , Xu Hong 
Published: December 2021

Abstract
Background
Fabry disease (FD) remains poorly recognized, especially in children in China. Considering the diversity and nonspecific clinical manifestations accompanying with life-threatening aspect of this disease, methods to improve effective screening and management of the suspects are needed. This study aims to explore how it can be done effectively from a multidisciplinary perspective for children with FD at a tertiary children’s hospital in China.

Methods
A multidisciplinary team (MDT) of pediatric FD experts was launched at Children’s Hospital of Fudan University. Children with high-risk characteristics were referred by the MDT screening team using the dried blood spot (DBS) triple-test (α-galactosidase A, globotriaosylsphingosine, GLA gene). For newborns who were undergoing genetic testing in the hospital, the GLA gene was listed as a routine analysis gene. Evaluation, family screening, and genetic counselling were implemented after screening by the MDT management team.

Results
Before the establishment of the MDT, no case was diagnosed with FD in the hospital. However, twelve months following the MDT program's implementation, thirty-five children with high-risk profiles were referred for screening by DBS triple-test, with a yield of diagnosis of 14.3% (5/35). These 5 diagnosed children were referred due to a high-risk profile of pain accompanied by dermatological angiokeratoma and hypohidrosis (n = 2), pain accompanied by abnormal liver function (n = 1), pain only (n = 1), and unexplained renal tubular dysfunction (n = 1). Two neonates were detected early with GLA mutations in the hospital, with a yield of detection of 0.14% (2/1420). Furthermore, another 3 children diagnosed with FD were referred from other hospitals. Family screening of these 10 diagnosed children indicated that 9 boys inherited it from their mothers and 1 girl inherited it from her father. Four of them started to receive enzyme replacement therapy.

Conclusion
Screening and management of children with FD is effective based on a defined screening protocol and a multidisciplinary approach. We should pay more attention to the high-risk profiles of pain, angiokeratoma, decreased sweating, and unexplained chronic kidney disease in children.
Clinical development innovation in rare diseases: lessons learned and best practices from the DevelopAKUre consortium
Authors: Rudebeck Mattias , Scott Ciarán , Rhodes Nicholas P. , van Kan Christa , Olsson Birgitta , Al-sbou Mohammed , Hall Anthony K. , Sireau Nicolas , Ranganath Lakshminarayan R. 
Published: December 2021

AbstractNew opportunities have arisen for development of therapies for rare diseases with the increased focus and progress in the field. However, standardised framework integrating individual initiatives has not been formed. We present lessons learned and best practice from a collaborative success case in developing a treatment for a rare genetic disease. Our unique consortium model incorporated several of the identified developments under one project, DevelopAKUre, truly bringing together academia, industry and patient organisations in clinical drug development. We found that the equal partnership between all parties in our consortium was a key success factor creating a momentum based on a strong organisational culture where all partners had high engagement and taking ownership of the entire programme. With an agreed mutual objective, this provided synergies through connecting the strengths of the individual parties. Another key success factor was the central role of the patient organisation within the management team, and their unique study participants’ advocacy role securing the understanding and meeting the needs of the clinical study participants in real-time. This resulted in an accelerated enrolment into the clinical studies with a high retention rate allowing for delivery of the programme with significantly improved timelines. Our project was partly funded through an external EU research grant, enabling our model with equal partnership. Further attention within the community should be given to establishing a functional framework where sustainable funding and risk sharing between private and public organisations allow for our model to be replicated.
Mobile clinics in conflict-affected communities of North West and South West regions of Cameroon: an alternative option for differentiated delivery service for internally displaced persons during COVID-19
Authors: Omam Lundi-Anne , Jarman Elizabeth , Ekokobe Wilfred , Evon Agbor , Omam Esther Njomo 
Published: December 2021

Abstract
Introduction
The guidelines for differentiated service delivery (DSD) for HIV treatment became operational in Cameroon in 2017 with the Test and Treat national strategy elaborating services that can be decentralized and task shifted at community level, but with little to no guidelines for DSD in fragile and conflict-affected settings. Since 2016, more than 680,000 Cameroonians have been internally displaced due to the conflict in the North West and South West regions (NWSW). This conflict has impacted on the health system with numerous attacks on health facilities and staff, reducing access to health care for internally displaced persons. The outbreak of COVID-19 further reduced humanitarian responses for fear of spreading COVID-19. Mobile clinics were utilized as a model of care in piloting DSD for HIV in conflict-affected settings within the COVID-19 context.

Methods
The HIV DSD framework was used to evaluate a project that used mobile clinics in 05 divisions across the NWSW to provide primary health care to internally displaced persons in hard-to-reach areas. These mobile clinics were operated in the COVID-19 context and integrated HIV services in the benefit package. The mobile clinics mainstreamed HIV and COVID-19 sensitization during community mobilization, HIV consultations, HIV testing and referrals, and in some cases antiretroviral (ARV) dispensation. The project ran from March to October 2020. The results from the evaluation of this model of HIV care delivery were analysed in 06 of 08 mobile clinics.

Results
In 07 months, a total of 14,623 persons living in conflict-affected settings were sensitized on HIV, 1979 received HIV testing from which 122 were positive and 33 placed on ARVs. 28 loss-to-follow up people living with HIV were relinked to treatment and 209 consultations for persons living with HIV were conducted. Despite the good collaboration at regional and field level, there was distrust by ARV centers for humanitarian organizations.

Conclusion
Mobile clinics are a model of care which could be leveraged in fragile and conflict-affected settings as an alternative model of care for HIV DSD to ensure continuum of HIV care and treatment. However this should be integrated within the benefit package of primary health care services offered by mobile clinics.
The impact of armed conflict on utilisation of health services in north-west Syria: an observational study
Authors: Ekzayez Abdulkarim , Alhaj Ahmad Yasser , Alhaleb Hasan , Checchi Francesco 
Published: December 2021

AbstractBackgroundArmed conflicts are known to have detrimental impact on availability and accessibility of health services. However, little is known on potential impact on utilisation of these services and health seeking behaviour. This study examines whether exposure to different types of war incidents affected utilisation of key health services—outpatient consultations, antenatal care, deliveries, and C-sections, in conflict affected areas of north west Syria between 1 October 2014 and 30 June 2017.MethodsThe study is an observational study using routinely collected data of 597,675 medical consultations and a database on conflict incidents that has 11,396 events. Longitudinal panel data analysis was used with fixed effect negative binomial regression for the monthly analysis and distributed lag model with a lag period of 30 days for the daily analysis.ResultsThe study found strong evidence for a negative association between bombardments and both consultations and antenatal care visits. The monthly Risk Ratio was 0.95 (95% CI 0.94–0.97) and 0.95 (95% CI 0.93–0.98); and the cumulative daily RR at 30 days was 0.19 (95% CI 0.15–0.25) and 0.42 (95% CI 0.25–0.69) for consultations and antenatal care respectively. Explosions were found to be positively associated with deliveries and C-sections. Each one unit increase in explosions in a given month in a given village was associated with about 20% increase in deliveries and C-sections; RR was 1.22 (95% CI 1.05–1.42) and 1.96 (95% CI 1.03–3.74) respectively.ConclusionThe study found that access to healthcare in affected areas in Syria during the study period has been limited. The study provides evidence that conflict incidents were associated negatively with the utilisation of routine health services, such as outpatient consultations and antenatal care. Whereas conflict incidents were found to be positively associated with emergency type maternity services—deliveries, and C-sections.