bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychiatric symptoms among migrants to Malaysia from the southernmost provinces of Thailand
Authors: Ford Kathleen , Jampaklay Aree , Chamatrithirong Aphichat 
Published: January 2021

Aim: The objective of this paper is to examine the level of psychiatric symptoms and associated factors among Thai migrants from the southernmost Thai provinces of Pattani, Yala, and Narithiwat who are working in Malaysia. Comparisons will be made with the sending population in the southernmost provinces of Thailand. Methods: Data are drawn from survey and in-depth interviews with Thai migrants who are working in Malaysia. Comparisons are made with a probability sample of working age adults in Thailand. The twenty item Self Reporting Questionnaire (SRQ) was the measure of mental health. Results: The study found that the migrants, on average, have normal levels of psychiatric symptoms. However, although about 24% of migrants reported more eight or more symptoms that may indicate a need for evaluation. There are many stressors in their lives including distance from families, reduced social support, legal matters surrounding immigration, and discrimination/exploitation of migrant groups. Conclusion: The study highlights the need for policy makers and non-governmental organizations to give attention to migrants’ mental health, well-being and sustainable livelihoods.
The politics of crisis management by regional and international organizations in fighting against a global pandemic: the member states at a crossroads
Authors: Van Hecke Steven , Fuhr Harald , Wolfs Wouter 
Published: January 2021

Despite new challenges like climate change and digitalization, global and regional organizations recently went through turbulent times due to a lack of support from several of their member states. Next to this crisis of multilateralism, the COVID-19 pandemic now seems to question the added value of international organizations for addressing global governance issues more specifically. This article analyses this double challenge that several organizations are facing and compares their ways of managing the crisis by looking at their institutional and political context, their governance structure, and their behaviour during the pandemic until June 2020. More specifically, it will explain the different and fragmented responses of the World Health Organization, the European Union and the International Monetary Fund/World Bank. With the aim of understanding the old and new problems that these international organizations are trying to solve, this article argues that the level of autonomy vis-a-vis the member states is crucial for understanding the politics of crisis management. Points for practitioners As intergovernmental bodies, international organizations require authorization by their member states. Since they also need funding for their operations, different degrees of autonomy also matter for reacting to emerging challenges, such as the COVID-19 pandemic. The potential for international organizations is limited, though through proactive and bold initiatives, they can seize the opportunity of the crisis and partly overcome institutional and political constraints.
Impact of point-of-care ultrasound on the diagnosis and treatment of patients in rural Uganda
Authors: Baker Daniel E , Nolting Laura , Brown Heather A 
Published: January 2021

 Ultrasound is increasingly used by physicians at the bedside to diagnose and treat a variety of conditions and is particularly useful in the resource-limited setting. The purpose of this study was to determine whether point-of-care ultrasound (POCUS) performed by physicians changed the diagnosis or treatment of patients in mobile clinics in rural Uganda. Patients presenting to mobile clinics in Uganda were assessed by physicians and, when appropriate, POCUS was performed. When available, a radiologist reviewed ultrasound images in real time. A de-identified questionnaire was completed for each ultrasound and reviewed retrospectively. A total of 177 ultrasounds were performed. A radiologist reviewed 50% of the ultrasounds. In 73% of patients, the findings either confirmed (50%) or changed (23%) a diagnosis. In 53% of patients, the ultrasound findings changed the treatment plan. POCUS positively impacted patient care in rural Ugandan clinics by improving diagnostic capabilities and influencing treatment plans.
A wrapper feature selection approach for efficient modelling of gully erosion susceptibility mapping
Authors: Rouhani Hamed , Fathabadi Aboalhasan , Baartman Jantiene 
Published: January 2021

Identifying the vulnerability level of an area to soil erosion, particularly gully erosion, is key to the development of an efficient management strategy for policymakers. While efforts into susceptibility mapping of natural disasters have grown in recent years, understanding the most relevant predictive causal factors is still a challenge. As the selection of these factors, among many potentially relevant factors, is an important part of the model selection process, we propose a hybrid intelligent approach for the optimal selection of a set of relevant factors based on logistic regression (LR) and genetic algorithms. In order to verify the effectiveness of the proposed approach, this study also identified areas that were highly susceptible to gully erosion using three different classifiers – namely, the LR, support vector machine (SVM) and k-nearest neighbours (k-NN) techniques. We tested the approach in the Yeli Bedrag watershed in north-eastern Golestan province, Iran. The results showed that the elevation, distance to fault, slope and the index of connectivity were the most important causal factors affecting the successful prediction of gully occurrence. Comparison of maximum True Skill Statistic values showed that increased model sophistication did not necessarily result in a higher level of model performance. In terms of performance, k-NN was superior to the SVM and LR methods. This method can be effectively used for gully erosion susceptibility (GES) zonation in the study area, which is very important to support spatial planning to initiate designing mitigation strategies and conservation needs over a large area, or to plan additional conservation efforts and relocate soil conservation plans. In conclusion, our findings indicate that by incorporating the proposed hybrid intelligent approach, the number of relevant factors for GES mapping was reduced, while classification accuracy was increased.
Congenital Myasthenic Syndrome From a Single Center: Phenotypic and Genotypic features
Authors: Prior Devin E. , Ghosh Partha S. 
Published: January 2021

Background: Congenital myasthenic syndrome is a group of rare genetic disorders affecting transmission across the neuromuscular junction. Patients present with variable ocular, bulbar, respiratory, and extremity weakness that may respond to symptomatic therapies. Methods: We identified 18 patients with congenital myasthenic syndrome from a pediatric neuromuscular center over a decade. Through a retrospective chart review, we characterize demographic profile, clinical features, genetic variants, treatment, and follow-up of these patients. Results: Patients had the following genetic subtypes: CHRNE (6), CHAT (2), MUSK (2), DOK7 (2), COLQ (1), RAPSN (1), PREPL (1), GFPT1 (1), CHRBB1 (1), and CHRNA1 (1). The phenotype varied based on the genetic variants, though most patients have generalized fatigable weakness affecting ocular, bulbar, and extremity muscles. There was a significant delay in the diagnosis of this condition from the onset of symptoms. Although most patients improved with pyridostigmine, some subtypes showed worsening with pyridostigmine and others benefited from albuterol, ephedrine, or 3,4-diaminopyridine treatment. Conclusion: Increasing recognition of this rare syndrome will lead to early diagnosis and prompt treatment. Prompt utilization of genetic testing will identify novel variants and the expanding phenotype of this condition.
The impact of low muscle function on health-related quality of life in Indonesian women with systemic lupus erythematosus
Authors: Sumantri Stevent , Rengganis Iris , Laksmi Purwita Wijaya , Hidayat Rudy , Koesnoe Sukamto , Shatri Hamzah 
Published: January 2021

Objective There was no study aimed at evaluating the effect of muscle function on SLE patients' quality of life using the Sarcopenia Quality of Life (SarQoL) questionnaire. Methods This cross-sectional study recruited 61 women with SLE consecutively, muscle function was measured with Jamar handheld-dynamometer and 6-meter walk test, HRQoL was measured with Sarcopenia Quality of Life (SarQoL) questionnaire. The cut-off point for low muscle strength (<18 kg) and low gait speed (<1.0 m/s) was according to the Asian Working Group on Sarcopenia 2019 criteria. Statistical analysis was conducted with a t-test for mean difference, and linear regression was used to adjust confounders (age, protein intake, physical exercise, and disease activity). Results The subjects' mean muscle strength was 19.54 kg (6.94), and 44.3% (n = 27) was found to have low muscle strength. The subjects' mean gait speed was 0.77 m/s (0.20), and 90.3% (n = 55) was found to have low gait speed. The difference of total SarQoL score in subjects with normal and low muscle strength was found to be significant; 74.86 (9.48) vs. 65.49 (15.51) (p = 0.009), and still statistically significant after adjustments with age, protein intake, physical exercise level, and disease activity [B 0.56; 95% CI 0.08–1.03; p = 0.022]. The difference of total SarQoL score in subjects with normal and low physical performance was found to be not significant, 70.67 (11.08) vs. 70.72 (13.56) (p = 0.993). Conclusion There was a significant difference in SarQoL's total score in normal compared with low muscle strength groups of Indonesian women with SLE.
Exploring practice site contributions and professionalization impact of engaging student pharmacists on hematology-oncology advanced pharmacy practice experience rotations
Authors: Yacobucci Matthew J , Lombardi Christina L , Briceland Laurie L 
Published: January 2021

Introduction Student pharmacists contribute meaningfully to patient care during Advanced Practice Pharmacy Experiences (APPEs) in varied settings. We aimed to characterize and evaluate the impact of student participation in hematology-oncology (hem-onc) APPEs on the practice site, and on student professionalization. Methods For students completing hem-onc APPEs during 2016–2019, rotation activities and post-APPE self-reflections describing meaningful impact were reviewed; activities were categorized into direct and indirect patient care, and up to three reflection themes of professionalization impact were extracted from each self-reflection. Hem-onc preceptor cohort was surveyed to assess impact of student contributions on the practice site. Results 171 students completed hem-onc APPEs in ambulatory care (133) and/or inpatient (38) settings. Of 932 student-reported activities, the most common were: evaluating patient pharmacotherapy (209), providing education to medical staff (132), patient counseling [non-chemotherapy (99); chemotherapy (82)], and providing drug information (96); 89% involved direct patient care/education. Survey results from 16 of 33 preceptors identified the most impactful student activities as evaluating pharmacotherapy, medication education/adherence resources, and in-service presentations. Of 392 student self-reflections, themes of impact focused on professionalization/self-awareness (39.3%), counseling/communication skills (27.8%), practice skills development (20.4%) and collaborative teamwork (12.5%). Conclusion Pharmacy students make significant direct patient care contributions to hem-onc practice settings by evaluating pharmacotherapy and providing education to patients and healthcare personnel. Participation in hem-onc APPEs is highly influential to the professionalization of students, particularly in developing skills in oncology practice, patient interactions/communications, and developing self-awareness.
Utilization of telehealth in paediatric genome-wide sequencing: Health services implementation issues in the CAUSES Study
Authors: Elliott Alison M , Dragojlovic Nick , Campbell Teresa , Adam Shelin , Souich Christèle du , Fryer Michele , Lehman Anna , Karnebeek Clara van , Lynd Larry D , Friedman Jan M 
Published: January 2021

Introduction Genome-wide sequencing (exome or whole genome) is transforming the care and management of paediatric patients with a rare disease because of its diagnostic capabilities. Genome-wide sequencing is most effective when both parents and the child are sequenced as a trio. Genetic counselling is recommended for all families considering genome-wide sequencing. Although telehealth is well established in genetic counselling for hereditary cancer and prenatal genetics, its use with genome-wide sequencing has not been well studied. The CAUSES Clinic at BC Children’s and Women’s Hospitals was a translational paediatric trio-based genome-wide sequencing initiative. Pre-test genetic counselling via telehealth (at a clinical site near the family’s residence) was offered to families who had been previously evaluated by a clinical geneticist. We report on the first 300 families seen in the CAUSES clinic and compare health services implementation issues of families seen via telehealth versus on-site. Methods Demographics, cost to families (travel and time), time to first appointment, complete trio sample accrual and diagnostic rates were studied. Results Of the 300 patients, 58 (19%) were seen via telehealth and 242 (81%) were seen on-site for pre-test counselling. The mean time to completion of accrual of trio samples in the telehealth group was 56.3 (standard deviation ±87.3) days versus 18.9 (standard deviation ±62.4) days in the onsite group ( p < 2.2 × 10−16). The mean per-family estimated actual or potential travel/time cost savings were greater in the telehealth group (Can$987; standard deviation = Can$1151) than for those seen on-site (Can$305; standard deviation = Can$589) ( p = 0.0004). Conclusions Telehealth allowed for access to genome-wide sequencing for families in remote communities and for them to avoid significant travel and time costs; however, there was a significant delay to accrual of the complete trio samples in the telehealth group, impacting on time of result reporting and delaying diagnoses for families for whom genome-wide sequencing was diagnostic.
Increased telestroke call burden after the extended thrombectomy window trials
Authors: Almallouhi Eyad , Debenham Ellen , Grant Cheryl , Spiotta Alejandro M , Holmstedt Christine A , Al Kasab Sami 
Published: January 2021

Introduction Clinical trials have proven the efficacy of mechanical thrombectomy in stroke patients with large-vessel occlusion presenting within 24 hours of symptom onset. Extending the thrombectomy window to 24 hours resulted in a higher number of thrombectomies being performed. However, little is known about the impact of the extended thrombectomy window on the telestroke call burden. Methods We used the prospectively maintained database of a telestroke network covering a large geographic area in the Southeast USA. We included patients presenting between January 2015 and December 2019. We compared the characteristics and outcomes between patients who presented before and after the publication of the extended window thrombectomy trials. Results A total of 9041 patients presented with stroke-like symptoms during the study period. Of these, 4995 presented after February 2018. There was no difference in the patient demographics in both groups. However, patients in the post extended window group had a lower National Institute of Health Stroke Scale on presentation (3 vs. 4; p < 0.001) and longer symptom-onset-to-door time (124 vs. 85 minutes; p < 0.001). The number of consults per month nearly doubled (200 vs. 103; p < 0.001) in the extended thrombectomy window era. Similarly, the number of mechanical thrombectomies performed per month increased from four to seven since extending the thrombectomy window ( p < 0.001). Discussion The number of telestroke consults nearly doubled after the publication of the extended thrombectomy window trials, with an increase in the number of thrombectomies performed. These findings have important operational implications for hospitals implementing telestroke call coverage.
Marginal assessment of the cost and benefits of aphasia treatment: Evidence from community-based telerehabilitation treatment for aphasia
Authors: Jacobs Molly , Briley Patrick M , Wright Heather Harris , Ellis Charles 
Published: January 2021

Introduction Few studies have reported information related to the cost-effectiveness of traditional face-to-face treatments for aphasia. The emergence and demand for telepractice approaches to aphasia treatment has resulted in an urgent need to understand the costs and cost-benefits of this approach. Methods Eighteen stroke survivors with aphasia completed community-based aphasia telerehabilitation treatment, utilizing the Language-Oriented Treatment (LOT) delivered via Webex videoconferencing program. Marginal benefits to treatment were calculated as the change in Western Aphasia Battery-Revised (WAB-R) score pre- and post-treatment and marginal cost of treatment was calculated as the relationship between change in WAB-R aphasia quotient (AQ) and the average cost per treatment. Controlling for demographic variables, Bayesian estimation evaluated the primary contributors to WAB-R change and assessed cost-effectiveness of treatment by aphasia type. Results Thirteen out of 18 participants experienced significant improvement in WAB-R AQ following telerehabilitation delivered therapy. Compared to anomic aphasia (reference group), those with conduction aphasia had relatively similar levels of improvement whereas those with Broca’s aphasia had smaller improvement. Those with global aphasia had the largest improvement. Each one-point of improvement cost between US$89 and US$864 for those who improved (mean = US$200) depending on aphasia type/severity. Discussion Individuals with severe aphasia may have the greatest gains per unit cost from treatment. Both improvement magnitude and the cost per unit of improvement were driven by aphasia type, severity and race. Economies of scale to aphasia treatment–cost may be minimized by treating a variety of types of aphasia at various levels of severity.
A systematic review examining the clinical and health-care outcomes for congenital heart disease patients using home monitoring programmes
Authors: Crawford Rachel , Hughes Ciara , McFadden Sonyia , Crawford Jacqui 
Published: January 2021

Objectives This review aimed to present the clinical and health-care outcomes for patients with congenital heart disease (CHD) who use home monitoring technologies. Methods Five databases were systematically searched from inception to November 2020 for quantitative studies in this area. Data were extracted using a pre-formatted data-collection table which included information on participants, interventions, outcome measures and results. Risk of bias was determined using the Cochrane Risk of Bias 2 tool for randomised controlled trials (RCTs), the Newcastle–Ottawa Quality Assessment Scale for cohort studies and the Institute of Health Economics quality appraisal checklist for case-series studies. Data synthesis: Twenty-two studies were included in this systematic review, which included four RCTs, 12 cohort studies and six case-series studies. Seventeen studies reported on mortality rates, with 59% reporting that home monitoring programmes were associated with either a significant reduction or trend for lower mortality and 12% reporting that mortality trended higher. Fourteen studies reported on unplanned readmissions/health-care resource use, with 29% of studies reporting that this outcome was significantly decreased or trended lower with home monitoring and 21% reported an increase. Impact on treatment was reported in 15 studies, with 67% of studies finding that either treatment was undertaken significantly earlier or significantly more interventions were undertaken in the home monitoring groups. Conclusion The use of home monitoring programmes may be beneficial in reducing mortality, enabling earlier and more timely detection and treatment of CHD complication. However, currently, this evidence is limited due to weakness in study designs.
Comparative Analysis of Mucociliary Clearance and Mucosal Morphology Using High-Speed Videomicroscopy in Children With Acute and Chronic Rhinosinusitis
Authors: Alekseenko Svetlana , Karpischenko Sergey , Barashkova Svetlana 
Published: January 2021

Objective evaluation of mucociliary clearance and mucosal morphology using high-speed videomicroscopy, and their association with markers of disease severity in children with acute (ARS) and chronic rhinosinusitis (CRS). Methods A total of 67 children aged from 6 to 17 years including 15 healthy children, 20 pediatric patients with acute rhinosinusitis, and 32 cases with chronic rhinosinusitis were enrolled in the present study. SNOT20, Lund-Kennedy, and Lund-Mackay scores were also evaluated. Results Children with rhinosinusitis were characterized by significantly lower number of cells with motile cilia, ciliary beat frequency, cilia length, and cell viability, as well as ciliary beat asynchrony, epithelia dystrophy and reduced epithelial cell height, being more severe in ARS group. Neutrophil infiltration of sinonasal mucosa was more profound in children with ARS, whereas the number of lymphocytes was significantly reduced. Markers of ciliary function were characterized by a significant correlation with epithelia dystrophia and neutrophil infiltration. Discriminant analysis demonstrated significant group separation based on the parameters of mucociliary clearance and mucosal morphology. In regression models mucociliary function was also associated with SNOT20, Lund-Kennedy, and Lund-Mackay scores. Conclusion The results of the present study demonstrate significant alteration of mucociliary clearance and mucosal morphology and its association with sinonasal inflammation and disease severity in patients with rhinosinusitis. Given a tight association between altered mucociliary clearance and severity of the disease, modulation of inflammation and ciliary function both in acute and chronic rhinosinusitis may be considered as the potential tool in therapeutic and surgical management of the disease.
Renal Manifestations of Fabry Disease: A Narrative Review
Authors: Silva Cassiano Augusto Braga , Moura-Neto José A. , dos Reis Marlene Antônia , Vieira Neto Osvaldo Merege , Barreto Fellype Carvalho 
Published: January 2021

Purpose of review: In this narrative review, we describe general aspects, histological alterations, treatment, and implications of Fabry disease (FD) nephropathy. This information should be used to guide physicians and patients in a shared decision-making process. Source of information: Original peer-reviewed articles, review articles, and opinion pieces were identified from PubMed and Google Scholar databases. Only sources in English were accessed. Methods: We performed a focused narrative review assessing the main aspects of FD nephropathy. The literature was critically analyzed from a theoretical and contextual perspective, and thematic analysis was performed. Key findings: FD nephropathy is related to the progressive accumulation of GL3, which occurs in all types of renal cells. It is more prominent in podocytes, which seem to play an important role in the pathogenesis of this nephropathy. A precise detection of renal disorders is of fundamental importance because the specific treatment of FD is usually delayed, making reversibility unlikely and leading to a worse prognosis. Limitations: As no formal tool was applied to assess the quality of the included studies, selection bias may have occurred. Nonetheless, we have attempted to provide a comprehensive review on the topic using current studies from experts in FD and extensive review of the literature.