bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Emergent Theory Depicting Patients’ Fortitude Through the Healing and Recovering Process of Depression
Authors: Sun Fan-Ko , Long Ann , Wu Ming-Kung , Chiu Nien-Mu , Hung Chi-Fa , Tseng Yun Shan 
Published: August 2021

Background: Depression is a common mental disorder. Literature has explored patients’ perspectives of the recovering process of depression. However, there is a lack of research to explore both patients’ and caregivers’ perspectives of the healing process and develop a theory to support patients with depression. Aims: The purpose of this study is to develop a substantive theory that depicts patients with depression toward healing and recovering. Methods: This study used a grounded theory approach and collected data between 2019 and 2020 in a medical center in Taiwan. A theoretical sampling was performed after interviewing 29 participants, including 20 patients who had recovered from depression and nine caregivers; data saturation was achieved. Data analysis was conducted with open, axial, and selective coding and used NVivo Version 11 to aid the process of coding. Results: A substantive theory was developed and the core category was “Patients’ fortitude through the healing and recovering process of depression.” Other main categories interrelated in this core category were reframing negative thinking and cultivating positive thinking, rebuilding a positive self-worth by embracing self-compassion, and learning to cope with everyday stress. Conclusions: This theory could help health care professionals to work therapeutically with patients and commend their fortitude while experiencing depression and engaging them with the care they planned together; and find some joy in life. Educators and researchers could use this theory to advance nursing care.
Cortical involvement and leptomeningeal inflammation in myelin oligodendrocyte glycoprotein antibody disease: A three-dimensional fluid-attenuated inversion recovery MRI study
Authors: Tzanetakos Dimitrios , Tzartos John S , Vakrakou Aigli G , Breza Marianthi , Velonakis Georgios , Stathopoulos Panos , Pantou Eirini , Markakis Ioannis , Papadimitriou Dimitra , Karavasilis Efstratios , Toulas Panagiotis , Evangelopoulos Μaria-Eleptheria , Koutsis Georgios , Anagnostouli Maria , Stefanis Leonidas , Kilidireas Costantinos 
Published: August 2021

Background: Cortical demyelination and meningeal inflammation have been detected neuropathologically in multiple sclerosis (MS) and recently in myelin oligodendrocyte glycoprotein antibody disease (MOGAD). Objectives: To assess in vivo cortical and leptomeningeal involvement in MOGAD. Methods: We prospectively evaluated 11 MOGAD and 12 relapsing-remitting MS (RRMS) patients combining three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) and 3D-T1-weighted (3D-T1w) sequences at 3-Tesla magnetic resonance imaging (MRI). Leptomeningeal contrast enhancement (LMCE) was assessed on 3D-FLAIR post-gadolinium (3D-FLAIRGd). Cerebral cortical lesions (CCLs) were classified as either intracortical–subpial (IC–SP) or leukocortical (LC). Results: CCLs were present in 8/11 MOGAD and 12/12 RRMS patients, with the number of CCLs being significantly lower in MOGAD (median (interquartile range (IQR)) 3 (0.5–4) vs 12 (4.75–19), p = 0.0032). In MOGAD, IC–SP lesions were slightly more prevalent than LC lesions (2 (0–2.5) vs 1 (0–2), p = 0.6579); whereas in RRMS, IC–SP lesions were less prevalent than LC lesions (3.5 (2.75–5.5) vs 9 (2–12.75), p = 0.27). LMCE was observed in 3/11 MOGAD and 1/12 RRMS patients; MOGAD with LMCE showed an increased median number of CCLs compared with MOGAD without LMCE (8 (4–9) vs 2.5 (0.75–3.25), p = 0.34). No correlation was observed between MOGAD MRI findings and (a) MOGAD duration, (b) serum MOG-immunoglobulin G1 titers, and (c) oligoclonal band presence. Conclusion: We described cortical lesion topography and detected for the first time LMCE using 3D-FLAIRGd sequences in MOGAD patients.
Hemostatic factors in the pathogenesis of neuroinflammation in multiple sclerosis
Authors: Abbadessa Gianmarco , Lavorgna Luigi , Treaba Constantina Andrada , Bonavita Simona , Mainero Caterina 
Published: August 2021

Background: A growing body of evidence has shed light on the role of the hemostatic pathway and its components in the pathogenesis of multiple sclerosis (MS), particularly in enhancing and sustaining neuroinflammation. Objective: To review the clinical, experimental, and neuroimaging evidence supporting the role of different components of the hemostatic pathway in the pathogenesis of neuroinflammation in MS and discuss their translational potential as disease biomarkers and therapeutic targets. Methods: A literature search for most relevant articles from 1956 to 2020 was conducted in PubMed and Scopus. Results: Hemostasis components appear to be involved in different key events of neuroinflammation in MS including mononuclear cell diapedesis, microglia activation, and neuronal damage. Conclusion: The findings on the interplay between hemostatic and thrombotic molecular pathways in the pathogenesis of neuroinflammation in MS open new opportunities for developing novel biomarkers for disease monitoring and prognosis, as well as novel therapeutic targets.
Cognition and disease characteristics in adult onset versus late onset multiple sclerosis
Authors: Butler Pagnotti Rachel , Hua Le H , Miller Justin B 
Published: August 2021

Background: Cognitive impairment is common sequelae of multiple sclerosis (MS); however, relatively little is known about cognitive impairment in late-onset multiple sclerosis (LOMS). Objective: To investigate differences in disease characteristics and cognition in LOMS and adult-onset multiple sclerosis (AOMS) patients. Methods: Archival medical records and neuropsychological evaluations from an MS specialty center were reviewed. Differences in disease characteristics between 53 LOMS and 124 AOMS were compared using chi-square or analysis of variance (ANOVA). To investigate differences in cognitive functioning, age-adjusted standardized scores were compared via analysis of covariance (ANCOVA), using cardiac risk factors and disease duration as covariates. Results: Compared to AOMS, LOMS patients had significantly more cardiac risk factors, shorter disease duration, and shorter time to diagnosis. LOMS patients had similar Expanded Disability Status Scale scores as AOMS patients. LOMS patients demonstrated significantly more impairment on tasks of visual learning and memory, and working memory than AOMS patients. Conclusion: Despite a shorter disease duration, LOMS and AOMS patients had similar levels of physical impairment. However, even after accounting for differences in disease duration and cardiac risk, LOMS patients showed a greater burden of cognitive impairment than AOMS patients, suggesting MS diagnosed later in life may progress faster due to the interaction between MS neuropathology and aging.
Association of turn-taking functions with joint attention in toddlers with autism
Authors: Lee Kwangwon , Schertz Hannah H 
Published: August 2021

Nonverbal turn taking, defined as back-and-forth exchanges, may be used to convey instrumental or social intent. It has been theorized that social turn taking is foundational to joint attention and, as such, it has been incorporated as a component of early interventions for children with autism, who often have challenges in joint attention competency. The purpose of this study was to analyze the relationships between two turn-taking functions and joint attention as observed during interactions between 20 toddlers with autism who received intervention and their caregivers. It was hypothesized that socially driven turn taking would be positively related to joint attention, but instrumentally motivated turn taking would not. Video analysis revealed a positive relationship between social turn taking and joint attention, but not between instrumental turn taking and joint attention. While not causal, the findings support the promotion of social content in intervention and the concept that social turn taking may be a precursory competency to joint attention. Lay abstract Back-and-forth interaction, or turn taking, may support later joint attention, a more complex form of interaction, when promoted in interventions for young children with autism, especially depending on the child’s intent when interacting. In the present study, we observed videos of 20 toddlers with autism engaging in turn taking with their caregivers during an intervention designed to support children’s joint attention. We sought to identify when the children displayed turn taking socially and when they were using it for nonsocial purposes in the intervention videos. We also observed videos after the intervention was complete to identify when children used joint attention when interacting with their caregivers. After these observations, we used these video data to explore the relationship of social turn taking to joint attention, and the relationship of nonsocial turn taking to joint attention. We found a significant relationship between social turn taking and joint attention, but not between nonsocial turn taking and joint attention. These findings support the importance of considering social turn taking in interactions between young children with autism and their caregivers.
The diagnostic value of orthopantomograms in detecting resorption of lateral incisors associated with ectopic canines: a CBCT study
Authors: Hershaw Catherine Maria , Mhani Nizar , Brown Angharad 
Published: August 2021

Objective: To examine the diagnostic value of orthopantomograms (OPG) in the identification of root resorption of lateral incisors, secondary to an impacted canine, as confirmed by a cone-beam computed tomography (CBCT) scan. Design: Retrospective observational cohort study. Setting: South Wales secondary care setting: Royal Gwent Hospital, Newport and Nevill Hall Hospital, Abergavenny. Methods: A total of 40 consecutive patients with impacted canines between January 2018 and December 2019 were selected. For each patient, one consultant orthodontist examined the OPG in isolation to detect the presence and extent of resorption of lateral incisors. The CBCT report was then studied to confirm the presence and extent of pathology. Sensitivity, specificity, accuracy, positive predictive values and negative predictive values were calculated. Results: In total, 19 maxillary right canines, 18 maxillary left canines, one mandibular right canine and two mandibular left canines were examined. Impactions were more prevalent in the maxilla (92.5%) with higher predilection towards female patients (65%). There was higher prevalence of root resorption in the maxillary right quadrant (57.1%), in concordance with other studies. OPGs were found to have a sensitivity of 81.0% and a specificity of 10.5%, with an accuracy value of 47.5%. Positive and negative predictive values were found to be 50.0% and 33.3%, respectively. The extent of root resorption was incorrectly estimated from the OPG in 84% of cases. Correct estimation occurred in 16% of cases, with overestimation and underestimation occurring in equal proportion (42%). Conclusion: This study demonstrates the limitations of plain film radiographs and the merits of using CBCT in the accurate diagnosis of resorption of lateral incisors with an associated impacted canine. It also gives an indication into the location prevalence of resorption in a small cohort of patients. This preliminary study establishes the basis for future, larger-scale studies where outcomes can be generalisable at a population level.
Patients’ beliefs toward generic medication in Yemen
Authors: Jaber Ammar Ali Saleh , Al-Worafi Yaser Mohammed , Dhabali Abdullah Ahmed 
Published: August 2021

Purpose This study aims to explore patients’ knowledge and beliefs toward generic medicines and identify the factors affecting their beliefs toward them in Yemen. Patients and methods A cross-sectional study was conducted from April 1 to July 1, 2016. A self-administered questionnaire was distributed to 590 adult patients in Sana’a. The data were analyzed using Statistical Package for the Social Sciences® (IBM SPSS) version 26 for Windows. Results Overall, 370 patients participated in this study. The study identified that a majority of the respondents did not know the similarities and differences between generic and branded medication and had negative beliefs toward generic medication. The study identified the factors contributing to the patients’ beliefs toward generic medication. Conclusion Yemeni patients had poor knowledge and negative beliefs toward generic medication. Educational programs provided to patients and healthcare professionals regarding generic medication can improve patients’ knowledge and correct their beliefs in this regard.
Outcomes of secondary trapeziectomy after revision of trapeziometacarpal implants: a retrospective comparative matched study
Authors: Cerlier Alexandre , Guinard Didier , Gay André M , Legré Régis 
Published: August 2021

We evaluated secondary trapeziectomy for revision of trapeziometacarpal implants and compared this to primary trapeziectomy with a matched retrospective single centre study performed between October 2003 and February 2015. Thirty-one patients with trapeziometacarpal prosthesis failure who had a secondary trapeziectomy were matched with a primary trapeziectomy regarding sex, date of the operation and age. We evaluated function, mobility, autonomy, pain, strength, complications and shortening of the thumb on radiographs. The median time until removal of the implant was 37 months. The median age in both groups was similar. Median follow-up was more than 7 years in both groups. There was no statistically significant difference in terms of function, mobility, autonomy, pain, strength, complications and shortening of the thumb. Secondary trapeziectomy after revision of trapeziometacarpal implants provides results comparable with primary trapeziectomy. Level of evidence: III
Knowledge assessment of anti-snake venom among healthcare practitioners in northern Nigeria
Authors: Bala Auwal A. , Jatau Abubakar I. , Yunusa Ismaeel , Mohammed Mustapha , Mohammed Al-Kassim H. , Isa Abubakar M. , Wada Abubakar S. , Gulma Kabiru A. , Bello Inuwa , Malami Sani , Michael Godpower C. , Chedi Basheer AZ. 
Published: August 2021

Introduction: Anti-snake venom (ASV) is the standard therapy for the management of snakebite envenoming (SBE). Therefore, the knowledge of ASV among healthcare practitioners (HCPs) is essential for achieving optimal clinical outcomes in snakebite management. This study aimed to assess knowledge of ASV among the HCPs in northern Nigeria. Methods: We conducted a cross-sectional study involving eligible HCPs from different healthcare settings in northern Nigeria. The participants were recruited into the study using a combination of online (via Google Form) and face-to-face paper-based survey methods. The ASV knowledge of the respondents was measured using a validated anti-snake venom knowledge assessment tool (AKAT). Inadequate overall knowledge of ASV was defined as scores of 0–69.9%, and 70–100% were considered adequate overall knowledge scores. The predictors of ASV knowledge were determined using multiple logistic regression. Results: Three hundred and thirty-one (331) eligible HCPs were included in the study analysis (310 from online and 21 from paper-based survey). Overall, an estimated 12.7% of the participants had adequate knowledge of ASV. Adequate ASV knowledge was higher among physicians compared with other HCPs (21.7%; χ2 = 8.1; p = 0.04). Those without previous training on ASV (adjusted odds ratio [aOR], 0.37; 95% confidence interval [CI], 0.18–0.73; p = 0.004) and who have not previously administered/dispensed ASV (aOR, 0.31; 95% CI, 0.15–0.63; p < 0.001) were less likely to have adequate knowledge of ASV. Conclusion: The knowledge of ASV among healthcare practitioners in northern Nigeria is grossly inadequate. Experience with administering or dispensing ASV predicts ASV knowledge. Therefore, appropriate interventions are needed to improve ASV knowledge, particularly among the HCPs, for optimal healthcare outcomes.
Mobile consulting as an option for delivering healthcare services in low-resource settings in low- and middle-income countries: A mixed-methods study
Authors: Harris Bronwyn , Ajisola Motunrayo , Alam Raisa Meher , Watkins Jocelyn Anstey , Arvanitis Theodoros N , Bakibinga Pauline , Chipwaza Beatrice , Choudhury Nazratun Nayeem , Kibe Peter , Fayehun Olufunke , Omigbodun Akinyinka , Owoaje Eme , Pemba Senga , Potter Rachel , Rizvi Narjis , Sturt Jackie , Cave Jonathan , Iqbal Romaina , Kabaria Caroline , Kalolo Albino , Kyobutungi Catherine , Lilford Richard J , Mashanya Titus , Ndegese Sylvester , Rahman Omar , Sayani Saleem , Yusuf Rita , Griffiths Frances 
Published: August 2021

Objective Remote or mobile consulting is being promoted to strengthen health systems, deliver universal health coverage and facilitate safe clinical communication during coronavirus disease 2019 and beyond. We explored whether mobile consulting is a viable option for communities with minimal resources in low- and middle-income countries. Methods We reviewed evidence published since 2018 about mobile consulting in low- and middle-income countries and undertook a scoping study (pre-coronavirus disease) in two rural settings (Pakistan and Tanzania) and five urban slums (Kenya, Nigeria and Bangladesh), using policy/document review, secondary analysis of survey data (from the urban sites) and thematic analysis of interviews/workshops with community members, healthcare workers, digital/telecommunications experts, mobile consulting providers, and local and national decision-makers. Project advisory groups guided the study in each country. Results We reviewed four empirical studies and seven reviews, analysed data from 5322 urban slum households and engaged with 424 stakeholders in rural and urban sites. Regulatory frameworks are available in each country. Mobile consulting services are operating through provider platforms ( n = 5–17) and, at the community level, some direct experience of mobile consulting with healthcare workers using their own phones was reported – for emergencies, advice and care follow-up. Stakeholder willingness was high, provided challenges are addressed in technology, infrastructure, data security, confidentiality, acceptability and health system integration. Mobile consulting can reduce affordability barriers and facilitate care-seeking practices. Conclusions There are indications of readiness for mobile consulting in communities with minimal resources. However, wider system strengthening is needed to bolster referrals, specialist services, laboratories and supply chains to fully realise the continuity of care and responsiveness that mobile consulting services offer, particularly during/beyond coronavirus disease 2019.
A Systematic Review of Definitions for Dysphagia and Dysphonia in Patients Treated Surgically for Degenerative Cervical Myelopathy
Authors: Tetreault Lindsay , Lange Stefan F. , Chotai Silky , Lupo Mercedes , Kryshtalskyj Michael T. , Wilson Jefferson R. , Martin Allan R. , Davies Benjamin M. , Nater Anick , Devin Clinton , Fehlings Michael G. 
Published: August 2021

Study Design: Systematic review. Surgical decompression for degenerative cervical myelopathy (DCM) is associated with perioperative complications, including difficulty or discomfort with swallowing (dysphagia) as well as changes in sound production (dysphonia). This systematic review aims to (1) outline how dysphagia and dysphonia are defined in the literature and (2) assess the quality of definitions using a novel 4-point rating system. Methods: An electronic database search was conducted for studies that reported on dysphagia, dysphonia or other related complications of DCM surgery. Data extracted included study design, surgical details, as well as definitions and rates of surgical complications. A 4-point rating scale was developed to assess the quality of definitions for each complication. Results: Our search yielded 2,673 unique citations, 11 of which met eligibility criteria and were summarized in this review. Defined complications included odynophagia (n = 1), dysphagia (n = 11), dysphonia (n = 2), perioperative swelling complications (n = 2), and soft tissue swelling (n = 3). Rates of dysphagia varied substantially (0.0%-50.0%) depending on whether this complication was patient-reported (4.4%); patient-reported using a modified Swallowing Quality of Life questionnaire (43.1%) or the Bazaz criteria (8.8%-50.0%); or diagnosed using an extensive protocol consisting of clinical assessment, a bedside swallowing test, evaluation by a speech and language pathologist and a modified barium swallowing test/fiberoptic endoscopy (42.9%). The reported incidences of dysphonia also ranged significantly from 0.6% to 38.0%. Conclusion: There is substantial variability in reported rates of dysphagia and dysphonia due to differences in data collection methods, diagnostic strategies, and definitions. Consolidation of nomenclature will improve evaluation of the overall safety of surgery.
Posterior Temporary C1-2 Pedicle Screws Fixation for the Treatment of Unstable C1-2 Complex Fractures: Minimum of 2-Year Follow-Up
Authors: Ibrahim Yakubu , Li Hao , Zhao Geng , Yuan Suomao , Zhao Yiwei , Liu Wubo , Tian Yonghao , Wang Lianlei , Liu Xinyu 
Published: August 2021

Study Design: Retrospective. Objectives: To present rarely reported complex fractures of the upper cervical spine (C1-C2) and discuss the clinical results of the posterior temporary C1-2 pedicle screws fixation for C1-C2 stabilization. Methods: A total of 19 patients were included in the study (18 males and 1 female). Their age ranged from 23 to 66 years (mean age of 39.6 years). The patients were diagnosed with complex fractures of the atlas and the axis of the upper cervical spine and underwent posterior temporary C1-2 pedicle screws fixation. The patients underwent a serial postoperative clinical examination at approximately 3, 6, 9 months, and annually thereafter. The neck disability index (NDI) and the range of neck rotary motion were used to evaluate the postoperative clinical efficacy of the patients. Results: The average operation time and blood loss were 110 ± 25 min and 50 ± 12 ml, respectively. The mean follow-up was 38 ± 11 months (range 22 to 60 months). The neck rotary motion before removal, immediately after removal, and the last follow-up were 68.7 ± 7.1°, 115.1 ± 11.7°, and 149.3 ± 8.9° ( P < 0.01). The NDI scores before and after the operation were 42.7 ± 4.3, 11.1 ± 4.0 ( P < 0.01), and the NDI score 2 days after the internal fixation was removed was 7.3 ± 2.9, which was better than immediately after the operation ( P < 0.01), and 2 years after the internal fixation was removed. The NDI score was 2.0 ± 0.8, which was significantly better than 2 days after the internal fixation was taken out ( P < 0.001). Conclusions: Posterior temporary screw fixation is a good alternative surgical treatment for unstable C1-C2 complex fractures.