bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing the prevalence of personality pathology in Australian psychiatric emergency care centres: A feasibility study
Authors: Nguyen Yvonne , Glozier Nick , Huber Jacqueline 
Published: December 2024

Objectives To assess feasibility and acceptability of self-report measures in estimating prevalence of measurable personality disorder (PD) pathology in a Psychiatric Emergency Care Centre (PECC) unit. Method Patients meeting eligibility criteria admitted to an inner-city PECC unit were invited to complete the (1) Standardised Assessment of Personality – Abbreviated Scale (SAPAS), (2) Personality Inventory of DSM-5 Brief Form (PID-5-BF), and (3) Level of Personality Functioning Scale – Brief Form 2.0 (LPFS-BF-2.0). Results There were 24 participants – 80% of invited patients but only 51% of eligible patients and 21% of total PECC inpatients. Barriers to recruitment included: not meeting eligibility criteria, rapid discharge, and high workload. All participants completed the self-report measures. There was a very high prevalence of likely PD (87.5%) (SAPAS), personality trait dysfunction (87.5%) (PID-5-BF) and impaired personality functioning (91.7%) (LPFS-BF 2.0) but there was a low rate of agreement between discharge summary diagnoses and self-report measures. Conclusions Using self-report measures to assess PD pathology in a PECC unit was acceptable and may improve discharge summary diagnosis accuracy. Logistical challenges may limit this approach unless it can be embedded in routine care measures. Having accurate prevalence estimates would enable appropriate research, treatment and resourcing in PECCs.
Self-Reported Cervical Cancer Screening Uptake Among Women of Reproductive Age in Zambia: Evidence from the 2021 Zambia Population-Based HIV Impact Assessment (ZAMPHIA) Survey
Authors: Lubeya Mwansa Ketty , Sinyani Angela , Mukosha Moses , Lindsay Brianna , Mumbula Enock Mulowa , Agbakwuru Chinedu , Daka Bwalya , Nowak Rebecca G. , Ehoche Akipu , Mulundu Gina 
Published: December 2024

Background Despite Zambia implementing the World Health Organisation's (WHO) tri-pillar cervical cancer prevention goals 90-70-90 Prevent, Screen, and Treat, cervical cancer claims 2000 lives annually and reigns as the most common cancer among women, especially those living with HIV (WLHIV). Our study describes the national uptake of screening and treatment from the ZAMPHIA 2021 survey. Methods Utilising a two-stage cluster sampling approach, the study included participants aged 15 years and older across Zambia’s ten provinces. Data were collected on demographic traits, reproductive history, sexual behaviour, and cervical cancer prevention using a structured questionnaire, and HIV was diagnosed from biological samples. Women aged 15-49 were eligible for inclusion in the analysis. The primary outcome of interest was whether a woman self-reported being screened for cervical cancer. Sociodemographic characteristics were calculated for categorical variables using the SAS proc surveyfreq procedure, producing both raw and weighted estimates. The weighted estimates and their variance were generated using jackknife replicate weights for each record. Results Of the 8801 surveyed women, 22.2% reported undergoing cervical cancer screening, the majority being aged between 35-49 years. Cervical cancer screening uptake was more likely among compared to HIV negative counterparts (aOR = 3.92, 95% CI: 3.10, 4.95), those aged 25-34 years (aOR = 1.76, 95% CI: 1.42, 2.21) or 35-49 years (aOR = 2.65, 95% CI: 2.11, 3.33) than younger and those with 1-4 (aOR = 2.16, 95% CI: 1.54, 3.02) or more than 5 live births (aOR = 1.98, 95% CI: 1.37, 2.87) than none. Marital status, WLHIV, education, and parity were other factors significantly associated with screening. Conclusion We report low cervical cancer screening uptake compared to the 70% target of WHO. The WHO’s call for bolstered strategies and efforts to increase cervical cancer screening and treatment is timely and urgent. Therefore, ongoing messaging and health education among all women is key.
Measuring factors associated with telehealth use by people who use mental health services: A psychometric analysis of a theoretical domains framework questionnaire
Authors: Wilson Jessica , Heinsch Milena , Buykx Penny , Ticker Campbell , Gupta Rahul , Clancy Richard , Brosnan Caragh , Wilson Rhonda , Rutherford Jennifer , Sampson Dara , Paolucci Francesco , Kay-Lambkin Frances 
Published: December 2024

Introduction Telehealth has the potential to improve access to mental health care, especially for people living in rural and remote regions. Yet, telehealth accessibility remains a challenge in Australia, and there is a scarcity of appropriate, psychometrically sound tools for evaluating telehealth use by mental health service users. The aim of this study was to adapt and validate a scale for measuring factors associated with mental healthcare telehealth use. Methods A 39-item scale was adapted from the Theoretical Domains Framework questionnaire (TDFQ); a 14-domain framework for measuring implementation of evidence-based practice in health research and service delivery. Since use of the TDFQ in the service user and telehealth space is novel, we adapted and piloted the TDFQ using a rigorous and iterative consultation process and analysis. The study sample included 208 people who use mental health services (52% male). Preliminary analysis identified 32-items for inclusion in the exploratory factor analysis. Internal reliability and construct validity were also analysed. Results The resulting 21-item telehealth adaption of the TDFQ includes four factors, each with good internal reliability: satisfaction and habit (6 items), knowledge and training (5 items), benefit and value (6 items), and emotionality (4 items). Both the total scale and individual factors were positively associated with telehealth use. Discussion The telehealth adaption of the TDFQ is a psychometrically sound tool for assessing factors associated with the use of telehealth by people who use mental health services.
Folic Acid-Decorated Chitosan-PLGA Nanobiopolymers for Targeted Drug Delivery to Acute Lymphoblastic Leukemia Cells: In Vitro Studies
Authors: Ramezani Fatemeh , Moghadasi Maryam , Shamsasenjan Karim , Narmani Asghar 
Published: December 2024

Objectives This study developed a drug delivery system (DDS) using folic acid (FA)-functionalized chitosan (CS) and poly (lactic-co-glycolic acid) (PLGA) nanocarriers for targeted sodium butyrate (NB) delivery to leukemia cells (NALM6). The goal was to enhance NB's therapeutic efficacy while reducing its cytotoxicity to non-malignant cells. Methods FA-CS-PLGA nanocarriers were synthesized and characterized using Fourier-transform infrared spectroscopy (FT-IR), dynamic light scattering (DLS), zeta potential analysis, transmission electron microscopy (TEM), and thermogravimetric analysis (TGA). Encapsulation efficiency, release kinetics, cytotoxicity, and apoptosis induction were assessed using MTT assays and flow cytometry in NALM6 cells. Results The FA-CS-PLGA nanocarriers had a surface charge of 34.2 ± 0.12 mV and a size range of 40–60 nm. Encapsulation efficiency was 16%, with 16% of NB released within the first 4 h. MTT assays showed a reduction in leukemia cell viability to 26% after 24 h with 400 nM FA-CS-PLGA-NB, compared to over 50% viability with pure NB. The IC50 was around 300 nM. Flow cytometry revealed that FA-CS-PLGA-NB induced apoptosis in over 20% of leukemia cells, far exceeding the 5% induced by unmodified NB. Conclusion FA-CS-PLGA nanocarriers show significant promise as a targeted DDS for leukemia therapy, enhancing NB delivery to leukemia cells and improving therapeutic efficacy while minimizing off-target toxicity. These results support further in vivo studies and potential clinical applications.
Circulating MiR-126 as a potential biomarker in Egyptian colorectal cancer patients: A case-control study
Authors: Ghorab Rasha Ahmed , Fouad Shaimaa H. , Sherief Ahmed F. , Taha Rana M. , Hamdy Marwa , Darwish Mohammad M. , El-Sehsah Eman M. , Taha Sara I. 
Published: December 2024

Background Globally, colorectal cancer (CRC) is among the most prevalent malignant tumors. It is characterized by unlimited proliferation, invasion, and metastasis. MicroRNA-126 (miR-126) has been shown in many studies to play a significant role in CRC, but data regarding its role in CRC Egyptian patients are limited. Objectives This case-control study aimed to investigate the miR-126 as a potential marker in CRC Egyptian patients and to correlate its expression levels with CRC tumor, node, metastasis (TNM) stage, distant metastasis, and tumor size. Methods The study included 50 adult Egyptian participants (30 patients with CRC, 10 patients with colorectal adenoma as a pathological control, and 10 healthy controls). MiR-126 expression levels were detected using Real-Time Quantitative PCR (qPCR) along with the endogenous reference gene hsa-miR-103a in all participants. Results MiR-126 expression was significantly decreased in CRC patients than both control groups. It was associated with advanced TNM stage ( p = 0.001) and distant metastasis ( p = 0.002). However, it was not correlated with tumor size ( p = 0.980), carcinoembryonic antigen (CEA) ( p = 0.397), and cancer antigen 19-9 (CA19-9) ( p = 0.236). The best cut-off point of miR-126 to discriminate CRC from both controls was 0.7 and to discriminate metastatic CRC from non-metastatic CRC was 0.3. Conclusions Our results suggest that miR-126 could be used as an early marker for CRC detection among Egyptian patients and a good prognostic indicator associated with metastasis.
Addressing Disparities Using Continuous Glucose Monitors and Remote Patient Monitoring for Youth With Type 1 Diabetes
Authors: Lee Ming Yeh , Ritter Victor , Shaw Blake , Ferstad Johannes O. , Johari Ramesh , Scheinker David , Bishop Franziska , Desai Manisha , Maahs David M. , Prahalad Priya 
Published: December 2024

Background: Youth with type 1 diabetes (T1D) and public insurance have lower diabetes technology use. This pilot study assessed the feasibility of a program to support continuous glucose monitor (CGM) use with remote patient monitoring (RPM) to improve glycemia for youth with established T1D and public insurance. Methods: From August 2020 to June 2023, we provided CGM with RPM support via patient portal messaging for youth with established T1D on public insurance with challenges obtaining consistent CGM supplies. We prospectively collected hemoglobin A1c (HbA1c), standard CGM metrics, and diabetes technology use over 12 months. Results: The cohort included 91 youths with median age at enrollment 14.7 years, duration of diabetes 4.4 years, 33% non-English speakers, and 44% Hispanic. Continuous glucose monitor data were consistently available (≥70%) in 23% of the participants. For the 64% of participants with paired HbA1c values at enrollment and study end, the median HbA1c decreased from 9.8% to 9.0% ( P < .001). Insulin pump users increased from 31 to 48 and automated insulin delivery users increased from 11 to 38. Conclusions: We established a program to support CGM use in youth with T1D and barriers to consistent CGM supplies, offering lessons for other clinics to address disparities with team-based, algorithm-enabled, remote T1D care. This real-world pilot and feasibility study noted challenges with low levels of protocol adherence and obtaining complete data in this cohort. Future iterations of the program should explore RPM communication methods that better align with this population’s preferences to increase participant engagement.
Metabolic Syndrome: An Updated Review on Diagnosis and Treatment for Primary Care Clinicians
Authors: Peterseim Carolyn Mae , Jabbour Katarzyna , Kamath Mulki Ashwini 
Published: December 2024

Objective: Metabolic syndrome is a cluster of cardiovascular risk factors (central obesity, hypertension, dyslipidemia, and insulin resistance) that affects between 12.5% and 31.4% of adults worldwide. It correlates with increased risks of cardiovascular disease, diabetes, cancer, and overall mortality in a dose-dependent fashion. This review aims to provide primary care clinicians an updated review of the evidence on metabolic syndrome, with a focus on treatment. Design: Scoping evidence review. Eligibility Criteria: English-language studies of evidence Level I or II that focused on defining, diagnosing, and treating metabolic syndrome or its components. Information Sources: PubMed and Cochrane Database of Systematic Reviews. Results: Though evidence is still lacking for improved outcomes with treating the syndrome per se, addressing its individual components reduces risks. Lifestyle changes like weight loss and increased physical activity are first line. Surgical options assist with weight loss for certain patients. Pharmacotherapies like glucagon-like peptide-1 receptor agonists, sodium-glucose cotransporter-2 inhibitors, statins, and antihypertensives also have efficacy. Conclusions: Metabolic syndrome is an independent risk factor for many poor health outcomes. Its individual components should be treated with medication and behavioral changes to reduce cardiovascular risk and prevent diabetes and its complications. More research is needed on how to treat the syndrome itself. A diagnosis of metabolic syndrome may be useful for motivating patients toward lifestyle changes, though more research is needed on how to treat the syndrome versus its components.
Randomized Trial of Pulsatile and Nonpulsatile Flow in Cyanotic and Acyanotic Congenital Heart Surgery
Authors: Patel Krishna , Lin Tracie K. , Clark Joseph B. , Ceneviva Gary D. , Imundo Jason R. , Spear Debra , Kunselman Allen R. , Thomas Neal J. , Myers John L. , Ündar Akif 
Published: December 2024

Background The study objective was to determine the impact of cardiopulmonary bypass perfusion modalities on cerebral hemodynamics and clinical outcomes in congenital cardiac surgery patients stratified by acyanotic versus cyanotic heart disease. Methods A total of 159 pediatric (age <18 years) cardiac surgery patients were prospectively randomized to pulsatile or nonpulsatile cardiopulmonary bypass and stratified by type of congenital heart disease: acyanotic versus cyanotic. Intraoperative cerebral gaseous microemboli counts and middle cerebral artery pulsatility index were assessed. Organ injury was quantified by Pediatric Logistic Organ Dysfunction-2 (PELOD-2) score at 24, 48, and 72 h postoperatively. Additional outcomes included Pediatric Risk of Mortality-3 score, vasoactive–inotropic score, duration of mechanical ventilation, intensive care and hospital length of stay, and 180-day mortality. Heterogenous variance linear models (ie, ANOVA and mixed models) and χ2 tests were used to compare groups for continuous and categorical variables, respectively. Results Within congenital heart disease subgroups, patients randomized to nonpulsatile versus pulsatile bypass had similar preoperative and operative characteristics. While the intraoperative pulsatility index was higher in the pulsatile subset of both acyanotic and cyanotic groups ( P < .05), regional cerebral oxygen saturation, mean arterial pressure, and gaseous microemboli counts were similar. Postoperative PELOD-2 scores decreased at similar rates in the acyanotic and cyanotic subgroups regardless of the perfusion modality utilized. There were also no significant between-group differences in the additional postoperative outcomes by perfusion modality in either acyanotic or cyanotic groups. Conclusions Despite patients undergoing pulsatile cardiopulmonary bypass experiencing a more physiologic pulsatility index in both acyanotic and cyanotic groups, no significant differences in cerebral hemodynamics or clinical outcomes were appreciated.
Sociodemographic Factors Associated with Improved Metabolic Syndrome in Slum Dwelling Adults in Kenya: A Randomized Controlled Trial
Authors: Okube Okubatsion Tekeste , Kimani Samuel T. 
Published: December 2024

Background Sociodemographic factors have been implicated in cardiovascular health with differential morbidity and mortality. It is essential to comprehend how sociodemographic factors contribute to the improvement of Metabolic Syndrome (MetS), the primary cardiovascular diseases indicator. Objective Determine the role of sociodemographic factors in improving MetS among adults residing in the Slums of Nairobi, Kenya. Methods Adults with MetS participated in this randomized controlled trial study for a period of 12-months. A random assignment was used to place eligible participants in the intervention or control groups. The intervention group received lifestyle intervention that entails not using tobacco products or alcohol, exercising, and adhering to recommended dietary guidelines, while the control group had standard medical care. Clinical, biochemistry, and lifestyle habits were measured before and a year after the intervention. The association between the sociodemographic factors and the improvement in MetS was examined using a multiple logistic regression model with backward conditional. Results In the intervention group, lack of improvement in metabolic syndrome was significantly higher among aged (≥50 years) respondents [AOR = 9.097; P < .001]; Protestants [AOR = 7.292; P = .017] and Catholics [AOR = 5.270; P = .050]. Compared to unemployed, formally employed respondents had an 84.6% lower chance of having MetS [AOR = 0.154; P = .005]. Within the control group, lack of improvement in metabolic syndrome was significantly higher among aged (≥50 years) respondents [AOR = 5.013; P = .047]. Compared to respondents who had less than $100, individuals with monthly incomes between $100 and $500 had a roughly 10-fold [AOR = 10.499; P = .024] higher chance of having MetS. Conclusion In the current study, the findings show that sociodemographic factors namely: advanced age, unemployment, being Protestants and Catholics as well as higher income were negatively associated with improvement in MetS. The findings indicate that social factors have impact in the management and intervention outcomes of CVDs. Programmers and policy makers should plan interventions for CVD prevention and response with these factors in mind.
Patients and physicians differently consider severity and outcomes of systemic sclerosis-associated interstitial lung disease: Results of an international survey
Authors: Petelytska Liubov , Elhai Muriel , Galetti Ilaria , Guimaraes Vera , Yan Qingran , Muraru Sinziana , Sauer Gesa , Msabri Gharbi Nada , Sen Parikshit , Khadija El-Aoufi , Jordan Suzana , Distler Oliver , Bruni Cosimo 
Published: December 2024

Objectives: We aimed to identify which measures are considered important by patients and physicians when assessing disease severity and outcomes in systemic sclerosis-associated interstitial lung disease. Methods: We designed an international survey based on a systematic literature review data and distributed it to patients with systemic sclerosis-associated interstitial lung disease and physicians with expertise in treating it. Survey participants rated on a scale of 1–10 the importance of each item defining severe systemic sclerosis-associated interstitial lung disease and outcomes considering the aim of the treatment, with higher values representing increasing importance. Items scored on average ⩾ 8 and voted ⩾ 8 by ⩾ 80% of participants were arbitrarily considered as highly ‘important’. Results: In general, 388 physicians and 350 patients completed the survey. Referral to lung transplantation, need for oxygen supplementation, interstitial lung disease extent and dyspnoea were important severity domains to both physicians and patients. Similarly, death, decline of pulmonary functional tests, increase of interstitial lung disease extent on high-resolution computed tomography and onset/worsening of dyspnoea were important treatment outcomes for both groups. We observed a discrepancy for both severity tools and outcomes, with patients deeming patients-reported outcomes domains and lung infections as more important than physicians did. Conclusion: The perspectives of patients and physicians partially overlap, when considering targets of treatment of systemic sclerosis-associated interstitial lung disease and items contributing to the perceived disease severity. Based on these insights, the opinions of both stakeholders should be included in defining the long-term targets of systemic sclerosis-associated interstitial lung disease treatment.
Clinical and Radiographic Comparison of Lateral Malleolar Ankle Fractures Treated with or without Deltoid Fixation
Authors: Cho David , Drakos Mark , Kukadia Saanchi , Eble Stephanie , Kumar Prashanth 
Published: December 2024

Category: Ankle; Other Introduction/Purpose: There is a lack of consensus on how deltoid injuries should be addressed in the setting of acute ankle fractures. This study aims to evaluate whether deltoid repair during lateral malleolar fracture fixation leads to improved clinical outcomes compared to fixation without deltoid repair. Methods: This was a single-center retrospective study conducted from the institutional review board-approved Foot and Ankle Registry data, and the protocol was approved by the steering committee at the investigators’ institution. Patient-reported outcomes via PROMIS scores were collected preoperatively and at least one year postoperatively for all patients. Inclusion criteria included patients aged 18 or older who underwent open fixation for a SER IV equivalent lateral malleolar ankle fracture with a deltoid injury and had preoperative PROMIS scores. Excluded were patients without preoperative radiographs and patients with histories of previous ipsilateral ankle surgeries, rheumatoid arthritis, or gout. Retrospective review of the registry was performed, and 146 patients were included. 80 patients received a deltoid repair (DR) and 66 patients did not receive a deltoid repair (NDR). Preoperative and postoperative medial clear space (MCS) were reviewed for all patients. Results: Both DR and NDR cohorts demonstrated significant improvement in Physical Function, Pain Interference, Pain Intensity, and Global Physical Health. There were no significant differences in preoperative and postoperative PROMIS domains between the two cohorts. There were also no significant differences in preoperative MCS and postoperative MCS between the two cohorts. There were no significant differences in the incidence of subsequent procedures for removal of painful hardware, revisions, infections, progression to arthritis, and persistent pain. Conclusion: This study compares short- to medium-term patient-reported clinical outcomes and complications of lateral malleolar ankle fractures with and without deltoid repair. Repairing the deltoid did not increase the incidence of postoperative complications and produced similar PROMIS scores at 1-year minimum follow-up. This study suggests that any potential differences in outcomes between groups are not large enough to be clinically meaningful in the short term and that other factors may be more relevant in determining the best course of treatment. A longer follow-up is required to evaluate long-term functional and clinical outcomes.