bluuebunny/crossref_metadata_2025_split huggingface dataset:
Domestic violence in Mozambique: from policy to practice
Authors: Jethá Eunice , Keygnaert Ines , Martins Emilia , Sidat Mohsin , Roelens Kristien 
Published: April 2021

AbstractBackgroundTo reduce the impact of domestic violence (DV), Mozambican governmental and non-governmental entities are making efforts to strengthen the legislative framework and to improve the accessibility of care services for survivors of violence. Despite this remarkable commitment, the translation of policies and legislation into actions remains a considerable challenge. Therefore, this paper aims to identify gaps in the implementation of existing national policies and laws for DV in the services providing care for survivors of DV.MethodsThis qualitative study comprised of two approaches. The first consisted of content analysis of guidelines and protocols for DV care provision. The second consisted of in-depth interviews with institutional gender focal points (Professionals with experience in dealing with aspects related to DV). The analysis of the document content was based on a framework developed according to key elements recommended by international agencies (PAHO and UN) for design of DV policies and strategies. Data from the in-depth interviews, where analysed in accordance with the study objectives.ResultsEleven (11) guidelines/protocols of care provision and innumerable brochures and pamphlets were identified and analysed. There is a standardised form which contains fields for police and the health sector staff to complete, but not for Civil Society Organisations. However, there is no specific national DV database. Although the seventeen (17) focal points interviewed recognised the relevance of the reviewed documents, many identified gaps in their implementation. This was related to the weaknesses of the offender’s penalisation and to the scarcity of care providers who often lack appropriate training. The focal points also recognised their performance is negatively influenced by socio-cultural factors.ConclusionWithin services providing care to survivors of DV, a scarcity of guidelines and protocols exist, compromising the quality and standardisation of care. The existence of guidelines and protocols was regarded as a strength, however its implementation is still problematic. There was also recognition for the need to strengthening by governmental and non-governmental entities the defined policies and strategies for DV prevention and control into practice.
Challenges and opportunities for spiritual care practice in hospices in a middle-income country
Authors: Mahilall Ronita , Swartz Leslie 
Published: April 2021

Abstract
Background
Spiritual care is a key component of palliative care, but it has been overlooked and understudied in low- and middle-income country contexts, especially in Africa. In this study we sought to establish what the current spiritual care practices are in hospice palliative care settings in South Africa with a focused view on what spiritual care training is currently offered and what training needs still remain unmet.

Methods
We explored spiritual care practices, and training needs, through a national quantitative online study of palliative care organisations in South Africa registered with the Hospice Palliative Care Association of South Africa. A survey was sent to representatives of all member organisations listed on the national database of Hospice Palliative Care Association of South Africa. Viable data from 41% (n = 40) member organisations were analysed through the use of simple statistics.

Results
An expressed need (75%; n = 30) was recorded for the development of a national spiritual care curriculum. Although 48% (n = 20) of the member organisations were willing to participate in the development of a spiritual care curriculum, 37% (n = 14) could not participate, citing financial (n = 27), time (n = 31) and expertise constraints (n = 22). A set of hard and soft skills were suggested to suit the diverse South African context.

Conclusions
Spiritual care was seen by participants as a key component of palliative care. International curricula in spiritual care, while useful, do not offer easy adaptation to the diversities of South Africa. A bespoke spiritual care curriculum was called for, for diverse South Africa.
Study protocol medical rehabilitation after COVID-19 disease: an observational study with a comparison group with obstructive airway disease / Re_Co
Authors: Rutsch Mercedes , Frommhold Jördis , Buhr-Schinner Heike , Djeiranachvili Levan , Gross Thomas , Schüller Per Otto , Katalinic Alexander , Deck Ruth 
Published: April 2021

AbstractBackgroundNovel coronavirus disease 2019 (COVID-19) has been the subject of a numerous research projects over the past year. In cases with a severe disease course or threatening long-term impairment due to disease, the German health care system offers insured persons the possibility of medical rehabilitation. In contrast to what was observed and expected at the beginning of the pandemic, COVID-19 patients with varying degrees of disease severity are represented in rehabilitation. To date, there is no common consensus on the content and aftercare of rehabilitation nor is there any knowledge about the short- and long-term effects of such a rehabilitation programme. In addition, these aspects were not considered with regard to the varying severity of the course of the disease. The present research project investigates this question.MethodsThe study sample will consist ofN = 350 rehabilitants after COVID-19 and a comparison group (CG) withN = 230 rehabilitants suffering from an obstructive respiratory disease. The participants will be recruited at five German rehabilitation facilities and undergo medical rehabilitation. This prospective, exploratory, multicentre, mixed-methods study will be evaluated as follows: (A) The quantitative portion includes questionnaires at different points in time (at the beginning and end of rehabilitation, after six and twelve months) and contains standardised measurement instruments. For example, participation limitations, quality of life, health status, fatigue, psychomental limitations and disorders, performance in different areas of life and ability to work are measured. (B) Qualitative interviews are held at different times (end of rehabilitation, after six and twelve months), and an expert workshop is conducted. Topics are rehabilitation content, satisfaction and aftercare as well as different outcomes on subjective health and participation impairments.DiscussionStudies on other indications have already shown that pneumological rehabilitation has positive effects. Thus, it is expected that an improvement in different dimensions will be observed at the end of rehabilitation in both groups. With regard to the different severities of COVID-19, this study evaluates the long-term developments. Subsequently, the authors will elaborate concrete recommendations for medical rehabilitation after different courses of disease with regard to existing pneumological rehabilitation concepts.Trial RegistrationGerman Register of Clinical Trials,www.drks.de.Identifier: DRKS00023642; Registered: 01.12.2020.Date and version identifier: 08.04.2021; version 4.
Overexpressed pseudogene MT1L associated with tumor immune infiltrates and indicates a worse prognosis in BLCA
Authors: Ding Yanpeng , Liu Nuomin , Chen Mengge , Xu Yulian , Fang Sha , Xiang Wenbin , Hua Xinying , Chen Gaili , Zhong Yahua , Yu Haijun 
Published: April 2021

Abstract
Background
BLCA is a common cancer worldwide, and it is both aggressive and fatal. Immunotherapy (ICT) has achieved an excellent curative effect in BLCA; however, only some BLCA patients can benefit from ICT. MT1L is a pseudogene, and a previous study suggested that MT1L can be used as an indicator of prognosis in colorectal cancer. However, the role of MT1L in BLCA has not yet been determined.

Methods
Data were collected from TCGA, and logistic regression, Kaplan-Meier plotter, and multivariate Cox analysis were performed to demonstrate the correlation between the pseudogene MT1L and the prognosis of BLCA. To identify the association of MT1L with tumor-infiltrating immune cells, TIMER and TISIDB were utilized. Additionally, GSEA was performed to elucidate the potential biological function.

Results
The expression of MT1L was decreased in BLCA. Additionally, MT1L was positively correlated with immune cells, such as Tregs (ρ = 0.708) and MDSCs (ρ = 0.664). We also confirmed that MT1L is related to typical markers of immune cells, such as PD-1 and CTLA-4. In addition, a high MT1L expression level was associated with the advanced T and N and high grade in BLCA. Increased expression of MT1L was significantly associated with shorter OS times of BLCA patients (p < 0.05). Multivariate Cox analysis revealed that MT1L expression could be an independent prognostic factor in BLCA.

Conclusion
Collectively, our findings demonstrated that the pseudogene MT1L regulates the immune microenvironment, correlates with poor survival, and is an independent prognostic biomarker in BLCA.
Clinical-MRI radiomics enables the prediction of preoperative cerebral spinal fluid dissemination in children with medulloblastoma
Authors: Zheng Hui , Li Jinning , Liu Huanhuan , Wu Chenqing , Gui Ting , Liu Ming , Zhang Yuzhen , Duan Shaofeng , Li Yuhua , Wang Dengbin 
Published: April 2021

Abstract
Background
Medulloblastoma (MB) is the most common pediatric embryonal tumor. Accurate identification of cerebral spinal fluid (CSF) dissemination is important in prognosis prediction. Both MRI of the central nervous system (CNS) and CSF cytology will appear false positive and negative. Our objective was to investigate the added value of preoperative-enhanced T1-weighted image-based radiomic features to clinical characteristics in predicting preoperative CSF dissemination for children with MB.

Materials and methods
This retrospective study included 84 children with histopathologically confirmed MB between November 2006 and November 2018 (training cohort, n=60; internal validation cohort, n=24). A set of cases between December 2018 and February 2020 were used for external validation (n=40). The children with normal head and spine magnetic resonance images (MRI) and no subsequent dissemination in 1 year were diagnosed as non-CSF dissemination. The CSF dissemination was manifested as intracranial or intraspinal nodular-enhanced lesions. Clinical features were collected, and conventional MRI features of preoperative head MRI examinations were evaluated. A total of 385 radiomic features were extracted from preoperative-enhanced T1-weighted images. Minimum redundancy, maximum correlation, and least absolute shrinkage and selection operator were performed to select the features with the best performance in predicting preoperative CSF dissemination. A combined clinical-MRI radiomic prediction model was developed using multivariable logistic regression. Receiver operating curve analysis (ROC) was used to validate the predictive performance. Nomogram and decision curve analysis (DCA) were developed to evaluate the clinical utility of the combined model.

Results
One clinical and nine radiomic features were selected for predicting preoperative CSF dissemination. The combined model incorporating clinical and radiomic features had the best predictive performance in the training cohort with an AUC of 0.89. This was validated in the internal and external cohorts with AUCs of 0.87 and 0.73. The clinical utility of the model was confirmed by a clinical-MRI radiomic nomogram and DCA.

Conclusions
The combined model incorporating clinical, conventional MRI, and radiomic features could be applied to predict preoperative CSF dissemination for children with MB as a noninvasive biomarker, which could aid in risk evaluation.
MSC-derived exosomes carrying a cocktail of exogenous interfering RNAs an unprecedented therapy in era of COVID-19 outbreak
Authors: Jamalkhah Monire , Asaadi Yasaman , Azangou-Khyavy Mohammadreza , Khanali Javad , Soleimani Masoud , Kiani Jafar , Arefian Ehsan 
Published: April 2021

Abstract
Background
The onset of the SARS-CoV-2 pandemic has resulted in ever-increasing casualties worldwide, and after 15 months, standard therapeutic regimens are yet to be discovered.

Main body
Due to the regenerative and immunomodulatory function of MSCs, they can serve as a suitable therapeutic option in alleviating major COVID-19 complications like acute respiratory distress syndrome. However, the superior properties of their cognate exosomes as a cell-free product make them preferable in the clinic. Herein, we discuss the current clinical status of these novel therapeutic strategies in COVID-19 treatment. We then delve into the potential of interfering RNAs incorporation as COVID-19 gene therapy and introduce targets involved in SARS-CoV-2 pathogenesis. Further, we present miRNAs and siRNAs candidates with promising results in targeting the mentioned targets.

Conclusion
Finally, we present a therapeutic platform of mesenchymal stem cell-derived exosomes equipped with exogenous iRNAs, that can be employed as a novel therapeutic modality in COVID-19 management aiming to prevent further viral spread within the lung, hinder the virus life cycle and pathogenesis such as immune suppression, and ultimately, enhance the antiviral immune response.
Human brain region-specific variably methylated regions are enriched for heritability of distinct neuropsychiatric traits
Authors:   GTEx Consortium, Rizzardi Lindsay F. , Hickey Peter F. , Idrizi Adrian , Tryggvadóttir Rakel , Callahan Colin M. , Stephens Kimberly E. , Taverna Sean D. , Zhang Hao , Ramazanoglu Sinan , Hansen Kasper D. , Feinberg Andrew P. 
Published: April 2021

AbstractBackgroundDNA methylation dynamics in the brain are associated with normal development and neuropsychiatric disease and differ across functionally distinct brain regions. Previous studies of genome-wide methylation differences among human brain regions focus on limited numbers of individuals and one to two brain regions.ResultsUsing GTEx samples, we generate a resource of DNA methylation in purified neuronal nuclei from 8 brain regions as well as lung and thyroid tissues from 12 to 23 donors. We identify differentially methylated regions between brain regions among neuronal nuclei in both CpG (181,146) and non-CpG (264,868) contexts, few of which were unique to a single pairwise comparison. This significantly expands the knowledge of differential methylation across the brain by 10-fold. In addition, we present the first differential methylation analysis among neuronal nuclei from basal ganglia tissues and identify unique CpG differentially methylated regions, many associated with ion transport. We also identify 81,130 regions of variably CpG methylated regions, i.e., variable methylation among individuals in the same brain region, which are enriched in regulatory regions and in CpG differentially methylated regions. Many variably methylated regions are unique to a specific brain region, with only 202 common across all brain regions, as well as lung and thyroid. Variably methylated regions identified in the amygdala, anterior cingulate cortex, and hippocampus are enriched for heritability of schizophrenia.ConclusionsThese data suggest that epigenetic variation in these particular human brain regions could be associated with the risk for this neuropsychiatric disorder.
Newly detected rapid eye movement associated sleep apnea after coronavirus disease 2019 as a possible cause for chronic fatigue: two case reports
Authors: Koczulla Andreas Rembert , Stegemann Antje , Gloeckl Rainer , Winterkamp Sandra , Sczepanski Bernd , Boeselt Tobias , Storre Jan , Dreher Michael 
Published: April 2021

Abstract
Background
Coronavirus disease 2019 has become a health problem spreading worldwide with pandemic characteristics since March 2020. Post coronavirus disease 2019 symptoms are more frequent than initially expected, with fatigue as an often-mentioned issue.

Case presentations
We describe a 32-year-old white male and a 55-year-old white female who suffered from post coronavirus disease 2019 fatigue syndrome. On polysomnography, rapid eye movement associated sleep apnea with an increased hypopnea index during rapid eye movement phases of 36.8 and 19.5 events per hour was found. Based on the patients’ burdensome fatigue symptoms, we initiated automatic positive airway pressure therapy, which diminished sleep apnea (rapid eye movement index: 0.0 in both patients) and, consequently, also the fatigue symptoms.

Conclusions
Since sleep apnea and coronavirus disease 2019 are both associated with fatigue, a screening for sleep apnea might be considered in coronavirus disease 2019 patients with fatigue syndrome.
Foucault understood critical psychiatry
Authors: Iliopoulos John 
Published: April 2021

SUMMARYCritical trends in psychiatry are abundant today. Their impact on how psychiatry is currently practised is considerable. Yet what deserves close examination is the extent to which these modes of critique (anti-psychiatry, liberation movements, activism, existential, narrative or hermeneutic approaches, theories of values, psychoanalysis) inherently belong to or have become part of the very system that they criticise. Despite their political, social or scientific influence, which is undeniable, their critical power is often limited by their inability to radically challenge the deeper anthropological and philosophical presuppositions on which mainstream psychiatry rests. It can be argued that Foucault offers such a challenge. Implementing his historico-philosophical method, Foucault is sceptical of the anti-psychiatric quest for non-oppressive modes of psychiatric power and the humanist and postmodern efforts to moralise or relativise psychiatric truth. All these modes of critique rest on preconceived notions of nature, power and truth and have been integrated by the pluralism of the psychiatric universe. Yet Foucault's critique seeks precisely the opposite: to explore a new anthropological conception of insanity that has the power to challenge the legal, moral or reductionist constraints under which medical truth currently operates.
Literature by Other Mediums: Revisiting Lu Xun's Preface to Outcry
Authors: Zhou Chenshu 
Published: April 2021

AbstractBy recounting how Lu Xun 鲁迅 went from studying medicine in Japan to writing for the magazine Xin qingnian 新青年 (New Youth), the preface to Nahan 呐喊 (Outcry, 1923), Lu Xun's first collection of short stories, not only presents an origin story of an important author but also contains important clues for understanding modern Chinese literature. This article offers a new reading of that canonical text by focusing on the problem of medium. Synthesizing author biography, media history, and textual analysis, it examines three intermedial references in the preface—the famous lantern slide, the modern periodical, and the recurring notion of outcry. As an autobiographical account, the preface contains narrated events that call for more media-centered analysis, including the “slide incident” (renamed “screen incident”) and Lu Xun's failed experiment with the periodical medium. Reading the preface as an act of narration, this article scrutinizes textual choices such as the confusing word dianying 电影 (film) and the outcry metaphor. The emergence of both modern vernacular literature and Lu Xun as a major literary figure, it is argued, should be historicized in a broader transnational media environment, in which diverse media practices intersected.
The Initiation Of Pre-Ecdysis And Ecdysis Behaviors In Larval Manduca Sexta: The Roles Of The Brain, Terminal Ganglion And Eclosion Hormone
Authors: Novicki Andrea , Weeks Janis C. 
Published: April 2021

ABSTRACT
Each larval molt of Manduca sexta culminates in the sequential performance of pre-ecdysis (cuticle loosening) and ecdysis (cuticle shedding) behaviors. Both behaviors are thought to be triggered by the release of a peptide, eclosion hormone (EH), from brain neurons whose axons extend the length of the nervous system. EH bioactivity appears in the hemolymph at the onset of pre-ecdysis behavior, and EH injection can trigger pre-ecdysis and ecdysis behaviors prematurely. The present study examined the effects of removing or disconnecting portions of the central nervous system prior to the time of EH release on the initiation of pre-ecdysis and ecdysis behaviors at the final larval molt. We found that the initiation of pre-ecdysis abdominal compressions at the appropriate time required the terminal abdominal ganglion (AT) but not the brain; the initiation of pre-ecdysis proleg retractions at the appropriate time required neither the AT nor the brain; the initiation of ecdysis at the appropriate time usually required the brain but did not require the AT; and premature pre-ecdysis (but not ecdysis) could be elicited in isolated abdomens by injection of EH. Finally, pre-ecdysis behavior performed by brainless larvae was not associated with the normal elevation of EH bioactivity in the hemolymph or the normal loss of EH immunoreactivity from peripheral neurohemal release sites.
Shoulder pain and functional disability in type 1 diabetic patients: A cross-sectional survey
Authors: Farooq Muhammad Nazim , Mehmood Aqsa , Amjad Fatima , Syed Jaweria 
Published: April 2021

Objective: To assess the prevalence of shoulder pain and functional disability (SPFD) in Type-1 diabetic patients, and to explore its association with duration of the disease, age and gender.
Methods: A cross-sectional survey was carried out on previously diagnosed patients with Type-1 diabetes mellitus between April 2019 and March 2020. Data was collected from six hospitals including three tertiary care hospitals of Islamabad and Rawalpindi. Three hundred and twenty-eight patients were recruited through convenience sampling. Shoulder Pain and Disability Index was used to determine SPFD among participants. Point-biserial and Pearson correlation coefficients were calculated to find out the correlation between the variables. Independent t-test was used to determine the difference in the mean scores between the variables.
Results: The prevalence of SPFD was found 85.7%. A significant correlation was found of the SPFD with age (r = 0.332, p < 0.001), duration of the diabetes mellitus (r = 0.154, p = 0.005) and gender (rpb = 0.171, p = 0.002). A significant difference was found in SPFD mean scores between female and male patients (female patients = 43.42±22.80, male patients = 35.31±22.91, p = 0.002).
Conclusion: SPFD seems prevalent among Type-1 diabetic patients. Increasing age, long history of diabetes mellitus and female gender appear the associated risk factors for the shoulder pain and disability.
doi: https://doi.org/10.12669/pjms.37.4.3401
How to cite this:Farooq MN, Mehmood A, Amjad F, Syed J. Shoulder pain and functional disability in type 1 diabetic patients: A cross-sectional survey. Pak J Med Sci. 2021;37(4):1211-1214. doi: https://doi.org/10.12669/pjms.37.4.3401
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.