bluuebunny/crossref_metadata_2025_split huggingface dataset:
The mediating roles of coping styles and resilience in the relationship between perceived social support and posttraumatic growth among primary caregivers of schizophrenic patients: a cross-sectional study
Authors: Wu Chen , Liu Yaping , Ma Songcui , Jing Guojian , Zhou Wei , Qu Lei , Wang Zitong , Cheng Mei , Wu Yulong 
Published: January 2021

Abstract
Background
Despite the substantial burden of caring schizophrenic patients, primary caregivers can also experience posttraumatic growth (PTG) which may buffer their negative experience. Influencing factors of PTG and their functional pathways among primary caregivers of schizophrenic patients remain unclear. This study is designed to test the simple and serial mediating roles of coping styles and resilience in the relationship between perceived social support and PTG among those primary caregivers.

Methods
A cross-sectional study was conducted from October 2018 to January 2019, and 365 primary caregivers (self-reported) of schizophrenic patients were analyzed. Measures used to assess their perceived social support, coping styles, resilience, and PTG were the Perceived Social Support Scale, the Simplified Coping Style Questionnaire, the Connor-Davidson Resilience Scale, and the Posttraumatic Growth Inventory, respectively. Structural equation modeling was used to run the analysis.

Results
The average scores of PTG (range: 0–5), perceived social support (range: 1–7), positive coping style (range: 0–3), negative coping style (range: 0–3), resilience (range: 0–4) reported by primary caregivers was (2.91 ± 0.99), (4.80 ± 1.26), (1.79 ± 0.65), (1.49 ± 0.56), and (2.46 ± 0.66), respectively. The fitness indices of measurement and structural models were satisfactory. Three indirect pathways totally explained 55.56% variance of the PTG. The indirect effect of positive coping style between perceived social support and PTG was 0.20 [95% confidence interval (CI) 0.05 to 0.37], and this simple mediation pathway explained 27.78% variance of PTG. The indirect effect of resilience between perceived social support and PTG was 0.11 [95% CI 0.01 to 0.20], and this simple mediation pathway explained 15.28% variance of PTG. The indirect effect of positive coping style and then resilience between perceived social support and PTG was 0.09 [95% CI 0.01 to 0.17], and this serial mediation pathway explained 12.50% variance of PTG.

Conclusions
Both simple and serial mediation roles of positive coping style and resilience are established in the relationship between perceived social support and PTG among primary caregivers of schizophrenic patients. Positive coping style and resilience are two important targets for future interventional studies, and interventions on them may bring the synergistic effect on improving PTG.
Thoughts about health and patient-reported outcomes among people with diabetes mellitus: results from the DiaDec-study
Authors: Borgmann Sandra O. , Chernyak Nadja , Haastert Burkhard , Linnenkamp Ute , Andrich Silke , Schlenker Rabea , Razum Oliver , Icks Andrea 
Published: January 2021

AbstractBackgroundThere is considerable evidence that repetitive negative thoughts are often associated with adverse health outcomes. The study aims are (i) to identify the frequency and valence of thoughts about health in people with diabetes mellitus using questions based on the day reconstruction method (DRM) and (ii) to analyse associations between thoughts about health and health-related quality of life (HRQoL), diabetes-related distress and depressive symptoms.MethodsCross-sectional study of a random sample of a German statutory health insurance population with diabetes aged between 18 and 80 linking questionnaire and claims data. Associations between frequency and valence of thoughts about health on a previous day and HRQoL assessed by a 12-Item Short-Form Health Survey, diabetes-related distress assessed using the Problem Areas in Diabetes scale and depressive symptoms assessed by Patient Health Questionnaire-9 were analysed using linear and logistic regression analysis, adjusting for sociodemographic and clinical characteristics.ResultsThoughts about health were analysed in 726 participants (86% type 2 diabetes, 62% male, mean age 67.6 ± 9.7 years). A total of 46% had not thought about their health the day before, 17.1% reported low frequency and negative thoughts, 21.4% low frequency and positive thoughts, 12.1% high frequency and negative thoughts and 3.4% high frequency and positive thoughts. The presence of thoughts about health irrespective of their frequency and valence is associated with a lower physical and mental component summary score of the 12-Item Short-Form Health Survey. Negative thoughts are associated with high diabetes-related distress. Frequent or negative thoughts are associated with depressive symptoms.ConclusionsThoughts about health are a part of everyday life for a substantial number of people with diabetes. Surprisingly, even positive thoughts are associated with poorer HRQoL in our study. Further research within the DRM paradigm is needed to understand how thoughts about health may affect people’s (assessment of) state of health. Thoughts about health should be considered in diabetes education and patient counselling with a view to preventing and treating emotional disorders. More attention should be paid to the outcomes of interventions that may themselves lead to an increase in the frequency of thoughts about health.
A qualitative analysis of barriers and facilitators to reducing sedentary time in adults with chronic low back pain
Authors: Lansing Jeni E. , Ellingson Laura D. , DeShaw Kathryn J. , Cruz-Maldonado Gabriel , Hurt Tera R. , Meyer Jacob D. 
Published: January 2021

Abstract
Background
Sedentary time (SED) is associated with many detrimental health outcomes, yet little is known about what factors influence one’s ability to reduce SED. Even less is known about these factors in specific patient populations for whom high levels of SED may influence symptoms, such as those with chronic low back pain (cLBP). The purpose of this study was to qualitatively explore participants’ perceptions of factors that influenced their ability to reduce SED across an 8-week intervention to reduce SED in adults with cLBP and elevated depressive symptoms.

Methods
Three months after a theory-based intervention to break up and reduce sitting, semi-structured interviews explored factors that influenced reducing SED. Three researchers independently coded each conversation. Codes were charted and mapped with participants reviewing their own transcripts and the merged codes. The research team then defined key themes. Factors that were perceived to either facilitate behavior change or acted as barriers were identified and thematized as positive or negative determinants.

Results
Common barriers for reducing SED included environmental constraints, opposing social norms, and productivity; these barriers were frequently encountered in the workplace. Common facilitators for reducing SED included habit development, self-monitoring tools, restructuring the physical environment, and social accountability. Notably, back pain was not a frequently reported barrier or facilitator for reducing SED.

Conclusion
This sample of patients with cLBP and elevated depressive symptoms had similar determinants for reducing SED as previously reported in non-patient populations and did not appear to need strategies specific to dealing with chronic pain. Since work-related social norms and environmental factors were perceived as significant barriers to sitting less, workplace interventions that provide standing desks, offer standing meetings rooms, and/or institution-wide standing breaks may help reduce SED at work. The use of an activity monitor with sitting reminders and education regarding how to use the reminders as external cues to develop new sitting habits may also aid in adoption and adherence to this behavior change across settings. Developing coping plans and restructuring physical environments were perceived as successful strategies for overcoming social and environmental barriers. Future interventions targeting SED reductions may benefit from incorporating these strategies.
Cervical cancer mortality in Peru: regional trend analysis from 2008–2017
Authors: Torres-Roman J. Smith , Ronceros-Cardenas Luz , Valcarcel Bryan , Arce-Huamani Miguel A. , Bazalar-Palacios Janina , Ybaseta-Medina Jorge , La Vecchia Carlo , Alvarez Christian S. 
Published: January 2021

Abstract
Background
Cervical cancer is the third leading cause of cancer-related death among Latin American women. Peru has the sixth highest mortality rate for cervical cancer in the region with regional variations. We aimed to determine overall and regional cervical cancer mortality rates and trends in Peru between 2008 and 2017.

Methods
We performed an ecological study on the number of deaths by cervical cancer in Peru. Deaths were extracted from the Peruvian Ministry of Health mortality database. Age-standardized mortality rates (ASMR) were estimated per 100,000 women-years using the world standard Segi population. We computed mortality trends using the Joinpoint regression program, estimating the annual percent change (APC). For spatial analysis, GeoDA software was used.

Results
Peru showed downward trends in the last decade (from 11.62 in 2008 to 9.69 in 2017 (APC = − 2.2, 95% CI: − 4.3, − 0.1, p < 0.05). According to regional-specific analysis, the highest ASMR was in the rainforest region, although this declined from 34.16 in 2008 to 17.98 in 2017 (APC = − 4.3, 95% CI: − 7.2, − 1.3, p < 0.01). Concerning spatial analysis and clustering, the mortality rates from 2008 to 2017 showed a positive spatial autocorrelation and significant clustering (Moran’s I: 0.35, p < 0.001) predominantly in the neighboring North-East departments (Loreto, Ucayali, and San Martin).

Conclusions
Although mortality trends in the entire population are decreasing, mortality rates remain very high, mainly in the rainforest region. Our results encourage a need for further development and improvement of the current health care delivery system in Peru.
Zosteriform skin metastasis caused by retrograde lymphatic migration of metastatic squamous cell lung carcinoma
Authors: Maki Yohei , Kimizuka Yoshifumi , Murakami Koji , Sato Kimiya , Sasaki Hisashi , Yamamoto Takayuki , Watanabe Chie , Sano Tomoya , Miyata Jun , Fujikura Yuji , Kawana Akihiko 
Published: January 2021

Abstract
Background
Zosteriform skin metastasis (ZSM) is rare, and its etiology is not well understood. ZSM is possibly derived from the retrograde movement of cancer cells through the lymphatic vessels during disease development. However, it has been difficult to demonstrate it, as no specific findings have been observed.

Case presentation
A 68-year-old man presented to our department with neck lymphadenopathy. After detailed examinations, squamous cell lung carcinoma (cT2aN3M1c) was diagnosed. Although cisplatin combined with gemcitabine was administered, his cancerous lymphangiopathy was exacerbated, and ZSM was observed on his right chest. Pembrolizumab was initiated as a second-line chemotherapy; however, the patient died 7 months after the initial presentation. In this case, fluorodeoxyglucose-positron emission tomography indicated the presence of skin metastasis and cancerous lymphangiopathy. Similarly, after performing an autopsy, tumor-cell filled lymph ducts were observed in the right subclavian and the cutaneous lymphatic vessel from the right hilar lymph nodes.

Conclusions
To the best of our knowledge, this is the first study to demonstrate that the localization of ZSM in the cutaneous lymphatics was caused by the retrograde movement of cancer cells through the lymphatic vessels, using radiographical and pathological analysis. In addition, fluorodeoxyglucose-positron emission tomography may help predict skin metastasis induced by cancerous lymphangiopathy.
Profiling lower extremity injuries sustained in a state police population: a retrospective cohort study
Authors: Lyons Kate , Stierli Mick , Hinton Ben , Pope Rodney , Orr Robin 
Published: January 2021

AbstractBackgroundTactical populations, such as military, firefighter and law enforcement populations, are known to suffer a relatively high number of musculoskeletal injuries, with the lower extremity of notable concern. The aim of this retrospective cohort study was to determine the profile of lower extremity musculoskeletal injuries within a state police agency.MethodsInjury data were collected by an Australian state police force over a 7-year period (2009–2016) and records not meeting the definition for lower extremity musculoskeletal injury were excluded. Statistical analyses were descriptive, with frequencies, means and standard deviations calculated where applicable. Chi-square analysis was performed to compare injury profiles by gender. Ethics approval was granted by Bond University Human Research Ethics Committee (Research Protocol 15360).ResultsOf the initial 65,579 incident records, 12,452 (19%) related to lower extremity musculoskeletal injuries. The knee was the most commonly injured site (31.4%) with sprains/strains (42.3%) the most common nature of injury and arresting offenders (24.2%) the most common activity at time of injury. Slips/trips/falls (37.8%) was found to be the most common cause of injury. Variations were found between genders, most notably within the injury activity (p < .001). 27.1% of male officers were injured when arresting offenders compared to 16.5% for female officers. Walking/running contributed to 17.9% of female officer incidents compared to 9.3% for male officers. The mean number of hours worked prior to injury occurrence was 6.00 ± 3.56 h with significantly more injuries occurring in the middle third of the shift (4.34–8.67 h,p < 0.001).ConclusionsWhile the proportion of injuries that affected the lower extremity was lower for police, the leading sites of injuries (knees and ankles) were similar to those of military and fire and rescue populations. Variations between genders suggest there may need to be differences in return-to-work rehabilitation.
Knowledge, attitude, and perception of oral and maxillofacial surgery specialty amongst healthcare professionals, and the General Public from a Gulf Cooperation Council (GCC) Country
Authors: Kamal Mohammad , Abdulwahab Mohammad , Al-Zaid Ahmed 
Published: January 2021

Abstract
Background
Oral and maxillofacial surgery specialty has grown rapidly in Kuwait in recent years. However, the general public and healthcare professionals remain unaware of its expanding scope of practice. The aim of the study is to assess public and professional (dental and medical) perception of the oral and maxillofacial surgical specialty in Kuwait.

Methods
This is a cross-sectional study evaluating responses of dental professionals, medical professionals, and general public in Kuwait toward the oral and maxillofacial surgical specialty using a previously validated survey instrument with 100 participants in each group. Participants were asked to choose the most appropriate specialist to treat certain procedures across 4 disciplines: reconstruction, trauma, pathology, and cosmetic. Statistical comparison was conducted between dentists and medical doctors using Fisher’s exact test with a p-value of < 0.05.

Results
Disparities were noted each group’s responses. Oral and maxillofacial surgery was preferred overall for most clinical scenarios in trauma (p < 0.001), pathology (p < 0.001), and reconstructive surgery (p < 0.001). Plastic surgery was preferred for cosmetic surgeries (p < 0.001).

Conclusions
This study indicates the need to increase awareness especially towards cosmetic surgery procedures, and conduct health campaigns regarding oral and maxillofacial surgery among healthcare professionals, especially medical doctors, and the general public.
Preoperative risk factors including serum levels of potassium, sodium, and creatinine for early mortality after open abdominal surgery: a retrospective cohort study
Authors: Ebrahim Mohamed , Larsen Pia Bükmann , Hannani Damoun , Liest Sara , Jørgensen Lars Nannestad , Jørgensen Henrik Løvendahl 
Published: January 2021

Abstract
Background
In hospitalized patients, abnormal plasma electrolyte concentrations are frequent and have been linked to poor outcomes following acute surgery. The aim of this study was to assess whether preoperative plasma levels of potassium, sodium, and creatinine at the time of admission were associated with 30-day mortality in patients following open abdominal surgery.

Methods
This was a single-center register-based retrospective study. By means of electronic search in a maintained surgery database, all patients (n = 4177) aged ≥ 60 years old undergoing open surgery in our department from January 2000 to May 2013 were identified. Plasma was assessed within 30 days prior to surgery. The primary endpoint was 30-day postoperative mortality. The association between mortality and plasma levels of potassium, sodium, and creatinine were examined using Cox proportional hazard models.

Results
A total of 3690 patients were included in the study cohort. The rates of abnormal preoperative plasma levels were 36, 41, and 38% for potassium, sodium, and creatinine, respectively. The overall 30 day mortality was 20%. A predictive algorithm for 30 day mortality following abdominal surgery was constructed by means of logistic regression showing excellent distinction between patients with and without a fatal postoperative outcome.

Conclusion
Apart from demographic factors (age, sex, and emergency surgery), preoperative imbalance in potassium, sodium and creatinine levels were significant independent predictors of early mortality following open abdominal surgery.
Misleading localization by 18F-fluorocholine PET/CT in familial hypocalciuric hypercalcemia type-3: a case report
Authors: Mukhtar Noha N , Abouzied Mohei El-Din M , Alqahtani Mohammed H , Hammami Muhammad M 
Published: January 2021

Abstract
Background
Familial hypocalciuric hypercalcemia (FHH) is a heterogeneous autosomal-dominant disorder of calcium hemostasis that may be difficult to distinguish clinically from mild primary hyperparathyroidism. Loss-of-function mutations mainly involving Arg15 residue of the adaptor-related protein complex 2, sigma subunit 1 (AP2S1) cause a rarer, more recently recognized form of FHH, FFH type-3. Recently, 18F-fluorocholine positron emission tomography/computed tomography (FCH-PET/CT) showed superior sensitivity to conventional imaging in localizing parathyroid adenomas. We report a new FFH type-3 patient who underwent unnecessary parathyroidectomy in association with misleading FCH-PET/CT imaging.

Case presentation
A 29-year old woman was initially evaluated for parathyroid hormone (PTH)-dependent hypercalcemia in 2013. Medical history was positive only for chronic constipation and malaise with no personal or family history of hypercalcemia, kidney stones, or neck surgery. Over seven years, serum calcium level was 2.51–2.89 mmol/L with concomitant PTH level of 58.7–94.8 mmol/L. Serum phosphate levels were in the low/low normal range. Serum creatinine and magnesium levels were normal. 25-hydroxy vitamin D level was 13 nmol/L. 24-hour urine calcium level was 1.92 mmol/day but increased to 6.99 mmol/day after treatment with cholecalciferol 1000 IU daily. Bone mineral density and renal ultrasound were normal. Parathyroid ultrasound showed two hypoechoic nodules inferior to the left and right thyroid lobes; however, 99mtechnitium-sestamibi scans (2013, 2016, 2018) were negative. FCH-PET/CT (2019) showed focal uptake co-localizing with the nodule inferior to the left thyroid lobe. The patient underwent left inferior parathyroidectomy and pathology was consistent with parathyroid hyperplasia. However, postoperatively, serum calcium and PTH levels remained elevated and FCH-PET/CT and ultrasound showed persistence of the uptake/nodule. Whole exome sequencing showed Arg15Cys mutation in the AP2S1 gene characteristic of FHH type-3.

Conclusions
In this new case of FHH type-3, FCH-PET/CT failed to localize to the hyperplastic parathyroid glands and localized instead to apparently a lymph node. This, together with increased urinary calcium after vitamin D supplementation, led to unnecessary parathyroidectomy. Given the increasingly lower cost of genetic testing and the cost of follow up and unnecessary surgery, it may prudent to include genetic testing for FHH early on in patients with mild PTH-dependent hypercalcemia.
Objective predictors of intern performance
Authors: Filiberto Amanda C. , Cooper Lou Ann , Loftus Tyler J. , Samant Sonja S. , Sarosi George A. , Tan Sanda A. 
Published: January 2021

Abstract
Background
Residency programs select medical students for interviews and employment using metrics such as the United States Medical Licensing Examination (USMLE) scores, grade-point average (GPA), and class rank/quartile. It is unclear whether these metrics predict performance as an intern. This study tested the hypothesis that performance on these metrics would predict intern performance.

Methods
This single institution, retrospective cohort analysis included 244 graduates from four classes (2015–2018) who completed an Accreditation Council for Graduate Medical Education (ACGME) certified internship and were evaluated by program directors (PDs) at the end of the year. PDs provided a global assessment rating and ratings addressing ACGME competencies (response rate = 47%) with five response options: excellent = 5, very good = 4, acceptable = 3, marginal = 2, unacceptable = 1. PDs also classified interns as outstanding = 4, above average = 3, average = 2, and below average = 1 relative to other interns from the same residency program. Mean USMLE scores (Step 1 and Step 2CK), third-year GPA, class rank, and core competency ratings were compared using Welch’s ANOVA and follow-up pairwise t-tests.

Results
Better performance on PD evaluations at the end of intern year was associated with higher USMLE Step 1 (p = 0.006), Step 2CK (p = 0.030), medical school GPA (p = 0.020) and class rank (p = 0.016). Interns rated as average had lower USMLE scores, GPA, and class rank than those rated as above average or outstanding; there were no significant differences between above average and outstanding interns. Higher rating in each of the ACGME core competencies was associated with better intern performance (p < 0.01).

Conclusions
Better performance as an intern was associated with higher USMLE scores, medical school GPA and class rank. When USMLE Step 1 reporting changes from numeric scores to pass/fail, residency programs can use other metrics to select medical students for interviews and employment.