bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of pain in children with juvenile idiopathic arthritis using the pediatric pain questionnaire
Authors: El Deriny Ghada F. , Aref Galal H. , Eissa Maged M. , Abo-Elanin Shaimaa G.A. 
Published: September 2024

Background
Juvenile idiopathic arthritis (JIA) is a chronic autoinflammatory disease of unknown etiology and is the most common cause of autoimmune musculoskeletal disease in children. Pain is a commonly reported symptom in JIA. There are levels of pain that interfere with physical, educational, emotional, and social activity, even when disease activity is controlled. Assessment of pain at each office visit is the cornerstone of effective pain management. Pediatric Pain Questionnaire (PPQ) uses a 100-mm horizontal visual analog score (VAS) anchored with happy and sad faces to assess the present pain intensity and the worst pain intensity in the past week. Patients are also asked to choose from a list of 46 word descriptors to express sensory (e.g., cutting), affective (e.g., horrible), and evaluative (e.g., sad) qualities of their pain.

Aim
The aim of the study was to assess pain in children with JIA attending the Rheumatology Clinic in Alexandria University Children’s Hospital and to determine its relation to disease activity.

Patients and methods
Fifty-eight patients and their parents who attended the Pediatric Rheumatology Clinic of Alexandria University Children Hospital were asked to fill out the questionnaire. Of the patients 58.6% were females and 41.4% patients were males; the mean age of the patients was 10.36±3.34 (months).

Results
According to pain and emotion, most parents in this study answered that the pain seemed worse when their children are tired. Distribution of the studied cases for present pain on VAS in this study showed that no significant differences were found between the children and parent scorings of present pain on VAS. All correlations were highly significant for present pain (P<0.001*). The distribution of the studied cases for worst pain last week on the VAS showed no significant differences between the children and parents scorings of worst pain on the VAS. All correlations were highly significant for worst pain (P<0.001*). Distribution of the studied cases according to the relationship between pain intensity on VAS and disease activity score showed no significant difference between pain intensity reported by children, parents, and physicians on VAS and disease activity score.

Conclusion
This work should be viewed in the light of some potential limitations. The results of this study revealed that the PPQ questionnaire was valid, reliable, and sensitive to the assessment of pain. Integrating patient-reported outcome measures of pain severity and responsiveness to standard clinical practice is feasible and applicable in the follow-up of patients and monitoring the treatment effectiveness.
Attitudes of Indian Undergraduate Occupational Therapy Students Toward Mental Health and Psychiatry
Authors: Dave Nidhi N. , Praveen S. G. 
Published: September 2024

Background:
In India, the number of occupational therapy practitioners currently working in mental health settings is lower than most other specialties. The attitudes of students influence their interest in any field and their desire for working in it.

Objectives:
The objective of this study was to examine the attitudes of Indian undergraduate occupational therapy students toward mental health and psychiatry, and to explore the differences in attitudes across different years of study, gender, resulting from personal experiences, and educational coursework, and to examine if the attitudes influence future career choices.

Study Design:
This was a cross-sectional survey.

Methods:
Permission was obtained from heads of institutions of 14 occupational therapy colleges and the survey link was sent. In order to obtain a representative sample, the link was also shared on social groups. The purpose of the study, voluntary participation, and confidentiality were explained on the landing page. The subsequent sections consisted of the demographic questionnaire, the Attitudes toward Psychiatry-30 (ATP-30) Questionnaire, and the Career Preference Questionnaire. A total of 402 responses were obtained within the stipulated period. Statistical analysis was performed, and the odds ratio using logistic regression and Pearson's correlation coefficient were determined.

Results:
Gender and contact with persons with mental illness were significant predictors of positive ATP. Females are 5.387 times more likely to have positive ATP (odds ratio [OR] = 5.387, 95% confidence interval [CI]: 2.101–13.814, P = 0.000). Furthermore, those in contact with persons with mental illness are 2.883 times more likely to have positive ATP (OR = 2.883, 95% CI: 1.076–7.724, P = 0.035). Moderately high positive correlations existed between ATP and career preference in psychiatry.

Conclusions:
Overall, positive attitudes were found. Significant correlations were seen across the domains of the ATP-30 and career preference in psychiatry. Female students are five times more likely to have positive attitudes than male students. Those in contact with persons with mental illness were almost thrice more likely to have positive attitudes than those without any contact.
Falls and its Impact on the Lives of the Rural and Urban South Indian Older Adults using the International Classification of Functioning, Disability, and Health Framework
Authors: Manishanair Murugan , Allenjuda James , Jeromedanypraveenraj Jones , Aruna Ranjan , Samuelprasannavinothkumar James , Samuelkamaleshkumar Selvaraj , George Jacob 
Published: September 2024

Background:
A fall is a ubiquitous event experienced by all but, in older adults, it leads to more adverse events. The International Classification of Functioning, Disability, and Health (ICF) framework offers a better understanding of the consequences of falls. Studies concerning the impact of falls on older adults living in rural and urban areas based on the ICF framework are sparse.

Objectives:
We examined the difference in the fall rate, fall characteristics, and the impact of falls based on the ICF framework in rural and urban older adults.

Study Design:
We did a cross-sectional survey among older adults living in rural and urban areas in a South Indian district from November 2017 to April 2018.

Methods:
We included 304 community-dwelling rural (n = 210) and urban (n = 94) older adults in the study. Self-designed data form was used to get the details on age, gender, educational level, visual problems, comorbidities, history, frequency, and fall-related injuries. Based on the ICF framework, we used measures such as the Berg Balance Scale (BBS), modified Barthel Index (MBI), Community Integration Questionnaire (CIQ), and World Health Organization Quality of Life Instrument (WHOQOL-BREF).

Results:
Out of 210 rural older adults, 101 (48%) experienced falls, and out of 94 urban older adults, 52 (55%) experienced falls. The fall rate did not differ significantly between the rural and urban older adults (odds ratio: 0.86, 95% confidence interval [CI]: 0.57–1.31,P= 0.507). The rural and urban older adult fallers differed significantly in gender (male: 95% CI: 0.06–0.39; female: 95% CI: 0.06–0.39;P= 0.007), education (<10 years: 95% CI: 0.31–0.57; >10 years: 95% CI: 0.75–0.94;P= 0.001), comorbidities (diabetes mellitus: 95% CI: 0.03–0.30; hypertension: 95% CI: 0.04–0.26; no comorbidities: 95% CI: 0.05–0.21;P= 0.001), problem in visual acuity (yes: 95% CI: 0.15–0.39; no: 95% CI: 0.15–0.39;P= 0.001), and frequency of falls (once: 95% CI: 0.01–0.33; recurrent: 95% CI: 0.01–0.33;P= 0.001) and did not differ in age, vocational status, and hospitalization. Except in CIQ scores (95% CI: 2.08–5.91;P= 0.001), they did not differ significantly in the fall-related injuries, BBS, MBI, and WHOQOL-BREF scores.

Conclusion:
The rural older women and the urban older adults with higher levels of education who had diabetes, hypertension, and visual problems experienced more falls. Although the urban older adults reported a higher frequency of falls, they showed a higher level of community reintegration than the rural older adults.
Understanding Daily Routine and Schedule of Children with Attention-Deficit Hyperactivity Disorder
Authors: Shikerkar Divesha , Vajaratkar Pooja Vivek 
Published: September 2024

Background:
Attention-deficit hyperactivity disorder (ADHD) is characterized by diminished sustained attention, hyperactive and impulsive behavior and is known to have an impact on the daily routine and self-regulation of children. There is a dearth of evidence for understanding the routine of the children with ADHD and their parents, which is necessary for organizing and scheduling the routine for the better management of daily occupations.

Objectives:
This study aimed to understand the daily routine and schedule of children with ADHD in Goa.

Study Design:
A qualitative, descriptive study design was conducted.

Methods:
This pilot study was conducted in resource rooms and schools in Goa, India. The recruitment of 10 parents of children with ADHD was done by the convenient sampling method and parents were administered a semi-structured questionnaire and in-depth interview was undertaken to understand the children's daily routine.

Results:
Ten parents (mean ± standard deviation [SD] age 45.4 ± 7.97 years) of children with ADHD (mean ± SD age 9.5 ± 1.85 years) participated in this study. The study understood and described in depth the extent of the organized schedule and routine present, child's home and school routine and schedule, how the routine of the child affects the child and the family in terms of their socialization and how important is a routine for the family.

Conclusion:
The study inferred that the parents of children with ADHD have difficulty in managing the daily routine of their child at home as well as in school, including the self-care routine, meal-time, bed-time routine, and study schedule. The study helped understand the importance of an organized routine with a well-defined structure in the daily life to carry out timely meaningful occupations.
Myelofibrosis – A Less Known Complication of Vitamin D Deficiency: A Case Report with Review of Literature
Authors: Mishra Ruchi , Agrawal Mukesh , Nalavade Omkar Gajanan , Hegde Darshan G. 
Published: September 2024

Background:
Pediatric myelofibrosis is uncommon and is usually secondary to an underlying hematopoietic or nonhematopoietic condition. Among the nonhematopoietic secondary causes, Vitamin D deficiency is an important but rare cause.

Clinical Description:
An 18-month-old male child with delay in achieving milestones for the past 6 months along with anemia and distention of the abdomen for the past 3 months was referred to our institute. Clinical examination revealed global developmental delay with a developmental quotient of 49%, short stature, rachitic features, and massive splenomegaly.

Management and Outcome:
After ruling out common nutritional and hemolytic causes of anemia, a bone marrow biopsy was done which showed extensive fibrosis, few megakaryocytes, myeloid and erythroid cells with normal maturation, and no storage cells – features consistent with myelofibrosis possibly secondary to Vitamin D deficiency. The clinical and laboratory findings of myelofibrosis improved with Vitamin D therapy and calcium.

Conclusion:
In developing countries like India, nutritional rickets is highly prevalent. However, rarely such children with rickets may show anemia with extramedullary erythropoiesis. If pediatricians are aware of Vitamin D deficiency-induced secondary myelofibrosis, many unnecessary investigations and work-up for storage diseases can be avoided. The condition is easily reversible with Vitamin D therapy.
Transient Hyperleukocytosis in One of the Extreme Preterm Twins: A Case Report with Review of Literature
Authors: Kuriakose Mathews E. , Chandran Shanu , Tawab Abdul 
Published: September 2024

Background:
Although physiological leukocytosis is known in premature neonates, hyperleukocytosis (total leukocyte count more than 100 × 103 /µL) is rarely seen. Commonly known disorders leading to hyperleukocytosis include leukemia, leukocyte adhesion defect, and myeloproliferative disorders. Transient hyperleukocytosis of unidentified etiology or attributed to sepsis has been rarely reported.

Clinical Description:
One of the extremely preterm twins (delivered at 26 weeks gestation) developed hyperleukocytosis on day 3 of life, without any evidence of blast cells on the peripheral smear, with normal C-reactive protein levels, while Twin 2 had normal leukocyte counts.

Management and Outcome:
Twin 1 was managed conservatively with mechanical ventilation, supportive care, and broad-spectrum antibiotics. His total leukocyte counts started reducing since day 5 of life and returned to normal after day 18, although he required prolonged respiratory support due to bronchopulmonary dysplasia (BPD). The other twin with a normal leukocyte count had a less difficult course and did not develop BPD. The twins being dichorionic-diamniotic type, and the placental histopathology of Twin 1 showing evidence of chorioamnionitis (the placenta of the other twin was normal), the transient hyperleukocytosis of Twin 1 was attributed to chorioamnionitis.

Conclusion:
The presence of hyperleukocytosis in only one of the neonates of an extremely preterm delivery highlights the fact that some factors such as chorioamnionitis or early-onset sepsis may contribute to this condition, which is transient, and resolves with supportive conservative care.
Infantile Spasms and Developmental Delay: A Case of Miller–Dieker Syndrome
Authors: George Jewel Maria , Cherian Carol Sara , Thomas Reji , Sunnychan Sebin 
Published: September 2024

Background:
Miller–Dieker syndrome (MDS) is a rare genetic disorder, due to contiguous gene deletion on chromosome 17p13.3, characterized by classical type I lissencephaly, severe developmental delay, seizures, cardiac defects, and dysmorphisms. West syndrome is a severe form of epilepsy with epileptic spasms, hypsarrhythmia in electroencephalogram (EEG), and neuropsychomotor delay. Herein, we describe the neurophysiological and neuroimaging findings of a patient with MDS with associated West syndrome.

Clinical Description:
A 5-month-old boy was brought with new-onset infantile spasms and a history of delay and some regression in milestones. Facial dysmorphism was noted in the form of a prominent forehead, bitemporal hollowing, short nose with upturned nares, thickened upper lip, long philtrum, low-set ears, and hypertelorism. There was hypotonia of all four limbs.

Management and Outcome:
An EEG showed hypsarrhythmia, and the magnetic resonance imaging brain revealed hypoplastic sulci with pachygyria and smooth cortical surface of supratentorial brain parenchyma – features suggestive of lissencephaly type 1. Echocardiography showed atrial septal defect and minimal pericardial effusion. Whole-exome sequencing showed a contiguous large heterozygous deletion on chromosome 17 which was suggestive of Miller–Dieker lissencephaly syndrome. Parents were counseled, and the spasms were treated with an injection adrenocorticotropic hormone and oral vigabatrin.

Conclusion:
Structural brain abnormalities are well-known causes of infantile spasms. MDS is a severe malformative condition, lissencephaly being the hallmark of this disorder. This case report will create awareness among pediatricians regarding this rare condition with a characteristic combination of clinical features, which can be confirmed by brain imaging and genetic analysis.
Malignant Infantile Osteopetrosis: A Rare Cause of Refractory Hypocalcemia
Authors: Dipak Niraj Kumar , Shagufta Nadia 
Published: September 2024

Background:
Infantile malignant osteopetrosis (IMO) is a rare autosomal recessive disease characterized by a higher bone density in bone marrow caused by the dysfunction of bone resorption.

Clinical Description:
A 2-month-old baby boy presented with features of lower respiratory tract infection, along with a swollen right upper arm due to fracture of humerus, along with signs of bicytopenia and hepatosplenomegaly. He had a history of hypocalcemic seizures at 8th day of life.

Management and Outcome:
Current hospitalization revealed refractory hypocalcemia and hypophosphatemia with normal to increased Vitamin D and parathormone levels and increased density of bone. Hypocalcemia was particularly refractory in nature needing multiple intravenous calcium corrections. Whole exome sequencing detected compound heterozygous variants in the T-cell immune regulator 1 pathogenic gene of IMO. Simultaneously, a heterozygous nonsense variation in exon 4 of the CHRNA4 gene was detected causing nocturnal frontal lobe epilepsy. As the infant had evidence of bone marrow failure, he was considered and referred for hematopoietic stem cell transplantation.

Conclusion:
Neonatal and early infantile hypocalcemia are commonly seen by pediatricians, but an etiology of IMO is rarely considered. The presence of fracture of long bones with cytopenias and hepatosplenomegaly in a young infant with recurrent hypocalcemia, without Vitamin D deficiency, should raise suspicion of this disorder and genetic analysis should be carried out for the same.
Understanding Self-medication Trends in First-year Medical Students: A Cross-sectional Study
Authors: Adake Prabhakar , Petimani Mahalaxmi S. , Naik Rajesh Vishnu 
Published: September 2024

Objectives:
The objective is to explore self-medication perceptions and practices among 1st year undergraduate medical students.

Materials and Methods:
This cross-sectional study was conducted among 1st-year medical students in a private college in North Karnataka. A prevalidated questionnaire assessing self-medication perceptions and practices was administered to 176 participants through Google Forms. Descriptive statistics were used to analyze the data.

Results:
Nearly half of our study participants (52.3%) reported engaging in self-medication. The common sources of information included previous experience/prescriptions (43.8%) and advice from parents/friends (41.5%). Reasons for self-medication included perceiving the illness as nonsevere (82.4%) and time-saving (10.8%). The most common conditions prompting self-medication were the common cold (29%), fever (25.6%), and pain (18.8%). Analgesics (28.4%) and antipyretics (27.3%) were the most commonly used drug classes.

Conclusion:
The relatively lower prevalence of self-medication among 1st-year medical students in this study may be attributed to factors such as the targeted focus on this specific demographic, limited availability of self-medication resources in hostels, and foundational training emphasizing evidence-based medicine principles. However, concerns arise regarding the use of alternative medicine systems like Ayurveda, potentially leading to herb–drug interactions. To address these issues, structured educational initiatives, regulatory enforcement, and improved access to health-care consultations are crucial for promoting rational medication use and mitigating self-medication risks among medical students.
Retraction Notice: Study on Dynamic Response Characteristics of Offshore Floating Wind Turbine Pitch System
Authors: Guan Xin , Wu Shiwei , Li Mingyang , Xie Yuqi 
Published: September 2024

The article Study on Dynamic Response Characteristics of Offshore Floating Wind Turbine Pitch System has been retracted at the request of EAI's Research Integrity Committee on the grounds of plagiarism.
Analytical Sensitivity Analysis and Clinical Impact Modeling of Rapigen Rapid Diagnostic Tests for Malaria
Authors: Golden Allison , Slater Hannah C. , Jang Ihn Kyung , Walke Sayali , Phan Thanh T. , Bizilj Greg T. , Rashid Andrew , Barney Rebecca , Das Smita , Rist Melissa J. , McCarthy James S. , Nosten Francois , Landier Jordi , Imwong Mallika , Hume Jennifer C. C. , Sagara Issaka , Healy Sara A. , Duffy Patrick E. , Ntuku Henry , Mumbengegwi Davis , Hsiang Michelle S. , Murphy Sean C. , Rek John , Torres Katherine , Gamboa Dionicia , Domingo Gonzalo J. 
Published: September 2024

ABSTRACT.
Laboratory benchmarking allows objective analysis of the analytical performance of malaria rapid diagnostic tests (RDTs). We present the analytical detection limits of the Rapigen BIOCREDIT Malaria Ag Pf/Pv (pLDH/pLDH), the Rapigen BIOCREDIT Malaria Ag Pf (pLDH/HRPII), and two best-in-class WHO-prequalified comparator RDTs, generated using standardized panels containing recombinant antigen, in vitro cultured parasites, international standards, and clinical samples. Detection limit antigen concentrations of HRP2, PfLDH, and PvLDH were determined for the Rapigen and comparator RDTs. Detection of antigens in international units (IU)/mL was also evaluated. The Rapigen Ag Pf (pLDH/HRPII) detected 3.9 and 3.9 IU/mL for PfLDH and HRP2, respectively, and the Ag Pf/Pv (pLDH/pLDH) detected 3.9 and 5.0 IU/mL for PfLDH and PvLDH, respectively. The comparator HRP2/PfLDH and HRP2/PvLDH detected 15.6 and 31.3 IU/mL for HRP2 and PfLDH and 15.6 and 50.0 IU/mL for HRP2 and PvLDH, respectively. The RDT clinical sensitivity was predicted through application of analytical detection limits to antigen concentration distributions from clinical symptomatic and asymptomatic cases. Febrile cases would be detected in a majority by both standard and Rapigen RDTs, but incremental increases in sensitivity in the Rapigen RDTs may be important for clinical cases currently missed by microscopy. Rapigen RDTs were predicted to have improved detection of asymptomatic cases and infections with parasites carrying hrp2 deletions through more sensitive PfLDH detection. Through the benchmarking and simulation of clinical sensitivity, a method for rapidly assessing the ability of new RDTs to meet clinical needs using high-sensitivity antigen distribution data is presented.
Disseminated Macrolide-Resistant Mycobacterium intracellulare Infection in a Child with Autoimmune Lymphoproliferative Disorder: A Case Report and Literature Review
Authors: Nithirungruang Phuwakrit , Tanpowpong Pornthep , Getsuwan Songpon , Boonsathorn Sophida 
Published: September 2024

ABSTRACT.
A 4-year-old girl, previously treated with prednisolone and cyclosporin A due to autoimmune lymphoproliferative syndrome, presented with acute fever, progressive pancytopenia, intermittent abdominal pain, and acute episode of hematemesis. Esophagogastroduodenoscopy revealed diffuse erythematous gastric mucosa and blunt duodenal villi. Histopathology of the duodenal mucosa was notable for numerous acid-fast bacilli within foamy macrophages in the lamina propria, and nontuberculous Mycobacterium DNA was detected by polymerase chain reaction of duodenal tissue. Azithromycin, rifampicin, and ethambutol were started while waiting for species identification and drug susceptibility testing. Macrolide-resistant Mycobacterium intracellulare was demonstrated from blood culture, indicating disseminated infection. The patient died of overwhelming infection, despite receiving newly adjusted regimen (rifampicin, ethambutol, clofazimine, and amikacin). This case highlights the importance of considering disseminated Mycobacterium avium complex (MAC) in the differential diagnosis of immunocompromised, non-HIV patients presenting with gastrointestinal manifestations. Early identification of macrolide-resistant MAC is crucial for guiding appropriate treatment and potentially improve patient outcomes.