bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Skip Generation Family Structure on Diabetes Mellitus Treatment Outcomes at a Primary Care Unit in Khon Kaen Province
Authors: Teprungsirikul Kittima , Luvira Varisara 
Published: May 2024

Background:
Self-care is an essential component of diabetes mellitus (DM) treatment and often depends heavily on family support. In skip generation families, children's grandparents are their primary caretakers, many of whom have chronic diseases such as DM. The objective of this study was to determine the proportion of DM patients receiving treatment at a primary care unit in Khon Kaen Province in the skip generation families and the effects of this family structure on clinical indicators of treatment outcomes.

Methods:
This was a prospective descriptive study in DM patients who visited a primary care unit in Khon Kaen Province from July to October 2019. Patients were asked to fill out a questionnaire interviewed, and demographic and clinical data were analyzed.

Results:
This study included 202 participants. We found that 11.4% of patients were in skip generation families, 91.3% of whom were elderly. We found no statistically significant association between family structure and either self-care practices or clinical indicators of treatment outcomes.

Conclusions:
Neither clinical indicators of treatment outcomes nor self-care practices differed between DM patients in skip generation families and those with other family structures. However, additional studies should be conducted to examine other possible factors, such as the age of the grandchildren of whom patients are the primary caretakers.
The Effect of Water-Pipe and Cigarette Smoking on Exhaled Nitric Oxide
Authors: Mehrparvar Amir Houshang , Ghanbari Laleh , Mirmohammadi Seyyed Jalil , Zare Sakhvidi Mohammad Javad , Vakili Mahmood , Davari Mohammad Hossein , Mirzaei Masoud 
Published: May 2024

Context:
Fractional exhaled nitric oxide can be used as a biomarker of some respiratory diseases.

Aims:
This study was conducted to compare exhaled nitric oxide in cigarette and water-pipe smokers with nonsmokers.

Methods:
This cross-sectional study was conducted on 549 adult subjects as a sub-study of Shahedieh cohort in Yazd. Participants were divided into 5 groups according to their smoking habits: non-smokers (n = 202), cigarette smokers (n = 121), water-pipe smokers (n = 129), cigarette ex-smokers (n = 58), water-pipe and cigarette smokers (n = 39). The smokers were also categorized into heavy and light smokers. Fractional exhaled nitric oxide was compared between the groups.

Statistical Analysis Used:
The data were analyzed by SPSS (ver. 20) using Kolmogorov-Smirnov, Kruskal-Wallis, and Mann-Whitney U tests.

Results:
Fractional exhaled NO was lower in all smokers than nonsmokers, but cigarette smokers showed the least level of NO than other groups. Fractional exhaled NO was not significantly lower in water-pipe smokers than nonsmokers.

Conclusions:
Cigarette smoking significantly affect fractional exhaled NO, but water-pipe smoking did not significantly affect exhaled NO level.
The Relationship between Screening Markers in the First Trimester of Pregnancy and Chromosome Aberrations
Authors: Mirsafaie Maryam , Moghaddam-Banaem Lida , Kheirollahi Majid 
Published: May 2024

Background:
This study was designed and performed to investigate the relationship between fetal chromosome aberrations and screening markers in the first trimester of pregnancy in order to prevent the birth of infants with chromosome aberrations with early prenatal diagnosis.

Methods:
We conducted an analytic cross-sectional study on result of chromosomal culture of 762 pregnant women with high-risk combined screening test from December 2018 to June 2020 and analyzed by SPSS program.

Results:
There was a significant relationship between chromosome structural abnormalities with free beta-human chorionic gonadotropin (free β-hCG) values equal to and higher than 1.5 multiples of the median (MoM) (P: 0.05). The highest incidence of disorder in number of chromosomes with abnormal nuchal translucency (NT) percentiles (≥99%) was seen (P < 0.001). It also shows that the cumulative number of chromosome aberrations of 25 (78.12%) occurred in individuals with a NT less than 99th percentile and at the same time a risk of 1/50≤ risk <1/10.

Discussion:
According to the results, Comparative Genomic Hybridization (CGH) array method is recommended to detect structural abnormalities in chromosomes in samples with NT ≥3.5. In addition, it is noteworthy that chromosomal structural abnormalities occur in free β-hCG ≥1.5 MoM.

Conclusion:
Due to the frequency of chromosomal structural disorders and its effect on the incidence of fetal abnormalities, the study of chromosomal structural disorders is recommended.
Purification of Ambient Air by Novel Green Plant with Titanium Dioxide Nanoparticles
Authors: Salama Khaled F. , Zafar Mubashir 
Published: May 2024

Background:
Indoor air pollution is an important environmental health problem. Nanotechnology is one of the most important methods to reduce the indoor air pollution. Titanium dioxide (TiO2) is generally accepted as one of the most effective photoinduced catalysts. It is frequently used to oxidize organic and inorganic compounds in the air due to its strong oxidative ability and long-term photostability. The aim of this study was to determine the effectiveness of nanotechnology in the purification of ambient air by using Saudi myrtle plants treated with TiO2.

Methods:
Experiments were conducted in two academic departments of the laboratories at the Public Sector University. Concentration of formaldehyde, nitrogen dioxide (NO2), sulphur dioxide (SO2) and other toxic gases was measured in the environment of the laboratories. Myrtus plant was growing in the growth media which contained TiO2. After 8 hours of exposure of the plant, concentration of NO2, SO2 and other toxic pollutant gases in the air was measured. The total duration of the experiment was 4 days.

Results:
It was found that the levels of formaldehyde, volatile organic compounds (VOCs) and other pollutants were significantly reduced the concentration from 10% to 98% in the air. After intervention, air containing the concentration of formaldehyde, TVOCs, NO2 SO2 and carbon monoxide (CO) on the fourth day reduced from 0.251, 401, 0.032, 0.009 and 0.99 to 0.014, 54,0.0003, 0.003 and 0.01 after exposure of Myrtus plant to ambient air.

Conclusions:
Significant reduction of air pollutants in the air after application of TiO2 in the green plant (Myrtus communis). It is a novel approach and economically feasible for purification of indoor air.
The Prevalence of Metabolic Syndrome in First Degree Relatives of Patients with Obstructive Sleep Apnea Syndrome
Authors: Amra Babak , Shafiei Amin , Soltaninejad Forogh , Asgari Abdollah , Farajzadegan Ziba 
Published: May 2024

Background:
There was the association between the metabolic syndrome (MS) and obstructive sleep apnea (OSA). Also, the genetic factors have been implicated in the OSA. Our aim was to compare the frequency of MS in first-degree relatives (FDRs) of OSA patients with healthy controls.

Methods:
39 FDR (parents, siblings, and children) of patients diagnosed with OSA at Bamdad Respiratory and Research Center as cases and age- and sex-matched healthy controls were included in the current case–control pilot study. The sampling method was convenience sampling based on having inclusion criteria and consent to participate in the study. Demographic characteristics and essential criteria for diagnosing MS included blood pressure, anthropometric [weight (kg), height (cm), waist circumference (cm) and body mass index (BMI) (kg/m2)], and biochemical indices (lipid profile and blood glucose) were assessed based on standard protocols.

Results:
In the comparison of the demographic and clinical characteristics of two39 cases and control groups, weight and diastolic blood pressure were significantly higher in case group than controls (P < 0.05). Case and control groups were not significantly different in the frequency of MS (P > 0.05). Although, the frequency of hypertension as an important cardiovascular risk factor was higher in cases than controls (P < 0.05).

Conclusions:
The present study demonstrates that the frequency of MS is not significantly different between FDRs of OSA patients and controls. However, further large-scale studies are warranted to detect the frequency of MS in people with hereditary background for OSA compared to general population.
Serum Prooxidant-Antioxidant Balance and hs-CRP in Patients with Clinical and Subclinical Hypothyroidism
Authors: Shirzad Nooshin , Taghvaee Mahdieh , Ferns Gordon A. , Qorbani Mostafa , Hemmatabadi Mahboobeh , Mobarra Naser 
Published: May 2024

Background:
Oxidative stress (OS) is caused by an imbalance between prooxidant substance production and antioxidant defense. OS is involved in physiologic interactions in the body and the pathogenesis of various disorders. This study aimed to evaluate serum prooxidant-antioxidant balance (PAB) as a selective prooxidant, antioxidant defense, and acute phase reactant protein in patients with subclinical and clinical hypothyroidism.

Methods:
This case-control study was conducted in three groups including clinical hypothyroidism (32 patients), subclinical hypothyroidism, (42 cases), and healthy controls (32 individuals). This study was performed in the Endocrine Clinic of Arash Training and Research Hospital, Tehran, 2017. In the study groups, thyroid hormones including T4 and Thyroid Stimulating Hormone (TSH), fasting blood glucose (FBG), lipid profile, PAB, and hs-CRP as inflammatory markers were measured and compared between the groups.

Results:
Among 106 participants, 95.3% were females, the gender balance was similar across groups and mean age was 30.79 ± 7.65 years. FBG and lipid profile except for cholesterol level were not significantly different between the three study groups. However, cholesterol level in the clinical hypothyroid group was significantly higher than the other two groups. PAB was higher in subclinical hypothyroidism compared to healthy controls after adjustment for age and TSH levels (P value: 0.04) but there was no significant difference in the clinical hypothyroid group in comparison with healthy controls. In addition, there was no significant difference in high-sensitivity C-reactive protein (hs-CRP) between the three study groups.

Conclusions:
This study suggests that that subclinical hypothyroidism increases PAB in comparison to healthy control which could indicate OS response in patients with subclinical hypothyroidism, respectively.
Bacteriological Quality of Drinking Water and Hygienic Assessment of Water Cooler Dispensers in Higher Education Institution
Authors: Precha Nopadol , Rattanaphan Chayada , Galiga Tanyaporn , Makkaew Presert , Narom Nutcha , Jawjit Siriuma 
Published: May 2024

Background:
The bacteriological quality of drinking water has become a public health concern according to its association with water-borne diseases. Nowadays, there are several different types of drinking water, including water cooler dispensers (WCDs), which are becoming a popular device in educational institutions. Therefore, this study aims to determine the bacteriological quality of drinking water from WCDs, and inspect their hygienic conditions in students’ dormitories at a university in Nakhon Si Thammarat, Thailand.

Methods:
Water samples from 53 WCDs installed in 13 dormitories were collected and analyzed coliform bacteria by using the multiple-tube fermentation technique. The hygienic inspection form from the Department of Health, Ministry of Public Health, was used for inspection of the sanitary conditions. The hygienic factors of water cooler sanitation were analyzed using the generalized linear model.

Results:
Coliform bacteria were found in 10 out of 53 samples; moreover, Escherichia coli was recovered in three samples. Maintenance/cleaning and monitoring were the most two sanitary issues found in 100% (53/53) of the WCDs. Location and features of machine were found the correlation with the prevalence of coliform bacteria in drinking water.

Conclusions:
The findings of this study suggest regular monitoring of water quality in educational institutions. Also, the Sanitary Standard and Operational Procedures (S.S.O.P.) should be developed to improve the hygienic conditions of the water cooler dispensers.
Major Dietary Patterns in Association with the Grades of Nonalcoholic Fatty Liver Disease in Newly Diagnosed Patients Living in North of Iran
Authors: Mansour-Ghanaei Fariborz , Mahdavi-Roshan Marjan , Darabi Zahra , Seyyedin Bahareh , Joukar Farahnaz , Rezazadeh Arezoo 
Published: May 2024

Background:
Evidence suggests that dietary pattern is related to incidence and grades of nonalcoholic fatty liver disease (NAFLD). The aim of this study was to investigate the relationship between major dietary patterns and hepatic histologic features of newly diagnosed patients with NAFLD.

Methods:
This cross-sectional study included 260 newly diagnosed NAFLD patients. Hepatic fibrosis and steatosis were diagnosed using Fibroscan. Dietary information was obtained using a validated 168-item semiquantitative food frequency questionnaire. The association between dietary patterns and odds ratio of the grade of fibrosis and steatosis was examined by multinomial logistic regression.

Results:
The mean ± SD age participant was 46.53 ± 11.71 years. Fifty-seven percent of the participants were women. Two major dietary patterns were recognized: “Western dietary pattern” and “Mediterranean dietary pattern.” After adjustment for various confounders, adherence to the two extracted dietary patterns was not associated with odds of fibrosis and steatosis (P > 0.05). However, P was not significant. Patients in the second quartile of the Mediterranean dietary pattern had a higher risk for being in the F1 grade compared to those in the reference group in the crude and adjusted model.

Conclusions:
The major dietary patterns of NAFLD patients living in Gilan were not related to the severity of their disease. More precise study design such as cohort or interventional studies is suggested to reveal the strength of this study findings.
Does Therapeutic Alliance Help “in Search for Meaning?” Experiences of Working through a “Trilogy”
Authors: Basu Aniruddha 
Published: May 2024

Background:
Therapeutic alliance has been the 'Holy-Grail' of doctor patient relationship but is most discussed in relation to psychotherapy. At times in an individual therapeutic scenario it has been conceptualized as a working alliance to a collaborative plan but more than that it influences the lives of the clients and the therapists alike.

Aims and Objectives:
Understanding therapeutic alliance and its influence on the client and the therapist.

Materials and Method:
Three interrelated cases scenarios and the therapeutic alliance has been allegorized through the Shakespearian perspective.

Results:
In this exposition, a trilogy of three interrelated therapeutic case scenarios culminates in the existential framework. The first gentleman was a middle aged physician who had everything in life and at the end was drinking heavily as he had nothing else to do. In the second a soldier who fought bravely for his country but received no recognition and in lieu lost an arm in an conflict with the insurgents. Thereafter he found drinking as the only way forward. In the third case a gentleman who had alcohol dependence could quit alcohol unlike the other two. The main driving force of the latter was to do something for his son – this 'search for meaning' was lacking in the previous two. In the course it was seen that therapeutic alliance not only influences the life perspectives of the clients but also the therapist alike through an interplay of transference and counter transference.

Conclusion:
The influence of therapeutic alliance is not only limited to some narrow therapeutic scenarios but extends beyond in a much broader sense.
Depression and Anxiety among Tuberculosis Patients: A Systematic Review and Meta-analysis
Authors: Panibatla Vikas , Nagaraja Sharath Burugina , Mohan Deepa , Kizhakkethil Sreenath Menon Parambanattu , Sangeetha M. D. 
Published: May 2024

Background:
Tuberculosis (TB) patients often experience depressive and anxiety symptoms, which can significantly impact their quality of life, treatment adherence, and outcomes. Understanding the magnitude of these mental health issues is crucial for improving TB programs and achieving successful treatment outcomes.

Materials and Methods:
We conducted a systematic review and meta-analysis, to assess the prevalence of depressive and anxiety symptoms among TB patients. Relevant studies were identified through a search of the PubMed database. Studies were assessed for quality using the Newcastle–Ottawa Quality Assessment Scale (NOS). Data extraction was performed, and a random-effects meta-analysis was conducted to estimate pooled prevalence rates.

Results:
Forty studies were included in the analysis. The pooled estimated prevalence of depression among TB patients was 11% (95% confidence interval [CI]: 11–12), while the pooled estimated prevalence of anxiety was 28% (95% CI: 26–29). Subgroup analyses revealed variations in the prevalence rates among drug-sensitive (DS-TB), drug-resistant, and extensively drug-resistant patients, as well as across continents and settings.

Conclusions:
The review indicates that there was a considerable burden of depressive and anxiety symptoms among TB patients worldwide. The findings emphasize the need for routine screening, integrated care approaches, and targeted interventions to address the mental health needs of TB patients.
A comparative study of disability between bipolar affective disorder and schizophrenia using Indian disability evaluation and assessment scale
Authors: Borah Kabyashree , Nagarajan Padmavathi , Bharadwaj Balaji 
Published: May 2024

Background:
Schizophrenia and bipolar affective disorder (BPAD) have been identified as two severe mental disorders that are associated with a considerable amount of disability. These disorders create significant impairment in many aspects of an individual's life.

Objective:
This study was undertaken to compare the disability associated with schizophrenia and bipolar affective disorder (BPAD).

Materials and Methods:
A descriptive cross-sectional study was carried out among patients with a diagnosis of schizophrenia spectrum disorder (F20.0–F20.9) (n = 30) or BPAD (F30.0–F39) (n = 30) as per the International Classification of Diseases-10. The level of disability was assessed by the Indian Disability Evaluation and Assessment Scale. A semi-structured pro forma was used to assess the sociodemographic and clinical parameters.

Results:
The level of disability was mild in 17 (56.7%) subjects, moderate in 12 (40%) subjects among patients with BPAD. In Schizophrenia, 20 (66.7%) subjects had a mild disability and 10 (33.3%) had a moderate level of disability. The mean global disability score among patients with BPAD was significantly higher than in those with schizophrenia (7.57 + 2.84) versus 6.93 + 2.94, t = 0.846,P= 0.033.

Conclusion:
The level of disability among individuals diagnosed with BPAD was higher mostly related to self-care and work-related domain disability.
Loneliness, social isolation, traumatic life events, and risk of alzheimer's dementia
Authors: Rauf Insha , Hussain Arshad , Roub Fazle 
Published: May 2024

Context:
Alzheimer's disease, an affliction of old age, is the leading cause of dementia worldwide. Vascular risk factors such as hypertension, dyslipidemia, hyperinsulinemia, type II diabetes, and obesity have been widely implicated in the pathogenesis of dementia. Environmental factors such as social isolation, loneliness, and traumatic life events, though less studied, have been associated with an increased risk of developing Alzheimer's disease.

Aim:
We aimed to find out if loneliness, social isolation, and traumatic life events are risk factors for Alzheimer's dementia (AD).

Materials and Methods:
This was a case–control study based on 100 patients selected for the study using Mini-Mental State Examination (MMSE) (Kashmiri version) and diagnosed using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria for dementia of the Alzheimer's type. Patients having “mild degree of impairment” on MMSE (Kashmiri version) were taken up for the study. Patients were assessed using De Jong Gierveld Loneliness Scale (eleven items), Lubben Social Network Scale, and Traumatic Life Events Checklist.

Results:
Loneliness is associated with an increased risk of developing AD. Social isolation acts as a proxy indicator of loneliness. The number of traumatic events is not associated with an increased risk of developing AD. However, death of a child was associated with an increased risk of developing AD (P = 0.033).

Conclusion:
Loneliness is a robust risk factor for dementia and as such more research needs to focus on it so that suitable cognitive behavioral interventions may be developed and refined to help the vulnerable population.
Impact and Facilitators of a Psychiatric Rehabilitation Daycare Work Program
Authors: Roy Amrita , Sivakumar Thanapal , Jayarajan Deepak 
Published: May 2024

Background:
Work confers many benefits to persons with psychiatric disabilities. The daycare work programs can be helpful for patients in multiple ways. Many stakeholders plan and implement a daycare work program, including patients, caregivers, trainers, staff members, and professionals. The literature on daycare work programs is limited. The present study aimed to understand the impact and facilitators of a selected daycare work program (Green Skills Program [GSP]) from the lens of stakeholders.

Methods:
Criterion sampling was used to recruit the stakeholders who have been part of GSP. Twenty-seven stakeholders were interviewed using a researcher-prepared semi-structured interview schedule. Atlas. ti version 9 was used for coding. Thematic analysis was done to identify themes.

Results:
Stakeholders considered GSP easy, enjoyable, and accommodative to patients with different functioning levels. GSP participation was deemed as gainful engagement and vital to day-structuring. The patients worked in groups, which promoted peer learning and teamwork. Various behavioral, social, and work-related improvements were noted among the patients by the stakeholders. Incentives and social reinforcements were significant motivators. Stakeholders were content with the trainer's way of teaching the patients and felt that she possessed many essential attributes that motivated them and improved their work outcomes.

Conclusions:
While conceiving daycare work programs, ease of doing activities, accommodation of patients with varying levels of functionality, trainer's aptitude, and use of reinforcements should be considered.