bluuebunny/crossref_metadata_2025_split huggingface dataset:
Home blood pressure telemonitoring in the Netherlands: a pilot study in GP practices
Authors: van Steenkiste Job , Verberk Iris , Versmissen Jorie , Dohmen Daan , Jainandunsing Sjaam 
Published: April 2024

Abstract
Background
Home Blood Pressure Telemonitoring (HBPT) has been proposed to improve drug adherence, blood pressure control, and efficient care delivery in patients with hypertension. Its adoption in GP practices however remains low. In this pilot study we evaluated barriers and facilitators for successful implementation, patient satisfaction, clinical effectiveness, and efficiency for a HBPT project in Dutch GP practices by means of the Quadruple Aim Model.

Methods
GP practices included patients with hypertension that were part of their regular cardiovascular disease program. We conducted semi-structured interviews at 3- and 6-months to identify barriers and facilitators for successful implementation. Patient satisfaction was measured with Telehealth Usability (TUQ)—and Mhealth App Usability (MAUQ) Questionnaires. A SPRINT-protocol blood pressure measurement was performed after the pilot project to assess clinical effectiveness. Efficiency data were collected on the number of registered consultations and practice measurements performed during the 6-month project.

Results
Three GP practices included 19 patients. Barriers for implementation were a lack of a reimbursement structure, lack of information technology (IT) system integration and increased experienced workload when using HBPT. Facilitators included the positive effects on blood pressure control, increased sense of safety for patient and care provider, and increased disease-insight. Median satisfaction scores for TUQ and MAUQ questionnaires (scale 1–7) were 6 (IQR 5–6) and 6 (IQR 5–7). At baseline, 16% of the patients had a blood pressure < 140/90 mmHg. Based on the performed SPRINT measurements, 68% had a well-controlled blood pressure (< 140/90 mmHg) after 6 months. Average blood pressure improved from 151/89 mmHg to 132/81 mmHg (p =  < 0.05). On average, one monthly contact moment related to hypertension between patient and GP practice was registered.

Conclusions
We found positive results following the introduction of HBPT in GP practices on clinical outcomes and patients’ satisfaction, however for large-scale implementation improvements with regards to organizational efficiency and a clear reimbursement structure are needed.
Approach to the Patient With Headache
Authors: Friedman Deborah I. 
Published: April 2024

ABSTRACT

Objective
The evaluation of patients with headache relies heavily on the history. This article reviews key questions for diagnosing primary and secondary headache disorders with a rationale for each and phrasing to optimize the information obtained and the patient’s experience.

Latest Developments
The availability of online resources for clinicians and patients continues to increase, including sites that use artificial intelligence to generate a diagnosis and report based on patient responses online. Patient-friendly headache apps include calendars that help track treatment response, identify triggers, and provide educational information.

Essential Points
A structured approach to taking the history, incorporating online resources and other technologies when needed, facilitates making an accurate diagnosis and often eliminates the need for unnecessary testing. A detailed yet empathetic approach incorporating interpersonal skills enhances relationship building and trust, both of which are integral to successful treatment.
Headache in Children and Adolescents
Authors: Orr Serena L. 
Published: April 2024

ABSTRACT

OBJECTIVE
This article reviews the assessment of children and adolescents presenting with headache, provides an overview of primary headache disorders, and reviews evidence-based management of headache in this age group.

LATEST DEVELOPMENTS
In the last few years, new epidemiological data have shed light on less common pediatric headache disorders (eg, pediatric trigeminal autonomic cephalalgias) and psychosocial risk factors associated with primary headache disorders in children and adolescents. There has also recently been a substantial increase in interventions that target the calcitonin gene-related peptide pathway and that treat primary headache disorders using noninvasive neuromodulation. Although these interventions have primarily been studied in adults, there is emerging evidence of their use in the pediatric population.

ESSENTIAL POINTS
Primary headache disorders are very common in youth, and the most commonly encountered headache diagnosis in neurology practice is migraine, which affects approximately 10% of children and adolescents. Diagnosing and effectively treating primary headache disorders before adulthood may have a sustained impact on the patient by improving long-term headache and mental health outcomes, thereby significantly reducing the burden of disability over time. There are several available and emerging acute and preventive interventions for youth with primary headache disorders, and treatment decisions should be made in the context of available evidence using a shared decision-making approach.
Cranial Neuralgias
Authors: Nahas Stephanie J. 
Published: April 2024

ABSTRACT

Objective
The cranial neuralgias are relatively rare, but recognizing these syndromes and distinguishing among them is critical to reducing unnecessary pain and disability for affected patients. Despite their distinctive features, cranial neuralgias may go undiagnosed or misdiagnosed for several years. A notable proportion of cranial neuralgia presentations are due to secondary causes and require targeted treatment. The purpose of this article is to review the diagnosis and management of cranial neuralgias encountered in clinical practice.

Latest Developments
In 2020, the International Classification of Orofacial Pain was released for the first time. Modeled after the International Classification of Headache Disorders, it includes updated terminology for cranial neuralgias. The underlying pathophysiology of the cranial neuralgias is currently believed to be rooted in both peripheral and central nociceptive systems. In addition, a growing number of familial cases are being identified. Recent therapeutic advancements include a better understanding of how to utilize older therapies and procedures more effectively as well as the development of newer approaches.

Essential Points
Cranial neuralgia syndromes are rare but important to recognize due to their debilitating nature and greater likelihood of having potentially treatable underlying causes. While management options have remained somewhat limited, scientific inquiry is continually advancing the understanding of these syndromes and how best to address them.
The possible protective role of HLA B27 and relevant immune markers in Juvenile Idiopathic Arthritis patients
Authors: Shahzad Farhana , Tahir Romeeza , Shahzad Faheem , Afzal Nadeem 
Published: April 2024

Background & Objectives: JIA is a disease with different immunological characteristics and a complicated genetic foundation. HLA B27 is a risk factor for the development of JIA, and its impact on immunopathogenesis of the disease is also an area of interest. To determine whether HLA B27 and immune markers varied between JIA patients and healthy population.
Methods: This comparative cross-sectional study was conducted at Immunology Department of University of Health sciences (UHS), Lahore from February 2018 till August 2021. A total of (71) JIA patients and (34) healthy controls were enrolled. B cells were enumerated by flowcytometry, ELISA was used for serum cytokines estimation and HLA B27 allele was detected by SPSS polymerase chain reaction.
Results: The HLA B27 allele was significantly more in the control group than in the patient group, suggesting it is a protective allele to prevent JIA. Peripheral blood B cell counts and percentages were significantly lower in the HLA B27 positive group than in the HLA B27 negative group of control population. Serum cytokine levels were not significantly different between the HLA B27 positive and HLA B27 negative allele of the two study populations.
Conclusion: In this study B cells are different between the two groups of control population however; serum cytokines are comparable between the study groups. Though, it was indicated that HLA B27 may be a preventive allele in the onset of JIA.
doi: https://doi.org/10.12669/pjms.40.5.7915
How to cite this: Shahzad F, Tahir R, Shahzad F, Afzal N. The possible protective role of HLA B27 and relevant immune markers in Juvenile Idiopathic Arthritis patients. Pak J Med Sci. 2024;40(5):---------. doi: https://doi.org/10.12669/pjms.40.5.7915
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.
Social and nature connectedness, coping strategies, and mental health symptoms.
Authors: Gawrych Magdalena 
Published: April 2024

Aim of the studyThe study evaluates the role of connectedness and coping strategies in mental health model.Subject or material and methodsThe sample included a total of 81 adult participants aged 19-57 years (M=28.02), of whom 76,5% were female. More than half of participants live in the biggest cities in Poland, including capital city (61,73%). The online semi-structured questionnaire included sections concerning several areas: sociodemographic data, mental health symptoms (DASS-21), nature connectedness (CNS), social connectedness (SCS-R), coping strategies (Mini-COPE).ResultsThe analysis examined how depression, stress, anxiety, and coping mechanisms are related to the nature and social connectedness. Obtained results shown: (1) significant negative relationship of social connectedness with severity of stress (r = -.41; BCa 95% CI), anxiety (r = -.40; BCa 95% CI) and depression (r = -.50; BCa 95% CI); (2) significant negative relationship of nature connectedness with anxiety level (r = -.22; BCa 95% CI) and symptoms of depression (r = -.26; BCa 95% CI). Furthermore, the results showed a significant relationships of social connectedness/ nature connectedness and adaptive and maladaptive coping strategies.DiscussionRecent studies have shown the mental health is broad concept and both nature and social connectedness seems to be one of important factors affecting it. The stronger both nature and social connectedness we can observe the clear tendency to using positive, adaptive coping strategies.ConclusionsAs this research seems to indicate that prevention should include strengthening both social and nature connectedness, the implications of these findings may be useful for mental health care planning.
Moderating the effect of age and sex on the relationship between personality and adherence to containment measures
Authors: Magarotto Machado Gisele , Santos-Vitti Laís , Valentini Felipe , Carvalho Lucas de Francisco 
Published: April 2024

Aim of the studyWe aimed to investigate the moderation effect of sex and age on the relationship between personality and adherence to COVID-19 containment measures.Subject or material and methodsParticipants were 4,538 Brazilian adults, ranging from 18 to 79 years old (M= 31.07, DP= 11.37), which responded to the BFI-2-S and questions regarding adherence to COVID-19 containment measures. We performed an SEM model to investigate the relationship between variables.ResultsOverall, our results indicated that agreeableness, neuroticism, extroversion, openness, and sex are significant predictors of adherence to containment measures. We also identified a positive moderation effect of age in the relationship between neuroticism and commitment to containment measures.DiscussionLevels of personality traits and sex can influence the tendency to comply with containment measures. Age does not directly impact adherence to containment measures; however, it can strengthen the relationship between neuroticism and commitment.ConclusionsIndividual differences can affect the adherence to the containment measures directly and indirectly.
Offline Planning and Online Learning Under Recovering Rewards
Authors: Simchi-Levi David , Zheng Zeyu , Zhu Feng 
Published: April 2024

Motivated by emerging applications, such as live-streaming e-commerce, promotions, and recommendations, we introduce and solve a general class of nonstationary multi-armed bandit problems that have the following two features: (i) the decision maker can pull and collect rewards from up to [Formula: see text] out of N different arms in each time period and (ii) the expected reward of an arm immediately drops after it is pulled and then nonparametrically recovers as the arm’s idle time increases. With the objective of maximizing the expected cumulative reward over T time periods, we design a class of purely periodic policies that jointly set a period to pull each arm. For the proposed policies, we prove performance guarantees for both the offline and the online problems. For the offline problem when all model parameters are known, the proposed periodic policy obtains a long-run approximation ratio that is at the order of [Formula: see text], which is asymptotically optimal when K grows to infinity. For the online problem when the model parameters are unknown and need to be dynamically learned, we integrate the offline periodic policy with the upper confidence bound procedure to construct on online policy. The proposed online policy is proved to approximately have [Formula: see text] regret against the offline benchmark. Our framework and policy design may shed light on broader offline planning and online learning applications with nonstationary and recovering rewards. This paper was accepted by J. George Shanthikumar, data science. Supplemental Material: The online appendix and data files are available at https://doi.org/10.1287/mnsc.2021.04202 .
Technology commitment of emergency medical service practitioners and dispatchers
Authors: Elsenbast Christian , Hagemann Vera 
Published: April 2024

Background: Digitalisation and artificial intelligence (AI) have entered the emergency medical service (EMS). Successful use of them depends on employees' personal attitudes towards modern technology and its use. Aims: This study explored the technology commitment of EMS professionals, dispatchers and emergency physicians, including towards AI systems. Methods: To assess attitudes in the context of AI systems in EMS, employees were asked to answer an online questionnaire between October 2021 and March 2022. Findings: A total of 510 participants, including 184 EMS professionals, 199 dispatchers and 68 emergency physicians, participated. These professionals had moderate to high technology commitment values with minor differences. Technology commitment correlated negatively with age. Gender had no effect. Conclusion: The EMS provides fertile ground for AI systems. It is important to keep in mind that people with uncertainties and reservations need support. The scales in the questionnaire proved to be reliable and validt.
Ice memorial
Authors: Lowry Sean 
Published: April 2024

This text serves as ‘vehicular medium’ or thought projection towards the existence of an ephemeral Ice memorial on a stretch of intermittently frozen sea ice in the Bering Strait at 168° 58’ 37” W. This ‘work’ is offered as a memorialisation to the consequences of collectively imagined fear—in this case the (first) Cold War. Through this text, I seek to demonstrate that this location’s historical, political and aesthetic significance can be augmented through the imagination. In short, this text is an invitation to project our thoughts towards a small but significant stretch of water in the North Pacific Ocean.
Understanding of MILD Combustion Characteristics of NH3 Air Flames in N2 And H2O Steam Diluted Environment at Atmospheric Pressure
Authors: Singh Anand Shankar , Vijrumbana Y , Garnayak Subrat , Dash Sukanta Kumar , Reddy V Mahendra 
Published: April 2024

Ammonia is becoming increasingly popular as a carbon-neutral fuel with zero carbon dioxide emissions. However, a significant hurdle lies in its combustion, which leads to substantial emissions of NOx. The current research involves conducting a chemical kinetic investigation to examine the characteristics of Intense Low oxygen Dilution (MILD) or Moderate combustion in ammonia (NH3)/air flames. This study is carried out under specific conditions, such as oxygen concentrations ranging from 11to 23%, premixed reactant temperatures between 1300 and 1700 K, and a pressure of one atmosphere. The study focuses on investigating the combustion characteristics of MILD using dilution with H2O and N2.With the rise in the inlet temperature of the premixed reactant, the peak temperature of the flame also rises. Moreover, flames diluted with H2O exhibit lower peak temperatures compared to flames diluted with N2.Flames diluted with H2O result in lower NOx emissions compared to flames diluted with N2. Additionally, for N2diluted flames, the exit NOx emissions rise as the oxygen concentration increases.Despite this, NOx emissions from H2Odiluted flames demonstrate non-monotonic behaviour.This means that the exit NOx increases initially as the oxygen concentration reaches 21%, but then begins to decrease. In contrast to N2and H2Odiluted flames exhibits a wider regime of no-ignition.Moreover, the rise in peak temperature in H2Odiluted flames is less apparent than in N2diluted flames, corresponding to broader ranges MILD combustion ranges.Furthermore, to attain MILD combustion in H2O diluted flames at a specific O2 concentration, the temperature of reactant needs to be higher than that required for N2diluted flames.
ANTIBACTERIANOS E AUTOMEDICAÇÃO EM NÍVEL NACIONAL: REVISÃO INTEGRATIVA
Authors: Macedo Leonardo Henrique Sales , Alencar Gustavo de Oliveira , Alencar Jean Pierre de Oliveira , Mendes Rafael de Carvalho 
Published: April 2024

Os antimicrobianos são substâncias naturais ou sintéticas capazes de eliminar ou impedir a multiplicação de bactérias. O uso inadequado tornou-se um grave problema de saúde pública, ocasionando a resistência bacteriana. As causas abrangem desde a realização incompleta do tratamento, erro no horário da administração, da dosagem sugerida até mesmo o uso do fármaco incorreto para a situação clínica. O objetivo do trabalho foi realizar uma revisão integrativa sobre a automedicação de antibacterianos em nível nacional, demonstrando os impactos para a saúde. Os trabalhos selecionados foram lidos integralmente, avaliando a relevância no questionamento abordado e a contribuição nessa temática. Dados como autor, ano, estado, município, objetivo, metodologia e resultados foram extraídos e organizados em um quadro, dessa forma visualizando as respectivas propostas abordadas. A ideia central de cada artigo foi sintetizada e abordada com trabalhos adjacentes, contextualizando as informações e enriquecendo a discussão. Dos 195 artigos, apenas 7 foram selecionados conforme o protocolo de pesquisa. Os estados envolvidos nos trabalhos são Amazonas [4], Goiás [2] e Minas Gerais [1]. Portanto, o uso inapropriado de antimicrobianos sem a prescrição adequada contribui para o aumento de cepas resistentes, sendo necessária uma fiscalização contundente em todos os ambientes de distribuição, em especial nas farmácias comerciais.
Mediation in autonomous practices among novice language teachers while discussing conflicts in their teaching practice
Authors: Rico Cruz Ma. de Lourdes , Pluvinet Delphine , Sanaphre Villanueva Mónica 
Published: April 2024

Becoming an effective language teacher does not only depend on how well the teacher knows the language but also on how the teacher can deal with the complex situations that emerge in the profession. Therefore, it is crucial to provide novice teachers with opportunities to share with others these complications during their teaching training programs. This document has the purpose of presenting the results of a research which aims to explore how novice language teachers mediate their discussions while they reflect on the emerging conflicts that they have faced during their initiating teaching practice. The study has a twofold purpose: to inquire about the main hardships these teachers deal with and the implications of mediation in their solution. Twelve English language teachers were involved as participants who were grouped in four groups of three each to discuss during 6 sessions. The study used a mixed method research approach that involved discourse analysis of the transcribed discussions, the teachers’ diaries and open observations by the researchers. The results show that socializing conflicts leads to cognitive, social and affective dimensions of mediation; in such a way that mediation reinforces teacher’s self-efficacy and decision making to solve their problems.
Clinicopathological Profile Of Her2 Positive (Non-Luminal) Breast Cancer Subtype At Haji Adam Malik General Hospital From 2020-2021
Authors: Natanael Yosua , Siregar Denny Rifsal , Siregar Kamal Basri , Rohmawati Lili 
Published: April 2024

Background: Breast cancer is one of the cancers with the highest prevalence in Indonesia. According to GLOBOCAN data for 2020, the number of breast cancer cases reached 68,858 (16.6%) cases out of a total of 396,914 new cancer cases in Indonesia. There are many factors that can trigger cancer with different clinical manifestations and subtypes from one event to another, so researchers are interested in researching the profile of breast cancer patients with the HER2 subtype at H. Adam Malik General Hospital in 2020-2021.Objective: In the present study, we aim to determine the clinicopathological profile of Her2 positive (non-luminal) breast cancer subtype patients at Haji Adam Malik General Hospital from 2020-2021.Methods: The method used in this study is descriptive quantitative with total sampling technique. The data samples was obtained from medical records of breast cancer patient with her2 positive (non-luminal) subtype which was then sorted according to the availability of characteristic needed for this study. Results: majority of breast cancer patients with her2 positive (non-luminal) subtype at H Adam Malik General Hospital in 2020-2021 was within the age group of > 50 years, with all married status. the BMI of the majority of patients (68.6%) was normal weight, all respondent admit there was no family history diagnosed with cancer (100%), majority tumor size (52,9%) is >5 cm, with most patients having cancer metastasized to 1-3 lymph nodes (54,9%), distant metastases only in 39,2% of the total sample observed, majority (35,3%) histopathological degree is in grade 1 and grade 3 , the histopathological classification of the majority (86,3%) was IDC type. Conclusion: Overall there is diversity of frequencies within the observed clinicopathological characteristics.