bluuebunny/crossref_metadata_2025_split huggingface dataset:
Self-Care Practices and the Associated Socio-Demographic Variables of Persons With Type 2 Diabetes Mellitus (T2dm) in Southeast, Nigeria
Authors: Okafor Christiana Nkiru , Okonkwo Uchenna Prosper , Ani Kenneth Umezulike , Onuora Ethel Ogoemeka , Nwokike Mathew , Byabagambi Jane Turyasingura , JohnBosco Munezero Tamu , Mfitumukiza Valence , Nwankwo Mercy Chinenye , Tumusiime Alex 
Published: March 2024

Objective: The study was aimed at assessing the self-care practices and the associated socio-demographic variables of persons with T2DM in South East, Nigeria. Methodology: A cross-sectional study involving 382 persons with T2DM proportionately selected from 4 tertiary health institutions in South Eastern, Nigeria. Data was collected using the Summary of Diabetes Self-Care Activities (SDSCA) and a researcher-developed questionnaire. The questionnaire was administered to persons with T2DM who attended a diabetic outpatient clinic. Data collected was analyzed in frequency percentage. Responses on SDSCA were ranked and rated as poor, moderate, and good self-care behavior. The level of significance was placed at P < .05. Result: The majority of the participants were within the age groups of 40 to 59 (46.9%) and 60 and above (46.9%); the majority (74.6%) were married while a good proportion were traders (59.7%). Also, the majority of participants (81.2%) were on oral hypoglycemic agents. Findings further showed that a good proportion (51.3% and 89.8%) of study participants had good self-care behavior in diet and medication domains respectively. Whereas the proportion of participants with poor self-care behavior was very high in foot care (75.1%) and fairly high in both self-blood sugar testing (37.7%) and exercise (37.2%) domains. Only 7.9% practiced 3-monthly laboratory blood glucose testing while 16.5% went for eye checks every 6 months. Conclusion: Individuals with diabetes mellitus have poor self-management behavior in most domains of the self-management practice. Age, gender, marital status, educational level, and occupation significantly influenced self-management practices. Hence nurses and health educators should take diabetes self-management education very seriously to help diabetes sufferers improve their self-management behavior.
Workforce perspective on racial and ethnic equity in early childhood autism evaluation and treatment: “The cornerstone of everything we do”
Authors: Buck A , Hurewitz S , Franklin M Scotton 
Published: March 2024

Black and non-White Latinx children have historically been diagnosed with autism at a later age and with more significant impairments than White peers. This study aimed to gather insights from members of the autism service provider workforce on current barriers and facilitators to achieving equity in early childhood autism evaluation, referrals, and treatment. We employed a qualitative descriptive design using semi-structured virtual focus groups with autism experts in North Carolina (N = 26). Our final sample included pediatric clinicians across disciplines, researchers, family/caregiver advocates, and policymakers/government representatives. We identified four overarching themes representing challenges to equitable autism service provision: (1) workforce composition and recruitment concerns, (2) workforce capacity and accessibility concerns, (3) workforce compensation obstacles, and (4) COVID-19 pandemic adaptations’ impact. Our findings demonstrate the need for improved workforce diversity, autism-specific education, adequate compensation, and interventions to address burnout. To remediate existing barriers to equity, diversity in recruitment across training levels, cultural awareness, autism education for all pediatric providers, and partnerships with caregivers as experts must be prioritized. These investments in the autism workforce will allow its interdisciplinary professionals to better meet the needs of children and families from historically marginalized communities and achieve equitable early childhood service provision. Lay abstract Black and non-White Latinx children tend to receive autism diagnoses later in life and with a higher degree of impairment than White children. The purpose of this study was to learn what is currently helping as well as preventing Black and non-White Latinx children from getting access to autism evaluation and services. We held virtual interviews with 26 experts who work with autistic children and their families, including clinical providers, researchers, advocates, and policymakers/government representatives. From these interviews, we identified four themes that have an impact on equity in autism services: (1) who makes up the workforce, (2) w orkforce capacity and accessibility, (3) workforce payment structure, and (4) changes due to the COVID-19 pandemic. These findings show the need for improved workforce diversity, autism-specific education, payment structures, and additional support for workforce members to avoid burnout. To make childhood autism services more equitable, diversity in recruitment across training levels, cultural awareness, increased autism education for all pediatric providers, and partnerships with caregivers as experts must be prioritized. These investments in the autism workforce will allow professionals in the field to better meet the needs of children and families from Black and non-White Latinx communities and achieve equity in early childhood autism services.
Numerical investigation on acoustic damping characteristics of dual Helmholtz resonators in presence of a grazing flow
Authors: Zhao He , Zhao Dan , Dong Xu 
Published: March 2024

In this study, the acoustic damping performances of the dual Helmholtz resonators were numerically evaluated using a 3D model. The grazing flow passes tangentially through the resonator neck, with a Mach number range of 0 ≤ Ma ≤ 0.1. The numerical model operates by solving the linearized Navier–Stokes equations. The current model is validated through a comparison with experimental data. The model is then utilized to explore the effects of the dual Helmholtz resonators on acoustic transmission loss performance in the presence of a grazing flow. Three key parameters are examined: 1) different implementation configurations of the dual Helmholtz resonators (including Models (b), (c), and (d)), 2) the mean temperature of the grazing flow, and 3) the axial distance between the dual Helmholtz resonators. For comparison, the acoustic damping performance of these dual Helmholtz resonators is compared to the single Helmholtz resonator case (Model (a)). The maximum transmission loss of Model (c) is significantly higher, recording values of 91%, 89.4%, and 92.5% than those observed for Model (a) at Ma = 0, Ma = 0.05, and Ma = 0.1, respectively. It is observed that the dual Helmholtz resonators dramatically increase the transmission loss. Model (c) is demonstrated to be associated with the most significant damping on the acoustic plane waves in comparison with that of Model (a). Additionally, the maximum transmission loss of Model (c) is 23.23 dB, 30.32 dB, and 34.58 dB at mean temperatures of 300 K, 600 K, and 900 K, respectively. Therefore, increasing the mean temperature is shown to be beneficial to enhance transmission losses in the presence of the grazing flow. Furthermore, under Ma = 0.1, the resonant frequency of Model (c) is 127 Hz, 152 Hz, and 172 Hz, corresponding to mean temperatures of 300 K, 600 K, and 900 K. It can be concluded that increasing the temperature has the effect of broadening the resonant frequency, especially at a high grazing flow Mach number. However, increasing the mean temperature results in a reduction of transmission loss in the absence of the grazing flow. In the case of Model (c), a 32 cm axial distance results in a 5.6% larger transmission loss at Ma = 0 and a 26.4% larger loss at Ma = 0.1 compared to a 16 cm axial distance. This indicates that increasing the axial distance between the dual Helmholtz resonators improves transmission loss.
The Fagerström Test for Nicotine Dependence, as a prognostic factor, in current smokers with and without COPD: A cross-sectional study in northern Greece
Authors: Papadopoulou Efthymia , Haidich Anna-Bettina , Mathioudakis Alexander , Tsavlis Drosos , Papadopoulou Konstantina , Oikonomidou Rena , Bogiatzidis Panagiotis , Tryfon Stavros 
Published: March 2024

Background Smoking poses the most common risk factor for chronic obstructive pulmonary disease (COPD) and aggravates disease progression. Tobacco dependence inhibits smoking cessation and may affect smoking patterns that increase tobacco exposure and predispose to lung function decline. Aims and objectives We aimed to assess tobacco dependence in current smokers with and without COPD and evaluate its role in disease development. Method This cross-sectional study was conducted in Greek rural areas. Current smokers completed the Fagerström Test for Nicotine Dependence and were classified into COPD and non-COPD groups based on spirometry parameters. Results Among current smokers, 288 participants comprised the non-COPD and 71 the COPD group. Both presented moderate tobacco dependence, but smokers with COPD started to smoke earlier in the morning. Multiple logistic regression analysis revealed higher COPD prevalence in smokers with higher scores in the Fagerström test (odds ratio OR = 1.12, 95% confidence interval [1.01 – 1.24]) and older age (OR = 1.06 [1.03 – 1.09]), independently of pack-years smoking index. Multiple linear regression analysis in smokers with COPD showed that the forced expiratory volume in the 1st second decreased by 2.3% of the predicted value for each point increase in the Fagerström Test and 0.59% for each year of age, independently of participants’ sex and pack-years smoking index. Conclusion The Fagerström score appears to indicate a higher probability for COPD and lung function deterioration when assessed along with age in current smokers. Smoking cessation support programs are fundamental to COPD prevention and management.
Squeaking Shoulder Following Arthroscopic Shoulder Surgery: A Case–Control Study
Authors: Tan Si Heng Sharon , Kumar V. P. , Lim Joel Louis Zongwei , Manohara Ruben , Ng Dennis Zhaowen , Poh Keng Soon , Tan Hsi Ming Bryan 
Published: March 2024

Background: To date, the occurrence of unusual squeaking noises during shoulder movements following shoulder arthroscopic surgeries have been minimally reported. Purpose: The aim of this study was to report the incidence, natural history, possible risk factors and functional outcomes of patients who reported to have squeaking noises following shoulder arthroscopic procedures. Methods: In this 2-year case-control study, all patients who underwent arthroscopic shoulder in a single institution were included. All patients were then evaluated preoperatively and postoperatively for demographics, pathology, surgical factors, and functional outcomes. The possible risk factors and functional outcomes of the patients who experienced squeaking following shoulder arthroscopic surgeries were then compared with those patients who did not experience squeaking following shoulder arthroscopic surgeries. Results: Of the 360 patients included in the study, the incidence of squeaking following arthroscopic shoulder surgeries was 2.23%, and the incidence of squeaking following arthroscopic shoulder labral repair was 3.1%. The age, gender, hand dominance, body mass index, participation in sports, pathology, side of pathology, use of knot-tying versus knotless suture anchors, number of suture anchors, and surgical duration were not significantly different between patients who experienced squeaking and patients who did not. All patients had comparative functional outcomes preoperatively and postoperatively (at the 3-month, 6-month, and 1-year follow-ups). Conclusion: This case-control study provides an analysis of a series of patients with squeaking of the shoulder following arthroscopic shoulder surgeries. No risk factors or etiology of the condition have been identified in the series. However, there is no functional compromise among these patients who experienced squeaking following shoulder arthroscopic surgeries.
Hostile neck anatomy contributes to higher rates of reintervention following endovascular aortic repair for ruptured infrarenal abdominal aortic aneurysm
Authors: Gedney Ryan , Barksdale Christian , Wright Antwana Sharee , Genovese Elizabeth A , Ruddy Jean Marie 
Published: March 2024

Introduction Ruptured abdominal aortic aneurysms (AAA) presenting with hostile neck anatomy can represent a challenge in surgical decision-making. We hypothesized that, patients who require reinterventions have higher rates of compromised neck anatomy at initial presentation and may indicate a need for altered surveillance paradigm. Methods Patients presenting with ruptured AAA to a single tertiary care institution from 2014 to 2021 were retrospectively reviewed. Those treated with infrarenal EVAR, with no prior aortic surgeries, and with available pre-operative computed tomography (CT) scans were included. Demographics, timing and type of reintervention, follow-up, and survival were collected. CT scans were assessed for hostile neck anatomy via measurements of diameter, length, angle, taper, bulge, calcification, and thrombus. Demographics, comorbidities, and neck anatomy of those with and without reintervention were compared using Fischer’s Exact and Student’s T-test. Survival was analyzed via Kaplan-Meier and log-rank test. Results Eighty-nine patients were available for analysis, 37 of which met inclusion criteria. Intraoperative death occurred in 3 patients (8.1%) and 1 patient (2.7%) was intraoperatively converted to an open repair. Thirty-day and 1-year survival were 97% and 91%, respectively. The reintervention rate was 30% ( n = 10), occurring at a median of 200 days (18–2053 days) after the index operation. All patients requiring reintervention met hostile neck criteria ( p = .002) and had a statistically higher number of hostile neck criteria (1.80 vs 0.87, p = .03). Thirty percent ( n = 3) of patients that received a reintervention had neck diameter greater than 3 cm, compared to zero patients in the non-reintervention group ( p = .022). Proximal reinterventions ( n = 5) had statistically higher neck diameters and neck angle compared to the non-reintervention group. Conclusion Infrarenal rEVAR is effective at preventing acute mortality despite specific anatomic considerations that may contribute to the higher reintervention rates, and therefore those parameters ought to be considered when following patients in the post-intervention period.
First confirmed case of hydatid disease of the male breast: A case report
Authors: Sethi Humsheer Singh , Mohapatra Satya , Panda Adyakinkar , Mali Chayasmita 
Published: March 2024

Introduction: Hydatid disease of the male breast has not been documented in literature to date. Case report: We present a case of a 46-year old male patient who presented with a painful breast lump for 1 year. On imaging, it was suspicious for hydatid disease of the breast and was successfully diagnosed preoperatively on fine-needle aspiration cytology and histopathology as hydatid disease of the breast. Discussion: Incidence of hydatid disease of the breast contributes to a minute number of total cases of hydatid disease. Male breast hydatid disease was unknown prior to this report. We did find similarities in the imaging features of our case and the ones described for female breasts. On ultrasonography, we found it analogous to the ‘water-lily’ sign which has been described in hepatic hydatic cysts. Conclusion: Keeping hydatid disease as a differential in the setting of a suspicious breast mass even in a male patient proved to be rewarding as it negated the need for further cross-sectional imaging and a definitive diagnosis could be sought based on the fine-needle aspiration cytology and histopathological findings.
The synergy of dual faecal immunochemical and faecal calprotectin testing for accurate assessment of endoscopic and histological activity in inflammatory bowel disease
Authors: Bohra Anuj , Batt Nicholas , Dutt Krishneel , Lewis Diana , Segal Jonathan P. , Newiadomski Olga , Vasudevan Abhinav , Langenberg Daniel R. Van 
Published: March 2024

Background: Faecal biomarkers are increasingly utilized for disease assessment in inflammatory bowel disease (IBD). Objectives: To characterize the relative and combined accuracy of faecal calprotectin (FC) and faecal immunochemical testing (FIT) for detecting endoscopic and histologically active disease in Crohn’s disease (CD) and ulcerative colitis (UC), subdivided by disease location. Design: A prospective cohort study. Methods: Patients with confirmed IBD undergoing routine ileocolonoscopy for activity assessment were prospectively recruited and performed both FC and FIT ±30 days of ileocolonoscopy. Endoscopic activity was assessed via the simplified endoscopic score for CD, Mayo endoscopic score for UC and histological activity graded as nil/mild/moderate. Receiver-operator curve analyses were utilized to assess the performance of FC and FIT per disease subtype and location. Results: In all, 137 (79 CD, 57 UC) patients were recruited. FC was more sensitive than FIT in detecting active endoscopic (CD: 91% versus 69%, UC: 94% versus 82%) and histological (CD: 86% versus 55%, UC 88% versus 56%) disease. However, FIT was more specific than FC in detecting active endoscopic (CD: 94% versus 56%, UC: 85% versus 69%) and histological (CD: 93% versus 55%, UC: 96% versus 70%) diseases. FIT was more sensitive and specific than FC in detecting active colonic CD (endoscopic activity: 94% versus 93%, histological activity: 92% versus 77%, respectively); however, it was poorly sensitive for active ileal CD (43% versus 89%). Conclusion: FC demonstrated higher sensitivity and FIT higher specificity for active IBD. Hence, dual testing was synergistic, displaying excellent performance characteristics across most IBD locations and subtypes, holding promise for future clinical application. Trial registration: Not applicable.
Benefits of Usability Evaluation in the Development Process of Diabetes Technologies Using the Example of a Continuous Glucose Monitoring System Prototype
Authors: Beltzer Anne , Kölle Julia , Gil Miró Marta , Pleus Stefan , Krauss Collin , Haug Cornelia , Safary Elvis , Vetter Beatrice , Freckmann Guido 
Published: March 2024

Background: Usability engineering analyzes the interaction between the intended users and a device. Its implementation is mandatory for manufacturers to obtain regulatory approval for the European market. The aim of this evaluation was assessing the role of usability testing in the development process. For this purpose, a continuous glucose monitoring (CGM) device under development was investigated to determine whether it could be used safely and effectively by the intended users. Methods: Conduct of the usability testing was based on the international standard IEC 62366-1. Medical device use of CGM-experienced and non-experienced users (n = 15 each) was observed without initial training in use scenarios containing 18 tasks. The success rate of task completion was determined and the System Usability Scale (SUS) score was calculated from a questionnaire. A prototype of the FiberSense CGM System (EyeSense GmbH, Großostheim, Germany), comprising of a single-use sensor and a reusable detector, was investigated. Results: Most use errors made by both user groups were related to ease of handling of the reusable detectors. The SUS scores achieved in this study were below the pre-defined SUS score acceptance criterion of ≥68. The most frequently mentioned reason for use errors was an incomprehensible and non-chronological instructions for use (IFU). Conclusions: The evaluation provides valuable insights on how to improve usability of the prototype device and demonstrates the value of conducting structured usability testing prior to product finalization. The results reflected areas for improvement of the user interface, mainly by restructuring the IFU, provision of an additional leaflet, and device training prior to use.
Avatrombopag for the salvage treatment of platelet transfusion refractoriness
Authors: Qin Yuehong , Wang Yu , Zhang Yujiao , Jiao Yingying , Ye Jieyu 
Published: March 2024

Background: Platelet transfusion refractoriness (PTR) is a life-threatening and intractable condition in hematological patients. Thrombopoietin receptor agonists such as avatrombopag promote platelet production and modulate immune intolerance. However, its application in PTR has not been extensively studied. Objectives: We aimed to compare the platelet response (PR) as well as bleeding events and mortality rate between the best available therapies (BATs) and avatrombopag (Ava) treatments in refractory PTR patients. Design: A total of 71 refractory PTR patients were enrolled at Nanfang Hospital. Intravenous immunoglobulin, steroids, and human leucocyte antigen-matched platelet transfusions were administered to 30 patients in the BATs group. The Ava group included 41 patients. Methods: Data of refractory PTR patients were retrospectively collected. The primary endpoint was PR (defined as an increase of platelet count to ⩾50 × 109/L without platelet transfusion support for 7 consecutive days). Secondary endpoints included platelet-transfusion independence rate, cumulative platelet transfusion units, World Health Organization bleeding grades, adverse events, overall survival (OS), and bleeding event-free survival (EFS). Results: There were 75.6% and 13.3% refractory PTR patients who reached PR within 3 months in Ava and BATs groups. The median platelet counts were significantly higher in Ava group from day 7. Platelet-transfusion independence rate in Ava was higher than BATs group. The median cumulative platelet transfusion unit in Ava was lower than that of BATs group. The OS and bleeding events-free EFS rate of Ava group improved within 3 months as compared to BATs group. Cox proportional hazards regression analysis revealed that Ava therapy was a protective factor for the OS and EFS. No primary disease progression or termination of avatrombopag was observed due to intolerability. Conclusion: Our study suggests that avatrombopag is an effective and safe treatment option for refractory PTR patients.