bluuebunny/crossref_metadata_2025_split huggingface dataset:
Knowledge, Attitude, and Practices related toNaegleria fowleriAmong General Population of Karachi, Pakistan: A Cross-Sectional Study
Authors: Younus Shaheera , Fatima Hareer , Rangwala Burhanuddin Sohail , Munir Ashna , Ahsan Syed Muhammad , Naeem Wania , Abbas Syed Raza , Rangwala Hussain Sohail 
Published: November 2023

BackgroundNaegleria fowleri, a “brain-eating” amoeba, is the cause of primary amoebic meningoencephalitis. It spreads through the nasal route via contaminated water sources and invades the central nervous system.PurposeThe objective of our study was to assess the knowledge, attitude, and practices about N. fowleri among the general population of Karachi, Pakistan.MethodsThis study was conducted on the general population in Karachi to assess their knowledge, attitudes, and practices regarding N. fowleri. Data was collected using a questionnaire with four parts, covering demographics, N. fowleri knowledge, attitudes, and preventive practices. The sample size of 400 was determined using the Raosoft Survey Tool. Data analysis was performed using SPSS 25.0, including descriptive analysis and the Pearson chi-square test. Non-probability convenience sampling was used. The study period was June–December 2022.ResultsThis study showed that around 80% of people had never heard about N. fowleri.ConclusionThis study revealed the level of awareness of N. fowleri and measures to avoid its infection in Karachi is very low, where N. fowleri infections are reported every year. Hence, appropriate measures should be taken to increase knowledge and awareness to avoid the spread of N. fowleri infection among the population.
From Diagnosis to Treatment: A Comprehensive Review of Biomarkers and Therapeutic Advances in Parkinson’s Disease
Authors: Rangwala Hussain Sohail , Fatima Hareer , Syed Aina Marzia , Abbas Syed Raza , Rangwala Burhanuddin Sohail 
Published: November 2023

Background Parkinson’s disease (PD) is a progressive neurodegenerative disorder characterized by the loss of dopaminergic neurons, resulting in motor symptoms. Ongoing research shows promise for long-term solutions. Summary Studies highlight the dysregulation of Syt11 and α-synuclein (α-syn) in PD. Disrupted α-syn homeostasis due to palmitoylation of Syt11 contributes to its aggregation, potentially playing a role in PD pathology. α-synuclein aggregates in stool samples show promise as an early diagnostic biomarker. Vocal impairments in PD may be linked to α-syn-induced neuropathology. Irisin, produced after exercise, promotes the degradation of pathologic α-syn. Progress has been made in identifying PD biomarkers. Retinal thinning and abnormal protein aggregates in skin biopsies provide noninvasive diagnostic indicators. Blood-based biomarkers like α-syn, DJ-1, and LRRK2 hold promise but face limitations. Artificial intelligence (AI) models enhance mitophagy, detect PD through sleep-breathing signals, and improve survival. AI analysis aids noninvasive assessment and risk prediction. Further understanding of PD involves studying pathological seeds and genetic mutations. Adenosine receptor regulation relates to early-onset PD, and specific gene mutations impact patient survival. Differentiated-induced pluripotent stem cells offer the potential for cell replacement therapy. Autoimmune features and T-cell involvement suggest intervention targets. Stem cell-based therapies and neurostimulation strategies show promise for improving motor function. Imaging reveals increased central inflammation in PD, suggesting an inflammatory role. Machine learning algorithms and home gait speed monitoring aid in diagnosis and disease progression tracking. Abnormal putamen gradients reflect dopaminergic loss and motor dysfunction. Antiepileptic drug prescriptions are associated with an increased PD risk. Personalized medicine, gut–brain axis involvement, and vestibular stimulation therapy offer potential PD treatment avenues. Genetic engineering techniques and deep brain stimulation show promise for alleviating PD symptoms. Key Message Ongoing research and technological advancements promise to improve PD screening, diagnosis, and treatment, bringing hope to affected individuals.
Practical psychiatry: Taking gaming seriously – a primer for psychiatrists on gamers and gaming culture
Authors: Looi Jeffrey CL , Wilkes Fiona A , Bastiampillai Tarun , Allison Stephen 
Published: November 2023

Objective Up to three billion, of the eight billion people in the world, play videogames. Gaming is a significant global sociocultural influence. This primer will aid psychiatrists in understanding sociocultural milieux of gamers, who include patients and their communities. Method A rapid narrative review. Results Benefits include expression of personality, identity and culture through social aspects of gaming. Improved physical health, neurocognition, self-efficacy and quality of life are associated with gaming in those with certain mental health disorders including schizophrenia. Harms may include in-game discrimination, disordered gaming, as well as encouragement of online gambling. There is no longitudinal association between violent games and youth aggression. Conclusions Psychiatrists should enquire about gaming as part of the sociocultural milieux of patients’ lives, and the perceived mental health benefits and harms of gaming.
Resilience and family quality of life in parents of children with autism spectrum disorders
Authors: Cardelle-Pérez Federico , Banacloig-Delgado Cristina , García-García Lorena 
Published: November 2023

Introduction Resilience and quality of life (QOL) can involve a positive approach in group interventions for parents of children with autism spectrum disorders (ASD). This study aims to evaluate resilience and family QOL at the start of a psychoeducational group. Methods Cross-sectional assessment of resilience and family QOL used the Family Quality of Life Scale (ECVF) and 14-item Resilience Scale (RS-14). Results The study group showed high levels of resilience. Parents considered the resources/support domain crucial, although satisfaction in this area was comparatively lower. Concerns about low satisfaction with available resources and support were notable. Gender differences were observed but not statistically significant. Discussion The study’s findings support prior research on parental resilience in families of children with ASD. The literature on the QOL for these families presents mixed findings. The importance of parental involvement in service planning is highlighted. Conclusions This study emphasizes the importance of resilience in parents of children with ASD, suggesting it as a potential therapeutic target. The findings underscore the need to address the perceived low quality of available resources and support. Further investigation is needed.
Open Management of an Asymptomatic 4.2 Cm Middle Colic Artery Aneurysm and Liteture Review
Authors: Dimitriadis Konstantinos , Karanikas Michail , Malafi Maria Eleni , Parisidis Stavros , Georgakarakos Efstratios 
Published: November 2023

Background Aneurysms of the middle colic artery (MCAA) and its branches are exceedingly rare accounting for <3% of total visceral aneurysms. Very few MCAA cases have been reported in the literature with only three cases accounting for a diameter >4 cm. Method We describe the successful open repair with ligation of a 4.2 cm asymptomatic MCAA in a female patient through the gastrohepatic ligament taking meticulous caution to avoid injury of the pancreas. The postoperative period was uneventful and the patient was discharged from the hospital on the fifth postoperative day. At 1 month follow-up the postoperative computed tomographic angiography documented complete exclusion of the MCAA and absence of contrast agent in the sac both in the arterial and the venous phase. Conclusion While the endovascular treatment is the first-line option for visceral aneurysms, the open approach is still reserved for certain cases of hostile anatomy, challenging location and large size. Our case highlights the irreplaceable role of open surgery and underlines the collaboration between surgical specialties.
Validity, reliability and responsiveness of a goniometer watch to measure pure forearm rotation
Authors: Harte Daniel , Nevill Alan , Ramsey Lucia , Martin Suzanne 
Published: November 2023

Introduction Innovative instruments have been designed to assess forearm rotation, an anatomically challenging motion to measure. This study assessed the concurrent validity, interrater reliability and responsiveness of a novel goniometer watch (GoWatch) to measure pure forearm rotation. The modified finger goniometer (MFG) was the criterion reference. Methods Forty participants with restricted forearm rotation were recruited. Two raters measured supination and pronation using the GoWatch and MFG before and after a hand therapy session. Repeated-measures ANOVA assessed for systematic bias with an apriori residual error of 5° deemed as acceptable. Secondary analysis used intraclass coefficients (ICCs) to categorise interrater reliability. Responsiveness of the GoWatch was calculated using Cohen’s d Results The GoWatch demonstrated acceptable agreement with the MFG with a mean difference for supination 1.19° and pronation 0.20°. Interrater reliability was also within acceptable limits with a mean difference GoWatch supination 4.43° and pronation 2.23°. Interrater reliability for GoWatch supination and pronation were categorized as excellent (ICC = 0.94) and good (ICC = 0.85) respectively. Systematic bias was observed in the instrument by rater interaction with rater two consistently underestimating GoWatch measures ( p<.05). GoWatch supination showed small to medium responsiveness (Rater 1: d = 0.14; Rater 2: d = 0.29) and pronation very small to medium responsiveness (Rater 1: d = 0.29; Rater 2: d = 0.05). Conclusion The GoWatch is a viable and user-friendly alternative to measure forearm rotation with demonstrable validity, interrater reliability and responsiveness. Further research is required to ensure systematic bias is not endemic when used across multiple raters.
Feasibility of communication platforms to empower transgender cultural competence among human immunodeficiency virus screeners: A qualitative analysis
Authors: Chiou Piao-Yi , Chou Szu-Jui , Tsao Wei-Wen , Yu Jheng-Min 
Published: November 2023

Background Human immunodeficiency virus (HIV) screeners have limited experience of interacting with trans people. The application of communication platforms between them to empower HIV screeners’ trans-related cultural competence remains unknown. Objective This study aims to qualitatively explore the follow-up interviews of HIV screeners regarding their opinions on the feasibility of an online platform group discussion and web page to enhance communication between them and trans people and to explore their perspectives on how these components enhanced their promotion of cultural competence. Methods This study was conducted between October 2020 and June 2021. Purposive and snowball sampling were applied to recruit 6 trans persons and 11 HIV screeners. Six online platform group discussions were held on weekday evenings, each group meeting for 60 min, 360 min in total within 3 months, via a video chat room of Google Meet; this was supplemented by a closed web page. The major results were presented through content analysis of the HIV screeners’ follow-up interviews. Results The HIV screeners identified the facilitators of participating in the communication platforms, which included a reminder message, easy-to-use interface, visible–audible and readable interaction, recalled and reviewable content and group belonging; the barriers included time and space limitation, device restrictions and operation problem. Two categories of trans-related cultural competence – trans awareness and action taken – were revealed, from which five major themes emerged: provoked to ask questions, improved cognition, reflection, trans-sensitive communication and self-enhancement. Conclusion The results revealed that the communication platforms could facilitate the mutual and vivid discussion between HIV screeners and trans people and empower the trans-related cultural competence of HIV screeners. The highly feasible intervention design of this research can be applied to digital training courses related to gender diversity issues.
Developing a mobile health app for chronic illness management: Insights from focus groups
Authors: Fernández César , Vicente María Asunción , Guilabert Mercedes , Carrillo Irene , Mira José Joaquín 
Published: November 2023

Background Mobile applications have the potential to assist patients and caregivers in managing chronic diseases, but current offerings are typically limited to a single disease or only focused on patients. A multifaceted app could expand the user base and provide more comprehensive support for patients who usually suffer from diverse chronic conditions at the same time and their caregivers. Objectives This study aimed to design, develop, and evaluate a mobile application that could aid chronic patients and their caregivers in managing the range of chronic conditions. Methods Focus group meetings were conducted with patients and caregivers to identify their needs, which were translated into app functionalities. The final version of the app was evaluated through a survey and analysis of the most used features. Results Five focus group (FG) meetings were held, involving 39 patients and 22 caregivers. The app included medication aids, self-monitoring aids, activation reminders, messages for caregiver shifts, remote monitoring, medicine management, and informative videos. Testing by 65 patients revealed that medication reminders (96.8% positive responses), medicine information (96.8%), messages for caregiver shifts (90.3%), and ease of use (80.6%) were the most valued aspects. The most frequently used feature was the health data record check. Conclusions A multifaceted mobile application can address the needs of a variety of chronic patients and their caregivers, while still being easy to use. The app's most used functionalities were aligned with the needs expressed in the FG, which reflects the success of this study and suggests that future research could benefit from incorporating similar user-centered design methodologies.
Digital inclusion: A mixed-method study of user behavior and content on Twitter
Authors: Salzmann-Erikson Martin 
Published: November 2023

Objective This study is the first to explore user behavior and characterize the content shared about digital inclusion on Twitter. Methods This mixed-methods research consists of 14,000 tweets featuring the hashtag “#digitalinclusion,” posted on Twitter over 15 months. A machine learning technique, latent Dirichlet allocation, was utilized to discover abstract topics within the tweets statistically. The algorithm identified important keywords and text associated with each topic by modeling the underlying word co-occurrence patterns in the dataset. A manual qualitative content analysis was applied to the qualitative data (1000 tweets). Results Tweets containing #digitalinclusion are driven by four motives: 1) warning against the risks of digital exclusion; 2) tweets that promote actions to increase digital inclusion; 3) tweets that call for others to take action to improve digitalization; and 4) tweets that are neutral but fuel the debate by being active. Quantitative analysis revealed that users discussing digital inclusion come from various continents, including the USA, Europe, Africa, and Asia. There were 3931 unique user accounts, with individuals posting between one and 368 tweets. Approximately half of the tweets contained some embedded media. Conclusion The study concludes that digital inclusion is a subject that engages Twitter users worldwide. Tweets that were associated with community and local initiatives and sustainable development had the highest engagement in terms of the number of retweets and likes. The interpretation is that digital inclusion is crucial for achieving equity in living conditions and enhancing access to health information and services. While initiatives to increase digital inclusion are underway, Twitter users call for more efforts to prevent growing digital exclusion. Twitter, as a social media platform, is valuable for studying the motivations that drive digital inclusion and help counter digital exclusion.
Early and recurrent cerebral vasospasms after aneurysmal subarachnoid hemorrhage: The impact of age
Authors: Tokareva Bogdana , Meyer Lukas , Heitkamp Christian , Wentz Rabea , Faizy Tobias D , Meyer Hanno S , Bester Maxim , Fiehler Jens , Thaler Christian 
Published: November 2023

Introduction: Cerebral vasospasms remain a strong predictor of poor outcome after aneurysmal SAH. The aim of this study was to describe the time course of relevant vasospasms after aneurysmal SAH and to determine the variables associated with early-onset or prolonged and recurrent vasospasms. Patients and methods: We conducted a retrospective, single-center study of consecutive adult patients with aneurysmal SAH admitted between 2016 and 2022 at our tertiary stroke center. Relevant vasospasms, defined as vessel narrowing detected in DSA in combination with clinical deterioration or new perfusion deficit, were detected according to our in-house algorithm and eventually treated endovascularly. The primary endpoint was the diagnosis of relevant vasospasms. As secondary endpoints, the time from hemorrhage to the onset of vasospasms and the time from the first to the last endovascular intervention were measured. Results: Of 368 patients with aneurysmal SAH, 135 (41.0%) developed relevant vasospasms. The median time between ictus and detection of vasospasms was 8 days (IQR: 6–10). Patients with early-onset vasospasms were significantly younger (mean 52.7 ± 11.2 years vs 58.7 ± 11.5 years, p = 0.003) and presented more frequently vasospasm-related infarctions at discharge (58.8% vs 38.7%, p = 0.03). In 74 patients (54.8%), recurrent relevant vasospasms were observed despite endovascular treatment. Younger age and early onset were significantly associated with longer duration of relevant vasospasms (both p < 0.05). Discussion and conclusion: Younger age was associated with early-onset and longer duration of relevant vasospasms in this study. More frequent clinical and diagnostic follow-up should be considered in this subgroup of patients that are at risk for poor outcomes.
Sex differences in the clinical manifestations related to dependence behaviors in medication-overuse headache
Authors: Wang Yen-Feng , Tzeng Yi-Shiang , Yu Chia-Chun , Ling Yu-Hsiang , Chen Shih-Pin , Lai Kuan-Lin , Chen Wei-Ta , Wang Shuu-Jiun 
Published: November 2023

Abstract
Objective
The present study aimed to compare sex differences in the clinical manifestations related to dependence behaviors in medication-overuse headache (MOH).

Methods
Consecutive patients with newly diagnosed chronic migraine (CM) with and without MOH based on the Third Edition of International Classification of Headache Disorders (ICHD-3) were enrolled prospectively from the headache clinic of a tertiary medical center. Demographics and clinical profiles were collected by using a questionnaire, which included current use of tobacco, alcohol, and caffeinated beverages, the Leeds Dependence Questionnaire (LDQ), the Severity of Dependence Scale (SDS), the Headache Impact Test-6 (HIT-6), and the Pittsburgh Sleep Quality Index (PSQI).

Results
In total, 1419 CM patients (1135F/284 M, mean age 41.7 ± 13.9 years) were recruited, including 799 with MOH (640F/159 M, mean age 42.5 ± 13.2 years) (56.3%). Smoking was associated with an increased risk for MOH in men (odds ratio [OR] = 3.60 [95% confidence interval = 1.73–7.50], p = 0.001), but not in women (OR = 1.34 [0.88–2.04], p = 0.171) (p = 0.021 for interaction). Hypnotic use ≥ 3 days/week was a risk factor for MOH (OR = 2.55 [95% confidence interval = 2.00–3.24], p < 0.001), regardless of sex. By using receiver operating characteristics (ROC) curves, the cutoff scores of the LDQ for MOH were determined at 7 for women and 6 for men, and those for the SDS were 5 and 4, respectively (area under curve all ≥ 0.83). Among patients with MOH, the male sex was associated with a shorter latency between migraine onset and CM onset (12.9 ± 11.1 vs. 15.4 ± 11.5 years, p = 0.008), despite less average headache intensity (6.7 ± 1.9 vs. 7.2 ± 1.9, p = 0.005), functional impacts (HIT-6: 63.4 ± 8.3 vs. 65.1 ± 8.0, p = 0.009), and sleep disturbances (PSQI: 10.9 ± 4.4 vs. 12.2 ± 4.3, p = 0.001).

Conclusions
The current study identified an association between smoking and MOH in men, as well as sex-specific cutoffs of the LDQ and the SDS, for MOH. MOH was characterized by a shorter latency between migraine onset and CM onset in men and a more severe phenotype in women. Sex should be considered as an important factor in the evaluation of MOH.
Locating helicopter ambulance bases in Iceland: efficient and fair solutions
Authors: Gunnarsson Björn , Björnsdóttir Kristrún María , Dúason Sveinbjörn , Ingólfsson Ármann 
Published: November 2023

Abstract
Background
Fixed-wing air ambulances play an important role in healthcare in rural Iceland. More frequent use of helicopter ambulances has been suggested to shorten response times and increase equity in access to advanced emergency care. In finding optimal base locations, the objective is often efficiency—maximizing the number of individuals who can be reached within a given time. This approach benefits people in densely populated areas more than people living in remote areas and the solution is not necessarily fair. This study aimed to find efficient and fair helicopter ambulance base locations in Iceland.

Methods
We used high-resolution population and incident location data to estimate the service demand for helicopter ambulances, with possible base locations limited to twenty-one airports and landing strips around the country. Base locations were estimated using both the maximal covering location problem (MCLP) optimization model, which aimed for maximal coverage of demand, and the fringe sensitive location problem (FSLP) model, which also considered uncovered demand (i.e., beyond the response time threshold). We explored the percentage of the population and incidents covered by one to three helicopter bases within 45-, 60-, and 75-min response time thresholds, conditioned or not, on the single existing base located at Reykjavík Airport. This resulted in a total of eighteen combinations of conditions for each model. The models were implemented in R and solved using Gurobi.

Results
Model solutions for base locations differed between the demand datasets for two out of eighteen combinations, both with the lowest service standard. Base locations differed between the MCLP and FSLP models for one combination involving a single base, and for two combinations involving two bases. Three bases covered all or almost all demand with longer response time thresholds, and the models differed in four of six combinations. The two helicopter ambulance bases can possibly obtain 97% coverage within 60 min, with bases in Húsafell and Grímsstaðir. Bases at Reykjavík Airport and Akureyri would cover 94.2%, whereas bases at Reykjavík Airport and Egilsstaðir would cover 88.5% of demand.

Conclusion
An efficient and fair solution would be to locate bases at Reykjavík Airport and in Akureyri or Egilsstaðir.
Conventional type 1 dendritic cells (cDC1) in cancer immunity
Authors: Liu Peng , Zhao Liwei , Kroemer Guido , Kepp Oliver 
Published: November 2023

AbstractCancer immunotherapy, alone or in combination with conventional therapies, has revolutionized the landscape of antineoplastic treatments, with dendritic cells (DC) emerging as key orchestrators of anti-tumor immune responses. Among the distinct DC subsets, conventional type 1 dendritic cells (cDC1) have gained prominence due to their unique ability to cross-present antigens and activate cytotoxic T lymphocytes. This review summarizes the distinctive characteristics of cDC1, their pivotal role in anticancer immunity, and the potential applications of cDC1-based strategies in immunotherapy.