bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of and Factors Associated with Hypersexuality in Patients with Dementia: A Retrospective Cross-Sectional Study
Authors: Borges Saulo Queiroz , Camargos Einstein Francisco 
Published: December 2023

Introduction The psychological and behavioral symptoms of dementia are frequently observed in clinical practice, and those related to sexuality are particularly challenging. However, few studies have evaluated the prevalence or factors associated with hypersexuality in patients with dementia. Objectives This study aims to determine the prevalence of hypersexuality in patients with dementia, describe associated factors, and qualitatively report the most common presentations and treatments. Methods This retrospective cross-sectional study collected data from semi-structured charts of dementia patients who were followed up at a secondary care reference center between 2015 and 2019. Results: Of 552 total patients, 52 (9.3%) were hypersexual, which was associated with male sex ( P < .000; OR 2.95, 95% CI 1.73-5.01), frontotemporal dementia ( P < .007), alcohol use ( P < .015; OR 2.35, 95% CI 1.16-4.73) and tobacco use ( P < .000; OR 2.88, 95% CI 1.61-5.13). Conclusions Although our findings were similar to the literature, their significant variability reflects the limited and low quality of the available evidence and a lack of standardization regarding terminology, definitions, and diagnostic criteria for hypersexuality.
Virtual Patient Simulations in Nursing Education: A Descriptive Systematic Review
Authors: Sahin Karaduman Gul , Basak Tulay 
Published: December 2023

Background Virtual patients commonly train students in clinical competence in nursing education. This review aimed to evaluate the sample characteristics and sampling method, technological design of the virtual patients, duration of simulation methods, comparison methods used in control groups, outcomes of simulation interventions, and quality of the included randomized controlled studies. Methods Five databases were searched using English-language keywords between 1995 and 2019. The Turkish Quality Assessment Tool for Quantitative Studies was used to evaluate the quality of randomized controlled trials. Of the 4235 studies identified, 10 randomized controlled trials reporting virtual patients in nursing education were reviewed. Results The total number of participants in the review was 787. The virtual patient methods used in all studies differed. The duration was different in all the studies. Standardized patients, traditional education, facilitated mannequin-based simulation, written descriptions of the skills, low-, medium-, and high-fidelity simulation, and virtual simulation without training methods were used in the control groups for the comparison. Six studies indicated that virtual patients increased students’ knowledge, skills, self-efficacy, self-confidence, nursing competencies, and satisfaction levels in clinical practice, while four studies found no significant difference between the groups. The quality was poor in four of 10 studies, moderate in two of 10 studies, and strong in four of 10 studies. Conclusions This study demonstrated that the virtual patient methods used in studies varied in terms of technological design. The duration of simulation in the studies varied from less than 30 minutes to more than two months. The virtual patients could improve knowledge, skill acquisition, self-efficacy, self-confidence, and nursing competency compared with low-fidelity simulation, didactic education, no-intervention, or no-education studies. The quality results of the studies show that most of them had weak or strong research designs.
Using Artificial Intelligence as a Melanoma Screening Tool in Self-Referred Patients
Authors: Crawford Madeleine E. , Kamali Kiyana , Dorey Rachel A. , MacIntyre Olivia C. , Cleminson Kristyna , MacGillivary Michael L. , Green Peter J. , Langley Richard G. , Purdy Kerri S. , DeCoste Ryan C. , Gruchy Jennette R. , Pasternak Sylvia , Oakley Amanda , Hull Peter R. 
Published: December 2023

Introduction: Early detection of melanoma requires timely access to medical care. In this study, we examined the feasibility of using artificial intelligence (AI) to flag possible melanomas in self-referred patients concerned that a skin lesion might be cancerous. Methods: Patients were recruited for the study through advertisements in 2 hospitals in Halifax, Nova Scotia, Canada. Lesions of concern were initially examined by a trained medical student and if the study criteria were met, the lesions were then scanned using the FotoFinder System®. The images were analyzed using their proprietary computer software. Macroscopic and dermoscopic images were evaluated by 3 experienced dermatologists and a senior dermatology resident, all blinded to the AI results. Suspicious lesions identified by the AI or any of the 3 dermatologists were then excised. Results: Seventeen confirmed malignancies were found, including 10 melanomas. Six melanomas were not flagged by the AI. These lesions showed ambiguous atypical melanocytic proliferations, and all were diagnostically challenging to the dermatologists and to the dermatopathologists. Eight malignancies were seen in patients with a family history of melanoma. The AI’s ability to diagnose malignancy is not inferior to the dermatologists examining dermoscopic images. Conclusion: AI, used in this study, may serve as a practical skin cancer screening aid. While it does have technical and diagnostic limitations, its inclusion in a melanoma screening program, directed at those with a concern about a particular lesion would be valuable in providing timely access to the diagnosis of skin cancer.
Literacy instruction and lexicon size determine bilingual reading development of Russian-German children
Authors: Czapka Sophia , Topaj Nathalie , Gagarina Natalia 
Published: December 2023

Research question: How does Russian and German reading comprehension develop during the first 3 years of primary school in Russian heritage speakers and which factors predict performance in each language? Methodology: 40 Russian-German children were tested annually from first to third grade (age in grade 1 M = 7; 1 years). Reading was assessed with comparable Russian and German word and sentence reading comprehension tests. The Russian test was available in Cyrillic and Latin script (the latter for children who could not read Cyrillic letters). Potential predictors included lexicon size in Russian and German and rapid automatized naming (RAN) of numbers (both assessed in primary school). Other factors were assessed in kindergarten, that is, nonverbal reasoning and, derived from a parents’ questionnaire, their socioeconomic status and language input in the family. Data and analysis: Linear regressions were used to compare the development of Russian and German. Stepwise regression analyses identified predictors for reading comprehension in each language. Findings: German reading ability improved faster than that of Russian, likely due to the increasing amount of German input outside the family, literacy instruction in German at school, and the large variance in Russian literacy abilities. Children who could read Cyrillic script, who likely received some form of Russian literacy instruction, and who had a larger Russian lexicon size exhibited better reading performance. These results are discussed regarding the divergent attainment trajectories. Decisive factors for German were German lexicon size and RAN. Originality: This longitudinal study tracked Russian and German reading development over 3 years in primary school, assessed Russian reading in Cyrillic and Latin scripts, and identified predictors for bilingual reading development in both languages. Implications: To become proficient readers in their heritage language, children need to have a substantial lexicon size and receive literacy instruction.
Mechanisms of Post-Stroke Fatigue: A Follow-Up From the Third Stroke Recovery and Rehabilitation Roundtable
Authors: Kuppuswamy Annapoorna , Billinger Sandra , Coupland Kirsten G. , English Coralie , Kutlubaev Mansur A. , Moseley Lorimer , Pittman Quentin J. , Simpson Dawn B. , Sutherland Brad A. , Wong Connie , Corbett Dale 
Published: December 2023

Background Post-stroke fatigue (PSF) is a significant and highly prevalent symptom, whose mechanisms are poorly understood. The third Stroke Recovery and Rehabilitation Roundtable paper on PSF focussed primarily on defining and measuring PSF while mechanisms were briefly discussed. This companion paper to the main paper is aimed at elaborating possible mechanisms of PSF. Methods This paper reviews the available evidence that potentially explains the pathophysiology of PSF and draws parallels from fatigue literature in other conditions. We start by proposing a case for phenotyping PSF based on structural, functional, and behavioral characteristics of PSF. This is followed by discussion of a potentially significant role of early inflammation in the development of fatigue, specifically the impact of low-grade inflammation and its long-term systemic effects resulting in PSF. Of the many neurotransmitter systems in the brain, the dopaminergic systems have the most evidence for a role in PSF, along with a role in sensorimotor processing. Sensorimotor neural network dynamics are compromised as highlighted by evidence from both neurostimulation and neuromodulation studies. The double-edged sword effect of exercise on PSF provides further insight into how PSF might emerge and the importance of carefully titrating interventional paradigms. Conclusion The paper concludes by synthesizing the presented evidence into a unifying model of fatigue which distinguishes between factors that pre-dispose, precipitate, and perpetuate PSF. This framework will help guide new research into the biological mechanisms of PSF which is a necessary prerequisite for developing treatments to mitigate the debilitating effects of post-stroke fatigue.
ParkinSong Online: Feasibility of Telehealth Delivery and Remote Data Collection for a Therapeutic Group Singing Study in Parkinson’s
Authors: Tamplin Jeanette , Haines Simon J. , Baker Felicity A. , Sousa Tanara Vieira , Thompson Zara , Crouch Helen , Dunn Stephen , Tull Victoria , Vogel Adam P. , Morris Meg E. 
Published: December 2023

Background Parkinson’s disease can negatively affect vocal functioning and social wellbeing, particularly in the latter stages of disease progression. Face-to-face group singing interventions can improve communication and wellbeing outcomes, yet not all people can access in-person sessions. To help overcome barriers to participation, exploration of the feasibility and utility of online therapeutic singing programs is needed. Objectives To evaluate the feasibility, acceptability, and preliminary efficacy of a 12-week ParkinSong Online intervention on speech and wellbeing for people with Parkinson’s disease. Methods A total of 28 participants with idiopathic Parkinson’s disease were recruited to a single-arm feasibility study. Weekly 90-minute online sessions were co-facilitated by a music therapist and speech pathologist. Speech and wellbeing assessments were conducted pre and post intervention. Participant and facilitator surveys were administered after each session, with focus group interviews at the end of the program. Results The recruitment rate was high (90%) with no attrition, adverse events, or safety issues. There was good intervention fidelity, attendance (average 89%), and positive participant experience. Feasibility was good, with technology reported as the main challenge (connecting and navigating Zoom). No improvements were seen in voice measures or wellbeing outcomes in this small trial. The online format used in this study did not provide the same benefits as in-person ParkinSong sessions. Conclusions ParkinSong Online is feasible for recreational purposes and social engagement provided that people have adequate technological knowledge or support. The optimal online delivery format to achieve communication improvements in Parkinson’s awaits confirmation.
The Enterprise stent…still useful after all these years
Authors: El Naamani Kareem , Syal Amit , Field Nicholas C. , Teichner Eric M. , Ghanem Marc , Herial Nabeel A. , Tjoumakaris Stavropoula I. , Jabbour Pascal , Rosenwasser Robert H. , Paul Alexandra R. , Gooch M. Reid 
Published: December 2023

Background The Enterprise stent (Codman Neuro, Massachusetts, USA) received Food and Drug Administration (FDA) approval in 2007 for stent-assisted coiling (SAC). Since its introduction, newer stents and devices for aneurysm treatment have been developed resulting in a shift in the utilization of this stent from SAC to other off-label indications. Objective To describe our experience with the Enterprise stent being used for SAC and other off-label indications. Methods This is a multi-center retrospective review of the use of the Enterprise stent between 2018 and 2023. All patients in which the Enterprise stent was successfully deployed were included in the study. Results Our study cohort comprised of 194 patients, mostly females (n = 112, 57.7%), with a mean age of 63.2 years ± 14.3. The Enterprise stent was used for SAC in only 24 (12.4%) patients and was used for rescue stenting in stroke in 101 patients (52.1%), treatment of intracranial stenosis in 53 patients (27.3%), treatment of in-stent stenosis in 1 patient (0.5%), and for treatment of dissections in 15 patients (7.7%). From 2018 to 2023, the use of Enterprise stents for SAC significantly decreased ( p < 0.0001) while the use of Enterprise stents for non-SAC purposes was insignificantly variable ( p = 0.05). Conclusion Our study shows that the Enterprise stent remains a reliable tool in neuroendovascular procedures, even if its original intended use has been supplanted by other devices.
Correlation between intravascular pressure gradients and ultrasound velocities in carotid artery stenosis: An exploratory study
Authors: Diana Francesco , Peschillo Simone , Requena Manuel , Romano Daniele G , Frauenfelder Giulia , de Dios Lascuevas Marta , Hernandez David , Ribó Marc , Tomasello Alejandro , Romoli Michele 
Published: December 2023

Introduction Grading of carotid stenosis is routinely performed with non-invasive techniques, such as carotid ultrasound (CUS) and computerized tomography angiography (CTA), which have limitations in grading definition. Moreover, the actual hemodynamic impact of a stenosis remains poorly defined. Preliminary studies explored the application of the resting full-cycle ratio (RFR), measured with pressure wire (PW), but the correlation between RFR and morphological/hemodynamic parameters is still undefined. This study aims to test the correlation between RFR and CUS-CTA-DSA based degree of stenosis, to define the suitability of RFR as carotid stenosis index. Methods We included patients with symptomatic carotid stenosis receiving carotid artery stenting (CAS), between November 2022 and May 2023. We performed CUS and PW measurements before and after stenting, at four different sites (trans-lesion, distal cervical, petrous and supraclinoid internal carotid artery [ICA] segments). We compared CUS and PW parameters by Pearson's or Spearman test for continuous variables. Results Among 15 patients included the mean stenosis degree was 81.3%. Trans-lesion RFR was significantly higher than other sites (0.72 ± 0.2 trans-lesion vs. 0.69 ± 0.18 distal cervical ICA vs. 0.66 ± 0.2 petrous ICA vs. 0.6 ± 0.2 intracranial ICA, p < 0.05). All RFR values significantly increased after treatment; the highest relative increase was registered at stenosis site (0.72 ± 0.2 pre-stent vs. 1.01 ± 0.1 post-stent, p < 0.01). Trans-lesion RFR was significantly associated with the CTA and DSA stenosis degree and CUS measurements. Conclusions Pressure wire in carotid artery stenosis seems safe and suitable. Resting full-cycle ratio has a significant correlation with CUS values and stenosis degree and might be used as carotid stenosis index during CAS.
Regional Variation in Opioid-Related Emergency Medical Services Transfers During the COVID-19 Pandemic: An Interrupted Time Series Analysis
Authors: Yazdanfard Sahar , Thornton Douglas , Bhatt Prachet , Fatima Bilqees , Khalid Javeria , Song Juhyeon , Varisco Tyler Jordan 
Published: December 2023

Background: The COVID-19 pandemic has impacted public infrastructure and healthcare utilization. However, regional variation in opioid-related harm secondary to COVID-19 remains poorly understood. This study aimed to measure the regional variation in the association between stay-at-home orders (SAHOs) and nonfatal opioid-related emergency medical services (EMS) transfers in the United States. Methods: In this interrupted time series design, counts of nonfatal opioid overdoses were identified in each week between July 29, 2019 and December 27, 2020 from the National Emergency Medical Services Information System Dataset. A longitudinal, interrupted time series model was used to compare the change in the number of nonfatal opioid overdose transfers between the pre-pandemic period (July 29, 2019-January 6, 2020) and the pandemic period (June 1, 2020-December 27, 2020). The time period between January 7, 2020 and May 31, 2020 was treated as a washout period to account for state-level variation in the timing of SAHO implementation. Results: We identified 277 141 adult nonfatal opioid-related overdose EMS transfers in the United States across all census regions. After implementation of the SAHO, EMS transfers significantly increased in all regions, with an increase most notable in the Southern United States (2161, 95% CI: 1699-2623 transfers per week). In the post-SAHO period between June 1 and December 27, 2020, EMS transfers declined from this regional peak in the Southern, Midwestern, and Northeastern United States. No change in trend was observed in the Western United States. Conclusion: These findings underscore the importance of tailoring public health policies regionally. While most regions saw a modest decline in opioid-related EMS transfers after an initial increase, the COVID-19 pandemic led to notable increases in opioid-related EMS transfers nationwide. Future research should focus on identifying public health strategies to counteract the deleterious effects of the COVID-19 pandemic on opioid-related morbidity.
Impact of emotional intelligence in resolving clinical conflicts among postgraduate residents of surgery
Authors: Gillani Syed Faraz Ul Hassan Shah , Khan Rehan Ahmed , Sethi Ahsan 
Published: December 2023

Background & Objective: Emotional intelligence (EI) can become a vital tool for resolving clinical conflicts (CC) in surgery. The postgraduate residents focus on the technical skills and undermine the soft skills required for their better training. Our aim was to determine the EI of postgraduate resident (PGR) years one & two in General and Orthopedic Surgery. The CC in their workplace and how they use their EI to resolve these conflicts.
Methods: This mixed-method study was conducted from March 10, 2019 to May 28, 2020 at Departments of General and Orthopedic Surgery, Mayo Hospital, Lahore. The study was conducted in two phases 1 & 2. In Phase-1, one hundred PGR years one & two were administered the Mayor-Salovey-Caruso Emotional Intelligence test (MSCEIT) to measure EI. In phase-2, semi-structured in-depth interviews of 10 PGRs five with high and five with low EI were conducted to determine the CC and use of EI to resolve the CC at the workplace. A thematic analysis was done.
Results: Out of 100 PGR, the mean EI score was 46.25±14.8 with a maximum score of 75.4, and a minimum score of 18.16 (p-value =0.775). Ninety-one (91%) have not improving EI, and 09 (09%) have considered developing EI. Five themes in four settings, including emergency, ward, elective operation theatre, and outpatient department (OPD) were determined. The emerged themes for the CC were nepotism, gender biases, burnout, lack of professionalism, and toxic culture. The following were CC management strategies: self-study, deceit, gender affinity, performing attention-attaining work, aggrieved reaction and being disgruntled when alone.
Conclusion: None of the PGR was emotionally intelligent in overall grades, as well as a particular aspect of MSCEIT.
doi: https://doi.org/10.12669/pjms.40.3.7363
How to cite this: Gillani SFHS, Khan RA, Sethi A. Impact of emotional intelligence in resolving clinical conflicts among postgraduate residents of surgery. Pak J Med Sci. 2024;40(3):399-404. doi: https://doi.org/10.12669/pjms.40.3.7363
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.
Effects of a low, medium, and high-intensity aquatic physiotherapy protocol on functional and biochemical parameters in individuals with knee osteoarthritis: protocol for a crossover randomized controlled trial
Authors: Augusto Teixeira Cesar , Haas Lisete , Frata Bruna , Fiori Bortoli Andressa , Scalco Acco Fernanda , de Castro Gustavo , Cechetti Fernanda 
Published: December 2023

Background: Knee osteoarthritis affects the performance of daily activities, independence, and quality of life. The etiopathogenesis of this condition considers the mechanisms of activation of metalloproteinase and reactive oxygen species production pathways. Metalloproteinases-3 (MMP-3) and Glutathione Peroxidase (GPx) may be responsible for cartilage destruction. Aquatic physiotherapy promotes a positive impact on the clinical picture of osteoarthritis, and this study presents an intervention protocol that aims to evaluate the effects of a single session of different aquatic physiotherapy modalities on the biochemical and functional behavior of patients with knee osteoarthritis. Methods: This will be a crossover randomized controlled trial in which 15 individuals will be submitted to three aquatic physiotherapy modalities with a minimum 15-day wash-out period in patients over 50 years old and diagnosed with OA in at least one knee, presence of pain and at least one functional dysfunction for at least 6 months, absence of physical limitation that prevents the exercise protocol from being performed, Kellgren and Lawrence ranking between I and IV, walk independently and without auxiliary device. Variations in the concentrations of MMP-3 and GPx in peripheral blood, pain, edema, and flexibility resulting from the three aquatic physiotherapeutic interventions will be evaluated both pre- and immediate post-intervention. The reference group will be submitted to the same aquatic physiotherapy protocols, however, only the biochemical parameters and the self-perception questionnaires will be evaluated. Registration: ClinicalTrials.gov (NCT05610696, 18/01/2023).
Case Report: A newborn in western Nepal with Harlequin ichthyosis
Authors: Rajput Prabhat Singh , Basnet Santosh , Paudel Pradip kumar , Devkota Bibek , Prasad Ram Jiban , Amgain Kapil 
Published: December 2023

Harlequin ichthyosis(HI) is a rare autosomal recessive congenital ichthyosis with an incidence of 1 in 300,000 live births. It is lethal in 44% of cases and the baby is usually prematurely born. These babies have thick, highly keratinized armor-like skin, which forms large diamond, trapezoid or rectangular plates separated by deep fissures. These affect the shapes of eyelids, nose, mouth and ears, and also limit movement of the arms, legs and chest. This condition is linked with a nonsense or frameshift mutation in the ABCA12 gene, which is responsible for lipid transport in the keratinocytes. This gene synthesizes a protein that transports a lipid, epidermoside, a glucosylceramide, out of stratum corneum cells in the epidermis. To our knowledge, this is the first case report on Harlequin ichthyosis from Nepal, which makes this case unique. The takeaway lesson from this case is that couples with consanguineous marriages should undergo screening of ABCA12 gene if they plan to conceive.