bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Economic Crisis (2008-2019) and Health Care in Zimbabwe: A Structured Literature Review
Authors: Mangundu M , Roets Lizeth , ES Janse van Rensburg 
Published: March 2023

Background:
The multi-prolonged nature and severity of the economic crisis (2008-2019) in Zimbabwe provided a distinct prospect to analyse the impact of economic crisis on the healthcare system. According to the System Model, the possible effect on health infrastructure, material resources, human resources, and financial resources is relevant.

Aim:
The structured literature review aimed to conduct an analysis of available evidence referring to the impact of economic crisis on health care in Zimbabwe between 2008 and 2019.

Methods:
A search of publications in English with inclusion criteria of timeframe between January, 2008 and December, 2019 that referred to the effect or impact of the economic crisis on health care was conducted utilising databases, such as Google Scholar, EBSCOhost, Pubmed, and UNISA repository. A thematic analysis for data extraction and synthesis was carried out. Exclusion criteria referred to irrelevance to the objectives and inappropriateness.

Results:
A total of 87 research publications were identified on various databases for analyses, 75 were excluded at different stages of screening, and 12 were included in the study. The thematic analysis, conducted according to the steps explained by Tesch (in Creswell 2014), revealed economic effects on health care in four themes: public health infrastructure, health workers, medical drugs, and public health expenditure and management, which were affected by an economic crisis.

Conclusion:
The effects of the economic crisis were evident in terms of negative changes in the healthcare delivery system, including a reduction in medical drug supply, loss of human resources, reduced financial resources, and an increase in the disease burden.
A Digital Self-help Intervention for Atopic Dermatitis: Analysis of Secondary Outcomes From a Feasibility Study
Authors: Kern Dorian , Ljótsson Brjánn , Lönndahl Louise , Hedman-Lagerlöf Erik , Bradley Maria , Lindefors Nils , Kraepelien Martin 
Published: March 2023

Background
Atopic dermatitis (AD) is a common inflammatory skin disease characterized by dry skin, eczematous lesions, and an often severe pruritus. The disease may have a negative effect on quality of life and is also associated with symptoms of anxiety and depression. Few individuals with AD receive any form of behavioral intervention. Behavioral interventions for AD are potentially efficacious but need to be constructed so that they are safe, credible, and user-friendly. We have previously reported on a feasibility study that demonstrated that a self-management version of a digital intervention based on cognitive behavioral therapy (CBT) for AD can potentially be effective in reducing AD symptoms. The aim of this secondary report was to further examine treatment feasibility and preliminary effects on dermatological quality of life, itching sensations, depressive symptoms, and perceived stress.

Objective
This is a secondary report on intervention credibility, usability, adverse events, and preliminary effects on secondary measures of a self-management digital intervention for atopic dermatitis.

Methods
In total, 21 adults with AD, recruited nationwide in Sweden, were assessed by telephone, and used the digital intervention for 8 weeks. Participants were also assessed directly afterward and 3 months after the end of the intervention. There was no therapist guidance. Feasibility indicators included intervention credibility, usability, and possible adverse effects. Other measures included preliminary effects on dermatological quality of life, itching sensations, depressive symptoms, and perceived stress.

Results
The intervention was regarded as credible and no serious adverse events were reported. System usability was, however, found to be below the predetermined cutoff for acceptable usability. Preliminary effects at 3-month follow-up were in the moderate to large range for dermatological quality of life (Cohen d=0.89, 95% CI 0.18-1.56), itching sensations (Cohen d=0.85, 95% CI 0.15-1.52), depressive symptoms (Cohen d=0.78, 95% CI 0.1-1.45), and perceived stress (Cohen d=0.75, 95% CI 0.01-1.36).

Conclusions
This 8-week self-management digital CBT-based intervention was, together with telephone calls before and after, a feasible intervention for participants with AD. Preliminary effects were promising and should be explored further in a randomized controlled trial. Intervention usability was, however, rated below cutoff scores. Efforts should be made to improve written material to increase usability.
Using Wearable Technology to Quantify Physical Activity Recovery: Secondary Report From the AFTER (App-Facilitated Tele-Rehabilitation) Program for COVID-19 Survivors Randomized Study
Authors: Churchill Laura , Morrow Mary , Capin Jacob J , Jolley Sarah E , Hare Kristine , MaWhinney Samantha , Stevens-Lapsley Jennifer E , Erlandson Kristine M 
Published: March 2023

Background
Knowledge on physical activity recovery after COVID-19 survival is limited. The AFTER (App-Facilitated Tele-Rehabilitation) program for COVID-19 survivors randomized participants, following hospital discharge, to either education and unstructured physical activity or a telerehabilitation program. Step count data were collected as a secondary outcome, and we found no significant differences in total step count trajectories between groups at 6 weeks. Further step count data were not analyzed.

Objective
The purpose of this analysis was to examine step count trajectories and correlates among all participants (combined into a single group) across the 12-week study period.

Methods
Linear mixed models with random effects were used to model daily steps over the number of study days. Models with 0, 1, and 2 inflection points were considered, and the final model was selected based on the highest log-likelihood value.

Results
Participants included 44 adults (41 with available Fitbit [Fitbit LLC] data). Initially, step counts increased by an average of 930 (95% CI 547-1312; P<.001) steps per week, culminating in an average daily step count of 7658 (95% CI 6257-9059; P<.001) at the end of week 3. During the remaining 9 weeks of the study, weekly step counts increased by an average of 67 (95% CI −30 to 163; P<.001) steps per week, resulting in a final estimate of 8258 (95% CI 6933-9584; P<.001) steps.

Conclusions
Participants showed a marked improvement in daily step counts during the first 3 weeks of the study, followed by more gradual improvement in the remaining 9 weeks. Physical activity data and step count recovery trajectories may be considered surrogates for physiological recovery, although further research is needed to examine this relationship.

Trial Registration
ClinicalTrials.gov NCT04663945; https://tinyurl.com/2p969ced
General Practitioners’ Experiences With Potentials and Pitfalls of Video Consultations in Norway During the COVID-19 Lockdown: Qualitative Analysis of Free-Text Survey Answers
Authors: Norberg Børge Lønnebakke , Getz Linn Okkenhaug , Johnsen Tor Magne , Austad Bjarne , Zanaboni Paolo 
Published: March 2023

Background
The use of video consultations (VCs) in Norwegian general practice rapidly increased during the COVID-19 pandemic. During societal lockdowns, VCs were used for nearly all types of clinical problems, as in-person consultations were kept to a minimum.

Objective
This study aimed to explore general practitioners’ (GPs’) experiences of potentials and pitfalls associated with the use of VCs during the first pandemic lockdown.

Methods
Between April 14 and May 3, 2020, all regular Norwegian GPs (N=4858) were invited to answer a web-based survey, which included open-ended questions about their experiences with the advantages and pitfalls of VCs. A total of 2558 free-text answers were provided by 657 of the 1237 GPs who participated in the survey. The material was subjected to reflexive thematic analysis.

Results
Four main themes were identified. First, VCs are described as being particularly convenient, informative, and effective for consultations with previously known patients. Second, strategically planned VCs may facilitate effective tailoring of clinical trajectories that optimize clinical workflow. VCs allow for an initial overview of the problem (triage), follow-up evaluation after an in-person consultation, provision of advice and information concerning test results and discharge notes, extension of sick leaves, and delivery of other medical certificates. VCs may, in certain situations, enhance the GPs’ insight in their patients’ relational and socioeconomical resources and vulnerabilities, and even facilitate relationship-building with patients in need of care who might otherwise be reluctant to seek help. Third, VCs are characterized by a demarcated communication style and the “one problem approach,” which may entail effectiveness in the short run. However, the web-based communication climate implies degradation of valuable nonverbal signals that are more evidently present in in-person consultations. Finally, overreliance on VCs may, in a longer perspective, undermine the establishment and maintenance of relational trust, with a negative impact on the quality of care and patient safety. Compensatory mechanisms include clarifying with the patient what the next step is, answering any questions and giving further advice on treatment if conditions do not improve or there is a need for follow-up. Participation of family members can also be helpful to improve reciprocal understanding and safety.

Conclusions
The findings have relevance for future implementation of VCs and deserve further exploration under less stressful circumstances.
DEVELOPMENT AND EVALUATION OF ANTIDIABETIC POLYHERBAL TABLET USING MEDICINAL PLANTS OF TRADITIONAL USE
Authors: KOLHE ROHINI C. , CHAUDHARI RAJESH Y. 
Published: March 2023

The aim of the present study is to develop and evaluate polyherbal tablet prepared for the management of diabetes with enhanced disintegration time. The polyherbal extract prepared using methanolic extract of selected traditionally used medicinal plants such as Adenanthera pavonina, Kigelia africana, Parkia biglandulosa and Syzygium jambose (1:1:1:2) was evaluated in alloxan monohydrate induced diabetic rat model. The polyherbal tablets were prepared by wet granulation method with excipients microcrystalline cellulose; dicalcium phosphate dehydrate and sodium starch glycolate. After preformulation studies, tablets were evaluated by using weight variation, hardness, friability and disintegration time. The diabetic rats treated with polyherbal extract were compared with the diabetic control rats group. Positive results were obtained in the observed parameters, thus favoring the use of the plants. Pre-formulation study revealed that all the evaluated parameters were found to be within acceptable limits. The weight variation of the formulated tablets was 1.43 % RSD. The disintegration time of the formulations was found to be 9.50 min. The tablets also underwent accelerated stability over the period of three months. No marked changes were observed in all the parameters evaluated during three months of accelerated stability study. Laboratory-scale preparation of polyherbal tablet can lead to new powerful and stable oral dosage formulations for diabetes mellitus and lighten the synergistic area of ​​action of herbs.
Утааны механик шинж чанарыг судлах хялбар арга
Authors: Ж Ванчинхүү , Ж Даваасамбуу , Б Бат-Эрдэнэ 
Published: March 2023

Утааны бөөмцөрийн шугаман хэмжээ, тоон нягт буюу концентраци, хурд, бөөмцөр хоорондын зай, утаан дахь бөөмцөрийн концентраци зэрэг зарим механик чанарыг хялбар тодорхойлох боломжит арга, аргачлалыг энд судлав. Энд дэвшүүлж байгаа аргыг ашиглан тамхины утааны зарим механик шинж чанарыг тогтоож агаар мандал руу орж байгаа эмиссийг үнэлэв. Агаарын бохирдлын судалгааны тохиромжтой байх зарим шинэ параметрүүдийг дэвшүүлэн гаргасан.
A case study on the Healthcare Workers in Karachi: The Effect Of Post-Covid Stress On Anxiety and Coping Mechanisms
Authors: Gillani Syeda Zahra Urooj , Zahid Muhammad Shaheer 
Published: March 2023

Abstract
The aim of this research was to examine the impact of post-COVID stress on the anxiety and coping mechanisms of healthcare workers. A phenomenological approach was utilized to gain a deeper understanding of the personal experiences of the participants. The results of the study revealed the challenges faced by healthcare workers in the aftermath of the pandemic and the coping strategies they employed to manage stress. These findings provide valuable insights for healthcare organizations and policymakers in their efforts to support the mental well-being of healthcare workers.
Keywords: Post-covid-19, anxiety, depression, infection, mental health, pandemics, frontline workers, qualitative study, covid aftermaths
Immunotherapy With Low-Dose IL-2/CD25 Prevents β-Cell Dysfunction and Dysglycemia in Prediabetic NOD Mice
Authors: Qureshi Farhan M. , Panzer Julia K. , Põder Janika , Malek Thomas R. , Caicedo Alejandro 
Published: March 2023

Low-dose IL-2 is a promising immunotherapy in clinical trials for treating type 1 diabetes. A new IL-2 analog, IL-2/CD25 fusion protein, has been shown to more efficiently delay or prevent diabetes in NOD mice by expanding the population of activated regulatory T cells. This therapy is intended for use before clinical diagnosis, in the early stages of type 1 diabetes progression. During this prediabetic period, there is a chronic decline in β-cell function that has long-term implications for disease pathogenesis. Yet, to date, the effects of IL-2/CD25 on β-cell function have not been evaluated. In this study, we treated prediabetic NOD mice with low-dose mouse IL-2/CD25 over 5 weeks and determined its impact on β-cell function. This treatment limited the progressive impairment of glucose tolerance and insulin secretion typical of the later stages of prediabetes. Intracellular Ca2+ responses to glucose in β-cells became more robust and synchronous, indicating that changing the local immune cell infiltrate with IL-2/CD25 preserved β-cell function even after treatment cessation. Our study thus provides mechanistic insight and serves as a steppingstone for future research using low-dose IL-2/CD25 immunotherapy in patients.

Article Highlights
Immunotherapies such as IL-2/CD25 are known to prevent or delay diabetes. However, their impact on individual β-cell function is not yet understood. Female NOD mice progress from stage 1 to 2 pre–type 1 diabetes between 12 and 17 weeks. Treatment with mouse IL-2 (mIL-2)/CD25 prevents this progression even after treatment cessation. Individual β-cell function (measured via intracellular Ca2+ responses to glucose) declines during the pathogenesis of type 1 diabetes. Treatment with mIL-2/CD25 therapy limits β-cell dysfunction, and function continues to improve after treatment cessation. Insulin secretion is improved with mIL-2/CD25 therapy.
Earlier Age at Type 2 Diabetes Diagnosis Is Associated With Increased Genetic Risk of Cardiovascular Disease
Authors: Lee Hyunsuk , Choi Jaewon , Kim Na Yeon , Kim Jong-Il , Moon Min Kyong , Lee Seunggeun , Park Kyong Soo , Kwak Soo Heon 
Published: March 2023

OBJECTIVE
We investigated genetic risk of cardiovascular disease (CVD) by age at type 2 diabetes (T2D) diagnosis.

RESEARCH DESIGN AND METHODS
We compared incident CVD events by age at T2D diagnosis using UK Biobank (N = 12,321) and the Seoul National University Hospital (SNUH) cohort (N = 1,165). Genetic risk was quantified using polygenic risk score (PRS).

RESULTS
Individuals with earlier T2D diagnosis had higher CVD risk. In UK Biobank, the effect size of coronary artery disease (CAD) PRS on incident CAD was largest in individuals diagnosed with T2D at ages 30–39 years (hazard ratio 2.25; 95% CI 1.56–3.26) and decreased as age at diagnosis increased: ages 40–49 (1.51; 1.30–1.75), 50–59 (1.36; 1.24–1.50), and 60–69 years (1.30; 1.14–1.48) (Pinteraction = 0.0031). A similar trend was observed in the SNUH cohort. This increased genetic risk associated with earlier T2D diagnosis was largely mitigated by a healthy lifestyle.

CONCLUSIONS
Individuals with an earlier T2D diagnosis have a higher genetic risk of CAD, and this information could be used to tailor lifestyle interventions.
A comparison of daily glucose fluctuation among GCK-MODY and type 2 diabetes using continuous glucose monitoring technology
Authors: Ren Qian , Zhang Ping , Pang Wuyan , Ma Yumin , Gong Siqian , Ba Tianhao , Liu Wei , Zhang Fang , Zhang Xiuying , Zhang Rui , Wang Xiangqing , Zhang Xiaomei , Yang Wenjia , Lv Fang , Gao Leili , Han Xueyao , Ji Linong 
Published: March 2023

<p> </p>
<p>Glucokinase variant-induced maturity-onset diabetes of the young (GCK-MODY) exhibits the unique clinical features of mild fasting hyperglycaemia. However, formal studies of its glucose excursion pattern in daily life in comparison with those with or without other types of diabetes are lacking. We conducted a case-control study including 25 patients with GCK-MODY, 25 A1c-matched, drug naive patients with type 2 diabetes (T2DM) and 25 age-, BMI- and sex-matched subjects with normal glucose tolerance (NGT). All the subjects wore flash glucose monitoring (FGM) sensors for 2 weeks, and glucose readings were masked. Glucose excursion was significantly lower in the GCK-MODY than that in A1c-matched T2DM during the daytime, but was similar during the nighttime. The daytime coefficient of variation [CV] driven by postprandial glucose could separate GCK-MODY from well-controlled T2DM, but the nighttime CV could not. In discriminating between GCK-MODY and T2DM, the area under the curve (AUC) of the CV was 0.875. However, in GCK-MODY and NGT subjects, the CVs were similar at 24h, whereas the other four excursion parameters were significantly higher in GCK-MODY than those in NGT subjects. FGM confirmed the stability and mildness of hyperglycemia in GCK-MODY patients. Postprandial regulation is a key driver of the difference in excursion between GCK-MODY and T2DM.</p>
An Exponential Decay Model for Decaying of Contact Patch Friction Steering Moment with Rolling Speed
Authors: Prakash Jai , Vignati Michele , Sabbioni Edoardo 
Published: March 2023

ABSTRACT
Steering torque is a very important quantity for the driver's response. In fact, it gives the driver an idea of the road adherence condition during driving. Several models have been developed to simulate shear forces at the contact patch; most of them are based on semi-empirical tire models that account for slip and slip angles. They have good reliability when speed is high enough, but at very low speed, such as in parking, these models suffer from reliability and numerical issues. This paper presents a model to compute the steering moment due to contact patch friction at any longitudinal speed including pivot steering condition. In particular, it supplements the pivot steering model with a novel exponential decay of moment model to simulate steering moment for various wheel rolling speeds. The decay rate was found to be dependent upon contact patch geometry and rolling speed.
Trends in age-specific and sex-specific pulmonary hypertension mortality in Italy between 2005 and 2017
Authors: Zuin Marco , Bilato Claudio , Rigatelli Gianluca , Quadretti Laura , Roncon Loris 
Published: March 2023

Aims
Data regarding the pulmonary hypertension (PH)-related mortality and relative trends in the Italian population remain scant. We sought to assess the PH mortality rates and relative trends among the Italian population between 2005 and 2017.

Methods
Data regarding the cause-specific mortality and population size by sex in 5-year age groups were extracted from the WHO global mortality database. The age-standardized mortality rates, with relative 95% confidence intervals (CIs), also stratified by sex, were using the direct method. Joinpoint regression analyses were used to identify periods with statistically distinct log linear trends in PH-related death rates. To calculate nationwide annual trends in DCM-related mortality, we assessed the average annual percentage change (AAPC) and relative 95% CIs.

Results
In Italy, the PH age-standardized annual mortality rate decreased from 2.34 (95% CI: 2.32–2.36) deaths per 100 000 to 1.51 (95% CI: 1.48–1.53) deaths per 100 000 population. Over the entire period, men had higher PH-related mortality rates than women. Moreover, the PH-related mortality trend rose with a seemingly exponential distribution with a similar trend among male and female individuals. Joinpoint regression analysis revealed a linear significant decrease in age-standardized PH-related mortality from 2005 to 2017 [AAPC: −3.1% (95% CI: −3.8 to −2.5), P < 0.001] in the entire Italian population. However, the decline was more pronounced among men [AAPC: −5.0 (95% CI: −6.1 to −3.9), P < 0.001] compared with women [AAPC: −1.5 (95% CI: −2.3 to −0.7), P = 0.001].

Conclusion
In Italy, the PH-related mortality rates linearly declined from 2005 to 2017.
Echocardiography in the preparticipation screening: an old topic revisited
Authors: Donati Federica , Guicciardi Claudio , Lodi Elisa , Fernando Fredrick , Palermi Stefano , Modena Maria Grazia , Biffi Alessandro 
Published: March 2023

Background
Preparticipation screenings have been conceived for the potential to prevent sudden cardiac death in young athletes by early identification of hidden cardiac diseases. Commonly used protocols include family history collection, physical examination, and resting electrocardiogram. Transthoracic echocardiography has been hypothesized to have a primary role in the preparticipation screening.

Aims
The present study aimed to evaluate the additional role of echocardiogram in identifying cardiovascular abnormalities that might be undetected by commonly used preparticipation screening.

Methods
We retrospectively reviewed Ferrari Formula Benessere, a corporate wellness program database, and analyzed data recorded from 2017 to 2022 to compare two medical models: a ‘standard’ preparticipation screening including medical history, physical examination, electrocardiogram and exercise stress testing versus an ‘advanced’ preparticipation screening comprising history, physical examination, electrocardiogram, exercise stress testing and echocardiography.

Results
From an initial sample size of 7500 patients, we included 500 patients (420 male, 33.69 ± 7.9 mean age) enrolled for the first time in the corporate wellness program between 2017 and 2022. Three hundred and thirty-nine (67.8%) patients had no abnormal findings at ‘standard’ preparticipation screening and, even if they would have not required further evaluation, we performed echocardiography anyway (‘advanced’ preparticipation screening): 31 (9.1%) showed some abnormal cardiovascular findings at echocardiography, such as patent foramen ovalis, bicuspid aortic valve, aortic root ectasia or mitral valve prolapse.

Conclusions
Screening echocardiogram showed an additional value (about 10% more) in detecting patients with cardiovascular abnormalities, otherwise undiagnosed with the ‘standard’ preparticipation screening protocol.
International Protection of the Rights of Forced Migrants in Judgments of the European Court of Human Rights (Part II)
Authors: Ivanov Dmitriy V. 
Published: March 2023

The article highlights the role of the European Court of Human Rights in international protection of the rights of migrants and expands on the practice of the Court regarding various rights and freedoms granted by the European convention on human rights and its Protocols (1950).The present article continues the overall scientific research of aspects of international protection of forced migrants in the practice of the European Court of Human Rights.