bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of Scheduling Method,Appointment Delay, and No-show Rate in the Ultrasound Unit of a Nigerian Teaching Hospital
Authors: Idigo F. U. , Chijioke N. I. K. , Anakwue A. C. , Nwogu U. B. , Maduka B. U. 
Published: June 2023

Increasing incidence of no-shows has been identified as a major challenge to planning of appointment schedules which imparts negatively on revenue generation and system efficiency. This cross-sectional study analysed the scheduling method in use, appointment delay time, appointment compliance rate and no-show rate of patients in the ultrasound unit of a Nigerian tertiary hospital, using observation, patient records and questionnaires. Information obtained were: The time interval between clinician request and examination appointment schedule, patient load distribution, scheduling method, number of patients scheduled and number that kept to appointment scheduling, and as well staff opinion on reasons for patients’ length of stay for ultrasound investigations. The results showed that the single-block scheduling method was used and patients’ arrival was highest between 7:12 and 9:00 hours with decreasing rate as the day progresses. The time interval between request and appointment was 12–14 days. Appointment compliance rate was observed to be 5.5, while no show rate was 4.5. Poor state of ultrasound machines was observed to be the highest contributing factor to patient delays with Kendall’s coefficient of concordance 0.466. The findings of this work can be utilized in efficient planning of public hospital ultrasound units to enhance patient access.
A model of care for attention deficit and hyperactivity disorder among adults in the community
Authors: Suetani Shuichi , Hull Jaimie , Zeniou Lakis , Chong Leshay , Stimming Andrea , Nelson Carmel , Panagoda Gaj 
Published: June 2023

Objective To describe the process of collaborative, contextualised development and implementation of a model of care for adults with symptoms suggestive of attention deficit and hyperactivity disorder in an Aboriginal community-controlled health service. Conclusion The current article describes an attempt to reduce unmet mental health needs through a systemic approach within a well-established Indigenous community-controlled organisation.
Beliefs and Practices on Depression Among Selected Filipino Indigenous Peoples: A Focused Ethnography
Authors: Moreno-Lacalle Rainier C. , Bangsal Myra R. , Bay-Ya Mae Rose T. , Erese Kristine Ann R. , Gabol Lourrie Ann P. , Geronimo Meriam M. , Legiralde Saintly Blaise B. , Lomandas Marfil Mae A. , Menzi Ma. Mae R. , Real Cici Donna L. , Solis John Michael Brico F. , Ufina Keanu U. , Lacanaria Mary Grace C. 
Published: June 2023

Introduction: Depression beliefs and practices among indigenous peoples are essential to creating responsive mental health services. The purpose of the study is to explore the cultural beliefs and practices on depression among the Ilocanos, Kankana-eys, and Maranaos indigenous peoples in the Philippines. Method: The study employed a focused ethnography research design. The study involved 41 ( N = 41) traditional healers and tribal leaders across Ilocano, Kankana-ey, and Maranao ethnic groups in the Philippine Islands. Interviews, reviews of records, and participant observation were used as data gathering tools. Results: Beliefs about depression include magico-spiritual influence, relational problems, economic pressure, and emotional domains. Practices were divided into three domains: preventive, curative, and rehabilitative interventions. Discussion: The depression beliefs and practices of Ilocano, Kankana-ey, and Maranao indigenous peoples are rooted in their tradition, culture, religion, and medical influences largely rooted in magico-spiritual approaches. These findings suggest the inclusion of culturally-based care to address depression.
Assessing the Agreement of Hypernasality and Audible Nasal Emission Ratings Between Audio-Recordings and a Clinic Setting
Authors: Williams Jessica L. , Cordero Kelly N. , Sitzman Thomas J. 
Published: June 2023

Assess agreement of hypernasality and audible nasal emission (ANE) ratings between audio-recordings and a clinic setting. Cross-sectional study using retrospective clinical recordings. Audio-recording ratings by two trained speech language pathologists. Percent agreement and intra- and inter-rater reliability of perceptual ratings. Intra-rater reliability (AC2) of 167 audio-recorded speech samples for the primary and secondary raters, respectively, was 0.82 and 0.79 for hypernasality; for ANE, it was 0.57 and 0.75. Inter-rater reliability was 0.77 for hypernasality and 0.63 for ANE. When comparing ratings made from audio-recording versus the original clinical ratings, intra-rater reliability was 0.85 and 0.61 (primary and secondary rater, respectively) for hypernasality and 0.21 and 0.34 for ANE. Ratings for hypernasality made from audio recordings were consistent with clinical evaluation, while ratings of ANE were not. ANE ratings made from audio recordings may not be a valid measure of velopharyngeal insufficiency speech characteristics.
Does Dietary Polyunsaturated Fatty Acid Intake Associate With Bone Mineral Density and Limb Structural Changes in Early Rheumatoid Arthritis?
Authors: Valner Annika , Müller Raili , Kull Mart , Põlluste Kaja , Lember Margus , Kallikorm Riina 
Published: June 2023

Background: Rheumatoid arthritis (RA) is an inflammatory disease that can result in bone erosion, lean mass lowering, and increase of fat mass without changes in body weight. The dietary consumption of polyunsaturated fatty acids (PUFAs) has been assessed in many studies due to their potential anti-inflammatory effect. Aim: The aim of this research was to identify if dietary intake of PUFAs associates with bone mineral density (BMD) and limb structural changes in early rheumatoid arthritis (ERA) compared to a population-based control group. The study was conducted because previous results have been insufficient. Methods: The study group consisted of 83 ERA patients and 321 control subjects. A dual-energy X-Ray absorptiometry (DXA) machine was used to measure hip, lumbar spine, and radius BMD, as well as arm and leg fat, lean, and bone mass. Dietary habits and inflammatory markers were assessed to evaluate the effects to BMD and limb structural changes. Results: In ERA subjects, higher dietary consumption of PUFAs was associated with a decrease in arm fat mass (b −28.17, P = .02) and possibly with higher lumbar BMD (b 0.008, P  = .058). Limb bone and lean mass changes were not associated with dietary intake of PUFAs. Conclusion: Balanced nutrition is essential. Consuming PUFAs could be beneficial in ERA preventing structural changes to hands, but additional research is needed.
A scoping review of tissue interposition flaps used in vesicovaginal fistulae repair
Authors: Serinçay Halime , Güler Hayrullah Uğur , Ulubayram Kezban , Mangır Naşide 
Published: June 2023

Background: Research on the use of tissue interposition flaps (TIFs) in vesicovaginal fistulae (VVF) repair is a broad area where a very wide range of natural and synthetic materials have been used. The occurrence of VVF is also diverse in the social and clinical settings, resulting in a parallel heterogeneity in the published literature on its treatment. The use of synthetic and autologous TIFs in VVF repair is not yet standardized with a lack of the most efficacious type and technique of the TIF. Objectives: The aim of this study was to systematically review all synthetic and autologous TIFs used in the surgical repair of VVFs. Data sources and methods: In this scoping review, the surgical outcomes of autologous and synthetic interposition flaps used in VVF treatment meeting the inclusion criteria were determined. We searched the literature using Ovid MEDLINE and PubMed databases between 1974 and 2022. Study characteristics were recorded, and data on the change in fistulae size and location, surgical approach, success rate, preoperative patient evaluation and outcome evaluation were extracted from each study independently by two authors. Results: A total of 25 articles that met the inclusion criteria were included in the final analysis. A total of 943 and 127 patients who had received autologous and synthetic flaps, respectively, were included in this scoping review. The fistulae characteristics were highly variable with regard to their size, complexity, aetiology, location and radiation. Outcome assessments of fistulae repair in included studies were mostly based on symptom evaluation. Physical examination, cystogram and methylene blue test were the methods in order of preference. Postoperative complications, such as infection, bleeding, donor site, pain, voiding dysfunction and other complications, were reported in patients after fistulae repair in all included studies. Conclusion: The use of TIFs in VVF repair was common especially in complex and large fistulae. Autologous TIFs appear to be the standard of care at the moment, and synthetic TIFs were investigated in prospective clinical trials in a limited number of selected cases. Evidence levels of clinical studies evaluating the effectiveness of interposition flaps were overall low.
An Online CMC–LC/MS Method for Screening Angiogenesis Promoting Components in Yiqi Fumai Lyophilization Injection (YQFM)
Authors: Xu Qing , Li Dekun , Wan Meixu , Zhang Yanxin , Li Zhi , Ju Aichun 
Published: June 2023

Objective In this study, an online CMC–LC/MS method was established in order to screen the active components of Yiqi Fumai lyophilization injection (YQFM) related to angiogenesis. The pro-angiogenic active components of YQFM were screened using this system and were then further verified. Methods The ECV304/CMC model coupled online with an HPLC–MS system was initially developed to screen, analyze, and identify the allergenic components of YQFM. A fraction was retained on the ECV304/CMC column, which was identified as ginsenoside Rb2. A cell proliferation assay and zebrafish intestinal microvascular model labeled with green fluorescence were used to detect the proliferation effect of ginsenoside Rb2. Results (1) The active component in YQFM, which was retained on the column, was ginsenoside Rb2. (2) Within a concentration range of 2.5–20 μg/mL, ginsenoside Rb2 was shown to promote the proliferation of ECV304 and EPCs cells and increase the area of sub-intestinal vessels in zebrafish. Conclusion Ginsenoside Rb2, the active component in YQFM, can promote angiogenesis. The ECV304/CMC-online-HPLC system may serve as an effective screening tool for the vasoactive components from the traditional Chinese medicine injection.
Multiple sclerosis and lower urinary tract symptoms: A survey of prevalence, characteristic and urological evaluations
Authors: Sharifiaghdas Farzaneh , Narouie Behzad , Taheri Maryam , Jalali Saba , Shalbafan Bita , Azadvari Mohaddeseh , Dadpour Mehdi , Rouientan Hamidreza , Ahmadzade Mohadese , Hanafi Bojd Hamideh 
Published: June 2023

Objective: Most multiple sclerosis patients have urological complications such as lower urinary tract symptoms. This study was conducted to evaluate the prevalence of these symptoms and whether they result in a urological evaluation. Methods: A cross-sectional study of 517 multiple sclerosis patients at Tehran’s referral multiple sclerosis center and neurology clinics between 2018 and 2022 was performed. Data were collected through interviews after patients completed informed consent forms. Urological examinations, including urine analysis and ultrasonography, were evaluated as final assessments. The data were analyzed using descriptive and inferential statistical tests in Statistical Package for Social Science. Results: Among all participants, the prevalence of lower urinary tract symptoms was 73% ( n = 384), with urgency (44.8% n = 232) being the most common symptom. The prevalence of intermittency was significantly higher among women ( p = 0.004). There was no gender-significant difference in terms of the prevalence of other symptoms ( p > 0.050). Lower urinary tract symptoms were significantly correlated with age, clinical course, disease duration, and disability ( p < 0.001). Additionally, 37.3% and 18.7% of patients with lower urinary tract symptoms, as well as 17.9% and 37.5% of patients with multiple sclerosis attacks, respectively, had undergone urine analysis and ultrasonography. Conclusion: Multiple sclerosis patients rarely undergo urological evaluations during the course of their disease. Proper assessment is essential as these symptoms are among the most detrimental manifestations of this disease.
Leg Length Discrepancy After Hip Fracture Repair is Associated With Reduced Gait Speed
Authors: Pearce Alexa N. , Sieber Frederick E. , Wang Nae-Yuh , Stambough Jeffrey B. , Stronach Benjamin M. , Mears Simon C. 
Published: June 2023

Introduction A negative correlation exists between functional outcomes and leg length discrepancy (LLD) following hip fracture repair. We have assessed the effects of LLD following hip fracture repair in elderly patients on 3-meter walking time, standing time, activities of daily living (ADL), and instrumental activities of daily living (IADL). Methods One hundred sixty-nine patients enrolled in the STRIDE trial were identified with femoral neck, intertrochanteric, and subtrochanteric fractures that were treated with partial hip replacement, total hip replacement, cannulated screws, or intramedullary nail. Baseline patient characteristics recorded included age, sex, body mass index Charlson comorbidity index (CCI) score. ADL, IADL, grip strength, sit-to-stand time, 3-meter walking time and return to ambulation status were measured at 1 year after surgery. LLD was measured on final follow-up radiographs by either the sliding screw telescoping distance or the difference from a trans-ischial line to the lesser trochanters, and was analyzed as a continuous variable using regression analysis. Results Eighty eight patients (52%) had LLD <5 mm, 55 (33%) between 5-10 mm and 26 subjects (15%) >10 mm. Age, sex, BMI, Charlson score, and ambulation status had no significant impact on LLD occurrence. Type of procedure and fracture type did not correlate with severity of LLD. Having a larger LLD was not found to have a significant impact on post-operative ADL ( P = .60), IADL ( P = .08), sit-to-stand time ( P = .90), grip strength ( P = .14) and return to former ambulation status ( P = .60), but did have a statistically significant impact on 3-meter walking time ( P = .006). Discussion LLD after hip fracture was associated with reduced gait speed but did not affect many parameters associated with recovery. Continued efforts to restore leg length after hip fracture repair are likely to be beneficial.
Prevalence of little finger brachymesophalangia (BMP-V) in the Chinese population
Authors: Tang Nga Ping , Lam Gloria Yan Ting , Chow Esther Ching San 
Published: June 2023

Objective This study aims at determining the prevalence of little finger brachymesophalangia (BMP-V) in the Chinese ethnic population. Methods A retrospective study reviewing hand radiographs taken in United Christian Hospital from January 2011 to July 2016. Exclusion criteria included previous hand trauma, background history of genetic syndromes and non-Chinese ethnic origin. The radiographs were assessed with objective measurement using computer software and were defined BMP-V with the following criteria: (1) 5th MP length: 4th MP length <0.65 and (2) 5th MP length: 5th PP length <0.50. The radiographs would be included as BMP-V cases if they fulfil both criteria. Results A total of 563 hand radiographs in 394 patients (290 left hands and 273 right hands; 169 bilateral hands) were reviewed. The mean age (± standard deviation) was 51.3 ± 11.7 years (ranging from 25 to 69 years). Forty-four patients were identified to have BMP-V. The prevalence of BMP-V was found to be 11.2%. Clinodactyly with trapezoidal shape middle phalanx was found in 6.82% of the BMP-V cases. All subjects with bilateral hand radiographs showed symmetrical findings concerning the presence of BMP-V. Conclusion This is the first study to report the prevalence of brachymesophalangia-V in the Chinese adult population. The prevalence of BMP-V in the Chinese adult population was found to be 11.2%. It is lower than Japanese group but higher than other ethnic groups documented in other studies.
Antibody-mediated antigen loss switches augmented immunity to antibody-mediated immunosuppression
Authors: Jajosky Ryan P. , Patel Kashyap R. , Allen Jerry William L. , Zerra Patricia E. , Chonat Satheesh , Ayona Diyoly , Maier Cheryl L. , Morais Dominique , Wu Shang-Chuen , Luckey C. John , Eisenbarth Stephanie C. , Roback John D. , Fasano Ross M. , Josephson Cassandra D. , Manis John P. , Chai Li , Hendrickson Jeanne E. , Hudson Krystalyn E. , Arthur Connie M. , Stowell Sean R. 
Published: June 2023

Abstract
Antibodies against fetal red blood cell (RBC) antigens can cause hemolytic disease of the fetus and newborn (HDFN). Reductions in HDFN due to anti-RhD antibodies have been achieved through use of Rh immune globulin (RhIg), a polyclonal antibody preparation that causes antibody-mediated immunosuppression (AMIS), thereby preventing maternal immune responses against fetal RBCs. Despite the success of RhIg, it is only effective against 1 alloantigen. The lack of similar interventions that mitigate immune responses toward other RBC alloantigens reflects an incomplete understanding of AMIS mechanisms. AMIS has been previously attributed to rapid antibody-mediated RBC removal, resulting in B-cell ignorance of the RBC alloantigen. However, our data demonstrate that antibody-mediated RBC removal can enhance de novo alloimmunization. In contrast, inclusion of antibodies that possess the ability to rapidly remove the target antigen in the absence of detectable RBC clearance can convert an augmented antibody response to AMIS. These results suggest that the ability of antibodies to remove target antigens from the RBC surface can trigger AMIS in situations in which enhanced immunity may otherwise occur. In doing so, these results hold promise in identifying key antibody characteristics that can drive AMIS, thereby facilitating the design of AMIS approaches toward other RBC antigens to eliminate all forms of HDFN.
Mutations in atypical hemolytic uremic syndrome provide evidence for the role of calcium in complement factor I
Authors: Java Anuja , Atkinson John , Hu Zheng , Pozzi Nicola 
Published: June 2023

Abstract
Atypical hemolytic uremic syndrome (aHUS) is a rare thrombotic microangiopathy. Genetic variants in complement proteins are found in ≈60% of patients. Of these patients, ≈15% carry mutations in complement factor I (CFI). Factor I (FI) is a multidomain serine protease that cleaves and thereby inactivates C3b and C4b in the presence of cofactor proteins. Crystal structures have shown that FI possesses 2 calcium-binding domains, low-density lipoprotein receptor class A (LDLRA) 1 and LDLRA2. Yet, the role of calcium in FI is unknown. We determined that 9 genetic variants identified in aHUS (N151S, G162D, G188A, V230E, A240G, G243R, C247G, A258T, and Q260D) cluster around the calcium-binding site of LDLRA1. Using site-directed mutagenesis, we established that the synthesis of all, except A258T, was impaired, implying defective protein folding, perhaps due to loss of calcium binding. To further explore this possibility, we generated 12 alanine mutants that coordinate with the calcium in LDLRA1 and LDLRA2 (K239A, D242A, I244A, D246A, D252A, E253A, Y276A, N279A, E281A, D283A, D289A, and D290A) and are expected to perturb calcium binding. Except for K239A and Y276A, none of the mutants was secreted. These observations suggest that calcium ions play key structural and functional roles in FI.
Representation of the population in need for pivotal clinical trials in lymphomas
Authors: Casey Mycal , Odhiambo Lorriane , Aggarwal Nidhi , Shoukier Mahran , Islam K. M. , Cortes Jorge 
Published: June 2023

Abstract
Despite the advances in cancer outcomes, significant health disparities persist. Several new agents have been recently approved for treatment of lymphomas, leading to improved outcomes. Extending the benefits of these new agents starts by adequate enrollment of all affected patient populations. This study aimed to evaluate the extent to which randomized controlled trials (RCTs) match the demographic and geographic diversity of the population affected by lymphoma. Two Food and Drug Administration databases, clinicaltrials.gov, and relevant primary manuscripts were reviewed for drug approval data and demographic representation in RCTs for classical Hodgkin lymphoma (cHL) and non-Hodgkin lymphoma. Maps showing the distribution and frequency of trial participation relative to disease burden, insurance status, and racial representation were created. Black, Hispanic, and female patients were significantly underrepresented in the RCTs for lymphoma compared with that for the disease burden (3.6% [95% confidence interval (CI), 2.8-5.4] vs 14.6% [95% CI, 13.8-15.3]; 6.7% [95% CI, 5.5-7.9] vs 16.3% [95% CI, 15.5-17.1]; and 39.1% [95% CI, 37.3-40.9] vs 42.7% [95% CI, 42.3-43.1], respectively). White and male patients were overrepresented. More counties with higher mortality rates and racial minority representation had low access to the trials, particularly for cHL in the southern region of the United States. There are significant racial misrepresentations in pivotal RCTs in the United States, and geographic distribution of these trials may not provide easy access to all patients in need. Disparities in enrollment should be corrected to make results applicable to all populations.