bluuebunny/crossref_metadata_2025_split huggingface dataset:
Work Stress, Overcommitment and Somatization among Early Childhood Professionals during COVID-19: A Cross-sectional Study
Authors: Gritzka S. , Angerer P. , Diebig M. 
Published: August 2023

IntroductionIn addition to posing major public health challenges, the COVID-19 pandemic has affected psychological and physical stressors in workplaces as well as strain by workers worldwide. Even prior COVID-19, the working conditions of early childhood professionals (ECPs) were described as critical leading to (psycho)somatic complaints. Despite the high societal relevance of ECPs and the potential increase in stressors caused by COVID-19, there is a lack of empirical evidence to which extent work-related demands had an adverse effect on ECPs health during COVID-19.ObjectivesWe aimed to obtain updated prevalence rates of somatic symptoms of ECPs as well as unfavourable working conditions inducing stress (in terms of an effort-reward imbalance; ERI) in childcare. The overall objective was to establish associations between work stress and health during the early phase of the pandemic. Given the tendency of ECPs to overcommit themselves, we further explored the potential moderating role of overcommitment.MethodsBetween June 2020 and May 2021, questionnaire data was collected using validated instruments (i.e., ERI, PHQ-15) from ECPs in childcare centers as well as from family providers (N = 1.009). ECPs were informed about the study and contacted through the youth welfare office. Multiple logistic regression tested the influence of ERI and overcommitment on the severity of somatic symptoms. It was controlled for age, gender as well as leadership position. SPSS 28.0 was used to analyze the data.ResultsThe ERI ratio of the sample averaged 1.28 (SD = 0.45), with 72.7% of subjects exceeding the critical cut-off value > 1, indicating a gratification crisis. The averaged sum score of the PHQ-15 was 8.99 (SD = 5.43). Based on a PHQ-15 cut-off ≥ 10, the overall prevalence of somatization at a moderate to high level is estimated to be 44.6%. The mean overcommitment score was 15.14 (SD = 3.55) and 23.4% of ECPs were in the highest overcommitment tertile. ERI (OR = 4.12, 95% CI: 2.73 - 6.22) and overcommitment (OR = 5.20, 95% CI: 2.17 - 12.47) were associated with an increased likelihood of greater severity of somatic symptoms. Yet, the interaction effect between both predictors remained non-signifcant. Being female and having no leadership position were predictors for a moderate to high level of somatization.ConclusionsThe results demonstrate the high relevance of work stress for somatic health among ECPs in the midst of a pandemic. Given the high overall prevalence of somatic symptoms and the female-dominated work sector, ECPs may be at high risk for somatoform disorders. There remains a strong need for action to reduce work-related stress in order to decrease the somatic symptom burden. Large-scale and longitudinal studies are needed to further investigate coping with and persistence of somatic symptoms among this occupational group.Disclosure of InterestNone Declared
The impact of severe mental illness (SMI) on the rate of COVID-19 vaccine uptake and hesitancy
Authors: Hamakarim T. , Arumuham A. , Parmar S. , Howes O. D. 
Published: August 2023

IntroductionThe COVID-19 pandemic has disproportionately affected patients with severe mental illness (SMI), a vulnerable population with high morbidity and mortality. A UK-based study found reduced vaccination rates in patients with SMI; they therefore need to be prioritised for prevention and disease management.ObjectivesThe objectives were to determine risk factors for vaccine hesitancy, and how best to manage those in patients with SMI, as well as whether our intervention of calling patients for their vaccines had a positive outcome.MethodsFollowing approval from the Lambeth Directorate of South London and Maudsley (SLaM) NHS Foundation Trust, we investigated COVID-19 vaccination rates inpatients with SMI from a psychosis community service in South London (n=236). Dates of first and second doses were recorded through audit; reasons for refusal of vaccination were noted. Patients were encouraged to take the vaccine. A re-audit was performed after allowing three months. Chi-squared statistical analysis was performed to determine the value of our intervention.ResultsBefore the intervention, 143 patients (60.6%) received at least one vaccine. 24 patients (10.2%) received one dose, and 77 (32.8%) were yet to receive any. There was no statistical significance (p=0.1509) between the number of patients who received a vaccine before and after intervention, with 33.1% of patients still remaining unvaccinated.Image:Image 2:Image 3:ConclusionsThere is limited research on perceptions of receiving vaccines in patients with SMI, despite their cost-effectiveness in disease prevention. Even after intervention, 33.1% of patients remained unvaccinated, compared to 6.6% nationally. A lack of knowledge and recommendations from care teams are reasons for hesitancy. Misinformation, conspiracy theories and propaganda can drive people towards refusal. Patients with SMI typically have disadvantages of healthcare inequality, lower levels of education and access to inaccurate information. Patients and their healthcare team should be knowledgeable about vaccine efficacy and side effects. Studies have shown low uptake in the Black/African/Caribbean ethnic group (49.3%, table 3). Reasons include general mistrust in institutions and access barriers. For minority communities, vaccination sites in community centres or places of worship have proven to be effective, providing familiarity.Patients taking clozapine may have a weaker immune system due to myelosuppression. 24.3% of our patients take this, with many unsure of interactions or side effects. Poorer prognosis means a focussed approach is needed.Vaccine hesitancy is complex and requires targeted, tailor-made strategies, with consideration for patients who may lack capacity. It is evident from our results that calling patients alone may not be effective. A future multi-modal approach may be necessary to address poor vaccine uptake and opens up avenues to further explore vaccine hesitancy.Disclosure of InterestNone Declared
The behavior of Tunisian students toward people with mental illness
Authors: Ben Amor M. , Zgueb Y. , Aissa A. , SchöBerlein Ouali U. , Zaibi Jomli R. 
Published: August 2023

IntroductionOver the years, several studies have shown the high rate of discrimination experienced in particular by mental health service users. Stigma is composed of three elements: knowledge, behaviors, and attitudes. Although behaviors are the core of discrimination, this element has often been overlooked or intertwined with the other components.ObjectivesOur study aimed to assess Tunisian students’ behavior toward people with mental illnessMethodsThis was a cross-sectional study conducted on 2501 Tunisian students who anonymously completed a form circulated online through social network groups and pages related to each academic institution. We have used the validated Arabic version of the “Reported and Intended Behaviour Scale” (RIBS) which assesses self-reported mental health behaviors and future intentions.ResultsThe median RIBS score was 15 out of 20, ranging from 4 to 20. Among the participants, 40% were living or have lived with someone with a mental health problem and 49.7% would be willing to live with someone with a mental health problem. Moreover, 24% were working or have worked with a person with a mental health problem and 53.4% would be willing to work with him or her. In addition, 34% were having or have had a neighbor with a mental illness and 58% would be willing to have a neighbor with a mental illness. Finally, 51% were having or have had a close friend with a mental health problem and 83.7% answered that they would be able to maintain a relationship with a friend who had developed a mental health problem.ConclusionsThe assessment of behavior toward people with mental illness is fundamental as it has the most impact on individuals. However, behavior may be mediated by knowledge. Thus, it would be interesting to evaluate mental health knowledge to study the relationships between these constructs and optimize anti-stigma interventions.Disclosure of InterestNone Declared
Integrating Artificial Intelligence with Quality by Design in the Formulation of Lecithin/Chitosan Nanoparticles of a Poorly Water-Soluble Drug
Authors: Dawoud Marwa H. S. , Mannaa Islam S. , Abdel-Daim Amira , Sweed Nabila M. 
Published: August 2023

AbstractThe aim of the current study is to explore the potential of artificial intelligence (AI) when integrated with Quality by Design (QbD) approach in the formulation of a poorly water-soluble drug, for its potential use in carcinoma. Silymarin is used as a model drug for its potential effectiveness in liver cancer. A detailed QbD approach was applied. The effect of the critical process parameters was studied on each of the particle size, size distribution, and entrapment efficiency. Response surface designs were applied in the screening and optimization of lecithin/chitosan nanoparticles, to obtain an optimized formula. The release rate was tested, where artificial neural network models were used to predict the % release of the drug from the optimized formula at different time intervals. The optimized formula was tested for its cytotoxicity. A design space was established, with an optimized formula having a molar ratio of 18.33:1 lecithin:chitosan and 38.35 mg silymarin. This resulted in nanoparticles with a size of 161 nm, a polydispersity index of 0.2, and an entrapment efficiency of 97%. The optimized formula showed a zeta potential of +38 mV, with well-developed spherical particles. AI successfully showed high prediction ability of the drug’s release rate. The optimized formula showed an enhancement in the cytotoxic effect of silymarin with a decreased IC50 compared to standard silymarin. Lecithin/chitosan nanoparticles were successfully formulated, with deep process and product understanding. Several tools were used as AI which could shift pharmaceutical formulations from experience-dependent studies to data-driven methodologies in the future.
Graphical abstract
Systematic Review—Type B Insulin Resistance With Isolated Hypoglycemia and Suppressed Insulin
Authors: Brown Natasha , Elston Marianne S 
Published: August 2023

Abstract

Objective
Type B insulin resistance syndrome is a rare autoimmune disorder affecting glucose homeostasis, characterized by serum autoantibodies to the insulin receptor (AIRAbs). Patients typically present with severe insulin resistance. A mixed hyper- and hypoglycemia phenotype may also occur, as may isolated hypoglycemia. The classic biochemical pattern comprises elevated insulin levels despite hypoglycemia; however, a small proportion of cases demonstrate “isolated hypoglycemia with low insulin.” The primary objectives of this systematic review were to identify the clinical characteristics and outcome of this subgroup.

Design
Systematic review of cases with hypoglycemia with suppressed insulin. Exclusions: hyperglycemia, elevated insulin, AIRAbs not confirmed.

Methods
PubMed, Medline, and Embase databases were searched up until February 2023 and complemented by manual citation search. The Joanna Briggs Institute critical appraisal checklist for case reports was used to assess bias.

Results
A total of 5342 articles were identified after duplicate removal. Eleven, all case reports, met all inclusion criteria and were included. Cases belonging to this subgroup were more diverse in sex, age, and ethnicity when compared with type B insulin resistance as a whole. Of the 11 cases, 3 developed lymphoma. High-dose corticosteroid therapy appeared to be effective therapy for the hypoglycemia, with often rapid response.

Conclusions
Isolated hypoglycemia with low insulin forms a rare subgroup of type B insulin resistance. These patients lack the common characteristics of hyperinsulinemic hypoglycemia and hyperglycemia/insulin resistance. Furthermore, while coexisting autoimmune disease is commonly observed, there is potentially an association with aggressive lymphoma, the onset of which may be delayed.
Serum MicroRNA-191-5p Levels in Vascular Complications of Type 1 Diabetes: The EURODIAB Prospective Complications Study
Authors: Bellini Stefania , Guarrera Simonetta , Matullo Giuseppe , Schalkwijk Casper , Stehouwer Coen D , Chaturvedi Nish , Soedamah-Muthu Sabita S , Barutta Federica , Gruden Gabriella 
Published: August 2023

AbstractContextMicroRNA-191-5p regulates key cellular processes involved in the pathogenesis of diabetic complications such as angiogenesis, extracellular matrix deposition, and inflammation. However, no data on circulating microRNA-191-5p in the chronic complications of diabetes are available.ObjectiveTo assess whether serum levels of microRNA-191-5p were associated with micro- and macrovascular disease in a large cohort of subjects with type 1 diabetes mellitus (DM1) from the EURODIAB Prospective Complication Study.Design and SettingLevels of microRNA-191-5p were measured by quantitative PCR in 420 patients with DM1 recruited as part of the cross-sectional analysis of the EURODIAB Prospective Complication Study. Cases (n = 277) were subjects with nephropathy and/or retinopathy and/or cardiovascular disease (CVD). Controls (n = 143) were patients without complications. Logistic regression analysis was performed to evaluate the potential independent association of microRNA-191-5p levels with chronic complications of diabetes.ResultsLevels of microRNA-191-5p were significantly reduced (P &lt; .001) in cases compared with controls even after adjustment for age, sex, and diabetes duration. Logistic regression analysis revealed that microRNA-191-5p was negatively associated with a 58% reduced odds ratio (OR) of chronic diabetes complications, specifically CVD, micro-macroalbuminuria, and retinopathy (OR, 0.42; 95% CI, 0.23-0.77), independent of age, sex, physical activity, educational levels, diabetes duration, glycated hemoglobin, total insulin dose, hypertension, smoking, total cholesterol, albumin excretion rate, estimated glomerular filtration rate, serum vascular cell adhesion molecule-1, and tumor necrosis factor-α. Analyses performed separately for each complication demonstrated a significant independent association with albuminuria (OR, 0.36; 95% CI, (0.18-0.75) and CVD (OR, 0.34; 95% CI, 0.16-0.70).ConclusionsIn DM1 subjects, microRNA-191-5p is inversely associated with vascular chronic complications of diabetes.
Downregulated Adipose Tissue Expression of Browning Genes With Increased Environmental Temperatures
Authors: Oliveras-Cañellas Núria , Moreno-Navarrete José María , Lorenzo Paula M , Garrido-Sánchez Lourdes , Becerril Sara , Rangel Oriol , Latorre Jèssica , de la Calle Vargas Elena , Pardo Maria , Valentí Victor , Romero-Cabrera Juan L , Oliva-Olivera Wilfredo , Silva Camilo , Diéguez Carlos , Villarroya Francesc , López Miguel , Crujeiras Ana B , Seoane Luisa-Maria , López-Miranda José , Frühbeck Gema , Tinahones Francisco José , Fernández-Real José-Manuel 
Published: August 2023

Abstract

Context
Climate change and global warming have been hypothesized to influence the increased prevalence of obesity worldwide. However, the evidence is scarce.

Objective
We aimed to investigate how outside temperature might affect adipose tissue physiology and metabolic traits.

Methods
The expression of genes involved in thermogenesis/browning and adipogenesis were evaluated (through quantitative polymerase chain reaction) in the subcutaneous adipose tissue (SAT) from 1083 individuals recruited in 5 different regions of Spain (3 in the North and 2 in the South). Plasma biochemical variables and adiponectin (enzyme-linked immunosorbent assay) were collected through standardized protocols. Mean environmental outdoor temperatures were obtained from the National Agency of Meteorology. Univariate, multivariate, and artificial intelligence analyses (Boruta algorithm) were performed.

Results
The SAT expression of genes associated with browning (UCP1, PRDM16, and CIDEA) and ADIPOQ were significantly and negatively associated with minimum, average, and maximum temperatures. The latter temperatures were also negatively associated with the expression of genes involved in adipogenesis (FASN, SLC2A4, and PLIN1). Decreased SAT expression of UCP1 and ADIPOQ messenger RNA and circulating adiponectin were observed with increasing temperatures in all individuals as a whole and within participants with obesity in univariate, multivariate, and artificial intelligence analyses. The differences remained statistically significant in individuals without type 2 diabetes and in samples collected during winter.

Conclusion
Decreased adipose tissue expression of genes involved in browning and adiponectin with increased environmental temperatures were observed. Given the North-South gradient of obesity prevalence in these same regions, the present observations could have implications for the relationship of the obesity pandemic with global warming.
Treating Primary Aldosteronism-Induced Hypertension: Novel Approaches and Future Outlooks
Authors: Mullen Nathan , Curneen James , Donlon Padraig T , Prakash Punit , Bancos Irina , Gurnell Mark , Dennedy Michael C 
Published: August 2023

Abstract
Primary aldosteronism (PA) is the most common cause of secondary hypertension and is associated with increased morbidity and mortality when compared with blood pressure–matched cases of primary hypertension. Current limitations in patient care stem from delayed recognition of the condition, limited access to key diagnostic procedures, and lack of a definitive therapy option for nonsurgical candidates. However, several recent advances have the potential to address these barriers to optimal care. From a diagnostic perspective, machine-learning algorithms have shown promise in the prediction of PA subtypes, while the development of noninvasive alternatives to adrenal vein sampling (including molecular positron emission tomography imaging) has made accurate localization of functioning adrenal nodules possible. In parallel, more selective approaches to targeting the causative aldosterone-producing adrenal adenoma/nodule (APA/APN) have emerged with the advent of partial adrenalectomy or precision ablation. Additionally, the development of novel pharmacological agents may help to mitigate off-target effects of aldosterone and improve clinical efficacy and outcomes. Here, we consider how each of these innovations might change our approach to the patient with PA, to allow more tailored investigation and treatment plans, with corresponding improvement in clinical outcomes and resource utilization, for this highly prevalent disorder.
Detection of Postpartum Hemorrhage Using Compensatory Reserve Index in Patients Undergoing Cesarean Delivery
Authors: Reppucci Marina L. , Rogerson Jonathan Seth , Pickett Kaci , Kierstead Stephanie , Nolan Margo M. , Moulton Steven L. , Wood Cristina L. 
Published: August 2023

BACKGROUND:
Postpartum hemorrhage (PPH) is the leading cause of maternal death worldwide. Early recognition and management are imperative for improved outcomes. The compensatory reserve index (CRI) is a novel physiological parameter that trends changes in intravascular volume, by continuously comparing extracted photoplethysmogram waveforms to a reference model that was derived from a human model of acute blood loss. This study sought to determine whether the CRI pattern was differential between those who do and do not experience PPH during cesarean delivery and compare these results to the American Society of Anesthesiologists (ASA) standards for noninvasive monitoring.

METHODS:
Parturients undergoing cesarean delivery were enrolled between February 2020 and May 2021. A noninvasive CRI monitor was applied to collect continuous CRI values throughout the intraoperative and immediate postpartum periods. Patients were stratified based on blood loss into PPH versus non-PPH groups. PPH was defined as a quantitative blood loss >1000 mL. Function-on-scalar (FoS) regression was used to compare trends in CRI between groups (PPH versus non-PPH) during the 10 to 60-minute window after delivery. Two subanalyses excluding patients who received general anesthesia and preeclamptics were performed.

RESULTS:
Fifty-one patients were enrolled in the study. Thirteen (25.5%) patients experienced PPH. Pregnant patients who experienced PPH had, on average, lower postdelivery CRI values (−0.13; 95% CI, −0.13 to −0.12; P < .001) than those who did not experience PPH. This persisted even when adjusting for preeclampsia and administration of uterotonics. The average mean arterial pressure (MAP) measurements were not statistically significant (−1.67; 95% CI, −3.57 to 0.22; P = .09). Similar trends were seen when excluding patients who underwent general anesthesia. When excluding preeclamptics, CRI values remained lower in those who hemorrhaged (−0.18; 95% CI, −0.19 to −0.17; P < .001).

CONCLUSIONS:
CRI detects changes in central volume status not distinguished by MAP. It has the potential to serve as a continuous, informative metric, notifying providers of acute changes in central volume status due to PPH during cesarean delivery.
Muhammad Shahrur's millenial interpretation of women’s issues
Authors: Herlambang Saifuddin 
Published: August 2023

Background: This study examines Muhammad Shahrur's theory of limits and women’s issues. This theory adjusts the muhkamat verses to remain relevant to sociocultural conditions while remining within the jurisdiction of Allah SWT. Shahrur's approach conveyed women as different from traditional ulema, and controversial. Therefore, it is necessary to describe Shahrur's theory and interpretation on women issues. Methods: This was an exploratory bibliographic study using descriptive-hermeneutic analysis. Two of Shahrur's books were selected and five chapters from Al-Kitāb wa Al-Qur’ān, Qirā’ah Mu’āshirah and five chapters from Nahw Ushūl al-Jadīdah Li al-Fiqh al-Islāmy; Fiqh al-Mar'ah . Results: Shahrur’s interpretations on women issues are: a) relationships between teenagers of the opposite sex without marriage or living together is "halal" if it follows their will, without a contract, being accompanied by syecih or permission, b) The maximum limit of hijab is to cover the entire body except the face and palms. In contrast, the minimum limit covers the juyūb, including cleavage under the armpits, body parts, genitals, and buttocks. Apart from these, it does not include intimate parts and adapts to the community. c) women's intimate parts are shown only to the seven groups; brothers, fathers, children of a sibling, parents of one's wives and their children, d) Polygamy has both an upper limit and lower limit. Shahrur allows polygamy under two conditions: widows with children whose husbands left them to protect them, polygamy has two limitations, limit for quantity and limit for quality, e) the law of adultery has a lower and upper limit.  Conclusion: According to Shahrur, women's issues are divided into four limits, sometimes they are at the upper limit and sometimes at the lower limit. Shahrur's linguistic approach finally led him to draw a conclusion that the product of Islamic law is highly dependent on the sociocultural context.