bluuebunny/crossref_metadata_2025_split huggingface dataset:
The burden of caregivers of schizophrenia outpatients during the COVID-19 pandemic: A same-sample comparison with the pre-pandemic burden
Authors: Di Sarno Elaine , Louzã Mario Rodrigues 
Published: February 2023

Background: The coronavirus disease 2019 (COVID-19) has affected the vulnerable Brazilian population. In this study, we investigated the burden of COVID-19 on caregivers for patients with schizophrenia. Objective: This study assessed objective and subjective burden of caregivers for patients with schizophrenia during the COVID-19 pandemic and compared the measurements obtained in the study to that before the pandemic. Methods: The study included 50 caregivers who were assessed using the Sociodemographic Questionnaire, and the Family Burden Interview Schedule, Brazilian version (FBIS-BR). An adaptation of the Clinical Global Impression-Improvement (CGI-I) was made, in which caregivers evaluated their ‘clinical’ impression about the patient during the COVID-19 pandemic in comparison to pre-pandemic mental status. Results: Most caregivers were female, aged between 24 and 80 years, who were in contact with the patient for about 88.56 hours/week. In relation to caregiver burden, there was a significant increase in the total subjective burden ( p < .001), but not in the total objective burden. The following subjective domains of the burden showed a significant increase: assistance in daily life ( p < .001) and worries about patients’ present and future life ( p = .033). There was a decrease in the objective burden related to supervision of patients’ problematic behaviors ( p = .031). Although the caregiver’s income did not change significantly during the COVID-19 pandemic, there was an increase in the percentage of caregivers who perceived the frequency of financial burden imposed by the patient as ‘very frequent’ and ‘always or almost always’; conversely there was a significant decrease in the subjective perception of the caregiver that the patient imposed financially ‘no burden’ or a ‘seldom burden’ (from 34% to 4%). Conclusion: Although the objective burden of the caregivers, during the pandemic, was similar the pre-pandemic levels, caregivers’ subjective burden increased reinforcing the need for special attention to the caregiver in this global emergency.
The Moderating Role of Self-Rated Oral Health on the Association Between Oral Health Status and Subjective Well-Being: Findings From Chinese Older Adults in Hawaiʻi and Taiwan
Authors: Zhang Keqing , Wu Bei , Tsay Ruey-Ming , Wu Li-Hsueh , Zhang Wei 
Published: February 2023

This paper aims to address the research questions of whether individual’s oral health status is associated with subjective well-being, as well as if there is possible moderating role of self-rated oral health among two groups of Chinese older adults (≥55 years old) in Honolulu, Hawaiʻi and Taichung, Taiwan. Using survey data collected in 2018 ( N = 430, Honolulu) and in 2017 ( N = 645, Taichung), ordinary least square regressions were applied. Results showed that, for both samples, oral health status was negatively and significantly associated with subjective well-being, and both associations were moderated by self-rated oral health. In addition, the moderating effects were more salient for the Honolulu sample, who enjoyed higher levels of self-rated oral health and life satisfaction. These results suggest the significant associations of both oral health status and self-rated oral health on individual health and well-being for Chinese older adults residing in different cultural contexts.
Wade in the waters! A critical reflection of supervision: The perspective of a Dramatherapist of African Caribbean decent
Authors: Williams Clancy 
Published: February 2023

Until the lion learns to tell their side of the story, the hunter will always be glorified! Zimbabwean proverb! The lion’s recount of its history will always read different to that of the hunter; one thing that I have learnt over the years of my engagement with Dramatherapy and its clinical therapies, frameworks and practices rooted in historical Eurocentric psychologies, ideologies and practices predominantly based on the notion of ‘whiteness and all offshoots of that whiteness being ‘right’. Black therefore, is deemed as ‘other’ and all offshoots of that ‘other’ and Black ‘being inferior’. It would make perfect sense that one day I would, ‘affi mek sense owta dis yah nonsense!’ (Caribbean Proverb: you have to make sense out of this here nonsense), if I was going to remain safe and sane throughout my journey as a Clinical Supervisor and practitioner. I had been asked for many years to consider becoming a Clinical Supervisor, but the thought of re-entering any educational institution filled me with dread. However, if I was going to help the many students, supervisees and clients; particularly from African and African Caribbean heritage to gain a sense of identity and perspective in relation to their own negative experiences within institutions, then I was going to have to decide to use this opportunity to give voice to the challenges I encountered. With the support of my own Clinical supervisor and the lecturers on the Diploma in African Centred Psychology and African Psychotherapeutic Practice, I took courage as I began to tell my side of my story from being trained, practicing and becoming a Clinical Supervisor.
Estimating glucocorticoid-related morbidity in lupus nephritis using the glucocorticoid toxicity index
Authors: Usiskin Ilana M , Kyttaris Vasileios C 
Published: February 2023

Objective Lupus nephritis (LN) is often treated with high doses of glucocorticoids (GCs). The glucocorticoid toxicity index (GTI) was developed by expert consensus to quantify GC toxicity. To date, the GTI has not been shown to correlate with GC exposure in patients with LN. Methods We performed a retrospective cohort study of patients with biopsy-confirmed LN between 2006 and 2016. Cumulative GC exposure and GTI scores were determined via medical record review. Both the aggregate improvement score (GTI-AIS) and the cumulative worsening score (GTI-CWS) were calculated. We performed linear regression to determine the association between GC exposure and GTI scores at 1 year and 5 years following kidney biopsy. Results This study included 49 patients with a mean age of 33.3 (SD 9.5) years. Mean GC exposure was 23.0 mg prednisone-equivalents per day through year 1 and 9.9 mg prednisone-equivalents per day through year 5. At 5 years, higher GC exposure was associated with higher GTI-AIS ( p < 0.001) and GTI-CWS ( p = 0.002), and this association persisted in multivariate analysis adjusting for age, sex, race, induction medication, and nephritis class ( p = 0.026 for AIS, p = 0.012 for CWS). At 1 year, GC exposure was not associated with GTI scores ( p = 0.70 for AIS; p = 0.58 for CWS). Conclusion In this cohort study, the GTI was associated with cumulative steroid exposure at 5 years after diagnosis. In patients with LN, the GTI may serve as a useful outcome measure in future LN trials evaluating the steroid sparing effect of novel therapies.
Somatic symptoms associated with mental distress during the COVID-19 pandemic: a systematic review
Authors: Theocharis Andreas , Antonopoulos Victor , Christodoulou Nikos G 
Published: February 2023

Objective The primary objective of this article was to systematically review the prevalence of somatic symptoms in patients, healthcare workers and general population during the COVID-19 pandemic. The secondary objectives were to record the association between somatic symptoms and indices of mental distress and to record the qualitative characteristics of such somatic complaints. Methods Following the PRISMA methodology we systematically searched PubMed, Scopus and Google Scholar for primary research reporting on somatic symptoms in association with mental distress. We specifically sought papers reporting on bodily distress disorder, somatic symptoms disorder or medically unexplained symptoms. Results 1569 papers were retrieved, which yielded 36 relevant studies after screening. 15 studies referred to healthcare workers, 13 to general population, 5 to COVID-19 patients, 2 compared medical with non-medical professionals and 1 was studying COVID-19 patients some of which were also healthcare workers. The reported prevalence of somatic symptoms ranged from 7.4% to 67.8%. Commonly seen symptoms were shortness of breath, dyspnea, palpitations and pain in arms, legs and joints. Conclusions Our systematic review suggests that somatic symptoms are very frequent during the pandemic and are often linked to mental distress. All three population groups are affected.
Association Between Sex Hormone-Binding Globulin, Atherogenic Indices of Plasma Among Young Sedentary Males
Authors: Mohammadrezaei Ali , Mokhtari Ardekani Abnoos , Abbasalizad-Farhangi Mahdieh , Mesgari-Abbasi Mehran , Mousavi Reihaneh 
Published: February 2023

Background: Males are more likely than females to suffer from cardiovascular disease (CVD). So, sex hormones may modify these variations and affect the lipid profile. We examined the relationship between sex hormone-binding globulin (SHBG) and CVD risk factors among young males in this study. Methods: Using a cross-sectional design, we measured total testosterone, SHBG, lipids, glucose, insulin, antioxidant parameters, and anthropometric factors in 48 young males in the age range of 18 to 40 years. Atherogenic indices of plasma were calculated. In this study, a partial correlation analysis was carried out to assess the relationship between SHBG and other variables after adjustment for confounders. Results: According to the results of multivariable analyses adjusted for age and energy, SHBG had a negative correlation with total cholesterol ( r = −.454, P =.010), low-density lipoprotein cholesterol ( r = −.496, P =.005), quantitative insulin-sensitivity check index, and positive correlation with high-density lipoprotein cholesterol ( r = .463, P =.009). No significant correlation was observed between SHBG and triglycerides ( P >.05). Several atherogenic indices of plasma have a negative correlation with SHBG levels. These include Atherogenic Index of Plasma ( r = −.474, P = .006), Castelli Risk Index (CRI)1 ( r = −.581, P < .001), CRI2 ( r = −.564, P = .001), and Atherogenic Coefficient (r = −.581, P < .001). Conclusion: Among young men, high plasma SHBG was associated with reduced CVD risk factors, modified lipid profile and atherogenic ratios, and better glycemic markers. Therefore, reduced SHBG concentrations could be a prognostic marker of CVD among young sedentary males.
Short-term outcome prediction for myasthenia gravis: an explainable machine learning model
Authors: Zhong Huahua , Ruan Zhe , Yan Chong , Lv Zhiguo , Zheng Xueying , Goh Li-Ying , Xi Jianying , Song Jie , Luo Lijun , Chu Lan , Tan Song , Zhang Chao , Bu Bitao , Da Yuwei , Duan Ruisheng , Yang Huan , Luo Sushan , Chang Ting , Zhao Chongbo ,   The Pan-Yangtze River Delta Alliance for Neuromuscular Disorders (PYDAN)
Published: February 2023

Background: Myasthenia gravis (MG) is an autoimmune disease characterized by muscle weakness and fatigability. The fluctuating nature of the disease course impedes the clinical management. Objective: The purpose of the study was to establish and validate a machine learning (ML)–based model for predicting the short-term clinical outcome in MG patients with different antibody types. Methods: We studied 890 MG patients who had regular follow-ups at 11 tertiary centers in China from 1 January 2015 to 31 July 2021 (653 patients for derivation and 237 for validation). The short-term outcome was the modified post-intervention status (PIS) at a 6-month visit. A two-step variable screening was used to determine the factors for model construction and 14 ML algorithms were used for model optimisation. Results: The derivation cohort included 653 patients from Huashan hospital [age 44.24 (17.22) years, female 57.6%, generalized MG 73.5%], and the validation cohort included 237 patients from 10 independent centers [age 44.24 (17.22) years, female 55.0%, generalized MG 81.2%]. The ML model identified patients who were improved with an area under the receiver operating characteristic curve (AUC) of 0.91 [0.89–0.93], ‘Unchanged’ 0.89 [0.87–0.91], and ‘Worse’ 0.89 [0.85–0.92] in the derivation cohort, whereas identified patients who were improved with an AUC of 0.84 [0.79–0.89], ‘Unchanged’ 0.74 [0.67–0.82], and ‘Worse’ 0.79 [0.70–0.88] in the validation cohort. Both datasets presented a good calibration ability by fitting the expectation slopes. The model is finally explained by 25 simple predictors and transferred to a feasible web tool for an initial assessment. Conclusion: The explainable, ML-based predictive model can aid in forecasting the short-term outcome for MG with good accuracy in clinical practice.
Perceptions of effective policy interventions and strategies to address antibiotic misuse within primary healthcare in India: A qualitative study
Authors: Nair Mohit , Engel Nora , Zeegers Maurice P , Burza Sakib 
Published: February 2023

Objectives Antimicrobial resistance poses a major public health threat. Despite Indian retail sector antibiotic consumption per capita increasing by approximately 22% between 2008 and 2016, empirical studies that examine policy or behavioural interventions addressing antibiotic misuse in primary healthcare are scarce. Our study aimed to assess perceptions of interventions and gaps in policy and practice with respect to outpatient antibiotic misuse in India. Methods We conducted 23 semi-structured, in-depth interviews with a variety of key informants with diverse backgrounds in academia, non-government organisations, policy, advocacy, pharmacy, medicine and others. Data were charted into a framework matrix and analysed using a hybrid, inductive and deductive thematic analysis. Themes were analysed and organised according to the socio-ecological model at various levels ranging from the individual to the enabling environment. Results Key informants largely focused on the importance of adopting a structural perspective to addressing socio-ecological drivers of antibiotic misuse. There was a recognition that educational interventions targeting individual or interpersonal interactions were largely ineffective, and policy interventions should incorporate behavioural nudge interventions, improve the healthcare infrastructure and embrace task shifting to rectify staffing disparities in rural areas. Conclusions Prescription behaviour is perceived to be governed by structural issues of access and limitations in public health infrastructure that create an enabling environment for antibiotic overuse. Interventions should move beyond a clinical and individual focus on behaviour change with respect to antimicrobial resistance and aim for structural alignment between existing disease specific programs and between the informal and formal sector of healthcare delivery in India.
Multicenter Analysis of the Epidemiology of Injury Patterns and Return to Sport in Collegiate Gymnasts
Authors: Trikha Rishi , Greig Danielle E. , Shi Brendan Y. , Schroeder Grant G. , Chernoff Daniel J. , Jones Kristofer J. , Kremen Thomas J. 
Published: February 2023

Background: Gymnastics requires intense year-round upper and lower extremity strength training typically starting from an early age. As such, the injury patterns observed in these athletes may be unique. Purpose: To characterize the types of injuries and provide return-to-sport data in male and female collegiate gymnasts. Study Design: Descriptive epidemiology study. Methods: A conference-specific injury database was utilized to perform a retrospective review of injuries for male and female National Collegiate Athletic Association (NCAA) Division I gymnasts within the Pacific Coast Conference between 2017 and 2020 (N = 673 gymnasts). Injuries were stratified by anatomic location, sex, time missed, and injury diagnoses. Relative risk (RR) was used to compare results between sexes. Results: Of the 673 gymnasts, 183 (27.2%) experienced 1093 injuries during the study period. Injuries were sustained in 35 of 145 male athletes (24.1%) as compared with 148 of 528 female athletes (28.0%; RR, 0.86 [95% CI, 0.63-1.19]; P = .390). Approximately 66.1% (723/1093) of injuries occurred in a practice setting, compared with 84 of 1093 injuries (7.7%) occurring during competition. Overall, 417 of 1093 injuries (38.2%) resulted in no missed time. Shoulder injuries and elbow/arm injuries were significantly more common in male versus female athletes (RR, 1.99 [95% CI, 1.32-3.01], P = .001; and RR, 2.08 [95% CI, 1.05-4.13], P = .036, respectively). In total, 23 concussions affected 21 of 673 athletes (3.1%); 6 concussions (26.1%) resulted in the inability to return to sport during the same season. Conclusion: For the majority of musculoskeletal injuries, the gymnasts were able to return to sport during the same season. Male athletes were more likely to experience shoulder and elbow/arm injuries, likely because of sex-specific events. Concussions occurred in 3.1% of the gymnasts, highlighting the need for vigilant monitoring. This analysis of the incidence and outcomes of injuries observed in NCAA Division I gymnasts may guide injury prevention protocols as well as provide important prognostic information.
Neurocritical Patients: Review of the Scope of Nursing Diagnoses and Care in the Intensive Care Unit
Authors: Peixoto Brito Maria Luiza , Reis Macedo Luis Fernando , Siqueira Coelho Lisboa Kenya Waléria de , Santos Sales Valterlúcio dos , Lima Pinto Sarah de , Felix Silva Darly Suyane 
Published: February 2023

Objective To identify the diagnoses and nursing care for neurocritical patients in the intensive care unit. Method This is a scope review study, based on the Joanna Briggs Institute, led by the following guiding question: what are the diagnoses and nursing care for neurocritical patients in the intensive care unit? Data collection was carried out in February 2022 in a paired manner, in the following databases: EMBASE, MEDLINE, PubMed, and SCOPUS. For sample selection, the following search strategy was used: “Neurology” AND “Nursing Care” OR “Nursing Diagnosis” AND “Critical Care.” Studies were independently selected, blinded by two reviewers. Result It was possible to identify 854 studies, which after analysis by title and abstract, only 27 articles passed the eligibility, of which 10 were part of this review. Conclusion According to the analysis of the studies, it was found that nursing care, combined with a care plan for neurocritical patients, allows for better results, with a view to the quality of life and health promotion.
Lenalidomide-associated B-cell ALL: clinical and pathologic correlates and sensitivity to lenalidomide withdrawal
Authors: Geyer Mark B. , Shaffer Brian C. , Bhatnagar Bhavana , Mims Alice S. , Klein Victoria , Dilip Deepika , Glass Jacob L. , Lozanski Gerard , Hassoun Hani , Landau Heather , Zhang Yanming , Xiao Wenbin , Roshal Mikhail , Park Jae H. 
Published: February 2023

Abstract
Lenalidomide is an effective component of induction and maintenance therapy for multiple myeloma, though with a risk of secondary malignancies, including acute lymphoblastic leukemia (ALL). In contrast to therapy-related myeloid neoplasia, lenalidomide-associated lymphoblastic neoplasia remains poorly characterized. We conducted a dual institution retrospective study of 32 ALL cases that arose after lenalidomide maintenance (all B-lineage, 31/32 BCR::ABL-negative). B-cell ALL (B-ALL) was diagnosed at median 54 months (range, 5-119) after first exposure to lenalidomide and after median 42 months of cumulative lenalidomide exposure (range, 2-114). High incidence of TP53 mutations (9/19 evaluable cases) and low hypodiploidy (8/26 patients) were identified. Despite median age of 65 years and poor-risk B-ALL features observed in the cohort, rates of complete response (CR) or CR with incomplete hematologic recovery were high (25/28 patients receiving treatment). Median event-free survival was 35.4 months among treated patients (not reached among those undergoing allogeneic hematopoietic cell transplantation [HCT]). Sixteen patients remain alive without evidence of B-ALL after HCT or extended maintenance therapy. We also describe regression of B-ALL or immature B-cell populations with B-ALL immunophenotype after lenalidomide discontinuation in 5 patients, suggesting lenalidomide may drive leukemic progression even after initiation of lymphoblastic neoplasia and that lenalidomide withdrawal alone may be an appropriate first-line intervention in selected patients. Monitoring for early B-ALL–like proliferations may offer opportunities for lenalidomide withdrawal to prevent progression. Established combination chemotherapy regimens, newer surface antigen-targeted approaches, and allogeneic HCT are effective in many patients with lenalidomide-associated B-ALL and should be offered to medically fit patients.
Pulse amplitude ratio under noninvasive ventilation as a new method in the diagnosis of left heart failure in patients with acute exacerbation of chronic obstructive pulmonary disease
Authors: Bel Haj Ali Khaoula , Sekma Adel , Chamtouri Ikram , Beltaief Kaouthar , Msolli Mohamed Amine , Mezgar Zied , Bouida Wahid , Boukef Riadh , Boubaker Hamdi , Grissa Mohamed Habib , Nouira Semir 
Published: February 2023

Abstract
Background
Left heart failure (LHF) is commonly associated with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) but its role is often underestimated.

Aim of study
To evaluate the performance of a new diagnostic technique based on the measurement of the pulse amplitude ratio (PAR) using non-invasive ventilation (NIV) for the early identification LHF in patients admitted to the emergency department (ED) for AECOPD.

Results
73 patients were included in this study: 32 in LHF group and 41 in non LHF- group. The two groups had comparable demographic and clinical characteristics at admission. The mean values of PARNIV was significantly higher among LHF patients (0.86 vs. 0.71; p < 0.01). The area under the receiver operating characteristic curve of PARNIV was 0.75. Using the best cut-off (0.6), the sensitivity of PARNIV was 93% with a specificity 21%, a positive predictive value of 48%, and a negative predictive value of 81%. Correlation between PARNIV and BNP was significant (r = 0.52; p = 0.002).

Conclusion
Measurement of PARNIV in patients presenting to the ED with AECOPD had a good diagnostic performance for the detection of LHF and could represent an interesting alternative for the currently available methods.
Trial registration The study was registered in the Clinical Trial Registration System (clinicaltrials.gov) under the study number NCT05189119, https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S000BOO4&selectaction=Edit&uid=U0000QAM&ts=2&cx=qrmluh.