bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Lived Experience of Resilience in the Setting of Chronic Illness and Low-Resource Communities of African Americans That Reside in Tallahatchie County, Mississippi
Authors: Moore Tara Leigh 
Published: July 2023

Introduction Strong links can be made between chronic illness, low-resource communities, and poor health outcomes. One such area is the Mississippi Delta within the United States that has identified its residents rank the lowest in overall health indicators with high rates of chronic illness. Objective This study aimed to explore the phenomenon of resilience in the setting of chronic illness and low resourced communities to gain baseline knowledge of the topic to improve protective resilience within the community. Methods The descriptive phenomenological psychological reduction method outlined by Giorgi et al. was used based on semistructured and in-depth interviews with eight individuals (ages 33–64) who were recruited by purposive sampling through a humanitarian organization. Results Six themes of the lived experience of the participants revealed the eidetic structure and essence of the experience. The results of the study provided important implications related to the meaning of chronic illness to the individual, poor resilient risk factors, antecedents to resilience, and areas to focus on for resilience promotion. Conclusion A lifeworld perspective of the individual can help nurses develop a greater understanding in formulating interventions for resilience promotion.
Clinical Pattern and Outcome of Burn Injury in Children in AaBet Trauma Center Addis Ababa Ethiopia: Prospective Study
Authors: Mamo Sosina Tamre , Addisie Asmamaw Abebe , Heye Tigist Bacha , Tegegne Ousman Adal 
Published: July 2023

Introduction Burn injuries are among the most prevalent health conditions worldwide that happen mainly in children, military, and victims of fire accidents. The previous literature had general limitations in that it focused on the retrospective study design, which can be prone to incomplete data or lack the full evidence of the problem, however, this study is a prospective study that gives a clue to the possible determinant factors of burn injury in pediatrics. Objectives The purpose of this study was to assess the clinical pattern and outcome of burn injury in children at the AaBet trauma center in Addis Ababa, Ethiopia, between July 2016 and July 2020. Methods An institutional-based prospective study was conducted in an AaBet trauma center. The study participants were chosen using a systematic random sampling method and followed for 4 years to determine their clinical outcomes after burn injury. A pretested observational check list was used to collect the data. The collected data were coded, entered Epi-data version 4.6, and exported to SPSS version 26 for descriptive and inferential analysis. A binary logistic regression model was used to identify factors associated with burn injury on the adjusted odd ratio with a 95% confidence interval at a p-value of  < .05. Results A total of 256 patients were recruited for this study. Scald burns accounted for 50.8% of the injury mechanisms, with 93.8% of the incidents occurring in private residences. Second-degree burns were the most common presentation of the victims (83%). Lower limbs were the most frequently burned body part (47%). Over 70% of the victims had 20% of their body surface area burned. Intentional burns accounted for 1.2% of all burn victims. The length of the hospital stay ranged from 1 day to 164 days with a mean stay of 24.73 days. Eight patients (3.1%) died during the study period. Conclusion and recommendation Pediatric burn incidences showed no significant discrepancies between males and females. Scald and open flame are the common causes of burn injury. Most incidents occurred in indoor settings, and most of the victims had not received first aid at home. Most patients left the hospital with no or minimal complications. Only 3.1% of the patients died. Patients who had burn-associated injuries were 98.8% less likely to be alive than those who had no associated injuries at all. For all governmental and non-governmental bodies, it is highly recommended to give priority to preventive measures and education on the need for appropriate prehospital care.
Assessment of efficacy and safety of endoscopic lung volume reduction with one-way valves in patients with a very low FEV1
Authors: Sgarbossa Thomas , Lenga Pavlina , Stanzel Franz , Holland Angelique , Grah Christian , Gesierich Wolfgang , Gebhardt Andreas , Ficker Joachim , Eggeling Stephan , Andreas Stefan , Schmidt Bernd , Eisenmann Stephan , Schwick Björn , Franke Karl-Josef , Fertl Andreas , Witzenrath Martin , Hübner Ralf-Harto 
Published: July 2023

IntroductionEndoscopic lung volume reduction (ELVR) with one-way valves produces beneficial outcomes in patients with severe emphysema. Evidence on the efficacy remains unclear in patients with a very low forced expiratory volume in 1 s (FEV1) (≤20% predicted). We aim to compare clinical outcomes of ELVR, in relation to the FEV1restriction.MethodsAll data originated from the German Lung Emphysema Registry (Lungenemphysem Register), which is a prospective multicentric observational study for patients with severe emphysema after lung volume reduction. Two groups were formed at baseline: FEV1≤20% pred and FEV121–45% pred. Pulmonary function tests (FEV1, residual volume, partial pressure of carbon dioxide), training capacity (6-min walk distance (6MWD)), quality of life (modified Medical Research Council dyspnoea scale (mMRC), COPD Assessment Test (CAT), St George's Respiratory Questionnaire (SGRQ)) and adverse events were assessed and compared at baseline and after 3 and 6 months.Results33 patients with FEV1≤20% pred and 265 patients with FEV121–45% pred were analysed. After ELVR, an increase in FEV1was observed in both groups (both p<0.001). The mMRC and CAT scores, and 6MWD improved in both groups (all p<0.05). The SGRQ score improved significantly in the FEV121–45% pred group, and by trend in the FEV1≤20% pred group. Pneumothorax was the most frequent complication within the first 90 days in both groups (FEV1≤20% pred: 7.7%versusFEV121–45% pred: 22.1%; p=0.624). No deaths occurred in the FEV1≤20% pred group up to 6 months.ConclusionOur study highlights the potential efficacy of one-way valves, even in patients with very low FEV1, as these patients experienced significant improvements in FEV1, 6MWD and quality of life. No death was reported, suggesting a good safety profile, even in these high-risk patients.
Association between blood eosinophil count and small airway eosinophils in smokers with and without COPD
Authors: Maetani Tomoki , Tanabe Naoya , Sato Atsuyasu , Shiraishi Yusuke , Sakamoto Ryo , Ogawa Emiko , Sakai Hiroaki , Matsumoto Hisako , Sato Susumu , Date Hiroshi , Hirai Toyohiro , Muro Shigeo 
Published: July 2023

IntroductionAirway eosinophilic inflammation is a pathological feature in a subgroup of patients with COPD and in some smokers with a high COPD risk. Although blood eosinophil count is used to define eosinophilic COPD, the association between blood eosinophil count and airway eosinophilic inflammation remains controversial. This cross-sectional study tested this association in smokers with and without COPD while considering potential confounders, such as smoking status and comorbidities.MethodsLung specimens were obtained from smokers with and without COPD and non-COPD never-smokers undergoing lung lobectomy. Those with any asthma history were excluded. The infiltration of eosinophils into the small airway wall was quantified on histological sections stained with major basic protein (MBP).ResultsThe number of airway MBP-positive cells was greater in smokers (n=60) than in never-smokers (n=14). Smokers with and without COPD (n=30 each) exhibited significant associations between blood eosinophil count and airway MBP-positive cells (ρ=0.45 and 0.71). When smokers were divided into the high and low airway MBP groups based on their median value, blood eosinophil count was higher in the high-MBP group, with no difference in age, smoking status, comorbidities, emphysema or coronary artery calcification on computed tomography, and inhaled corticosteroid (ICS) use. The association between greater blood eosinophil count and the high-MBP group was confirmed in multivariable models adjusted for smoking status, airflow limitation and ICS use.ConclusionThe blood eosinophil count may reflect eosinophilic inflammation in the small airways in smokers with and without COPD.
Bayesian model averaging for predicting factors associated with length of COVID-19 hospitalization
Authors: Bahrami Shabnam , Hajian-Tilaki Karimollah , Bayani Masomeh , Chehrazi Mohammad , Mohamadi-Pirouz Zahra , Amoozadeh Abazar 
Published: July 2023

AbstractIntroductionThe length of hospital stay (LOHS) caused by COVID-19 has imposed a financial burden, and cost on the healthcare service system and a high psychological burden on patients and health workers. The purpose of this study is to adopt the Bayesian model averaging (BMA) based on linear regression models and to determine the predictors of the LOHS of COVID-19.MethodsIn this historical cohort study, from 5100 COVID-19 patients who had registered in the hospital database, 4996 patients were eligible to enter the study. The data included demographic, clinical, biomarkers, and LOHS. Factors affecting the LOHS were fitted in six models, including the stepwise method, AIC, BIC in classical linear regression models, two BMA using Occam's Window and Markov Chain Monte Carlo (MCMC) methods, and GBDT algorithm, a new method of machine learning.ResultsThe average length of hospitalization was 6.7 ± 5.7 days. In fitting classical linear models, both stepwise and AIC methods (R2 = 0.168 and adjustedR2 = 0.165) performed better than BIC (R2 = 0.160 and adjusted = 0.158). In fitting the BMA, Occam's Window model has performed better than MCMC withR2 = 0.174. The GBDT method with the value ofR2 = 0.64, has performed worse than the BMA in the testing dataset but not in the training dataset. Based on the six fitted models, hospitalized in ICU, respiratory distress, age, diabetes, CRP, PO2, WBC, AST, BUN, and NLR were associated significantly with predicting LOHS of COVID-19.ConclusionThe BMA with Occam's Window method has a better fit and better performance in predicting affecting factors on the LOHS in the testing dataset than other models.
Multidimensional interventions to increase life-space mobility in older adults ranging from nursing home residents to community-dwelling: a systematic scoping review
Authors: Seinsche Julia , Jansen Carl-Philipp , Roth Sandro , Zijlstra Wiebren , Hinrichs Timo , Giannouli Eleftheria 
Published: July 2023

Abstract
Background
Life-space mobility (LSM) is an important aspect of older adults’ real-life mobility. Studies have shown that restricted LSM is a risk factor for many adverse outcomes such as low quality of life and mortality. Therefore, an increasing number of interventions aim to enhance LSM. However, the intervention approaches differ in terms of their type/content, duration, targeted populations, but also in terms of their outcome measures and assessment tools. Especially the latter impairs the comparability of studies with otherwise similar interventional approaches and thus also the interpretation of their results. Therefore, this systematic scoping review aims to provide an overview of the intervention components, assessment tools, and effectiveness of studies aiming to improve LSM in older adults.

Methods
A systematic literature search was carried out in PubMed and Web of Science. We considered studies in older adults of any design that included an intervention approach and at least one outcome of LSM.

Results
27 studies were included in the review. These studies analyzed healthy community-dwelling as well as frail older adults in need of care or rehabilitation and nursing home residents with a mean age between 64 and 89. The percentage of female participants ranged from 3 to 100%. The types of interventions were of the following: physical, counseling, multidimensional, miscellaneous. Multidimensional interventions consisting of physical interventions plus any of the following or a combination of counseling/education/motivation/information appear to be most effective in increasing LSM. Older adults with mobility impairments were more responsive to these multidimensional interventions compared to healthy older adults. Most of the studies used the questionnaire-based Life-Space Assessment to quantify LSM.

Conclusions
This systematic scoping review provides a comprehensive overview of a heterogenous stock of literature investigating LSM-related interventions in older adults. Future meta-analyses are needed to provide a quantitative evaluation of the effectiveness of LSM interventions and recommendations.
Isolated diffuse choroidal hemangioma without systemic symptoms: a case report
Authors: Zhang Xiaohua , Hu Yongping , Li Di , Qian Xiaoxiao , Xu Yongning , Guo Man , Li Qihang 
Published: July 2023

Abstract
Background
Sturge-Weber syndrome is a nonhereditary congenital neurocutaneous syndrome characterized by a distinctive facial capillary malformation,neurological abnormalities, and ocular abnormalities such as glaucoma and choroidal hemangioma.It can be divided into different subtypes according to different clinical manifestations. It is rare for a patient to present with isolated difuse choroidal hemangioma and ipsilateral abnormal conjunctival and episcleral vessels without other systemic symptoms.

Case presentation
We report a 30-year-old man with isolated diffuse choroidal hemangioma in his right eye without systemic symptoms, such as vascular malformations in the skin or leptomeningeal angiomatosis. The only additional ophthalmic finding was ipsilateral abnormal conjunctival and episcleral vessels without glaucoma. However, there was no evidence of leptomeningeal angiomatosis or port-wine stain on the right side of the face, or glaucoma, which are common clinical manifestations of the Sturge-Weber syndrome (SWS).The absence of these characteristic symptoms did not preclude the diagnosis, and the patient could be diagnosed with a particular subtype of SWS.

Conclusions
This is a rare case of documented isolated difuse choroidal hemangioma with ipsilateral abnormal conjunctival and episcleral vessels without glaucoma which we think it is belonging to a particular subtype of SWS.In addition to the traditional clinical manifestations, more and more atypical clinical manifestations are also accompanied by SWS, which requires our clinicians to continuously discover and report, so as to help more clinicians understand this disease.
Triglyceride-glucose index and coronary artery disease: a systematic review and meta-analysis of risk, severity, and prognosis
Authors: Liang Shichu , Wang Cui , Zhang Jing , Liu Zhiyue , Bai Yanlin , Chen Zhonglan , Huang He , He Yong 
Published: July 2023

Abstract
Background
The TyG index is an indicator of insulin resistance (IR), which is associated with the development and prognosis of cardiovascular disease. This study aimed to summarize the relationship between the TyG index and the risk, severity, and prognosis of coronary artery disease (CAD) by performing a systematic review and meta-analysis.

Methods
The PubMed, EMBASE, The Cochrane Library, and Web of Science databases were searched for articles published from inception until May 1, 2023. Cross-sectional studies, retrospective or prospective cohort studies recruiting patients with CAD were included. For the analysis of CAD severity, the outcomes were coronary artery calcification, coronary artery stenosis, coronary plaque progression, multi-vessel CAD, and in-stent re-stenosis. For the analysis of CAD prognosis, the primary outcome was major adverse cardiovascular events (MACE).

Results
Forty-one studies were included in this study. Compared to patients with the lowest TyG index, those with the highest TyG index had a higher CAD risk [odds ratio (OR): 1.94, 95% confidence interval (CI) 1.20–3.14, I2 = 91%, P = 0.007]. Additionally, these patients were more likely to have stenotic coronary arteries (OR: 3.49, 95% CI 1.71–7.12, I2 = 0%, P = 0.0006), progressed plaques (OR: 1.67, 95% CI 1.28–2.19, I2 = 0%, P = 0.002), and with more vessels involved (OR: 2.33, 95% CI 1.59–3.42, I2 = 0%, P < 0.0001). When calculated as a categorized variable, it appears that acute coronary syndrome (ACS) patients with higher TyG index levels may have a higher incidence rate of MACE [hazard ratio (HR): 2.09, 95% CI 1.68–2.62, I2 = 87%, P < 0.00001], whereas chronic coronary syndrome (CCS) or stable CAD patients with higher TyG index levels showed a trend towards an increased incidence rate of MACE (HR: 1.24, 95% CI 0.96–1.60, I2 = 85%, P = 0.09). When calculated as a continuous variable, ACS patients had an HR of 2.28 per 1-unit/1-standard deviation increment of the TyG index (95% CI 1.44–3.63, I2 = 95%, P = 0.0005). Similarly, CCS or stable CAD patients had an HR of 1.49 per 1-unit/1-standard deviation increment of the TyG index (95% CI 1.21–1.83, I2 = 75%, P = 0.0001). Myocardial infarction with non-obstructive coronary arteries patients had an HR of 1.85 per 1-unit increment of the TyG index (95% CI 1.17–2.93, P = 0.008).

Conclusions
The TyG index is a simple new synthetic index that has been proven to be a valuable tool in the whole-course management of CAD patients. Patients with higher TyG index levels are at a higher risk of CAD, more severe coronary artery lesions, and worse prognosis compared to those with lower TyG index levels.
Caregiver burden in Bardet-Biedl syndrome: findings from the CARE-BBS study
Authors: Forsythe Elizabeth , Mallya Usha G. , Yang Min , Huber Caroline , Cala Mary Lynn , Greatsinger Alexandra , Hagopian Ella , Pomeroy Jeremy , Haqq Andrea M. 
Published: July 2023

Abstract
Background
Bardet-Biedl syndrome (BBS) is a rare, genetically heterogeneous obesity syndrome associated with hyperphagia. Given the early onset of BBS symptoms in childhood and multifaceted complications, this study aimed to quantify the caregiver burden associated with BBS.

Methods
A cross-sectional, multi-country survey of caregivers from the United States (US), United Kingdom (UK), Canada, and Germany was designed to quantify the extent of caregiver burden associated with obesity and hyperphagia symptoms (i.e., uncontrollable hunger) among patients with BBS.

Results
A total of 242 caregivers across the four countries met the inclusion criteria and completed the survey. The mean (standard deviation [SD]) age of the caregivers was 41.9 (6.7) years, and the mean (SD) age of individuals with BBS in their care was 12.0 (3.7) years. Hyperphagia contributed to a BBS diagnosis in 230 of 242 individuals (95.0%). On average, caregivers used eight different weight management approaches for those in their care and expressed a strong desire for more effective weight management methods. Based on the Impacts of Hyperphagia: Caregiver version, patients’ hyperphagia had a moderate-to-severe impact on caregiver mood (56.6%), sleep (46.6%), and relationships (48.0%). Caregivers reported experiencing a high level of personal strain (mean [SD], 17.1 [2.9]) and family impact (mean [SD] score, 26.0 [3.8]) due to BBS, as measured by the Revised Impact on Family Scale. Among caregivers in the workforce, there also was high impairment in total work productivity (mean [SD], 60.9% [21.4%]) due to caring for patients with BBS according to the Work Productivity and Activity Impairment. More than half (53%) of the caregivers reported spending over 5,000 out-of-pocket in local currency for medical expenses for the patient with BBS in their care.

Conclusions
Obesity and hyperphagia have negative impacts on the lives of caregivers of patients with BBS. The burden is demonstrated to be multifaceted, with various components that may interact with and confound each other, including intensive weight management efforts, productivity loses, impaired family dynamics and out-of-pocket medical expenses.
Burden of hyperphagia and obesity in Bardet–Biedl syndrome: a multicountry survey
Authors: Forsythe Elizabeth , Mallya Usha G. , Yang Min , Huber Caroline , Cala Mary Lynn , Greatsinger Alexandra , Hagopian Ella , Pomeroy Jeremy , Haqq Andrea M. 
Published: July 2023

Abstract
Background
Signs and symptoms of Bardet–Biedl syndrome (BBS) occur during early childhood, progress over time, and place substantial, multifaceted burden on patients and their caregivers. Hyperphagia may be a contributing factor to early-onset obesity in BBS; however, there are limited insights into its impacts on patients and caregivers. We quantified disease burden as it relates to the physical and emotional impacts of hyperphagia in BBS.

Methods
The CAREgiver Burden in BBS (CARE-BBS) study was a multicountry, cross-sectional survey of adult caregivers of patients with BBS who have had hyperphagia and obesity. The survey consisted of questionnaires including Symptoms of Hyperphagia, Impacts of Hyperphagia, Impact of Weight on Quality of Life (IWQOL)-Kids Parent Proxy, and Patient-Reported Outcome Measurement Information System (PROMIS) v1.0-Global Health 7. In addition, clinical characteristics, medical history, and weight management questions were included. Outcomes were scored and summarized descriptively in aggregate and by country, age, and obesity severity according to weight class.

Results
There were 242 caregivers of patients with BBS who completed the survey. Caregivers observed hyperphagic behaviors throughout the day, with negotiating for food (90%) and waking up and asking or looking for food during the night (88%) being the most frequent. Hyperphagia had at least a moderate negative impact on most patients’ mood/emotions (56%), sleep (54%), school (57%), leisure (62%), and familial relationships (51%). Hyperphagia affected concentration at school (78%), and symptoms of BBS contributed to patients missing ≥ 1 day of school a week (82%). Responses from the IWQOL-Kids Parent Proxy suggested obesity most greatly negatively affected physical comfort (mean [standard deviation (SD)], 41.7 [17.2]), body esteem (41.0 [17.8]), and social life (41.7 [18.0]). On the PROMIS questionnaire, mean (SD) global health score for pediatric patients with BBS and overweight or obesity (36.8 [10.6]) was lower than the general population (mean, 50).

Conclusions
Evidence from this study suggests that hyperphagia and obesity may have broad negative impacts on the lives of patients with BBS, including physical health, emotional well-being, school performance, and personal relationships. Therapies that target hyperphagia may alleviate the extensive clinical and nonclinical impacts experienced by patients with BBS and their caregivers.