bluuebunny/crossref_metadata_2025_split huggingface dataset:
“Frustrated with the whole system”: a qualitative framework analysis of the issues faced by people accessing health services for chronic pain
Authors: Hopkins Ria E. , Degenhardt Louisa , Campbell Gabrielle , Farnbach Sara , Gisev Natasa 
Published: December 2022

Abstract
Background
Chronic non-cancer pain (CNCP) is complex and often requires multimodal management comprising of both pharmacological and non-pharmacological treatments. To inform delivery of CNCP management, it is important to understand how current health services providing non-pharmacological treatments are accessed by exploring the experiences of people attempting to access services. In doing so, this study sought to explore the underlying drivers of service access barriers.

Methods
This study explored the experiences of Australians accessing services for CNCP using semi-structured telephone interviews undertaken between 01 October 2020 and 31 March 2021. Thematic analysis was guided by Levesque et al.’s 2013 conceptual framework of access to health care, with emerging themes mapped to five dimensions of accessibility and corresponding abilities of consumers: Approachability/Ability to perceive; Acceptability/Ability to seek; Availability and Accommodation/Ability to reach; Affordability/Ability to pay; and Appropriateness/Ability to engage.

Results
The 26 participants (aged 24–78 years, 22 female) reported accessing a range of services including general practitioners (GP), allied health services, and specialised pain clinics, for a variety of conditions. Three themes were mapped to accessibility dimensions (in brackets): ‘GP as guide or gatekeeper’ (Approachability); ‘Outside of my control’ (Availability and Accommodation; Affordability); and ‘Services aren’t always good enough’ (Appropriateness). A fourth identified theme illustrated how participants responded to encountering these barriers: ‘Leading my own pain management’. Participant experiences suggest problems with the translation of contemporary pain management principles into practice, including continued application of biomedical health models as opposed to the biopsychosocial model, and demonstrate systemic issues with service delivery, including a lack of benchmarking of specialised services.

Conclusions
The identified themes highlight several evidence-to-practice gaps in the delivery of health services for people with CNCP in Australia. To address these gaps, there is a need for improved clinician training, increased investment in specialised pain services, and development of clear primary care pathways for CNCP management for evidence-based multimodal pain management to be accessible and equitable.
High-density lipoprotein subclasses and cardiovascular disease and mortality in type 2 diabetes: analysis from the Hong Kong Diabetes Biobank
Authors: Jin Qiao , Lau Eric S. H. , Luk Andrea O. , Tam Claudia H. T. , Ozaki Risa , Lim Cadmon K. P. , Wu Hongjiang , Chow Elaine Y. K. , Kong Alice P. S. , Lee Heung Man , Fan Baoqi , Ng Alex C. W. , Jiang Guozhi , Lee Ka Fai , Siu Shing Chung , Hui Grace , Tsang Chiu Chi , Lau Kam Piu , Leung Jenny Y. , Tsang Man-wo , Cheung Elaine Y. N. , Kam Grace , Lau Ip Tim , Li June K. , Yeung Vincent T. , Lau Emmy , Lo Stanley , Fung Samuel , Cheng Yuk Lun , Chow Chun Chung , Yu Weichuan , Tsui Stephen K. W. , Huang Yu , Lan Hui-yao , Szeto Cheuk Chun , So Wing Yee , Jenkins Alicia J. , Chan Juliana C. N. , Ma Ronald C. W. ,   the Hong Kong Diabetes Biobank Study Group
Published: December 2022

Abstract
Objective
High-density lipoproteins (HDL) comprise particles of different size, density and composition and their vasoprotective functions may differ. Diabetes modifies the composition and function of HDL. We assessed associations of HDL size-based subclasses with incident cardiovascular disease (CVD) and mortality and their prognostic utility.

Research design and methods
HDL subclasses by nuclear magnetic resonance spectroscopy were determined in sera from 1991 fasted adults with type 2 diabetes (T2D) consecutively recruited from March 2014 to February 2015 in Hong Kong. HDL was divided into small, medium, large and very large subclasses. Associations (per SD increment) with outcomes were evaluated using multivariate Cox proportional hazards models. C-statistic, integrated discrimination index (IDI), and categorial and continuous net reclassification improvement (NRI) were used to assess predictive value.

Results
Over median (IQR) 5.2 (5.0–5.4) years, 125 participants developed incident CVD and 90 participants died. Small HDL particles (HDL-P) were inversely associated with incident CVD [hazard ratio (HR) 0.65 (95% CI 0.52, 0.81)] and all-cause mortality [0.47 (0.38, 0.59)] (false discovery rate < 0.05). Very large HDL-P were positively associated with all-cause mortality [1.75 (1.19, 2.58)]. Small HDL-P improved prediction of mortality [C-statistic 0.034 (0.013, 0.055), IDI 0.052 (0.014, 0.103), categorical NRI 0.156 (0.006, 0.252), and continuous NRI 0.571 (0.246, 0.851)] and CVD [IDI 0.017 (0.003, 0.038) and continuous NRI 0.282 (0.088, 0.486)] over the RECODe model.

Conclusion
Small HDL-P were inversely associated with incident CVD and all-cause mortality and improved risk stratification for adverse outcomes in people with T2D. HDL-P may be used as markers for residual risk in people with T2D.
Cucurbitacins as potential anticancer agents: new insights on molecular mechanisms
Authors: Varela Carla , Melim Catarina , Neves Beatriz G. , Sharifi-Rad Javad , Calina Daniela , Mamurova Assem , Cabral Célia 
Published: December 2022

AbstractSince ancient times, plants have been an extensive reservoir of bioactive compounds with therapeutic interest for new drug development and clinical application. Cucurbitacins are a compelling example of these drug leads, primarily present in the plant kingdom, especially in the Cucurbitaceae family. However, these natural compounds are also known in several genera within other plant families. Beyond the Cucurbitaceae family, they are also present in other plant families, as well as in some fungi and one shell-less marine mollusc. Despite the natural abundance of cucurbitacins in different natural species, their obtaining and isolation is limited, as a result, an increase in their chemical synthesis has been developed by researchers. Data on cucurbitacins and their anticancer activities were collected from databases such as PubMed/MedLine, TRIP database, Web of Science, Google Scholar, and ScienceDirect and the information was arranged sequentially for a better understanding of the antitumor potential. The results of the studies showed that cucurbitacins have significant biological activities, such as anti-inflammatory, antioxidant, antimalarial, antimicrobial, hepatoprotective and antitumor potential. In conclusion, there are several studies, both in vitro and in vivo reporting this important anticancer/chemopreventive potential; hence a comprehensive review on this topic is recommended for future clinical research.
Clinicopathological features and genomic profiles of a group of secretory breast carcinomas in which progressive cases have more complex genomic features
Authors: Lei Ting , Yang Yuyan , Shi Yongqiang , Deng Xu , Peng Yan , Wang Hui , Chen Tongbing 
Published: December 2022

AbstractBackgroundSecretory breast carcinoma (SBC) is a rare malignant breast neoplasm with distinct histological features, including solid, microcystic, tubular, and rarely papillary structures, traditionally characterized by a t (12;15) (p13:q25) translocation, which usually leads toETV6-NTRK3fusion, suggesting an early event in tumorigenesis. Due to the rarity of this disease, very few genome sequencing studies have been performed on a series of cases, especially progressive cases.MethodsSeven lesions from 5 patients diagnosed at the Third Affiliated Hospital of Soochow University from 2007 to 2021 were included. Clinicopathological features and prognosis/survival data were collected. Next-generation DNA sequencing was performed on six of the seven lesions.ResultsIn total, 3/7 (42.9%) lesions demonstrated estrogen receptor (ER) expression, including weak, moderate to strong staining, and no lesion demonstrated progesterone receptor (PR) expression. There were no cases of human epidermal growth factor (HER2) overexpression, and the Ki-67 index was low. S-100 and pan-TRK protein were diffusely positively expressed in all cases. All lesions were characterized by a t(12;15) (p13:q25) translocation, leading toETV6-NTRK3fusion confirmed by fluorescence in situ hybridization (FISH). The sequencing results showed thatETV6-NTRK3fusion was the main driver of early tumorigenesis, while SBC with invasive biological behavior had more complex genomic variation in whichTERTpromoter mutation was detected.ConclusionsImmunohistochemical staining of a biomarker panel, including ER, PR, HER2, Ki-67, S-100 and pan-TRK, can be used as an auxiliary diagnostic tool, and FISH detection can be used as a diagnostic tool.ETV6-NTRK3gene fusion involving multiple sites may drive tumorigenesis, while mutations in theTERTpromoter region may be a factor driving tumor progression.
Isolation, bioassay and 3D-QSAR analysis of 8-isopentenyl flavonoids from Epimedium sagittatum maxim. as PDE5A inhibitors
Authors: Li Juntao , Wu Yue , Yu Xinxin , Zheng Xinyu , Xian Jiechen , Li Senjie , Shi Wanyin , Tang Yun , Chen Zhe-Sheng , Liu Guixia , Yao Shen , Xu Jian , Zheng Xiangwei 
Published: December 2022

Abstract
Background
As known, inhibition of phosphodiesterase 5 (PDE5) has the therapeutic effect on male erectile dysfunction (ED), and the processed folium of Epimedium sagittatum Maxim. (PFES) characterized by 8-isopentenyl flavonoids is a famous herb for treating ED. However, the main flavonoids inhibitory activities, structure–activity relationship (SAR) and signaling pathway have been not systematically studied so that its pharmacodynamic mechanism is unclear.

Methods
We aimed to initially reveal the PFES efficacy mechanism for treating ED. For the first time, 6 main 8-isopentenyl flavonoids (1–6) from PFES were isolated and identified. Then based on HPLC detection, we proposed a novel method to screen inhibitors among them. We further analyze the three-dimensional quantitative structure–activity relationship (3D-QSAR) for those inhibitors.

Results
The results were verified by cellular effects of the screened flavonoids. Among 6 compounds, Icariin: (1), 2-Oʹʹrhamnosylicaridide II (2) and Baohuoside I (3) were identified with significant activities (IC50 = 8.275, 3.233, 5.473 μM). Then 3D-QSAR studies showed that the replacement of C8 with bulky steric groups as isopentenyl, C3 with positive charge groups and C4' with a hydrogen bond acceptor substituent could increase inhibitory effects. In contrast, the substitution of C7 with bulky steric groups or hydrophilic groups tended to decrease the efficacies. And compounds 1, 2, 3 could increase cGMP level and decrease cytoplasmic Ca2+ of rat corpus cavernosum smooth muscle cells (CCSMCs)by activating PKG.

Conclusion
8-isopentenyl flavonoids could be the main pharmacodynamic substances of PFES in the treatment for ED, and some had significant PDE5A1 inhibitory activities so as to activate cGMP/PKG/Ca2+ signaling pathway in CCSMCs, that was related to the substituents at the key sites such as C8, C3, C4ʹ and C7 in the characteristic compounds.
Internalized stigma and associated factors among people with mental illness at University of Gondar Comprehensive Specialized Hospital, Northwest, Ethiopia, 2021
Authors: Sori Lamesa Melese , Sema Faisel Dula , Tekle Masho Tigabe 
Published: December 2022

Abstract
Background
Internalized stigma has been found to be high among people with mental illness (PWMI) and it results in poor treatment outcome, increased disability and high economic burden. So, this study was designed to determine the prevalence and associated factors of high internalized stigma among PWMI attending psychiatric follow-up at University of Gondar Comprehensive Specialized Hospital, Northwest, Ethiopia, 2021.

Methods
A cross-sectional study was conducted among PWMI (n = 365), and internalized stigma was measured by using internalized stigma of mental illness 29 (ISMI-29) scale. The data was entered in to EPI DATA software (4.6.0.2) and analyzed by Statistical Package for Social Sciences version 20. A binary logistic regression was used to identify factors associated with internalized stigma and reported with 95% confidence interval (CI). P-value < 0.05 was considered as statistically significant.

Results
The prevalence of high internalized stigma was found to be 27.9% (95% CI 23.1–32.6). A male gender (AOR = 0.332; 95% CI 0.175–0.629), occupation, specifically government employee (AOR = 0.309; 95% CI 0.118–0.809), life time substance use (AOR = 3.561; 95% CI 1.867–6.793), low self-esteem (AOR = 8.313; 95% CI 3.641–18.977), and history of hospitalization (AOR = 4.236; 95% CI 1.875, 9.570) were factors significantly associated with higher internalized stigma.

Conclusion
The result of this study showed that there was an intermediate prevalence of high internalized stigma among PWMI at University of Gondar Comprehensive Specialized Hospital. The hospital needs to take immediate action to fight internalized stigma by focusing on females, people with low self-esteem, individuals with history of lifetime substance use, and people who have history of hospital admission.
Joint antenna selection and waveform design for coexistence of MIMO radar and communications
Authors: Zhang Xuan , Wang Xiangrong , Wang Xianghua 
Published: December 2022

AbstractAs the problem of spectral congestion is becoming severe, the coexistence between two primary spectrum users, radar and communications, has spurred extensive research interest. To reduce the mutual interferences between the two functions, MIMO radar waveform design needs to consider the compatibility in both spectral and spatial domains, where the former is achieved by null forming in the frequency domain and the latter is achieved by shaped beampattern synthesis. Additionally, high power efficiency and low system overhead are two desirable characteristics for MIMO radar system design. To this end, we first introduce a new realistic waveform constraint, peak-to-valley-power-ratio (PVPR) constraint per antenna to improve the power efficiency. Then, combined with PVPR constraint, we propose a switchable individual antenna power control scheme to jointly optimize waveforms and antenna locations. We adopt a max–min beampattern matching criterion and impose the $$\ell _{2,1}$$

ℓ

2
,
1

-norm penalty on the waveform matrix to promote the sparsity of the array. To solve the resultant non-smooth and non-convex problem, we develop a modified alternating directions method of multipliers, where a surrogate subproblem over primal variables is solved instead of the original problem, and its local convergence is analyzed. Finally, numerical experiments demonstrate the effectiveness and superiority of the proposed method over counterparts, especially obtaining the lowest sidelobe level and deeper spectral nulls using much fewer antennas.
Real-life Data on the Effect of Medical Therapy for Amiodarone-induced Thyrotoxicosis on CV Events and Hospitalizations
Authors: Cappellani Daniele , Marconcini Giulia , Manetti Luca , Bartalena Luigi , Bogazzi Fausto 
Published: December 2022

Abstract

Context
Patients with amiodarone-induced thyrotoxicosis (AIT) often receive initial therapy for thyrotoxicosis in several different medical settings before admission to a referral center.

Objective
This work aimed to determine whether first-line medical therapy (ie, therapies for thyrotoxicosis at first diagnosis of AIT) affects the outcome of AIT patients.

Methods
A single-center historical-prospective cohort study was conducted on 313 AIT patients. Clinical and biochemical data were collected at first diagnosis, at a referral center, and during the course of AIT. Primary outcomes were cardiovascular (CV) events and hospitalizations. First-line therapies were considered appropriate when they included glucocorticoids for type 2 AIT and methimazole for type 1 AIT at the approved dose, either alone (optimal medical therapy, OMT) or in combination (right-dose combination therapy, RCT). Other therapies were considered not appropriate, including no therapy. Duration of exposure to thyrotoxicosis was the time from first diagnosis of AIT to its remission.

Results
A total of 34.5% patients received appropriate therapies (28.1% OMT, 6.4% RCT), whereas the remaining (65.5%) received inappropriate therapies. CV events and hospitalizations were more frequent in patients who received inappropriate therapies (33.2% vs 4.5%, and 24.9% vs 6.5%, respectively; P &lt; .0001 for both). Appropriate therapies reduced serum thyroid hormone concentrations (P = .018) from first diagnosis to referral, unlike the inappropriate therapies. The duration of exposure to thyrotoxicosis was longer in patients receiving inappropriate therapies and was a risk factor for arrhythmias (hazard ratio [HR] 1.004; P = .0008), major acute CV events (HR 1.004; P = .020), and hospitalizations (HR 1.006; P &lt; .0001).

Conclusion
The first medical therapy of AIT influences the exposure time to thyrotoxicosis and the occurrence of CV events and hospitalizations.
Changing Patterns in the Distribution of Skin Lesions of Scabies during the COVID -19 Pandemic – A Cross-Sectional Observational Study
Authors: Chanchal Chauhan  , Praveen Kumar Rathore  , Aarzoo Pahwa  
Published: December 2022

BACKGROUND
An ectoparasitic disease, scabies, caused by the mite Sarcoptes scabiei var hominis. Some of the predisposing factors are overcrowding, unhygienic surroundings, immunocompromised status, dementia, homelessness, and sexual contact. In this study, we wanted to evaluate the changed distribution of lesions of scabies during pandemic.
METHODS
A cross sectional study was performed on 600 patients attending the skin department of our tertiary care hospital over a period of 6 months. The sites of the scabies lesions were noted along with types of lesions. Demographic data and history of regular hand washing and sanitization were also documented.
RESULTS
Our study revealed an important correlation between change in pattern of distribution of scabies lesions from being less frequent on finger webs (19 %) to being more frequent on abdomen (periumbilical area) (73 %) and groins (67 %) due to regular hand washing and frequent sanitization, in this pandemic era.
CONCLUSIONS
A significant change in distribution of skin lesions in scabies can be noticed during this COVID-19 pandemic.
A Comparison of Air-Q and I-Gel in Terms of Insertion Conditions and as Intubating Aids for Elective Surgeries under General Anaesthesia
Authors: Babita Ramdev  , Heena Goyal  , Dinesh Kumar Sharma  , Archit Sharma  
Published: December 2022

BACKGROUND
Supraglottic airway devices (SAD) like air Q and I-Gel are widely used in place of tracheal intubation for general anaesthesia. The present study was undertaken to compare the insertion conditions of these two supraglottic airway devices and as conduits for endotracheal tube (ETT) insertion in adult patients undergoing elective surgeries.
METHODS
100 patients belonging to American Society of Anaesthesiologists (ASA) grade 1 and 2 between 18 to 70 years were randomly divided into 2 groups of 50 each. In group A, Air-Q was used and in group B, I-gel. The following parameters were compared while inserting SAD and endotracheal tube (ETT): number of insertion attempts, insertion time, ease of insertion, intraoperative and postoperative complications.
RESULTS
Insertion in first attempt was 90 % in air- Q and 72 % in I-gel. The mean time of insertion for air-Q was 7.28 1.46 seconds which was shorter as compared to I-gel which was 8.46 2.18 seconds (p = 0.002). Air Q was easy to insert in 93 % cases and I-Gel in 52 % cases. ETT insertion through Air-Q was easy when compared to I-Gel .Complications occurred in some patients in both the groups.
CONCLUSIONS
We concluded that Air-Q has better efficacy than I-gel in terms of insertion conditions and as a conduit for endotracheal intubation.
INTERVENÇÃO FARMACÊUTICA PARA ORIENTAÇÃO DE PACIENTES ASMÁTICOS EM UMA UNIDADE DE SAÚDE DA FAMÍLIA EM SANTA MARIA, DISTRITO FEDERAL, BRASIL: UM RELATO DE EXPERIÊNCIA
Authors: Almeida dos Santos Giselly , Leite Meira Kaic , Pereira Santos Raissa , Vaz Machado Alexandre 
Published: December 2022

Ações educativas, cuidados ambientais e tratamento farmacológico são condutas necessárias ao tratamento da asma. O objetivo deste trabalho foi aplicar técnica que ajude a compreensão de asmáticos quanto ao uso dos medicamentos. Trata-se de um relato de experiência, realizado em uma Unidade Básica de Saúde em Santa Maria, Distrito Federal, de março a agosto de 2022, no qual o Arco de Maguerez foi o instrumento metodológico. Foram desenvolvidas etapas de estudo, sendo a primeira, a observação da realidade, identificando a dificuldade de entendimento de pacientes sobre o uso dos antiasmáticos. Na segunda etapa, foram elencados os pontos-chave para o problema, sendo o principal, a falta de informação desde a consulta com o profissional de saúde até a dispensação do medicamento. As etapas anteriores foram teorizadas durante a terceira etapa do estudo. A produção de um folder educativo, a organização de um fluxo de atendimento, a educação continuada dos técnicos da farmácia e o matriciamento dos prescritores foram hipóteses de soluções avaliadas na quarta etapa. Por fim, na última etapa, foi preparado um folder com as principais informações para uso correto de antiasmáticos e seus dispositivos. Dessa forma, a solução escolhida é uma intervenção farmacêutica capaz de auxiliar o paciente em uma farmacoterapia racional.
Strengthening Individual Resilience Through Self-Reliance Building Programs on Prisons
Authors: Herwina Wiwin , Nurlaila Nurlaila , Hamdan Ahmad 
Published: December 2022

Individual resilience is an important ability that must be possessed by assisted residents to respond adaptively to the difficulties they experience while in prison and when leaving prison. The purpose of this study is to explore how the individual resilience of the assisted residents is strengthened through an independence coaching program carried out at the Tasikmalaya City Class IIB Prison. This research uses a descriptive method with a qualitative approach. The sample determination technique is carried out using purpossive sampling techniques. Data collection techniques are carried out through field observations, in-depth interviews, and documentation studies. The results showed that strengthening individual resilience through self-reliance development programs implemented in prisons has an impact on the stronger level of trust, spirituality, internal control and external control. Meanwhile, in the context of self-efficacy and self-esteem, it has not been seen as prominent in strengthening the individual resilience of the fostered residents.
On $A$-statistical convergence and $A$-statistical Cauchy via idea
Authors: Edely O.H. , Mursaleen M. 
Published: December 2022

In [Analysis 1985, 5 (4), 301-313], J.A. Fridy proved an equivalence relation between statistical convergence and statistical Cauchy sequence. In this paper, we define $A^{I^{\ast }}$-statistical convergence and find under certain conditions, that it is equivalent to $A^{I}$-statistical convergence defined in [Appl. Math. Lett. 2012, 25 (4), 733-738]. Moreover, we define $A^{I}$- and $A^{I^{\ast }}$-statistical Cauchy sequences and find some equivalent relation with $A^{I}$- and $A^{I^{\ast }}$-statistical convergence.
Cracking Codes With Confidence: Coding for the Primary Care Pediatrician
Authors:   American Academy of Pediatrics
Published: December 2022

Included in this article are tips for coding and reporting primary care services, including the following:
Preventive medicine visits and other preventive services Office and other outpatient evaluation and management (E/M) services General tips for appropriate coding and documentation
Please use your Current Procedural Terminology (CPT®) reference for full code descriptors and reporting instructions beyond those discussed in this article.