bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stakeholders’ perspectives on the development of an Africa-focused postgraduate diploma to address public mental health training needs in Africa: a qualitative study
Authors: van der Westhuizen Claire , Richter Marlise , Kagee Ashraf , Roomaney Rizwana , Schneider Marguerite , Sorsdahl Katherine 
Published: April 2023

Abstract
Background
Despite the significant contribution of mental health conditions to the burden of disease, there is insufficient evidence from Africa to inform policy, planning and service delivery. Thus, there is a need for mental health research capacity building, led by African public mental health researchers and practitioners, to drive local research priorities. The aim of African mental health Researchers Inspired and Equipped (ARISE) was to develop a one-year postgraduate diploma (PGDip) in public mental health to address the current gaps in public mental health training.

Methods
Thirty-six individual interviews were conducted online with three groups of participants: course convenors of related PGDips in South Africa, course convenors of international public mental health degree programmes and stakeholders active in public mental health in Africa. The interviewers elicited information regarding: programme delivery, training needs in African public mental health, and experiences of facilitators, barriers and solutions to successful implementation. The transcribed interviews were analysed by two coders using thematic analysis.

Results
Participants found the Africa-focused PGDip programme acceptable with the potential to address public mental health research and operational capacity gaps in Africa. Participants provided several recommendations for the PGDip, including that: (i) the programme be guided by the principles of human rights, social justice, diversity and inclusivity; (ii) the content reflect African public mental health needs; (iii) PGDip faculty be skilled in teaching and developing material for online courses and (iv) the PGDip be designed as a fully online or blended learning programme in collaboration with learning designers.

Conclusions
The study findings provided valuable insight into how to communicate key principles and skills suited to the rapidly developing public mental health field while keeping pace with changes in higher education. The information elicited has informed curriculum design, implementation and quality improvement strategies for the new postgraduate public mental health programme.
Gender-based differences in interaction effects between childhood maltreatment and problematic mobile phone use on college students’ depression and anxiety symptoms
Authors: Zhang Yulin , Li Shuqin , Xu Huiqiong , Jin Zhengge , Li Ruoyu , Zhang Yi , Wan Yuhui 
Published: April 2023

Abstract
Background
Childhood maltreatment and problematic mobile phone use are risk factors for depression and anxiety symptoms among college students. However, how the interaction between the two factors affects depression and anxiety has yet to be validated. This study aimed to investigate the independent and interaction effects of childhood maltreatment and problematic mobile phone use on depression and anxiety among college students and explored gender-based differences in these associations.

Method
A cross-sectional study was conducted from October to December 2019. We collected data from 7623 students at two colleges in Hefei and Anqing cities in Anhui Province, China. Multinomial logistic regression models were performed to explore the associations of childhood maltreatment and problematic mobile phone use with depression and anxiety symptoms and their interaction effects on depression and anxiety symptoms.

Results
Childhood maltreatment and problematic mobile phone use were significantly associated with increased risk of depression and anxiety symptoms (P < 0.001). Moreover, following adjustments for covariates, there was a multiplicative interaction between childhood maltreatment and problematic mobile phone use on depression and anxiety symptoms (P < 0.001). Gender-based differences were also observed in the associations. For instance, depression was more common in males and male students with childhood maltreatment were at higher risk of depression-only symptoms.

Conclusion
Focusing on childhood maltreatment and problematic mobile phone use could facilitate a reduction in the occurrence of depression and anxiety symptoms in college students. Furthermore, it is necessary to develop gender-targeted intervention strategies.
Head posture mediates the association of cognition with hand grip and pinch strength in older adults: an examination using structural equation modeling
Authors: Celik Halil Ibrahim , Unver Banu , Akbas Eda , Erdem Emin Ulas 
Published: April 2023

Abstract
Background
The association of cognition with hand grip and pinch strength has been well-recognized in older adults. The authors sought to explore: (1) associations among forward head posture (FHP), cognition, and hand grip and pinch strength in older adults; and (2) the mediator role of FHP in these pathways using structural equation modeling (SEM).

Methods
This cross-sectional study included 88 older adults (70.5% male; mean age = 68.75±3.87 years). Cognition was assessed by the Mini-Mental State Examination (MMSE), head posture by the Craniovertebral Angle (CVA) obtained from photographic analysis, hand grip strength by a handheld dynamometer, and pinch strength by a pinch meter. Using the two SEMs, a potential mediator role of the CVA was investigated. While the MMSE was addressed as an independent variable in both models, hand grip and pinch strength were addressed as dependent variables in model 1 and model 2, respectively.

Results
The correlations between the CVA and MMSE (r = 0.310), hand grip strength (r = 0.370), and pinch strength (r = 0.274 to 0.292) were statistically significant (p < 0.001). In addition, significant associations were found between the MMSE and hand grip and pinch strength, ranging from 0.307 to 0.380 (p < 0.001). The mediation analysis showed that the standardized total (β = 0.41, p < 0.001) and indirect (mediated) effects (β = 0.12, p = 0.008) of the MMSE on hand grip strength were significant in model (1) The results were similar for model (2) The standardized total (β = 0.39, p = 0.001) and indirect effects (β = 0.10, p = 0.026) of the MMSE on pinch strength were significant. As a partial mediator in both models, the CVA explained 29% and 26% of the total effect in models 1 and 2, respectively.

Conclusions
The CVA was associated with the MMSE, hand grip strength, and pinch strength, and CVA partially mediates the association of the MMSE with grip and pinch strength in older adults, indicating that cognition had an effect on grip and pinch strength through an indirect path via head posture. This finding reveals that evaluating head posture and providing corrective therapeutic interventions as needed may be beneficial in reducing the negative impact of decreased cognition on motor functions in older adults.
Learning styles of medical students and related factors
Authors: Gayef Albena , Çaylan Ayşe , Temiz Selahattin Alp 
Published: April 2023

Abstract
Background
The concept of learning style is quite important for teachers to teach, organize students’ learning experiences, and accomplish educational goals. Motivation is one of the most important psychological concepts in education. Motivation is multidimensional and ranges from amotivation to extrinsic motivation and intrinsic motivation. When students are motivated extrinsically, they enjoy striving toward rewards and goals which may differ from individual goals. Intrinsically motivated students enjoy exploring, learning, and curiosity-oriented academic efforts. Understanding learning styles can make it easier to create, modify, and develop more efficient curriculum and educational programs. It can also encourage students’ participation in these programs and motivate them to gain professional knowledge This study aims to determine the learning styles of medical school students and to evaluate whether there is a relationship between their learning styles and academic motivation and the sociodemographic variables.

Methods
In this study a questionnaire containing socio-demographic factors, Grasha-Reichmann Learning Styles Scale, Academic Motivation Scale was filled out by 1st, 2nd, 3rd, 4th, and 5th -year medical students of the 2019–2020 academic year. Frequency, percentage, mean, ANOVA, Pearson correlation analysis, and independent group t-test (for analyzing data with normal distribution) were applied. Mann Whitney U test, Kruskal Wallis test, and Spearman correlation analysis were used for analyzing data without normal distribution.

Results
We found that the mean of independent learning was the highest among the learning style dimensions, and the mean of the intrinsic motivation to know (IMKN) was the highest among the academic motivation dimensions. We found that there were significant relationships between independent learning and intrinsic motivation (IM), between avoidant learning and extrinsic motivation (EM) and between collaborative learning and IMKN, IM to accomplish things (IMAT) and IM to experience stimulation (IMES).

Conclusion
We think that different teaching methods can be applied to strengthen collaborative learning, participant learning, and intrinsic motivation. We hope that this research will contribute to medical education on the subject of establishing appropriate teaching methods. Teachers have to plan and implement activities based on students’ learning styles and academic motivation to encourage students to effectively participate in the classroom.
Economic burden of acute otitis media, pneumonia, and invasive pneumococcal disease in children in the United States after the introduction of 13-valent pneumococcal conjugate vaccines during 2014–2018
Authors: Hu Tianyan , Song Yan , Done Nicolae , Mohanty Salini , Liu Qing , Sarpong Eric M. , Lemus-Wirtz Esteban , Signorovitch James , Weiss Thomas 
Published: April 2023

Abstract
Background
Streptococcus pneumoniae remains a leading cause of morbidity, mortality, and healthcare resource utilization (HRU) among children. This study quantified HRU and cost of acute otitis media (AOM), pneumonia, and invasive pneumococcal disease (IPD).

Methods
The IBM MarketScan® Commercial Claims and Encounters and Multi-State Medicaid databases from 2014 to 2018 were analyzed. Children with AOM, all-cause pneumonia, or IPD episodes were identified using diagnosis codes in inpatient and outpatient claims. HRU and costs were described for each condition in the commercial and Medicaid-insured populations. National estimates of the number of episodes and total cost ($US 2019 for each condition were extrapolated using data from the US Census Bureau.

Results
Approximately 6.2 and 5.6 million AOM episodes were identified in commercial and Medicaid-insured children, respectively, during the study period. Mean cost per AOM episode was $329 (SD $1505) for commercial and $184 (SD $1524) for Medicaid-insured children. A total of 619,876 and 531,095 all-cause pneumonia cases were identified among commercial and Medicaid-insured children, respectively. Mean cost per all-cause pneumonia episode was $2304 (SD $32,309) in the commercial and $1682 (SD $19,282) in the Medicaid-insured population. A total of 858 and 1130 IPD episodes were identified among commercial and Medicaid-insured children, respectively. Mean cost per IPD episode was $53,213 (SD $159,904) for commercial and $23,482 (SD $86,209) for the Medicaid-insured population. Nationally, there were over 15.8 million cases of AOM annually, with total estimated cost of $4.3 billion, over 1.5 million cases of pneumonia annually, with total cost of $3.6 billion, and about 2200 IPD episodes annually, for a cost of $98 million.

Conclusions
The economic burden of AOM, pneumonia, and IPD among US children remains substantial. IPD and its manifestations were associated with higher HRU and costs per episode, compared to AOM and all-cause pneumonia. However, owing to their higher frequencies, AOM and all-cause pneumonia were the main contributors to the economic burden of pneumococcal disease nationally. Additional interventions, such as the development of pneumococcal conjugate vaccinees with sustained protection of existing vaccine type serotypes as well as broader inclusion of additional serotypes, are necessary to further reduce the burden of disease caused by these manifestations.
Eosinophilic solid and cystic renal cell carcinoma with TSC2 mutation: a case report and literature review
Authors: He Xin , Chen Ying , Tang Hao , Xu Yujuan , Zhu Xingyan , Wang Caihong , Chen Qiang , Guo Deyu 
Published: April 2023

Abstract
Background
Eosinophilic solid and cystic renal cell carcinoma (ESC-RCC) is an under-recognized, emerging new entity of sporadic renal neoplasms, which is listed as a rare type of renal cell carcinoma in the 2022 WHO renal tumor classification. It is easily misdiagnosed because its characteristics are insufficiently understood.

Case presentation
We report one case of ESC-RCC, a 53-year-old female patient with a right kidney mass found during clinical examination. The patient experienced no discomforting symptoms. Computer-tomography imaging at our urinary department showed a round soft tissue density shadow around the right kidney. Microscopic examination revealed a tumor displaying a solid-cystic composition of eosinophilic cells with unique features, revealed by characteristic immunohistochemical markers (CK20-positive/CK7-negative), and a nonsense mutation in TSC2. Ten months after the renal tumor resection, the patient presented in good condition with no recurrence or metastasis.

Conclusions
The distinct morphological, immunophenotypic, and molecular characteristics of ESC-RCC we describe here, based on our case and the relevant literature, highlight the key points of the pathological and differential diagnosis of this novel renal neoplasm. Our findings will therefore deepen our understanding of this novel renal neoplasm and help reduce misdiagnosis.
Transition for adolescents with a rare disease: results of a nationwide German project
Authors: Grasemann Corinna , Höppner Jakob , Burgard Peter , Schündeln Michael M. , Matar Nora , Müller Gabriele , Krude Heiko , Berner Reinhard , Lee-Kirsch Min Ae , Hauck Fabian , Wainwright Kerstin , Baumgarten Sylvana , Atinga Janet , Bauer Jens J. , Manka Eva , Körholz Julia , Kiewert Cordula , Heinen André , Kretschmer Tanita , Kurth Tobias , Mittnacht Janna , Schramm Christoph , Klein Christoph , Graessner Holm , Hiort Olaf , Muntau Ania C. , Grüters Annette , Hoffmann Georg F. , Choukair Daniela 
Published: April 2023

Abstract
Purpose
The transition process from paediatric/adolescent to adult medical care settings is of utmost importance for the future health of adolescents with chronic diseases and poses even more difficulties in the context of rare diseases (RDs). Paediatric care teams are challenged to deliver adolescent-appropriate information and structures. Here we present a structured transition pathway which is patient-focused and adoptable for different RDs.

Methods
The transition pathway for adolescents 16 years and older was developed and implemented as part of a multi-centre study in 10 university hospitals in Germany. Key elements of the pathway included: assessment of patients’ disease-related knowledge and needs, training/educational and counselling sessions, a structured epicrisis and a transfer appointment jointly with the paediatric and adult specialist. Specific care coordinators from the participating university hospitals were in charge of organization and coordination of the transition process.

Results
Of a total of 292 patients, 286 completed the pathway. Deficits in disease-specific knowledge were present in more than 90% of participants. A need for genetic or socio-legal counselling was indicated by > 60%. A mean of 2.1 training sessions per patient were provided over a period of almost 1 year, followed by the transfer to adult care in 267 cases. Twelve patients remained in paediatric care as no adult health care specialist could be identified. Targeted training and counselling resulted in improved disease-specific knowledge and contributed to empowering of patients.

Conclusion
The described transition pathway succeeds to improve health literacy in adolescents with RDs and can be implemented by paediatric care teams in any RD specialty. Patient empowerment was mainly achieved by individualized training and counselling.
Portal hypertension in patients with hepatocellular carcinoma and immunotherapy: prognostic relevance of CT-morphologic estimates
Authors: Müller Lukas , Gairing Simon J. , Foerster Friedrich , Weinmann Arndt , Mittler Jens , Stoehr Fabian , Graafen Dirk , Düber Christoph , Galle Peter R. , Kloeckner Roman , Hahn Felix 
Published: April 2023

Abstract
Background
Clinically significant portal hypertension (CSPH) has been identified as an important prognostic factor in patients with hepatocellular carcinoma (HCC) undergoing curative treatment. This study aimed to assess PH estimates as prognostic factors in patients with HCC treated with immunotherapy.

Methods
All patients with HCC treated with an immunotherapeutic agent in first or subsequent lines at our tertiary care center between 2016 and 2021 were included (n = 50). CSPH was diagnosed using the established PH score for non-invasive PH estimation in pre-treatment CT data (cut-off ≥ 4). Influence of PH on overall survival (OS) and progression-free survival (PFS) was assessed in uni- and multivariable analyses.

Results
Based on the PH score, 26 patients (52.0%) were considered to have CSPH. After treatment initiation, patients with CSPH had a significantly impaired median OS (4.1 vs 33.3 months, p < 0.001) and a significantly impaired median PFS (2.7 vs 5.3 months, p = 0.02). In multivariable Cox regression, CSPH remained significantly associated with survival (HR 2.9, p = 0.015) when adjusted for established risk factors.

Conclusions
Non-invasive assessment of CSPH using routine CT data yielded an independent prognostic factor in patients with HCC and immunotherapy. Therefore, it might function as an additional imaging biomarker to detect high-risk patients with poor survival and possibly for treatment decision making.
Simplified screening and referral protocol for sinonasal mucormycosis in post COVID-19 patients
Authors: Singh Jitendra , Arora Rubeena , Rawat Vijay , Singh Vikas , Goyal Snigdha , Joshi Liza 
Published: April 2023

Abstract
Background
To study incidence of sinonasal mucormycosis in active and post COVID-19 patients in a district-level hospital in India and develop a simplified screening and referral protocol for use at peripheral centres to aid rapid diagnosis/treatment.

Methods
Study design: A prospective, interventional cohort study conducted from April 2021 to January 2022. Setting: Secondary level hospital in North India. Inclusion criteria: COVID-19 positive patients with diabetes mellitus as co-morbidity and with at least one of the following: received steroid therapy and/or on high flow oxygen therapy and/or had prolonged hospital stay (> 7 days). Exclusion criteria: Patients already immunocompromised/having malignancy/organ transplant recipients. Clinical workup: History, examination, imaging (CECT/MRI nose and paranasal sinuses if indicated), diagnostic nasal endoscopy + Nasal scrapings for KOH mount to detect fungal elements. STROBE guidelines were followed in the study.

Results
Fourteen out of 250 patients tested positive for mucormycosis (incidence 5.6%). Thirteen were symptomatic, one patient was asymptomatic and detected on screening. No significant difference was found in mucormycosis versus non-mucormycosis group with respect to HbA1c status, vaccination status or steroid + oxygen treatment (p > 0.05 in all scenarios). Patients were treated with intravenous liposomal amphotericin B and surgical debridement when indicated. Two succumbed to disease (survival 85.7%). A clinical screening protocol was thus developed which can be used as an effective tool even at far-flung and remote healthcare facilities for diagnosis and timely referral of patients.

Conclusions
Mucormycosis is a potentially lethal disease which needs rapid diagnosis and timely action to decrease morbidity and mortality.
A modified NARX approach for evaluating the time history effect of climate change on load combination in designing façade structures
Authors: Rezvanifar Mostafa , Vosoughifar Hamidreza 
Published: April 2023

AbstractIn recent years, researchers, designers, and project owners have deemed the dry facade system to be a suitable option. Consequently, much research has been conducted on the structural behavior of the dry facade system when subjected to seismic loads, climate change, thermal loads, etc. Of particular concern is the destructive phenomenon of corrosion due to climate change in coastal areas which can damage the infrastructure of the dry façade. To address this issue, a modified NARX method was employed in this study to predict climate change variables for use in dry facade analysis. The author of this paper developed a flowchart and subroutines in MATLAB as a new toolbox for this purpose. Temperature was identified as the most influential parameter in consequent configurations and was thus considered in load combination for the design of a dry facade structure. The statistical results obtained from NARX showed good agreement with measured data; specifically, there was a low mean absolute error (MAE) of 0.345 °C, a low root-mean-square error (RMSE) of 0.442 °C, and a high coefficient of determination (R2) of 0.998 (P-value = 0.918 > 0.05). Finally, this study proposed a modified formula for load combination to ensure durability and constructability of dry facades in coastal cities.
Exploratory Study of the Association of Genetic Factors With Recovery of Adrenal Function in Cushing Disease
Authors: Nguyen Matthew H , Zhang Wei , Pankratz Nathan , Lane John , Chitiboina Prashant , Faucz Fabio R , Mills James L , Stratakis Constantine A , Tatsi Christina 
Published: April 2023

Abstract
Successful treatment of endogenous Cushing disease (CD) is often followed by a period of adrenal insufficiency (AI). We performed an exploratory study on genetic factors potentially involved in the hypothalamic-pituitary-adrenal (HPA) axis recovery in patients with CD after remission. We identified 90 patients who achieved remission after surgery and had a minimum of 3 months follow-up. Variants in a selected panel of genes that were rare in the general population and predicted as damaging in silico were retrieved from whole exome sequencing analysis. We did not identify any variant with significant correlation with recovery time after adjusting for multiple comparisons. On gene-specific analysis the BAG1 gene showed a correlation with shorter duration of postsurgical AI, but both patients with BAG1 variants later experienced a recurrence. After excluding patients with recurrence, no statistical association was recorded. To conclude, we did not identify a strong genetic modifier of HPA recovery in this exploratory study.