bluuebunny/crossref_metadata_2025_split huggingface dataset:
Scaling-up filariasis lymphoedema management into the primary health care system in Kerala State, Southern India: a case study in healthcare equity
Authors: Krishnasastry Suma T. , Mackenzie Charles D. , Sadanandan Rajeev 
Published: January 2022

Abstract
Background
Lymphatic filariasis (LF) remains one of the world’s most debilitating parasitic infections and is a major contributor to poor health in many endemic countries. The provision of continuing care for all those affected by LF and its consequences is an important component of the United Nations’ Sustainable Development Goals. The aim of this study is to integrate lymphedema care into the primary health care system of the State by developing lymphedema clinics at each district, through training of health personnel to fulfill WHO recommendation for morbidity management and disability prevention.

Methods
Selected health care providers from all the districts in Kerala State of India participated in intensive training sessions endorsed by the State’s health administration. The six training sessions (from 5 June 2017 to 25 May 2018) included appropriate self-care information and development of individual plans for each participating institution to provide instruction and care for their lymphoedema patients. The learning achieved by attendees was assessed by pre- and post-training tests. The number of lymphoedema patients receiving care and instruction from the post-training activities of each participating institution was assessed from local records, 6 months after the conclusion of the training sessions.

Results
One hundred and eighty-four medical personnel (91 doctors and 93 nurses) from 82 medical institutions were trained which quickly led to the establishment of active lymphoedema clinics providing the essential package of care (EPC) for lymphoedema patients at all the participating institutions. Six months after the training sessions the number of previously unidentified lymphoedema patients registered and receiving care at these clinics ranged from 296 to almost 400 per clinic, with a total of 3,477 new patients receiving training in EPC.

Conclusions
Generalist health personnel, when appropriately trained, can provide quality lymphoedema care in public health settings and patients when provided services close to their home, are willing to access them. This is a feasible strategy for integrating long term care for LF patients into the national health system, and is a clear example of moving towards equity in health care for the medically underserved, and thus successfully addresses a major goal of the global program to eliminate lymphatic filariasis.

Graphical Abstract
Influence of extracellular volume fraction on peak exercise oxygen pulse following thoracic radiotherapy
Authors: Canada Justin M. , Weiss Elisabeth , Grizzard John D. , Trankle Cory R. , Gharai Leila Rezai , Dana Franklin , Buckley Leo F. , Carbone Salvatore , Kadariya Dinesh , Ricco Anthony , Jordan Jennifer H. , Evans Ronald K. , Garten Ryan S. , Van Tassell Benjamin W. , Hundley W. Gregory , Abbate Antonio 
Published: January 2022

Abstract
Background
Radiation-induced myocardial fibrosis increases heart failure (HF) risk and is associated with a restrictive cardiomyopathy phenotype. The myocardial extracellular volume fraction (ECVF) using contrast-enhanced cardiac magnetic resonance (CMR) quantifies the extent of fibrosis which, in severe cases, results in a noncompliant left ventricle (LV) with an inability to augment exercise stroke volume (SV). The peak exercise oxygen pulse (O2Pulse), a noninvasive surrogate for exercise SV, may provide mechanistic insight into cardiac reserve. The relationship between LV ECVF and O2Pulse following thoracic radiotherapy has not been explored.

Methods
Patients who underwent thoracic radiotherapy for chest malignancies with significant incidental heart dose (≥5 Gray (Gy), ≥10% heart) without a pre-cancer treatment history of HF underwent cardiopulmonary exercise testing to determine O2Pulse, contrast-enhanced CMR, and N-terminal pro-brain natriuretic peptide (NTproBNP) measurement. Multivariable-analyses were performed to identify factors associated with O2Pulse normalized for age/gender/anthropometrics.

Results
Thirty patients (median [IQR] age 63 [57–67] years, 18 [60%] female, 2.0 [0.6–3.8] years post-radiotherapy) were included. The peak VO2 was 1376 [1057–1552] mL·min− 1, peak HR = 150 [122–164] bpm, resulting in an O2Pulse of 9.2 [7.5–10.7] mL/beat or 82 (66–96) % of predicted. The ECVF, LV ejection fraction, heart volume receiving ≥10 Gy, and NTproBNP were independently associated with %O2Pulse (P < .001).

Conclusions
In patients with prior radiotherapy heart exposure, %-predicted O2Pulse is inversely associated markers of diffuse fibrosis (ECVF), ventricular wall stress (NTproBNP), radiotherapy heart dose, and positively related to LV function. Increased LV ECVF may reflect a potential etiology of impaired LV SV reserve in patients receiving thoracic radiotherapy for chest malignancies.
Cell-free DNA from plasma as a promising alternative for detection of gene mutations in patients with Maffucci syndrome
Authors: Sun Yi , Fan Xindong , Rao Yamin , Wang Zhenfeng , Wang Deming , Yang Xitao , Zheng Lianzhou , Wen Mingzhe , Cai Ren , Su Lixin 
Published: January 2022

AbstractMaffucci syndrome (MS, OMIM 166000) is an extremely unusual, nonhereditary, multisystemic disorder that is characterized with multiple enchondromas and vascular lesions, most of which are spindle cell hemangiomas. Complications of MS, such as bone deformities and dysfunction caused by enchondromas, usually increase during childhood and adolescence. Malignant transformation of enchondromas and other malignancies are the most severe complications. MS is caused by somatic mosaic IDH1/2 mutations, 65% of which are the IDH1 p.Arg132Cys variant. Due to its rarity, there is no international consensus for the most appropriate treatment option of MS.Here, we report a case of a female patient presenting with multiple enchondromas and spindle cell hemangiomas (SCHs) on bilateral hand and feet diagnosed as MS. A detailed clinical, pathological and genetic diagnosis of MS was rendered. Integrative Genomics Viewer (IGV) visualization of next-generation sequencing (NGS) data revealed the consistent detection of the low-frequency somatic IDH1 p.Arg132Cys mutation between SCH tissue and cystic blood-derived cfDNA. This is the first successful molecular diagnosis of MS complicated with SCH utilizing minimally invasive cfDNA techniques. We suggest that cfDNA sequencing could potentially be used as an alternative, reliable and sensitive method to identify molecular information for genetic diagnosis and for future targeted therapies of MS.
Roasted fox nuts (Euryale Ferox L.) contain higher concentration of phenolics, flavonoids, minerals and antioxidants, and exhibit lower Glycemic Index (GI) in human subjects
Authors: Liaquat Marrium , Pasha Imran , Ahsin Muhammad , Salik Abdullah 
Published: January 2022

AbstractFox nut (Euryale ferox) is categorized among superior quality foods because of its highly nutritious profile. It also serves as a good protein source for vegetarian diets. However, it is not widely consumed, due to soggy texture and bland flavor as compared to other nuts. In this study, we used roasting and seasoning to enhance its consumer acceptance. Furthermore, we have also compared biochemical, nutritional and physical properties of the roasted and unroasted fox nuts; and their Glycemic Index (GI) in human subjects. Results showed that roasting significantly (P ≤ 0.05) improved the minerals content (from 0.58 to 0.66%), protein content (from 11.40 to 14.57%), total phenolics (from 346.02 to 470.62 mg GAE/100 g), flavonoids (from 4.15 to 4.43 mg CE/g), 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging activity (from 48.54 to 79.13% inhibition) and Ferric Reducing Antioxidant Power (from 662.46 to 957.14 μmol FeSO4/g). Consumer acceptance was evaluated with and without seasoning; both salt and spice seasoned roasted nuts had greater overall acceptability as compared to plain roasted and unroasted nuts. Fox nuts also reported low GI (37%) in human subjects (ethical approval #1772/01-06-2020). Thus, roasted fox nuts can be consumed as nutrient rich and low GI snack; not only as a component of healthy diet but can also be served to patients with metabolic disorders like obesity and diabetes.
Impact of compulsory admission on treatment and outcome: A propensity score matched analysis
Authors: Hofmann Andreas B. , Schmid Hanna M. , Hofmann Lena A. , Noboa Vanessa , Seifritz Erich , Vetter Stefan , Egger Stephan T. 
Published: January 2022

AbstractBackgroundDespite multiple ethical issues and little evidence of their efficacy, compulsory admission and treatment are still common psychiatric practice. Therefore, we aimed to assess potential differences in treatment and outcome between voluntarily and compulsorily admitted patients.MethodsWe extracted clinical data from inpatients treated in an academic hospital in Zurich, Switzerland between January 1, 2013 and December 31, 2019. Observation time started upon the first admission and ended after a one-year follow-up after the last discharge. Several sociodemographic and clinical characteristics, including Health of the Nation Outcome Scales (HoNOS) scores, were retrospectively obtained. We then identified risk factors of compulsory admission using logistic regression in order to perform a widely balanced propensity score matching. Altogether, we compared 4,570 compulsorily and 4,570 voluntarily admitted propensity score-matched patients. Multiple differences between these groups concerning received treatment, coercive measures, clinical parameters, and service use outcomes were detected.ResultsUpon discharge, compulsorily admitted patients reached a similar HoNOS sum score in a significantly shorter duration of treatment. They were more often admitted for crisis interventions, were prescribed less pharmacologic treatment, and received fewer therapies. During the follow-up, voluntarily admitted patients were readmitted more often, while the time to readmission did not differ.ConclusionsUnder narrowly set circumstances, compulsory admissions might be helpful to avert and relieve exacerbations of severe psychiatric disorders.
Decreased Electroencephalographic Alpha Power During Anesthesia Induction Is Associated With EEG Discontinuity in Human Infants
Authors: Chao Jerry Y. , Gutiérrez Rodrigo , Legatt Alan D. , Yozawitz Elissa G. , Lo Yungtai , Adams David C. , Delphin Ellise S. , Shinnar Shlomo , Purdon Patrick L. 
Published: January 2022

BACKGROUND:
Electroencephalogram (EEG) discontinuity can occur at high concentrations of anesthetic drugs, reflecting suppression of electrocortical activity. This EEG pattern has been reported in children and reflects a deep state of anesthesia. Isoelectric events on the EEG, a more extreme degree of voltage suppression, have been shown to be associated with worse long-term neurologic outcomes in neonates undergoing cardiac surgery. However, the clinical significance of EEG discontinuities during pediatric anesthesia for noncardiac surgery is not yet known and merits further research. In this study, we assessed the incidence of EEG discontinuity during anesthesia induction in neurologically normal infants and the clinical factors associated with its development. We hypothesized that EEG discontinuity would be associated with sevoflurane-induced alpha (8–12 Hz) power during the period of anesthesia induction in infants.

METHODS:
We prospectively recorded 26 channels of EEG during anesthesia induction in an observational cohort of 54 infants (median age, 7.6 months; interquartile range [IQR] [4.9–9.8 months]). We identified EEG discontinuity, defined as voltage amplitude <25 microvolts for >2 seconds, and assessed its association with sevoflurane-induced alpha power using spectral analysis and multivariable logistic regression adjusting for clinically important variables.

RESULTS:
EEG discontinuity was observed in 20 of 54 subjects (37%), with a total of 25 discrete events. Sevoflurane-induced alpha power in the posterior regions of the head (eg, parietal or occipital regions) was significantly lower in the EEG discontinuity group (midline parietal channel on the electroencephalogram, International 10-20 System [Pz]; 8.3 vs 11.2 decibels [dBs]; P = .004), and this association remained after multivariable adjustment (adjusted odds ratio [aOR] = 0.51 per dB increase in alpha power [95% CI, 0.30–0.89]; P = .02). There were no differences in the baseline (unanesthetized) EEG between groups in alpha power or power in any other frequency band.

CONCLUSIONS:
We demonstrate that EEG discontinuity is common during anesthesia induction and is related to the level of sevoflurane-induced posterior alpha power, a putative marker of cortical-thalamic circuit development in the first year of life. This association persisted even after adjusting for age and propofol coadministration. The fact that this difference was only observed during anesthesia and not in the baseline EEG suggests that otherwise hidden brain circuit properties are unmasked by general anesthesia. These neurophysiologic markers observed during anesthesia may be useful in identifying patients who may have a greater chance of developing discontinuity.
Clinical spectrum of Celiac Disease in adults at a tertiary care hospital in Karachi, Pakistan
Authors: Arshad Verda , Inam Maha , Awan Safia , Ismail Faisal Wasim 
Published: January 2022

Objectives: Celiac Disease (CD) is a disorder that impacts physical, social and emotional health. Requiring life-long treatment, it poses a major economic burden on the healthcare system. Our objective was to study CD in patients from initial presentation to diagnosis and to ascertain the effect of a low resource setting on improvement in disease process.
Methods: This is a retrospective cross-sectional study conducted at a Aga Khan University Hospital (AKUH), a tertiary care center in Karachi, Pakistan. Medical records of patients (≥18 years) from 2008 to 2018 with a diagnosis of CD were reviewed. Data on demographics, presenting complaints, investigations, endoscopy results and follow up visits was collected.
Results: One hundred and twenty-six patients were included (61.6% females, mean age 35.5 years). The most common intestinal and extra-intestinal symptoms were abdominal pain (56.3%) and fatigue (24.6%) respectively. After microcytic anemia (36.5%), increased ALT (27.2%) was the most common laboratory derangement. On endoscopy, visible fissuring (29.4%) and atrophic mucosa (29.4%) were reported. Biopsy findings showed increased intraepithelial lymphocytes (92.9%) and villous atrophy (77.8%). Improvement in at least one of three parameters (symptoms, laboratory values or EGD) was reported by 42.0% of subjects, whereas 48.4% subjects were lost to follow-up.
Conclusion: The most commonly reported symptoms by CD patients were abdominal pain, diarrhea and anemia. Thus, patients presenting with vague abdominal symptoms and anemia should be worked up for CD. A concerning majority of subjects was lost to follow up for reasons such as inability to afford advised GFD and a poor understanding of the disease process.
doi: https://doi.org/10.12669/pjms.38.3.4446
How to cite this:Arshad V, Inam M, Awan S, Ismail FW. Clinical spectrum of Celiac Disease in adults at a tertiary care hospital in Karachi, Pakistan. Pak J Med Sci. 2022;38(3):---------. doi: https://doi.org/10.12669/pjms.38.3.4446
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Do Maya women have the chance to improve their quality of life?
Authors: Siniarska Anna , Wolański Napoleon 
Published: January 2022

Background: Maya families suffered greatly during the henequen industry in the Yucatan, but the lives of the Maya women at the time were perhaps worse than anywhere in the world. Changes in Maya body height over the 20th century were assessed in order to show secular changes. The use of the sexual dimorphism index (SDI) allowed for the evaluation of the living conditions prevailing during the existence of the henequen haciendas to the Mexican revolution and a gradual improvement of these conditions by the end of the 20th century. Methods: In 1994, 364 men and 320 women aged 20-98 years were studied in Merida, Yucatan, Mexico. They were divided into six age groups and by sex: 20-29, 30-39, 40-49, 50-59, 60-69 and 70+ years. Stature for both sexes, and age at menarche for women were considered. SDI in stature was calculated to assess living conditions. Results: There were smaller (0.25 cm/10 years) changes in height in men than in women (0.9 cm/10 years) and no significant changes in acceleration of maturation. SDI results showed changes from 9.9 to 7.6, and this may indicate a constant, but very small improvement of living conditions. The age at menarche of women did not show statistically significant acceleration with age. Conclusions: In the colonial period of the late 19th century until the Mexican Revolution, women were worse off than men. Previous research has shown that when living conditions change, men always react faster than women, e.g. by lowering or increasing body height. Our study of the Maya population in the 20th century showed otherwise; female height increased more than male height. This may reflect that the living conditions of Maya men have not changed over the 20th century, but have improved for women.
The indigenous meaning of dysmenorrhea: using modified photovoice to document perspectives of traditional health practitioners (THPs) and indigenous knowledge holders (IKHs)
Authors: Rasweswe Melitah Molatelo , Peu Mmapheko Doriccah , Mulaudzi Fhumulani Mavis 
Published: January 2022

Background: Globally, health understanding and beliefs vary across sub-cultural groups, depending on geographical location. Increasingly, various parts of the world recognize these perspectives to offer culturally sensitive healthcare services at primary level. Understanding the indigenous perspectives of dysmenorrhea meaning from the custodians of knowledge holders may add to the value of literature that may be used to advocate humanized culturally sensitive healthcare. This article aimed to explore and describe the perspectives regarding the meaning of indigenous dysmenorrhea among Batlokwa traditional health practitioners (THPs) and indigenous knowledge holders (IKHs). Methods: A qualitative, explorative study with a modified photovoice design, which included photographs, interviews and lekgotla discussion was employed to engage THPs and IKHs residing in Botlokwa Limpopo province, South Africa. Initially, a purposive sampling technique was used to select the participants, followed by snowball sampling. The participants themselves analyzed the photographs and described their meaning during individual interview using the acronym “PHOTO”. The researchers employed thematic analysis of interviews and Lekgotla discussion, in which themes were identified, formulated and analyzed from the codified data set. Results: In total, eight women participated in the photovoice study. The findings showed that indigenous understanding of dysmenorrhea stems from the African belief about health and illness with special emphasis on importance of holistic meaning. To the THPs and IKHs dysmenorrhea was a broad and integrated trend of a normal or abnormal process of illness that occurs periodically during menstruation. Conclusions: The THP’s and IKH’s indigenous meaning of dysmenorrhea reflects physical, mental, emotional, social, environmental, political and economic dimensions. Therefore, dysmenorrhea should be understood from a holistic approach. With appropriate partnerships and processes in place, this knowledge may be well represented in dominant healthcare systems and health research.
Creating equity in health research to drive more and better evidence
Authors: Lang Trudie , Reeder John , Moorthy Vasee , Trindade Lima Nísia , Gray Glenda , Kaleebu Pontiano , Ihekweazu Chikwe , Nsanzimana Sabin , Kang Gagandeep , Makanga Michael , Swaminathan Soumya 
Published: January 2022

Health research is rapidly changing with evidence being gathered through new agile methods. This evolution is critical but must be globally equitable so the poorest nations do not lose out. We must harness this change to better tackle the daily burden of diseases that affect the most impoverished populations and bring research capabilities to every corner of the world so that rapid and fair responses to new pathogen are possible; anywhere they appear. We must seize this opportunity to make research easier, better and more equitable. Currently too many nations are unable to generate the evidence or translate it to directly change health outcomes in their own communities. It is essential to act and harness this emerging change in how research data can be generated and shared, so that all nations sustainably gain from this development. There are positive examples to draw on from COVID-19, but we now need to act. Here we present an initiative to develop a new framework that can guide researchers in the design and execution of their studies. This highly agile system will work by adapting to risk and complexity in any given study, whilst generating quality, safe and ethical data.
Determination of optical constants of thin films in the EUV
Authors: Ciesielski Richard , Saadeh Qais , Philipsen Vicky , Opsomer Karl , Soulié Jean-Philippe , Wu Meiyi , Naujok Philipp , van de Kruijs Robbert W. E. , Detavernier Christophe , Kolbe Michael , Scholze Frank , Soltwisch Victor 
Published: January 2022

The determination of fundamental optical parameters is essential for the development of new optical elements such as mirrors, gratings, or photomasks. Especially in the extreme ultraviolet (EUV) and soft x-ray spectral range, the existing databases for the refractive indices of many materials and compositions are insufficient or are a mixture of experimentally measured and calculated values from atomic scattering factors. Since the physical properties of bulk materials and thin films with thicknesses in the nanometer range are not identical, measurements need to be performed on thin layers. In this study we demonstrate how optical constants of various thin film samples on a bulk substrate can be determined from reflection measurements in the EUV photon energy range from 62 eV to 124 eV. Thin films with thickness of 20 nm to 50 nm of pure Mo, Ni, Pt, Ru, Ta, and Te and different compositions of

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