bluuebunny/crossref_metadata_2025_split huggingface dataset:
Alienation: A useful concept for health inequality research
Authors: Øversveen Emil , Kelly Conor A. 
Published: May 2022

Aims: While Marxist class analysis has strongly influenced the development of health inequality research, other aspects of Marx’s theory have received less attention. Among the most relevant of Marx’s theoretical contributions for social inequalities in health is the theory of alienation. As empirical applications of the theory of alienation are currently scarce, the purpose of this commentary is to invigorate interest in alienation theory within the field of health inequality research by demonstrating its potential to illuminate the relationship between social inequality, psycho-social affects and health outcomes. Results: Alienation theory describes how the class structure of capitalist societies creates experiences of powerlessness, estrangement and isolation. These experiences are further posited as emerging from the exploitation of labour, thus connecting social inequality to psychological wellbeing. Alienation theory is particularly compatible with psycho-social explanations of health inequalities, which similarly posits that social inequality affects health through psychological mechanisms. We argue that alienation theory contributes in three ways to health inequality research: a) by suggesting potential mechanisms and offering predictions that may be put to use in empirical research, b) by providing a potential explanation of the welfare state paradox, and c) by situating the psycho-social determinants of health within a critical analysis of the sources of social inequality in capitalist society. Conclusions: Alienation theory may provide a more textured understanding of the relationship between inequality and psycho-social health, while also foregrounding issues of class, power and exploitation that are often absent from psycho-social explanations.
Dementia-friendliness – Inclusion or exclusion: A critical discourse analysis
Authors: Hansen Tania EA , Andresen Mette , Præstegaard Jeanette , Tjørnhøj-Thomsen Tine , Nørgaard Birgitte 
Published: May 2022

This article explores how individuals with dementia and their relatives discursively construct dementia-friendliness in a situation where different definitions of this term exists. Thirteen semi-structured interviews were conducted, including seven individual interviews with people living with dementia. The remaining six interviews consisted of three interviews with the relatives of a person with dementia and three with married couples of which one were diagnosed with dementia. Notes taken by the first author during 6 months of fieldwork at a day centre and a drop-in centre for people with dementia and their families were used to supplement the interviews. Critical discourse analysis provides an analytical tool for revealing the discourses constructing dementia-friendliness. The analysis revealed that people with dementia and their relatives draw on the three discourses of sameness, security and care and autonomy during their attempts to construct dementia-friendliness. The ensuing discursive battles over dementia-friendliness appear to constitute a tightrope walk between the inclusion and exclusion of people with dementia, which underscores the importance of including the voices of people living with dementia when dementia-friendly initiatives and communities are developed.
Spousal Caregiver Resilience in A Nutshell: A Directed Content Analysis in the Context of Dementia Caregiving in Vietnam
Authors: Nguyen Trang T 
Published: May 2022

Objectives This study aims to define resilience of spousal family caregivers for older adults living with dementia in the Vietnamese context. Methods A directed content analysis was conducted on 22 interview transcripts, including nine follow-up interviews, of a sub-sample of 13 spousal caregivers, drawn from a larger study with family caregivers for relatives with dementia in a hospital in Vietnam. The study started with key categories from the theory of the unifying model of resilience in dementia caregiving to guide the analysis process, while new codes and categories were identified during this process. Findings The study results show a revision and extension of this model by introducing a revised model with newly developed sub-categories under the five revised key categories of adversity, resilience processes, outcomes, internal resources, and external resources. Conclusions The results provide evidence for the development of resilience-based interventions and services for spousal caregivers in their contexts.
Evaluation of three nutritional indices as predictors of 2-year mortality and major amputation in patients with chronic limb-threatening ischemia
Authors: Morisaki Koichi , Matsubara Yutaka , Kurose Shun , Yoshino Shinichiro , Furuyama Tadashi 
Published: May 2022

Objective The present study aimed to examine which nutritional index, such as the controlling nutritional status (CONUT), prognostic nutritional index (PNI), and geriatric nutritional risk index (GNRI), is better for predicting prognosis in patients with chronic limb-threatening ischemia (CLTI) following revascularization. Method We retrospectively analyzed data of patients who underwent revascularization for CLTI between 2008 and 2020. The endpoints were 2-year overall survival and limb salvage. The optimal cutoff values of 2-year overall survival and major amputation were determined by receiver operating characteristic curve analyses. Result A total of 238 patients with CLTI and 289 limbs were analyzed. The 2-year overall survival rates were 48.9%, 54.6%, and 53.5% in patients with CONUT score ≥4, PNI score <42.6, and GNRI <98.4 compared with 80.0%, 80.0%, and 78.4% in patients with CONUT score <4, PNI score ≥42.6, and GNRI ≥98.4 ( p < 0.01). Age, non-ambulatory status, hemodialysis, and nutritional indices were independent risk factors for 2-year mortality in the multivariate analyses. The 2-year limb salvage rates were 70.1%, 82.2%, and 81.9% in patients with CONUT score ≥7, PNI score <41.9, and GNRI <95.3 compared with 92.8%, 98.3%, and 94.2% in patients with CONUT score <7, PNI score ≥41.9, and GNRI ≥95.3 ( p < 0.01). Wound, ischemia, and foot infection stage and each nutritional index (CONUT and PNI) were independent risk factors for major amputation in multivariate analyses. The overall survival and limb salvage rates of patients with malnutrition diagnosed by CONUT score were poor compared with those of normal nutrition or malnutrition diagnosed by PNI and/or GNRI scores. Conclusion The CONUT, PNI, and GNRI scores can predict the 2-year overall survival in patients with CLTI after revascularization. The CONUT and PNI scores were associated with major amputation.
Real-world efficacy and safety of cabozantinib in Korean patients with advanced hepatocellular carcinoma: a multicenter retrospective analysis
Authors: Bang Yeong Hak , Lee Choong-kun , Yoo Changhoon , Chon Hong Jae , Hong Moonki , Kang Beodeul , Kim Hyung-Don , Park Sook Ryun , Choi Won-Mook , Choi Jonggi , Lee Danbi , Shim Ju Hyun , Kim Kang Mo , Lim Young-Suk , Lee Han Chu , Ryu Min-Hee , Ryoo Baek-Yeol 
Published: May 2022

Background: Cabozantinib, a multiple kinase inhibitor, was recently approved for patients with previously treated unresectable hepatocellular carcinoma (uHCC). We investigated the real-world safety and efficacy profiles of cabozantinib. Methods: This multicenter retrospective study included 110 patients with uHCC who received cabozantinib after progression on other systemic treatments between October 2019 and May 2021. Results: The median age was 58 (range, 20–77) years, and 98 (89.1%) were male. Prior to cabozantinib, all patients were treated with other systemic therapies: sorafenib ( n = 104, 94.5%) and regorafenib ( n = 91, 82.7%) were the most commonly used agents. Immune checkpoint inhibitors were previously used in 93 patients (84.5%). Cabozantinib was used beyond the third-line of therapy in most patients ( n = 90, 81.8%). With a median follow-up duration of 11.9 months [95% confidence interval (CI), 10.8–17.2], the median progression-free survival (PFS) was 3.7 months (95% CI, 3.1–4.9), and the median overall survival (OS) was 7.5 months (95% CI, 5.5–9.5). The disease control rate and overall response rate (ORR) were 66.3% and 3.6%, respectively. In the Child–Pugh A cohort ( n = 88), the ORR was 4.5%, and the median PFS and OS were 4.3 months (95% CI, 3.6–5.8) and 9.0 months (95% CI, 7.5–11.7), respectively. Conclusion: Cabozantinib showed consistent efficacy outcomes with a prior phase III trial, although in this study, it was used as later-line therapy for patients who were refractory to multiple systemic treatments, including immune checkpoint inhibitors.
Extended Total Temporomandibular Joint Replacement – A Feasible Option for Functional and Aesthetic Reconstruction of Mandibular Defects Involving the Temporomandibular Joint
Authors: Schlabe Juergen , Davies Rhodri O.H.L. , Aagaard Esben , Cousin Gary , Edwards Andrew Ian , McAlister Kenneth , Cascarini Luke 
Published: May 2022

Study design: Retrospective case series. Objective: Alloplastic temporomandibular joint replacement has been established as a standard technique for end- stage temporomandibular (TMJ) pathologies. Joint replacement when there are extensive mandibular defects remains a challenging clinical problem. Custom-made extended temporomandibular joint replacement is a feasible option but there is limited information about this emerging technique. Methods: Included were all patients undergoing extended TMJ-replacements (TMJe), all operatrions were carried out by the senior author. Surgical technique was either single stage or two stage protocol. Surgical details and pitfalls and outcome of more than 2 years follow-up with reference to thirteen including twelve patients were recorded. Results: The most common diagnosis was ameloblastoma of the mandibular ramus. Single stage or two stagge regime were carried out depending on resection requirements and involvement of teeth. Improved mouth opening of more than 30mm was achieved in 10 of 12 patients. One patient with previous TMJ replacement reported temporary weakness of the facial nerve, which resolved after 10 months. Conclusions: The authors suggest a simplified anatomically based single-stage or two-stage regime, with both regimes achieved excellent anatomic reconstruction, facial appearance and function with low surgical morbidity. Custom-made extended temporomandibular joint protheses appear an advanced and reliable solution for reconstruction of combined complex mandibular defects including the temporomandibular joint. If surgical clearance of the pathology can be achieved, a single-stage regime is favoured.
Mathematical Modeling of Vessel Geometry and Circumference in Microvascular Surgery
Authors: Nedrud Stacey , Fleissig Yoram , Sanjuan-Sanjuan Alba , Bunnell Anthony , Fernandes Rui 
Published: May 2022

Introduction Microvascular anastomosis has traditionally been executed with a perpendicular transection through the vessel at the widest diameter to increase circumference and thus increase blood flow while decreasing resistance. In Chen’s 2015 article, it was suggested that an “open Y” would improve vessel size match, and Wei and Mardini discuss angled transections of the vessels. This project aims to explore the geometric configurations feasible at the anastomotic transection and mathematically model the resulting hypothetical increases in circumference. Materials and Methods The mathematical models were theoretically developed by our team. The formulas model increases in circumference of the transection at different distances in relation to the bifurcation of a blood vessel, as well as changes in circumference at different transection angulations. An in vitro exploration as to the anastomotic feasibility of each geometric cut was completed on ten poultry tissue specimens. Results The mathematical models demonstrated the change in vessel circumference, with multiple geometric designs calculated, best shown through diagrams. For example, if the vessel width is 1 mm, the distance from the increasing vessel diameter to the final bifurcation is 1 mm, and the bifurcation angle is 45°, the circumference of the transected vessel increases by 82.8%. Models of transections at different angulations, for instance 30°, 45°, and 60°, yield an increase in elliptical circumference of 8.0%, 22.5%, and 58.1%, respectively. Additional derivations calculate the elliptical circumference at any angle in a single vessel, and at any angle in a bifurcating vessel. Conclusion The theoretical and clinical aim of this project is to increase awareness of the anastomotic creativity and mathematically demonstrate the optimal anastomotic geometry, which has not been objectively explored to our knowledge. An in vivo study would further support clinical improvements, with the aim to map postoperative fluid dynamics through the geometric anastomoses.
Astragalus Polysaccharide Relieves Inflammatory Responses in Guinea Pigs with Allergic Rhinitis via Ameliorating NF-kB-Mediated Treg/Th17 Imbalance
Authors: He Xian , Liu Lei , Luo Xiaoqin , Zhu Jiali , Yang Haoxiang , Wang Jian , Chen Long , Zhong Lunkun 
Published: May 2022

Background Allergic rhinitis (AR) is regarded as a prevalent and non-infectious inflammation in nasal mucosa, and astragalus polysaccharide (APS) could mitigate inflammation. Objectives Herein, this study probed the specific mechanism of APS in inflammatory responses in AR. Methods Firstly, AR guinea pig models were established through the stimulation and sensitization of ovalbumin (OVA) and received APS treatment. Changes in nasal symptoms were assessed through counting the sneezing and rubbing times of guinea pigs. The change patterns of OVA-specific immunoglobulin-E (OVA-sIgE), OVA-specific immunoglobulin-G1 (OVA-sIgG1), tumor necrosis factor (TNF)-α, and interleukin (IL)-6 in guinea pig serum were identified. Meanwhile, the levels of IL-17, transforming growth factor (TGF)-β, IL-10, and forkhead box protein P3 (Foxp3) in the guinea pig tissues or serum were examined, and CD25+Foxp3+Treg or CD4+IL17+Th17 cell proportion was detected. Afterwards, nuclear factor-kappa B (NF-kB) expression in guinea pig nasal mucosa tissues were examined. Rescue experiments were designed to probe the role of NF-kB overexpression in inflammatory responses and Treg/Th17 imbalance in AR guinea pigs. Results APS treatment reduced sneezing and rubbing times of AR guinea pigs and suppressed OVA-sIgE, OVA-sIgG1, TNF-α, and IL-6 levels in guinea pig serum, and meanwhile, increased CD25+Foxp3+Treg cell proportion while reduced CD4+IL17+Th17 cell proportion in AR guinea pig serum or tissues, in a dose-dependent manner. NF-kB was highly-expressed in AR guinea pigs and down-regulated after APS treatment. NF-kB overexpression facilitated inflammatory responses and Treg/Th17 imbalance in AR. Conclusion APS reduced Treg/Th17 imbalance via suppressing NF-kB expression, thereby ameliorating inflammatory responses in AR.
Efficacy and safety of cyclosporine A treatment in autoimmune cytopenias: the experience of two Italian reference centers
Authors: Fattizzo Bruno , Cantoni Silvia , Giannotta Juri Alessandro , Bandiera Laura , Zavaglia Rachele , Bortolotti Marta , Barcellini Wilma 
Published: May 2022

Background: Immune thrombocytopenia (ITP) and autoimmune hemolytic anemia (AIHA) show good responses to frontline steroids. About two-third of cases relapse and require second-line treatment, including rituximab, mainly effective in AIHA, and thrombopoietin-receptor agonists (TPO-RAs) in ITP, while the use of splenectomy progressively decreased due to concerns for infectious/thrombotic complications. For those failing second line, immunosuppressants may be considered. Objectives: The aim of this study was to evaluate the efficacy of cyclosporine treatment in patients with ITP and AIHA. Design: In this retrospective study, we evaluated the efficacy and safety of cyclosporine A (CyA) in ITP ( N = 29) and AIHA ( N = 10) patients followed at two reference centers in Milan, Italy. Methods: Responses were classified as partial [Hb > 10 or at least 2 g/dl increase from baseline, platelets (PLT) > 30 × 109/l with at least doubling from baseline] and complete (Hb > 12 g/dl or PLT > 100 × 109/l) and evaluated at 3, 6, and 12 months. Treatment emergent adverse events were also registered. Results: The median time from diagnosis to CyA was 35 months (3–293), and patients had required a median of 4 (1–8) previous therapy lines. Median duration of CyA was 28 (2–140) months and responses were achieved in 86% of ITP and 50% of AIHA subjects. Responders could reduce or discontinue concomitant treatment and resolved PLT fluctuations on TPO-RA. CyA was generally well tolerated, and only two serious infectious complications in elderly patients on concomitant steroids suggesting caution in this patient population. Conclusion: CyA may be advisable in ITP, which is not well controlled under TPO-RA, and in AIHA failing rituximab, particularly if ineligible in clinical trial.
Medical students in Karachi and COVID-19: Myths and facts
Authors: Jamil Omer Bin Khalid , Muhib Muhammad , Abbal Muhammad Anas , Ahmed Amna Muhammed , Khan Hafsa Hayat , khan Nabeela Yar 
Published: May 2022

Objectives: COVID-19 pandemic brought mortalities, morbidities, fear, and financial despair among people around the world. As it advanced, misinformation and myths about it caught wildfire, contributing to misbelief among the already shocked population. Medical students are the building blocks of the medical community and can provide a pivotal role in combating COVID-19 misinformation by delivering correct knowledge and awareness to the non-medical population of the country. Hence, it is important to assess their knowledge and perception of COVID-19 myths. Therefore, this study evaluates medical student’s knowledge regarding myths and misinformation related to COVID-19 infection and its vaccine. The study also assesses the belief of medical students on various conspiracy theories of COVID-19. Methods: An online cross-sectional survey was conducted among 401 undergraduate medical students of Karachi in June–August 2021. A validated, structured, and self-administrated questionnaire was used for data collection. The data were entered on an open EPI version 3.01 and Statistical Package of Social Science version 26 for analysis. A chi-square test was performed to identify determinant factors. All p-values less than 0.05 were considered significant. Results: Overall knowledge score of participants about myths and misinformation related to COVID-19 and its vaccine was as follows: 166 (28.9) participants possess good knowledge, while 167 (41.6) and 118 (29.4) had moderate to poor knowledge, respectively. Senior students, vaccinated, and participants infected by COVID-19 had good to moderate knowledge. Overall, 139 (34.7) participants strongly disagree and 103 (25.7) participants somewhat disagree with conspiracy theories related to COVID-19. Absence of belief in the conspiracies is associated with vaccinated participants. Conclusion: The study shows that most medical students possess adequate knowledge of misinformation about COVID-19 and its vaccines, and have low belief in conspiracy theories of COVID-19.
Depression, anxiety, and diabetes-related distress in type 2 diabetes in primary care in Greece: Different roles for glycemic control and self-care
Authors: Kintzoglanakis Kyriakos , Gkousiou Anna , Vonta Paraskevi , Sagmatopoulos Agisilaos , Copanitsanou Panagiota 
Published: May 2022

Objectives: The psychological distress of people living with diabetes is increased and associated with poorer glycemic outcomes and self-care. We aimed to examine the frequency of depression, anxiety, and diabetes-related distress (DRD) of individuals with type 2 diabetes (T2D) in primary care (PC) and their comparative associations with clinical, self-care, and socio-demographic characteristics, testing for possible different roles on glycemic control and self-care. Methods: This is a cross-sectional study of 182 adults with a T2D diagnosis of at least six months, recruited between August 2019-March 2020 and May-October 2020, from an urban PC unit. Participants were screened for symptoms of depression (Patient Health Questionnaire-9 (PHQ-9)), anxiety (Generalized Anxiety Disorder-7 (GAD-7)), and DRD (Diabetes Distress Scale (DDS)). Clinical, self-care, and socio-demographic parameters were recorded. Results: The frequency of clinically significant symptoms of depression was 16.6%, (PHQ-9 score ⩾10), anxiety 17.7% (GAD-7 score ⩾10), and DRD 22.6% (DDS score ⩾2). All PHQ-9, GAD-7, and DDS scores intercorrelated, and higher scores were found to be associated with female gender, lower income, and prior diagnosis of depression. Higher PHQ-9 and GAD-7 scores were found to be associated with lower education, more hypoglycemia episodes, more blood glucose self-tests and antidepressant or benzodiazepine use. The retired/housewives scored significantly lower in GAD-7 and DDS compared to the unemployed participants. Higher DDS scores were associated with higher glycated hemoglobin, higher fasting plasma glucose, and insulin use. It was also noted that higher PHQ-9 scores were associated with lower uric acid levels and were significantly higher in the sedentary lifestyle group. Conclusion: DRD was associated with poorer glycemic outcomes while depressive symptoms were associated with lower physical activity perhaps sharing different roles for glycemic control and self-care. The psychological burden of individuals with T2D may be considered in PC.
Evaluating the impact of a novel telerehabilitation service to address neurological, musculoskeletal, or coronavirus disease 2019 rehabilitation concerns during the coronavirus disease 2019 pandemic
Authors: Brehon Katelyn , Carriere Jay , Churchill Katie , Loyola-Sanchez Adalberto , O’Connell Petra , Papathanasoglou Elisavet , MacIsaac Rob , Tavakoli Mahdi , Ho Chester , Manhas Kiran Pohar 
Published: May 2022

Introduction A novel telerehabilitation service provides wayfinding and self-management advice to persons with neurological, musculoskeletal, or coronavirus disease 2019 related rehabilitation needs. Method We utilized multiple methods to evaluate the impact of the service. Surveys clarified health outcomes (quality of life, self-efficacy, social support) and patient experience (telehealth usability; general experience) 3-months post-call. We analysed associations between, and within, demographics and survey responses. Secondary analyses described health care utilization during the first 6 months. Results Sixty-eight callers completed the survey (42% response rate). Self-efficacy was significantly related to quality of life, interpersonal support and becoming productive quickly using the service. Becoming productive quickly was significantly related to quality of life. Education level was related to ethnicity. Survey respondents’ satisfaction and whether they followed the therapist's recommendations were not significantly associated with demographics. Administrative data indicated there were 124 callers who visited the emergency department before, on, or after their call. The average (SD) frequency of emergency department visits before was 1.298 times (1.799) compared to 0.863 times (1.428) after. Discussion This study offers insights into the potential impact of the telerehabilitation service amidst pandemic restrictions. Usability measurements showed that callers were satisfied, corroborating literature from pre-pandemic contexts. The satisfaction and acceptability of the service does not supplant preferences for in-person visits. The survey sample reported lower quality of life compared with the provincial population, conflicting with pre-pandemic research. Findings may be due to added stressors associated with the pandemic. Future research should include population-level comparators to better clarify impact.