bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perceptions of safety, subjective effects, and beliefs about the clinical utility of lysergic acid diethylamide in healthy participants within a novel intervention paradigm: Qualitative results from a proof-of-concept study
Authors: Hendricks Peter S , Copes Heith , Family Neiloufar , Williams Luke TJ , Luke David , Raz Shlomi 
Published: March 2022

Background: Classic psychedelics show promise in the treatment of mental health conditions; however, more scalable intervention protocols are needed to maximize access to these novel therapeutics. In this proof-of-concept study, perceptions of safety, subjective effects, and beliefs about the clinical utility of lysergic acid diethylamide (LSD) were evaluated among healthy participants ( N = 31) administered 50 to 100 µg LSD in a treatment paradigm conceptualized as more scalable than traditional approaches to administering classic psychedelics. Methods: Semi-structured interviews assessed participants’ expectations, experience, and thoughts on the safety and efficacy of the study design. These interviews were transcribed for thematic analysis relating to perceptions of safety, subjective effects, and beliefs about the clinical utility of LSD. Results: Most participants felt safe throughout the study, with a minority reporting concerns related to having a challenging experience that diminished over time. Participants attributed their feelings of safety to the study structure and support of their attendants, which allowed them to “let go” and immerse themselves in the experience without pre-occupation. Furthermore, participants reported transcendent, mystical-type experiences characteristic of classic psychedelics, with almost half highlighting the prominent role played by music during the acute period of drug action. Finally, participants endorsed support for the clinical utility of LSD in controlled environments, expressing the belief that LSD is safe and has the potential to help others. Conclusion: Findings provide preliminary support for the feasibility of this scalable interventional paradigm and set the stage for future critical research with clinical populations.
The Acceptance/Avoidance-Promoting Experiences Questionnaire (APEQ): A theory-based approach to psychedelic drugs’ effects on psychological flexibility
Authors: Wolff Max , Mertens Lea J , Walter Marie , Enge Sören , Evens Ricarda 
Published: March 2022

Background: Many benefits and some harms associated with psychedelic use could be attributable to these drugs’ acceptance/avoidance-promoting effects and corresponding changes in psychological flexibility. Underlying psychological mechanisms are insufficiently understood. Aim: The purpose of this study was the validation of a psychological model of acceptance/avoidance-promoting psychedelic experiences, which included the development of a theory-based self-report instrument: the Acceptance/Avoidance-Promoting Experiences Questionnaire (APEQ). Its two main scales, acceptance-related experience (ACE) and avoidance-related experience (AVE), represent the theorized model’s core constructs. We aimed to test the model’s central assumptions of complementarity (ACE and AVE may occur alternatingly but not simultaneously, and are therefore empirically independent), intertwinedness (subaspects within ACE and AVE are mutually contingent and therefore highly inter-correlated), context-dependence (ACE and AVE depend on context factors) and interaction (longer-term outcomes depend on the interplay between ACE and AVE). Method: A bilingual retrospective online survey including 997 English- and 836 German-speaking participants. Each participant reported on one psychedelic experience occasioned by lysergic acid diethylamide (LSD), psilocybin, mescaline, or ayahuasca. Results: Whereas ACE and AVE were found to be relatively independent aspects of participants’ reported psychedelic experiences (complementarity), their subaspects were mostly distinguishable but strongly correlated among each other (intertwinedness). Therapeutic, escapist, and hedonic use motives were differentially associated with ACE and AVE (context-dependence), which were in turn associated with retrospective changes in psychological flexibility following participants’ reported experiences. The positive association between ACE and increased psychological flexibility was significantly moderated by AVE (interaction). Conclusion: These results provide an initial validation of the APEQ and its underlying theoretical model, suggesting the two can help clarify the psychological mechanisms of psychedelic-induced benefits and harms. Both should be further investigated in prospective-longitudinal and clinical studies.
Pathologic Findings on Hip Arthroscopy in High-Level Athletes Competing in Flexibility Sports
Authors: Saks Benjamin R. , Monahan Peter F. , Maldonado David R. , Jimenez Andrew E. , Ankem Hari K. , Sabetian Payam W. , Lall Ajay C. , Domb Benjamin G. 
Published: March 2022

Background: Athletes who compete in flexibility sports (FS) place unique demands on their hip joints because of the supraphysiologic range of motion required. Purpose: To compare the pathologic features, outcomes, and return-to-sports (RTS) rates of high-level athletes participating in FS who underwent hip arthroscopy for femoroacetabular impingement syndrome (FAIS) and labral tear against a propensity score–matched cohort of high-level athletes participating in non–flexibility sports (NFS). Study Design: Cohort study; Level of evidence, 3. Methods: Data were prospectively collected and retrospectively reviewed for high-level athletes who underwent primary hip arthroscopy for FAIS from April 2008 to December 2018. Patients who participated in FS such as dancing, gymnastics, martial arts, figure skating, and cheerleading were propensity score matched by body mass index, age at time of surgery, sex, sports competition level, and labral treatment to a cohort of high-level athletes participating in all other sports, such as distance running, soccer, volleyball, and softball. Baseline patient characteristics, intraoperative findings, and surgical procedures were compared. Minimum 2-year patient-reported outcome measures were compared for the modified Harris Hip Score, Nonarthritic Hip Score, Hip Outcome Score–Sport Specific Subscale, and visual analog scale for pain and satisfaction. Rates of secondary surgery and RTS were compared. Results: A total of 47 patients (50 hips) who participated in FS were included and propensity score matched to 130 patients (150 hips) who participated in NFS. Follow-up time was 37.5 ± 10.4 months (mean ± SD). Most patients (96.0%) were female with a mean age of 19.5 ± 7.3 years. FS athletes had significantly higher rates of femoral head cartilage lesions (Outerbridge ≥2; 12.0% vs 2.0%; P = .008) and ligamentum teres tears (48% vs 26%; P = .003). FS and NFS athletes demonstrated significant clinical improvements after surgery for all patient-reported outcome measures. Of the patients who attempted, 34 (75.6%) participating in FS were able to RTS while 11 (24.4%) were not because of ongoing hip issues. This was not significantly different than the NFS group ( P = .073). Conclusion: High-level athletes who participated in FS and were treated for FAIS with hip arthroscopy exhibited higher rates of femoral head cartilage lesions and ligamentum teres tears requiring debridement when compared with a benchmark group of athletes who participated in other sports. Despite this, both groups demonstrated similar improvements in outcome scores and comparable rates of RTS at minimum 2-year follow-up.
Patient & Caregiver Experiences: Qualitative Study Comparison Before and After Implementation of Early Palliative Care for Advanced Colorectal Cancer
Authors: Ahmed Sadia , Naqvi Syeda Farwa , Sinnarajah Aynharan , McGhan Gwen , Simon Jessica , Santana Maria J. 
Published: March 2022

Background The Palliative Care Early and Systematic (PaCES) program implemented an early palliative care pathway for advanced colorectal cancer patients in January 2019, to increase specialist palliative care consultation and palliative homecare referrals more than three months before death. This study aimed to understand the experience of patients with advanced colorectal cancer and family caregivers who received early palliative care supports from a specialist palliative care nurse and compared those experiences with participants who experienced standard oncology care prior to implementation of early palliative care. Methods This was a qualitative and patient-oriented study. We conducted semi-structured telephone interviews with two cohorts of patients with advanced colorectal cancer before and after implementation of an early palliative care pathway. We conducted a thematic analysis of the transcripts guided by a Person-Centred Care Framework. Results Seven patients living with advanced colorectal cancer and five family caregivers who received early palliative care supports expressed that visits from their early palliative care nurse was helpful, improved their understanding of palliative care, and improved their care. Four main themes shaped their experience of early palliative care: care coordination, perception of palliative care & advance care planning, coping with advanced cancer, and patient and family engagement. These findings were compared with experiences of 15 patients and seven caregivers prior to pathway implementation. Conclusion An early palliative care pathway can improve advanced cancer care, and improve understanding and acceptance of early palliative care. This work was conducted in the context of colorectal cancer but may have relevance for the care of other advanced cancers.
Engaging Native American Youth and Their Caregivers in Sexual Violence Research: A Case Study Documenting Challenges, Opportunities, and Lessons Learned
Authors: Edwards Katie M. , Herrington Ramona , Charge Leon Leader , Charge Damon Leader , Hopfauf Skyler , Camp Emily E. , Simon Briana , Waterman Emily A. , Banyard Victoria L. 
Published: March 2022

Native Americans (the preferred term of our partners/co-authors) experience high rates of sexual violence, which is rooted in colonization and multiple historical traumas. Sexual violence leads to numerous deleterious outcomes, underscoring the critical need for prevention early in life. Yet, most research to date on sexual violence has not focused on Native American populations, and we know little about the most effective strategies to recruit and retain Native American individuals in sexual violence prevention research. The purpose of the current study, grounded in principles of participatory action research, is to describe strategies that were used to recruit (e.g., traditional feeds, door knocking) and retain (e.g., monetary incentives, ongoing community engagement) Native American youth for a study that sought to assess, via surveys and qualitative interviews, the impacts of a youth-led sexual violence prevention initiative in a small city in the Great Plains. We also collected qualitative data from Native American caregivers regarding their perceptions of research. Overall, 67.9% ( n = 545) of eligible Native American youth completed the survey, and school and door knocking were most effective methods of recruitment/enrollment followed by community and school events and texting. Over the course of 3 years of data collection, there were higher rates of attrition among Native American youth compared to white youth, and several factors (e.g., older age, sexual assault victimization) predicted attrition among Native American youth. Native American caregivers’ responses reflected on reasons it is hard to engage youth and caregivers in research (e.g., lack of time, distrust) as well as strategies to enhance engagement (e.g., personal connection, providing community resources). Throughout the paper, Native American co-authors and project partners reflect on these findings. Implications for future sexual violence prevention research with Native American youth and their caregivers that uses decolonized, participatory action research methodologies are discussed.
The relation of CD4+CD25+Foxp3+ regulatory T cells concentration with disease activity and damage index in systemic lupus erythematosus
Authors: Kamal Mostafa , Gabr Hala , Anwar Somaya , Bastawy Samah , Salah Lamiaa 
Published: March 2022

Introduction Regulatory T cells (Treg) deficits, both quantitative and qualitative, are known to be possible triggers for the development of autoimmune disorders by causing T and B cells dysfunction. The contribution of Treg deficiency in the etiology of systemic lupus erythematosus (SLE) is still being debated. The aim of the present study is to evaluate the percentage of circulating CD4+CD25+Foxp3+ Treg cells in a cohort of Egyptian SLE patients and to correlate this value with the activity and damage index of these patients. Methods 50 female patients with SLE together with an equal number of age- and sex-matched healthy controls were enrolled in the study. Flow cytometric determination of peripheral Treg cells was carried out for all participants by detecting the percentage of CD4+CD25+Foxp3+ cells to compare cases with the control group. Disease activity was assessed using the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K), while disease damage was assessed using the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SLICC/ACR DI). Both indices were correlated with the percentage of CD4+CD25+Foxp3 T regulatory cells. Results CD4+CD25+Foxp3+ Treg cells percentage was significantly decreased in patients with SLE as compared to healthy controls. On correlating CD4+CD25+Foxp3+ Treg percentage with SLEDAI-2K, a significantly negative correlation was found. Also, there was a negative significant correlation between CD4+CD25+Foxp3+ Treg cells percentage and SLICC/ACR DI. On correlating SLEDAI-2K with damage index (SLICC/ACR DI), we found highly significant positive correlation. Conclusion Our study showed impaired production of CD4+CD25+Foxp3+ Tregs in SLE patients, which can play a reciprocal role with some cytokines to affect the activity of the disease and organ damage. CD4+CD25+Foxp3+ Tregs cells should be the target to determine the clinical effectiveness of new therapy to modulate Tregs besides the traditional treatments.
A pharmacoeconomic study comparing the use of mycophenolate mofetil or cyclophosphamide as induction therapy in lupus nephritis patients in Egypt
Authors: Khattab Nada M , Abbassi Maggie , A Raafat Hala , Farid Samar 
Published: March 2022

Introduction/objectives Lupus nephritis (LN) is a major and serious complication of systemic lupus erythematosus (SLE) and is associated with morbidity and mortality. The difference in drug cost between mycophenolate mofetil (MMF) and cyclophosphamide (CYC) inducing regimens becomes a relevant and realistic issue, especially in developing countries. Thus, this study aims to estimate and compare the costs and outcomes of CYC and MMF for better allocation of resources to reduce the burden on the Egyptian healthcare system. Methods A prospective, parallel observational study was conducted at Kasr Al-Aini Hospital between 2018 and 2020. One hundred and twenty-two LN patients were followed up monthly during the study period. Remission and maintenance of renal remission were assessed at 6 and 12 months from the start of therapy. Total direct medical costs associated with both regimens were examined. We applied the cost-minimization analysis method from governmental perspective. Besides, a prospective evaluation of reported changes in health-related quality of life using SF-36 was included in our study. Results There was no statistically significant difference in treatment response at 6 and 12 months (RR 0.6 [0.26;1.43] and 0.8 [0.27;2.33]), respectively, as well as the incidence of infection episodes between MMF and CYC group (71.4% versus 70.45%, p > 0.05). The average direct medical expenditures per patient in the MMF group were approximately one and half times more than the CYC group (2339.69 $ versus 1329.03 $, p <0.001). Conclusion The CYC arm was associated with lower costs than the MMF arm, with equally effective outcomes indicating that CYC is an attractive treatment option.
How does Context Influence Implementation Mechanism of Publicly Funded Health Insurance Schemes in Indian States
Authors: Rout Sarit Kumar , Boyanagari Vamsi Krishna , Pani Saumya Ranjan , Mokashi Tushar , Chokshi Maulik , Kadam Shridhar M. 
Published: March 2022

Introduction: The success of any insurance scheme is contingent upon well-defined processes related to payment, referral, grievances and quality control mechanisms. Any deviation observed may result in unsatisfactory performance. This study attempts to examine various processes related to the implementation of Pradhan Mantri Jan Arogya Yojana (PMJAY) and a state-specific insurance scheme across three states of India. Objective: To describe the policies and process adapted by selected states in implementing a government-sponsored health insurance scheme. To examine the strategies that work effectively, how they operate and what contextual factors enable or disable the desired implementation mechanisms. Methodology: The three states of Karnataka, Chhattisgarh, and Odisha were selected to understand various processes related to the implementation of Publicly Funded Health Insurance Schemes (PFHIS) schemes in diverse settings. A realist evaluation framework was used to study the contexts and mechanisms and how this influences outcomes. Results: The three schemes differ in implementation modes and follow different strategies owing to the local contexts. Some mechanisms worked well in specific contexts, whereas similar things have hindered the process in other contexts. Conclusion: The evidence generated is helpful to strengthen implementation processes under PMJAY and allows learning from each other to increase uptake of the scheme.
Exchange Rate Volatility and Financial Stress: Evidence from Developing Asia
Authors: Tiwary Daitri , Das Khanindra Ch. , Shettigar Jagdish , Misra Pooja 
Published: March 2022

The study investigates the role of financial stress in triggering exchange rate volatility in developing Asia, where instability in financial markets contributes to the extent of exogenous shocks. We investigate volatility clustering in nominal exchange rate (NER) of dollar-denominated domestic currencies of developing Asia. Using country-level monthly time series data from 2006 to 2019 of NER and financial stress for seven representative economies of developing Asia, namely, Philippines, Indonesia, Malaysia, India, Republic of Korea, Singapore, and Thailand, we construct conditional volatility of returns. With volatility clustering in dollar-denominated exchange rates, we find significant bi-directional and predictive causality in exchange rate volatility and financial stress using vector autoregressive model and test for Granger’s causality. Our findings corroborate with the third-generation model of currency crises in the context of emerging economies. For developing Asian nations, our study implicates the strength of the financial system impacting the level and spread of stress, inducing exchange rate volatility. Our empirical model propounds that though stress is driven by multiple factors, management of exchange rate volatility in emerging economies will need to address problems not only in the foreign exchange market, but also in other financial sectors. JEL Codes: G01, F31, C58
The Impact of Fan-Type Rapid Palatal Expanders on Speech in Patients With Unilateral Cleft Lip and Palate
Authors: Bertucci Virginia , Stevens Kyle , Sidhu Nicole , Suri Sunjay , Bressmann Tim 
Published: March 2022

Rapid palatal expanders (RPEs) are commonly used in patients with cleft lip and palate (CLP) prior to secondary alveolar bone grafting (SABG). Their position and size can impede tongue movement and affect speech. This study assessed changes in perception and production of speech over the course of RPE treatment. Prospective longitudinal. Tertiary university-affiliated hospital. Twenty-five patients with unilateral CLP treated with Fan-type RPEs, and their parents. Patient and parent speech questionnaires and patient speech recordings were collected at baseline before RPE insertion (T1), directly after RPE insertion (T2), during RPE expansion (T3), during RPE retention (T4), directly after RPE removal but before SABG (T5), and at short-term follow-up after RPE removal and SABG (T6). Ratings for patient and parent questionnaires, first (F1) and second (F2) formants for vowels /a/, /i/, and /u/, and nasalance scores for non-nasal and nasal sentences, were obtained and analyzed using mixed model analyses of variance. Ratings worsened at T2. For the vowel /a/, F1 and F2 were unchanged at T2. For the vowel /i/, F1 increased and F2 decreased at T2. For the vowel /u/, F1 was unchanged and F2 decreased at T2. Nasalance was unchanged at T2. All outcome measures returned to T1 levels by T4. RPE insertion resulted in initial adverse effects on speech perception and production, which decreased to baseline prior to removal. Information regarding transient speech dysfunction and distress may help prepare patients for treatment.
Analysis of feline humeral fracture morphology and a comparison of fracture repair stabilisation methods: 101 cases (2009–2020)
Authors: Gall Nick , Parsons Kevin , Radke Heidi , Comerford Eithne , Mielke Ben , Grierson James , Ryan John , Addison Elena , Logethelou Vasileia , Blaszyk Agnieszka , Langley-Hobbs Sorrel J 
Published: March 2022

Objectives The aims of this study were to describe the type, presentation and prognostic factors of feline humeral fractures over a 10-year period and to compare three stabilisation systems for feline humeral diaphyseal fractures. Methods In total, 101 cats with humeral fractures presenting to seven UK referral centres between 2009 and 2020 were reviewed. Data collected included signalment, weight at the time of surgery, fracture aetiology, preoperative presentation, fixation method, surgical details, perioperative management and follow-up examinations. Of these cases, 57 cats with humeral diaphyseal fractures stabilised using three different fixation methods were compared, with outcome parameters including the time to radiographic healing, time to function and complication rate. Results The majority of the fractures were diaphyseal (71%), with only 10% condylar. Of the known causes of fracture, road traffic accidents (RTAs) were the most common. Neutered males were over-represented in having a fracture caused by an RTA ( P = 0.001) and diaphyseal fractures were significantly more likely to result from an RTA ( P = 0.01). Body weight had a positive correlation ( r = 0.398) with time to radiographic healing and time to acceptable function ( r = 0.315), and was significant ( P = 0.014 and P = 0.037, respectively). Of the 57 humeral diaphyseal fractures; 16 (28%) were stabilised using a plate–rod construct, 31 (54%) using external skeletal fixation and 10 (18%) using bone plating and screws only. Open diaphyseal fractures were associated with more minor complications ( P = 0.048). There was a significant difference between fixation groups in terms of overall complication rate between groups ( P = 0.012). There was no significant difference between fixation groups in time to radiographic union ( P = 0.145) or time to acceptable function ( P = 0.306). Conclusions and relevance All three fixation systems were successful in healing a wide variety of humeral diaphyseal fractures. There was a significantly higher overall complication rate with external skeletal fixators compared with bone plating; however, the clinical impact of these is likely low.