bluuebunny/crossref_metadata_2025_split huggingface dataset:
Coping With Changes to Sex and Intimacy After a Diagnosis of Metastatic Breast Cancer: Results From a Qualitative Investigation With Patients and Partners
Authors: Reese Jennifer Barsky , Zimmaro Lauren A. , McIlhenny Sarah , Sorice Kristen , Porter Laura S. , Zaleta Alexandra K. , Daly Mary B. , Cribb Beth , Gorman Jessica R. 
Published: April 2022

Objective:Prior research examining sexual and intimacy concerns among metastatic breast cancer (MBC) patients and their intimate partners is limited. In this qualitative study, we explored MBC patients’ and partners’ experiences of sexual and intimacy-related changes and concerns, coping efforts, and information needs and intervention preferences, with a focus on identifying how the context of MBC shapes these experiences.Methods:We conducted 3 focus groups with partnered patients with MBC [N = 12; M age = 50.2; 92% White; 8% Black] and 6 interviews with intimate partners [M age = 47.3; 83% White; 17% Black]. Participants were recruited through the Fox Chase Cancer Center Tumor Registry and the Cancer Support Community. Qualitative data were analyzed using the Framework Method and Dedoose software.Results:Qualitative analyses revealed several key themes reflecting ways in which MBC shapes experiences of sex/intimacy: (1) the heavy disease/treatment burden leads to significant, long-term sexual concerns (e.g., loss of interest and vaginal dryness/discomfort) and consequent heightened emotional distress for both patients (e.g., guilt around not being able to engage in intercourse) and partners (e.g., guilt around pressuring the patient to engage in sexual activity despite pain/discomfort); (2) viewing the relationship as having “an expiration date” (due to expected earlier mortality) influences patients’ and partners’ concerns related to sex/intimacy and complicates coping efforts; and (3) information needs extend beyond managing sexual side effects to include emotional aspects of intimacy and the added strain of the life-limiting nature of the disease on the relationship. The heightened severity of sexual concerns faced by patients with MBC, compounded by the terminal nature of the disease, may place patients and partners at risk for significant adverse emotional and interpersonal consequences.Conclusion:Findings suggest unique ways in which sex and intimate relationships change after a diagnosis of metastatic breast cancer from both patients’ and partners’ perspectives. Consideration of the substantial physical and emotional burden of MBC and the broader context of the relationship and intimacy overall is important when developing a sexuality-focused intervention in this population. Addressing sexual concerns is a critical part of cancer care with important implications for patients’ health and quality of life.
Depression Mediates the Association Between Childhood Emotional Abuse and the Onset of Type 2 Diabetes: Findings From German Multi-Cohort Prospective Studies
Authors: Atasoy Seryan , Johar Hamimatunnisa , Fleischer Toni , Beutel Manfred , Binder Harald , Braehler Elmar , Schomerus Georg , Zöller Daniela , Kruse Johannes , Ladwig Karl-Heinz 
Published: April 2022

BackgroundThe dysregulation of glucose homeostasis via mental health stress is increasingly acknowledged, whereby depression independently increases the risk of the onset of type 2 diabetes by up to 60%. Contributing mental health factors starting in early life have further been considered, indicating that exposure to childhood emotional abuse is associated with both depression and an increased onset of type 2 diabetes in adulthood. However, the potential role of depression within the emotional abuse and type 2 diabetes link remains unknown.MethodsData were derived from community-dwelling participants in southern and northeastern Germany who participated in the longitudinal KORA-F4 and SHIP-3 studies. Multivariable logistic regression analyses adjusted for lifestyle, somatic, and psychological risk factors were used to investigate the association between childhood emotional abuse, assessed retrospectively by the Childhood Trauma Screener, and newly diagnosed type 2 diabetes cases, which were confirmed using a standard oral glucose tolerance test. The mediating role of depressive symptoms between childhood emotional abuse and type 2 diabetes was assessed by the Patient Health Questionnaire-9 and calculated by using the Sobel test for mediation.ResultsA total of 2,973 (53.2% women, 46.8% men) participants with a mean age of 49.7 were included in the analyses, of whom 5.9% (7.1% women, 4.5% men) reported emotional abuse in childhood. Participants exposed to childhood emotional abuse had a 1.70 (1.12–2.56; p = 0.02) times higher odds of depression in the fully adjusted model than unexposed participants. During the 6.5-year follow-up period, 104 (3.5%) participants developed type 2 diabetes. Participants who were exposed to childhood emotional abuse had a 2.56 (1.31–4.98, p = 0.005) times higher odds of developing type 2 diabetes than unexposed participants. This association was significantly mediated by the increased odds of depression in participants with childhood emotional abuse (Sobel Test, 1.84, p = 0.06; Goodman Test, 1.91, p = 0.05).ConclusionThe current results indicate that the increased likelihood of type 2 diabetes onset in participants who were exposed to childhood emotional abuse is significantly attributed to increased depression in adulthood.
The Impact of the COVID-19 Pandemic on Diagnosing and Treating Attention Deficit Hyperactivity Disorder: New Challenges on Initializing and Optimizing Pharmacological Treatment
Authors: Segenreich Daniel 
Published: April 2022

IntroductionCOVID-19 has been causing huge disruptions in mental healthcare services worldwide, including those related to ADHD. Some consequences of the pandemic, such as virtual schooling and remote work, as well as increased telemedicine, have posed new challenges for ADHD diagnosis and treatment. In this narrative review, we summarize existing COVID-19 and ADHD literature especially focusing on ADHD diagnostic during the pandemic and treatment adherence.MethodsThe databases searched were: PubMed, PsycINFO, EMBASE, Google Scholar and medRxiv. We included all English language articles and preprints that reported on medication/pharmacological treatment among the terms “ADHD” and “COVID-19” resulting in a total of 546 articles. The final search was done on Dec-23 2021. We selected fifteen articles focusing on the challenges of ADHD diagnostic during COVID-19 pandemic.ResultsOf the fifteen studies included, most were cross-sectional and perspective pieces. Most of them discussed that individuals with ADHD present risk factors that may make them more vulnerable to health negative consequences of the pandemic, which in turn may have an impact on treatment efficacy and adherence. Telemedicine is also addressed as a potential powerful instrument on monitoring ADHD treatment.ConclusionDespite the challenges posed by the pandemic on monitoring ADHD treatment, the available literature stressed that the current scenario also may offer new opportunities that could lead to the development of individualized treatment interventions, such as the remote monitoring of symptoms.
Evaluating Simulation-Based Tobacco Treatment Scenarios for Providers Delivering Treatment for People Living With Mental Illnesses
Authors: Okoli Chizimuzo T. C. , Otachi Janet K. , Seng Sarret , Abufarsakh Bassema , Williams Lovoria B. 
Published: April 2022

BackgroundPeople living with mental illnesses (PMI) experience elevated tobacco use and related morbidity and mortality. Despite the availability of effective and safe tobacco treatments along with evidence that PMI are motivated and able to quit successfully, few Mental and behavioral healthcare providers (MHPs) engage PMI in such treatment. MHPs may lack the confidence or skills to engage their clients in tobacco treatment. Currently, there are limited training modalities to prepare MHPs in delivering tobacco treatment for PMI. However, animated scenario-based simulated encounters can bridge this gap to effectively provide tailored MHP training to enhance treatment delivery. Hence, the purpose of this study was to evaluate simulated tobacco treatment education scenarios tailored to MHPs.MethodsFor this evaluation, we used a pretest-posttest design to assess changes in MHPs tobacco treatment knowledge and behavioral intentions after viewing simulated treatment encounters. We developed four animated scenarios, using brief tobacco treatment interventions, simulating treatment encounters with PMI. MHPs were primarily recruited from mental or behavioral healthcare facilities and were asked to complete a web-based questionnaire. Their knowledge, views, and experiences in providing tobacco treatment were assessed prior to viewing the animated scenarios. Participants were then asked to evaluate the desirability, acceptability, and applicability of the animated scenarios; and thereafter, their knowledge of and intentions to provide evidence-based tobacco treatment (i.e., ASK, ADVISE, ASSESS, ASSIST, ARRANGE) were again assessed.ResultsParticipants (N = 81) were on average 41.0 years of age, mostly female (79.0%), and non-Hispanic White (86.4%). Nearly a quarter endorsed current tobacco use and few had tobacco treatment training (14.8%). Overall knowledge of tobacco treatment scores significantly increased before and after viewing the videos (M = 3.5 [SD = 1.0] to M = 4.1 [SD = 1.0], p &lt; 0.0001). After viewing the simulated scenario videos, participants endorsed moderate to high mean scores (ranging from 4.0-4.2 on a 0 to 5 scale) on the desirability, acceptability, and applicability of the different animated scenarios. In addition, after viewing the scenarios the proportion of participants who endorsed that they intended to occasionally/very often engage clients in evidence based tobacco treatment were high for ASK (94.9%), followed by ADVISE and ASSESS (84.7% each), followed by ASSIST (81.4%), and ARRANGE (74.6%). Evaluation scores significantly differed by type of animated scenario and participants' work settings and discipline.ConclusionsThese findings suggest that the use of brief animated scenarios may be a useful modality to enhance MHPs knowledge acquisition and treatment delivery intentions. Such approaches may be integrated into tobacco treatment trainings for MHPs.
Perceptions of the Doctor-Patient Relationship Among Patients in a Private, Secondary-Level Hospital in Southern India
Authors: Gala Pooja , Sriram Veena , Kotian Chitra , Ballala Kirthinath , Vedanthan Rajesh , Perish Emily , Umakanth Shashikiran , Meltzer David 
Published: April 2022

IntroductionAn epidemic of non-communicable diseases (NCDs) in India is fueling a growing demand for primary care and hospitalization services. Difficulties in coordinating inpatient and outpatient care create significant barriers to providing high-quality medical care. In this paper, we describe patient experiences, perceptions, and expectations of doctor-patient relationships in a secondary-level private hospital in Karnataka, India.MethodsWe conducted a cross-sectional, mixed-method needs assessment with surveys and in-depth interviews at Dr. TMA Pai Hospital (TMAPH), a secondary-level, private sector hospital in Karnataka, India. Inclusion criteria included all adults over 18 years old hospitalized at TMAPH in the past year. Patients were consecutively recruited from August 2019-October 2019 and asked to rate aspects of their relationship with their primary care provider (PCP). Descriptive statistics and multivariable logistic regression were used to analyze predictors of the doctor-patient relationship. Patients were interviewed regarding their perceptions of care coordination and doctor-patient relationships. General Thematic Analysis was utilized to analyze qualitative data and develop themes. Quantitative and qualitative findings were then merged to interpret the various dimensions of doctor-patient relationships.ResultsA total of 150 patients (47.3% male) enrolled. Ten patients underwent qualitative interviews. The median patient age was 67 years (IQR 56–76). 112 (74.7%) of patients identified a PCP either at or outside of TMAPH. 89% had diabetes and/or hypertension. Compared to patients without a PCP, having a PCP led to a significantly higher adjusted odds of always spending optimal time with their doctors (aOR 2.7, 95% CI 1.1–6.8, p = 0.04), and always receiving clear instructions on managing their medical conditions (aOR 2.5, 95% CI 1.0–6.1, p = 0.04). The following themes were developed from patient interviews: (1) patients trusted and respected their PCP believing they were receiving high quality care; and (2) despite perceived fragmentation in care, patients spoke favorably of their relationships with their doctors.ConclusionsAmong a sample of recently hospitalized patients, those with a PCP reported more positive doctor-patient relationships, though rates of dissatisfaction with doctors were still high. Further research and strategies are required to optimize continuity of care and doctor-patient relationships across the entire continuum of outpatient and inpatient care.
Prevalence, Associated Factors, and Health Expenditures of Noncommunicable Disease Multimorbidity—Findings From Gorakhpur Health and Demographic Surveillance System
Authors: Reddy Mahendra M. , Zaman Kamran , Yadav Rajaram , Yadav Priyanka , Kumar Kaushik , Kant Rajni 
Published: April 2022

BackgroundNoncommunicable disease (NCD) multimorbidity throws a unique challenge to healthcare systems globally in terms of not only management of disease, but also familial, social, and economic implications associated with it.ObjectiveTo assess the prevalence of NCD multimorbidity and its associated risk factors along with health expenditures among adults (≥18 years) living in a rural area.MethodsA secondary data analysis of the first-round survey done as part of the Gorakhpur Health and Demographic Surveillance Site (GHDSS) was done. Information related to self-reported morbidity and other variables related to sociodemographics and out-of-pocket expenditure (OOPE) was captured using a pretested questionnaire. Multivariable cluster adjusted binomial regression analysis was done to identify factors associated with multimorbidity.ResultsThe overall prevalence of NCD multimorbidity was found to be 1.8% (95% CI: 1.7–1.9%). The prevalence of NCD multimorbidity was highest among elderly (≥60 years) [6.0% (95% CI: 5.5–6.5%)] and among women [2.4% (95% CI: 2.3–2.6%)]. Sociodemographic factors, such as age, gender, occupation, education, marital status, religion, caste, and household wealth, were all found to be independently associated with NCD multimorbidity. The median annual OOPE was found to be significantly higher among those with NCD multimorbidity (INR 20,000) compared with those with no NCD (INR 5,000) or having only one NCD (INR 8,000).ConclusionAmong the adults in GHDSS, about 13 in every 100 were suffering from at least one NCD and around two in 100 were having NCD multimorbidity. Those with NCD multimorbidity spent almost four times higher annual OOPE compared with those without NCDs.
The Impact of Slice Interval and Equation on the Accuracy of Magnetic Resonance Image Estimation of Quadriceps Muscle Volume in End Stage Liver Disease
Authors: Quinlan Jonathan I. , Jones Clare , Bissonnette Emma , Dhaliwal Amritpal , Williams Felicity , Choudhary Surabhi , Breen Leigh , Lavery Gareth G. , Armstrong Matthew J. , Elsharkawy Ahmed M. , Lord Janet M. , Greig Carolyn A. 
Published: April 2022

IntroductionEnd stage liver disease (ESLD) is associated with loss of muscle mass and function, known as sarcopenia, which can increase the risk of complications of ESLD, hospitalization and mortality. Therefore, the accurate assessment of muscle mass is essential to evaluate sarcopenia in ESLD. However, manual segmentation of muscle volume (MV) can be laborious on cross-sectional imaging, due to the number of slices that require analysis. This study aimed to investigate the impact of reducing the number of slices required for MV estimation. Further, we aimed to compare two equations utilized in estimating MV (cylindrical and truncated cone).MethodsThirty eight ESLD patients (23 males; 54.8 ± 10.7 years) were recruited from the Queen Elizabeth University Hospital Birmingham. A 3T MRI scan was completed of the lower limbs. Quadriceps MV was estimated utilizing 1-, 2-, 3-, and 4 cm slice intervals with both cylindrical and truncated cone equations. Absolute and relative error (compared to 1 cm slice interval) was generated for 2-, 3-, and 4 cm slice intervals. L3 skeletal muscle index (SMI) was also calculated in 30 patients.ResultsRelative error increased with slice interval using the cylindrical (0.45 vs. 1.06 vs. 1.72%) and truncated cone equation (0.27 vs. 0.58 vs. 0.74%) for 2, 3, and 4 cm, respectively. Significantly, the cylindrical equation produced approximately twice the error compared to truncated cone, with 3 cm (0.58 vs. 1.06%, P &lt; 0.01) and 4 cm intervals (0.74 vs. 1.72%, P &lt; 0.001). Finally, quadriceps MV was significantly correlated to L3 SMI (r2 = 0.44, P &lt; 0.0001).ConclusionThe use of the truncated equation with a 4 cm slice interval on MRI offers an efficient but accurate estimation of quadricep muscle volume in ESLD patients.
Deep Convection as Inferred From the C2OMODO Concept of a Tandem of Microwave Radiometers
Authors: Auguste Franck , Chaboureau Jean-Pierre 
Published: April 2022

Probing the atmosphere from space using radiometers is a challenging way to improve our knowledge of deep convection. Exploration of water absorption bands in the 183, 325, and 448 GHz range is promising because of the radiation scattered by icy hydrometeors produced by deep convection. We investigate what properties of deep convection could be inferred from the Convective Core Observations through MicrOwave Derivatives in the trOpics (C2OMODO) concept of a tandem of microwave radiometers separated by several tens of seconds. Two tropical deep convective events (Hector the Convector and a radiative-convective equilibrium case) are simulated with the Meso-NH non-hydrostatic numerical model, the outputs of which are used to compute brightness temperatures (Tbs) using the Radiative Transfer for the Television and Infrared Observation Satellite (TIROS) Operational Vertical Sounder (RTTOV) code. We find different relationships between the ice water path, vertical ice momentum, vertical ice velocity, and the time derivative dTb/dt. They depend on where they are probed after separating the growing convective cores from their surrounding environment with a radiometric point of view. Tb and dTb/dt are highly dependent on the ice water path that depends on horizontal and vertical ice advection and microphysical processes. Looking at deep convection in general, we find that the ice water path increases linearly with decreasing dTb/dt. In the specific case of the core of growing convective cells, the vertical ice momentum and the vertical ice velocity are related to dTb/dt. However, such a relationship breaks down in the anvil because horizontal ice advection can dominate microphysical processes. These results are robust to horizontal resolution and time delay.
The Impact of the COVID-19 Pandemic on the Functionality of International Surgical Volunteer Organizations
Authors: Lyons Spencer , Xu Amy L. , Durand Wesley M. , Patel Shyam , Oni Julius K. , Babu Jacob M. 
Published: April 2022

BackgroundSurgical volunteer organizations have been severely limited during the ongoing coronavirus disease pandemic. Our purpose was to identify obstacles to surgical volunteer organizations secondary to COVID-19 and their responses.MethodsForty-one surgical volunteer organizations participated in a web-based survey (156 invited, 26% response rate). Respondents were separated into two groups: low donations surgical volunteer organizations (≤50% donations of previous year; n = 17) and high donations surgical volunteer organizations (≥75%; n = 24). Univariate analyses were used to compare the two cohorts.ResultsOf responding surgical volunteer organizations, 34 (83%) were unable to maintain full functionality due to COVID-19; 27% of high donations vs. 0% of low donations surgical volunteer organizations (p = 0.02). The three leading obstacles were finances/donations (78%), fewer volunteers (38%), and inadequate personal protective equipment (30%). In response, 39% of surgical volunteer organizations developed novel E-volunteering opportunities. For support, 85% of surgical volunteer organizations suggested monetary donations, 78% promotion through social media platforms, and 54% donation of personal protective equipment.ConclusionThe majority of surgical volunteer organizations were unable to maintain full functionality due to stressors caused by COVID-19, including limitations on finances, volunteers, and personal protective equipment.
Management of Unilateral Vocal Fold Paralysis after Thyroid Surgery with Injection Laryngoplasty: State of Art Review
Authors: Liao Li-Jen , Wang Chi-Te 
Published: April 2022

BackgroundUnilateral vocal fold paralysis (UVFP) after thyroid surgery often leads to significant morbidity including dysphonia, dysphagia, and aspiration. Injection laryngoplasty (IL) is an effective treatment of UVFP with numerous readily available materials. However, few studies focus on IL for UVFP following thyroidectomy.ObjectivesThis review aims to critically review current literature to determine the timing, materials, methods and outcomes of IL for UVFP after thyroid surgery.Type of ReviewLiterature review.MethodsA literature review was performed using the Pubmed, Medline and EMBASE databases. All relevant articles published in English addressing the effect of IL in post thyroid surgery related UVFP were analyzed. Studies using IL for UVFP of multiple etiologies were excluded. Meta-analysis was conducted using fixed and random effect model.ResultsFive original studies were identified, including 214 patients received IL for UVFP following thyroid surgery. Two studies injected autologous fat via direct suspension laryngoscope under general anesthesia, while the other 3 studies injected polyacrylamide, hyaluronic acid, and polymethyl methacrylate from cricothyroid membrane under local anesthesia. All 5 studies reported improved voice outcomes of IL for post-thyroidectomy UVFP. Meta-analysis showed MPT increased for 3.18 s (95% CI: 2.40–3.96, fix effect model) after IL. Another common acoustic parameter, jitter (%) also improved for 1.46 (95% CI: 0.73–2.19, random effects model) after IL for post-thyroidectomy UVFP.ConclusionsThis review supported that IL can improve the voice outcome for post-thyroidectomy UVFP. Autologous fat remains a good augmentation material with a potential longer lasting effect. More research and long-term surveys are needed to document the safety and longevity of other synthetic materials.