bluuebunny/crossref_metadata_2025 huggingface dataset:
The Use of Clinical Parameters as Adjuncts to Endoscopic Evaluation of Mural Thickening on Conventional Computed Tomography in Diagnosing Malignancy
Authors: Donlon Noel E. , Kelly Michael E. , Zafar Muneeb , Boland Patrick A. , Davis Cian , Wei Teh Jia , Corless Kevin , Khan Waqar , Khan Iqbal , Waldron Ronan , Barry Kevin
Published: March 2021

Background: Mural thickening (MT) on computed tomography (CT) poses a diagnostic dilemma in the absence of clear reporting guidelines. The aim of this study was to analyse CT reports, identifying patients in whom gastrointestinal wall MT was observed, and to correlate these reports with subsequent endoscopic evaluation. Methods: Patients with MT who had follow-up endoscopy were included in the study (n = 308). The cohort was subdivided into upper gastrointestinal mural thickening (UGIMT) & lower gastrointestinal mural thickening (LGIMT). Results: In total, 55.71% (n = 122) of colonoscopies and 61.8% (n = 55) of gastroscopies were found to be normal. Haemoglobin (HB) level in combination with MT was a predictor of neoplasia in both arms (p = 0.04 UGIMT cohort, p < 0.001 LGIMT cohort). In addition to this, age was a significant correlative parameter in both UGIMT and LGIMT cohorts (p = 0.003, p < 0.001 respectively). Dysphagia and weight loss were associated with UGI malignancies (38 and 63% respectively) and rectal bleeding was correlative in 20% of patients with LGI malignancies. Conclusion: HB, advancing age, and red flag symptoms are potentially useful adjuncts to MT in predicting upper and lower gastrointestinal malignancies. We propose the adoption of a streamlined pathway to delineate patients who should undergo endoscopic investigation following CT identification of MT.
Early Detection of Arteriovenous Fistula Stenosis in Hemodialysis Patients through Routine Measurements of Dialysis Dose (Kt/V)
Authors: Ekart Robert , Varda Luka , Vodošek Hojs Nina , Dvoršak Benjamin , Piko Nejc , Bevc Sebastjan , Hojs Radovan
Published: March 2021

Background: Monitoring of arteriovenous (AV) fistula to detect hemodynamically important stenosis is crucial for the prevention of AV fistula thrombosis. The aim of our study was to analyze the importance of dialysis dose (Kt/V) during online postdilution hemodiafiltration (HDF) for early detection of AV fistula stenosis. Methods: Hemodialysis patients with AV fistula were included in this study. We compared a group of 44 patients who have undergone fistulography and subsequently percutaneous transluminal angioplasty (PTA) of significant AV fistula stenosis (active group) with a group of 44 age- and sex-matched patients without PTA (control group). Observational time in both groups was the same. Results: All patients had postdilution online HDF using a F5008 dialysis machine, which can measure online single-pool Kt/V. All data were analyzed during the performance of 2056 HDF procedures. In the active group, we found statistically significantly lower values of Kt/V, all 8 weeks before PTA. In the active group, there was a significant improvement in Kt/V in the first (p < 0.001) and second week (p = 0.049) after PTA. Three and 8 weeks after PTA, we did not find any statistically significant difference in Kt/V between both groups (p = 0.114; p = 0.058). Patients in the active group had statistically significantly lower substitution volumes and blood pump flow rates during HDF over the whole observation period before and after PTA. In contrast, there were no differences in venous pressure in the dialysis circuit between both groups throughout the observation period. Conclusion: In hemodialysis patients with AV fistula, treated with online HDF, routine measurements of Kt/V during each HDF are a beneficial, quick, and straightforward method for early detection of hemodynamically significant AV fistula stenosis.
Using FOSS TTS Developer Tool to build Malay TTS System
Authors: Tiun Sabrina , Salikin Ahmad Lufti , Muhammad Siti Khaotijah
Published: March 2021

In order to develop a complete and usable Text-to-Speech (TTS) system requires years of time, hours of human workloads and tons of knowledge from various field of subjects. However, with a simple and easy software tools to use and understand, the burden of developing a complete TTS for a specific language can be overcome. Thus, such existing software is able to cater for dynamic society that demands for less and less appliance to communicate with machines and prefers natural user interface, like voices and visual to interact with machine. In this paper, we will present our work and experience as a user in using a software developer tool called eSpeakedit (a free/open source software (FOSS)) of eSpeak TTS system to build a Malay TTS system within a short time. In this paper, not only our experience as a user will make other TTS researcher in Malay or non-Malay language be awared of the eSpeak developer tools and architecture, but other FOSS and non-FOSS researcher might be enlighten of such well-designed FOSS architecture as well
Property Based Dynamic Slicing of Object Oriented Programs
Authors: Pani Santosh Kumar , Mund G.B.
Published: March 2021

Slicing is used for program analysis. It the process of extracting the statements of a program that are relevant to a given computation. Static slicing generates slices for all possible execution of a program helping in program understanding, verification, maintenance and testing. Dynamic slices are smaller in size as they extract slices for a given execution of a program and helps in interactive applications like debugging and testing. With the wide spread use of object oriented software, there are many papers on Dynamic Slicing of object oriented programs but few papers only address in details about the most basic features of Object Oriented Programming that is class definition, Object creation, accessing object through reference, invoking methods of a class , polymorphism, inheritance etc. From last three decades many algorithms have been designed to slice a program with respect to the syntax of the program. The real world object oriented programs consists of thousands of lines of code. Traditional Syntax based slices for program variables used at many places in a program are generally large even for dynamic slices. Recently, some work has been done to get slices based on abstract/concrete properties of program variables. For smooth debugging and testing, the slice will be small if any particular property is being considered (semantics based). Most of the semantics based slicing algorithms have focused on finding static slices on the abstract properties by using SSA as intermediate representation and extract slices by storing an execution trace of a program. To the best of our knowledge generating dynamic slices based on abstract/Concrete properties of program variables is scarcely reported in literature. In this paper we present an algorithm for generating dynamic abstract slices of object oriented programs addressing all key object oriented features.
The Application of Thinning Zhang-Suen Method in the Image of Balinese Scripts on the Papyrus
Authors: Sudarma Made , Sutramiani Putu
Published: March 2021

One of the cultural heritage which are now starting to be forgotten is the papyrus library. Balinese papyrus is one of the media to write the ideas from minstrels in ancient times. Currently, many of ancient literature that written in papyrus very difficult to identify because the writings were beginning to rot or fade influenced by age. The introduction of Balinese scripts on papyrus can be done first by performing papyrus digitalization. The papyruses are scanned to become one image file. Further the papyrus image is done by Thresholding since prior to the thinning process it is required a binary image. The application of Thinning Zhang-Suen method is very effective because from the original image with 2 sub iteration until yielding in 1 pixel. The benefits of this research is to improve the quality of the image and further segmented to read papyrus making it easier to read text on the papyrus.
Proposed Metrics for Process Capability Analysis in Improving Software Quality: An Empirical Study
Authors: Patnaik K Sridhar , Jha Pooja
Published: March 2021

A software project faces its top expense on defect removal; thereby delaying the schedules. There has been increasing demand for high quality software. Here, high quality software means, delivering defect free software and meeting the predictable results within time and cost constraints. Software defect prediction strives to improve software quality and testing efficiency. The research work presented here is an empirical study and analyzes importance of different metrics used in the organization. The paper examines the impact of LSL and USL, known as organization baselines, on various projects and proposes four metrics for capability analysis metrics. These can prove beneficial for categorizing the process of software development. These metrics aim to improve the ongoing software development process and are helpful in determining the quality of these processes in terms of their specification limits. Also, the paper attempts to justify the probability of the values related to the data provided by normal distribution or Gaussian distribution.
Anti-Epidemic Emergency Regimes under Polish Law in Comparative, Historical and Jurisprudential Perspective
Authors: Bosek Leszek
Published: March 2021

The SARS-CoV-2 crisis of 2020 triggered a number of unprecedented reactions of European states, in particular in the form of either constitutional emergency measures or statutory anti-epidemic emergency measures. Poland chose to deal with the crisis by delegating powers to the executive by ordinary legislative means and declared a nationwide state of epidemic emergency on 13 March 2020 and a week later a state of epidemic on the basis of the Act of 5 December 2008 on preventing and combating infections and infectious diseases. For a century, Poland has been dealing with epidemics by delegating powers to the executive by ordinary legislative means. Anti-epidemic emergency measures were developed under the relevant acts of 1919, 1935, 1963, 2001, 2008 and now form an autonomous normative model authorised directly by Article 68 (4) of the Constitution of the Republic of Poland of 2 April 1997. The Constitution of 2 April 1997 authorises also extraordinary measures in situations of particular danger, “if ordinary constitutional measures are inadequate”. This article analyses anti-epidemic emergency regimes under Polish law in a comparative, historical and jurisprudential perspective.
Medieval Translation in the Light of the Polysystem and Rewriting Theories
Authors: Doborjginidze Nino , Mataradze Nino , Tatishvili Elene
Published: March 2021

This paper examines through the lens of translation studies (TS) the pattern of sociocultural and linguistic evolution to which medieval vernaculars of the Christian East adhered. It aims to contribute to discussions in medieval studies and TS with regard to vernacular translations. The medieval Georgian tradition of translation is examined from the perspective of descriptivist translation theories, namely, in the light of Even-Zohar’s polysystem and Lefevere’s rewriting theories. The Georgian literary polysystem is viewed as part of a larger mega-polysystem of the Christian East, with Greek being at its centre. This explains parallels in the emancipation of vernacular languages. From the viewpoint of the rewriting theory, emphasis is given to the roles of professional circles, patronage and dominant poetics. The evolution of the Georgian translation tradition from free rendering to a higher concern for precision reflects the impact of different sociocultural factors, evidencing the validity of the mentioned descriptivist models.
The Old Testament in the First Discourse on Martyrs
Authors: Francisco Hector Ricardo
Published: March 2021

The aim of this paper is to analyze the use of Biblical Testimonia in the First Discourse of the Holy Martyrs of the Land of Orient (BHO 706). It will be argued that the main purpose of the author was not only to promote the cult of their relics but also to demonstrate that the persecution was part of God’s plan for the Church. As long as Christ, the Apostles and the Prophets were Models for those suffering persecution, the Biblical text was the testimony of the truth of Christian Martyrdom. Moreover, by stressing the continuity between the Heroes of both Testaments and the Martyrs, the author was engaged in a controversy against Marcionism.
Social Media Representations of the Pilgrimage to Mecca
Authors: Al-Ajarma Kholoud , Buitelaar Marjo
Published: March 2021

In this article, we compare representations of the pilgrimage to Mecca posted on Facebook and Youtube by ‘ordinary’ pilgrims from Morocco and (semi)professional bloggers of Moroccan parentage in the Netherlands. We discuss how such posts challenge representations that circulate in the mainstream media in both countries about Islam in general and the hajj in particular. For Morocco we demonstrate that this kind of digital mediation of pilgrimage contests the ways in which the state-organized hajj is framed in Morocco’s national media. For the Netherlands, we argue that bloggers deconstruct dominant images of the Muslim ‘other’ in their self-presentations as specifically Dutch Muslim pilgrims by connecting the meanings they attribute to the pilgrimage to Mecca to universal issues.
An EnKF-based method to produce rainfall maps from simulated satellite-to-ground MW-link signal attenuation
Authors: Ortolani Alberto , Caparrini Francesca , Melani Samantha , Baldini Luca , Giannetti Filippo
Published: March 2021

Measuring rainfall is complex, due to the high temporal and spatial variability of precipitation, especially in a changing climate, but it is of great importance for all the scientific and operational disciplines dealing with rainfall effects on the environment, human activities, and economy.

Microwave (MW) telecommunication links carry information on rainfall rates along their path, through signal attenuation caused by raindrops, and can become measurements of opportunity, offering inexpensive chances to augment information without deploying additional infrastructures, at the cost of some smart processing. Processing satellite telecom signals bring some specific complexities related to the effects of rainfall boundaries, melting layer, and non-weather attenuations, but with the potential to provide worldwide precipitation data with high temporal and spatial samplings. These measurements have to be processed according to the probabilistic nature of the information they carry. An EnKF-based (Ensemble Kalman Filter) method has been developed to dynamically retrieve rainfall fields in gridded domains, which manages such probabilistic information and exploits the high sampling rate of measurements. The paper presents the EnKF method with some representative tests from synthetic 3D experiments. Ancillary data are assumed as from worldwide-available operational meteorological satellites and models, for advection, initial and boundary conditions, rain height. The method reproduces rainfall structures and quantities in a correct way, and also manages possible link outages. It results computationally viable also for operational implementation and applicable to different link observation geometries and characteristics.
Short-term outcomes of Chinese transient ischaemic attack patients in an Emergency department in Hong Kong: Result of management with an agreed protocol with neurologists
Authors: Chiu Simon Lai Hong , Wong William Cheung Lun , Yu Ellen Lok Man
Published: March 2021

Introduction:

Emergency department management of transient ischaemic attack varies from admission for all to outpatient referral. We studied the short-term outcomes of transient ischaemic attack managed with an agreed protocol. Predictors of stroke can be different for Asians and non-Asians. ABCD2 as initial triage of transient ischaemic attack is debatable. The predictive ability of ABCD2 score was studied as well.

Methods:

This was a prospective observational study with consecutive subject recruitment in Emergency department. All transient ischaemic attacks were admitted, hard and e-records of Emergency department, transient ischaemic attack clinic, Medical and Neurosurgical department and general follow-ups in Hospital Authority hospitals were studied up to 1 year. Stroke-day was measured from symptom-onset to time-of-stroke.

Results:

In 18-month period, 124 patients were recruited. The median onset-to-door time was 3.5 h. All computed tomography brain positive findings, except one subdural haematoma, were ischaemic in origin. Six strokes, all disabling, recurred within 90 days, three on day 1–3, two died in 6 months. The stroke risks at 2, 7, 90 days and 1 year were 1.61%, 3.23%, 4.84% and 4.84%, respectively. No significant trend was observed in stroke risk across ABCD2 scores ( p = 0.783) with area under the curve of 0.537 (95% confidence interval = 0.380–0.694; p = 0.762). The short-term stroke risk was associated with atrial fibrillation ( p = 0.002). The median Emergency Medicine ward length of stay was 1.33 days.

Conclusion:

In our Emergency department–based management, the short-term stroke risk of transient ischaemic attack is low, and the predictivity of ABCD2 score in risk stratification cannot be validated. Stroke recurrences were associated with atrial fibrillation. A low ABCD2 could be falsely reassuring. As half of the strokes recurred very early, we recommend admission in the hyperacute phase.
Rapid Photovoice as a Close-Up, Emancipatory Methodology in Student Experience Research: The Case of the Student Movement Violence and Wellbeing Study
Authors: Luescher Thierry M. , Fadiji Angelina Wilson , Morwe Keamogetse , Letsoalo Tshireletso S.
Published: March 2021

In this paper, we critically reflect on our conceptualization and operationalization of “rapid photovoice” as a close-up, emancipatory, action research methodology which has multiple, intersecting social-justice goals; and consider the methodology’s potential for helping to achieve such goals. We first consider photovoice in relation to its typical use in public health research, as well as in prior research into student experiences of higher education. We then consider our pragmatic redesign of the methodology as rapid photovoice (RPV), which we conceptualized in response to the goals, parameters, and constraints inherent in our project, which studied student movement violence and wellbeing. In the third part of the article, we describe and discuss our operationalization of RPV in this study on four university campuses in South Africa. In the fourth section, we reflect on some of the ethical considerations arising from the topic and the methodology. In the final section of the article, we critically assess the interim outcomes of our use of RPV in terms of (1) psychologically empowering students to reflect on traumatic experiences in a safe space and enhancing their self-awareness of wellbeing, wellbeing resources and coping strategies; (2) the politically emancipatory potential of photovoice to represent student experiences authentically and with immediacy to higher education policy role-players, and (3) its ability to co-create artifacts of collective memory that provide authentic empirical material for making trustworthy knowledge claims.
The crowding-out effect of elderly support expenditure on household consumption from the perspective of population aging: evidence from China
Authors: Huo Congjia , Xiao Guoan , Chen Lingming
Published: March 2021

The pace of aging in China is accelerating, from the introduction of family planning to the liberalization of the two-child policy, with a growing proportion of families in the 4–2-1 structure. With filial piety in mind, most adult children will live with their elderly parents and share income and expenditure. Concurrently, due to the inadequacy of the social security system, a heavy supplementary burden of supporting the elderly has been placed on adult children. Based on data from the 2011, 2013, 2015, and 2017 Chinese Social Survey (CSS) of the Chinese Academy of Social Sciences (CASS), this study analyzes the objective factors affecting household elderly support expenditure using the ordinary least squares (OLS) estimation method. It also examines the crowding-out effect of elderly support expenditure on the consumption of different types of households through a panel generalized method of moments (GMM) approach. Finally, the crowding-out effect of elderly support expenditure is discussed in a sub-sample according to the number of households needing to support the elderly aged 60 and above. The empirical results illustrate that there is a crowding-out effect of elderly support expenditure on household consumption, and the magnitude of the crowding-out effect varies for diverse consumption. Our study reveals that the crowding-out effect of elderly support expenditure on core consumption is the largest in a sample with different numbers of elderly persons in families. The empirical results for the sub-sample show that the larger the elderly population, the stronger the crowding-out effect of elderly support expenditure on core consumption and the less pronounced the effect on marginal consumption.
Successful induction of deep hypothermia by isoflurane anesthesia and cooling in a non-hibernator, the rat
Authors: Shimaoka Hiroki , Shiina Takahiko , Suzuki Hayato , Horii Yuuki , Horii Kazuhiro , Shimizu Yasutake
Published: March 2021

The aim of the present study was to establish a novel method for inducing deep hypothermia in rats. Cooling rats anesthetized with isoflurane caused a time-dependent decrease in rectal temperature, but cardiac arrest occurred before their body temperature reached 20 °C when isoflurane inhalation was continued during the cooling process. Stopping inhalation of isoflurane when the rectal temperature reached 22.5 °C successfully induced deep hypothermia, although stopping the inhalation at 27.5 °C resulted in spontaneous recovery of rectal temperature. The hypothermic condition was able to be maintained for up to 6 h. A large number of c-Fos-positive cells were detected in the hypothalamus during hypothermia. Both the maintenance of and recovery from hypothermia caused organ injury, but the damage was transient and recovered within 1 week. These findings indicate that the established procedure is appropriate for inducing deep hypothermia without accompanying serious organ injury in rats.
Confocal laser endomicroscopy under propofol‐based sedation for early gastric cancer and pre‐cancerous lesions is associated with better diagnostic accuracy: a retrospective cohort study in China
Authors: Chu Lihua , Zhao Jialian , Sheng Cheng , Yue Min , Wang Feifei , Song Shengwen , Cheng Baoli , Xie Guohao , Fang Xiangming
Published: March 2021

Background

Confocal laser endomicroscopy (CLE) has advantages in detecting gastric neoplastic lesions, meanwhile it requires strict patient cooperation. Sedation could improve patient cooperation and quality of endoscopy. However, sedation is still not very popular in some resource-limited countries and regions. The purpose of this study was to compare propofol-based sedated versus un-sedated CLE in the value of diagnosing early gastric cancer (EGC) and precancerous lesions.

Methods

A retrospective, cohort, single center study of 226 patients who underwent CLE between January 1, 2015 and December 31, 2017 was performed. Patients enrolled were allocated into the propofol-based sedated group (n = 126) and the un-sedated group (n = 100). The comparison of validity and reliability of CLE for identifying EGC and precancerous lesions between the two groups was performed through analyzing CLE diagnosis and pathological diagnosis. Reporting followed the STROBE guidelines.

Results

The area under receiver operating characteristic curve (AUROC) of diagnosing EGC in the sedated group was 0.97 (95 % CI: 0.95 to 0.99), which was higher than that in the un-sedated group (0.88 (95 % CI: 0.80 to 0.97), P = 0.0407). CLE with sedation performed better than without sedation in diagnosing intraepithelial neoplasia and intestinal metaplasia (P = 0.0008 and P = 0.0001, respectively). For patients considered as high-grade intraepithelial neoplasia or EGC by endoscopists, they would not get biopsy during CLE but receive endoscopic submucosal dissection (ESD) subsequently, and the misdiagnosis rate of CLE was 0 % in the sedated group and 27.59 % (95 % CI: 10.30–44.91 %) in the un-sedated group (P = 0.006).

Conclusions

Propofol based sedation was associated with improved diagnostic value of CLE for detecting EGC as well as precancerous lesions (intraepithelial neoplasia OR intestinal metaplasia).
Coronavirus disease 2019 (COVID-19) and QTc prolongation
Authors: Changal Khalid , Paternite David , Mack Sean , Veria Spiro , Bashir Rehana , Patel Mitra , Soni Ronak , Ali Muhammad , Mir Tanveer , Sheikh Mujeeb , Ramanathan P. Kasi
Published: March 2021

Introduction

The cause-and-effect relationship of QTc prolongation in Coronavirus disease 2019 (COVID-19) patients has not been studied well.

Objective

We attempt to better understand the relationship of QTc prolongation in COVID-19 patients in this study.

Methods

This is a retrospective, hospital-based, observational study. All patients with normal baseline QTc interval who were hospitalized with the diagnosis of COVID-19 infection at two hospitals in Ohio, USA were included in this study.

Results

Sixty-nine patients had QTc prolongation, and 210 patients continued to have normal QTc during hospitalization. The baseline QTc intervals were comparable in the two groups. Patients with QTc prolongation were older (mean age 67 vs. 60, P 0.003), more likely to have underlying cardiovascular disease (48% versus 26%, P 0.001), ischemic heart disease (29% versus 17%, P 0.026), congestive heart failure with preserved ejection fraction (16% versus 8%, P 0.042), chronic kidney disease (23% versus 10%, P 0.005), and end-stage renal disease (12% versus 1%, P < 0.001). Patients with QTc prolongation were more likely to have received hydroxychloroquine (75% versus 59%, P 0.018), azithromycin (18% vs. 14%, P 0.034), a combination of hydroxychloroquine and azithromycin (29% vs 7%, P < 0.001), more than 1 QT prolonging agents (59% vs. 32%, P < 0.001). Patients who were on angiotensin-converting enzyme inhibitors (ACEi) were less likely to develop QTc prolongation (11% versus 26%, P 0.014). QTc prolongation was not associated with increased ventricular arrhythmias or mortality.

Conclusion

Older age, ESRD, underlying cardiovascular disease, potential virus mediated cardiac injury, and drugs like hydroxychloroquine/azithromycin, contribute to QTc prolongation in COVID-19 patients. The role of ACEi in preventing QTc prolongation in COVID-19 patients needs to be studied further.
Public perceptions of Lyme disease and climate change in southern Manitoba, Canada: making a case for strategic decoupling of climate and health messages
Authors: Cameron Laura , Rocque Rhéa , Penner Kailey , Mauro Ian
Published: March 2021

Background

Despite scientific evidence that climate change has profound and far reaching implications for public health, translating this knowledge in a manner that supports citizen engagement, applied decision-making, and behavioural change can be challenging. This is especially true for complex vector-borne zoonotic diseases such as Lyme disease, a tick-borne disease which is increasing in range and impact across Canada and internationally in large part due to climate change. This exploratory research aims to better understand public risk perceptions of climate change and Lyme disease in order to increase engagement and motivate behavioural change.

Methods

A focus group study involving 61 participants was conducted in three communities in the Canadian Prairie province of Manitoba in 2019. Focus groups were segmented by urban, rural, and urban-rural geographies, and between participants with high and low levels of self-reported concern regarding climate change.

Results

Findings indicate a broad range of knowledge and risk perceptions on both climate change and Lyme disease, which seem to reflect the controversy and complexity of both issues in the larger public discourse. Participants in high climate concern groups were found to have greater climate change knowledge, higher perception of risk, and less skepticism than those in low concern groups. Participants outside of the urban centre were found to have more familiarity with ticks, Lyme disease, and preventative behaviours, identifying differential sources of resilience and vulnerability. Risk perceptions of climate change and Lyme disease were found to vary independently rather than correlate, meaning that high climate change risk perception did not necessarily indicate high Lyme disease risk perception and vice versa.

Conclusions

This research contributes to the growing literature framing climate change as a public health issue, and suggests that in certain cases climate and health messages might be framed in a way that strategically decouples the issue when addressing climate skeptical audiences. A model showing the potential relationship between Lyme disease and climate change perceptions is proposed, and implications for engagement on climate change health impacts are discussed.
Meaningful activities during COVID-19 lockdown and association with mental health in Belgian adults
Authors: Cruyt Ellen , De Vriendt Patricia , De Letter Miet , Vlerick Peter , Calders Patrick , De Pauw Robby , Oostra Kristine , Rodriguez-Bailón Maria , Szmalec Arnaud , Merchán-Baeza Jose Antonio , Fernández-Solano Ana Judit , Vidaña-Moya Laura , Van de Velde Dominique
Published: March 2021

Background

The spread of COVID-19 has affected people’s daily lives, and the lockdown may have led to a disruption of daily activities and a decrease of people’s mental health.

Aim

To identify correlates of adults’ mental health during the COVID-19 lockdown in Belgium and to assess the role of meaningful activities in particular.

Methods

A cross-sectional web survey for assessing mental health (General Health Questionnaire), resilience (Connor-Davidson Resilience Scale), meaning in activities (Engagement in Meaningful Activities Survey), and demographics was conducted during the first Belgian lockdown between April 24 and May 4, 2020. The lockdown consisted of closing schools, non-essential shops, and recreational settings, employees worked from home or were technically unemployed, and it was forbidden to undertake social activities. Every adult who had access to the internet and lived in Belgium could participate in the survey; respondents were recruited online through social media and e-mails. Hierarchical linear regression was used to identify key correlates.

Results

Participants (N = 1781) reported low mental health (M = 14.85/36). In total, 42.4% of the variance in mental health could be explained by variables such as gender, having children, living space, marital status, health condition, and resilience (β = −.33). Loss of meaningful activities was strongly related to mental health (β = −.36) and explained 9% incremental variance (R2 change = .092, p < .001) above control variables.

Conclusions

The extent of performing meaningful activities during the COVID-19 lockdown in Belgium was positively related to adults’ mental health. Insights from this study can be taken into account during future lockdown measures in case of pandemics.
Bayesian regression model with application to a study of food insecurity in household level: a cross sectional study
Authors: Gebrie Yenesew Fentahun
Published: March 2021

Background

Food insecurity is a situation in which access to sufficient food is limited at times during the year by a lack of money and other resources. Even though several efforts were made to recover food security, still it is a critical social problem that needs immediate attention from policy and other decision makers especially in Ethiopia. The objective of the paper was to identify the significant predictors of food insecurity at household level in the given District.

Method

A cross-sectional survey study was employed among 305 households selected using systematic random sampling technique. The data was collected using structured interviewer administrative questionnaire. Descriptive statistics was used to assess the prevalence of food insecurity status, and Bayesian estimation on binary logistic regression was used to identify the significant predictors of household food insecurity. Gibbs sampler algorithm was employed on Win BUGS software. Convergence of algorithm was assessed by using time series plot, density plot and auto correlation plot.

Result

The prevalence of household food insecurity was 59% in the study District. From Bayesian estimation, the significant predictors of food insecurity were sex of household head, agro-ecological zone, loan status, access to agricultural training, age of household head, marital status of household head, family size, agricultural land size, tropical livestock unit, and soil fertility of agricultural land.

Conclusion

The result shows that the households headed by male; who had own land, who land fertile soil, and those who took agricultural training were less likely to be food insecure. On the other hand, households with large family size, small farm land size and less tropical livestock unit were more likely to be food insecure. Hence, to increase food production and productivity of the farmers, proper attention should be given to improve soil fertility of agricultural land. Creating access to credit to households and providing them with agricultural training and family planning should be also emphasized.
New risk factors of postoperative complications in elective gastrointestinal surgery of elderly patients: a prospective cohort study
Authors: Yokozuka Kei , Tomita Koichi , Nakagawa Masashi , Koganezawa Itsuki , Ochiai Shigeto , Gunji Takahiro , Ozawa Yosuke , Hikita Kosuke , Kobayashi Toshimichi , Sano Toru , Tabuchi Satoshi , Chiba Naokazu , Hidaka Eiji , Kawachi Shigeyuki
Published: March 2021

Background

Gastrointestinal surgery in elderly individuals presents unexpected postoperative complications. However, predicting postoperative complications in elderly patients undergoing gastrointestinal surgeries is challenging because of the lack of a reliable preoperative evaluation system. We aimed to prospectively evaluate three new preoperative assessment methods to predict the postoperative complications in elderly patients undergoing elective gastrointestinal surgery. Moreover, we aimed to identify new risk factors of postoperative complications in this patient group.

Methods

This prospective cohort study enrolled 189 patients (age ≥ 65 years) who underwent elective gastrointestinal surgery at Tokyo Medical University Hachioji Medical Center between April 2017 and March 2019. Assessments performed preoperatively included the biological impedance analysis for evaluating the skeletal muscle mass, the SF-8 questionnaire for evaluating the subjective health-related quality of life, and the blood pressure/pulse wave test for assessing arteriosclerosis. The risk factors for Clavien–Dindo Grade ≥ III postoperative complications were assessed using these new evaluation methods.

Results

Clavien–Dindo Grade ≥ III postoperative complications were observed in 28 patients (14.8%). Univariate and multivariate analyses identified male sex, low skeletal muscle mass, and cardio-ankle vascular index ≥ 10 (arteriosclerosis) as significant independent risk factors of developing Grade ≥ III complications.

Conclusions

Male sex, low skeletal muscle mass, and arteriosclerosis were significant risk factors of postoperative complications in elderly patients undergoing elective gastrointestinal surgery. The obtained knowledge could be useful in identifying high-risk patients who require careful perioperative management.
Non-energy devices to dissect recurrent laryngeal nerve lymph nodes of non-small cell lung cancer under video-assisted thoracic surgery
Authors: Yu Minhao , Ge Mingjian
Published: March 2021

Background

Systematic nodal dissection plays a crucial role in improving survival and staging in resectable non-small cell lung cancer (NSCLC) patients but at the cost of increasing the occurrence of recurrent laryngeal nerve injury. Technology should be improved to protect the recurrent laryngeal nerve (RLN) during surgery.

Methods

NSCLC patients who underwent video-assisted thoracic surgery (VATS) surgical treatment by the same surgeon at our hospital from January 2016 to December 2017 were included as the research subjects and were divided into an energy-device group and a non-energy-device group. Their procedures included anatomic pulmonary resection, normative N1 dissection, and systemic N2 dissection.

Results

The rate of metastatically involved recurrent laryngeal nerve lymph nodes (RLNLNs) was 5.19% (39/752). Dissection device, side of primary, FEV1, operative time and BMI were independent predictors of recurrent laryngeal nerve injury (RLNI) (hazard ratio (HR) = 3.576, 95% confidence interval (CI): 1.490–8.583, P = 0.004; HR = 0.175, 95% CI: 0.072–0.424, P =  < 0.001; HR = 3.008, 95% CI: 1.30–6.927, P = 0.010; HR = 0.328, 95% CI: 0.136–0.794, P = 0.013; HR = 0.344, 95%CI: 0.147–0.801, P = 0.013, respectively). Patients in the non-energy-device group had significantly less RLNI than the energy-device group (P = 0.016) and nearly half of the non-thermal RLNI recovered in 2 weeks (P = 0.025) whereas most thermal RLNI required 3 months for recovery.

Conclusions

Every station of RLNLN had some degree of cancer metastasis in NSCLC patients and when dissecting RLNLNs, dissection device was an independent and artificially controlled predictor of RLNI. Using a non-energy device is a feasible method to protect the RLN as well as an improved recovery time of RLNI.
Protective role of intravesical BCG in COVID-19 severity
Authors: Gallegos Héctor , Rojas Pablo A. , Sepúlveda Francisca , Zúñiga Álvaro , San Francisco Ignacio F.
Published: March 2021

Objectives

To establish the role of BCG instillations in the incidence and mortality of COVID-19.

Patients and methods

NMIBC patients in instillations with BCG (induction or maintenance) during 2019/2020 were included, establishing a COVID-19 group (with a diagnosis according to the national registry) and a control group (NO-COVID). The cumulative incidence (cases/total patients) and the case fatality rate (deaths/cases) were established, and compared with the national statistics for the same age group. T-test was used for continuous variables and Fisher's exact test for categorical variables.

Results

175 patients were included. Eleven patients presented CIS (11/175, 6.3%), 84/175 (48.0%) Ta and 68/175 (38.9%) T1. Average number of instillations = 13.25 ± 7.4. One hundred sixty-seven patients (95.4%) had complete induction. Forty-three patients (cumulative incidence 24.6%) were diagnosed with COVID-19. There is no difference between COVID-19 and NO-COVID group in age, gender or proportion of maintenance completed. COVID-19 group fatality rate = 1/43 (2.3%). Accumulated Chilean incidence 70–79 years = 6.3%. Chilean fatality rate 70–79 years = 14%.

Conclusions

According to our results, patients with NMIBC submitted to instillations with BCG have a lower case-fatality rate than the national registry of patients between 70 and 79 years (2.3% vs. 14%, respectively). Intravesical BCG could decrease the mortality due to COVID-19, so instillation schemes should not be suspended in a pandemic.
Feasibility and acceptability of a culturally tailored physical activity intervention for Arab-Australian women
Authors: El Masri Aymen , Kolt Gregory S. , George Emma S.
Published: March 2021

Background

Despite being one of the largest migrant groups in Australia, few physical activity interventions exist for Arab-Australians. The primary aim of this study was to test the feasibility and acceptability of a 12-week culturally tailored physical activity intervention for Arab-Australian women.

Methods

This study used a single-group pretest–posttest design, and was informed by extensive formative research and consultation involving the Arab-Australian community. Participants were insufficiently active Arab-Australian women aged 35–64 with no current illness or injury that would limit physical activity participation. The intervention comprised 6 face-to-face physical activity and education sessions over 12 weeks. The intervention was conducted at 2 separate intervention sites in Western Sydney, Australia. Feasibility outcomes included recruitment, session attendance, and retention. The acceptability of the intervention was assessed through a process evaluation questionnaire completed post-intervention. Accelerometers and the short-form International Physical Activity Questionnaire were used to measure physical activity at baseline and post-intervention. Descriptive statistics were used for feasibility and acceptability outcomes, and changes in physical activity were examined using Wilcoxon signed-rank tests.

Results

Of the 53 women who were contacted or expressed interest, 22 were eligible and enrolled in the study. Participants were primarily recruited through direct contact by Arab-Australian community workers and by word-of-mouth. Average session attendance was 63% and the retention rate post-intervention was 68%. The culturally-related intervention components, such as the appropriateness of content, and women-only setting, were rated highly favourably (4.33 to 4.87/5). General intervention elements, such as the face-to-face delivery, knowledge and approachability of facilitators, and session structure, were also rated favourably (4.33 to 4.93/5), and the lowest scored item was the intervention session frequency (3.2/5). There were no statistically significant changes in physical activity post-intervention.

Conclusions

The findings from this study highlighted factors related to recruitment and delivery that need to be considered when developing physical activity interventions for Arab-Australian women. Further research is required using a larger sample and a randomised controlled trial design to examine the longer-term impact on physical activity, and to also examine ways of increasing intervention engagement and retention among Arab-Australian women.

Trial Registration: ANZCTR, ACTRN12618001392257. Registered 20 August 2018,https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375636.
Prediction of steroid resistance and steroid dependence in nephrotic syndrome children
Authors: Zaorska Katarzyna , Zawierucha Piotr , Świerczewska Monika , Ostalska-Nowicka Danuta , Zachwieja Jacek , Nowicki Michał
Published: March 2021

Background

Steroid resistant (SR) nephrotic syndrome (NS) affects up to 30% of children and is responsible for fast progression to end stage renal disease. Currently there is no early prognostic marker of SR and studied candidate variants and parameters differ highly between distinct ethnic cohorts.

Methods

Here, we analyzed 11polymorphic variants, 6 mutations, SOCS3 promoter methylation and biochemical parameters as prognostic markers in a group of 124 Polish NS children (53 steroid resistant, 71 steroid sensitive including 31 steroid dependent) and 55 controls. We used single marker and multiple logistic regression analysis, accompanied by prediction modeling using neural network approach.

Results

We achieved 92% (AUC = 0.778) SR prediction for binomial and 63% for multinomial calculations, with the strongest predictors ABCB1 rs1922240, rs1045642 and rs2235048, CD73 rs9444348 and rs4431401, serum creatinine and unmethylated SOCS3 promoter region. Next, we achieved 80% (AUC = 0.720) in binomial and 63% in multinomial prediction of SD, with the strongest predictors ABCB1 rs1045642 and rs2235048. Haplotype analysis revealed CD73_AG to be associated with SR while ABCB1_AGT was associated with SR, SD and membranoproliferative pattern of kidney injury regardless the steroid response.

Conclusions

We achieved prediction of steroid resistance and, as a novelty, steroid dependence, based on early markers in NS children. Such predictions, prior to drug administration, could facilitate decision on a proper treatment and avoid diverse effects of high steroid doses.
Decreased complications but a distinctive fixation loosening mechanism of fully threaded headless cannulated screw fixation for femoral neck fractures in young adults
Authors: Sun Hui , Shu Lin-Yuan , Sherrier Matthew C. , Zhu Yi , Liu Jing-Wen , Zhang Wei
Published: March 2021

Background

Despite being a commonly encountered injury in orthopedic practice, controversy surrounds the methods of optimal internal fixation for femoral neck fractures (FNF) in young patients. The objective of the present study is to compare complication rates and failure mechanisms for surgical fixation of FNF using fully threaded headless cannulated screws (FTHCS) versus partial threaded cannulated screws (PTS) in young adults.

Methods

A total of 75 patients (18–65 years old) with FNF were prospectively treated with close reduction and internal fixation using three parallel FTHCS and compared to a historical control case-matched group (75 patients) with FNF treated by PTS fixation. After 2 years follow-up, rates of fixation failure (including varus collapse, fracture displacement, and femoral neck shortening), nonunion, and avascular necrosis of the femoral head (ANFH) were compared between the two cohorts. The demographic, follow-up information, and radiological images were assessed by independent blinded investigators.

Results

Patient demographics and fracture patterns were similar in the two patient groups. The overall fixation failure rates were 8% (6/75) in the FTHCS cohort, which was significantly lower than the 25.3% (19/75) seen in the PTS group. Rates of nonunion and ANFH were significantly lower in the FTHCS group when compared to the PTS control group. When stratified by injury severity (high-energy vs. low-energy fractures), the rate of fixation failure was significant lower with the use of FTHCS when compared with PTS for high-energy fractures while there was no difference in the rates of nonunion or ANFH for high or low-energy fracture patterns. Unique to the FTHCS cohort was an atypical screw migration pattern with varus collapse (6/75, 8%).

Conclusions

The results show that FTHCS fixation could significantly reduce the complication rate of young patients with FNF, especially in high-energy fracture patterns (Garden III–IV, Pauwels III, or vertical of the neck axis (VN) angle ≥ 15°). There was also confirmation that the modes of fixation loosening in the FTCHS group, including screw “medial migration” and superior cutout, were different from the screw withdrawal pattern seen in the PTS cohort.

Trial registration

The study was retrospectively registered at www.Chictr.org.cn (ChiCTR-IPR-1900025851) on September 11, 2019.
Nonoperative treatment of insertional Achilles tendinopathy: a systematic review
Authors: Zhi Xiaosong , Liu Xinyuan , Han Jing , Xiang Yang , Wu Helin , Wei Shijun , Xu Feng
Published: March 2021

Background

Insertional Achilles tendinopathy is difficult to manage, and there is no definite consensus on which nonoperative treatment is superior over the others. We aim to provide a clear summary of the best available evidence for nonoperative treatment specific to insertional Achilles tendinopathy.

Methods

Literatures were searched in PubMed, Embase, and Web of Science databases from inception to October 2020. The results were evaluated independently by two reviewers and assessed against the inclusion/exclusion criteria. All included articles were assessed for methodological quality, and study characteristics were extracted.

Results

Twenty-three studies (containing 35 groups) were eligible for the final review. The treatments included eccentric training, extracorporeal shockwave therapy (ESWT), injections, and combined treatment. Visual analog scale (VAS), Victorian Institute of Sport Assessment-Achilles questionnaire, AOFAS, satisfaction rate, and other scales were used to assess the clinical outcome.

Conclusion

Current evidence for nonoperative treatment specific for insertional Achilles tendinopathy favors ESWT or the combined treatment of ESWT plus eccentric exercises.