bluuebunny/crossref_metadata_2025 huggingface dataset:
Cost of Management of Diabetes Mellitus: A Pan India Study
Authors: Nagarathna Raghuram , Madhava M , Patil Suchitra S. , Singh Amit , Perumal K. , Ningombam Ganga , Nagendra and Hongasandra R.
Published: June 2021

Background:

Diabetes mellitus is a major noncommunicable disease. While mortality rates are increasing, the costs of managing the disease are also increasing. The all-India average monthly expenditure per person (pppm) is reported to be ₹ 1,098.25, which translates to an annual expenditure of ₹13,179 per person.

Purpose:

While a number of studies have gone into the aspect of the cost of disease management, we do not find any study which has pan-India reach. We also do not find studies that focus on differences (if any) between rural and urban areas, age or on the basis of gender. We planned to report the cost of illness (COI) in diabetes individuals as compared to others from the data of a pan-India trial.

Methods:

Government of India commissioned the Indian Yoga Association to study the prevalence of diabetes mellitus in India in 2017. As part of the questionnaire, the cost of treatment was also captured. Data collected from 25 states and union territories were analyzed using the analysis of covriance (ANCOVA) test on SPSS version 21.

Results:

There was a significant difference ( P < .05) between the average expenses per person per month (pppm) of individuals with self-reported known diabetes (₹1,357.65 pppm) and others (unknown and/or nondiabetes individuals–₹ 999.91 pppm). Similarly, there was a significant difference between rural (₹2,893 pppm) and urban (₹4,162 pppm) participants and between those below (₹1,996 pppm) and above 40 years (₹5,059 pppm) of age.

Conclusion:

This preliminary report has shown that the COI because of diabetes is significantly higher than others pointing to an urgent need to promote disease-preventive measures.
Aligning Medicaid and Medicare Advantage Managed Care Plans for Dual-Eligible Beneficiaries
Authors: Keohane Laura M. , Zhou Zilu , Stevenson David G.
Published: June 2021

To coordinate Medicare and Medicaid benefits, multiple states are creating opportunities for dual-eligible beneficiaries to join Medicare Advantage Dual-Eligible Special Needs Plans (D-SNPs) and Medicaid plans operated by the same insurer. Tennessee implemented this approach by requiring insurers who offered Medicaid plans to also offer a D-SNP by 2015. Tennessee’s aligned D-SNP participation increased from 7% to 24% of dual-eligible beneficiaries aged 65 years and above between 2011 and 2017. Within a county, a 10-percentage-point increase in aligned D-SNP participation was associated with 0.3 fewer inpatient admissions ( p = .048), 13.9 fewer prescription drugs per month ( p = .048), and 0.3 fewer nursing home users ( p = .06) per 100 dual-eligible beneficiaries aged 65 years and older. Increased aligned plan participation was associated with 0.2 more inpatient admissions ( p = .004) per 100 dual-eligible beneficiaries younger than 65 years. For some dual-eligible beneficiaries, increasing Medicare and Medicaid managed plan alignment has the potential to promote more efficient service use.
Sexual Assault: Indigenous Women’s Experiences of Not Being Believed by the Police
Authors: Murphy-Oikonen Jodie , Chambers Lori , McQueen Karen , Hiebert Alexa , Miller Ainsley
Published: June 2021

Rates of sexual victimization among Indigenous women are 3 times higher when compared with non-Indigenous women. The purpose of this secondary data analysis was to explore the experiences and recommendations of Indigenous women who reported sexual assault to the police and were not believed. This qualitative study of the experiences of 11 Indigenous women reflects four themes. The women experienced (a) victimization across the lifespan, (b) violent sexual assault, (c) dismissal by police, and (d) survival and resilience. These women were determined to voice their experience and make recommendations for change in the way police respond to sexual assault.
Blocked by YouTube? Unseen digital intermediaries for social imaginaries in the Asia Pacific
Authors: Hutchinson Jonathon
Published: June 2021

YouTube is one of the most utilised online content sharing sites, enabling commercial enterprise, education opportunities, and facilities for vernacular creativity. Its user engagement demonstrates online community development; alongside its use as a distribution platform to monetise one’s branded self. However, as a subset of Alphabet Incorporated, its access is often restricted by governments of Asian Pacific countries. This research describes how countries that have banned YouTube still have exceptionally strong online communities, bringing into question the sorts of augmentations used by its participants. This article focuses on digital intermediation strategies, specifically the DIY approach of community building through the use of unseen infrastructures. This comparative study of YouTube channels in several Asia Pacific countries highlights the techniques that bypass limiting infrastructures to boost online community activity. The results demonstrate digital intermediation provides unique opportunities for key agents to contribute to strengthening social imaginaries within the Asia Pacific region.
Book review: Ghodsee, K. 2019: Second World, Second Sex: Socialist Women’s Activism and Global Solidarity during the Cold War
Authors: Rothrock Brandon Anthony
Published: June 2021

Ghodsee, K. 2019: Second World, Second Sex: Socialist Women’s Activism and Global Solidarity during the Cold War. Durham: Duke University Press. 328 pp. US$104.95 cloth, US$ 27.95 paperback. ISBN: 9-781-47800139-3 (hardcover), 9-781-47800181-2 (paperback).
Evaluating the overall impression of concert lighting: An integrated approach
Authors: Lo VWL , Steemers KA
Published: June 2021

Using experimental data from four electric lighting scenarios at King’s College Chapel in Cambridge, we developed an integrated approach to evaluating the overall impression of concert lighting. First, we performed a group analysis based on the aggregated response from the audience, conductor and musician respondents, followed by an overall analysis accounting for all 624 responses. Ordered logistic regression analysis revealed the absence of statistically significant subjective–objective relationships for perceived visual balance, appropriateness, comfort and the overall impression. There were, however, significant results when the variables were correlated with subjective attributes. This suggests that the perceptual process was bi-level. To gain a more complete understanding of the perceived qualities, it is necessary for an approach to consider not only the intercorrelations between the subjective and objective measures, but also the intracorrelations among the subjective attributes. Further analysis of variance showed that increasing the overall lighting intensity was more likely to lead to a lower level of satisfaction. Nevertheless, providing peripheral and directional lights appeared to be the key to improving the overall impression. This paper confirms that combining detailed and generalised approaches to evaluate subjective responses can yield more meaningful interpretations, enabling relations with measures to be established with greater confidence.
Effects of Combined and Alone Transcranial Motor Cortex Stimulation and Mirror Therapy in Phantom Limb Pain: A Randomized Factorial Trial
Authors: Gunduz Muhammed Enes , Pacheco-Barrios Kevin , Bonin Pinto Camila , Duarte Dante , Vélez Faddi Ghassan Saleh , Gianlorenco Anna Carolyna Lepesteur , Teixeira Paulo Eduardo Portes , Giannoni-Luza Stefano , Crandell David , Battistella Linamara Rizzo , Simis Marcel , Fregni Felipe
Published: June 2021

Phantom limb pain (PLP) is a frequent complication in amputees, which is often refractory to treatments. We aim to assess in a factorial trial the effects of transcranial direct current stimulation (tDCS) and mirror therapy (MT) in patients with traumatic lower limb amputation; and whether the motor cortex plasticity changes drive these results. In this large randomized, blinded, 2-site, sham-controlled, 2 × 2 factorial trial, 112 participants with traumatic lower limb amputation were randomized into treatment groups. The interventions were active or covered MT for 4 weeks (20 sessions, 15 minutes each) combined with 2 weeks of either active or sham tDCS (10 sessions, 20 minutes each) applied to the contralateral primary motor cortex. The primary outcome was PLP changes on the visual analogue scale at the end of interventions (4 weeks). Motor cortex excitability and cortical mapping were assessed by transcranial magnetic stimulation (TMS). We found no interaction between tDCS and MT groups ( F = 1.90, P = .13). In the adjusted models, there was a main effect of active tDCS compared to sham tDCS (beta coefficient = −0.99, P = .04) on phantom pain. The overall effect size was 1.19 (95% confidence interval: 0.90, 1.47). No changes in depression and anxiety were found. TDCS intervention was associated with increased intracortical inhibition (coefficient = 0.96, P = .02) and facilitation (coefficient = 2.03, P = .03) as well as a posterolateral shift of the center of gravity in the affected hemisphere. MT induced no motor cortex plasticity changes assessed by TMS. These findings indicate that transcranial motor cortex stimulation might be an affordable and beneficial PLP treatment modality.
Relational Critical Discourse Analysis: A Methodology to Challenge Researcher Assumptions
Authors: Vaandering dorothy , Reimer Kristin E.
Published: June 2021

This paper introduces a new critical peace methodology—Relational Critical Discourse Analysis. For research to contribute to the well-being of people and their societies, traditional research methodologies need to be examined for biases and contributions to societal harm, and new approaches that contribute to just and equitable cultures need to be developed. As two researchers from dominant, privileged populations, we challenged ourselves to do this by creating and employing Relational Critical Discourse Analysis, a new research methodology that provides space for diverse perspectives and emphasizes the researchers’ interconnectedness with their participants. In this paper we describe the methodology and examine how, within one case study, it increased our ability to (a) listen deeply to participants and (b) be personally impacted by what participants are saying.
Systematic review with pooled data analysis reveals the need for a standardized reporting protocol including the visceral vessels during fenestrated endovascular aortic repair (FEVAR)
Authors: Karaolanis Georgios I , Antonopoulos Constantine N , Scali Salvatore , Koutsias Stylianos G , Kotelis Drosos , Donas Konstantinos P
Published: June 2021

Objectives

To collect and analyse the available evidence in the outcomes of patients treated with fenestrated endovascular aortic repair (f-EVAR) technique focusing specifically on visceral vessel outcomes.

Methods

The current meta-analysis was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. All the studies reporting the f-EVAR technique for the management of degenerative pararenal and/or type IV thoracoabdominal aortic aneurysms (TAAA) were considered eligible for inclusion in the study. The main study outcomes (technical success, type I endoleaks, fracture or occlusion of the bridging stents, overall aneurysm-related mortality, and the reintervention rate) were subsequently expressed as proportions and 95% confidence intervals.

Results

Fourteen studies with a total of 1804 patients were included in a pooled analysis. The technical success of the procedure was 95.97% (95%CI = 92.35–98.60). Intraoperatively, the pooled proportion of reported type I endoleak was 7.6% (95%CI = 2.52–14.60) while during a median follow-up of 41 months (range 11–96) follow-up period the pooled rate of fracture and occlusion of the bridging stents was 2.79% (95%CI = 0.00–8.52) and 4.46% (95%CI = 1.93–7.77), respectively. The overall aneurysm-related mortality was detected to be 0.63% (95%CI = 0.04–1.63), and the pooled estimate for re-intervention rate was 15.69%.

Conclusions

Fenestrated endovascular repair for p-AAA is an effective and safe treatment. Target vessel complications and endoleaks remain the two most important concerns for fenestrated endovascular procedures, contributing to most of the secondary interventions. The lack of computed tomography angiography follow-up evaluation does not allow us to draw robust conclusions about the complication rates for the superior mesenteric artery during f-EVAR. Due to the potential implications of SMA complications on aneurysm-related mortality, standardized reporting of short- and long-term target visceral vessel outcomes is required.
The Liability of Performing Orthognathic Surgery
Authors: Halepas Steven , Bryck Brendan , Lee Kevin C. , Koch Alia
Published: June 2021

Study Design:

This is a retrospective case series using the Thomson Reuters Westlaw Edge database, an online subscription-based database of over 40,000 state and federal records.

Objective:

There is growing academic interest in the medical malpractice literature. The primary objective of this study was to examine medical malpractice in orthognathic procedures in order to characterize factors that determine legal responsibility and help make the craniomaxillofacial (CMF) surgeon more comfortable when treating this patient population.

Methods:

The database was queried for medical malpractice cases involving orthognathic surgery from 1985-2021. The characteristics of each lawsuit were identified, and descriptive statistics were reported.

Results:

A total of 42 CMF malpractice cases were available for review, and total of 15 cases were included in the final sample. Verdict decisions and settlements occurred between 1991 and 2012. Of the 15 cases, the highest concentration of cases occurred in California (6) and Pennsylvania (2). 53% of cases were ruled in favor of the defendant, 7% of cases were settled, 27% of cases were ruled in favor of the plaintiff against the surgeon, and 13% were ruled in favor of the plaintiff against the hospital with the surgeon being found not liable. The minimum award of damages was $29,999 and the maximum was $550,000.

Conclusion:

Litigation experience can be very time consuming and troublesome for medical practitioners. The risk of litigation and complications might be a prohibiting factor as to why CMF surgeons may not be preforming orthognathic surgery. The best defense against a malpractice case is to avoid one altogether. Learning from past mistakes is one way of ensuring that goal.
School Counselors’ Experiences With Ethical Decision Making
Authors: Johnson Glenda S. , Purgason Lucy L.
Published: June 2021

Using a purposeful, convenience sampling method, we explored six school counselors’ experiences of ethical decision making. We used a transcendental phenomenology research method and identified the themes of consulting, referring to ethical guidelines, documenting, contributing factors, and engaging in professional development. This article discusses implications for school counselor preparation programs and practicing school counselors.
Teaching the Science of Human Flourishing, Unlocking Connection, Positivity, and Resilience for the Greater Good
Authors: Ekman Eve , Simon-Thomas Emiliana
Published: June 2021

Background

Human flourishing is a long sought-after aspiration historically considered and espoused through religious, philosophical, and creative avenues. Only recently has western science began to investigate the meaning, underlying foundations of, and effective strategies for promoting flourishing in life.

Objective

Here, we present a framework for teaching the science and practice of human flourishing grounded in connection, positivity, and resilience (CPR) based on a synthesis of theoretical frameworks and observations and input from a global sample of learners enrolled in an online course.

Methods

The CPR framework is distilled from empirical research in psychology and neuroscience and an applied pedagogy of flourishing delivered through a massive open online course (MOOC) that has reached over 650,000 people worldwide.

Results

Building knowledge and skills tied to three pillars of CPR: connection, positivity, and resilience intrinsically and measurably reinforces the experiences and behaviors that foster flourishing, mainly through prosocial human connection.

Conclusion

Human flourishing is malleable and the CPR framework is a promising method for teaching people the key ideas, spaces of opportunity for change, and behaviors, activities, exercises, and practices that strengthen flourishing in life.
Pattern and Trends of Financing in the Indian Manufacturing Sector
Authors: Sinha Pramod , Das Seshanwita
Published: June 2021

The firm’s choice to finance its asset reveals the pattern of flow of funds, the availability and reliance on sources of such funds. We study ‘Sources of fund’ statement for an unbalanced panel of nearly 3400 firms in the manufacturing sector during the financial year 2011–2018. We find that financing has been mostly met through internal sources, and the reliance on external financing has decreased during this period. We introduce a methodological improvement by studying change in total assets to understand financing. A series of empirical models was formulated to identify factors that influences external financing. The result shows that unlisted, non-exporting, new-aged and small-sized firms have higher share of external financing. Further, profitability ratios like return on asset and operating profit margin, tangibility ratio like gross fixed assets to total assets, and reserves to total assets, shows negative and significant relationship with share of external financing to total funds and external financing to total assets. Our results add the dimension that interaction of change in assets with firm specific characteristics provides a meaningful way to extend the results of existing models. We argue that while existing methods use limited balance sheet items for analyzing internal versus external finance, firm level decisions ought to include all sources of finance.

JEL Classifications: D22, G30, G32
Re-adapting to Changing Middle Eastern Politics: The Modification in Turkey’s Actor Perception and Turkey-Free Syrian Army (FSA) Relations
Authors: Yetim Mustafa , Kaşıkcı Tamer
Published: June 2021

This article investigates the current modification in Turkey’s actor perception according to the Middle East’s changing dynamics. Clarifying the shift in Turkish foreign policy under the Justice and Development Party (JDP) and the emergent structural realities in the Middle East as a result of increasing agency of the violent non-state actors (VNSAs) in the aftermath of several Arab revolutions, the current article scrutinizes the adaption of Turkish foreign policy to these regional realities. In this context, to prove Turkey’s active orientation toward the recent regional environment, its exceptional engagement with one of the important VNSAs, namely the Free Syrian Army (FSA) or Syrian National Army (SNA), has been empirically examined. Within this background, the current resurrection of the VNSAs in the Middle East and regional-global actors’ reactions to this reality will also be analyzed. Afterward, Turkey’s unique and swift compliance with this reality and the consequent modification of its actor perception will be explored.
Knowledge of Ghanaian Graduating Undergraduate Nurses About Ageing
Authors: Atakro Confidence Alorse
Published: June 2021

Introduction

Knowledge on ageing has an impact on the quality of care provided to older people. Although older Ghanaians provide various forms of support to family and communities, many of them experience poor nursing care in the Ghanaian health system. There is, however, dearth of evidence regarding knowledge of ageing among Ghanaian nurses.

Objective

This study therefore used a descriptive survey approach to investigate knowledge of graduating undergraduate nurses on physiological, and psychosocial changes in ageing.

Methods

Seventy graduating undergraduate nurses were surveyed to identify their knowledge on physiological and psychosocial changes leading to care needs of older people in Ghana. Three undergraduate nursing programs with gerontological nursing courses were purposively selected for the study. Descriptive statistics were used to analyze the data in order to present quantitative descriptions of variables in this study.

Results

The response rate in the study was 42%. Findings of the study show graduating undergraduate nursing students have inadequate knowledge on ageing. Several gaps in knowledge regarding ageing were identified. Although undergraduate nursing schools had gerontological nursing courses in their programs, over 90% of participating graduating nursing students indicated pain, anxiety and depression are normal aspects in the ageing process.

Conclusion

It is imperative to improve the current curricula content on gerontological nursing in Ghanaian nursing schools to equip nurses with knowledge and skills needed to provide quality healthcare to older people in Ghana. Improving knowledge on ageing through evidence-informed gerontological nursing curricula content will lead to better nursing care of older Ghanaians. Providing educational opportunities for improved quality nursing care of older Ghanaians is in line with the United Nations (UN) Sustainable Development Goal 3, which aims at providing equal and quality healthcare to all age groups by 2030.
Book review: Z. H. Raju, Bangladesh Cinema and National Identity: In Search of the Modern
Authors: Kakkar Ridhi
Published: June 2021

Z. H. Raju, Bangladesh Cinema and National Identity: In Search of the Modern. London: Routledge, 2019, ISBN: 978-0415465441. Paperback, £ 42.99, 242 pages
Partial Fundoplications (270° Toupet, 90° Dor)
Authors: Gotley David C. , Frankel Adam J.
Published: June 2021

Partial fundoplication such as the Toupet posterior 270° and the Dor anterior 90° to 180° wraps were developed with the aim of providing long-term GERD control as with the successful Nissen fundoplication, but with reduced post-operative side effects such as dysphagia and gas bloat. Randomized controlled trials with long-term follow-up show this to be the case. Failure of a fundoplication occurs along a predictable anatomical course with posterior herniation almost universal. This informs our method of dissection, hiatal repair, and wrap construction using fundopexy to the diaphragm. We present the indications and our techniques for partial fundoplication, including tips on how to reduce the incidence of fundoplication failure and recurrent reflux.
Proteome-wide analysis of Coxiella burnetii for conserved T-cell epitopes with presentation across multiple host species
Authors: Piel Lindsay M. W. , Durfee Codie J. , White Stephen N.
Published: June 2021

Background

Coxiella burnetiiis the Gram-negative bacterium responsible for Q fever in humans and coxiellosis in domesticated agricultural animals. Previous vaccination efforts with whole cell inactivated bacteria or surface isolated proteins confer protection but can produce a reactogenic immune responses. Thereby a protective vaccine that does not cause aberrant immune reactions is required. The critical role of T-cell immunity in control ofC. burnetiihas been made clear, since either CD8+or CD4+T cells can empower clearance. The purpose of this study was to identifyC. burnetiiproteins bearing epitopes that interact with major histocompatibility complexes (MHC) from multiple host species (human, mouse, and cattle).

Results

Of the annotated 1815 proteins from the Nine Mile Phase I (RSA 493) assembly, 402 proteins were removed from analysis due to a lack of inter-isolate conservation. An additional 391 proteins were eliminated from assessment to avoid potential autoimmune responses due to the presence of host homology. We analyzed the remaining 1022 proteins for their ability to produce peptides that bind MHCI or MHCII. MHCI and MHCII predicted epitopes were filtered and compared between species yielding 777 MHCI epitopes and 453 MHCII epitopes. These epitopes were further examined for presentation by both MHCI and MHCII, and for proteins that contained multiple epitopes. There were 31 epitopes that overlapped positionally between MHCI and MHCII across host species. Of these, there were 9 epitopes represented within proteins containing ≥ 5 total epitopes, where an additional 24 proteins were also epitope dense. In all, 55 proteins were found to contain high scoring T-cell epitopes. Besides the well-studied protein Com1, most identified proteins were novel when compared to previously studied vaccine candidates.

Conclusion

These data represent the first proteome-wide evaluation ofC. burnetiipeptide epitopes. Furthermore, the inclusion of human, mouse, and bovine data capture a range of hosts for this zoonotic pathogen plus an important model organism. This work provides new vaccine targets for future vaccination efforts and enhances opportunities for selecting multiple T-cell epitope types to include within a vaccine.
Association between polymorphism at IGF-1 rs35767 gene locus and long-term decline in renal function: a Japanese retrospective longitudinal cohort study
Authors: Honda Kosuke , Kuriyama Satoru , Ichida Kimiyoshi , Nakano Tomoko , Sugano Naoki , Yokoo Takashi
Published: June 2021

Background

Insulin-like growth factor-1 (IGF-1) acts on glucose and protein metabolism and human growth and also influences blood pressure and renal function. This study investigated whether the single-nucleotide polymorphism of IGF-1, rs35767, plays a role in metabolic syndrome indicators, including blood pressure, glucose metabolism, uric acid levels, and renal function.

Methods

In this retrospective longitudinal cohort study, blood samples from 1506 Japanese individuals were collected and used for genotyping for variant rs35767: T > C in the IGF-1 upstream promoter. Data were analyzed to identify associations between IGF-1 genotypes and patient biochemical parameters, including the components of metabolic syndrome and the long-term change in renal function.

Results

The cohort rs35767 genotypes included 650 CC carriers (43.2%), 687 TC carriers (45.6%), and 169 TT carriers (11.2%). Multiple regression analysis revealed no association between IGF-1 genotype and blood pressure, glycated hemoglobin level, and serum uric acid level. However, in females, blood pressure was negatively correlated with the TT genotype. Longitudinal observation revealed that the decline in eGFR over 10 years was greater in TT (− 18.51 ± 1.04 mL/min/1.73m2) than in CC carriers (− 16.38 ± 0.52 mL/min/1.73m2; P < 0.05).

Conclusion

The present study suggests that renal function declines faster in individuals with the TT genotype at the IGF-1 rs35767 locus than in those with the CC genotype, suggesting that the TT genotype is associated with the long-term chronological decline in renal function.
Anti-proliferative and pro-apoptotic activity of glycosidic derivatives of lawsone in melanoma cancer cell
Authors: de Franca Mariana Nobre Farias , Isidório Raquel Geralda , Bonifacio João Henrique Oliveira , dos Santos Edmilson Willian Propheta , Santos Jileno Ferreira , Ottoni Flaviano Melo , de Lucca Junior Waldecy , Scher Ricardo , Alves Ricardo José , Corrêa Cristiane Bani
Published: June 2021

Background

Melanoma is a malignant cancer that affects melanocytes and is considered the most aggressive skin-type cancer. The prevalence for melanoma cancer for the last five year is about one million cases. The impact caused of this and other types of cancer, revel the importance of research into potential active compounds. The natural products are an important source of compounds with biological activity and research with natural products may enable the discovery of compounds with potential activity in tumor cells.

Methods

The Sulforhodamine B was used to determine cell density after treatment with lawsone derivatives. Apoptosis and necrosis were analyzed by flow cytometer. Morphological changes were observed by fluorescence using the Phalloidin/FITC and DAPI stains. The clonogenic and wound healing assays were used to analyze reduction of colonies formation and migratory capacity of melanoma cells, respectability.

Results

In pharmacological screening, seven compounds derived from lawsone were considered to have high cytotoxic activity (GI > 75%). Three compounds were selected to assess the inhibitory concentration for 50% of cells (IC50), and the compound 9, that has IC50 5.3 μM in melanoma cells, was selected for further analyses in this cell line. The clonogenic assay showed that the compound is capable of reducing the formation of melanoma colonies at 10.6 μM concentration. The compound induced apoptotic morphological changes in melanoma cells and increased by 50% the cells dying from apoptosis. Also, this compound reduced the migratory capacity of melanoma cells.

Conclusions

The results of this study showed that the evaluated lawsone derivatives have potential activity on tumor cells. The compound 9 is capable of inducing cell death by apoptosis in melanoma cells (B16F10).
Years of life lost by COVID-19 in Portugal and comparison with other European countries in 2020
Authors: Vieira André , Ricoca Vasco Peixoto , Aguiar Pedro , Sousa Paulo , Nunes Carla , Abrantes Alexandre
Published: June 2021

Background

The impact of the COVID-19 pandemic has been measured in different metrics, mostly by counting deaths and its impact on health services. Few studies have attempted to calculate years of life lost (YLL) to COVID-19 and compare it with YLL due to other causes in different countries.

Methods

We calculated YLL to COVID-19 from week10 to week52 in 2020 for eight European countries by methods defined by the WHO. We calculated excess YLL by subtracting the average YLL from 2017 to 2019 to the YLL in 2020. Our analysis compared YLL to COVID-19 and the excess YLL of non-COVID-19 causes across countries in Europe.

Results

Portugal registered 394,573 cases and 6619 deaths due to COVID-19, accounting for 25,395 YLL in just 10 months. COVID-19 was responsible for 6.7% of all deaths but accounted for only 4.2% of all YLL. We estimate that Portugal experienced an excess of 35,510 YLL (+ 6.2%), of which 72% would have been due to COVID-19 and 28% due to non-COVID-19 causes. Spain, Portugal, and the Netherlands experienced excess YLL to non-COVID-19 causes. We also estimated that Portugal experienced an excess of 10,115 YLL due to cancer (3805), cardiovascular diseases (786) and diseases of the respiratory system (525).

Conclusion

COVID-19 has had a major impact on mortality rates in Portugal, as well as in other European countries. The relative impact of COVID-19 on the number of deaths has been greater than on the number of YLL, because COVID-19 deaths occur mostly in advanced ages.
Health behaviours of young adults during the outbreak of the Covid-19 pandemic – a longitudinal study
Authors: Czenczek- Lewandowska Ewelina , Wyszyńska Justyna , Leszczak Justyna , Baran Joanna , Weres Aneta , Mazur Artur , Lewandowski Bogumił
Published: June 2021

Background

The outbreak of the Covid-19 pandemic has created a number of obstacles to daily functioning, which have led to a need for major changes in lifestyles. The aim of the study was to assess whether and to what extent the outbreak of the Covid-19 pandemic has affected the health behaviours of young adults.

Methods

506 people aged 18 to 34 ($$ \overline{x} $$

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=24.67 years ±4.23 years) who filled in an online survey were qualified for the study. Assessment was made of eating habits (a modified Food Frequency Questionnaire, FFQ), physical activity and sedentary behaviours (International Physical Activity Questionnaire, short form IPAQ-SF), sleep quality (The Pittsburgh Sleep Quality Index, PSQI), and generalized anxiety (Generalized anxiety Disorder, 7-item, GAD-7 scale).

Results

During the pandemic, young adults changed their dietary preferences toward sweets and cereal products, increased alcohol (p < 0.001) and fat (p = 0.005) intake, significantly reduced their physical activity (from 8752.5 metabolic equivalents (MET) min/week vs. 6174.6 MET min/week, p < 0.001), increased the time spent sedentarily (Me = 240 min vs. Me = 360 min, p < 0.001) and had decreased sleep quality (PSQI score Me = 7.00 vs. Me = 9.00).

Conclusions

The Covid-19 pandemic worsened health behaviours and intensified the feeling of generalized anxiety in young adults. Generalized anxiety during obligatory lockdown had the greatest negative impact on sedentary behaviours and sleep quality.
Serum S100 calcium-binding protein A4 as a novel predictive marker of acute exacerbation of interstitial pneumonia after surgery for lung cancer
Authors: Kagimoto Atsushi , Tsutani Yasuhiro , Kushitani Kei , Kambara Takahiro , Mimae Takahiro , Miyata Yoshihiro , Takeshima Yukio , Okada Morihito
Published: June 2021

Background

Acute exacerbation (AE) of interstitial pneumonia (IP) is the most fatal complication after lung resection for lung cancer. To improve the prognosis of lung cancer with IP, the risk factors of AE of IP after lung resection should be assessed. S100 calcium-binding protein A4 (S100A4) is a member of the S100 family of proteins and is a known marker of tissue fibrosis. We examined the usefulness of S100A4 in predicting AE of IP after lung resection for lung cancer.

Methods

This study included 162 patients with IP findings on preoperative high-resolution computed tomography scan who underwent curative-intent lung resection for primary lung cancer between April 2007 and March 2019. Serum samples were collected preoperatively. Resected lung tissue from 76 patients exhibited usual IP (UIP) pattern in resected lung were performed immunohistochemistry (IHC). Relationship between S100A4 and the incidence of AE of IP and short-term mortality was analyzed.

Results

The receiver operating characteristic area under the curve for serum S100A4 to predict postoperative AE of IP was 0.871 (95% confidence interval [CI], 0.799–0.943; P < 0.001), with a sensitivity of 93.8% and a specificity of 75.3% at the cutoff value of 17.13 ng/mL. Multivariable analysis revealed that a high serum S100A4 level (> 17.13 ng/mL) was a significant risk factor for AE of IP (odds ratio, 42.28; 95% CI, 3.98–449.29; P = 0.002). A 1-year overall survival (OS) was significantly shorter in patients with high serum levels of S100A4 (75.3%) than in those with low serum levels (92.3%; P = 0.003). IHC staining revealed that fibroblasts, lymphocytes, and macrophages expressed S100A4 in the UIP area, and the stroma and fibrosis in the primary tumor expressed S100A4, whereas tumor cells did not.

Conclusions

Serum S100A4 had a high predictive value for postoperative AE of IP and short-term mortality after lung resection.
Umbilical two-port laparoscopic percutaneous extraperitoneal closure for patent processus vaginalis in boys: incision-hiding and solo-like surgery
Authors: Xiao Yuanhong , Shen Zhou
Published: June 2021

Background

Transumbilical two-port laparoscopic percutaneous extraperitoneal closure for the treatment of processus vaginalis patency in boys has been practising recent years. The applicable instruments and skills are still evolving. In this study, we used a self-made needle assisted by a disposable dissecting forceps to practise this minimal invasive method for patent processus vaginalis in boys. Its safety and effectiveness were studied. The methods for depth and orientation perceptions were analyzed.

Methods

From January 2020 to November 2020, boys characteristic of symtomatic patency of processus vaginalis were performed open surgery consecutively. From December 2020, the authors begun to propose transumbilical two-port laparoscopic percutaneous extraperitoneal closure for this kind of boy patients. The open group included fifteen boys and the laparoscopic group included ten ones. The data of the patients age, constituent ratios of unilateral and bilateral patency, operating time, postoperative stay in hospital, follow-up time, conversion, postoperative complications were assessed. Throughout the laparoscopic process, the parallel and synchronous movements of lens pole and dissecting forceps were maintained. Vas deferens protrude was imagined as one of the point to form the triangular manipulation plane.

Results

There were no statistically significant difference between the laparoscopic group and the open group for the following items: age, operating time, the constituent ratios of unilateral or bilateral patency of processus vaginalis (P > 0.05). Postoperative stay in hospital and follow-up time of the laparoscopic group was significantly shorter than that of the open group (P = 0.0000). No laparoscopic case was converted to open surgery. After 10 cases of laparoscopic practice, orientation perception was established. There were no postoperative complications for all the patients.

Conclusion

Our preliminary experience suggested that umbilical two-port laparoscopic percutaneous extraperitoneal closure is safe and convenient for patent processus vaginalis treatment in boys. It has the advantage of incision-hiding and can be manipulated like a solo-like surgery.
Influence of maintaining apical patency in post-endodontic pain
Authors: Shubham Snigdha , Nepal Manisha , Mishra Ravish , Dutta Kishor
Published: June 2021

Background

The concept of instrumentation beyond the apical foramen by small flexible file to prevent apical blockage is apical patency. However, this procedure might endow postoperative pain, thus to maintain apical patency or not is the matter of dilemma. Hence, the primary objective of this study was to compare postoperative pain between apical patency and non-patency groups and secondary objective was to evaluate the influence of number of visits, vitality of teeth, group of teeth and preoperative pain on post-operative pain.

Methods

Preselected (n = 178) patients based on group of teeth and status of pulp were randomly divided into 2 groups, apical patency and non-patency which was further treated in either single or multiple visits. After exclusion, 160 patients were included. Each group (n = 80) was subdivided in single visit (n = 40) and multiple visits (n = 40), including vital (n = 20) and non-vital teeth (n = 20) and single-rooted (n = 10) and multiple-rooted teeth (n = 10). Apical patency was maintained with a size 10 K-file during conventional hand filing step-back shaping procedure. Intensity of pain was recorded before treatment and on days 1, 2, and 7 after treatment using Numerical Rating Scale (NRS-11). Statistical analysis was done using Mann–Whitney U test, Spearman correlation and Multiple linear regression analysis.

Results

The primary outcome of this study showed statistically significant difference (p < 0.05) in postoperative pain scores between patency and non-patency groups with higher pain scores in patency group on 1st, 2nd and 7th day follow up. The secondary outcome showed postoperative pain in patency-maintained group was influenced by status of the pulp and preoperative pain only. Vital teeth of patency-maintained group treated in multiple visits showed statistically significant (p = 0.02) post-operative pain in day 1 follow up. Pre-operative pain showed positive correlation with postoperative pain with statistically significant difference.

Conclusions

Our study concluded that maintenance of apical patency increased postoperative pain. Evaluation of influence of number of visits, status of pulp, group of tooth and preoperative pain revealed status of pulp and preoperative pain as influencing factors for postoperative pain in patency group.
Identifying individual hospital levels of maternal care using administrative data
Authors: Handley Sara C. , Passarella Molly , Srinivas Sindhu K. , Lorch Scott A.
Published: June 2021

Background

The goal of regionalized perinatal care, specifically levels of maternal care, is to improve maternal outcomes through risk-appropriate obstetric care. Studies of levels of maternal care are limited by current approaches to identify a hospital’s level of care, often relying on hospital self-reported data, which is expensive and challenging to collect and validate. The study objective was to develop an empiric approach to determine a hospital’s level of maternal care using administrative data reflective of the patient care provided and apply this approach to describe the levels of maternal care available over time.

Methods

Retrospective cohort study of mother-infant dyads who delivered in California, Missouri, and Pennsylvania hospitals from 2000 to 2009. Linked mother-infant administrative records with an infant born at 24–44 weeks’ gestation and a birth weight of 400–8000 g were included. Using the American College of Obstetricians and Gynecologists and the Society for Maternal Fetal Medicine descriptions of levels of maternal care, four levels were classified based on the appropriate location of care for patients with specific medical or pregnancy conditions. Individual hospitals were assigned a level of maternal care annually based on the volume of patients who delivered reflective of the four classified levels as determined by International Classification of Diseases and Current Procedural Terminology.

Results

Based on the included 6,895,000 mother-infant dyads, the obstetric hospital levels of maternal care I, II, III and IV were identified. High-risk patients more frequently delivered in hospitals with higher level maternal care, accounting for 8.9, 10.9, 13.8, and 16.9% of deliveries in level I, II, III and IV hospitals, respectively. The total number of obstetric hospitals decreased over the study period, while the proportion of hospitals with high-level (level III or IV) maternal care increased. High-level hospitals were located in more densely populated areas.

Conclusion

Identification of the level of maternal care, independent of hospital self-reported variables, is feasible using administrative data. This empiric approach, which accounts for changes in hospitals over time, is a valuable framework for perinatal researchers and other stakeholders to inexpensively identify measurable benefits of levels of maternal care and characterize where specific patient populations receive care.
Prevalence and sociogeographical inequalities of violence against women in Ecuador: a cross-sectional study
Authors: Edeby Agnes , San Sebastián Miguel
Published: June 2021

Background

Violence against women (VAW) is a vast public health problem in Latin America. The aim of this study was to determine the prevalence of violence against women and to assess its sociogeographical inequalities in Ecuador during 2019.

Methods

This cross-sectional study used data from a national survey conducted in 2019 (n = 17,211) among women aged 15 years and over. Independent variables included age, marital status, education, ethnicity, place of residence and region. The chosen outcomes were lifetime experience of total violence, sexual violence, physical violence, psychological violence and economic violence. Frequency tables were first calculated, and then crude and adjusted regression models estimating risk differences and their 95% confidence intervals were computed.

Results

Nearly two-thirds (64.86%) of the participating women had experienced some form of violence during their lifetime, mainly psychological violence (56.92%). The second most prevalent type of violence was physical (35.44%) closely followed by sexual (32.67%). Almost one-fifth (16.38%) stated to have experienced some form of economic violence.

Physical and psychological violence were more common among women aged 26–35 and less among older women. All forms of violence were more often reported among women with no education except for sexual violence, which was more frequent among those with higher education. Physical, psychological and economic violence were more often reported by those living with a partner, being married or divorced/separated. Sexual violence was associated with those belonging to a non-indigenous ethnic group, while all types of violence were more common among those living in an urban setting (except physical violence), in the Highlands or in the Amazon region.

Conclusions

Our study showed that VAW is a common event in Ecuador and identified several sociogeographical inequalities that varied depending on the type of violence. VAW was more common among the younger age groups, those with low education, those living with a partner or being divorced/separated, or residing in an urban setting, in the Highlands or in the Amazon. Further studies including more social factors and a continuous monitoring of VAW are recommended. Current policies and laws to protect women need to be expanded and effectively implemented to reduce VAW in the Ecuador.
Effects of WNT1 c.110 T>C and c.505G>T mutations on osteoblast differentiation via the WNT1/β-catenin signaling pathway
Authors: Zhang Bashan , Li Rong , Wang Wenfeng , Zhou Xueming , Luo Beijing , Zhu Zinian , Zhang Xibo , Ding Aijiao
Published: June 2021

Background

WNT1 c.110 T>C and c.505G>T missense mutations have been identified in patients with osteogenesis imperfecta (OI). Whether these mutations affect osteoblast differentiation remains to be determined. This study aimed to investigate the effects of WNT1 c.110 T>C and c.505G>T mutations on osteoblast function, gene expression, and pathways involved in OI.

Methods

Empty vector (negative control), wild-type WNT1, WNT1 c.110 T>C, WNT1 c.505G>T, and WNT1 c.884C>A (positive control) mutant plasmids were constructed and transfected into preosteoblast (MC3T3-E1) cells to investigate their effect on osteoblast differentiation. The expressions of osteoblast markers, including BMP2, RANKL, osteocalcin, and alkaline phosphatase (ALP), were determined using quantitative real-time polymerase chain reaction (RT-qPCR), western blotting (WB), enzyme-linked immunosorbent assay, and ALP staining assay, respectively. The mRNA and protein expression levels of WNT1 or the expression levels of the relevant proteins involved in the WNT1/β-catenin signaling pathway were also determined using RT-qPCR, WB, and immunofluorescence (IF) assays after the different plasmids were transfected into MC3T3-E1 cells.

Results

Compared with those in the wild-type group, in the mutation groups, the mRNA and protein expression levels of BMP2 were suppressed, the expressions of osteocalcin and ALP were inhibited, and the mRNA and protein expression levels of RANKL were enhanced in MC3T3-E1 cells. WB and IF assays revealed that the protein expression levels of WNT1 in MC3T3-E1 cells were downregulated in the mutation groups compared with those in the wild-type WNT1 group. Furthermore, the expression levels of nonphosphorylated β-catenin (non-p-β-catenin) and phosphorylated GSK-3β (p-GSK-3β) were downregulated in the mutation groups compared with those in the wild-type group. However, no significant changes in the expression level of non-p-β-catenin or p-GSK-3β were observed in the mutation groups.

Conclusions

WNT1 c.110 T>C and c.505G>T mutations may alter the proliferation and osteogenic phenotype of MC3T3-E1 linked to the progression of OI via the inhibition of the WNT1/β-catenin signaling pathway. This is the first study to confirm the effect of WNT1 c.110 T>C and c.505G>T missense mutations on osteoblast differentiation and propose a new molecular mechanism for OI development.