bluuebunny/crossref_metadata_2025 huggingface dataset:
Outcome of flow diverter placement for intracranial aneurysm with dual antiplatelet therapy and oral anticoagulant therapy
Authors: Fujii Takashi , Oishi Hidenori , Teranishi Kohsuke , Yatomi Kenji , Suzuki Kazumoto , Arai Hajime
Published: July 2020

Purpose

Antiplatelet therapy initiated before flow diverter placement is effective for the prevention of ischemic complications. However, the effectiveness of oral anticoagulant treatment is unclear. This retrospective study evaluated the complications and obliteration rates after flow diverter placement in patients taking anticoagulants.

Methods

A total of 155 cases were treated by Pipeline Flex placement for unruptured large and giant cerebral aneurysms in our hospital between October 2015 and June 2019. The groups of 8 patients taking anticoagulants before operation and 147 patients not taking anticoagulants were compared.

Results

Clopidogrel oral dose ( P = 0.002) was significantly lower in the anticoagulant group. Delayed aneurysm rupture ( P = 0.002) and additional treatment ( P = 0.009) rates were significantly higher and complete obliteration rate ( P = 0.011) was lower in the anticoagulant group.

Conclusions

Additional oral anticoagulant administration before flow diverter placement does not reduce ischemic complications compared to dual antiplatelet therapy, but does increase hemorrhagic complications, especially delayed aneurysm rupture. Complete obliteration of the cerebral aneurysm is difficult to achieve in patients taking anticoagulants.
Sonographic evaluation of the portal vein diameter in patients with chronic liver disease in northeastern Nigeria
Authors: Luntsi Geofery , Muhammad Musa Abubakar , Shirama Yakubu Bababa , Lawal Mohammed Mohammed , Suleiman Aliyu , Ochie Kalu
Published: July 2020

Introduction

Chronic liver disease is a public health burden worldwide. Portal hypertension is a major portosystemic abnormality in chronic liver disease. This study aimed to determine the main, right, and the left portal vein diameter in patients with chronic liver disease.

Materials and methods

A cross-sectional study was carried out at the Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, northeastern Nigeria from December 2018 to September 2019. Ethical clearance was obtained from the institutional review board. A total of 200 subjects were recruited comprising 100 patients with chronic liver disease and 100 age-matched controls, aged 18 years and above. A transabdominal ultrasound scan was carried out measuring the main, right, and left portal vein diameter while lying supine and/or in the right anterior oblique position after overnight fasting, or 6 hours before the scan. Data analysis was done using SPSS version 22.0. Descriptive statistics (mean, standard deviation) and Pearson’s correlation were used.

Results

There were 106(53%) males and 94(47%) females, aged between 18 and 73 years with a mean age of 46.79 ± 15.43. The main, right, and left portal vein diameter in patients with chronic liver disease was 14.51 ± 0.78 mm, 6.83 ± 0.81 mm, and 6.26 ± 0.74 mm, which were higher than those of their control. The portal vein diameter positively correlated (weak) with age and respiratory phases among participants ( P < 0.05).

Conclusion

This study found the main, right, and left portal vein diameter among patients with chronic liver disease to be larger than those of the controls. Ultrasonography is a reliable diagnostic tool in evaluating portosystemic pathologies.
Relevant functioning aspects and environmental factors for adults and seniors undergoing hemodialysis: A qualitative study
Authors: Filho José C Araújo , Rocha Luana P , Cavalcanti Frederico CB , Marinho Patrícia EM
Published: July 2020

Objective

To identify which functioning, personal and environmental factors are more relevant to adults in hemodialysis treatment.

Materials and methods

Data was collected by semi-structured interview, recorded, transcribed in full, verified and produced by Bardin Thematic content analysis. Two independent researchers identified the relevant themes and named the thematic categories found according to the coding of the International Classification of Functioning, Disability and Health (ICF).

Results

Six men and three women aged between 32–65 years were interviewed, with per capita family income between 1–2.9 minimum salaries and hemodialysis treatment time between 5 to 26 years. Fifty-seven ICF categories were listed: 17 Body Functions, 9 Body Structures, 21 Activities and Participation, and 10 Environmental Factors. Health, transportation and general social support services, systems and policies; doing housework; recreation and leisure; emotional functions, temperament and personality functions; energy and drive functions; sensation of pain; and structures of the cardiovascular system, lower extremity and musculoskeletal structures related to movement were the most reported aspects by the participants.

Conclusion

Patients’ need for physical/emotional support from their partners, friends and health professionals, including emotional and social support, with health policies, transportation and job maintenance, in order to increase their survival and quality of life.
Why Paulo Freire is a threat for right-wing populism: Lessons for communication of hope
Authors: Waisbord Silvio
Published: July 2020

Right-wing populism advances a brand of communicative politics that are antithetical to Paulo Freire’s vision of liberating, critical, and participatory communication. This essential opposition helps to understand why the Bolsonaro government has turned Freire into a target of criticisms, as part of its ambitious, furious attempt to remove progressive politics and human rights advances from Brazilian society. Considering the current situation, the purpose of this paper is to examine the relevance of Freire’s ideas for the analysis of the politics of hope against populism. His principles of public criticism, dialogue, autonomous participation, humanism, and hope are antithetical to populism’s vision. The unfolding of both dialogic and expressive politics against populism in Brazil and elsewhere illustrate the significance of Freire’s arguments, and raise questions about the limitations of purely dialogic strategies to confront authoritarianism.
Wernicke–Korsakoff syndrome associated with mtDNA disease
Authors: Jimoh Idris Janos , Sebe Barbara , Balicza Peter , Fedor Mariann , Pataky Ilona , Rudas Gabor , Gal Aniko , Inczedy-Farkas Gabriella , Nemeth Gyorgy , Molnar Maria Judit
Published: July 2020

Introduction:

Wernicke encephalopathy (WE) and Wernicke–Korsakoff syndrome (WKS) are well-known disorders caused by thiamine deficiency. In addition to the classical concept of these diseases, some literature data suggest a connection between mitochondrial dysfunction and WE/WKS. Psychotic disorders and WKS seem to run in families, as the deficiency of the oxidative phosphorylation can be a trigger factor in psychotic events and WE/WKS as well. We present a patient harbouring the m.A3243G mtDNA mutation with the clinical and magnetic resonance imaging (MRI) findings of WKS who developed schizophrenia with predominantly negative symptoms some years later.

Case presentation:

A 27-year-old woman was referred to our clinic with severe weight loss after severe vomiting episodes, memory dysfunction and gait ataxia. Family history, as well as clinical, imaging and laboratory findings suggested a mitochondrial aetiology of her symptoms. Brain MRI detected bilateral mild thalamic lesions and loss of corpus mammillae, indicating Wernicke encephalopathy. Genetic testing detected an m.A3243G mtDNA mutation, which has been frequently associated with mitochondrial encephalopathy with lactic acidosis and stroke-like episodes. High-dose vitamin B1 supplementation with supportive antioxidant therapy improved the patient’s memory and learning disturbance; however, some months later she developed psychosis with predominantly negative symptoms and her cognitive functions deteriorated again. Both cognitive and negative symptoms responded well to cariprazine monotherapy.

Discussion:

Mitochondrial disease due to mtDNA alteration can be a rare cause of WE. In addition to vitamin B1 supplementation, cariprazine with significant dopamine D3 receptor binding can be useful to treat the predominantly negative symptoms and cognitive dysfunction in patients with mitochondrial dysfunction.

Conclusion:

We assume that patients with a mitochondrial disorder might be prone to develop WE/WKS and therefore need tailored supportive therapy during metabolic crisis as well as symptom-based personalized antipsychotic treatment.
Immunostimulatory Activity of Black Rice Bran in Cyclophosphamide-Induced Immunosuppressed Rats
Authors: Park Young Mi , Lee Hak Yong , Shin Dong Yeop , Lee Yang Hee , Yang Ye Jin , Lee Hae Seong , Lee Jung O , Choi Kyeong Suk , Kang Ji Hyun , Cho Young Ho , Kim Min Guk , Yun Chi Young , Kim Min Jung , Jang Dai Ja , Yang Hye Jeong , Lee Young-Rae
Published: July 2020

Black rice bran extract (BRBE), containing various biologically active compounds, such as anthocyanin, has antioxidant activity and numerous pharmacological effects. Here, we aimed to confirm the immunostimulatory effects of BRBE in cyclophosphamide (CP)-induced immunosuppressed cells. Our results confirmed that BRBE exerted an immunostimulatory effect. In vitro, BRBE treatment enhanced cell proliferation, activity of natural killer cells and cytotoxic T lymphocytes, and production of CP-repressed cytokines, such as tumor necrosis factor-α, interferon-γ, interleukin (IL)-2, and IL-12, and immunoglobulins G and A in isolated splenocytes. Additionally, in vivo, BRBE treatment increased the number of immune cells, such as white blood cells, lymphocyte counts, mid-range absolute counts, and neutrophils in CP-induced immunosuppressed rats. Furthermore, BRBE increased the serum levels of abovementioned inflammatory cytokines and immunoglobulins in CP-induced immunosuppressed rats. In addition, BRBE protected against CP-mediated spleen and thymic tissue damage. Our findings suggest that BRBE could be potentially used as a component of functional food for immunity enhancement.
Total Polyphenol Content, Antioxidant Activity, and Individual Phenolic Composition of Different Edible Parts of 4 Sweet Potato Cultivars
Authors: Makori Shadrack Isaboke , Mu Tai-Hua , Sun Hong-Nan
Published: July 2020

The quest to determine and use polyphenolic compounds present in fruits and vegetables as natural antioxidants has recently attracted much attention due to their beneficial health effects. In this study, the total polyphenol content (TPC), total flavonoid content (TFC), total anthocyanin content (TAC), antioxidant activity (AA), and individual polyphenol components of Simon No. 1, Yuzi No. 7, Shangshu 19, and Pushu 32 sweet potato cultivars (edible parts: leaf, stalk, stem, skin, and flesh) were investigated. TPC, TFC, and TAC values ranged from 440 ± 0.17-12080 ± 0.58 CAE mg/100 g DW, 94 ± 0.08-4210 ± 0.74 QE mg/100 g DW, and 7 ± 0.01-1010 ± 0.54 CGE mg/100 g DW, respectively. Yuzi No. 7 sweet potato cultivar contained significantly higher amounts of TPC, TFC, TAC, and AA in all its edible parts, followed by Pushu 32, Simon No. 1, and Shangshu 19 in that order. Regardless of the sweet potato cultivar used, TPC, TFC, and TAC of sweet potato leaves were significantly higher than those of other edible parts. High-performance liquid chromatography revealed 19 individual phenolic compounds. In general, 3,5-di- O-caffeoylquinic acid, astragalin, and cyanidin were the predominant phenolic acid, flavonoid, and anthocyanin compounds, respectively. The correlation analysis suggested that higher AA could be attributed to higher polyphenol content. Based on our results, edible parts of Yuzi No. 7 sweet potato cultivar presented the highest amounts of polyphenol content and AA suggesting the possibility of utilizing this cultivar by farmers and the food industry as a functional food product.
Antiallergic Effects of Phenolic Compounds Isolated From Stellera chamaejasme on RBL-2H3 Cells
Authors: Jo Beom-Geun , Bong Sim-Kyu , Jegal Jonghwan , Kim Su-Nam , Yang Min Hye
Published: July 2020

The current study was undertaken to isolate and identify anti-inflammatory and antiallergic active compounds in the ethyl acetate and butanol fractions of an ethanolic extract of the aerial parts of Stellera chamaejasme (SCAE). A new maltol glucoside, maltol 3-(6″-(2-( E)-butenoyl)-glucoside) and benzoic acid, daphnoretin (a coumarin), 6 flavonoids (apigenin, genkwanin, taxifolin, apigenin 7- O-glucoside, luteolin 7- O-sambubioside, genkwanin 5- O-glucoside), and 2 lignans (matairesinoside and lariciresinol) were isolated from SCAE by chromatographic separation. Their chemical structures were elucidated by analyzing spectroscopic data, including 1-dimensional and 2-dimensional nuclear magnetic resonance (Fig1). Maltol 3-(6″-(2-( E)-butenoyl)-glucoside) significantly inhibited β-hexosaminidase release by 85.5% in immunoglobulin E and dinitrophenyl/bovine serum albumin (DNP/BSA)-induced RBL-2H3 cells. Benzoic acid from S. chamaejasme inhibited β-hexosaminidase release (by 80.2%) in IgE and DNP/BSA-induced RBL-2H3 cells and interleukin-4 messenger ribonucleic acid expression (by 21.9% inhibition) in propidium iodide-induced RBL-2H3 cells.
Response Rates In Hospitality Research: An Overview of Current Practice and Suggestions For Future Research
Authors: Ali Faizan , Ciftci Olena , Nanu Luana , Cobanoglu Cihan , Ryu Kisang
Published: July 2020

In this paper, we examine published research in six top-tier hospitality journals to explore response rates for different survey distribution methods across specific characteristics like research context, respondents, and geographical regions. Data were analyzed from 1,389 papers published from January 2001 to December 2019. By looking at a large set of published response rates, distribution and enhancing methods and type of respondents, findings from this study will aid researchers in designing more effective surveys and successfully collecting necessary data. The implications for response rate in hospitality research are also presented.
Achieving Independence in Toileting: Self-Catheterization Efficacy and the Role of the School Nurse
Authors: Bradley Erin
Published: July 2020

The school nurse is the most consistent healthcare provider for students who require scheduled intermittent self-catheterization; however, there is little literature regarding the role of the school nurse for educating and promoting self-catheterization independence for pediatric populations in the school setting. School nurses are dependent on research to identify best practices when implementing teaching strategies with young students who are ready to start catheterizing independently. The intent of this article is to contribute relevant information that is both useful and evidence based, so the school nurse is equipped with information to support the assessment, planning, and implementation of independent self-catheterization of school-age children. Additionally, this article will examine how to determine candidates for independent self-catheterization, product information and procedure guidelines, and coordination with caregivers and other members of the school health team to provide best outcomes for students diagnosed with neurogenic bladder in the school setting.
Scutellarein inhibits BLM-mediated pulmonary fibrosis by affecting fibroblast differentiation, proliferation, and apoptosis
Authors: Miao Kang , Pan Ting , Mou Yong , Zhang Lei , Xiong Weining , Xu Yongjian , Yu Jun , Wang Yi
Published: July 2020

Introduction:

Idiopathic pulmonary fibrosis (IPF) is a progressive and irreversible interstitial pulmonary disease that has a poor prognosis. Scutellarein, which is extracted from the traditional Chinese medicine Erigeron breviscapus, is used to treat a variety of diseases; however, the use of scutellarein for the treatment of pulmonary fibrosis and the related mechanisms of action have not been fully explored.

Methods:

This study was conducted using a well-established mouse model of pulmonary fibrosis induced by bleomycin (BLM). The antifibrotic effects of scutellarein on histopathologic manifestations and fibrotic marker expression levels were examined. The effects of scutellarein on fibroblast differentiation, proliferation, and apoptosis and on related signaling pathways were next investigated to demonstrate the underlying mechanisms.

Results:

In the present study, we found that scutellarein alleviated BLM-induced pulmonary fibrosis, as indicated by histopathologic manifestations and the expression levels of fibrotic markers. Further data demonstrated that the ability of fibroblasts to differentiate into myofibroblasts was attenuated in scutellarein-treated mice model. In addition, we obtained in vitro evidence that scutellarein inhibited fibroblast-to-myofibroblast differentiation by repressing TGF-β/Smad signaling, inhibited cellular proliferation by repressing PI3K/Akt signaling, and increased apoptosis of fibroblasts by affecting Bax/Bcl2 signaling.

Discussion:

In general, scutellarein might exert therapeutic effects on pulmonary fibrosis by altering the differentiation, proliferation, and apoptosis of fibroblasts. Although scutellarein has been demonstrated to be safe in mice, further studies are required to investigate the efficacy of scutellarein in patients with IPF.
Third-Eye Rivalry
Authors: Gallagher Regan M. , Tsuchiya Naotsugu
Published: July 2020

We showcase an optical phenomenon that we call Third-Eye Rivalry. The effect is most easily induced by viewing one’s own reflection in a mirror. Using the pupil of the opposing eye as a fixation target, people can easily cross their eyes in free fusion to experience vivid rivalry. The resulting percept is of a prominent central “third” eye and two peripheral faces rivaling for perceptual dominance. We illustrate the process of achieving third-eye rivalry and discuss historical connotations of the third eye in scientific and mystical contexts.
Screen time behaviour in a sample of 11- to 12-year-old Greek-Cypriot children: A cross-sectional study of parental and child reports
Authors: Loucaides Constantinos A
Published: July 2020

Objective:

This cross-sectional study examined the association between parental and child-reported correlates and children’s screen time.

Methods:

Children ( N = 154) and their parents completed questionnaires examining correlates of screen time. Children recorded the time they devoted to screen-based and study-related sedentary activities and wore a pedometer for 6 days (four weekdays and two weekend days). Parents also provided information relating to the time their children devoted to screen time.

Results:

Children reported significantly higher time watching television and playing electronic games as well as higher total screen time during the weekend compared to weekdays. On the contrary, they reported significantly lower time doing homework and recorded significantly lower steps during the weekend compared to weekdays. The scale ‘Parent-child Television Viewing’ yielded significant associations with both parent and child-reported total screen time and television watching. Associations ranged from r = 0.193, p < 0.05 to r = 0.599, p < 0.001. The scales ‘Child Screen Time with Friends’ and ‘Friends’ Norms for Screen Time’ demonstrated significant associations with child-reported electronic games and total screen time, and with parent-reported electronic games and computer use. Associations ranged from r = 0.180, p < 0.05 to r = 0.478, p < 0.001. Variance explained for total screen time at the multivariate level ranged from 8% to 37% with the scale ‘Parent-child Television Viewing’ having significant associations with both parent and child-reported weekday total screen time.

Conclusions:

Obtaining data from both parents and children may provide further understanding of screen time behaviour. While parental factors appear to be consistently associated with children’s total screen time, studies may consider focusing more on parents to reduce time spent watching television, and more on friends to limit time spent in electronic games.
Diagnostic dilemma – sinonasal organizing hematoma
Authors: James Joel , Shackelford Austin J , Gudis David A , Overdevest Jonathan B
Published: July 2020

Sinonasal organizing hematomas are benign lesions often mistaken for malignancy due to their aggressive appearance on diagnostic imaging and endoscopic findings that favor advanced disease. The destructive nature of this pathology paired with the rarity of the presentation often results in diagnostic deception that may escalate intervention planning and affect discussion of prognosis with patients. Herein, we present a case of a 56-year-old male with left-sided nasal obstruction and daily epistaxis, where computed tomography imaging revealed heterogeneous opacification of the left maxillary sinus, erosion of the left inferior orbital wall and extension into the nasal cavity. Although clinical and radiographic presentations of sinonasal organizing hematomas can be managed definitively with endoscopic intervention, there is a need to increase awareness of this entity among clinicians to improve our prognostic counseling with patients.
Prevalence and predictors of lower urinary tract symptoms in Solomon Islander adult men
Authors: Lui Paraniala Silas C , Dorji Nidup
Published: July 2020

Background:

Despite growing interest in the prevention of lower urinary tract symptoms (LUTS) globally and in the Asia-Pacific region, population-based evidence is limited in the smaller Pacific Island countries such as in the Solomon Islands. This study aimed to investigate the prevalence and describe the risk factors associated with moderate to severe LUTS among Solomon Islander men.

Methods:

A cross-sectional survey was conducted among 400 men aged ⩾18 years living in Honiara, Solomon Islands. LUTS were assessed using the International Prostate Symptom Score (IPSS). The association between moderate to severe LUTS and sociodemographic, health conditions and health-related factors were estimated using logistic regression adjusted for age.

Results:

Overall, 13.8% reported moderate LUTS, and 0.8% reported severe LUTS. Frequent night-time urination was the most commonly reported LUTS. The adjusted odds of moderate to severe LUTS decreased with increasing level of education. The odds increased among men reporting elevated psychological distress, increased stressful events in the past 12 months and depression.

Conclusions:

About one in six Solomon Islander men experience moderate to severe LUTS, having a negative impact on their mental health and general well-being.
Different clinical presentations of xanthogranulomatous prostatitis: A case series and review of the literature
Authors: De Silva Supun , De Silva Lalani , Sooriyaarchchi Shyamini , Wijesighe Harshima , Ranaweera Gayani , De Silva Susantha , De Silva Chandu
Published: July 2020

Objective:

Xanthogranulomatous prostatitis (XGP) is a rare entity that has different clinical presentations. This report of three cases illustrates the diversity of clinical features of XGP, together with a comprehensive literature review.

Methods:

Three elderly male Sri Lankan patients underwent transurethral resection of the prostate for severe lower urinary tract symptoms. Carcinoma of the prostate was suspected in two patients, and one of them had a very high prostate-specific antigen level (324 ng/mL), suggestive of metastatic prostate carcinoma. The third patient had a clinically benign prostate gland. The histology of all three resected prostate chippings revealed XGP.

Results:

This case series encompasses two cases of XGP that mimicked carcinoma of the prostate clinically and another case that had benign clinical features. Patients with XGP can have clinical, radiological and serological evidence of advanced prostate carcinoma. Other rare modes of presentation of XGP include prostate abscess and haematospermia. Many concerns of XGP such as aetiology, epidemiology, natural history, risk of malignant transformation and possible treatment options remain unclear due to the paucity of the literature.

Conclusions:

XGP presents with a variety of benign and malignant clinical features. The possibility of encountering XGP in patients with clinically malignant prostates should not be overlooked.
Trainee satisfaction in higher speciality urology training: Can we mitigate a workforce crisis?
Authors: Mahesan Tharani , Drummond Lucy , Hussain Muddassar
Published: July 2020

Background:

Over 4 years urology as a speciality has seen a 49% increase in unfilled consultant posts and long term the British Association of Urological Surgeons is predicting a shortage of up to 149 consultants over a 12-year period. Striving to keep trainees within the NHS workforce is one way of minimising those figures. We aimed to examine the challenges to workforce retention in urology higher speciality training.

Methods:

A 10-item survey was designed and piloted, examining the attitudes and intentions of higher speciality trainees towards their training.

Results:

Forty-nine higher speciality trainees completed the survey, 29 men (59%), 20 women (41%). Twenty-two (45%) were ST4 or below; 24 (49%) had considered leaving urology training, with 31 of 49 trainees (63%) citing burnout as the most common reason for this. Concerns about a shortage of colleagues and financial challenges were the second and third most common reasons. Thirty-four (69%) respondents would still apply for urology higher speciality training if they had to make the decision again. Colleagues, operating time and the ability to make an impact were all cited as enjoyable factors.

Discussion:

The findings of this survey clearly demonstrate mixed feelings towards urology higher training. However, the majority of trainees would still pick the speciality again, and when asked trainees were able to select a number of factors which they enjoyed.

Conclusion:

A workforce crisis affects everyone. While the situation may be unavoidable, we must take this opportunity to limit its impact.
Ethnic minorities are at greater risk of presenting late with acute scrotal pain
Authors: Gray Struan Henry , Wignall Daniel , Stocking Katie , Lee Ling , Pantelides Michael , Gkentzis Agapios
Published: July 2020

Aim:

Delayed presentation in acute testicular torsion increases risk of testicular loss. We investigated whether there is a delay in presentation with suspected torsion in patients from an ethnic minority.

Patients and methods:

A retrospective audit of patients undergoing scrotal exploration for suspected torsion from September 2014 to September 2019 was completed. Notes were used to identify time between onset of pain and presentation to hospital. Patients’ ethnicity was identified through voluntary demographic information. Median time to presentation was compared between ethnic minorities and white British patients, as well as exploration findings.

Results:

Ethnic minority patients ( n=29) with suspected torsion presented significantly later with a median of 19 hours (range 1.3–192) compared to 4 hours (0.5–96) in white British patients ( n=65). ( p<0.001) In patients found to have torsion with or without testicular loss, ethnic minority patients ( n=18) presented at a median of 17.5 hours (3.1–192) compared to 3 hours (0.5–84) in white British patients ( n=33), a statistically significant delay ( p<0.001). The relative risk of ethnic minorities requiring orchidectomy when presenting with torsion was 12.83.

Conclusion(s):

In our population, ethnic minorities present later with acute scrotal pain, increasing their risk of testicular loss. More study is required to identify causes of delayed presentation in these patients with the aim of improving health education.

Level of evidence:

3
Delay to radical prostatectomy: Who, why and does it matter?
Authors: Nesbitt Alexander L , Smith Philip G , Antoniou Stefan , Evans Garrath A , Pridgeon Simon W
Published: July 2020

Objective:

This study aimed to analyse a population of men undergoing radical prostatectomy to determine whether a delay to surgery is associated with poorer outcomes. A secondary aim was to analyse whether the introduction of positron emission tomography (PET) imaging using probes labelled with radiotracers targeting prostate-specific membrane antigen (PSMA) was associated with delay.

Methods:

A retrospective chart review was performed for men undergoing radical prostatectomy in Cairns, Australia, between March 2014 and March 2018, who were identified from a prospectively maintained database.

Results:

A total of 332 cases were analysed. Logistic regression analysis failed to show extra time between biopsy and surgery as a predictor for any adverse outcome. Patients who underwent preoperative staging with PSMA-PET had a longer delay between biopsy and imaging (47.1±40.4 vs. 32.3±22.9 days; p<0.01) but a shorter duration between biopsy and surgery (109.5±64.7 vs. 132.5±70.8 days, p<0.01) compared with men staged with computed tomography and a bone scan.

Conclusions:

Delay to surgery was not a predictor for adverse pathological outcomes or the need for further postoperative treatment. Patients staged with PSMA-PET took longer to get their imaging but proceeded to surgery quicker overall, likely because they had a higher-risk disease.
Seven intersectional feminist principles for equitable and actionable COVID-19 data
Authors: D'Ignazio Catherine , F. Klein Lauren
Published: July 2020

This essay offers seven intersectional feminist principles for equitable and actionable COVID-19 data, drawing from the authors' prior work on data feminism. Our book, Data Feminism (D'Ignazio and Klein, 2020), offers seven principles which suggest possible points of entry for challenging and changing power imbalances in data science. In this essay, we offer seven sets of examples, one inspired by each of our principles, for both identifying existing power imbalances with respect to the impact of the novel coronavirus and its response, and for beginning the work of change.
Partial resolution of chronic unilateral sinonasal obstructive disease in a cat using a temporary polyvinylchloride stent
Authors: Brown James D , Woerde Dennis J , Hoffmann Karon L , Liu Wen-Meng , Goldsmid Sarah , Brown Narelle L
Published: July 2020

Case summary

A 3-year-old male neutered domestic shorthair cat presented for further investigation of a swollen left eyelid and a hard, non-painful bony swelling over the left frontal sinus. Physical examination revealed no nasal discharge or airflow through the left nostril. A CT of the head revealed a left frontal sinus obstruction with expansile remodelling and osteolucency. Drainage of the frontal sinus obstruction was alleviated via placement of a temporary polyvinylchloride (PVC) stent that was left in place for 6 weeks. Purulent material removed from the frontal sinus returned a positive culture for Pseudomonas aeruginosa susceptible to marbofloxacin that was continued for 4 weeks, and for an additional 2 weeks after stent removal. A left-sided mucoid nasal discharge returned 3 months after removal of the stent. Repeat CT performed 20 months after surgery found the presence of a gas-filled frontal sinus and partial resolution in the amount of fluid within the mid and rostral nasal cavity. A repeat positive culture for P aeruginosa was also obtained. The exact cause of the chronic unilateral sinonasal obstruction remains unclear, but an underlying chronic rhinitis with secondary obstructive frontal sinusitis or sinus mucocoele with secondary nasal extension was suspected.

Relevance and novel information

Chronic rhinosinusitis in cats can be a challenging condition to treat and cure. This case illustrates the partial resolution of chronic unilateral sinonasal obstructive disease in a cat using a temporary PVC stent.
The only-child premium and moderation by social origin: Educational stratification in post-reform China
Authors: Zheng Haowen
Published: July 2020

The One Child Policy initiated in the late 1970s created a birth cohort with an unusually high proportion of only children. This paper examines the relationship between being the only child in the family and educational attainment, as well as its potential variations by social origin. Drawing my sample from the China Family Panel Studies, I compare two birth cohorts born before and after the birth-control policy. Results show that in the younger cohort, being the only child in the family produces a premium in educational outcomes, including years of completed schooling and odds of progressing through critical grade transitions. In addition, I observe a pattern that the only-child premium tends to be larger for people with higher social origins in competitive grade transitions.
Preoperative Pulmonary Function Testing to Predict Recurrence of Chronic Rhinosinusitis With Nasal Polyps
Authors: Nakamaru Yuji , Suzuki Masanobu , Honma Aya , Nakazono Akira , Kimura Shogo , Fujiwara Keishi , Morita Shinya , Konno Satoshi , Homma Akihiro
Published: July 2020

Background

Although the close relationship between the upper and lower airways has been highlighted previously, little is known about the association between lung function and the recurrence of chronic rhinosinusitis with nasal polyps (CRSwNP). This study aimed to evaluate the factors associated with pulmonary function that affect CRSwNP recurrence after surgery.

Methods

We performed a series of routine pulmonary function tests for general anesthesia prior to CRSwNP surgery. The values for each parameter were compared in the presence or absence of recurrence.

Results

Sixty-nine patients with CRSwNP were included. The percent predicted forced expiratory volume in one second (%FEV1) in the recurrent group was significantly lower than that in the non-recurrent group ( P = .005). A multivariable logistic regression model revealed that %FEV1 was a positive predictor of recurrence (odds ratio: 0.96, 95% CI: 0.92-0.99, P = .023). There were no significant differences in the other pulmonary functions between the two groups.

Conclusions

We found that %FEV1 may be a predictor of CRSwNP recurrence after surgery. As %FEV1 is a pulmonary function test that is routinely performed before surgery, this parameter is readily applicable. Moreover, as %FEV1 appears to have the potential to reveal concealed asthma, %FEV1 might be a particularly useful tool for the prediction of CRSwNP recurrence after surgery.
Classifying Complications: Assessing Adult Spinal Deformity 2-Year Surgical Outcomes
Authors: Klineberg Eric O. , Passias Peter G. , Poorman Gregory W. , Jalai Cyrus M. , Atanda Abiola , Worley Nancy , Horn Samantha , Sciubba Daniel M. , Hamilton D. Kojo , Burton Douglas C. , Gupta Munish Chandra , Smith Justin S. , Soroceanu Alexandra , Hart Robert A. , Neuman Brian , Ames Christopher P. , Schwab Frank J. , Lafage Virginie
Published: July 2020

Study Design:

Retrospective review of prospective database.

Objective:

Complication rates for adult spinal deformity (ASD) surgery vary widely because there is no accepted system for categorization. Our objective was to identify the impact of complication occurrence, minor-major complication, and Clavien-Dindo complication classification (Cc) on clinical variables and patient-reported outcomes.

Methods:

Complications in surgical ASD patients with complete baseline and 2-year data were considered intraoperatively, perioperatively (<6 weeks), and postoperatively (>6 weeks). Primary outcome measures were complication timing and severity according to 3 scales: complication presence (yes/no), minor-major, and Cc score. Secondary outcomes were surgical outcomes (estimated blood loss [EBL], length of stay [LOS], reoperation) and health-related quality of life (HRQL) scores. Univariate analyses determined complication presence, type, and Cc grade impact on operative variables and on HRQL scores.

Results:

Of 167 patients, 30.5% (n = 51) had intraoperative, 48.5% (n = 81) had perioperative, and 58.7% (n = 98) had postoperative complications. Major intraoperative complications were associated with increased EBL ( P < .001) and LOS ( P = .0092). Postoperative complication presence and major postoperative complication were associated with reoperation ( P < .001). At 2 years, major perioperative complications were associated with worse ODI, SF-36, and SRS activity and appearance scores ( P < .02). Increasing perioperative Cc score and postoperative complication presence were the best predictors of worse HRQL outcomes ( P < .05).

Conclusion:

The Cc Scale was most useful in predicting changes in patient outcomes; at 2 years, patients with raised perioperative Cc scores and postoperative complications saw reduced HRQL improvement. Intraoperative and perioperative complications were associated with worse short-term surgical and inpatient outcomes.
Does day of surgery affect length of stay and hospital charges following lumbar decompression?
Authors: Hijji Fady Y , Jenkins Nathaniel W , Parrish James M , Narain Ankur S , Hrynewycz Nadia M , Brundage Thomas S , Singh Kern
Published: July 2020

Study Design:

This is a retrospective cohort study.

Introduction:

Spine procedures are the most expensive surgical interventions on a per-case basis. Previously, orthopedic procedures occurring later in the week have been associated with an increased length of stay (LOS) and consequent increase in costs. However, no such analysis has been performed on common spinal procedures such as minimally invasive lumbar decompression (MIS LD). The purpose of this study is to determine if there is an association between day of surgery and LOS or direct hospital costs after MIS LD.

Materials and Methods:

A prospectively maintained surgical database of patients who underwent primary, single, or multilevel MIS LD for degenerative spinal pathology between 2008 and 2017 was reviewed. Patients undergoing MIS LD were grouped as early in the week (Monday/Tuesday) or late in the week (Thursday/Friday). Differences in patient demographics and preoperative characteristics were compared using χ 2 analysis or Student’s t-test. Associations between date of surgery, LOS, and costs were assessed using multivariate linear regression.

Results:

A total of 717 patients were included. Of these, 420 (58.6%) were in the early surgery cohort and 297 (41.4%) were in the late surgery cohort. There were no differences in demographic characteristics, operative levels, operative time, blood loss, or hospital LOS between cohorts ( p > 0.05). Furthermore, there was no difference in total direct costs or specific cost categories between cohorts ( p > 0.05).

Discussion:

The timing of surgery within the week is not associated with differences in inpatient LOS or hospital costs following MIS LD. As such, hospitals should not alter surgical scheduling patterns to restrict these procedures to certain days within the week.
Effectiveness of tranexamic acid in reducing blood loss in cervical laminoplasty: A retrospective observational study
Authors: Ho Chi-Hei , Wong Raymond Nang-Man
Published: July 2020

Background:

Tranexamic acid (TXA) has been proved effective in reducing perioperative blood loss in patients undergoing orthopedic operations. However, given the heterogeneity in the diagnoses and spinal operations, there are only limited studies comparing patients with uniform diagnoses and procedures performed.

Methods:

A comparative observational control study was performed on 62 patients with cervical myelopathy. They were divided into control (32) and TXA (30) groups according to whether they had received TXA before and during surgery. Cervical laminoplasty from C3 to C6/7 was performed for all patients using a consistent procedure. Preoperative and postoperative hematological data and perioperative blood loss were compared.

Results:

There were no statistically significant differences between the two groups in terms of age, gender, body mass index, and operating time. The TXA group had significantly less intraoperative (310 ± 215 ml vs. 144 ± 90 ml, p < 0.05) and postoperative blood loss than the control group (150 ± 50 ml vs. 249 ± 94 ml, p < 0.01). The drop of hemoglobin (Hb) level in the TXA group was also significantly lower (0.5 ± 0.42 g/dl vs. 2.1 ± 1.03 g/dl, p < 0.01). No thromboembolic complications found.

Conclusion:

TXA significantly reduced perioperative blood loss and reduced drop of postoperative Hb level in cervical laminoplasty.
Assessing Color-Neutral Racial Attitudes of Faculty at Hispanic-Serving Institutions
Authors: Garcia Gina A. , Koren Emily R. , Cuellar Marcela G.
Published: July 2020

The purpose of this exploratory quantitative study was to assess the color-neutral racial attitudes of faculty at Hispanic-Serving Institutions (HSIs) and to investigate the connection to knowledge and skills for teaching minoritized students. HSIs enroll a large percentage of racially minoritized students, and faculty must be able to assess their attitudes about institutional discrimination and blatant racial issues, which may affect how they teach students of color. We used The Color-Blind Racial Attitudes Scale and Multicultural Teaching Competency Scale to collect data from faculty at 10 HSIs across the United States. Results show that faculty in our sample have low levels of color-neutral racial attitudes, meaning they are aware of racial issues facing students, with slight differences by race, gender, and academic discipline. Moreover, higher color-neutral racial attitudes are associated with lower knowledge and skills for teaching minoritized students. Implications for enhancing “servingness” at HSIs are offered.
Implementation of a Bubble CPAP Treatment Program for Sick Newborns in Nakuru, Kenya: A Quality Improvement Initiative
Authors: Switchenko Nora , Kibaru Elizabeth , Tsimbiri Pamela , Grubb Peter , Anderson Berry Ann , Fassl Bernhard
Published: July 2020

Introduction. Respiratory distress (RD) contributes to common causes of neonatal mortality. Bubble continuous positive airway pressure (bCPAP) is a safe, low-cost therapy for RD; however, adoption of bCPAP programs remains challenging. Aim. To increase the percentage of neonates with RD treated with bCPAP from 2% to 25% by January 2019. Methods. In the newborn unit (NBU) at the Nakuru County and Referral Hospital in Kenya, a pre-initiative (pre) period (March 2016 to December 2017) and a post-initiative (post) period (January 2018 to December 2018) were defined. Tests of change included organization of infrastructure, staff trainings, development of a nurse educator role, and treatment protocols. Clinical and outcome data were abstracted from all available medical records. Results. A total of 405 infants were included in the pre group, with 2% bCPAP use. A total of 1157 infants were included in the post group, with 100 (17.6%) treated with bCPAP. bCPAP use increased during the post period. Rates of RD (49.9% pre, 49.0% post, P = .64) and mortality (30.9% pre, 29.1% post, P = .35) were similar. Neonates treated with bCPAP had lower mean birth weight and a higher risk of death (relative risk = 1.41, 95% confidence interval = 1.21-1.65) compared with those not treated with bCPAP. Conclusion. It was possible to build capacity for the use of bCPAP to treat neonates in this low-resource setting. Gaps in the delivery bCPAP remain, and the current capacity in the PGH NBU allows for application of bCPAP to smaller, likely, sicker neonates.
The Revised Champion’s Health Belief Model Scale: Predictive Validity Among Brazilian Women
Authors: Moreira Camila Brasil , Dahinten V. Susan , Howard A. Fuchsia , Fernandes Ana Fátima Carvalho
Published: July 2020

Introduction

Mammography screening is provided free of charge for the recommended target population in Brazil but participation rates have remained low, and breast cancer mortality has continued to increase. Thus, it is important to identify factors that are associated with poor participation in mammography screening so that service providers can target health promotion messages and screening programs more effectively. Objective: To evaluate the predictive validity of the Revised Champion’s Health Belief Model scale (RCHBMS) for identifying women at high risk of not adhering to national guidelines for mammography screening in Brazil. Methods: We used a longitudinal survey design with a 1-year follow-up data from 194 women living in northeastern Brazil, in the city of Fortaleza, Ceará, participants completed the RCHBMS at baseline, and mammography uptake was measured 1 year later. Hierarchical logistic regression was used to determine the predictive validity of the RCHBMS for identifying women who had not adhered to recommendations for mammography screening, after accounting for the women’s sociodemographic and clinical characteristics. The sensitivity and specificity of various cut-off points were calculated to determine the optimal cut-off point for identifying women at high risk of not adhering to mammography screening guidelines. Results: Two subscales of the RCHBMS uniquely predicted nonadherence: susceptibility and barriers, along with race and family history of cancer. The total scale score (with barriers reverse coded) was also highly predictive. For our sample, using only the RCHBMS with a cutoff of ≤ 3.67 (out of a total possible range of 1–5) yielded a high sensitivity and specificity for predicting nonadherence. Conclusion: Study findings support the validity and clinical utility of the RCHBM for identifying women at risk of not adhering to national guidelines for mammography screening in Brazil.
Outcomes of Operative Management of Insertional Achilles Tendinopathy in the Young vs Elderly
Authors: Phen Huai Ming , Manz Wesley J. , Mignemi Danielle , Greenshields Joel T. , Bariteau Jason T.
Published: July 2020

Background:

Insertional Achilles tendinopathy (IAT) is a common cause of chronic posterior heel pain. Surgical intervention reproducibly improves patients’ pain and functional status. We hypothesized that patients older than 60 years would have similar improvements in pain and function and low rates of complications after surgery for IAT when compared to a younger cohort.

Methods:

Retrospective review of adult case series in patients undergoing surgical management of IAT. Patients were stratified into those 60 years and younger and those older than 60 years. Patients with prior or concomitant surgical procedures and revisions were excluded. Visual analog scale (VAS), Short Form–36 Physical Component Summary and Mental Component Summary (SF-36 PCS/MCS) scores, wound infection, and recurrence, defined as a redevelopment of heel pain in the operative extremity within 6 months, were assessed with a minimum follow-up of 12 months. Statistical analysis was performed using linear regression mixed models and χ2 analysis. Thirty-seven patients were enrolled, with 38 operative heels. The younger cohort had an average age of 49.1 (range, 26-60) years. The older group had an average age of 66.8 (range, 61-76) years.

Results:

VAS and SF-36 PCS scores for the entire cohort significantly improved at 6 and 12 months postoperatively ( P < .001). Postoperative SF-36 MCS scores for the cohort significantly improved only at 12 months ( P < .001). No significant differences between the young and elderly were seen with regard to improvements in VAS and SF-36 PCS/MCS at 6 or 12 months postoperatively. Multiple linear regression models showed no significant difference between age groups and VAS score, SF-36 PCS/MCS, or change in pain scores after controlling for comorbidities. No significant difference in overall complication rates was seen between the 2 groups (4.9% vs 29.4%, P = .104). There was 1 recurrence of heel pain in the younger group and 4 recurrences of pain in the older group (23.5%) at 6 months, of which 2 resolved at 1 year. There was 1 case of a superficial wound infection requiring antibiotics in the older cohort (5.9%). No patients required surgical revision.

Conclusion:

Surgical management of IAT in an older population produced similar improvements in clinical results when compared to a younger cohort, with no significant increase in postoperative complications.

Level of Evidence:

Level III, retrospective comparative series.