bluuebunny/crossref_metadata_2025 huggingface dataset:
Median nerve compression caused by superficial brachial artery: an unusual clinical case
Authors: Liu Jialei , Zhong Kunjing , Lin Dingkun
Published: December 2020

An iatrogenic pseudoaneurysm of the radial artery and spontaneous venous malformation are associated with median nerve compression. However, the superficial brachial artery (SBA) has rarely been described as the cause of neurological deficits due to median nerve compression. A 61-year-old man was admitted to our clinic with a 1-year history of intermittent aching palsy in the left thumb that had progressed to the first three fingers. Clinical examination revealed mild sensory disturbance and hyperpathia in the first three fingers and weakness of the opponens pollicis. Ultrasound and magnetic resonance imaging confirmed that the SBA was compressing the median nerve by almost one-third. When anomalies of the SBA impinge on the median nerve, pulsatile pressure is applied to the nerve trunk. This may trigger ectopic stimulation of sensory fibers, leading to severe pain, sensory neuropathy, and motor disturbance. Considering the substantial difficulties and risks of a surgical operation as well as the patient’s wish to undergo conservative treatment, we performed muscle relaxation and acupuncture to relieve the pressure of the surrounding soft tissue and in turn decrease the impingement of the SBA on the median nerve. A satisfactory treatment effect was reached in this case.
Preoperative trans-arterial embolization of a giant scalp congenital hemangioma associated with cardiac failure in a premature newborn
Authors: Alluhaybi Abdulelah A. , Abdulqader Sarah Bin , Altuhayni Khalid , AlTurkstani Abdulellah , Kabbani Aseel , Ahmad Maqsood
Published: December 2020

Scalp congenital hemangiomas are a rare, but well-known, vascular malformation in infants. These hemangiomas are usually benign, but occasionally these are associated with cardiac complications and disfigurement. Giant hemangiomas that are associated with high-output heart failure require intervention because they have a high mortality rate and do not respond to medical therapy. We report here a case of a premature newborn who was diagnosed with a giant scalp hemangioma associated with cardiac failure. The newborn underwent successful arterial feeder embolization of the superficial temporal artery. He then underwent surgical excision 14 days after embolization. We believe that preoperative embolization of a giant scalp hemangioma in newborns is a safe measure for alleviating underlying cardiac failure and minimizing the risk of intraoperative bleeding.
Archives, promises, values: Forensic infrastructures in times of austerity
Authors: Gonzalez-Polledo EJ , Posocco Silvia
Published: December 2020

This article analyses the role of infrastructures in the ‘bioinformational turn’ in forensic science and examines processes through which evidence is constituted, validated or challenged in and through domains of expertise that engage different techniques, data, objects and knowledges through infrastructural arrangements. While the digitisation of the infrastructures that underpin forensic service delivery promised connectivity, prosperity and wellbeing, in reality it also brought forward new levels of risk and vulnerability, generating new tensions and frictions in the body politic. As genetic science reaches post-archival horizons through new genetic sequencing technologies, forensic science in post-archival times raises questions concerning the differential impact of the fragmentation of analytical and archival infrastructures and increasingly asynchronous bureaucracies whose role is displaced by the relative autonomy of datasets and computational architectures that elude governance, oversight and citizens’ scrutiny.
I. Gershon, Down and Out in the New Economy: How People Find (or Don't Find) Work Today; A.J. Ravenelle, Hustle and Gig: Struggling and Surviving in the Sharing Economy, Oakland; A. Rosenblat, Uberland: How Algorithms are Rewriting the Rules of Work, Oakland
Authors: Lenhard Johannes
Published: December 2020

A number of recent monographs have been focused on how work is organized and experienced today in the new economy, enabled through digital communication via apps and smartphones. Work by Ravenelle, Rosenblat and Gershon portrays both blue collar and white-collar labour, often as part of the so-called gig economy. With their ethnographic focus, the volumes complement the widespread media critique of Uber, AirBnB and Co. with a large variety of detailed accounts grounding the analysis and the (positive) change it could drive in a much more solid basis. Following their trail further and deeper into the world of new work seems like more than a worthwhile undertaking for our discipline.
Using a General Case Management Tool With Partner-violent Men on Community Supervision in Iowa
Authors: Perley-Robertson Bronwen , Serin Ralph C. , Chadwick Nick
Published: December 2020

Intimate partner violence (IPV) is among the most common acts of violence against women worldwide, making it a major global threat to women’s health and safety. The assessment and management of IPV offenders are therefore vital tasks in criminal justice systems. The current study examined whether the DRAOR, a general case management tool, was useful for supervising 112 male IPV offenders in Iowa, United States. Several risk factors emerged as potentially important treatment targets for partner-violent men, including poor attachment with others, substance abuse, anger/hostility, opportunity/access to victims, and problematic interpersonal relationships. While further research is needed to improve the utility of the DRAOR for predicting IPV recidivism, it assesses several factors that are relevant for supervising IPV cases (e.g., substance abuse, anger/hostility, victim access). This suggests the DRAOR could potentially be used to guide case management in the presence of a validated IPV tool that focuses on static risk factors, such as the ODARA. The use of the DRAOR with IPV offenders may also be warranted if they are found to be generally violent/antisocial rather than as family only offenders.
Demonstrating the value of digital health: Guidance on contextual evidence gathering for companies in different stages of maturity
Authors: Halminen Olli , Chen An , Tenhunen Henni , Lillrank Paul
Published: December 2020

Application of value-based healthcare policies affects all actors in social and health care field, including the Digital Health Intervention (DHI) providers aiming to enter the industry or expand their market. Apparent lack of fit between evidence and expectations inhibits the growth of DHI companies. The companies need efficient and credible methods to access and demonstrate the value of their DHIs. Building on the stage-of-maturity logic presented in World Health Organization’s (WHO) guide of monitoring and evaluating digital health interventions and Context-Intervention-Mechanism-Outcome (CIMO) logic, we provide a potential approach for DHI companies to assess the evidence needed in their current situation. The proposed approach takes into account the company’s future development goals and the business environment, reflecting for every stage of technology maturity according to the WHO guidelines and through the CIMO lens. The focus is on specific intervention and its fit for different organizational and national contexts. The solution guides the research process of the company to understand which evidence-gathering topics should be addressed. This evidence can be beneficial for companies to enter into, occupy, expand or sustain in the domestic or international market.
Sorption of phenols on hexadecyltrimethylammonium- modified bentonite: Application of Polanyi−Manes potential theory
Authors: Choi Jiyeon , Song Dong-Ik , Shin Won Sik
Published: December 2020

This study investigated the sorption of phenol and 4-chlorophenol (4-CP) on natural bentonite modified with hexadecyltrimethylammonium (HDTMA) cation. The Freundlich, Langmuir, Dubinin−Radushkevich (DR), Sips, and Polanyi−Dubinin−Manes (PDM) models fitted the sorption data well (R2 > 0.92). The Freundlich coefficient and the maximum sorbed amount of the Langmuir and PDM models of 4-CP were higher than phenol because of higher hydrophobicity (log Kow = 2.39 for 4-CP and 1.46 for phenol). The PDM model that includes solubility and molar volume was highly useful in predicting the sorption of phenols having widely different hydrophobicity and solubility. The characteristic curves, the plot of sorbed volume ( qv) versus the sorption potential per molar volume ( ε/ Vm) of 4-CP and phenol were distinctly different although they have similar chemical compositions. The selectivity of 4-CP (3.72) was higher than that of phenol (0.27) in binary sorption systems. The sorbed volume ( qv) in the binary sorption was remarkably reduced and the characteristic curve had wider distribution owing to competition in pore-filling. The sorption behaviors were elucidated by partitioning and pore-filling mechanisms. Among the tested binary sorption models, the modified Langmuir competitive model was the best in the prediction of the binary sorption (R2 > 0.98).
There is no I in Escape: Using an Escape Room Simulation to Enhance Teamwork and Medication Safety Behaviors in Nursing Students
Authors: Sarage Dawn , O’Neill Barbara J. , Eaton Carrie Morgan
Published: December 2020

Background.

Nurse educators are challenged to develop simulation activities that will engage interest and help baccalaureate nursing students administer medications safely. Students must be able to recognize and report medication errors and effectively collaborate with their patient care team to provide safe and competent care to patients across the healthcare spectrum. Escape rooms are an innovative learning platform where students can work as a team to build these skills.

Aim.

We report on the strategies and resources used to create and implement an escape room simulation for a problem-based learning activity to practice medication safety behaviors, using critical thinking, communication and team building skills.

Methods.

Using Kolb’s Learning Cycle and the International Association for Clinical Simulation in Learning (INACSL) Standards of Best PracticeSM, we developed a team-based, four-hour escape room simulation activity around detecting and reporting medication errors in the hospital setting.

The escape room simulation included a high-fidelity patient manikin, two embedded participants in the roles of family member and health care provider (HCP), puzzles, riddles, clues and lifelines. The learning objectives were paired with essential Quality and Safety Education for Nurses (QSEN) competencies. Promoting Excellence and Reflective Learning in Simulation (PEARLS) was used for debriefing.

Results.

The result was a hybrid escape room simulation that mimics a situation nursing students might face in the hospital setting where they have to work as a team to assess a new patient, reconcile medications, perform medication calculations, problem solve intravenous infusion set ups, and communicate medication errors. Data collected for quality purposes indicated a positive student response.

Discussion / Conclusion / Implication.

The escape room platform served as a foundation for incorporating other simulation modalities and provided a stimulating learning activity. The next step is to conduct a multi-site study with pre-test and post-test data collected from students to gauge learning and behavior change.
Effect of gamma irradiation against microbial spoilage of hummus preserved under refrigerated storage
Authors: Al-Qadiri Hamzah , Amr Ayed , Al-Holy Murad A , Shahein Mohammed
Published: December 2020

The current study aimed to evaluate the preservation of hummus packed in laminated pouches to extend its shelf life for a period of 35 d using a combined treatment of gamma irradiation and refrigerated storage. The effects of different irradiation doses (0, 0.1, 1.5 and 2.5 kGy) and refrigeration (4 °C) against microbial spoilage were investigated. Microbial criteria of total mesophilic aerobic counts, lactic acid bacterial counts, and yeasts and molds decreased significantly ( P ≤ 0.05) in a dose dependent manner. Furthermore, dose of 2.5 kGy decreased the lactic acid bacteria counts to undetectable levels for the first 10 d of storage. Although microbial load increased during 35 d of refrigerated storage, samples treated with doses of 1.5 and 2.5 kGy showed a good microbial quality that complies with microbial limits set by national and international authorities for ready to eat foods. Furthermore, Bacillus cereus, Staphylococcus aureus, Listeria monocytogenes, Enterococcus faecalis and coliform bacteria were not detected in the irradiated samples as well as in the controls. It was observed that a dose ≥1.5 kGy combined with refrigerated storage at 4 °C could be used to extend the shelf life of hummus samples in laminated pouches up to 35 d.
Using Evidence Integration Techniques in the Development of Health-Based Occupational Exposure Levels
Authors: Lent Emily May , Sussan Thomas E. , Leach Glenn J. , Johnson Mark S.
Published: December 2020

Development of toxicology-based criteria such as occupational exposure levels (OELs) are rarely straightforward. This process requires a rigorous review of the literature, searching for patterns in toxicity, biological plausibility, coherence, and dose–response relationships. Despite the direct applicability, human data are rarely used primarily because of imprecise exposure estimates, unknown influence of assumptions, and confounding factors. As a result, high reliance is often placed on laboratory animal data. Often, data from a single study is typically used to represent an entire database to extrapolate an OEL, even for data-rich compounds. Here we present a holistic framework for evaluating epidemiological, controlled in vivo, mechanistic/ in vitro, and computational evidence that can be useful in deriving OELs. It begins with describing a documented review process of the literature, followed by sorting of data into either controlled laboratory in vivo, in silico/read-across, mechanistic/ in vitro, or epidemiological/field data categories. Studies are then evaluated and qualified based on rigor, risk of bias, and applicability for point of departure development. Other data (eg, in vitro, in silico estimates, read-across data and mechanistic information, and data that failed to meet the former criteria) are used alongside qualified epidemiological exposure estimates to help inform points of departure or human-equivalent concentrations that are based on toxic end points. Bayesian benchmark dose methods are used to estimate points of departure and for estimating uncertainty factors (UFs) to develop preliminary OELs. These are then compared with epidemiological data to support the OEL and the use and magnitude of UFs, when appropriate.
Exogenous Ketones as Therapeutic Signaling Molecules in High-Stress Occupations: Implications for Mitigating Oxidative Stress and Mitochondrial Dysfunction in Future Research
Authors: Waldman Hunter S , McAllister Matthew J
Published: December 2020

High-stress occupations (ie, firefighters, military personnel, police officers, etc.) are often plagued by cardiometabolic diseases induced by exposure to chronic stressors. Interrupted sleep cycles, poor dietary patterns, lack of physical activity, and smoke exposure along with simultaneous psychological stressors promote chronic low-grade inflammation and excessive oxidative stress. Collectively, these data suggest that practical interventions which might mitigate the underlying pathologies of these cardiometabolic diseases are warranted. Ketones, specifically R-βHB, modulates intracellular signaling cascades such as the cellular redox ratios of NAD+/NADH, the activity of NAD dependent deacetylases SIRT1 and SIRT3, and promotes a robust mitochondrial environment which favors reductions in oxidative stress and inflammation. To date, the literature examining R-βHB as a signaling metabolite has mostly been performed from endogenous R-βHB production achieved through nutritional ketosis or cell culture and mouse models using exogenous R-βHB. To the authors knowledge, only 1 study has attempted to report on the effects of exogenous ketones and the mitigation of oxidative stress/inflammation. Therefore, the scope of this review is to detail the mechanisms of R-βHB as a signaling metabolite and the role that exogenous ketones might play in mitigating diseases in individuals serving in high-stress occupations.
Challenges and possibilities for re-wilding education policy in Japan
Authors: Oguri Yuko , Takano Takako
Published: December 2020

This paper discusses human relationships with the natural world in Japanese educational policy. Based on two case studies, we argue that policy must recognize the cultural and spiritual ties that people in Japan have fostered in order to live well, which this paper considers to be part of “re-wilding education policy.” We briefly review the history of educational policy in Japan and identify its core features before clarifying the existing power structure between national and local governments regarding such policy. We also describe the characteristics of the Japanese education system, which stem partly from tensions between central and local governments due to the interpretation of legal frameworks. Through two case studies—situated in a traditional farming community in a mountainous area, and a community on a group of remote islands—this paper focuses on educational practices derived not from the dominant education policy but from local realities. These two cases allow us to demonstrate effective efforts made in these communities to rebuild traditional human–nature relationships on a small scale based on the everyday lives of the inhabitants. We conclude that any successful re-wilding of education policy in Japan will depend on the central government’s release of power, recognition of the unique features of diverse localities in Japan, and support for spontaneous activities emerging in local communities.
How Can We Help Alleviate the Financial Concerns of Non-Directed (Altruistic) Living Kidney Donors?
Authors: Maghen Ariella , Mendoza Georgina , Vargas Grecia B. , Connor Sarah E. , Nassiri Sima , Kwan Lorna , Wood Erika L. , Lalezari Jonathan , Friedman Sarah , Waterman Amy D. , George Sheba , Maliski Sally L. , Veale Jeffrey L.
Published: December 2020

Introduction:

The recent increase in non-directed donors (NDDs) in the United States (U.S.) may help reduce the overwhelming number of patients on the waitlist. However, non-directed donation may be limiting its full potential. Out-of-pocket donation costs upward of $8,000 may be a barrier to potential donors with altruistic tendencies, but inadequate financial support. This study aimed to describe the financial concerns of 31 U.S. NDDs.

Methods:

We conducted qualitative interviews and administered quantitative demographic surveys between April 2013 and April 2015. Interview transcripts were analyzed using grounded theory techniques to describe and expand on themes relevant to the NDD experience.

Findings:

We identified 4 sub-themes related to the theme of financial concerns: (1) direct costs related to transportation, lodging, and parking, (2) indirect costs of lost wages encountered from taking time off work to recover from surgery, (3) sources of financial support, and (4) suggestions for alleviating donor financial burden. Two thirds of participants (20) expressed concerns about direct and indirect donation costs. 11 NDDs reported the negative impact of direct costs,15 NDDs had concerns about indirect costs; only 7 donors received supplemental financial support from state mandates and transplant programs.

Discussion:

Understanding the financial concerns of NDDs may guide improvements in the NDD donation experience that could support individuals who are interested in donating but lack the financial stability to donate. Removing financial disincentives may help increase nondirected donation rates, increase the living donor pool, and the number of kidneys available for transplantation.
Bidirectional Irrigation System to Treat a Difficult Wound: A Case Series
Authors: Chen Li-Yung , Hou Jin-De , Peng Chian-Ze
Published: December 2020

Aims

To date, there is no distinct principle determining whether to use irrigation under negative-pressure wound therapy (NPWT). We developed a new economical device to manage difficult wounds, employing 1 of 2 techniques depending on the wound condition.

Methods

This case series study was conducted in 12 patients with difficult wound, from 2017 to 2018. Four patients were treated with Type A bidirectional irrigation system (wound irrigation), while 8 patients were treated with Type B bidirectional irrigation system (wound irrigation combined with NPWT).

Results

In the Type A device group, inflammatory profiles in case I, case IV, and case VIII were not monitored due to the stability of their wound. The mean recovery period was 3.75 weeks (2-8 weeks), with decreases in 100% healing rate. In the Type B device group, we noted an average of 71% reduction in inflammatory profiles. All patients’ infections were resolved or were healing, and 7 patients recovered satisfactorily. The recovery period ranged from 4 to 17 weeks, with a median value of 7 weeks.

Conclusion

Bidirectional irrigation system decreases secondary infections and complications, and increases the healing rate in patients with difficult wound.
FOXM1 activates JAK1/STAT3 pathway in human osteoarthritis cartilage cell inflammatory reaction
Authors: Zeng Runming , Lu Xiaohui , Lin Jing , Ron Zhijie , Fang Jiezhuang , Liu Zewa , Zeng Wanting
Published: December 2020

Osteoarthritis (OA), the most prevalent form of arthritis disease, is characterized by destruction of articular cartilage, osteophyte development, and sclerosis of subchondral bone. Transcription factors Janus kinase 1/signal transducer and activator of transcription 3 (JAK1/STAT3) and Forkhead box M1 (FOXM1) are key mediators of this inflammatory reaction. In this study, we investigated the interaction between JAK1/STAT3 and FOXM1 in OA. Inflammation is related to the cartilage damage, and lipopolysaccharides (LPS) are a major pro-inflammatory inducer, so LPS was utilized to stimulate chondrocytes and establish a cell-based OA model. We found LPS treatment caused a generation of inflammatory cell factors (IL-1β, IL-6, and TNF-α), and upregulation of inducible nitric oxide synthases (iNOS), cyclooxygenase-2 (COX-2), nitric oxide (NO), prostaglandin E2 (PGE2) and other inflammatory mediators. Cell viability of chondrocytes was impaired with LPS stimulation, along with an upregulation of JAK1 expression, and phosphorylation and nuclear accumulation of STAT3. The administration of STAT3 inhibitor WP1066, which abated activation and nuclear location of STAT3, depleted the effect of LPS on inflammation and cell death. Co-immunoprecipitation showed that STAT3 was able to bind to FOXM1, and deactivation of STAT3 resulted in the downregulation of FOXM1. Moreover, FOXM1 silencing inhibited the generation of inflammatory cytokines induced by LPS, and the attenuation of cell survival. These findings indicated that the interaction between JAK1/STAT3 and FOXM1 may play a key role in OA pathogenic studies, and suggest the JAK1/STAT3 pathway may be a potential target for OA therapy.
An improved dynamic cooperative random drift particle swarm optimization algorithm based on search history decision
Authors: Zhao Ji , Fu Yi , Mei Juan
Published: December 2020

A novel dynamic cooperative random drift particle swarm optimization algorithm based on entire search history decision (CRDPSO) is reported. At each iteration, the positions and the fitness values of the evaluated solutions in the algorithm are stored by a binary space partitioning tree structure archive, which leads to a fast fitness function approximation. The mutation is adaptive and parameter-less because of the fitness function approximation enhancing the mutation strategy. The dynamic cooperation between the particles by using the context vector increases the population diversity helps to improve the search ability of the swarm and cooperatively searches for the global optimum. The performance of CRDPSO is tested on standard benchmark problems including multimodal and unimodal functions. The empirical results show that CRDPSO outperforms other well-known stochastic optimization methods.
Changing Perspectives: Offloading a Patient With a Diabetic Foot Ulcer as Opposed to Offloading a Diabetic Foot Ulcer
Authors: Samuelson Katherine L. , Kiefer Chase T. , Wu Stephanie C. , Crews Ryan T.
Published: December 2020

Diabetic foot ulcers (DFUs) represent a tremendous burden to health care systems. Offloading is one of the key tenants to healing DFU and knee-high irremovable offloading devices are considered the gold standard for offloading DFU. However, the gold standard is rarely utilized in clinical practice. Patients’ limited tolerance for such devices is one of a number of reasons that have been attributed to the lack of use of these devices. The practice of evidence-based medicine relies on shared decision making by pairing patients’ values and preferences with the best available evidence. The present case report reviews the process of a patient-centered approach to identify the best offloading option for a patient with DFU. In consultation with the patient, a series of modalities were evaluated for offloading 2 unilateral forefoot DFUs. It is suggested that optimizing DFU offloading outcomes at the population level will require concerted efforts to employ the best offloading solution at the individual patient level. Offloading modalities are necessitated to mitigate the physical stress imparted on DFU during the weightbearing activity that patients engage in. Success is likely to be maximized by maintaining a mind-set of treating individual patients with DFUs as opposed to simply treating DFUs.

Levels of Evidence: Level V: Case report
Relationship Satisfaction Can Help to Maintain the Positive Effect of Childbirth on Parental Self-Esteem
Authors: Wenzel Mario , Staab Doris , Rowland Zarah , van Scheppingen Manon A.
Published: December 2020

The transition to parenthood is accompanied by declined self-esteem levels, which may be explained by parents’ relationship satisfaction. However, prior research examined self-esteem only shortly before and after childbirth and had no or only unmatched childless respondents as a control group, limiting the possibility to examine long-term adaptive processes and the causal interpretation of the associations. Thus, we used panel data (10 years, 4,075 individuals, and 16,122 observations) to compare self-esteem and relationship satisfaction trajectories of parents with matched childless respondents using propensity score matching. We found a quadratic trajectory for parents’ self-esteem, which declined and increased before birth and declined and returned to baseline levels after birth. In contrast, matched childless respondents’ self-esteem decreased linearly before childbirth and then recovered. The quadratic postpartum process in parents was significantly associated with reduced relationship satisfaction. Thus, a fulfilling relationship may help to maintain the positive effects of childbirth on self-esteem in parents.
Targeting viral genome synthesis as broad-spectrum approach against RNA virus infections
Authors: Huchting Johanna
Published: December 2020

Zoonotic spillover, i.e. pathogen transmission from animal to human, has repeatedly introduced RNA viruses into the human population. In some cases, where these viruses were then efficiently transmitted between humans, they caused large disease outbreaks such as the 1918 flu pandemic or, more recently, outbreaks of Ebola and Coronavirus disease. These examples demonstrate that RNA viruses pose an immense burden on individual and public health with outbreaks threatening the economy and social cohesion within and across borders. And while emerging RNA viruses are introduced more frequently as human activities increasingly disrupt wild-life eco-systems, therapeutic or preventative medicines satisfying the “one drug-multiple bugs”-aim are unavailable. As one central aspect of preparedness efforts, this review digs into the development of broadly acting antivirals via targeting viral genome synthesis with host- or virus-directed drugs centering around nucleotides, the genomes’ universal building blocks. Following the first strategy, selected examples of host de novo nucleotide synthesis inhibitors are presented that ultimately interfere with viral nucleic acid synthesis, with ribavirin being the most prominent and widely used example. For directly targeting the viral polymerase, nucleoside and nucleotide analogues (NNAs) have long been at the core of antiviral drug development and this review illustrates different molecular strategies by which NNAs inhibit viral infection. Highlighting well-known as well as recent, clinically promising compounds, structural features and mechanistic details that may confer broad-spectrum activity are discussed. The final part addresses limitations of NNAs for clinical development such as low efficacy or mitochondrial toxicity and illustrates strategies to overcome these.
The potential synergistic effects between psychedelic administration and nature contact for the improvement of mental health
Authors: Gandy Sam , Forstmann Matthias , Carhart-Harris Robin Lester , Timmermann Christopher , Luke David , Watts Rosalind
Published: December 2020

Therapeutic psychedelic administration and contact with nature have been associated with the same psychological mechanisms: decreased rumination and negative affect, enhanced psychological connectedness and mindfulness-related capacities, and heightened states of awe and transcendent experiences, all processes linked to improvements in mental health amongst clinical and healthy populations. Nature-based settings can have inherently psychologically soothing properties which may complement all stages of psychedelic therapy (mainly preparation and integration) whilst potentiating increases in nature relatedness, with associated psychological benefits. Maximising enhancement of nature relatedness through therapeutic psychedelic administration may constitute an independent and complementary pathway towards improvements in mental health that can be elicited by psychedelics.
Vitrectomy for Tractional Retinal Detachment Due to Combined Hamartoma of the Retina and Retinal Pigment Epithelium
Authors: Holekamp Katherine E. , Holekamp Nancy M.
Published: December 2020

Purpose:

We discuss a peripheral combined hamartoma of the retina and retinal pigment epithelium (CHRRPE) with a macula-involving TRD that was repaired by vitrectomy surgery.

Methods:

A case report is presented.

Results:

A 15-year-old white girl with no significant medical or ocular history presented to the retina clinic with a 1-month history of progressive loss of inferior visual field in the right eye. A large, elevated CHRRPE was found in the superior midperipheral retina. On involvement of the macula, urgent vitrectomy surgery with peeling of the cortical vitreous membrane to the margins of the hamartoma was performed. Eighteen months later, vision had returned to 20/16 and the retina, relieved of traction, continued to reattach with trace remaining cystic changes at the fovea on optical coherence tomography.

Conclusions:

Physicians should consider vitrectomy surgery with membrane peeling of the cortical vitreous for TRD due to CHRRPE.
Le Fort III Distraction Osteogenesis: Early Experience With an Internal Bilevel Midface Distraction System
Authors: Brady Colin M. , Steinberg Jordan P. , Parks Marisa , Mobley Stacy , Williams Joseph K.
Published: December 2020

Internal distraction devices for severe midface hypoplasia are often criticized for their distraction at a single pivot point, resulting in “mid-face tipping,” a phenomenon which is in part related to the differential resistance of the soft tissues at orbital and maxillary levels. To address this deficiency, we present our early experience with an internal bi-level midface distraction system. Four patients underwent midface advancement with an internal bi-level distraction system. The specifics of design, application, distraction, and removal are detailed. Hospital records were reviewed to capture patient demographics, length of stay, OR times, and complications. Relevant cephalometry was performed pre- and post-operatively, and compared. In 2015, 4 patients with severe mid-face hypoplasia were treated with an internal bi-level mid-face distraction system. The mean age was 13.5 ± 1.7 years. The mean operative time was 269.7 ± 67.4 min. The mean LOS was 10 ± 7.4 days. The on-table distraction was 5 mm. Distraction subsequently proceeded at a variable rate of 0.5 to 1.0 mm daily with a maximal distraction of 20 and 30 mm at orbital and maxillary levels, respectively. Mean time to distractor removal was 11.2 ± 1.1 weeks. Device design allowed facile removal through minimally invasive incisions. Cephalometry was seen to progress towards age-matched norms. There were no major complications. Minor complications included breakage of the vertical component of the maxillary arm at the time of device removal in 1 patient. By allowing real-time adjustment at the orbital and maxillary levels to combat differential resistance, early experience with our device maximizes occlusal advancement without overcompensating orbital translation.
Cerebral artery dilation during transient ischemia is impaired by amyloid β deposition around the cerebral artery in Alzheimer’s disease model mice
Authors: Watanabe Nobuhiro , Noda Yoshihiro , Nemoto Taeko , Iimura Kaori , Shimizu Takahiko , Hotta Harumi
Published: December 2020

Transient ischemia is an exacerbation factor of Alzheimer’s disease (AD). We aimed to examine the influence of amyloid β (Aβ) deposition around the cerebral (pial) artery in terms of diameter changes in the cerebral artery during transient ischemia in AD model mice (APPNL-G-F) under urethane anesthesia. Cerebral vasculature and Aβ deposition were examined using two-photon microscopy. Cerebral ischemia was induced by transient occlusion of the unilateral common carotid artery. The diameter of the pial artery was quantitatively measured. In wild-type mice, the diameter of arteries increased during occlusion and returned to their basal diameter after re-opening. In AD model mice, the artery response during occlusion differed depending on Aβ deposition sites. Arterial diameter changes at non-Aβ deposition site were similar to those in wild-type mice, whereas they were significantly smaller at Aβ deposition site. The results suggest that cerebral artery changes during ischemia are impaired by Aβ deposition.
Socio-demographic and clinical characteristics of diabetes mellitus in rural Rwanda: time to contextualize the interventions? A cross-sectional study
Authors: Bavuma Charlotte M. , Musafiri Sanctus , Rutayisire Pierre-Claver , Ng’ang’a Loise M. , McQuillan Ruth , Wild Sarah H.
Published: December 2020

Background

Existing prevention and treatment strategies target the classic types of diabetes yet this approach might not always be appropriate in some settings where atypical phenotypes exist. This study aims to assess the socio-demographic and clinical characteristics of people with diabetes in rural Rwanda compared to those of urban dwellers.

Methods

A cross-sectional, clinic-based study was conducted in which individuals with diabetes mellitus were consecutively recruited from April 2015 to April 2016. Demographic and clinical data were collected from patient interviews, medical files and physical examinations. Chi-square tests and T-tests were used to compare proportions and means between rural and urban residents.

Results

A total of 472 participants were recruited (mean age 40.2 ± 19.1 years), including 295 women and 315 rural residents. Compared to urban residents, rural residents had lower levels of education, were more likely to be employed in low-income work and to have limited access to running water and electricity. Diabetes was diagnosed at a younger age in rural residents (mean ± SD 32 ± 18 vs 41 ± 17 years; p < 0.001). Physical inactivity, family history of diabetes and obesity were significantly less prevalent in rural than in urban individuals (44% vs 66, 14.9% vs 28.7 and 27.6% vs 54.1%, respectively; p < 0.001). The frequency of fruit and vegetable consumption was lower in rural than in urban participants. High waist circumference was more prevalent in urban than in rural women and men (75.3% vs 45.5 and 30% vs 6%, respectively; p < 0.001). History of childhood under-nutrition was more frequent in rural than in urban individuals (22.5% vs 6.4%; p < 0.001).

Conclusions

Characteristics of people with diabetes in rural Rwanda appear to differ from those of individuals with diabetes in urban settings, suggesting that sub-types of diabetes exist in Rwanda. Generic guidelines for diabetes prevention and management may not be appropriate in different populations.
Communication patterns in the doctor–patient relationship: evaluating determinants associated with low paternalism in Mexico
Authors: Lazcano-Ponce Eduardo , Angeles-Llerenas Angelica , Rodríguez-Valentín Rocío , Salvador-Carulla Luis , Domínguez-Esponda Rosalinda , Astudillo-García Claudia Iveth , Madrigal-de León Eduardo , Katz Gregorio
Published: December 2020

Background

Paternalism/overprotection limits communication between healthcare professionals and patients and does not promote shared therapeutic decision-making. In the global north, communication patterns have been regulated to promote autonomy, whereas in the global south, they reflect the physician’s personal choices. The goal of this study was to contribute to knowledge on the communication patterns used in clinical practice in Mexico and to identify the determinants that favour a doctor–patient relationship characterized by low paternalism/autonomy.

Methods

A self-report study on communication patterns in a sample of 761 mental healthcare professionals in Central and Western Mexico was conducted. Multiple ordinal logistic regression models were used to analyse paternalism and associated factors.

Results

A high prevalence (68.7% [95% CI 60.0–70.5]) of paternalism was observed among mental health professionals in Mexico. The main determinants of low paternalism/autonomy were medical specialty (OR 1.67 [95% CI 1.16–2.40]) and gender, with female physicians being more likely to explicitly share diagnoses and therapeutic strategies with patients and their families (OR 1.57 [95% CI 1.11–2.22]). A pattern of highly explicit communication was strongly associated with low paternalism/autonomy (OR 12.13 [95% CI 7.71–19.05]). Finally, a modifying effect of age strata on the association between communication pattern or specialty and low paternalism/autonomy was observed.

Conclusions

Among mental health professionals in Mexico, high paternalism prevailed. Gender, specialty, and a pattern of open communication were closely associated with low paternalism/autonomy. Strengthening health professionals’ competencies and promoting explicit communication could contribute to the transition towards more autonomist communication in clinical practice in Mexico. The ethical implications will need to be resolved in the near future.
Demography and determinants of dog and cat ownership in three towns of West Shoa zone, Oromia Region, Ethiopia
Authors: Gebremedhin Endrias Zewdu , Sarba Edilu Jorga , Getaneh Abraham Mekebib , Tola Getachew Kebebew , Endale Solomon Shiferaw , Marami Lencho Megersa
Published: December 2020

Background

The dog and cat population data is generally scarce in developing countries due to absence of surveys. The demography of owned dogs and cats, and the associated ownership characteristics, are essential for the control of pet population and zoonosis. This study was conducted in three towns of West Shoa Zone of Ethiopia with the objectives of assessing demographic characteristics of owned dogs and cats and determinants of ownership.

Results

About 65.1% (95% CI: 62.1–69.8%) of the householders own dogs, 39.2% (95% CI: 35.8–43.8%) own cats, and 30.6% (95% CI: 27.4–35.0%) own both. The majority of the dog-owning households own a single dog (74.8%) and cat (74.9%). There were significantly higher proportion of dog and cat-owning households in Bako than Ambo and Gojo towns. The human to owned-dog ratio was 6:1, and that of cat ratio was 10:1. There were more male dogs (72.1%) and more female cats (59.7%). The male to female sex ratio was estimated at 3:1 for the dog while nearly 1:1 for cats. About 37.5% of the owned dogs were indoor, and 62.5% have free access to outside. Dogs and cats were acquired as a gift from families, neighbors, and friends. The identified reason for not owning dogs/cats were fear of zoonosis, dislike, no time to devote, benefit not realized, and shortage of finance. Logistic regression analysis identified study town, community type, gender of head of household, ownership of other animals as determinants for dog/cat ownership. Besides, possessing dogs was significantly associated with cat ownership.

Conclusion

The current study provide insights into the determinants of dogs/cats ownership and their demographic characteristics in Ethiopia. Dogs are more commonly owned, but the household determinants for dog and cat ownership were comparable. Means of obtaining and reason of owning or abandoning dogs/cats is partly different from those reported in the developed countries. The results of this study could be used for the provision of veterinary services, quantifying health risks and benefits associated with dog/cat ownership, and control of pet population and related zoonosis.
Active surveillance for antibodies confirms circulation of lyssaviruses in Palearctic bats
Authors: Seidlova Veronika , Zukal Jan , Brichta Jiri , Anisimov Nikolay , Apoznański Grzegorz , Bandouchova Hana , Bartonička Tomáš , Berková Hana , Botvinkin Alexander D. , Heger Tomas , Dundarova Heliana , Kokurewicz Tomasz , Linhart Petr , Orlov Oleg L. , Piacek Vladimir , Presetnik Primož , Shumkina Alexandra P. , Tiunov Mikhail P. , Treml Frantisek , Pikula Jiri
Published: December 2020

Background

Palearctic bats host a diversity of lyssaviruses, though not the classical rabies virus (RABV). As surveillance for bat rabies over the Palearctic area covering Central and Eastern Europe and Siberian regions of Russia has been irregular, we lack data on geographic and seasonal patterns of the infection.

Results

To address this, we undertook serological testing, using non-lethally sampled blood, on 1027 bats of 25 species in Bulgaria, the Czech Republic, Poland, Russia and Slovenia between 2014 and 2018. The indirect enzyme-linked immunosorbent assay (ELISA) detected rabies virus anti-glycoprotein antibodies in 33 bats, giving an overall seroprevalence of 3.2%. Bat species exceeding the seroconversion threshold included Myotis blythii, Myotis gracilis, Myotis petax, Myotis myotis, Murina hilgendorfi, Rhinolophus ferrumequinum and Vespertilio murinus. While Myotis species (84.8%) and adult females (48.5%) dominated in seropositive bats, juveniles of both sexes showed no difference in seroprevalence. Higher numbers tested positive when sampled during the active season (10.5%), as compared with the hibernation period (0.9%). Bat rabies seroprevalence was significantly higher in natural habitats (4.0%) compared with synanthropic roosts (1.2%). Importantly, in 2018, we recorded 73.1% seroprevalence in a cave containing a M. blythii maternity colony in the Altai Krai of Russia.

Conclusions

Identification of such “hotspots” of non-RABV lyssavirus circulation not only provides important information for public health protection, it can also guide research activities aimed at more in-depth bat rabies studies.
The triglyceride-glucose index predicts ischemic heart disease risk in Koreans: a prospective study using National Health Insurance Service data
Authors: Park Byoungjin , Lee Yong-Jae , Lee Hye Sun , Jung Dong-Hyuk
Published: December 2020

Background

Ischemic heart disease (IHD) without diabetes is considered an important challenge to human health and is associated with a poor prognosis, as well as a lack of health awareness. We prospectively investigated the relationship between the triglyceride-glucose (TyG) index, a surrogate marker of early insulin resistance, and incident IHD risk in a large cohort of nondiabetic Korean adults using National Health Insurance Service data.

Methods

We assessed 16,455 participants (8426 men and 8029 women) without diabetes using data from a health risk assessment study (HERAS) and Korea Health Insurance Review and Assessment (HIRA) data. The participants were divided into four groups according to TyG index quartiles, calculated as ln [fasting triglycerides (mg/dL) × fasting plasma glucose (mg/dL)/2]. We prospectively assessed hazard ratios (HRs) with 95% confidence intervals (CIs) for IHD using multivariate Cox proportional-hazards regression models over a 50-month period that followed the baseline survey.

Results

During the follow-up period, 322 (2.0%) participants developed IHD. HRs of IHD for TyG index quartiles 2–4 were 1.61 (95% CI 1.05–2.48), 1.85 (95% CI 1.21–2.81), and 2.29 (95% CI 1.50–3.51), respectively, after adjusting for age, sex, body mass index, smoking status, alcohol intake, and physical activity.

Conclusions

A higher TyG index precedes and significantly predicts future IHD among nondiabetic Koreans. Accordingly, the TyG index may be a useful measure in assessing cardiovascular risk for nondiabetic adults in the preclinical stage.
No Coil® placement in patients undergoing left hemicolectomy and low anterior resection for colorectal cancer
Authors: Ammendola Michele , Ruggiero Michele , Talarico Carlo , Memeo Riccardo , Ammerata Giorgio , Capomolla Antonella , Filippo Rosalinda , Romano Roberto , Pallio Socrate , Navarra Giuseppe , Montemurro Severino , Currò Giuseppe
Published: December 2020

Background

Colorectal cancer (CRC) is the most common tumor of the gastrointestinal tract. Anastomotic leak (AL) and prolonged postoperative ileus (PPOI) are two important complications of colorectal surgery. In this observational retrospective study, we evaluated the positive effects of transanal tube No Coil®in patients with CRC undergoing low anterior resection (LAR) and left hemicolectomy (LC).

Methods

Thirty-eight cases and forty controls resulted eligible for the final sample. No Coil®placement (SapiMed Spa, Alessandria, Italy) was considered an inclusion criteria for the case group. No Coil®was placed immediately after the end of surgical treatment.

Results

PPOI was significantly more frequent in the control group. AL was evident in 1 patient (2.6%) of cases and 3 patients (7.5%) of controls. No statistical difference was found in AL occurrence between groups. POI days and AL resulted associated with hospital stay. POI days were negatively associated with No Coil placement and positively with AL.

Conclusion

With our preliminary data, we suggest that No Coil®placement can be considered as a valuable procedure assisting colorectal surgery, but further studies are required to confirm and enlarge actual evidence.