bluuebunny/crossref_metadata_2025 huggingface dataset:
What regional living conditions affect hypertension in Russia?
Authors: Maksimov S , Zelenina A , Balanova Yu , Shalnova S , Muromtseva G , Kapustina A , Drapkina O
Published: October 2021

Background

The area of residence and its characteristics affect cardiovascular disease indicators at different spatial scales. Our study evaluated the impact of a wide range of characteristics of large administrative regions (socio-economic, etc.) on individual probability of the prevalence, awareness, treatment, and control of hypertension among the Russian adult population.

Methods

We used data from the cross-sectional phase of the epidemiological study “Epidemiology of Cardiovascular Diseases in the Regions of the Russian Federation” (ESSE-RF) conducted in 2013-2014. A total of 19,791 individuals aged 25-64 years were examined. To calculate regional indices, 64 indicators were obtained from the official website of the Federal State Statistics Service of Russia.

Results

There were no associations between the territorial characteristics and the prevalence of hypertension in the general population. However, the Socio-Geographical Index has a direct impact on men (OR = 1.18; 95% CI: 1.05-1.32), people with low education (OR = 1.14; 95% CI: 1.02-1.27) and older people (OR = 1.16; 95% CI: 1.02-1.32). Hypertension awareness is directly associated with the Demographic (OR = 1.13; 95% CI: 1.02-1.25) and Industrial Territory Index (OR = 1.15; 95% CI: 1.01-1.33). The deterioration of the social situation (Socio-Geographic Index) related to poor adherence to treatment (OR = 0.76; 95% CI: 0.64-0.90) and poor control of hypertension (OR = 0.79; 95% CI: 0.69-0.90). The influence of territorial characteristics on the awareness, treatment, and control of hypertension is less pronounced than the individual characteristics of the population and differs when stratified by gender, age and educational level.

Conclusions

The analysis made it possible to assess the influence of the characteristics of the population living in large areas on the prevalence, awareness, treatment, and control of hypertension. These patterns reflect an empirical approach to the territorial characteristics.

Key messages

The first attempt to understand why there are such significant differences in the prevalence, awareness, treatment and control of hypertension in the Russian regions. New knowledge about the impact of living conditions on the health status.
Moderate partially skimmed milk consumption is associated with reduced mortality risk
Authors: Ruggiero E , Di Castelnuovo A , Costanzo S , Esposito S , Persichillo M , Cerletti C , Donati MB , de Gaetano G , Iacoviello L , Bonaccio M
Published: October 2021

Background

Data on milk and other dairy products intake with health outcomes are inconsistent. We investigated the association of milk and total dairy consumption with the risk of all-cause and cause-specific mortality in a Mediterranean population.

Methods

We performed a longitudinal analysis on 22,889 men and women (mean age 55.4±11.7 y; 52.3% women), from the Moli-sani Study cohort (enrollment 2005-2010) followed-up for a median of 11 years. Dietary data were collected through a 188-item food frequency questionnaire. Total dairy consumption (g/d) was calculated as the sum of milk (whole and partially-skimmed, g/d), yogurt (whole and partially skimmed, g/d) and cheese (fresh and hard, g/d). Hazard ratio (HRs) with 95% confidence interval (CI) were calculated by multivariable Cox regression, modelled by spline curves.

Results

In multivariable-adjusted analysis controlled for sociodemographic, clinical and dietary factors, cheese, yogurt or whole milk intake were not associated with either all-cause or cause-specific mortality (p for overall association >0.38), as well as was total diary intake (p > 0.18). On the contrary, non-linear J-shaped curves were observed for the association of partially skimmed milk intake with all-cause and cancer mortality (p value for total and non-linear association=0.0072 and 0.035, and 0.097 and 0.049, respectively; magnitude of the relative reduction =16% and 18% at nadir of 128 and 114 g/d, respectively). A linear association between partially skimmed milk intake and CVD mortality was observed (p for association =0.047; p for non-linearity= 0.41), with HR = 0.82 (95%CI: 0.68-0.98) at 125 g/d and a window of statistically significant protection ranging from 100 to 250 g/d.

Conclusions

In a large Mediterranean population of adults, consumption of 1 standard cup of partially skimmed milk was associated with lower all-cause, cancer and CVD mortality. Other dairy sources were not associated with mortality.

Key messages

In a large Mediterranean population, total dairy intake did not predict mortality. Daily consumption of 1 standard cup of partially skimmed milk lowers the risk of all-cause, cardiovascular and cancer mortality.
Public Health Services during the COVID-19 pandemic in 3 European countries: PT, EN and DE
Authors: Vareda R , Garcia T , Rachadell J
Published: October 2021

Background

Monitoring and responding to health hazards and emergencies is an Essential Public Health Operation delivered by public health services (PHS) (2). In the European Region, there is a wide range of organizational and financial models for PHS delivery to the populations, but the best approach is still largely unknown (3). This work aims to analyze PHS organization and financing and compare their health results during the COVID-19 pandemic in 3 countries: Portugal, England and Germany.

Methods

We searched The European Observatory on Health Systems and Policies database; GoogleScholar® for the terms “organization” and “financing” associated with PHS and Europe; OurWorldInData® for COVID-19 data.

Results

PHS Organization: PT has national, regional and local units with a top-down decision-making hierarchy, though information flows both ways. EN has the national health system and Public Health England (that supports autonomous local elected health authorities), with independence and little overlapping between them. DE has Federal, State, County and Municipal health actors with self-government and administrative autonomy to a certain degree. Spending on ‘preventing care' as a share of total health expenditure: PT (1,7%), DR (3,2%) and EN (5,1%). COVID-19 cases: DE showed best results while PT and EN were similar.

Conclusions

WHO states the most effective and efficient method of delivering PHS is through an integrated approach, rather than through vertical programmes (2), but PT vertical organization with information flowing both ways and a network of horizontal supporting PH institutions may favor needed coordinated responses during a pandemic. In geographically larger countries, exerting autonomous decisions at different levels may improve preventive measures' efficacy. This analysis adds to the previous literature that suggests the most efficient PHS are adapted to local contexts.

Key messages

The best PHS organization is still unknown, though adaptation to regional and local contexts seems key for better results. Greater spending on “preventive care” does not necessarily guarantee better results, suggesting PHS organization may have a more important role.
Practice surrounding adverse events in residential care facilities in Ireland
Authors: McGrane N , Dunbar P , Dunnion M , O'Connor L
Published: October 2021

Background

Part of regulation of residential care facilities (RCFs) is the statutory responsibility of RCFs to notify the regulator about adverse events (AEs). Notifications typically include a description of practice in the aftermath of AEs and are an information source that can inform quality and safety improvements. The herein aim therefore was to analyse narratives in notifications received by the Health Information and Quality Authority (HIQA) in Ireland, to identify practice surrounding AE management and reporting.

Methods

A sample (n = 447) of notifications received by HIQA in 2018 was drawn from the Database of Statutory Notifications from Social Care in Ireland, 2013-2019. Inductive thematic analysis was conducted. Analysis was structured using the a priori agreed themes of: practice in the aftermath of an AE, system vulnerabilities and reporting practices.

Results

Two overarching themes were identified. The first, a chronological theme contained three sub-themes: pre event, including existing measures and situations, response to the event and continued response. Measures that are resident focused and follow policies and protocols in RCFs to prevent or mitigate the seriousness of AEs, were evident in the response and continued response. From this chronological order emerged the cyclical theory where short and longer term actions become part of the pre-event of future similar or repeated AEs. The second overarching theme, regulatory input, encapsulated procedural notes, requests for further information and notes on repetitive patterns.

Conclusions

RCFs respond to AEs with short and longer term actions with resident health and wellbeing as the focus. These actions in turn become part of the pre-event of future AEs. This cycle can be leveraged for quality improvement initiatives. Input from inspectors was positive and constructive but highlighted some regulatory burden. Dissemination of these results as good practice guides may improve management and reporting of AEs.

Key messages

Residential care facilities respond to adverse events with short and long term measures which feed into the management of future AEs. This cycle can be leveraged for quality improvement initiatives. Improvement opportunities in reporting practices were found. The development of good practice guides for residential care facilities and inspectors could reduce regulatory burden.
Evidence and recommendations for a value-based decision making on vaccinations
Authors: de Waure C , Calabrò GE , Tognetto A , Carini E , Giacchetta I , Bonanno E , Mariani M , Ricciardi W , de Waure C
Published: October 2021

Issue/problem

Vaccinations are one of the most successful public health measures and contribute to the achievement of Sustainable Development Goals. Despite this, there are still several challenges, such as poor resources, unequal access, and vaccine hesitancy. An exploitation of the full value of vaccinations could help contrasting them.

Description of the problem

A dual approach was followed to exploit full value of vaccinations. First, the four pillars of value pinpointed by the Expert Panel on Effective Ways of Investing in Health of the European Commission, namely personal, societal, allocative, and technical value, were considered to carry out a systematic review of available papers addressing the value of vaccinations. The synthesis of data was the submitted to a panel of international experts in vaccinations who gave inputs on recommendations to drive a value-based decision-making.

Results

Overall, 54 papers published from 2010 onwards addressed at least one pillar of value with most of them (83.3%) assessing a single one. Two-thirds of papers addressed the technical pillar, namely the economic value, in most cases without catching the broad economic implications. Very few studies addressed allocative and societal value highlighting the need to generate evidence to support the application of these pillars. Furthermore, some aspects of the allocative pillar, such as equity, accessibility, and appropriate use, were not addressed so far. Recommendations on research on full value of vaccinations, decision-making process and public engagement were eventually issued.

Lessons

The project allowed to apply for the first the value-based approach to vaccinations. This led to the identification of current gaps in the assessment of full value of vaccinations and to recommendations to foster a value-based decision-making. These results have international relevance because of the growing attention to the value-based approach for sustainable health systems.

Key messages

The full value of vaccinations need to be further investigated according to the four pillars pinpointed by the Expert Panel on Effective Ways of Investing in Health. Different actions could be promoted with respect to research, decision-making process and public engagement in order to exploit the full value of vaccination and drive a value-based decision-making.
Hepatitis C infection among primary health care patients: prevalence and risk factors
Authors: Ciupkeviciene E , Dragunas G , Dabravalskis S , Petkeviciene J , Kupcinskas L
Published: October 2021

Background

Many people chronically infected with the hepatitis C virus (HCV) are not aware of their infection. The benefit of screening for HCV is earlier treatment with antiviral medications, which are highly effective and can prevent long-term complications of chronic HCV such as cirrhosis, liver cancer, and death. This study aimed to examine the prevalence of HCV infection and its risk factors among primary health care patients.

Methods

The study was carried out in the primary health care centre of seaport Klaipeda, Lithuania. Patients were invited to participate in the screening by family doctors, regional media, social networking sites, and leaflets. Screening for HCV involved a blood test for the presence of an antibody to HCV (TOYO rapid test). Those with positive test results and a randomly selected control group of patients with negative test results were invited to participate in a telephone interview about possible risk factors of infection. In total, 1720 patients were screened. The HCV infected group consisted of 32 patients (56.3% men, mean age 55.4±9.4 years) and a control group of 96 patients (55.2% men, mean age 54.8±9.5 years).

Results

The prevalence of HCV infection among screened patients was 1.9%. The odds ratio (OR) of HCV infection in patients who reported blood transfusions before 1993 was 7.7 (95% CI 2.1-27.6) compared to those who did not have a blood transfusion or had later. HCV infection was diagnosed more often among patients who were blood donors before 1993 compared to those who were not donors or were later (OR 5.6; 95% CI 2.3-13.1). Having a tattoo increased the likelihood of HCV infection by 5.6 times (95% CI 2.1-14.4). Injection of illegal drugs was reported by 8.4% of HCV positive patients, 34.9% of them was in a prison for more than 3 months.

Conclusions

Primary health care institutions should consider screening people who are at high risk of HCV infection.

Key messages

Risky behaviours are associated with higher risk of HCV infection. Epidemiologic data on HCV infection is crucial for developing optimal healthcare policies for the prevention and treatment of HCV infection.
Neutrophil-Lymphocyte Ratio as a Prognostic Factor for 15-Day Mortality of Patients infected in ICU
Authors: Tsoumbou-Bakana G , El Fahr K , Tamir M , Traore B , Charra B
Published: October 2021

Introduction

The determination of the groups at risk of death at admission in patients with bacterial infection in the ICU is important. Several prognostic factors have already been identified, however the neutrophil/lymphocyte ratio (NLR) has the advantage of being common and inexpensive.

Objective

To determine the threshold value of NLR to determine the group at risk of 15-day mortality and the overall survival of patients according to this threshold.

Methods

This was a retrospective cohort conducted in the intensive care unit of the Ibn Rochd University Hospital in Casablanca over a period of 2 years (January 2019 - January 2021), among hospitalized patients with bacterial infection, acquired or nosocomial. The sample size was calculated a priori and multivariate statistical analyses (multiple logistic regression, Youden index and Kaplan Meier survival estimation and Log Rank) were performed using Rstudio software. The significance level was less than 5%.

Results

A total of 200 patients were included in the study, 136 patients were alive at 15 days, there were no differences in age between the two groups. Factors associated with patient mortality at 15 days were: gender, use of vasoactive drugs, use of mechanical ventilation, type of sepsis, site of infection, SOFA score (p < 0.000), Apache score (p = 0.009) and NLR at admission (p = 0.001). The cut-off value for NLR was 15.07 with a mean discriminant value of 64.1%. The difference in median overall survival of patients in the two groups according to the threshold value was statistically significant 22 +/- 1.9 days and 11 +/-1.12 days (p = 0.042).

Conclusions

The NLR appears to be a prognostic factor for 15-day mortality. The knowledge of prognostic factors and threshold values of these indicators allow the prediction of at-risk groups in order to best adapt their management.

Key messages

The use of common and inexpensive biological prognostic markers are a reliable alternative to identify at-risk patients to optimize their management in developing countries. The RNL is a good biological prognostic markers of mortality of patients infected in ICU.
Young scientists: facing arboviruses and youth participation in the Ceilândia territory, Brazil
Authors: Cavaca A , Padrão MR , Rocha F , Mourão C , Garcez L , Silva M , Köptcke L
Published: October 2021

Background

Arboviruses currently represent a growing public health problem in the world. There is a set of structural and historical issues involved in the health-disease process and arboviruses prevention, among which are the need for critical and problematizing health education, with real participation of the school community and commitment of young students in the territories. Therefore, the study aims to analyze a training experience in scientific initiation on arboviruses, from the youth perception, as protagonists in the territory of Ceilândia-Distrito Federal-Brazil.

Methods

This study is characterized as a qualitative research-action, which was structured in 3 stages: 1) document analysis of the essays written by the students; 2) realization of the Training Course for Scientific Initiation in Basic Education and Arboviruses; 3) focus group with 12 students, after having participated in the training activity, in order to understand their pe rceptions about the educational process and its repercussion in the protagonism and responsibility of acting in the territories.

Results

The results of the Content Analysis showed the students' perception centered on eight analytical categories: students' motivation for scientific initiation; process of knowledge formation; importance of the scientific dissemination; training of young scientists; relationship of arboviruses with waste accumulation; health and environment; arboviruses prevention and control; youth participation and empowerment.

Conclusions

Facing arboviruses requires broad-spectrum policies and interventions, with interdisciplinary actions in society, both in the health and education scenarios. It is understood that youth are social protagonists in facing the vulnerabilities to which they are subjected. Therefore, scientific education strengthened the Ceilândia's youth as subjects of rights, stimulating the innovation in preventive ac tions to combat arboviruses in the territory.

Key messages

Facing arboviruses requires interdisciplinary broad-spectrum policies and interventions. Scientific education stimulates youth leadership in combating arboviruses in the territory.
Protector factors for use of non-prescribed hormones among transwomen in São Paulo, Brazil, 2020
Authors: Bassichetto K , Maschião LF , Paiatto BNM , Paula LG , Gomez Junior JL , Rocha F , Spíndola C , Barros C , Veras MA
Published: October 2021

Despite the Brazilian universal and free of charge public health system, transwomen (TGW) still face barriers to their right to access healthcare, especially transition-related. One of the most common gender- affirmative need is the use of hormones, which is available for free in the health national system. In spite of that, the use of non-prescribed hormones is a reality - rising the risk of complications. The aim of this analysis is to describe the frequency of non-prescribed hormones and assess risk factors among TGW. TransOdara is a cross-sectional study, conducted in São Paulo, Brazil, from December 2019-October 2020, which included TGW>18 years. Participants were recruited from an ongoing cohort study, originally assembled using RDS. A questionnaire collected socio-demographic and behavioral information. Predictor variables for non-prescribed hormone use were assessed using multivariable logistic regression. Brazilian MOH and PAHO supported the study. 403 TGW participants were recruited. The mean age was 34.4 years (SD 9.6). The majority (70%) declared themselves black/parda, while 103 (27%) participants self-reported white and 12 (3.0%) yellow/Indigenous. Most (95%) reported ever having taken hormones, from which 48.8% (197/384) reported presently taking hormones. Among those, 53% (104/196) reported non-prescribed hormone use. Among participants that ever took hormones, mean age for starting was 18.6 years (SD 6.7). In our multivariate model, higher education - high school (p < 0.05) and incomplete college or higher (p < 0.005) - and older age (p < 0.005) were protective factors for non-prescribed hormone use, adjusted by income and ethnicity. Non-prescribed hormones use is high among TGW, even though free access in Brazil's health system. High formal education and being older are protection factors for using hormones out of professional supervision. There is an urgency to review the current policy strategies, aiming to reduce this health risk behavior.

Key messages

Use of hormones among TGW is high. Majority reported hormonization out of professional supervision in lifetime. High formal education and being older are protective factors for non-prescribed use.
COVID-19 Dashboard for the Lisbon Region - an advisory tool for policy
Authors: Ferreira PP , Martins R , Tavares DP , Valente J
Published: October 2021

Issue/problem

At the time of arrival of the COVID-19 pandemic to Portugal, the Public Health Department of Lisbon and Tagus Valley Regional Health Administration was confronted with its obsolete information system, which could not provide the information that Public Health Authorities needed to bring the pandemic under control. In order to tackle this issue, our goal was to aggregate all the relevant epidemiological data for the region in an accessible and user-friendly dashboard.

Methods

Starting from March 2020 we created a dashboard, which compiled and analyzed COVID-19 data, such as: confirmed and active cases, deaths, hospitalizations (including ICU beds), high/low risk contacts, mandatory confinements, tests, and clusters. This dashboard had anonymized data and was updated daily as well as constantly upgraded by taking into consideration new incoming data and feedback provided by users, serving its purpose as an advisory tool for policy.

Results

The dashboard was available to Local, Regional, and National Public Health Authorities and made possible to monitor trends and predict epidemiological changes that, prior to its existence, were dispersed in several datasets. Most importantly, it allowed for a better allocation of human resources for contact tracing and case management activities, to easily identify basic social needs for the most vulnerable citizens. It also provided for policy measures adjusted to the smallest administrative division in Portugal, the parish, that ultimately allowed for a better epidemiological control in Lisbon Metropolitan Area in 2020.

Lessons

The regional dashboard is far from perfect, but it highlights the constant need for robust information and epidemiological surveillance systems, serving both National, Regional and Local Public Health Authorities. It appeared out of necessity during a pandemic and it proved once more the importance of data analytics for guiding public health action based on evidence.

Key messages

Data analytics can serve both as an advisory tool for policy as well as to guide public health interventions. The COVID-19 Dashboard for the Lisbon Region aggregates relevant epidemiological data that helped Public Health authorities better understand and control the Pandemic in the region.
Association of Retail Environment and Neighborhood Socioeconomic Status With Mortality Among Community-Dwelling Older Adults in the United States: Cardiovascular Health Study
Authors: Zhang Kehan , Lovasi Gina S , Odden Michelle C , Michael Yvonne L , Newman Anne B , Arnold Alice M , Kim Dae Hyun , Wu Chenkai
Published: October 2021

Background

Few studies have examined the association of neighborhood environment and mortality among community-dwelling older populations. Geographic Information Systems-based measures of neighborhood physical environment may provide new insights on the health effects of the social and built environment.

Method

We studied 4 379 community-dwelling older adults in the United States aged 65 years and older from the Cardiovascular Health Study. Principal component analysis was used to identify neighborhood components from 48 variables assessing facilities and establishments, demographic composition, socioeconomic status, and economic prosperity. We used a Cox model to evaluate the association of neighborhood components with 5-year mortality. Age, sex, race, education, income, marital status, body mass index, smoking status, disability, coronary heart disease, and diabetes were included as covariates. We also examined the interactions between neighborhood components and sex and race (Black vs White or other).

Results

We identified 5 neighborhood components, representing facilities and resources, immigrant communities, community-level economic deprivation, resident-level socioeconomic status, and residents’ age. Communities’ economic deprivation and residents’ socioeconomic status were significantly associated with 5-year mortality. We did not find interactions between sex or race and any of the 5 neighborhood components. The results were similar in a sensitivity analysis where we used 10-year mortality as the outcome.

Conclusions

We found that communities’ economic status but not facilities in communities was associated with mortality among older adults. These findings revealed the importance and benefits living in a socioeconomically advantaged neighborhood could have on health among older residents with different demographic backgrounds.
Improved Versions of Some Furstenberg Type Slicing Theorems for Self-Affine Carpets
Authors: Algom Amir , Wu Meng
Published: October 2021

Let $F$ be a Bedford–McMullen carpet defined by independent integer exponents. We prove that for every line $\ell \subseteq \mathbb{R}^2$ not parallel to the major axes, $$\begin{align*} & \dim_H (\ell \cap F) \leq \max \left\lbrace 0,\, \frac{\dim_H F}{\dim^* F} \cdot (\dim^* F-1) \right\rbrace\end{align*}$$and $$\begin{align*} & \dim_P (\ell \cap F) \leq \max \left\lbrace 0,\, \frac{\dim_P F}{\dim^* F} \cdot (\dim^* F-1) \right\rbrace,\end{align*}$$where $\dim ^*$ is Furstenberg’s star dimension (maximal dimension of microsets). This improves the state-of-the-art results on Furstenberg type slicing Theorems for affine invariant carpets.
Idiopathic ascites following laparoscopic appendicectomy: a case report
Authors: Martindale Aleksis , Tobbal Muhammad , Coventry Charles , Veeramootoo Darmarajah
Published: October 2021

Appendicitis is a common condition and is frequently treated with a laparoscopic appendicectomy. We present a rare case of delayed, idiopathic ascites following laparoscopic appendicectomy for histologically confirmed appendicitis. While the complications of this condition and this procedure are well documented, this case demonstrates very rare sequelae following a laparoscopic appendicectomy.
Recurrent terminal ventricle cyst: a case report
Authors: Baig Mirza Asfand , Visagan Ravindran , Boardman Timothy , Murphy Christopher , Al-Ali Bilal , Kellett Christopher , Grahovac Gordan
Published: October 2021

The terminal ventricle (TV) of Krause is a rare cystic dilation of the conus’ central canal. Due to limited understanding surrounding its pathophysiology, optimal management remains controversial. We report a 25-year-old female presenting with acute paraparesis. Magnetic resonance imaging spine revealed a cystic conus medullaris lesion in keeping with an incidental TV cyst. However, the patient experienced a rapid resolution of symptoms. We hypothesize that the TV cyst spontaneously ruptured and auto-decompressed. To our knowledge, this is the first reported case of an enlarging symptomatic TV cyst with spontaneous rupture and resolution of symptoms, highlighting the variable natural history of this condition.
Pregnancy Weight Gain and Postpartum Weight Retention in Active Duty Military Women: Implications for Readiness
Authors: Johnson Dawn , Madsen Cathaleen , Banaag Amanda , Krantz David S , Koehlmoos Tracey Pérez
Published: October 2021

Introduction

Weight gain in pregnancy is expected; however, excessive gestational weight gain and postpartum weight retention (PPWR) can cause long-term changes to a patient’s body mass index (BMI) and increase the risk for adverse health outcomes. This phenomenon is understudied in active duty military women, for whom excess weight gain poses challenges to readiness and fitness to serve. This study examines over 30,000 active duty military women with and without preeclampsia to assess changes in BMI postpartum.

Materials and Methods

This is a retrospective analysis of claims data for active duty military women, aged 18-40 years, and experiencing pregnancy during fiscal years 2010-2014. Women with eating disorders, high-risk pregnancy conditions other than preeclampsia, scheduled high-risk medical interventions, or a second pregnancy within 18 months were excluded from the analysis. Height and weight were obtained from medical records and used to calculate BMI. Women with and without preeclampsia were categorized into BMI categories according to the Centers for Disease Control and Prevention classification of underweight (BMI < 18.5), normal weight (BMI 18.5-24.9), overweight (BMI 25.0-29.9), or obese (>30.0). Linear regressions adjusted by age and race were performed to assess differences in prepregnancy weight and weight gain, retention, and change at 6 months postpartum.

Results

The greatest number of pregnant, active duty service women were found among ages 18-24 years, White race, Army service, junior enlisted rank, married status, and with no mental health diagnosis. Overall, over 50% of women in normal and preeclamptic pregnancies returned to their baseline BMI postpartum. Women in both populations more often gained than lost weight postpartum. Preeclampsia strongly affected weight retention, with 40.77% of overweight women and 5.33% of normal weight women progressing to postpartum obesity, versus 32.95% of overweight women and 2.61% of normal weight women in the main population. Mental health conditions were not associated with significant weight gain or PPWR. Women with cesarean deliveries gained more weight during pregnancy, had more PPWR, and lost more weight from third trimester to 6 months postpartum.

Conclusions

Most women remain in their baseline BMI category postpartum, suggesting that prepregnancy weight management is an opportunity to reduce excess PPWR. Other opportunities lie in readiness-focused weight management during prenatal visits and postpartum, especially for patients with preeclampsia and cesarean sections. However, concerns about weight management for readiness must be carefully balanced against the health of the individual service members.
Successful rituximab treatment in a patient with ANCA-negative granulomatosis with polyangitis: A case report
Authors: Kimura Koichi , Fujii Yusuke , Maekawa Makiko , Tsukamoto Hiroshi
Published: October 2021

A 68-year-old woman was referred to our hospital for further evaluation of fever, nasal congestion, deafness, and multiple pulmonary nodules refractory to antibiotic use. Despite negative findings of antineutrophil cytoplasmic antibodies, she was diagnosed with granulomatosis with polyangiitis based on the analysis of biopsy specimens of pulmonary nodules. The administrations of oral prednisolone and six intravenous cyclophosphamide (IVCY) resulted in the prompt relief of symptoms and disappearance of pulmonary nodules. However, 3 months after the completion of IVCY therapy, nasal congestion and deafness flared up with an increase in the C-reactive protein level; a repeat computed tomography revealed a left lung nodule. Consequently, she underwent remission induction and maintenance therapy with rituximab (RTX), which resulted in the symptomatic improvement and disappearance of pulmonary nodules after 6 months. The patient remained in remission thereafter. Therefore, RTX may be an effective therapeutic option even in the absence of detectable autoantibodies.
Prescription preferences of antiepileptic drugs in brain tumor patients: An international survey among EANO members
Authors: van der Meer Pim B , Dirven Linda , van den Bent Martin J , Preusser Matthias , Taphoorn Martin J B , Rudá Roberta , Koekkoek Johan A F
Published: October 2021

Background

This study aimed at investigating antiepileptic drug (AED) prescription preferences in patients with brain tumor-related epilepsy (BTRE) among the European neuro-oncology community, the considerations that play a role when initiating AED treatment, the organization of care, and practices with regard to AED withdrawal.

Methods

A digital survey containing 31 questions about prescription preferences of AEDs was set out among members of the European Association of Neuro-Oncology (EANO).

Results

A total of 198 respondents treating patients with BTRE participated of whom 179 completed the entire survey. Levetiracetam was the first choice in patients with BTRE for almost all respondents (90% [162/181]). Levetiracetam was considered the most effective AED in reducing seizure frequency (72% [131/181]) and having the least adverse effects (48% [87/181]). Common alternatives for levetiracetam as equivalent first choice included lacosamide (33% [59/181]), lamotrigine (22% [40/181]), and valproic acid (21% [38/181]). Most crucial factors to choose a specific AED were potential adverse effects (82% [148/181]) and interactions with antitumor treatments (76% [137/181]). In the majority of patients, neuro-oncologists were involved in the treatment of seizures (73% [132/181])). Other relevant findings were that a minority of respondents ever prescribe AEDs in brain tumor patients without epilepsy solely as prophylaxis (29% [53/181]), but a majority routinely considers complete AED withdrawal in BTRE patients who are seizure-free after antitumor treatment (79% [141/179]).

Conclusions

Our results show that among European professionals treating patients with BTRE levetiracetam is considered the first choice AED, with the presumed highest efficacy and least adverse effects.
The COVID-19 Mask
Authors: St-Amant Oona , Rummens J. Anneke , Parada Henry , Wilson-Mitchell Karline
Published: October 2021

The COVID-19 pandemic has imposed unprecedented restrictions on everyday life. Unlike lockdown or shelter-in-place measures, the facemask has emerged as an empowering response to the public spread of the virus, permitting some degree of return to prepandemic life—such as school or work—by disrupting transmission that would otherwise occur. And yet, this utilitarian tool has attracted considerable controversy and polarized opinions. This article uses Blumer's adaptation of symbolic interactionism as a theoretical roadmap to examine the various meanings ascribed to the facemask and its usage. We discuss how it is socially perceived and consider implications for health care providers within the Canadian social context.
Three-year clinical outcomes and posterior corneal elevation change after small-incision lenticule extraction in suspicious corneas
Authors: Cao Huazheng , Zhang Lin , Liang Shuang , Li Mengdi , Jhanji Vishal , Wang Yan
Published: October 2021

Purpose:

To determine the long-term clinical outcomes and change in posterior corneal elevation after small-incision lenticule extraction (SMILE) in eyes with suspicious tomographic features.

Setting:

Hospital clinic.

Design:

Retrospective, case-controlled, observational.

Methods:

This study included 43 patients with suspicious corneas (group A), defined by corneal morphology and a final D score from a Scheimpflug camera (Pentacam), and 43 patients with normal corneal topography (group B). Refraction, visual acuity, and posterior corneal elevation over a 6-mm central diameter, including posterior central elevation (PCE), posterior elevation at the thinnest point (PTE), and posterior maximal elevation (PME), were measured preoperatively and at 6 months, 12 months, and 36 months postoperatively.

Results:

The preoperative spherical equivalent was −5.51 ± 1.33 D in group A (n = 43) and −5.41 ± 1.19 D in group B (n = 43). Postoperative uncorrected distance visual acuity was 20/20 or better in 39 (91%) of 43 eyes in group A and 41 (95%) of 43 eyes in group B (P = .160); all eyes in both groups remained stable or had gained corrected distance visual acuity. The mean change in PCE, PTE, and PME at 3 years was −1.22 ± 2.65 μm, −1.21 ± 2.70 μm, and −1.00 ± 5.09 μmin group A and −1.76 ± 3.25 μm, −1.60 ± 3.33 μm, and −1.56 ± 5.01 μm in group B, respectively, indicating a tendency for backward displacement of the posterior surface, whereas the between-group difference was not statistically significant (P = .154, P = .547, and P = .319, respectively).

Conclusions:

Refraction, visual outcomes, and posterior corneal shift seem comparable between corneas with normal and suspicious tomographic features three years after SMILE. More long-term studies are warranted to corroborate the findings of this study.
Acute central and peripheral nervous system injury associated with coronavirus disease 2019: recognition and treatment strategies
Authors: Simon Dennis W. , Schober Michelle E.
Published: October 2021

Purpose of review

Acute central and peripheral nervous system injury may occur in association with coronavirus disease 2019 (COVID-19) caused by infection with the severe acute respiratory syndrome coronavirus 2 virus. This review will assist readers to recognize neurologic manifestations associated with COVID-19 including common and life-threatening symptoms and diagnostic testing. We will also review current recommendations for treatment of neurologic injury associated with COVID-19 infection in children.

Recent findings

Data from systematic reviews and prospectively collected cohorts of children with COVID-19 are beginning to characterize the breadth of neurologic manifestations associated with COVID-19 in the acute infectious and postinfectious periods. Among hospitalized children in particular, neurologic symptoms are common. Life threatening conditions including encephalitis, myelitis, stroke, and demyelinating syndromes have been reported. Within the pediatric population, age, and preexisting neurologic conditions appear to be important factors in determining likely phenotypes. Treatment at this time is based on careful neuromonitoring, supportive care, and neuromodulatory therapies as indicated.

Neurologic symptoms are common in children with COVID-19 and may be life threatening. The pathophysiology, therapeutic options, and long-term outcomes from COVID-19 associated neurologic injury are currently being investigated.
Cutaneous coronavirus disease 2019 in children: a clinical primer for diagnosis and treatment
Authors: Dinulos James Ellis , Dinulos James Gary
Published: October 2021

Purpose of review

This review examines the global literature regarding rashes encountered in children and adults infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and aims to provide practicing pediatricians with an understanding of the relationship between instances of rashes and coronavirus disease 2019 (COVID-19) in children in order to effectively evaluate and treat patients.

Recent findings

The true incidence of cutaneous reactions in children infected with SARS-CoV-2 is not known. Children's immune systems differ from those of adults and rashes as a manifestation of immune responses, in turn, differ in morphology and distribution. Rarely, children develop a severe multisystem inflammatory syndrome that has overlapping clinical features with Kawasaki disease. In addition, vaccinations produce rashes similar to natural infections. The rashes associated with COVID-19 vaccination are mild and transient, and should not preclude vaccination. Lastly, children who chronically wear masks are more likely to experience flaring of acne around the nose and mouth (’maskne’) and facial conditions such as seborrheic dermatitis.

There are ongoing worldwide registries, clinical and basic science studies to better understand the burden of skin disease and pathophysiology of rashes seen in patients infected with COVID-19. Robust vaccination programs should be encouraged as a way to contain viral spread among children and the greater population.
Reconstruction of Distal Nasal Defects With a Large Postauricular Skin-Fat-Fascia Composite Graft
Authors: He Aijuan , Yu Jinchao , Liu Ninghua , Ye Xinhai
Published: October 2021

Background

Composite grafts have previously been reported to achieve a good outcome for nasal defect repair, but composite grafts have greater metabolic needs than simple skin. Therefore, the traditionally recommended size of a composite graft for nasal reconstruction is less than 1.5 cm in diameter. However, the distal nose is generally well supplied with blood vessels, which might support the use of larger composite grafts in such a highly vascularized recipient site. The aim of the article is to investigate whether a large skin-fat-fascia composite graft (larger than 2.0 cm) is viable for the repair of partial-thickness nasal defects.

Methods

From October 2017 to December 2019, 13 patients with partial-thickness nasal defects underwent nasal reconstruction using a large postauricular skin-fat-fascia composite graft. Cases were followed up for 3 to 14 months postoperatively. The aesthetic outcome was evaluated in comparison with preoperative digital images.

Results

Skin-fat-fascia composite grafts survived without graft necrosis, dermal fibrosis, or skin contraction in all cases. Favorable aesthetic outcomes were obtained in all patients, and no further revision surgery was need.

Conclusions

A postauricular composite graft larger than 2.0 cm is a safe and effective reconstruction approach for partial-thickness nasal defects. This technique offers significant advantages in terms of no additional facial scar, no visible asymmetry on the face, no additional surgery for revision, and with mild scar in the donor site of the postauricular region.
The collective effect of finite-sized inhomogeneities on the spatial spread of populations in two dimensions
Authors: Möbius Wolfram , Tesser Francesca , Alards Kim M. J. , Benzi Roberto , Nelson David R. , Toschi Federico
Published: October 2021

The dynamics of a population expanding into unoccupied habitat has been primarily studied for situations in which growth and dispersal parameters are uniform in space or vary in one dimension. Here, we study the influence of finite-sized individual inhomogeneities and their collective effect on front speed if randomly placed in a two-dimensional habitat. We use an individual-based model to investigate the front dynamics for a region in which dispersal or growth of individuals is reduced to zero (obstacles) or increased above the background (hotspots), respectively. In a regime where front dynamics is determined by a local front speed only, a principle of least time can be employed to predict front speed and shape. The resulting analytical solutions motivate an event-based algorithm illustrating the effects of several obstacles or hotspots. We finally apply the principle of least time to large heterogeneous environments by solving the Eikonal equation numerically. Obstacles lead to a slow-down that is dominated by the number density and width of obstacles, but not by their precise shape. Hotspots result in a speed-up, which we characterize as function of hotspot strength and density. Our findings emphasize the importance of taking the dimensionality of the environment into account.
Influence of memory processes on choice-consistency
Authors: Nitsch Felix J. , Kalenscher Tobias
Published: October 2021

Choice-consistency is considered a hallmark of rational value-based choice. However, because the cognitive apparatus supporting decision-making is imperfect, real decision-makers often show some degree of choice inconsistency. Cognitive models are necessary to complement idealized choice axioms with attention, perception and memory processes. Specifically, compelling theoretical work suggests that the (imperfect) retention of choice-relevant memories might be important for choice-consistency, but this hypothesis has not been tested directly. We used a novel multi-attribute visual choice paradigm to experimentally test the influence of memory retrieval of exemplars on choice-consistency. Our manipulation check confirmed that our retention interval manipulation successfully reduced memory representation strength. Given this, we found strong evidence against our hypothesis that choice-consistency decreases with increasing retention time. However, quality controls indicated that the choice-consistency of our participants was non-discernable from random behaviour. In addition, an exploratory analysis showed essentially no test–retest reliability of choice-consistency between two observations. Taken together, this suggests the presence of a floor effect in our data and, thus, low data quality for conclusively evaluating our hypotheses. Further exploration tentatively suggested a high difficulty of discriminating between the choice objects driving this floor effect.
A review of π-conjugated polymer-based nanocomposites for metal-ion batteries and supercapacitors
Authors: Uke Santosh J. , Mardikar Satish P. , Kumar Ashwani , Kumar Yogesh , Gupta Meenal , Kumar Yogesh
Published: October 2021

Owing to their extraordinary properties of π-conjugated polymers (π-CPs), such as light weight, structural versatility, ease of synthesis and environmentally friendly nature, they have attracted considerable attention as electrode material for metal-ion batteries (MIBs) and supercapacitors (SCPs). Recently, researchers have focused on developing nanostructured π-CPs and their composites with metal oxides and carbon-based materials to enhance the energy density and capacitive performance of MIBs and SCPs. Also, the researchers recently demonstrated various novel strategies to combine high electrical conductivity and high redox activity of different π-CPs. To reflect this fact, the present review investigates the current advancements in the synthesis of nanostructured π-CPs and their composites. Further, this review explores the recent development in different methods for the fabrication and design of π-CPs electrodes for MIBs and SCPs. In review, finally, the future prospects and challenges of π-CPs as an electrode materials for strategies for MIBs and SCPs are also presented.
Auxetic vibration behaviours of periodic tetrahedral units with a shared edge
Authors: Tanaka H. , Asao S. , Shibutani Y.
Published: October 2021

A very low-frequency mode supported within an auxetic structure is presented. We propose a constrained periodic framework with corner-to-corner and edge-to-edge sharing of tetrahedra and develop a kinematic model incorporating two types of linear springs to calculate the momentum term under infinitesimal transformations. The modal analysis shows that the microstructure with its two degrees of freedom has both low- and high-frequency modes under auxetic transformations. The low-frequency mode approaches zero frequency when the corresponding spring constant tends to zero. With regard to coupled eigenmodes, the stress–strain relationship of the uniaxial forced vibration covers a wide range. When excited, a very slow motion is clearly observed along with a structural expansion for almost zero values of the linear elastic modulus.