bluuebunny/crossref_metadata_2025 huggingface dataset:
Ultrasound hepatic elastography with decaying signal technology allows assessing the degree of steatosis and dynamic monitoring of the effectiveness of NAFLD treatment
Authors: Diomidova V. N. , Tarasova L. V. , Tsyganova Yu. V. , Valeeva O. V. , Ivanova A. L.
Published: September 2020

The purpose of the research is to study the informativeness of the technology of Controlled Attenuation Parameter (CAP) in Shear Wave Elastography (SWE) in determining the degree of severity of liver steatosis depending on the elastometric quantitative values of liver fibrosis in a one-time study in a given volume of parenchima liver in patients with non-alcoholic fatty liver disease (NAFLD).

Materials and methods of research. The study included 169 patients with NHTSA between the ages of 19 and 81, the average age was 41.7 ±11.3 years, examined in the “City Clinical Hospital No. 1” of the Ministry of Health, Chuvashia (Cheboksary, Russia). Patients with functional disorders of bile evacuation (n= 72) were the first group; the 2nd group were the patients with liver steatosis without manifestations of liver fibrosis (n = 28); the 3rd contained the patients with cirrhosis of the liver (n = 25); patients with chronic viral hepatitis B and C (n= 44) were in the 4th group. All patients were screened with ultrasonic shear wave elastography with elastometry in one-dimensional (TE) (FibroScan 502 TOUCH, France) and two dimensional (2DSWE) modes (Aixplorer, Supersonic Imagine, France). Elastometry (kPa) and steatometry (dB/m) were completed simultaneously within the same volume of the analyzed liver tissue with two sensing devices of “FibroScan 502 TOUCH”. The statistical processing was carried out with the help of IBM SPSS Statistics 10.0. The results are reflected in the form of median (Me), minimum (min), maximum (max) and medium (Emean) values, standard deviation (SD) of Jung’s elasticity module. Correlational analysis of the received values of parameters F and S was made with the descriptive method of Bland-Altman and the method of Spearman.

Results and discussion. The average quantitative values of the severity of liver steatosis in patients with cirrhosis of liver had reliably lower values (234.5±62.1 dB/m) than in those suffering from steatosis of the liver without fibrosis (347.5±37.6 dB/m) and patients with chronic viral hepatitis (245.9±57.3dB/m, p lt; 0.001). The values of fibrosis in the same amount of the tested liver tissue with liver cirrhosis (45.5± 22.3 kP) were higher than similar rates in the other groups of patients with NAFLD (p lt; 0.001). Diagnostic informational content of the method of controlled ultrasound attenuation in establishing the degree of manifestation of liver steatosis had a higher specificity with II degree of liver steatosis (99.29% with a sensitivity of 84.92%).

The results of the study allow us to recommend ultrasound elastography with the technology of controlled ultrasound attenuation to determine the severity of liver steatosis for both primary diagnosis and for dynamic monitoring of the liver condition of patients with NAFLD.
Portal vein thrombosis — a literature review and our own clinical observations
Authors: Luzina E. V. , Tomina E. A. , Shchadneva S. I. , Lareva N. V.
Published: September 2020

The portal vein thrombosis (PVT) is a partial or complete occlusion of blood flow through the portal vein that occurs due to the presence of a blood clot in its lumen. Currently, PVT has become more common in the clinic of internal diseases. PVT can be caused by many factors, among which local and systemic. Systemic factors include congenital and acquired thrombophilia. Local factors include inflammatory, infectious, and oncological diseases of the abdominal organs. One of the most likely causes of PVT is currently being considered liver cirrhosis. The article presents the literature data, clinical guidelines for managing patients with PVT in the discussion of three own clinical cases of patients with PVT, which were caused by various diseases.
The addition of a succinate-containing drug to the treatment improves the clinical and functional state of the liver in patients with community-acquired pneumonia
Authors: Bobyleva E. S. , Gorbunov A. Yu.
Published: September 2020

Community-acquired pneumonia is currently one of the most common infectious diseases in the world. At the same time, the inflammation that occurs in community-acquired pneumonia, along with hypoxia, is one of the typical pathological processes that is associated with the introduction of an infecting agent. Under its influence, lipid peroxidation is activated through a cascade of reactions, which contributes to the formation of oxidative stress, accompanied by damage to the structures of various cells, including hepatocytes. The purpose of the study: to evaluate the clinical and functional state of the liver in the treatment of community-acquired pneumonia. Materials and methods: There were 120 people under observation, who were divided into 2 groups, receiving standard therapy for community-acquired pneumonia and patients receiving additional meglumin sodium succinate. The clinical and functional state of the liver was analyzed. Conclusions: when adding meglumin sodium succinate to the treatment of community-acquired pneumonia, the clinical and functional state of the liver in patients improves.
Crohn’s disease in a patient with ciliopathy (cystic disease of the kidneys, liver, lungs), ankylosing spondylitis and secondary polyosteoarthritis, who is on programmed hemodialysis
Authors: Styazhkina S. N. , Klimentov M. N. , Chernyshova T. E. , Neganova O. A. , Subaev F. F. , Matusevich A. E.
Published: September 2020

The aim. Discussion of a clinical case of Crohn’s disease in a patient with chronic kidney disease on program hemodialysis.

Materials and methods: the study analyzed the medical history of a patient diagnosed with Crohn’s disease with severe comorbid pathology.

Results. The provoking factors for the development of Crohn’s disease in a patient with ciliopathy (cystic disease of the kidneys, liver, lungs), ankylosing spondylitis, secondary polyosteoarthrosis, undergoing hemodialysis are discussed.
Management of postprandial distress syndrome in a young patient with the course application of still mineral water “Uvinskaya”
Authors: Shklyaev A. E. , Semenovykh E. A. , Maksimov K. V.
Published: September 2020

Aim. The purpose of the article is to study the possibilities of MRI diagnosis of postprandial distress syndrome using the drinking test and its correction with mineral water.

Materials and methods. Clinical observation is described. Patient A., 24 years old, came to the clinic with symptoms of functional dyspepsia. After a comprehensive examination, the diagnosis of Postprandial Distress Syndrome was established. The capabilities of MRI diagnostics of functional dyspepsia were assessed by drinking test. The study lasted 50 minutes. Scans were performed 5, 13, 20, 35 and 50 minutes after water intake. For the next 4 weeks, the patient ingested the non-carbonated mineral water “Uvinskaya” room temperature 30 minutes before taking a meal of 100 ml in the first 6-7 days, followed by an increase in volume to 200 ml 3 times a day.

Results. An MRI study with a drinking test in dynamics showed an increase in the volume of water drunk. When assessing the morphofunctional state of the stomach, differences were revealed at the level of the fundus: before treatment - the wall is tense, after course therapy - relaxed, relaxation accommodation is more pronounced. An acceleration of evacuation of the received water into the duodenum after treatment was also found. The positive dynamics of the state of motor-evacuation function of the stomach is due to the chemical composition of mineral water and the regimen of balneotherapy.

Conclusions. Gastric MRI is an informative and safe diagnostic method for Postprandial Distress Syndrome, which allows to evaluate the structural and functional features of the gastroduodenal zone. Drinking test can help in the MRI diagnosis of functional dyspepsia, increasing the information content of the study. The use of drinking mineral waters in postprandial distress syndrome is pathogenetically justified, but requires further research to develop rational balneotherapy regimens.
Scientist, doctor, teacher: on the 80th anniversary of Professor Yakov Maksimovich Vakhrushev
Authors: Khokhlacheva N. A. , Mikhailova O. D. , Gorbunov A. Yu.
Published: September 2020

The article describes the life, scientific and professional path of a doctor of medical sciences, professor, honored doctor of the Urals and the Russian Federation Y. M. Vakhrushev
Social and Behavioral Correlates of Adolescent Sexual Experience and Intention to Use Condoms in Northwestern Botswana
Authors: Barchi Francis , Apps Helen , Ntshebe Oleosi , Ramaphane Peggie
Published: September 2020

Adolescent sexual behavior is shaped by individual, social, and structural factors that can increase HIV-risk, unwanted pregnancy, and sexually transmitted disease. To inform the development of a comprehensive sexuality education program, 239 secondary school adolescents ages 14-19 in Maun, Botswana, completed a survey of sexual and reproductive health knowledge, attitudes, and behaviors in February-March 2020. Bivariate and multivariate analyses examined factors associated with sexual experience and perceived ability to insist on condoms. Approximately 21% of respondents reported having had sexual intercourse. More than half felt able to insist on condoms. Sources of information about human reproduction, alcohol use, attitudes about when sex is acceptable, and perceived sexual activity by one's peers were predictive of sexual experience. Age, confidence in correct condom use, perceived acceptability of adolescent sex with condoms, and endorsement of prevailing gender norms were significantly associated with perceived ability to insist on condom use.
THE PENETRATION OF ENGINEERING BY ECONOMICS: MCFADDEN (1974) AND THE TRANSFORMATION OF ROAD DEMAND ESTIMATION
Authors: Dupont-Kieffer Ariane , Rivot Sylvie , Madre Jean-Loup
Published: September 2020

The golden age of road demand modeling began in the 1950s and flourished in the 1960s in the face of major road construction needs. These macro-models as well as the econometrics and the data to be processed, were mainly provided by engineers. A division of tasks can be observed between the engineers in charge of estimating the flows within the network, and the transport economists in charge of managing these flows once they are on the road network. Yet the inability to explain their decision-making processes and individual drives gave some room to economists to introduce economic analysis, so as to better understand individual or collective decisions between transport alternatives. Economists, in particular McFadden, began to offer methods to improve the measure of utility linked to transport, and to inform the engineering approach. This paper explores the challenges to the boundaries between economics and engineering in road demand analysis.
STILL-BORN YET NOT WITHOUT INFLUENCE WHAT MILL’S POLITICAL ECONOMY OWES TO HIS PROJECT OF ETHOLOGY
Authors: Salvat Christophe
Published: September 2020

This article questions the articulation between John Stuart Mill’s initial project of creating a new science dedicated to the means of improving individual character, a science named ethology, and the treatise of political economy that he published instead. My claim is that his defence of free competition as well as some of the arguments he opposes to it, and which have often puzzled his readers, actually reveal the moral agenda of his political economy and of some of his political principles, specifically his ambivalent position towards paternalism.
THE EMERGENCE OF GEOGRAPHICAL ECONOMICS: AT THE CONTESTED BOUNDARIES OF ECONOMICS, GEOGRAPHY AND REGIONAL SCIENCE
Authors: Rahman Jasmeen , Dimand Robert
Published: September 2020

We explore disciplinary boundary-making in geographical economics or “the new economic geography” with attention to the approaches taken by, and attempts at communication between, scholars with primary affiliations in economics, geography and regional science. The Dixit-Stiglitz general equilibrium approach to monopolistic competition and increasing returns was applied to agglomeration and location by Paul Krugman, who had previously pioneered the “new trade theory” building on the Dixit-Stiglitz model, and, independently and slightly earlier, by Masahisa Fujita and his student Heshem Abdel-Rahman starting from regional science, a tradition with its own departments, doctorates, conferences and journals distinct from economics and geography. Economic geography, as studied by geographers, had already taken a quantitative and theoretical turn in the 1960s, reviving an earlier tradition of German location theory overshadowed within geography after World War II by areal differentiation. Another strand of economic geography pursued by geographers was influenced by economic theory, but by non-neoclassical Marxian and Sraffian economics. Debates between these scholars raised questions whether these analyses were multidisciplinary, drawing on distinct disciplines, or crossed disciplinary boundaries (as when geographical economics in the style of economists is undertaken in geography departments) or transcends disciplinary boundaries, or involved the emergence of a new discipline.
The Partial Reinforcement Extinction Effect Depends on Learning about Non-Reinforced Trials Rather than Reinforcement Rate
Authors: Harris Justin , Kwok Dorothy , Gottlieb Daniel
Published: September 2020

Conditioned responding extinguishes more slowly after partial (inconsistent) reinforcement than after consistent reinforcement. This Partial Reinforcement Extinction Effect (PREE) is usually attributed to learning about nonreinforcement during the partial schedule. An alternative explanation attributes it to any difference in the rate of reinforcement, arguing that animals can detect the change to nonreinforcement more quickly after a denser schedule than a leaner schedule. Experiments 1a and 1b compared extinction of magazine responding to a conditioned stimulus (CS) reinforced with one food pellet per trial and a CS reinforced with two pellets per trial. Despite the difference in reinforcement rate, there was no reliable difference in extinction. Both experiments did demonstrate the conventional PREE comparing a partial CS (50% reinforced) with a consistent CS. Experiments 2 and 3 tested whether the PREE depends specifically on learning about nonreinforced trials during partial reinforcement. Rats were trained with two CS configurations, A and AX. One was partially reinforced, the other consistently reinforced. When AX was partial and A consistent, responding to AX extinguished more slowly than to A. When AX was consistent and A was partial, there was no difference in their extinction. Therefore, pairing X with partial reinforcement allowed rats to show a PREE to AX that did not generalise to A. Pairing A with partial reinforcement meant that rats showed a PREE to A that generalised to AX. Thus, the PREE depends on learning about nonreinforced trials during partial reinforcement and is not due to any difference in per-trial probability of reinforcement
The new Accounting for Expected Adjusted Effect test (AEAE test) has higher positive predictive value than a zero-order significance test
Authors: Sorjonen Kimmo , Nilsonne Gustav , Melin Bo , Ingre Michael
Published: September 2020

Adjusting for possible confounders is common in statistical analyses, but the degree to which confounding can be eliminated depends on the reliability of measurement of the confounding variable. We have recently proposed a new test which formally incorporates the reliability of the confounding variable: the Accounting for the Expected Adjusted Effect test (AEAE test). In this paper, we extend previous work by demonstrating that the AEAE test tends to exhibit greater positive predictive value (PPV) compared to a traditional zero-order significance test, especially with a strong true adjusted effect, low prior probability, high degree of confounding, large sample size, high reliability in the measurement of predictor X and outcome Y, and low reliability in the measurement of confounder Z. The zero-order significance test, on the other hand, exhibits higher negative predictive value (NPV), except for some combinations of high degree of confounding and large sample size, or low reliability in the measurement of Z and high reliability in the measurement of X/Y, in which case the zero-order significance test can be completely uninformative. Taken together, the findings indicate desirable statistical properties for the AEAE test compared to a traditional zero-order significance test.
Cultivating a Gratitude Thinking Habit and Exploring Its Effects on Psychological Well-being: An Exploratory Longitudinal Study
Authors: LO Tak Tsun , LEUNG Freedom
Published: September 2020

This present study explored a novel approach of gratitude intervention by also focusing real-life habit formation as an intervention target. 180 Chinese college students were asked to do gratitude thinking before sleeping every night for 84 days while self-reporting daily their habit automaticity of and compliance in nightly gratitude. The effects of practices of gratitude thinking on improvements of life satisfaction, grateful affect and dispositional gratitude were mediated via the habit automaticity formed; for decrease of hostility, practices had a direct effect. Repetition and automaticity reciprocally predicted each other in different time points through 12-week follow-ups. Nonlinear regression fitted an asymptotic curve on each individual’s automaticity over the 84 days of intervention. Parameters produced suggested 110 days were needed to reach an automaticity which could sustain gratitude thinking for 4 weeks without further intervention. Overall, results favored the consideration to include habit formation as part of future gratitude interventions.
Experimenter as Automaton; Experimenter as Human: Exploring the Position of the Researcher in Scientific Research
Authors: Field Sarahanne Miranda , Derksen Maarten
Published: September 2020

The crisis of confidence in the social sciences has many corollaries which impact our research practices. One of these is a push towards maximal and mechanical objectivity in quantitative research. This stance is reinforced by major journals and academic institutions that subtly yet certainly link objectivity with integrity and rigor. The converse implication of this may be an association between subjectivity and low quality. Subjectivity is one of qualitative methodology’s best assets, however. In qualitative methodology, that subjectivity is often given voice through reflexivity. It is used to better understand our own role within the research process, and is a means through which the researcher may oversee how they influence their research. Given that the actions of researchers have led to the poor reproducibility characterising the crisis of confidence, it is worthwhile to consider whether reflexivity can help improve the validity of research findings in quantitative psychology. In this report, we describe a combination approach of research: the data of a series of interviews helps us elucidate the link between reflexive practice and quality of research, through the eyes of practicing academics. Through our exploration of the position of the researcher in their research, we shed light on how the reflections of the researcher can impact the quality of their research findings, in the context of the current crisis of confidence. The validity of these findings is tempered, however, by limitations to the sample, and we advise caution on the part of our audience in their reading of our conclusions.
The Partial-Reinforcement Extinction Effect Does Not Result from Reduced Sensitivity to Non-Reinforcement
Authors: Harris Justin , Seet Manuel Stephen , Kwok Dorothy
Published: September 2020

Five experiments used a magazine approach paradigm with rats to investigate whether learning about non-reinforcement is impaired in the presence of a conditioned stimulus (CS) that had been partially reinforced (PRf). Experiment 1 trained rats with a PRf CS and a continuously reinforced (CRf) CS, then extinguished responding to both CSs presented together as a compound. Probe trials of each CS presented alone revealed that extinction was slower for the PRf CS than the CRf CS, despite being extinguished in compound. In Experiment 2, a CRf light was extinguished in compound with either a CRf CS or a PRf CS that had been matched for overall reinforcement rate. Responding to the light extinguished at the same rate regardless of the reinforcement schedule of the other CS. Experiment 3 replicated this result with a PRf light. Thus, we found no evidence that a PRf CS impairs extinction of another CS presented at the same time. Experiments 4 and 5 extended this approach to study the acquisition of conditioned inhibition by training an inhibitor in compound with either a PRf or CRf excitatory CS. The reinforcement schedule of the excitatory CS had no effect on the acquisition of inhibition. In sum, conditioning with a PRf schedule slows subsequent extinction of that CS but does not affect learning about the non-reinforcement of other stimuli presented at the same time. We conclude that the Partial Reinforcement Extinction Effect is not due to a decrease in sensitivity to non-reinforcement following presentation of a PRf CS.
Cognitive efficiency beats top-down control as a reliable individual difference dimension relevant to self-control
Authors: Weigard Alexander Samuel , Clark D. Angus , Sripada Chandra
Published: September 2020

Top-down control of responses is a key construct in cognitive science that is thought to be critical for self-control. It is typically measured by subtracting performance in experimental conditions in which top-down control is theoretically present against performance in matched conditions in which it is assumed to be absent. Recently, however, subtraction-based metrics of top-down control have been criticized for having low test-retest reliability, weak intercorrelations, and little relation to self-report measures of self-control. Concurrently, there is growing evidence that task-general cognitive efficiency, indexed by the drift rate parameter of the diffusion model (Ratcliff, 1978), constitutes a cohesive, reliable individual difference dimension relevant to self-control. However, no previous studies have directly compared latent factors for top-down control (derived from subtraction metrics) with factors for task-general efficiency “head-to-head” in the same sample in terms of their cohesiveness, temporal stability, and relation to self-control. In this re-analysis of a large open data set (Eisenberg et al., 2019; N=522), we find that top-down control metrics fail to form cohesive latent factors, that these factors have poor temporal stability, and they exhibit tenuous connections to questionnaire measures of self-control. In contrast, cognitive efficiency measures—drawn from conditions of the same tasks that both are, and are not, assumed to demand top-down control—form a robust, temporally stable factor that correlates with questionnaire measures of self-control. These findings suggest that task-general efficiency is a central individual difference dimension relevant to self-control. Moreover, they go beyond recent measurement-based critiques of top-down control metrics, and instead suggest problems with key theoretical assumptions that have long guided this research paradigm.
Time, Trials, and Extinction
Authors: Harris Justin , Andrew Benjamin
Published: September 2020

Four experiments investigated the effect of number of trials and total duration of non-reinforced exposure to the conditioned stimulus (CS) on extinction of Pavlovian conditioning. Rats were first trained in a magazine approach paradigm with multiple CSs, each paired with the unconditioned stimulus (US) on a variable CS-US interval. During subsequent extinction, CSs would differ in the number and length of their extinction trials but would be matched for the total duration of exposure (e.g., one CS would have 20 trials per session with a mean length of 5 s, another CS would have 5 trials per session with a mean length of 20 s). In each case, extinction proceeded more quickly for the CS given more trials per session. Indeed, there was no difference in rate of extinction between CSs that were matched on number of trials but differed on the duration of each trial, indicating that duration of exposure has no effect on extinction. We discuss the implications of these findings for trial-based and time-based theories of conditioning.
Why do human languages have homophones?
Authors: Trott Sean , Bergen Ben
Published: September 2020

Human languages are replete with ambiguity. This is most evident in homophony––where two or more words sound the same, but carry distinct meanings. For example, the wordform “bark” can denote either the sound produced by a dog or the protective outer sheath of a tree trunk. Why would a system evolved for efficient, effective communication display rampant ambiguity? Some accounts argue that ambiguity is actually a design feature of human communication systems, allowing languages to recycle their most optimal wordforms (those which are short, frequent, and phonotactically well-formed) for multiple meanings. We test this claim by constructing five series of artificial lexica matched for the phonotactics and distribution of word lengths found in five real languages (English, German, Dutch, French, and Japanese), and comparing both the quantity and concentration of homophony across the real and artificial lexica. Surprisingly, we find that the artificial lexica exhibit higher upper-bounds on homophony than their real counterparts, and that homophony is even more likely to be found among short, phonotactically plausible wordforms in the artificial than in the real lexica. These results suggest that homophony in real languages is not directly selected for, but rather, that it emerges as a natural consequence of other features of a language. In fact, homophony may even be selected against in real languages, producing lexica that better conform to other requirements of humans who need to use them. Finally, we explore the hypothesis that this is achieved by “smoothing” out dense concentrations of homophones across lexical neighborhoods, resulting in comparatively more minimal pairs in real lexica.
Peritraumatic distress and perceived mental healthcare needs among residents of a community housing during COVID-19
Authors: Samson Priscilla , Shah Jay Narayan
Published: September 2020

Introduction: The consequences of lockdown, quarantine, and uncertainties of COVID-19 pandemic has not only caused physical sufferings but affected the mental health of the people around the globe. Peritraumatic distress is a strong predictor of posttraumatic stress disorder that may further lead to depression and suicidal risk. Thus, the aim of this study was to assess peritraumatic distress and perceived mental healthcare needs among the residents of a gated community in Kathmandu Valley.

Method: This was a quantitative online cross-sectional study conducted during June 2020 among adult residents of a gated community in Kathmandu Valley, Nepal. COVID-19 peritraumatic distress index and perceived mental healthcare questionnaire were used to find out peritraumatic distress and mental healthcare needs of the residents. Ethical approval was obtained. Statistical analysis of data was done using SPSS.

Result: A total of 45 residents returned the completed forms. Male were 62.2%, 53.3% belonged to 36 to 55 years and 46.7% had at least one comorbidity. Mild to moderate peritraumatic distress was found among 17.82%. Fisher’s exact test showed no association between age, gender, presence of comorbidity and peritraumatic distress (p > 0.05). Perceived mental healthcare needs were felt by more than 91% of the participants.

Conclusion: One sixth of the participants had mild to moderate level of peritraumatic distress. Almost all the participants felt they have mental healthcare needs. Study highlights the need for counseling for distress and mental health during COVID-19 pandemic.
Huge hemorrhagic ovarian cyst alongside suspected ovarian torsion: a case report
Authors: Sindan Namita , Bhandari Adheesh
Published: September 2020

An ovarian cyst is usually a relatively large, fluid-filled cystic structure (diameter greater than 3 cm) that originates from the surface or inside the ovary. Ovarian cysts can be simple or complex, depending on their internal material. Hemorrhagic ovarian cysts (HOCs) are commonly seen in clinical practice.

Most of them resolve naturally during follow-up except in a minority of cases in which surgical intervention is needed. Ovarian torsion indicates partial or complete rotation of the ovary and a portion of the fallopian tube along its supplying vascular pedicle. It usually occurs in the reproductive age group, more on the right side (about 60%), and often presents with acute lower abdominal pain lasting for a few hours to 24 hours. It is one of the harmful conditions, hampering blood supply of ovary which may rise to overall necrosis of ovarian tissue and other difficulties, if not identified and managed in time. We present a case of a huge hemorrhagic ovarian cyst managed in the Department of Gynecology and Obstetrics, Paropakar Maternity and Women’s Hospital, Kathmandu, Nepal.
Outcome of Febuxostat treatment in hyperuricemic pre-dialysis chronic kidney disease patients
Authors: Shrestha Dineshowri , Baral Anil , Dahal Kashyap , Shrestha Juju Raj , Hada Rajani
Published: September 2020

Introduction: Hyperuricemia is a cause and effect of chronic kidney disease (CKD), accelerates its progression and predisposes to acute kidney injury. Present study aimed to find out the outcome of Febuxostat treatment in hyperuricemic pre-dialysis CKD patients.

Method: This was a cross sectional study conducted in Nephrology department, Bir hospital, Nepal, during from February 2019 to January 2020, among pre-dialysis CKD stage 3-5 non dialysis (ND) patients with serum uric acid (SUA) >7 mg/d L who were treated with Febuxostat 40 mg once a day and followed up at one, two and three months. The baseline SUA, creatinine, estimated glomerular filtration rate (eGFR) calculated by the modification of diet in renal disease (MDRD) equation compared with values at follow up and according to CKD stages. The adverse effects and liver enzymes were recorded.

Result: There were total 50 patients, mean age 54.2±16.5 years, male 31 (62%).There were significant reductions of SUA from baseline of 8.9±1.4to 7.1±1.2 vs 5.9±0.9 vs 4.7±1.0) at one, two and three month respectively, p=0.000 and increment of eGFR (ml/min/1.73m2) from 29.6±15.0 to 31.6±16.0, 33.6±16.6, 34.1±17.1, p=0.000.And 41 (82%) patients achieved uric acid < 6 mg/dl at three month. Significant reduction of uric acid in all CKD stages and increment of eGFR in CKD stage 3 and 4 were observed. Adverse effects were epigastralgia in 5 (10%) and joint pain in 13 (26%).

Conclusion: Febuxostat is an effective serum uric acid lowering drug in pre-dialysis chronic kidney disease patients with improvement of kidney function.
Necrotizing enterocolitis: clinical characteristics and outcome of a cohort of 106 cases at a children’s hospital in North China
Authors: Rong Li Hui , Yao Si Xi , Shah Jay Narayan , Yong Jiao Fu
Published: September 2020

Introduction: Necrotizing enterocolitis (NEC) in neonates, especially in the preterm, is a life-threatening condition. This study aims to analyze the clinical profile of NEC to get an insight for better understanding and management.

Method: This was a retrospective analysis of neonatal NEC during the six-year period from 2014 to 2019. The prevalence and time for the development of NEC, clinical profile (term and preterm, low birth weight, gender, breast and formula feeding, abdominal distension, vomiting, hematochezia, apnea, fever, altered mental status, blood transfusion, breast or formula-fed, intestinal perforation, Bell’s stage and time for the development of NEC) and maternal factors (gestational hypertension, diabetes, premature rupture of membranes PROM, intrauterine fetal distress, placenta previa) were analyzed. Features in preterm and term neonates were compared. Ethical approval was obtained.

Result: There were 106 NEC (0.87% of 12,184 neonatal admissions), 62 (58.49%) male, 90 (84.91%) preterm, and 85 (80.19%) LBW. Overall, 88 (83.02%) were Bell’s stage II, and severe stage III was seen in eight (19.04%) out of 42 babies with formula feeding as compared to one (1.56%) out of 64 in breastfeeding. The median time for the development of NEC was 6 days of life. The yearly prevalence of NEC per thousand neonates admitted during 6-years increased from 2.90 in 2014 to 12.06 in 2019. Overall mortality was 14 (13.20%).

Conclusion: The yearly incidence of NEC increased with a higher incidence in preterm, in low birth weight and formula-fed neonates.
Knowledge and utilization of preconception care among women in selected community of Kathmandu
Authors: Khanal Laxmi Devi
Published: September 2020

Introduction: Preconception care is a critical component of maternal and child health care services to reduce adverse outcomes of pregnancy and to improve desired health outcomes for women, new-born, and children by focusing on health promotion, screening, and interventions. This study aimed to find out the knowledge and utilization of preconception care among women.

Method: A cross-sectional design was carried out among women. Non-probability purposive sampling technique was adopted to select married women of reproductive age in Tokha municipality-10, Kathmandu. Data was collected using face-to-face structured interview. Descriptive and inferential statistics were used to analyze the data. Association among variables was measured by Kruskal–Wallis H test.

Result: More than half of the 200 women surveyed, 133 (66.5%) had average level of knowledge and 61 (30.5%) adequate and 6 (3%) inadequate level of knowledge regarding preconception care. Similarly, 196 (98%) had low utilization and 4 (2%) had high utilization level. There was statistically significant association between educational level of respondents with the level of knowledge (p=0.05) and their husband’s educational level (p=0.00). There was no significant association with age, type of family, occupation, monthly family income, number of pregnancy, history of abortion/still birth and age at first pregnancy.

Conclusion: This study shows more than half of respondents had an average level of knowledge about preconception care whereas only 2% had high level of utilization of care.
COVID-19 & Mental Health
Authors: Thapa R. , Subedi S
Published: September 2020

Not available.
Ethical Issues in Suicide Research
Authors: Mozaffor M , Nurunnabi ASM , Shahriah S
Published: September 2020

Introduction: Quality research is needed in order to better understand, appropriately respond to, and reduce the incidence of suicide, which must be ethically sound as well. However, in South Asian region, there is a lack of knowledge and clarity around the nature of ethical problems related to suicide research and how to resolve them. This review work aims to describe the possible ethical problems and how to ensure ethical practice in different types of suicide research, especially involving groups of people who are or who have been suicidal.

Material And Method: This review was prepared through an extensive searching of published articles in 3 databases - Google, HINARI and PubMed. However, some institutional guidelines were also taken into considerations. Key words used for searching were ‘suicide’, ‘suicidal’, ‘ethics’, ‘ethical issues’ and ‘ethical research’. A total of 18 journal articles and 3 guidelines were finally selected for this review.

Results: Major concerns or ethical issues are accessing the population, potential harm to participants or the researcher, researchers’ competency, securing trust and confidence, maintaining confidentiality, providing support to the participants, and responding sensitively to the needs of the family involved.

Conclusion: Ethical research on suicide, especially involving people with suicidal ideation requires both procedures to protect the study participants, and consideration of ethical dilemmas (before, during and after research) as an ongoing negotiated process. The findings of this research provide a collection and compilation of views held by number of researchers, bioethicists, ethics committee members as well as institutions.
Alcohol Induced Psychotic Disorder: Prevalence and Risk Factors
Authors: Singh PM , Karmacharya S , Khadka S , Gautam Sc , Joshi N
Published: September 2020

Introduction: Alcohol is a potent drug that can produce serious psychiatric symptoms including psychosis. It is believed that approximately 3% of alcoholic persons experience auditory hallucinations or paranoid delusions in the context of heavy drinking or withdrawal. Across Nepal, alcohol use varies widely and alcohol dependence is an increasing problem. So this study aims to provide information regarding prevalence and risk factors of Alcohol Induced Psychotic Disorder in context of Nepal.

Material And Method: A hosiptal-based cross- sectional study was carried out among 37 patients admitted in psychiatric inpatient ward at Nepal Medical College Teaching Hospital, Kathmandu with the diagnosis of AIPD from the period of Magh 2075 to Poush 2076. Semi-structured proforma developed by department of Psychiatry was used to collect socio- demographic data. The consent was taken from the patients and caregivers and strict inclusion and exclusion criteria were applied. Diagnosis was based on ICD-10 DCR criteria and the collected data was analyzed with SPSS.

Results: There were total 37 patients (29 males and 8 females) admitted with the diagnosis of AIPD and the prevalence of AIPD in our study was 6.19%. Among them majority of the patients (35.1%) were of age group (41-50) years and more than half were from rural areas (64.9%). Nearly half of the patients were educated upto primary level (45.9%) and (35.1%) were farmer by occupation. Also Hindus (56.8%) were found to be more associated with AIPD than Buddhist or Christian.

Conclusion: The findings of this study concluded that alcohol is a substantial problem in Nepal. The efforts should be used to increase public awareness about the problems associated with alcohol.
Attitude of Senior Secondary Level Students towards Mental Illness
Authors: Nepal S , Rayamajhi A , Shrestha M. , Aryal N
Published: September 2020

Introduction: Mental disorders are recognized as a major contributor (12%) to the global burden of disease and are among the most stigmatizing conditions worldwide. The lack of awareness is very evident in Nepal. In this study, we aimed to learn about the attitude of senior secondary level students towards mental illness.

Material And Method: Descriptive cross-sectional study was conducted amongst senior secondary level students to investigate about their attitude towards mental illness. We recruited a sample of 138 students from classes 11 and 12 from a conveniently sampled school of Dharan Sub-metropolitan. Semi-structured questionnaire was used to elicit the information.

Results: Our study group consisted of 53.6% females while 46.4% were males. Equal numbers of students were sampled from each grades with their ages ranging from 14-18 years. The mean for total of BMI scale was 52 and the standard deviation was observed to be 12.810. The T-tests revealed males had more negative attitude than the female students which was statistically significant with a p value of 0.048. Our study revealed that there was a significant negative correlation between the attitude scores and the grade the respondents were studying and also between the gender of the respondent, father’s and mother’s education level and in students having a family member or neighbor suffer from mental illness.

Conclusion: Most of the students in the senior secondary level were found to have negative attitudes towards mental illness though no any variables were found to be contributing towards such perceptions from our research.
Awareness Regarding Attention Deficit Hyperactivity Disorder Among Teachers of Selected Schools in Municipality of Rupandehi
Authors: Bhattarai S , Bhusal CK , Jaishi AB
Published: September 2020

Introduction: Attention Deficit Hyperactivity Disorder (ADHD) is a chronic condition that affects millions of children and often continues into adulthood which includes a combination of persistent problems such as difficulty sustaining attention, hyperactivity and impulsive behavior. The aim of the study was to find out teachers awareness regarding ADHD.

Material And Method: Descriptive cross-sectional study was used to find out awareness regarding ADHD among 77 teachers. Three private school were selected using simple random sampling technique, among them seventy seven primary school teachers were selected as a study sample by using enumerative method. Data was collected by pretested self-administered semi-structured questionnaire and the collected data was analyzed by using descriptive and inferential statistics with Statistical Package for Social Sciences (SPSS) Software version 20.

Results: Ninety three percent of respondents had awareness that attention deficit hyperactivity disorder (ADHD) vary from person to person, 59.74% of respondents knew child with ADHD has a lower intelligence quotient than normal children. Sixty one percent of respondents had awareness that prolonged emotional disturbances as a risk factor of ADHD, 59.74% of the respondents had awareness that can't sit for long period to pay attention as symptom of ADHD and 64.94% of the respondents had awareness regarding teachers are the effective person for training of ADHD. Majority of the respondents had low awareness (55.84%) regarding ADHD. There was statistically significant association between awareness level regarding attention deficit hyperactivity disorder and years of teaching experience (p=0.043).

Conclusion: It is concluded that awareness regarding ADHD is inadequate among teachers. Respondents had low awareness regarding management and risk factors of ADHD. Hence concerned authority should focus on organizing awareness programme on ADHD to school teachers.
Childhood Onset Psychosis: A Case Report
Authors: Jha A , Kunwar A , Dhonju G
Published: September 2020

Childhood psychosis is an extremely rare condition. We describe the case of 6.5 yr old male child who presented with symptoms suggestive of psychosis and later responded well to antipsychotic clozapine. This case study reveals that the identification of very early onset psychosis is challenging and treatment is crucial for prevention of long-term disability.
Indigenous Over-representation in Canada’s Youth Correctional System: An Assessment of Regional Variability
Authors: Wiley Stephanie A. , Love Helene , Emmett Kelin A.
Published: September 2020

Although Indigenous youth make up 8% of Canada’s population, they are over-represented in the youth correctional system – comprising 46% of admissions in the 2016/17 fiscal year. The Youth Criminal Justice Act (YCJA) of 2003 calls for attention to the unique needs of Indigenous youth at all points of justice system contact, yet despite these special considerations and emphasis on fair treatment, overrepresentation has grown steadily in recent years. Examination of the number of correctional admissions for Indigenous and non-Indigenous youth, as well as the percentage of Indigenous admissions, across the provinces and territories provides insight into this unexpected trend. By incorporating regional population data, this research uncovers the areas that report the greatest levels of over-representation and those which have successfully reduced the percentage of system-involved Indigenous youth or maintained proportionate representation. This information provides a starting point for future research to uncover the systemic causes of the over-representation problem. These findings also draw attention to issues with recording and reporting practices – a problem that must be addressed in order to act on the Truth and Reconciliation Commission’s call to reduce criminal justice disparities among Indigenous youth.
Remote Monitoring of Patients with COVID-19 after Hospital Discharge with Connected Health Platform: Outcomes and Quality of Life
Authors: Serra César Morcillo , Serra César Morcillo , Marzal Martín Domingo , Moro Jorge Velázquez , Tomás Martínez José Francisco
Published: September 2020

Background: Telemonitoring with applications and connected devices facilitates a more accessible and efficient attention. Its implementation has been accelerated thanks to the pandemic by COVID-19, where they have allowed the continuity of care.
Objective: To evaluate the efficacy of a remote monitoring platform for the outpatient follow-up after hospital discharge by COVID-19.
Methods: Prospective observational study of patients discharged from the hospital with COVID-19 infection between March 23 and May 25, 2020, who were followed for one month with the Connected Health telemonitoring platform. The mobile phone application connected to a pulse oximeter, allowed to measure vital signs and answer health questionnaires (EQ5D3L and CAT) daily, and alert the medical team that could be contacted by video consultation.
Results: 95 patients (64% male) with a mean age of 54 (SD 26-81) years were included. The application allowed the detection of alerts for pain (80% of patients) and a decrease in oxygen saturation (12%). No patient required hospital readmission or presented complications. The application allowed strict monitoring of symptoms and quality of life. The main symptom was severe pain (59% of patients) followed by anxiety or depression (25%). The average state of health was 65 (SD 20-100). COVID-19 caused a low impact on the quality of life of 62% of the patients, although 8% reported a significant limitation, due to shortness of breath and leaving the house.
Conclusion: telemonitoring allows a safe remote monitoring of patients after hospital discharge by COVID-19. The Connected Health application has allowed the measurement of oxygen saturation, symptoms and quality of life, and the detection and management of alerts by the medical team through video consultation.
Arte e Comportamentalismo Radical
Authors: Vitti Gabriel Rodrigues , Laurenti Carolina
Published: September 2020

Em Walden two, Skinner descreveu uma comunidade fictícia capaz de promover a felicidade de seus membros por meio de um planejamento cultural que se utiliza, dentre outros recursos, da arte. Walden two apresenta-se, então, como obra privilegiada para se investigar o comportamento artístico no comportamentalismo radical. O objetivo desta pesquisa teórica foi apresentar uma sistematização sobre a arte em Walden two, mediante busca e registro de trechos do livro contendo palavras-chaves associadas às produções artísticas. Foram compiladas informações que permitiram destacar: as características das obras de arte, as variáveis descritivas do comportamento do artista e da audiência, e a função social das produções artísticas. Argumenta-se que a arte, entendida como uma forma de controle social, deve ser considerada nas discussões ético-políticas sobre planejamento cultural.