bluuebunny/crossref_metadata_2025 huggingface dataset:
Cruveilhier’s Unrecognized Case (c1831) of Dyke-Davidoff-Masson Syndrome
Authors: Lanska Douglas J.
Published: May 2021

In his serially published atlas of pathology, Anatomie Pathologique du Corps Humain (1829–1842), French anatomist and pathologist Jean Cruveilhier (1791–1874) provided an early clinical-pathologic description of Dyke-Davidoff-Masson syndrome. Cruveilhier’s case was initially published around 1830, more than a century before the clinical and radiologic report of Dyke and colleagues in 1933 based on a series of patients studied with pneumoencephalography. Although Dyke and colleagues were apparently unaware of Cruveilhier’s prior description, Cruveilhier’s case manifested all of the key osseous and neuropathological features of Dyke-Davidoff-Masson syndrome as later elaborated by Dyke and colleagues: (1) cerebral hemiatrophy with ex vacuo dilation of the lateral ventricle, (2) ipsilateral thickening of the diploe of the skull, and (3) ipsilateral hyper-pneumatization of the frontal sinuses. In addition, Cruveilhier noted crossed cerebral-cerebellar atrophy in his case and correctly inferred a “crossed effect” between the involved cerebral hemisphere and the contralateral cerebellum. Cruveilhier’s pathological case from 1830 clearly anticipated both the cases reported more than a century later by Dyke and colleagues based on pneumoencephalography and the more recent case reports recognized with computed tomography or magnetic resonance imaging.
Alteration of Macrophage Infiltrating Compartment: A Novel View on Oral Carcinogenesis
Authors: Shigeoka Manabu , Koma Yu-ichiro , Nishio Mari , Akashi Masaya , Yokozaki Hiroshi
Published: May 2021

Background: The mortality of oral squamous cell carcinoma (OSCC) has remained high for decades; therefore, methods for early detection of OSCC are warranted. However, in the oral cavity, various mucosal diseases may be encountered, including reactive lesions and oral potentially malignant disorders, and it is difficult to differentiate OSCC from these lesions based on both clinical and histopathological findings. It is well known that chronic inflammation contributes to oral cancer development. Macrophages are among the most common inflammatory cells in cancer stromal tissue and have various roles in cancer aggressiveness. Although the roles of macrophages in cancer development have attracted attention, only a few studies have linked macrophages to carcinogenesis, particularly, oral precancerous lesions. Summary: This review article consists of 3 parts: first, we summarize current knowledge on macrophages in human various epithelial precancerous lesions, excluding the oral cavity, to show the importance and gaps in knowledge regarding macrophages in carcinogenesis; second, we review published data related to the role of macrophages in oral carcinogenesis; finally, we present a novel view on oral carcinogenesis, focusing on crosstalk between epithelial cells and macrophages. Key Messages: The biological features of macrophages in oral carcinogenesis differ drastically depending on the anatomical compartment that they infiltrate. Focusing on the alteration of macrophage infiltrating compartment may serve as a useful novel approach for studying the role of the macrophages in oral carcinogenesis and for gaining further insight into cancer prevention and early detection.
Technical Nuances in Neuroendoscopic Lavage for Germinal Matrix Hemorrhage in Preterm Infants: Twenty Tips and Pearls after More than One Hundred Procedures
Authors: Tirado-Caballero Jorge , Herreria-Franco Jorge , Rivero-Garvía Mónica , Moreno-Madueño Gloria , Mayorga-Buiza Maria Jose , Marquez-Rivas Javier
Published: May 2021

Introduction: Posthemorrhagic hydrocephalus in preterm infants is a serious entity related to high mortality and morbidity. Neuroendoscopic lavage (NEL) is a suitable alternative for the management of this pathology. However, as with every endoscopic technique, it requires some experience and several cases to master. Methods: We present a descriptive study of some technical nuances, tips, and tricks that have been learned in the last 8 years with over a hundred NELs performed in preterm infants. These variations are classified into 3 categories according to their temporal relationship with the surgical procedure: preoperative stage, intraoperative stage, and postoperative stage. We include a brief description of each one and the reasons why they are included in our current clinical practice. Results: Twenty tips and pearls were described in detail and are reported here. Preoperative, intraoperative, and postoperative variations were exposed and related to the most frequent complications of this procedure: infection, cerebrospinal fluid leak, and rebleeding. Conclusions: NEL is a useful technique for the management of germinal matrix hemorrhage in preterm infants. These technical nuances have improved the results of our technique and helped us to prevent complications related to the procedure.
Cuidado de enfermagem em urgência/emergência às pessoas que tentam suicídio
Authors: Fontão Mayara Cristine , Rodrigues Jeferson , Lino Monica Motta , Lino Murielk Motta
Published: May 2021

Objetivo: trata-se de uma revisão integrativa que teve como objetivo caracterizar o cuidado de Enfermagem em urgência/emergência às pessoas que tentam suicídio. Método: a busca contemplou as bases de dados CINAHL®, SCOPUS®, SciElo®, LILACS®, MEDLINE® e Google Acadêmico® no período de 2011 a 2018. Resultados: a partir do universo de 5900 estudos, foram selecionados 16 artigos para o corpus de análise aprofundada. Emergiram três eixos centrais: caracterização do tema suicídio, trabalho e percepção da Enfermagem no cuidado e aspectos que envolvem o cuidado na área de urgência/emergência. Conclusão: os resultados dos estudos apontaram a importância de aprofundamento do tema, principalmente quanto ao estigma social que o profissional de Enfermagem apresenta ao prestar cuidado à pessoa em tentativa de suicídio, para trazer melhorias ao cuidado.
Impacto da intervenção educacional sobre suicídio na percepção de enfermeiras e agentes comunitários de saúde
Authors: Rocha Francielle de Rezende , Alvarenga Marcia Regina Martins , Giacon-Arruda Bianca Cristina Ciccone
Published: May 2021

Objetivo: analisar a percepção de enfermeiras e agentes comunitários de saúde em relação ao suicídio antes e após uma intervenção educativa. Método: estudo quase experimental, do tipo antes e depois, de abordagem qualitativa, baseado no referencial teórico da Transferência de Conhecimento. Participaram do estudo duas enfermeiras e dez agentescomunitários de saúde de uma unidade básica de saúde de Campo Grande, do estado de Mato Grosso do Sul. Foi utilizada a técnica de grupo focal, para a coleta de dados, antes e após a intervenção educativa. A análise dos dados foi realizada por meio da técnica de Triangulação de Métodos. Resultados: emergiram duas categorias da análise dos dados, “a percepção do suicídio nos seus diferentes aspectos”, que traz percepções, compreensões e conceitos relacionados ao suicídio e “o contexto da assistência à saúde no comportamento suicida”, que mostra como o suicídio é vivenciado pelos profissionais de saúde nos espaços de cuidado. Conclusão: a intervenção educativa favoreceu mudanças na percepção dos participantes referentes à identificação e abordagem do comportamento suicida, indicando a importância de ações dessa natureza para abordagens inerentes à prevenção do suicídio.
Prevalência de tentativas de suicídio entre adolescentes e jovens
Authors: Oliveira Erasmo de Carvalho , Meucci Tatiane Scolastrici , Rossato Lisabelle Mariano , Mendes-Castillo Ana Márcia Chiaradia , Silva Lucía
Published: May 2021

Objetivo: caracterizar as tentativas de suicídio entre adolescentes e jovens em um município brasileiro. Método: trata-se de estudo quantitativo, retrospectivo, descritivo exploratório, realizado no Núcleo de Apoio à Saúde da Família. Foram coletadas informações de 55 fichas de notificação compulsória de pessoas entre 12 e 25 anos de idade, notificadas como tentativa de suicídio pelo Núcleo de Vigilância Epidemiológica, no período estudado. A organização e a análise dos dados foram realizadas por meio de estatística descritiva. Resultados: evidenciou-se uma amostra composta principalmente por pessoas de 22 a 25 anos de idade, mulheres, da raça branca, estudantes, solteiras, residentes em zona urbana, com tentativa de suicídio no próprio domicílio, no período noturno, por envenenamento. Conclusão: este perfil assemelha-se ao perfil das tentativas entre adultos, apontado na literatura, sinalizando a importância de os profissionais programarem estratégias de prevenção inclusive entre crianças e adolescentes, a fim de se evitar, futuramente, não somente as tentativas, mas também o suicídio entre essa população.
Riscando pontos
Authors: Steel Roderick Peter
Published: May 2021

Este ensaio fotográfico cria um movimento paralelo entre a observação etnográfica e um arranjo fotográfico políptico, a fim de alinhar fronteiras artísticas e antropológicas entre cosmogramas afro-brasileiros – pontos-riscados – e marcações aeroportuárias. Essas fotografias exploram semelhanças entre vocabulários visuais simbólicos que predominam em cosmogramas e sinais de aeroporto para criar linhas fuga entre estes espaços liminares. O texto e imagens convidam a imaginar formas inéditas de relacionar mundos diametricamente opostos: terreiro/aeroporto; transe/estar-em-trânsito; cosmografia/sinalização aeroportuária; cura/covid-19. E desta fusão abrir para múltiplas dimensões temporais que nos possibilitam deslocar e visionar por meio de uma manifestação artística-acadêmica.
Funding of Studies Supporting IA Guideline Recommendations in Cardiovascular Medicine—A Systematic Review
Authors: Zeitler Emily P. , Gasperetti Alessio , Dodge Shayne E. , Cooper Lauren B. , Kaplan Aaron V.
Published: May 2021

Each guideline recommendation from the American Heart Association and the American College of Cardiology includes an indication of the level of supporting evidence and the associated strength of recommendation with “IA” recommendations representing those with the highest quality supporting evidence and the least amount of uncertainty for benefit. In this analysis, study type and funding sources were systematically tabulated across these IA guideline recommendations over the past 5 years. Nearly half of studies supporting IA guideline recommendations were randomized controlled trials (45%). Overall, about one third of studies supporting IA recommendations were publicly funded (34.9%) with slightly more funded through industry sources (43.5%). Funding sources varied based on the type of intervention being studied with randomized controlled trials of device, diagnostic, and pharmacological interventions reflecting predominantly industry‐funded studies. Over time, studies supporting IA cardiology guideline are funded by industry about twice as often as public sources. Thus, data of adequate quality to support cardiovascular guideline recommendations come from a variety of sources.
Post‐Cardiac Arrest Hydrocortisone Use Ameliorates Cardiac Mitochondrial Injury in a Male Rat Model of Ventricular Fibrillation Cardiac Arrest
Authors: Tsai Min‐Shan , Huang Chien‐Hua , Wang Chen‐Hsu , Cheng Hsaio‐Ju , Wu Shih‐Ni , Chang Wei‐Tien , Chen Wen‐Jone
Published: May 2021

Background

Steroid use after cardiac arrest has been reported to improve survival and neurological outcome in cardiac arrest survivors. The study aimed to evaluate the effect of post‐arrest hydrocortisone use on myocardial damage and cardiac mitochondrial injury in a rat model of ventricular fibrillation cardiac arrest.

Methods and Results

Ventricular fibrillation cardiac arrest was induced and left untreated for 5 minutes in adult male Wistar rats. Cardiopulmonary resuscitation and electric shocks were then applied to achieve return of spontaneous circulation (ROSC). Successfully resuscitated animals were randomized into 3 groups: control, low‐dose hydrocortisone (2 mg/kg), and high‐dose hydrocortisone (8 mg/kg). The low‐dose hydrocortisone and high‐dose hydrocortisone (treatment) groups received intravenous hydrocortisone immediately after ROSC and the control group received saline as placebo. Each group consisted of 15 animals. Within 4 hours of ROSC, both treatment groups showed a higher cardiac output than the control group. At the fourth hour following ROSC, histological examination and transmission electron microscopy demonstrated less myocardial damage and mitochondrial injury in the animals treated with hydrocortisone. In the treatment groups, hydrocortisone mitigated the acceleration of Ca
2+
‐induced mitochondrial swelling and suppression of complex activity observed in the control group. At the 72nd hour after ROSC, a significantly higher proportion of animals treated with hydrocortisone survived and had good neurological recovery compared with those given a placebo.

Conclusions

Hydrocortisone use after cardiac arrest may mitigate myocardial injury and cardiac mitochondrial damage and thus improve survival, neurological and histological outcomes in a rat model of ventricular fibrillation cardiac arrest.
Fluid-Attenuated Inversion Recovery May Serve As a Tissue Clock in Patients Treated With Endovascular Thrombectomy
Authors: Aoki Junya , Sakamoto Yuki , Suzuki Kentaro , Nishi Yuji , Kutsuna Akihito , Takei Yukako , Sawada Kazutaka , Kanamaru Takuya , Abe Arata , Katano Takehiro , Takeshi Yuho , Nakagami Toru , Numao Shinichiro , Kimura Ryutaro , Suda Satoshi , Nishiyama Yasuhiro , Kimura Kazumi
Published: May 2021

Background and Purpose:

We investigated whether the signal change on fluid-attenuated inversion recovery (FLAIR) can serve as a tissue clock that predicts the clinical outcome after endovascular thrombectomy (EVT), independently of the onset-to-admission time.

Methods:

Consecutive patients with acute stroke treated with EVT between September 2014 and December 2018 were enrolled. Based on the parenchymal signal change on FLAIR, patients were classified into FLAIR-negative and FLAIR-positive groups. The clinical characteristics, imaging findings, EVT parameters, and the intracranial hemorrhage defined as Heidelberg Bleeding Classification ≥1c hemorrhage (parenchymal hemorrhage, intraventricular hemorrhage, subarachnoid hemorrhage, and/or subdural hemorrhage) were compared between the 2 groups. A modified Rankin Scale score 0 to 1 at 3 months was considered to represent a good outcome.

Results:

Of the 227 patients with EVT during the study period, 140 patients (62%) were classified into the FLAIR-negative group and 87 (38%) were classified into the FLAIR-positive group. In the FLAIR-negative group, the patients were older (
P
=0.011), the onset-to-image time was shorter (
P
<0.001), the frequency of cardioembolic stroke was higher (
P
=0.006), and the rate of intravenous thrombolysis was higher (
P
<0.001) in comparison to the FLAIR-positive group. Although the rate of complete recanalization after EVT did not differ between the 2 groups (
P
=0.173), the frequency of both any-intracranial hemorrhage and Heidelberg Bleeding Classification ≥1c hemorrhage were higher in the FLAIR-positive group (
P
=0.004 and 0.011). At 3 months, the percentage of patients with a good outcome (FLAIR-negative, 41%; FLAIR-positive, 27%) was significantly related to the FLAIR signal change (
P
=0.047), while the onset-to-image time was not significant (
P
=0.271). A multivariate regression analysis showed that a FLAIR-negative status was independently associated with a good outcome (odds ratio, 2.10 [95% CI, 1.02–4.31],
P
=0.044).

Conclusions:

A FLAIR-negative status may predict the clinical outcome more accurately than the onset-to-admission time, which may support the role of FLAIR as a tissue clock.
Saotomia tuberculata, a new genus and species of Peritelini (Coleoptera; Curculionidae; Entiminae) from São Tomé, West Africa
Authors: BOROVEC ROMAN , ANDERSON ROBERT
Published: May 2021

Saotomia tuberculata, a new genus and species of Peritelini (Curculionidae; Entiminae) from São Tomé, West Africa is described. The new genus is most similar to the other African genera Dysommatus Marshal, 1933 and Fernandius Marshall, 1954. Important taxonomic characters are illustrated.
Annotated world checklist of the Trombiculidae and Leeuwenhoekiidae (1758–2021) (Acari: Trombiculoidea), with notes on nomenclature, taxonomy, and distribution
Authors: NIELSEN DAVID H. , ROBBINS RICHARD G. , RUEDA LEOPOLDO M.
Published: May 2021

The superfamily Trombiculoidea is a large and diverse group of acarines that comprises six families; of these, the families Trombiculidae and Leeuwenhoekiidae are characterized by larvae commonly known as chiggers that are parasites of terrestrial vertebrates, including humans, and some species are of medical importance as vectors of chigger-borne rickettsiosis (scrub typhus), caused by the rickettsia Orientia tsutsugamushi.  This paper presents an annotated checklist of 3,013 generally accepted chigger species, together with their distribution by zoogeographic region, and a non-comprehensive list of synonyms.  A total of 58 new combinations are proposed by transferring species to different genera, treating some subgenera as genera, or updating current generic names. The checklist updates earlier catalogs of the world chigger fauna, but because the literature on chigger taxonomy is voluminous and scattered, similar, regional monographs were utilized in constructing the classificatory foundation.  This list may not contain every species, synonym or taxonomic rearrangement that has been published, but it reflects the most recent arrangement of chigger taxa.  Distribution records are primarily drawn from collection sites listed in the original species descriptions, together with subsequently published geographical records.
World revision of Iteaphila with unbranched radial vein (Diptera: Empidoidea: Iteaphilidae)
Authors: SINCLAIR BRADLEY J. , SHAMSHEV IGOR V.
Published: May 2021

Iteaphila Zetterstedt is redefined to include species with both branched and unbranched radial vein (R4+5) on the basis of a morphological cladistic analysis and parsimony analysis of COI mitochondrial DNA barcode sequences. As a result, Anthepiscopus Becker is hypothesized as a junior synonym of Iteaphila and species of the Iteaphila setosa group are transferred to the new genus, Paraiteaphila gen. nov. The following new combinations are proposed: P. arundela (Shamshev & Sinclair, 2009) comb. nov., P. caucasica (Shamshev & Sinclair, 2009) comb. nov., P. italica (Loew, 1873) comb. nov., P. kubaniensis (Shamshev & Sinclair, 2009) comb. nov., P. merzi (Shamshev & Sinclair, 2009) comb. nov. and P. setosa (Bezzi, 1924) comb. nov. These two genera are assigned to the family Iteaphilidae stat. rev.                Thirty-five species of Iteaphila with unbranched radial vein are revised, including 26 new species: bulbosa species group (I. beringiensis sp. nov., I. bifida sp. nov., I. recta sp. nov., I. tribulosa sp. nov.), macquarti species group (I. bartaki sp. nov., I. falki sp. nov., I. kyrgyzstanensis sp. nov., I. ribesii (Becker, 1891) comb. nov.), nitidula species group (I. longiphallus sp. nov.), nupta species group (I. arnaudi sp. nov., I. bayarea sp. nov., I. brooksi sp. nov., I. dichoptica sp. nov., I. flavipilosa (Coquillett, 1900) comb. nov., I. glabricula sp. nov., I. gracilis sp. nov., I. grandis sp. nov., I. lolo sp. nov., I. longipalpis (Melander, 1928) comb. nov., I. luteitibia sp. nov., I. nupta (Melander, 1928) comb. nov., I. sierrensis sp. nov., I. spinosa sp. nov., I. subnupta sp. nov.), oedalina species group (I. aktruensis sp. nov., I. incus sp. nov., I. miranda sp. nov., I. oedalina (Zetterstedt, 1838) comb. nov., I. polygyna (Melander, 1928) comb. nov., I. recurvata sp. nov., I. sakhalinensis sp. nov., I. zontaki (Nowicki, 1871) comb. nov.), stentor species group (I. parastentor sp. nov., I. stentor (Melander, 1902) comb. nov.) and unplaced to species group (I. caelebs (Becker, 1891) comb. nov.). The following new synonyms are proposed: I. flavicoxa (Melander, 1928) is a junior synonym of I. polygyna (Melander, 1928); I. hirsutus (Melander, 1928) is a junior synonym of I. oedalina (Zettersedt, 1838). Lectotypes are designated for the following species: I. flavipilosa, I. fraternella Zetterstedt, I. nigra Zetterstedt, I. nupta, I. oedalina, I. polygyna and I. ribesii. All species of Iteaphila with unbranched R4+5 are described, key to species presented, male terminalia illustrated, distributions plotted and flowers visited by these species are listed. COI mitochondrial DNA barcode sequences were obtained for 18 identified Nearctic species of Iteaphila with both branched and unbranched R4+5.
Simulation of Sugarcane Residues Co-Gasification (Vinasse-Straw-Bagasse) for Different Equivalence Ratios and Gasifying Agents
Authors: Santos Cláudia C. , Oliveira Janaine dos A. , Barbieri Igor de A. , Monhol Filipe A. F
Published: May 2021

This study evaluates the co-gasification of the main residues of the sugarcane industry (vinasse, bagasse and straw), in order to recover their energy and give an appropriate destination, making them suitable for use as fuel gas (syngas). To verify the feasibility of energy conversion through gasification, thermodynamic equilibrium model for gasification process was carried out and verified by literature available data. The gasification parameters for different gasification agents and equivalence ratio values were then obtained, such as: syngas composition and energy content, operating temperature, production rate and conversion efficiency. For equivalence ratios (ER) between 0.35 and 0.4 and temperatures around 750 °C, the quality of the syngas obtained is better, but a higher energy content is obtained in ER values of 0.2. There is a high H2/CO ratio for the gasifying agent formed by air and steam, and when using oxygen-enriched air, there is a change in the ER value that generates better syngas quality (to 0.3–0.35) and an increase in its energy content. There is also a possible better return on investment in a thermoelectric plant for the lowest ER values, which can increase gains by up to 21.4% and decrease the installation’s payback. The results indicate that the co-gasification of the waste is feasible, allowing a better use of its energy potential.
The Atmospheric Carbon and Transport (ACT)-America Mission
Authors: Davis Kenneth J. , Browell Edward V. , Feng Sha , Lauvaux Thomas , Obland Michael D. , Pal Sandip , Baier Bianca C. , Baker David F. , Baker Ian T. , Barkley Zachary R. , Bowman Kevin W. , Cui Yu Yan , Denning A. Scott , DiGangi Joshua P. , Dobler Jeremy T. , Fried Alan , Gerken Tobias , Keller Klaus , Lin Bing , Nehrir Amin R. , Normile Caroline P. , O’Dell Christopher W. , Ott Lesley E. , Roiger Anke , Schuh Andrew E. , Sweeney Colm , Wei Yaxing , Weir Brad , Xue Ming , Williams Christopher A.
Published: May 2021

The Atmospheric Carbon and Transport (ACT)-America NASA Earth Venture Suborbital Mission set out to improve regional atmospheric greenhouse gas (GHG) inversions by exploring the intersection of the strong GHG fluxes and vigorous atmospheric transport that occurs within the midlatitudes. Two research aircraft instrumented with remote and in situ sensors to measure GHG mole fractions, associated trace gases, and atmospheric state variables collected 1,140.7 flight hours of research data, distributed across 305 individual aircraft sorties, coordinated within 121 research flight days, and spanning five 6-week seasonal flight campaigns in the central and eastern United States. Flights sampled 31 synoptic sequences, including fair-weather and frontal conditions, at altitudes ranging from the atmospheric boundary layer to the upper free troposphere. The observations were complemented with global and regional GHG flux and transport model ensembles. We found that midlatitude weather systems contain large spatial gradients in GHG mole fractions, in patterns that were consistent as a function of season and altitude. We attribute these patterns to a combination of regional terrestrial fluxes and inflow from the continental boundaries. These observations, when segregated according to altitude and air mass, provide a variety of quantitative insights into the realism of regional CO2 and CH4 fluxes and atmospheric GHG transport realizations. The ACT-America dataset and ensemble modeling methods provide benchmarks for the development of atmospheric inversion systems. As global and regional atmospheric inversions incorporate ACT-America’s findings and methods, we anticipate these systems will produce increasingly accurate and precise subcontinental GHG flux estimates.
Association between socioeconomic status and prolonged television viewing time in a general Japanese population: NIPPON DATA2010
Authors:   for NIPPON DATA2010 Research Group, Sumimoto Yuka , Yanagita Masahiko , Miyamatsu Naomi , Okuda Nagako , Nishi Nobuo , Nakamura Yosikazu , Nakamura Koshi , Miyagawa Naoko , Miyachi Motohiko , Kadota Aya , Ohkubo Takayoshi , Okamura Tomonori , Ueshima Hirotsugu , Okayama Akira , Miura Katsuyuki
Published: May 2021

Background

It has been pointed out that prolonged television (TV) viewing is one of the sedentary behaviors that is harmful to health; however, the association between socioeconomic status (SES) and prolonged TV viewing time has not been sufficiently investigated in Japan.

Methods

The study population are the participants of NIPPON DATA2010, which is a prospective cohort study of the National Health and Nutrition Survey 2010 in Japan. They were residents in 300 randomly selected areas across Japan. This study included 2752 adults. SES was classified according to the employment status, educational attainment, living status, and equivalent household expenditure (EHE). Prolonged TV viewing time was defined as more than or equal to 4 h of TV viewing per day. Multivariable logistic regression analyses were conducted to examine the association of SES with prolonged TV viewing time.

Results

The mean TV viewing time was 2.92 h in all participants. Of 2752 participants, 809 (29.4%) prolonged TV viewing, and the mean TV viewing time of them was 5.61 h. The mean TV viewing time in participants without prolonged TV viewing time was 1.81 h. The mean TV viewing time was prolonged as age classes increased and significantly longer in aged ≥60 years. Prolonged TV viewing time was associated with not working for all age classes and sexes. Only among women, education attainment and living status were also associated with prolonged TV viewing time. For education attainment, the lower the received years of education, the higher odds ratios (OR) of prolonged TV viewing time. For living status, in women aged <60 years, living with others had a significantly higher OR compared to living with spouse. On the other hand, in women aged ≥60 years, living alone had a significantly higher OR. EHE did not have any significant associations with prolonged TV viewing time.

Conclusions

In a general Japanese population, it should be noted that the association between SES and prolonged TV viewing time differed by age and sex. Particularly, it must draw attention to the prolonged TV viewing in elderly. The intervention in order to shorten TV viewing time needs to consider these attributes.
Diagnostic pitfalls: intramyocardial lymphoma metastasis mimics acute coronary syndrome in a diffuse large B cell lymphoma patient—case report
Authors: Prenek Lilla , Csupor Klára , Beszterczán Péter , Boros Krisztina , Kardos Erika , Vorobcsuk András , Egyed Miklós , Kellner Ádám , Rajnics Péter , Varga Csaba
Published: May 2021

Background

Cardiac tumors are very uncommon compared to other cardiac diseases. Their clinical symptoms can vary from absent to non-specific. The most common symptoms are arrhythmias, blood flow obstruction due to valvular dysfunction, shortness of breath, systemic embolization, and accumulation of pericardial fluid. Hereby, we describe a very rare case of a diffuse large B cell lymphoma patient who presented with the symptoms and signs of acute coronary syndrome (ACS) but the patient’s complaints were caused by his intramyocardial lymphoma metastasis.

Case presentation

Forty-eight-year-old diffuse large B cell lymphoma patient was admitted to our emergency department with chest pain, effort dyspnea, and fever. The patient had normal blood pressure, blood oxygen saturation, sinus tachycardia, fever, crackles over the left lower lobe, novum incomplete right bundle branch block with Q waves and minor ST alterations, elevated C-reactive protein, high-sensitivity troponin-T, and d-dimer levels. Chest X-ray revealed consolidation on the left side and enlarged heart. Bed side transthoracic echocardiography showed inferior akinesis with pericardial fluid. Coronary angiography showed no occlusion or significant stenosis. Chest computed tomography demonstrated the progression of his lymphoma in the myocardium. He was admitted to the Department of Hematology for immediate chemotherapy and he reached complete metabolic remission, followed by allogeneic hematopoietic stem cell transplantation. Unfortunately, about 9 months later, he developed bone marrow deficiency consequently severe sepsis, septic shock, and multiple organ failure what he did not survive.

Conclusions

Our case demonstrates a very rare manifestation of a heart metastasis. ACS is an unusual symptom of cardiac tumors. But our patient’s intramyocardial lymphoma in the right atrium and ventricle externally compressed the right coronary artery and damaged the heart tissue, causing the patient’s symptoms which imitated ACS. Fortunately, the quick diagnostics and immediate aggressive chemotherapy provided the patient’s remission and suitability to further treatment.
The use of dual oxygen concentrator system for mechanical ventilation during COVID-19 pandemic in Sabah, Malaysia
Authors: Cheah Phee Kheng , Steven Evelyn Marie , Ng Khai Keam , Hashim Muammar Iqbal , Abdul Kadir Mohamed Hakimi , Roder Nicholas Paul
Published: May 2021

Sabah in Malaysian Borneo is among the Malaysian states which reported a high number of detected COVID-19 cases during the current pandemic. Due to geographical challenges and limited resources, clinicians developed novel strategies for managing patients. The use of a dual oxygen concentrator system for mechanical ventilation is one of the innovations developed by retrieval team members from the Emergency Department (ED) of the Sabah Women and Children’s Hospital. Due to conditions requiring isolation of patients suspected of or positive for COVID-19, high-risk patients were treated in an ED extension area that lacked central wall oxygen. Direct access to oxygen tanks became the only viable option, but ensuring a continuous supply was laborious. The novel setup described within this paper has been used on intubated patients in the ED extension area with moderate to high ventilator settings successfully. This simple setup, designed to meet the limited resources within a pandemic environment, needed only a turbine-driven ventilator, two oxygen concentrators, a 3-way connector, and three oxygen tubing. The application of this setup could potentially save more critically ill patients who are being managed in resource-limited conditions such as in smaller district hospitals or out in the field.
The effect of dexmedetomidine on intraoperative blood glucose homeostasis: secondary analysis of a randomized controlled trial
Authors: Li Chun-Jing , Wang Bo-Jie , Mu Dong-Liang , Wang Dong-Xin
Published: May 2021

Purpose

To investigate the effect of dexmedetomidine on intraoperative blood glucose hemostasis in elderly patients undergoing non-cardiac major surgery.

Methods

This was secondary analysis of a randomized controlled trial. Patients in dexmedetomidine group received a loading dose dexmedetomidine (0.6 μg/kg in 10 min before anaesthesia induction) followed by a continuous infusion (0.5 μg/kg/hr) till 1 h before the end of surgery. Patients in control group received volume-matched normal saline at the same time interval. Primary outcome was the incidence of intraoperative hyperglycemia (blood glucose higher than 10 mmol/L).

Results

303 patients in dexmedetomidine group and 306 patients in control group were analysed. The incidence of intraoperative hyperglycemia showed no statistical significance between dexmedetomidine group and control group (27.4% vs. 22.5%, RR = 1.22, 95%CI 0.92–1.60,P = 0.167). Median value of glycemic variation in dexmedetomidine group (2.5, IQR 1.4–3.7, mmol) was slightly lower than that in control group (2.6, IQR 1.5–4.0, mmol),P = 0.034. In multivariable logistic analysis, history of diabetes (OR 3.007, 95%CI 1.826–4.950,P < 0.001), higher baseline blood glucose (OR 1.353, 95%CI 1.174–1.560,P < 0.001) and prolonged surgery time (OR 1.197, 95%CI 1.083–1.324,P < 0.001) were independent risk factors of hyperglycaemia.

Conclusions

Dexmedetomidine presented no effect on intraoperative hyperglycemia in elderly patients undergoing major non-cardiac surgery.

Trial registration

Present study was registered at Chinese Clinical Trial Registry on December 1, 2015 (www.chictr.org.cn, registration number ChiCTR-IPR-15007654).
Characterizing all-cause excess mortality patterns during COVID-19 pandemic in Mexico
Authors: Dahal Sushma , Banda Juan M. , Bento Ana I. , Mizumoto Kenji , Chowell Gerardo
Published: May 2021

Background

Low testing rates and delays in reporting hinder the estimation of the mortality burden associated with the COVID-19 pandemic. During a public health emergency, estimating all cause excess deaths above an expected level of death can provide a more reliable picture of the mortality burden. Here, we aim to estimate the absolute and relative mortality impact of COVID-19 pandemic in Mexico.

Methods

We obtained weekly mortality time series due to all causes for Mexico, and by gender, and geographic region from 2015 to 2020. We also compiled surveillance data on COVID-19 cases and deaths to assess the timing and intensity of the pandemic and assembled weekly series of the proportion of tweets about ‘death’ from Mexico to assess the correlation between people’s media interaction about ‘death’ and the rise in pandemic deaths. We estimated all-cause excess mortality rates and mortality rate ratio increase over baseline by fitting Serfling regression models and forecasted the total excess deaths for Mexico for the first 4 weeks of 2021 using the generalized logistic growth model.

Results

We estimated the all-cause excess mortality rate associated with the COVID-19 pandemic in Mexico in 2020 at 26.10 per 10,000 population, which corresponds to 333,538 excess deaths. Males had about 2-fold higher excess mortality rate (33.99) compared to females (18.53). Mexico City reported the highest excess death rate (63.54) and RR (2.09) compared to rest of the country (excess rate = 23.25, RR = 1.62). While COVID-19 deaths accounted for only 38.64% of total excess deaths in Mexico, our forecast estimate that Mexico has accumulated a total of ~ 61,610 [95% PI: 60,003, 63,216] excess deaths in the first 4 weeks of 2021. Proportion of tweets was significantly correlated with the excess mortality (ρ = 0.508 [95% CI: 0.245, 0.701], p-value = 0.0004).

Conclusion

The COVID-19 pandemic has heavily affected Mexico. The lab-confirmed COVID-19 deaths accounted for only 38.64% of total all cause excess deaths (333,538) in Mexico in 2020. This reflects either the effect of low testing rates in Mexico, or the surge in number of deaths due to other causes during the pandemic. A model-based forecast indicates that an average of 61,610 excess deaths have occurred in January 2021.
Mechanism and risk factors of nausea and vomiting after TACE: a retrospective analysis
Authors: Lu Haohao , Zheng Chuansheng , Liang Bin , Xiong Bin
Published: May 2021

Purpose

The mechanism of postoperative nausea and vomiting after TACE is not clear. This study retrospectively analyzed the patient data to explore the mechanism and risk factors of postoperative nausea and vomiting after TACE.

Materials and methods

The data of 221 patients who underwent TACE in the interventional department from January 2019 to December 2020 were collected. Including: gender, age, liver function before TACE, etiology of liver cirrhosis, BCLC stage of hepatocellular carcinoma, preoperative use of analgesic drugs, preoperative limosis, previous history of vomiting, history of kinetosis, smoking history, history of drinking, chemotherapeutic drugs used during TACE, Dosage of lipiodol, and occurrence of postoperative nausea and vomiting.

Results

There were 116 cases of nausea after TACE, using binary logistic regression analysis, Sig: ALT0.003; ALP0.000; history of vomiting 0.043; kinetosis 0.006; history of alcohol consumption 0.011; preoperative limosis 0.006; dosage of lipiodol (5–10 mL) 0.029, dosage of lipiodol (> 10 mL) 0.001.There were 89 cases of vomiting after TACE, all accompanied by nausea, Sig: ALP0.000; BCLC stage (B) 0.007; kinetosis 0.034; chemotherapeutic drugs 0.015; dosage of lipiodol (5–10 ml) 0.015, dosage of lipiodol (> 10 ml) 0.000; patients used analgesics before TACE 0.034.

Conclusions

Causes of post-TACE nausea and vomiting included operative trauma, aseptic inflammation caused by ischemia and hypoxia, chemotherapeutic drugs, ischemia of liver and bile duct, stress and pain during TACE, and patient factors. ALP, BCLC stage, kinetosis, chemotherapeutic drugs, dosage of lipiodol, and preoperative usage of analgesics were risk factors affecting nausea and vomiting after TACE.
Iranian children with overweight and obesity: an internet-based interventional study
Authors: Khatami Farnaz , Shariatpanahi Ghazal , Barahimi Hamid , Hashemi Rezvan , Khedmat Leila , Gheirati Mahta
Published: May 2021

Background

Obesity or overweight in children is an excessive accumulation of adipose tissue that can potentially regress health indicators and increase the likelihood of various diseases.

Objectives

This model was implemented to improve the nutritional status and lifestyle behavior of children aged 6–12 years with overweight/obesity.

Methods

A quasi-experimental design with 90 participants in each control and intervention group with a multistage cluster random sampling method after reviewing the literature, and their screening by experts were adopted.

Results

After 6 months there were significant differences in Body Mass Index and weight for age percentile values of children allocated in control and intervention groups after controlling for beginning values (p = 0.024, Partial eta2 = 0.028, 0.044, Partial eta2 = 0.023), respectively. Although there was an increased rate in BMI and weight for age percentile in both groups this increase in the control group after the 6th month significantly was more than that in the intervention group after the 6th months. A considerable difference in BMI of girls after the intervention was observed in the experimental group (p = 0.006, Partial eta2 = 0.092). However, our results showed that there was no significant difference in BMI of boys in the intervention and control groups before and 6 months after the intervention (p = 0.507).

Conclusions

We conclude that though the weight increase rate was lower in the experimental group, the implemented model alone was not enough.

Trial registration

Iranian Registry of Clinical Trials (IRCT):IRCT20200717048124N1at 05/08/2020, retrospectively registered.
Epidemiology of pediatric sepsis in the pediatric intensive care unit of king Abdulaziz Medical City, Jeddah, Saudi Arabia
Authors: Humoodi Mohamed O. , Aldabbagh Mona A. , Salem Maher M. , Al Talhi Yousef M. , Osman Sara M. , Bakhsh Mohammed , Alzahrani Abdullah M. , Azzam Maha
Published: May 2021

Background

Pediatric sepsis remains a significant cause of morbidity and mortality worldwide. This study aimed to identify the incidence of sepsis and septic shock among patients admitted to the pediatric intensive care unit (PICU) of a tertiary center in Saudi Arabia.  Patients' demographics and risk factors associated with sepsis-related mortality were also investigated.

Methods

A retrospective cohort study was conducted in the PICU of King Abdulaziz Medical City, Jeddah (KAMC-J). KAMC-J is a tertiary care hospital in the western region of Saudi Arabia. A total of 2389 patients admitted to the PICU of KAMC-J between January 1, 2013 and December 31, 2017 were screened and evaluated for sepsis using The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3).

Results

Of the 2389 total admissions to the PICU, 113 patients (4.9%) met the definition of Sepsis-3; 50.4% of the 113 patients met the definition of septic shock. Most patients (66.3%) were less than 6 years old, and 52.2% were male. Eight-five patients (75.2%) had underlying comorbidities. The respiratory system was the most common primary site of infection (57.5%). Bacterial and viral infections were the most common infectious etiology with reported rates of 29.2 and 21.2%, respectively. The median duration of PICU stay was 8 days and the 28-day PICU mortality rate was 23.9%. A Pediatric Sequential Organ Failure Assessment (pSOFA) Score greater than four and a pre-existing percutaneous central venous catheter were associated with a significant increase in mortality, with adjusted odds ratios of 3.6 (95% confidence interval: 1.30–9.93) and 9.27 (95% confidence interval: 1.28–67.29), respectively.

Conclusions

The incidence of sepsis in our institution is comparable to that reported internationally; however, the mortality rate is higher than that of developed countries. Nationwide studies identifying sepsis epidemiology are needed to improve the outcome of pediatric sepsis. Following international guidelines for central-line insertion and maintenance is of paramount importance.
Mediating effect of empowerment on the relationship between global function and personal recovery among community-dwelling patients with schizophrenia: a cross-sectional study
Authors: Lee Kuen Tai , Lee Shih Kai , Lu Mei Jou , Hsieh Wen Ling , Liu Wen I.
Published: May 2021

Background

Functional degradation among community-dwelling patients with schizophrenia can negatively influence their recovery. Given the importance of patient empowerment during recovery, this study examined the mediating effect of empowerment on the relationship between global function and personal recovery among community-dwelling patients with schizophrenia.

Methods

This cross-sectional study recruited community-dwelling patients with schizophrenia from northern and central Taiwan. Questionnaires with verified reliability and validity were provided and collected on site by trained nurses. Global function, empowerment, and personal recovery were measured using the Global Assessment of Functioning (developed by the American Psychiatric Association), Empowerment Scale, and Questionnaire on the Process of Recovery, respectively. The causal steps approach proposed by Baron and Kenny and the Sobel test were utilized to verify the mediation effect. The causal steps approach tested the four following pathways (regression coefficients): global function on empowerment (Path a), global function and empowerment as predictors of personal recovery (Path b), global function on personal recovery (Path c), and global function and empowerment on personal recovery (Path c’).

Results

A total of 373 participants completed the survey. After controlling for factors associated with recovery, Paths a (β = .24, p < .001), b (β = .68, p < .001), and c (β = .19, p < .001) were found to be significant; however, Path c’ was not significant (β = .03, p = .452). Empowerment was determined to exert “full mediation” over the effects of global function on personal recovery, and the Sobel test indicating significant mediation (Z = 3.61, p < .001).

Conclusions

Empowerment fully mediates the association between global function and personal recovery. This study suggested that offering empowerment-oriented care services may be more effective than global function improvement in recovery among these patients.
The use of Qualitative Comparative Analysis (QCA) to address causality in complex systems: a systematic review of research on public health interventions
Authors: Hanckel Benjamin , Petticrew Mark , Thomas James , Green Judith
Published: May 2021

Background

Qualitative Comparative Analysis (QCA) is a method for identifying the configurations of conditions that lead to specific outcomes. Given its potential for providing evidence of causality in complex systems, QCA is increasingly used in evaluative research to examine the uptake or impacts of public health interventions. We map this emerging field, assessing the strengths and weaknesses of QCA approaches identified in published studies, and identify implications for future research and reporting.

Methods

PubMed, Scopus and Web of Science were systematically searched for peer-reviewed studies published in English up to December 2019 that had used QCA methods to identify the conditions associated with the uptake and/or effectiveness of interventions for public health. Data relating to the interventions studied (settings/level of intervention/populations), methods (type of QCA, case level, source of data, other methods used) and reported strengths and weaknesses of QCA were extracted and synthesised narratively.

Results

The search identified 1384 papers, of which 27 (describing 26 studies) met the inclusion criteria. Interventions evaluated ranged across: nutrition/obesity (n = 8); physical activity (n = 4); health inequalities (n = 3); mental health (n = 2); community engagement (n = 3); chronic condition management (n = 3); vaccine adoption or implementation (n = 2); programme implementation (n = 3); breastfeeding (n = 2), and general population health (n = 1). The majority of studies (n = 24) were of interventions solely or predominantly in high income countries. Key strengths reported were that QCA provides a method for addressing causal complexity; and that it provides a systematic approach for understanding the mechanisms at work in implementation across contexts. Weaknesses reported related to data availability limitations, especially on ineffective interventions. The majority of papers demonstrated good knowledge of cases, and justification of case selection, but other criteria of methodological quality were less comprehensively met.

Conclusion

QCA is a promising approach for addressing the role of context in complex interventions, and for identifying causal configurations of conditions that predict implementation and/or outcomes when there is sufficiently detailed understanding of a series of comparable cases. As the use of QCA in evaluative health research increases, there may be a need to develop advice for public health researchers and journals on minimum criteria for quality and reporting.