bluuebunny/crossref_metadata_2025 huggingface dataset:
School Nurses on the Front Lines of Healthcare: Recognizing the Signs and Putting the “BRAKES” on the Commercial Sexual Exploitation of Children
Authors: Lucas Christy , Lind Marita , Olympia Robert P.
Published: June 2020

Through a presented case scenario, this article describes the assessment and management of the commercial sexual exploitation of children (CSEC), which includes sex trafficking, as relevant for the school nurse. CSEC is a major public health problem globally, nationally, and locally, even infiltrating school hallways. School nurses may be the last point of possible intervention for potential or actual victims of CSEC, therefore, it is vital for a school nurse to be able to recognize, report, and assist with advocacy and prevention efforts in the school community to put the brakes on the exploitation of children.
Applications of business intelligence and marketing analytics in the complementary and alternative medicine industry
Authors: Kanchanapoom Kessara , Chongwatpol Jongsawas
Published: June 2020

This case is designed to illustrate the application of business intelligence and marketing analytics to making proper decisions in a competitor-oriented pricing environment. The case started when Dan, the director of a business analytics consulting firm, was assigned a big project: to help Panacée Medical Center, one of the leading service providers in complementary and alternative medicine industry, envisage possible marketing strategies in response to competitors’ recent moves that threatened the sales and marketing strategies of its business. The case is divided into three parts. Case A provided an overview of challenges Panacée was facing when one of its competitors, Beauty and Clinic, was about to offer full complementary and alternative medicine services with a newly renovated, 5-star, resort-type clinic and high-quality facilities and another competitor, Natural Health Center, planned to promote its recent investment in a new laboratory that met international standards at the upcoming Thailand Health & Wellness Expo. Case B focused on insights into customers through different analytical techniques. Case C implicitly outlined possible strategies that might be applicable to Panacée, especially when the services from both Beauty and Clinic and Natural Health Center were expected to be priced 5% to 25% below the established market price. Dan needed to decide which direction he needed to propose to Panacée’s top management, as the combination of low prices and premium services threatened the medical center and Panacée might lose as much as 30% of its forecast revenue next year.
Thromboangiitis obliterans: Aggressive angioplasty provides a potential solution (randomized pilot study)
Authors: Soliman Mosaad , Mowafy Khaled , Elsaadany NA , Soliman Reem , Elmetwally Ahmed
Published: June 2020

Background:

Thromboangiitis obliterans is an inflammatory disease affecting both medium- and small-sized vessels. Vasodilators, antiplatelets were proposed for treatment but the effect was minimal.

Objective:

This study was conducted to investigate the effect of balloon angioplasty on patients with Buerger’s disease compared to medical treatment.

Methods:

Between January 2006 and December 2016, 82 patients with Buerger’s disease were enrolled in the study, of whom 52 were randomized to the aggressive endovascular intervention and 30 were randomized medically by cilostazol and aspirin as a control group. In all, 23% of the patients presented with severe claudication, 50% with ischemic rest pain and 27% with ischemic ulcers. Randomization was done using the opaque envelope method. Allocation concealment was maintained to ensure no selection bias. Patient groups were compared for the duration of ulcer healing, ankle–brachial index, peak systolic velocity changes and transcutaneous oximetry (TcPO2) level for 30 months.

Results:

No major procedural complications occurred in the endovascular group. Angiographic success was achieved in 100% of supragenicular lesions but in 90% of infrapopliteal lesions. The endovascular group showed a statistically significant improvement in the ulcer healing size and duration at 6 months after the procedure with a mean time of 3 ± 0.9 months compared to 5.8 ± 1.69 months for the medical treatment group (p < 0.001), the mean TcPO2 from 27.23 ± 16.75 mm Hg (range: 0–56 mm Hg) before the procedure to 71.32 ± 12.94 mm Hg (range: 52–92 mm Hg) following revascularization (p < 0.01). The mean ankle–brachial index significantly improved from 0.54 ± 0.14 preoperatively to 0.82 ± 0.08 at final follow-up (p < 0.01).

Conclusion:

The endovascular therapy should be considered as an effective, safe, minimally invasive method in the light of the promising results after a modification of the standard technique.
Point of technique: Limited anterior scrotectomy and scrotoplasty for multiple epidermoid cysts of the scrotum
Authors: Deverill Sally J , Menzies-Wilson Richard , Rees Rowland W
Published: June 2020

Multiple scrotal epidermoid cysts present a difficult challenge. Individual cyst excision for multiple cysts is painstaking, and there is a high risk of recurrence. If treated conservatively, multiple cysts may cause pain, become infected or cause problems with self-esteem due to the cosmetic appearance. We present a technique for excision of the anterior scrotal wall as a treatment for multiple scrotal epidermoid cysts.

Level of evidence: Not applicable.
Networks, Politics, and the Literary Public Sphere: The Foundation of Modern Democracy in Taiwan (1970s–1990s)
Authors: Au Anson
Published: June 2020

This article examines how literature is a networked social space of political repression and resistance, refracting broader contestations over national sovereignty, self-determination, and identity. Politicizing the traditionally apolitical “world of letters” in Habermas’s Structural Transformation of the Public Sphere, this article employs a novel analysis of the influence that the literary public sphere wields over political consciousness. Using the historical case of Taiwan’s literary networks from the 1970s to the 1990s, this article asserts that the literary public sphere produces a rational-critical generalization of knowledge and exposure to dissonant perspectives that invigorates civil society by creating intelligentsia. Through intelligentsia, ideas within the Taiwanese literary public sphere birthed powerful Dangwai parties that instituted democracy, informed their platforms, and ushered in a new wave of political elites. The Taiwanese case demonstrates how civic tasks can predict political tasks with enough force to stimulate a unique postcolonial political consciousness and spark a revolution.
The Impact of Corporate Governance and Sustainability Reporting on Integrated Reporting: A Conceptual Framework
Authors: Hamad Salaheldin , Draz Muhammad Umar , Lai Fong-Woon
Published: June 2020

Integrated Reporting (IR) is a relatively new concept that is considered one of the most recent trends in corporate reporting; it is still an emerging research area in different parts of the world. Malaysia is an appropriate emerging economy to investigate IR adoption. Large Malaysian public listed companies (PLCs) are encouraged by the Malaysian Code on Corporate Governance (MCCG) of 2017 to adopt IR based on the international IR framework. By combining the stakeholder theory and the agency theory, this article proposes a conceptual framework to explore the moderating effect of sustainability reporting on the relationship between corporate governance mechanisms and IR disclosure level for the Malaysian PLCs. To obtain the data related to IR and the other variables, the study suggests using a content analysis method on the annual reports of the top 100 Malaysian PLCs based on their market capitalization. The proposed conceptual framework could be very useful; it can assist PLCs having sustainability practices to adopt the IR framework, reduce information asymmetries, increase information transparency, and create value. This study contributes to the literature by investigating the IR practices and their determinants in Malaysia after the introduction of MCCG 2017.
Addiction or Transgression? Moral Incongruence and Self-Reported Problematic Pornography Use in a Nationally Representative Sample
Authors: Grubbs Joshua B. , Lee Brinna N. , Hoagland K. Camille , Kraus Shane W. , Perry Samuel L.
Published: June 2020

In the United States, pornography use is common, and it is increasingly a clinical concern under some circumstances. Excessive pornography use may qualify for the new diagnosis of compulsive sexual behavior disorder (CSBD) in the forthcoming 11th version of the International Classification of Diseases. There is also evidence, however, that moral incongruence (i.e., a misalignment of moral beliefs about sexual behavior and actual sexual behavior) may inflate self-reports of problems associated with pornography use. Prior work suggests religiousness may drive such moral incongruence. Using a large sample matched to U.S. representative norms (total: N = 2,519; past-year pornography users: n = 1,424, 66.4% men), we examined the interaction between pornography use and religiousness in predicting self-reported addiction to pornography. Results indicated that religiousness moderated the association between pornography use and self-reported addiction so that, despite a negative association between religiousness and use, at higher levels of religiousness, pornography use was more strongly related to self-reports of addiction.
The fifth cranial nerve in headaches
Authors: Edvinsson J. C. A. , Viganò A. , Alekseeva A. , Alieva E. , Arruda R. , De Luca C. , D’Ettore N. , Frattale I. , Kurnukhina M. , Macerola N. , Malenkova E. , Maiorova M. , Novikova A. , Řehulka P. , Rapaccini V. , Roshchina O. , Vanderschueren G. , Zvaune L. , Andreou A. P. , Haanes K. A. ,   On behalf of the European Headache Federation School of Advanced Studies (EHF-SAS)
Published: June 2020

The fifth cranial nerve is the common denominator for many headaches and facial pain pathologies currently known. Projecting from the trigeminal ganglion, in a bipolar manner, it connects to the brainstem and supplies various parts of the head and face with sensory innervation. In this review, we describe the neuroanatomical structures and pathways implicated in the sensation of the trigeminal system. Furthermore, we present the current understanding of several primary headaches, painful neuropathies and their pharmacological treatments. We hope that this overview can elucidate the complex field of headache pathologies, and their link to the trigeminal nerve, to a broader field of young scientists.
PS4DR: a multimodal workflow for identification and prioritization of drugs based on pathway signatures
Authors: Emon Mohammad Asif , Domingo-Fernández Daniel , Hoyt Charles Tapley , Hofmann-Apitius Martin
Published: June 2020

Background

During the last decade, there has been a surge towards computational drug repositioning owing to constantly increasing -omics data in the biomedical research field. While numerous existing methods focus on the integration of heterogeneous data to propose candidate drugs, it is still challenging to substantiate their results with mechanistic insights of these candidate drugs. Therefore, there is a need for more innovative and efficient methods which can enable better integration of data and knowledge for drug repositioning.

Results

Here, we present a customizable workflow (PS4DR) which not only integrates high-throughput data such as genome-wide association study (GWAS) data and gene expression signatures from disease and drug perturbations but also takes pathway knowledge into consideration to predict drug candidates for repositioning. We have collected and integrated publicly available GWAS data and gene expression signatures for several diseases and hundreds of FDA-approved drugs or those under clinical trial in this study. Additionally, different pathway databases were used for mechanistic knowledge integration in the workflow. Using this systematic consolidation of data and knowledge, the workflow computes pathway signatures that assist in the prediction of new indications for approved and investigational drugs.

Conclusion

We showcase PS4DR with applications demonstrating how this tool can be used for repositioning and identifying new drugs as well as proposing drugs that can simulate disease dysregulations. We were able to validate our workflow by demonstrating its capability to predict FDA-approved drugs for their known indications for several diseases. Further, PS4DR returned many potential drug candidates for repositioning that were backed up by epidemiological evidence extracted from scientific literature. Source code is freely available at https://github.com/ps4dr/ps4dr.
Skin transcriptome reveals the periodic changes in genes underlying cashmere (ground hair) follicle transition in cashmere goats
Authors: Yang Feng , Liu Zhihong , Zhao Meng , Mu Qing , Che Tianyu , Xie Yuchun , Ma Lina , Mi Lu , Li Jinquan , Zhao Yanhong
Published: June 2020

Background

Cashmere goats make an outstanding contribution to the livestock textile industry and their cashmere is famous for its slenderness and softness and has been extensively studied. However, there are few reports on the molecular regulatory mechanisms of the secondary hair follicle growth cycle in cashmere goats. In order to explore the regular transition through the follicle cycle and the role of key genes in this cycle, we used a transcriptome sequencing technique to sequence the skin of Inner Mongolian cashmere goats during different months. We analyzed the variation and difference in genes throughout the whole hair follicle cycle. We then verified the regulatory mechanism of the cashmere goat secondary hair follicle growth cycle using fluorescence quantitative PCR.

Results

The growth cycle of cashmere hair could be divided into three distinct periods: a growth period (March–September), a regression period (September–December), and a resting period (December–March). The results of differential gene analyses showed that March was the most significant month. Cluster analysis of gene expression throughout the whole growth cycle further supported the key nodes of the three periods of cashmere growth, and the differential gene expression of keratin corresponding to the ground haircashmere growth cycle further supported the results from tissue slices. Quantitative fluorescence analysis showed that KAP3–1, KRTAP 8–1, and KRTAP 24–1 genes had close positive correlation with the cashmere growth cycle, and their regulation was consistent with the growth cycle of cashmere.

Conclusion

The growth cycle of cashmere cashmere could be divided into three distinct periods: a growth period (March–September), a regression period (September–December) and a resting period (December–March). March was considered to be the beginning of the cycle. KAP and KRTAP showed close positive correlation with the growth cycle of secondary hair follicle cashmere growth, and their regulation was consistent with the cashmere growth cycle. But hair follicle development-related genes are expressed earlier than cashmere growth, indicating that cycle regulation could alter the temporal growth of cashmere. This study laid a theoretical foundation for the study of the cashmere development cycle and provided evidence for key genes during transition through the cashmere cycle. Our study provides a theoretical basis for cashmere goat breeding.
Source-sink modifications affect leaf senescence and grain mass in wheat as revealed by proteomic analysis
Authors: Lv Xuemei , Zhang Yan , Zhang Yunxiu , Fan Shoujin , Kong Lingan
Published: June 2020

Background

The grain yield of cereals is determined by the synergistic interaction between source activity and sink capacity. However, source-sink interactions are far from being fully understood. Therefore, a field experiment was performed in wheat to investigate the responses of flag leaves and grains to sink/source manipulations.

Results

Half-degraining delayed but partial defoliation enhanced leaf senescence. Sink/source manipulations influenced the content of reactive oxygen species in the flag leaf and the concentration of phytohormones, including cytokinins, indoleacetic 3-acid and jasmonic acid, in the flag leaves (LDef) and grains (GDef) in defoliated plants and flag leaves (LDG) and grain (GDG) in de-grained plants. Isobaric tag for relative and absolute quantitation (iTRAQ)-based quantitative proteomic analysis indicated that at 16 days after manipulation, a total of 97 and 59 differentially expressed proteins (DEPs) from various functional categories were observed in the LDG and LDef groups, respectively, compared with the control, and 115 and 121 DEPs were observed in the GDG and GDef groups, respectively. The gene ontology annotation terms of the DEPs mainly included carbon fixation, hydrogen peroxide catabolic process, chloroplast and cytoplasm, oxidoreductase activity and glutamate synthase activity in the flag leaves of manipulated plants and organonitrogen compound metabolic process, cytoplasm, vacuolar membrane, CoA carboxylase activity, starch synthase activity and nutrient reservoir activity in the grains of manipulated plants. KEGG pathway enrichment analysis revealed that photosynthesis, carbon, nitrogen and pyruvate metabolism and glycolysis/gluconeogenesis were the processes most affected by sink/source manipulations. Sink/source manipulations affected the activities of amylase and proteinases and, ultimately, changed the mass per grain.

Conclusions

Manipulations to change the sink/source ratio affect hormone levels; hydrolytic enzyme activities; metabolism of carbon, nitrogen and other main compounds; stress resistance; and leaf senescence and thus influence grain mass.
Bayesian alternatives to null hypothesis significance testing in biomedical research: a non-technical introduction to Bayesian inference with JASP
Authors: Kelter Riko
Published: June 2020

Background

Although null hypothesis significance testing (NHST) is the agreed gold standard in medical decision making and the most widespread inferential framework used in medical research, it has several drawbacks. Bayesian methods can complement or even replace frequentist NHST, but these methods have been underutilised mainly due to a lack of easy-to-use software. JASP is an open-source software for common operating systems, which has recently been developed to make Bayesian inference more accessible to researchers, including the most common tests, an intuitive graphical user interface and publication-ready output plots. This article provides a non-technical introduction to Bayesian hypothesis testing in JASP by comparing traditional tests and statistical methods with their Bayesian counterparts.

Results

The comparison shows the strengths and limitations of JASP for frequentist NHST and Bayesian inference. Specifically, Bayesian hypothesis testing via Bayes factors can complement and even replace NHST in most situations in JASP. While p-values can only reject the null hypothesis, the Bayes factor can state evidence for both the null and the alternative hypothesis, making confirmation of hypotheses possible. Also, effect sizes can be precisely estimated in the Bayesian paradigm via JASP.

Conclusions

Bayesian inference has not been widely used by now due to the dearth of accessible software. Medical decision making can be complemented by Bayesian hypothesis testing in JASP, providing richer information than single p-values and thus strengthening the credibility of an analysis. Through an easy point-and-click interface researchers used to other graphical statistical packages like SPSS can seemlessly transition to JASP and benefit from the listed advantages with only few limitations.
Portal hypertension as a result of the incomplete surgically treated advanced alveolar echinococcosis: a case description
Authors: Pielok Ł. , Karczewski M. , Cierach W. , Zmora P. , Lenartowicz E. , Stefaniak J.
Published: June 2020

Background

Infection of Echinococcus multilocularis causes in humans the alveolar echinococcosis. Although the infection has world-wide distribution it is rarely detected. Diagnosis of alveococcosis is difficult because of not typical clinical picture and irregular results of radiological examinations suggesting neoplasmatic process which begins in the liver tissue or in the biliary tracts. The parasitic growth is slow, so the illness is quite often established in late invasion period. Treatment of long-lasting and late diagnosed infection is difficult and requires cooperation of parasitologists together with surgeons to avoid life-threatening organ dysfunction.

Case presentation

We describe a young male patient, diagnosed, according to the radiological, immunological and histological examination results, infection of Echinococcus multilocularis, who was treated with not radical resection of pathologic mass together with persistent albendazole intake. The right hepatectomy was performed. In addition, visible cysts were removed from the left lobe of the liver in nonanatomical resection and suspicious calcified lesions in hepatoduodenal ligament were also removed. After the operation portal hypertension, with splenomegaly and symptoms of the liver cirrhosis occurred (thrombocytopenia, collateral venous circulation, first degree varices oesophagii). The portal hypertension probably could be a result of incomplete surgery due to extended parasitic infection and liver anathomical changes due to performed procedures, because the portal hypertension and it’s further complications had not been observed before the operation.

Conclusions

Echinococcus multilocularis should be taken under consideration in differential diagnosis of irregular lesions within the liver. Lon-lasting invasion could be responsible for the irreversible secondary liver changes such as cirrhosis and portal hypertension. The surgery treatment (treatment of choice) is difficult and it’s results depends on the invasion period the patient is operated on. After the surgery the patient requires careful follow – up, to detect early complications.
A comprehensive assessment for community-based, person-centered care for older adults
Authors: Aronoff-Spencer Eliah , Asgari Padideh , Finlayson Tracy L. , Gavin Joseph , Forstey Melinda , Norman Gregory J. , Pierce Ian , Ochoa Carlos , Downey Paul , Becerra Karen , Agha Zia
Published: June 2020

Background

Many health and social needs can be assessed and met in community settings, where lower-cost, person-centered, preventative and proactive services predominate. This study reports on the development and implementation of a person-centered care model integrating dental, social, and health services for low-income older adults at a community dental clinic co-located within a senior wellness center.

Methods

A digital comprehensive geriatric assessment (CGA) and referral system linking medical, dental, and psychosocial needs by real-time CGA-derived metrics for 996 older adults (age ≥ 60) was implemented in 2016–2018 as part of a continuous quality improvement project. This study aims to describe: 1) the development and content of a new CGA; 2) CGA implementation, workflows, triage, referrals; 3) correlations between CGA domains, and adjusted regression models, assessing associations with self-reported recent hospitalizations, emergency department (ED) visits, and clinically-assessed dental urgency.

Results

The multidisciplinary team from the senior wellness and dental centers planned and implemented a CGA that included standard medical history along with validated instruments for functional status, mental health and social determinants, and added oral health. Care navigators employed the CGA with 996 older adults, and made 1139 referrals (dental = 797, care coordination = 163, social work = 90, mental health = 32). CGA dimensions correlated between oral health, medical status, depressive symptoms, isolation, and reduced quality of life (QoL). Pain, medical symptoms, isolation and depressive symptoms were associated with poorer self-reported health, while general health was most strongly correlated with lower depressive symptoms, and higher functional status and QoL. Isolation was the strongest correlate of lower QoL.

Adjusted odds ratios identified social and medical factors associated with recent hospitalization and ED visits. General and oral health were associated with dental urgency. Dental urgency was most strongly associated with general health (AOR = 1.78,95%CI [1.31, 2.43]), dental symptoms (AOR = 2.39,95%CI [1.78, 3.20]), dental pain (AOR = 2.06,95%CI [1.55–2.74]), and difficulty chewing (AOR = 2.80, 95%CI [2.09–3.76]). Dental symptoms were associated with recent ED visits (AOR = 1.61, 95%CI [1.12–2.30]) or hospitalizations (AOR = 1.47, 95%CI [1.04–2.10]).

Conclusion

Community-based inter-professional care is feasible with CGAs that include medical, dental, and social factors. A person-centered care model requires coordination supported by new workflows. Real-time metrics-based triage process provided efficient means for client review and a robust process to surface needs in complex cases.
Measles outbreak amplified in a pediatric ward: Lyantonde District, Uganda, August 2017
Authors: Biribawa Claire , Atuhairwe Joselyn Annet , Bulage Lilian , Okethwangu Denis Othuba , Kwesiga Benon , Ario Alex Riolexus , Zhu Bao-Ping
Published: June 2020

Background

Measles is a highly infectious viral disease. In August 2017, Lyantonde District, Uganda reported a measles outbreak to Uganda Ministry of Health. We investigated the outbreak to assess the scope, factors facilitating transmission, and recommend control measures.

Methods

We defined a probable case as sudden onset of fever and generalized rash in a resident of Lyantonde, Lwengo, or Rakai Districts from 1 June-30 September 2017, plus ≥1 of the following: coryza, conjunctivitis, or cough. A confirmed case was a probable case with serum positivity of measles-specific IgM. We conducted a neighborhood- and age-matched case-control study to identified exposure factors, and used conditional logistic regression to analyze the data. We estimated vaccine effectiveness and vaccination coverage.

Results

We identified 81 cases (75 probable, 6 confirmed); 4 patients (4.9%) died. In the case-control study, 47% of case-patients and 2.3% of controls were hospitalized at Lyantonde Hospital pediatric department for non-measles conditions 7–21 days before case-patient’s onset (ORadj = 34, 95%CI: 5.1–225). Estimated vaccine effectiveness was 95% (95%CI: 75–99%) and vaccination coverage was 76% (95%CI: 68–82%). During the outbreak, an “isolation” ward was established inside the general pediatric ward where there was mixing of both measles and non-measles patients.

Conclusions

This outbreak was amplified by nosocomial transmission and facilitated by low vaccination coverage. We recommended moving the isolation ward outside of the building, supplemental vaccination, and vaccinating pediatric patients during measles outbreaks.
Identification of a novel WAS mutation in a South African patient presenting with atypical Wiskott-Aldrich syndrome: a case report
Authors: Glanzmann Brigitte , Möller Marlo , Schoeman Mardelle , Urban Michael , van Helden Paul D. , Frigati Lisa , Grewal Ravnit , Pieters Hermanus , Loos Ben , Hoal Eileen G. , Glashoff Richard H. , Cornelissen Helena , Rabie Helena , Esser Monika M. , Kinnear Craig J.
Published: June 2020

Background

The X-linked recessive primary immunodeficiency disease (PIDD) Wiskott-Aldrich syndrome (WAS) is identified by an extreme susceptibility to infections, eczema and thrombocytopenia with microplatelets. The syndrome, the result of mutations in theWASgene which encodes the Wiskott-Aldrich protein (WASp), has wide clinical phenotype variation, ranging from classical WAS to X-linked thrombocytopaenia and X-linked neutropaenia. In many cases, the diagnosis of WAS in first affected males is delayed, because patients may not present with the classic signs and symptoms, which may intersect with other thrombocytopenia causes.

Case presentation

Here, we describe a three-year-old HIV negative boy presenting with recurrent infections, skin rashes, features of autoimmunity and atopy. However, platelets were initially reported as normal in numbers and morphology as were baseline immune investigations. An older male sibling had died in infancy from suspected immunodeficiency. Uncertainty of diagnosis and suspected severe PIDD prompted urgent further molecular investigation. Whole exome sequencing identifiedc. 397 G > Aas a novel hemizygous missense mutation located in exon 4 ofWAS.

Conclusion

With definitive molecular diagnosis, we could target treatment and offer genetic counselling and prenatal diagnostic testing to the family. The identification of novel variants is important to confirm phenotype variations of a syndrome.
Adenocarcinomatous-predominant subtype associated with a better prognosis in adenosquamous lung carcinoma
Authors: Liu Yangli , Zhu Ying , Bai Lihong , Chen Fengjia , Wang Jue , Guo Yubiao
Published: June 2020

Background

According to the proportion of glandular and squamous pathological components, adenosquamous carcinoma (ASC) could be divided into adenocarcinoma (AC) and squamous cell carcinoma (SCC) predominant subtypes. Due to its rarity, no study investigating the impact of different subtypes on the clinical features, radiologic findings and prognosis characteristics of ASC has been reported.

Methods

Sixty eight patients who underwent surgical resection for lung adenosquamous carcinoma in our institute between January 2006 and March 2017 were retrospectively reviewed. Data regarding the clinical features, radiologic findings and prognosis characteristics were collected.

Results

Thirty nine patients of the study cohort were with AC-predominant ASC and 29 with SCC-predominant ASC. There was no significant difference between the two subgroups in age, gender, smoking history, serum carcinoembryonic antigen (CEA) level and T,N classification. Air bronchogram was found more frequently in AC-predominant ASC than in SCC-predominant ASC (P = 0.046). Multivariate analysis identified pathological subtype (P = 0.022) and CT findings of peripheral location (P = 0.009) to be independent prognostic factors.

Conclusions

AC-predominant ASC were more commonly presented with air bronchogram, and were with a better prognosis than SCC-predominant ASC.
The patient-level effect of the cost of Cancer care – financial burden in German Cancer patients
Authors: Mehlis Katja , Witte Julian , Surmann Bastian , Kudlich Matthias , Apostolidis Leonidas , Walther Jürgen , Jäger Dirk , Greiner Wolfgang , Winkler Eva C.
Published: June 2020

Background

Financial toxicity of cancer has so far been discussed primarily in the US health care system and is associated with higher morbidity and mortality. In European health care systems, the socio-economic impact of cancer is poorly understood. This study investigates the financial burden and patient-reported outcomes of neuroendocrine (NET) or colorectal (CRC) cancer patients at a German Comprehensive Cancer Center.

Methods

This prospective cross-sectional study surveyed 247 advanced stage patients (n = 122 NET/n = 125 CRC) at the National Center for Tumor Diseases, in Germany about cancer-related out-of-pocket costs, income loss, distress, and quality of life. Multiple linear regression analysis was performed to demonstrate the effects of economic deterioration on patients’ quality of life and distress.

Results

81% (n = 199) of the patients reported out-of-pocket costs, and 37% (n = 92) income loss as a consequence of their disease. While monthly out-of-pocket costs did not exceed 200€ in 77% of affected patients, 24% of those with income losses reported losing more than 1.200€ per month. High financial loss relative to income was significantly associated with patients’ reporting a worse quality of life (p < .05) and more distress (p < .05).

Conclusions

Financial toxicity in third-party payer health care systems like Germany is caused rather by income loss than by co-payments. Distress and reduced quality of life due to financial problems seem to amplify the burden that already results from a cancer diagnosis and treatment. If confirmed at a broader scale, there is a need for targeted support measures at the individual and system level.
Clozapine rechallenge and initiation despite neutropenia- a practical, step-by-step guide
Authors: Silva Edward , Higgins Melanie , Hammer Barbara , Stephenson Paul
Published: June 2020

Clozapine remains the only drug treatment likely to benefit patients with treatment resistant schizophrenia. Its use is complicated by an increased risk of neutropenia and so there are stringent monitoring requirements and restrictions in those with previous neutropenia from any cause or from clozapine in particular. Despite these difficulties clozapine may yet be used following neutropenia, albeit with caution. Having had involvement with 14 cases of clozapine use in these circumstances we set out our approach to the assessment of risks and benefits, risk mitigation and monitoring with a practical guide.
Test-retest reliability of the computer-assisted DIA-X-5 interview for mental disorders
Authors: Hoyer Jana , Voss Catharina , Strehle Jens , Venz John , Pieper Lars , Wittchen Hans-Ulrich , Ehrlich Stefan , Beesdo-Baum Katja
Published: June 2020

Background

There is a need of comprehensive standardized diagnostic assessment tools of psychopathology that match recent changes in diagnostic classification systems, such as the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Therefore, the computer-assisted DIA-X-5 was developed and its test-retest reliability was explored. The DIA-X-5 is based on the DIA-X/M-CIDI (Diagnostisches Expertensystem für psychische Störungen/Munich-Composite International Diagnostic Interview) which referred to the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV).

Methods

A convenience sample (N = 60, age: 15–67) was interviewed twice with the computer-assisted DIA-X-5 interview, on average nine days apart, by trained and blinded interviewers. The DIA-X-5 is a standardized instrument for research purposes covering symptoms, syndromes and diagnoses from eleven classes of mental disorders according to the DSM-5 with matching F codes of the 10th edition of the International Classification of Diseases (ICD-10).

Results

Kappa values ranged from 0.90 for post-traumatic stress disorder to 0.30 for social anxiety disorder. For age of onset and age of recency, test-retest reliability as measured by intra-class correlation was satisfying with values above 0.90 for most disorders.

Conclusions

Test-retest reliability of the DIA-X-5 syndromes and diagnoses were comparable to those of previous DSM-IV/DIA-X diagnoses for most disorders. Due to low case numbers for some diagnoses, further research in larger samples is required.
A meta-analysis of depressive symptoms among Ethiopian prisoners and a narrative description of its associated factors: a country based systematic review and meta-analysis study
Authors: Necho Mogesie , Belete Asmare , Tsehay Mekonnen , Zenebe Yosef
Published: June 2020

Background

The burden of depression in prisoners is increasing and factors such as co-existence of medical illness, lack of social support and longer duration of sentences are contributing to it. However, no pooled evidence on the magnitude and factors of depression in prisoners existed in Ethiopia. The current meta-analysis was therefore aimed to have aggregate evidence on the magnitude and factors of depression in prisoners of Ethiopia.

Methods

A search of databases on PubMed, Scopus, and EMBASE was carried out systematically. Besides, grey literature sources were extensively investigated. Moreover, the reference lists of the articles selected were searched. Random effects and quality-effects models were used to describe the pooled prevalence of depressive symptoms with 95% CI. We also detect heterogeneity between studies using Cochran’s Q- statistic and the Higgs I2 test. A sensitivity analysis was also implemented. Publication bias was checked with Egger’s test and funnel plots visually.

Results

Among 232 papers identified through the specified database searches only 17 full-text articles were assessed for eligibility and only nine (9) studies fulfilled the prespecified criteria and incorporated in the final meta-analysis. The pooled prevalence of Depressive symptoms among prisoners was 53.40%(95% CI: 41.33, 65.46). The pooled prevalence of Depressive symptoms in prisoners was 41.9% in Southwest Ethiopia, 44.43% in North West of Ethiopia, 59.05% in Addis Ababa, and 72.7% Southern Ethiopia. Besides, the pooled Depression symptoms prevalence among prisoners was 51.24% as measured with PHQ-9 and 56.15% with BDI-II. Besides, studies that utilized a relatively large sample size (≥350) yields a smaller pooled prevalence of Depression symptoms, 51.93% than those which utilized smaller sample sizes (< 350); 54.13%.

Conclusion

The pooled magnitude of depression in prisoner’s population is very high, 53.40%. This pooled effect size for the Depression symptoms was significantly higher in the southern region of the country than in the southwest region. Besides, the pooled prevalence was significantly higher as measured by the BDI-II tool than by PHQ-9. Also, studies that utilized a larger sample size provided a significantly lower pooled magnitude of symptoms of depression than studies that utilized a smaller sample size.
Case report: cognitive performance in an extreme case of anorexia nervosa with a body mass index of 7.7
Authors: Hemmingsen Simone Daugaard , Lichtenstein Mia Beck , Hussain Alia Arif , Sjögren Jan Magnus , Støving René Klinkby
Published: June 2020

Background

Studies show that adult patients with anorexia nervosa display cognitive impairments. These impairments may be caused by illness-related circumstances such as low weight. However, the question is whether there is a cognitive adaptation to enduring undernutrition in anorexia nervosa. To our knowledge, cognitive performance has not been assessed previously in a patient with anorexia nervosa with a body mass index as low as 7.7 kg/m2.

Case presentation

We present the cognitive profile of a 35-year-old woman with severe and enduring anorexia nervosa who was diagnosed at the age of 10 years. She was assessed with a broad neuropsychological test battery three times during a year. Her body mass index was 8.4, 9.3, and 7.7 kg/m2, respectively. Her general memory performance was above the normal range and she performed well on verbal and design fluency tasks. Her working memory and processing speed were within the normal range. However, her results on cognitive flexibility tasks (set-shifting) were below the normal range.

Conclusions

The case study suggests that it is possible to perform normally cognitively despite extreme and chronic malnutrition though set-shifting ability may be affected. This opens for discussion whether patients with anorexia nervosa can maintain neuropsychological performance in spite of extreme underweight and starvation.

Trial registration

ClinicalTrials.gov, NCT02502617. Registered 20 July 2015.
Accumulated unhealthy behaviors and psychosocial problems in adolescence are associated with labor market exclusion in early adulthood – a northern Finland birth cohort 1986 study
Authors: Heikkala Eveliina , Ala-Mursula Leena , Taimela Simo , Paananen Markus , Vaaramo Eeva , Auvinen Juha , Karppinen Jaro
Published: June 2020

Background

The relevance of health-related behaviors to exclusion from the labor market in early adulthood remains poorly studied in relation to the magnitude of the problem. We explored whether adolescents’ accumulated unhealthy behaviors and psychosocial problems are associated with later labor market exclusion, and whether multisite musculoskeletal pain (MMSP) impacts these relations.

Methods

We gathered questionnaire data on unhealthy behaviors and psychosocial problems and MMSP among adolescents aged 15 to 16 belonging to the Northern Finland Birth Cohort 1986. The findings were combined with registry data on unemployment, employment and permanent work disability during a five-year follow-up between the ages of 25 and 29 (n = 6692). In the statistical modeling we used education, family leave and socioeconomic status of childhood family as potential confounders, as well as latent class and logistic regression analyses.

Results

The Externalizing behavior cluster associated with over one year of unemployment (RR 1.64, CI 1.25–2.14) and permanent work disability (OR 2.49, CI 1.07–5.78) in the follow-up among the men. The Sedentary cluster also associated with over one year (RR 1.41, CI 1.13–1.75) and under one year of unemployment (RR 1.25, CI 1.02–1.52) and no employment days (RR 1.93, CI 1.26–2.95) among the men. Obese male participants were at risk of over one year of unemployment (RR 1.50, CI 1.08–2.09) and no employment days (RR 1.93, CI 1.07–3.50). Among the women, the Multiple risk behavior cluster related significantly to over one year of unemployment (RR 1.77, CI 1.37–2.28). MMSP had no influence on the associations.

Conclusions

Unhealthy behavior patterns and psychosocial problems in adolescence have long-term consequences for exclusion from the labor market in early adulthood, especially among men. Simultaneously supporting psychological well-being and healthy behaviors in adolescence may reduce labor market inclusion difficulties in the early phase of working life.
Community-based door to door census of suspected people living with epilepsy: empowering community drug distributors to improve the provision of care to rural communities in Cameroon
Authors: Kamgno Joseph , Tchatchueng-Mbougua Jules B. , Nana-Djeunga Hugues C. , Esso Lynda , Zouré Honorat G. , Mackenzie Charles D. , Boussinesq Michel
Published: June 2020

Background

Epilepsy is a severe neurological disorder with huge psychological, social, and economic consequences, including premature deaths and loss of productivity. Sub-Saharan Africa carries the highest burden of epilepsy. The management of epilepsy in Cameroon remains unsatisfactory due to poor identification of cases and a limited knowledge of the distribution of the disease. The objective of this study was to determine whether community drug distributors (CDDs) - volunteers selected by their communities to distribute ivermectin against onchocerciasis and who have been proven efficient to deliver other health interventions such as insecticide-treated bed nets to prevent malaria, vitamin A tablets, and albendazole to treat soil transmitted helminthiasis - can be used to reliably identify people living with epilepsy to promote better management of cases.

Methods

This study was carried out in three health Districts in Cameroon. An exhaustive house to house census was carried out by trained CDDs under the supervision of local nurses. In each household, all suspected cases of epilepsy were identified. In each health district, five communities were randomly selected for a second census by trained health personnel (research team). The results of the two censuses were compared for verification purposes.

Results

A total of 53,005 people was registered in the 190 communities surveyed with 794 (1.4%) individuals identified as suspected cases of epilepsy (SCE) by the CDDs. In the 15 communities where the SCE census was verified, the average ratio between the number of suspected cases of epilepsy reported in a community by the research team and that reported by the CDDs was 1.1; this ratio was < 0.8 and > 1.2 in 6 communities.

Conclusions

The results of this study suggest that CDDs, who are present in about 200,000 communities in 31 Sub Saharan African countries where onchocerciasis is endemic, can be successfully used to assess epilepsy prevalence, and therefore map epilepsy in many African countries.
Women’s autonomy in health decision-making and its effect on access to family planning services in Senegal in 2017: a propensity score analysis
Authors: Sougou N. M. , Bassoum O. , Faye A. , Leye M. M. M.
Published: June 2020

Background

The effect of women’s autonomy in decision-making for fertility control has been highlighted by research. The objective of this study was to analyze the effect of women’s autonomy over decision-making regarding their health and access to family planning in Senegal in 2017.

Methods

The analyses in this study were carried out using data from the Senegal Demographic and Health Survey in 2017. The sample consisted of 8865 women aged 15–49. The propensity score-matching method was applied. Autonomy in health decision-making was considered the treatment variable. Matching was performed using confounding variables. The outcome variables were the current use of modern contraceptive methods and the existence of unmet needs. The common support condition had been met. The analysis was conducted using STATA.15 software.

Results

This study showed that 6.26% of women had decision-making autonomy in relation to their health. For 80.33% of the women, their husbands/partners made health-related decisions for them. Decision-making autonomy increased significantly with the age of the woman (p < 0.05). In addition, 15.24% of women were using a modern method of contraception. An estimated 26.2% of women had unmet needs. Propensity score matching split the women into two groups based on autonomy over decision-making for their health. After matching, there was no longer a significant difference between women who were autonomous with respect to their decision-making and those who were not autonomous with respect to their current use of a modern contraceptive method. On the other hand, there was a 14.42% reduction (p < 0.05) in unmet needs for family planning in the group of women who were autonomous with respect to their health decision-making.

Conclusion

Autonomy in health decision-making would reduce unmet needs among Senegalese women. These results show the importance of accounting for gender in health interventions for the accessibility of family planning services.