bluuebunny/crossref_metadata_2025 huggingface dataset:
The road to fusion: The evolution of bilingual speech across three generations of speakers in Gibraltar
Authors: Goria Eugenio
Published: May 2020

Aims and objectives:

This article analyses English–Spanish code-mixing in Gibraltar. I describe the distribution of clause-peripheral alternation patterns in order to demonstrate that there is a correlation between single age-groups and particular types of bilingual patterns. This is interpreted as a case of fusion.

Methodology:

By seeking a correlation between age groups and particular instances of bilingual speech, this study adopts an apparent-time perspective. Furthermore, it tries to combine the quantitative methodology adopted in sociolinguistic studies with the theoretical tools of the sociology of language that are involved in the description of linguistic repertoires. This provides an important key for the interpretation of fusion in this scenario.

Data and analysis:

The study was based on a corpus of nearly 20 h of interviews with bilingual speakers belonging to three age-groups. After identifying three qualitatively different bilingual patterns, which mainly differed in the presence or absence of pragmatic functions, I took into account their distribution across age groups.

Findings and conclusions:

The results showed that elderly speakers were associated with pragmatically motivated code-switching, while younger speakers were associated with cases of single-word peripheral switches that were not related to any discourse- or participant-related function. This may be interpreted as incipient fusion in the periphery of the clause, possibly determined by recent changes in the linguistic repertoire.

Originality:

This is the first study to have applied the fusion framework to the case of Gibraltar and is also one of the few that has analysed code-mixing in this scenario from a quantitative corpus-based perspective.

Significance:

The data presented here shed new light on the early stages of the fusion process, highlighting the correlation between the onset of this phenomenon and macro-sociolinguistic processes involving the community.
Developing tension field action of embedded steel plates-Stiffened rebars composite reinforcement within concrete deep beams
Authors: Fahad Resan Sa’ad , Kamil Zemam Sajid , Sabah Abed Musab
Published: May 2020

For reinforced concrete beams, the shear failure mode is confirmed to occur in disturbed regions rather than in the Bernoulli region where stresses can be computed from the flexure formula. Thus, the provision of such regions with shear deficiencies is of great importance. In this study, a tension field system is suggested to embrace the inevitable concrete compression field originating within disturbed regions. Nine rectangular reinforced concrete beams dominated by disturbed regions are tested to verify the proposed shear reinforcement approach of the tension field concept. In this approach, the thin steel plate is embedded within shear span to resist shear strength in two different modes: with and without enhancement of reinforcement as stiffeners. All specimens were tested for failure using a four-point load testing arrangement. Test results demonstrate the feasibility of using embedded mild thin steel plate with and without ribs of rebars as tension field action against initiated concrete compression field action to upgrade the section shear capacity. As depicted by experimental results, the provided tension field system can remarkably upgrade the post cracking, stiffness, and ultimate shear capacity of the considered concrete beams. The stringer panel model is considered to verify and confirm strength improvement. The numerical solution is considered to investigate the proposed composite reinforcement provided within concrete deep beams using the concrete damaged plasticity model. The numerical investigation succeeded to depict the generation of tension field action within the suggested embedded steel plates–stiffened rebars composite reinforcement.
Improving in-plane seismic response of unreinforced masonry walls using steel strips
Authors: Darbhanzi Abbas , Marefat Mohammad S , Khanmohammadi Mohammad
Published: May 2020

This article discusses the results of an experimental program to retrofit unreinforced masonry walls by means of diagonal and vertical steel strips. The technique has several advantages such as simplicity to apply, relatively low costs, and insignificant disruption of service functions during the repair. The tests were conducted on three specimens: two with both diagonal and vertical steel strips and one with only diagonal steel strips, and all attached to one face of the walls. The tests showed that the steel strips improved lateral strength, increased non-linear displacement capacity, and changed the nature of the failure modes.
Techno-capital: Theorizing media and information literacy through information technology capabilities
Authors: Choi Jaewon Royce , Straubhaar Joseph , Skouras Maria , Park Soyoung , Santillana Melissa , Strover Sharon
Published: May 2020

The increasing presence of advanced information and communication technologies (ICTs) across various fields of our lives has elevated the significance of individuals’ capability to utilize these ICTs substantially. Although scholars have underscored the importance of understanding such capabilities in terms of skills that are multidimensional, few empirical investigations are connected to sound theoretical backgrounds. Analyzing a survey administered to a random sample of adults in the City of Austin, this study empirically examines multiplicities of technological capabilities. Building on the literatures of Bourdieu’s theory of capital, digital literacy, field, and participatory culture, this study finds three sets of technological capabilities that constitute individuals’ “techno-capital.” Furthermore, we analyze the influences of cultural and economic/financial capital reflected by key socioeconomic predictors on the different levels of techno-capital. We find that acquiring basic technological capabilities is a key factor explaining advanced techno-capital, while effects of gender, race, education, and income also persist.
#Me Too In the Kitchen
Authors: Harris Deborah A. , Giuffre Patti
Published: May 2020

In the wake of the #metoo movement, Harris and Giuffre use the restaurant industry as an example to illustrate how viewing sexual harassment as an issue of industry and organizational culture–rather than just the behavior of a few bad actors–can inform our understanding of sexual harassment in the workplace.
How the Privileged Fall
Authors: Streib Jessi
Published: May 2020

Not everyone born into the uppermiddle-class is equally advantaged. The disadvantaged portion of the advantaged class can fall into the middle class, or lower. This happens by making the most of the resources they have rather than trying to gain more resources.
Social Poverty and Relational Resources
Authors: Halpern-Meekin Sarah
Published: May 2020

Social poverty comes from lacking high-quality, trustworthy, dependable relationships. This is distinct from the experience of financial poverty and has consequences for wellbeing. Without adequately recognizing the multidimensional nature of human needs, we cannot understand individuals’ behavior and motivations, nor can we develop policies that successfully respond to their needs.
Exercise therapy in routine management of peripheral arterial disease and intermittent claudication: a scoping review
Authors: Abaraogu Ukachukwu O. , Abaraogu Onyinyechukwu D. , Dall Philippa M. , Tew Garry , Stuart Wesley , Brittenden Julie , Seenan Chris A.
Published: May 2020

Background:

Little is known about the extent to which routine care management of peripheral arterial disease (PAD) and intermittent claudication (IC) align with best practice recommendations on exercise therapy. We conducted a scoping review to examine the published literature on the availability and workings of exercise therapy in the routine management of patients with PAD and IC, and the attitude and practice of health professionals and patients.

Methods:

A systematic search was conducted in February 2018. The Cumulative Index of Nursing and Allied Health Literature, Ovid MEDLINE, Allied and Complementary Medicine Database, ScienceDirect, Web of Science and the Directory of Open Access Repositories were searched. Hand searching of reference lists of identified studies was also performed. Inclusion criteria were based on study aim, and included studies that reported on the perceptions, practices, and workings of routine exercise programs for patients with IC, their availability, access, and perceived barriers.

Results:

Eight studies met the eligibility criteria and were included in the review. Studies conducted within Europe were included. Findings indicated that vascular surgeons in parts of Europe generally recognize supervised exercise therapy as a best practice treatment for IC, but do not often refer their patients for supervised exercise therapy due to the unavailability of, or lack of access to supervised exercise therapy programs. Available supervised exercise therapy programs do not implement best practice recommendations, and in the majority, patients only undergo one session per week. Some challenges were cited as the cause of the suboptimal program implementation. These included issues related to patients’ engagement and adherence as well as resource constraints.

Conclusion:

There is a dearth of published research on exercise therapy in the routine management of PAD and IC. Available data from a few countries within Europe indicated that supervised exercise is underutilized despite health professionals recognizing the benefits. Research is needed to understand how to improve the availability, access, uptake, and adherence to the best exercise recommendations in the routine management of people with PAD and IC.
Pazopanib as a possible option for the treatment of metastatic non-clear cell renal carcinoma patients: a systematic review
Authors: Bersanelli Melissa , Brunelli Matteo , Gnetti Letizia , Maestroni Umberto , Buti Sebastiano
Published: May 2020

Background:

Effective systemic treatment of non-clear cell renal carcinoma (nccRCC) is still an unmet clinical need, with few studies to support an evidence-based approach. To date, the only recommended standard first-line treatment is sunitinib. Pazopanib may also be used in nccRCC but its place in therapy is not clearly established. It has comparable efficacy and better tolerability than sunitinib in clear cell renal carcinoma. Our objective was to review the use of pazopanib in metastatic nccRCC.

Methods:

We conducted a systematic review according to PRISMA guidelines. Any type of study reporting the use of pazopanib in metastatic renal cell carcinoma including cases with non-clear cell histology was eligible.

Results:

In all, 15 studies were included in our analysis, including a total of 318 nccRCC patients treated with pazopanib. Most studies were retrospective ( n = 12); three were prospective trials. The specific outcomes of nccRCC patients were reported by four studies. Pazopanib alone as first-line treatment gave overall response rates ranging from 27% to 33%, disease control rates of 81–89%, median progression free survival of 8.1–16.5 months and median overall survival of 17.3–31.0 months. Grade 3–4 adverse events rates were 21–55%.

Conclusion:

The present review provides for the first time a systematic summary of evidence about the possible use of pazopanib as first-line treatment for nccRCC, with a favorable outcome despite the low strength of evidence. Pazopanib could be considered as a possible therapeutic option in this setting.
Flipping a Classroom for Academically Talented Students
Authors: Gelgoot Erin S. , Bulakowski Paul F. , Worrell Frank C.
Published: May 2020

In flipped classrooms, students learn course content by watching flipped lessons (videos) outside of class time. During class, instructors guide learning by answering questions, facilitating projects, and fostering relationships with students. Although flipped classrooms are gaining popularity in secondary school settings, most research is performed with college-age samples. In this study, we compared two sections of a summer-based cognitive neuroscience course for academically talented youth: a flipped class and a class with traditional face-to-face instruction. Measures of academic achievement did not differ between the classes. The flipped class spent more time watching and re-watching lessons than the traditional class spent reading texts. Students rated organization, clarity, and enjoyment significantly higher in the traditional class. Despite these findings, the majority of students in both classes requested flipped lessons in the future. These results can inform how to flip classrooms for highly motivated secondary school students.
Anticholinergic burden in middle-aged women and recurrent falls in later life: findings from the Aberdeen prospective osteoporosis screening study (APOSS)
Authors: Neal Samuel R. , Wood Adrian D. , Ablett Andrew D. , Gregory Jenny S. , Guillot Jordan , Macdonald Helen M. , Reid David M. , Myint Phyo K.
Published: May 2020

Background:

Anticholinergic burden (ACB) is a recognised risk factor for falls in older people; however, whether ACB in middle age predicts falls in later life is unknown.

Methods:

We examined this association in the middle-aged women of the Aberdeen Prospective Osteoporosis Screening Study (APOSS). ACB was calculated at the second health visit (1997–1999, study baseline) using the Anticholinergic Cognitive Burden Scale. Outcomes were incidence of 1 fall and recurrent falls (⩾2 falls) during the 12 months prior to follow up 2007–2011. Multinomial logistic regression analyses adjusted for potential confounders including demographics, comorbidities and falls history.

Results:

A total of 2125 women {mean age (standard deviation [SD]): 54.7 (2.2) years at baseline and 66.0 (2.2) years at follow up} were included. Prevalence of baseline ACB score of 0, 1 and ⩾2 was 87.1%, 7.3% and 5.6%, respectively. Compared with no ACB, ACB ⩾2 was associated with recurrent falls in the previous 12 months [adjusted odds ratio (OR): 2.34, 95% confidence interval (CI): 1.31, 4.19] at an average of 11 years after initial exposure. No such association was found for an ACB score of 1.

Conclusions:

These findings highlight the potential negative effects of anticholinergic medications in middle age. While cautious use of anticholinergic medications is advisable, further longitudinal research should be conducted to confirm these findings before any specific clinical recommendations can be made.

Lay summary

Effect of medicines that block the chemical acetylcholine on falls in women in later life In this paper we describe the link between medicines that block the chemical acetylcholine and falls in later life in women. We used data from a large study in Scotland and we found that there may be a link between such medicines and recurrent falls in later life.
The man behind the woman: Publicity, celebrity public relations, and cultural intermediation
Authors: Ciszek Erica
Published: May 2020

Since the early 20th century, public relations has been implicated in the production and sustainment of celebrity. Celebrities rely on the work of publicists to strategically cast, produce, and place discourses within spheres of popular culture. Through an extended interview with Alan Nierob, publicist of transgender celebrity Caitlyn Jenner, this article is an analysis of celebrity public relations as a site of cultural intermediation. Drawing on Bourdieu’s notions of habitus, capital, and fields, this article sheds light on the practice of celebrity public relations to understand how publicists leverage cultural and social capital to construct legitimacy for their clients. This study contributes to a broader sociological understanding of celebrity public relations and opens new avenues for research in considering how publicity might translate into broader socio-political impacts.
The association of nadir CD4-T cell count and endothelial dysfunction in a healthy HIV cohort without major cardiovascular risk factors
Authors: Mogadam Emad , King Kevin , Shriner Kimberly , Chu Karen , Sondergaard Anders , Young Kristal , Naghavi Morteza , Kloner Robert A
Published: May 2020

Objectives:

HIV-infected population may have increased risk of cardiovascular disease. The prevalence of traditional cardiovascular disease risk factors such as hypertension, diabetes and dyslipidemia in HIV-infected individuals has made it difficult to assess the direct effects of HIV and immune factors on endothelial dysfunction and associated increased risk of atherosclerosis. The purpose of this study was to investigate indicators of endothelial dysfunction in an HIV cohort without hypertension and diabetes.

Methods:

We studied 19 HIV-infected patients between the ages of 25–76 years old with effectively suppressed viral load and without diagnosis of hypertension or diabetes. Endothelial function was measured by digital thermal monitoring of vascular reactivity using the VENDYS technique. Endothelial function was reported as vascular reactivity index. Systolic blood pressure and diastolic blood pressure at the time of VENDYS test were measured and latest lipid panels were recorded. The association between vascular reactivity index and CD4-T cells count, different antiretroviral therapy types (non-nucleoside reverse transcriptase, nucleoside reverse transcriptase, protease inhibitors, integrase inhibitors), vitamins use, systolic blood pressure, diastolic blood pressure, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol was investigated.

Results:

Mean vascular reactivity index was 1.87 ± 0.53. Vascular reactivity index, marker of endothelial dysfunction, showed a significant correlation with lower nadir CD4 count (p = 0.003) as well as low-density lipoprotein cholesterol (p = 0.02). No additional significant correlation between vascular reactivity index and the rest of the investigated variables was found.

Conclusion:

Vascular reactivity index, a clinical predictor of endothelial dysfunction, is associated with lower nadir CD4-T cell and low-density lipoprotein cholesterol in HIV-infected men with no history of hypertension or diabetes and before clinical evidence of cardiovascular disease.
A neonate with Langerhans cell histiocytosis presenting as blueberry muffin rash: Case report and review of the literature
Authors: Cyr Janelle , Langley Annie , Demellawy Dina El , Ramien Michele
Published: May 2020

In our case report, we discuss a 1-day-old boy presenting with blueberry muffin syndrome diagnosed with Langerhans cell histiocytosis. The diagnosis complicated by an initial difficult-to-interpret biopsy showing only a hint of perifollicular CD1a-positive cells; however, given our team’s strong clinical suspicion of Langerhans cell histiocytosis, a second biopsy of a more mature lesion was done and showed typical histopathology. This case introduces the possibility of perifollicular Langerhans cells early in this condition, demonstrates the importance of appropriate biopsy site selection, and highlights the importance of maintaining a high degree of suspicion when there is poor clinicopathologic correlation. Our case report contains a comprehensive table which reviews the systemic and cutaneous clinical features, as well as the laboratory, pathology, and imaging findings for the differential diagnoses of blueberry muffin baby.
The Meaning of “Father’s House” (בית אב‎ bêt ’āb) and a Chiastic Structure in Numbers 18.1-7
Authors: Schmidt Peter
Published: May 2020

The phrase bêt ’ābîkā “your father’s house” in Num 18.1 is often translated as referring to the Levites or the Kohathites. I suggest the reference is, rather, to Aaron’s own family and descendants. That is, the whole of v. 1 refers to the priests only. The possessive suffix - kā “your” does not refer to ’āb “father,” but to the compound noun bêt ’āb “father’s house,” an expression that means “family.” The two lines in v. 1 should be read as synonymous lines, not as contrasting ones. In both lines Aaron’s family stands in contrast to the whole tribe of Levi, which is not mentioned until v. 2. This understanding is confirmed by a chiastic structure that underlies the passage. Translating the phrase with “your family” (i.e., Aaron’s own family, not his family of origin) is recommended. Further translation issues in the passage are addressed.
Suspected phenobarbital-induced pancytopenia in a cat
Authors: Lyraki Maria , Wilson Helen
Published: May 2020

Case summary

A 3-year-old neutered male domestic shorthair cat developed pancytopenia 6 months after starting phenobarbital for treatment of recurrent seizures. The cat was switched from phenobarbital to levetiracetam and complete resolution of the pancytopenia was documented within 10 weeks, consistent with phenobarbital-induced pancytopenia.

Relevance and novel information

While phenobarbital is frequently used as the first-line treatment for seizures in cats, phenobarbital-induced feline pancytopenia has not been documented in the veterinary literature before. Based on this case, regular monitoring of the complete blood count in cats receiving long-term phenobarbital treatment should be considered. In cases of persistent or severe haematological abnormalities, further investigations are required and treatment discontinuation may be needed in the absence of other causes of pancytopenia.
Topical chemotherapy with mitomycin C in a feline corneal squamous cell carcinoma
Authors: Delgado Esmeralda Costa
Published: May 2020

Case summary

A 9-year-old cat was presented with a right globe lesion of 6 months’ duration. A large pink elevated mass covering two-thirds of the right cornea was detected. The corneal mass was surgically removed by superficial keratectomy and diagnosed by histopathology as a squamous cell carcinoma (SCC). The surgical procedure led to a relatively transparent cornea, but recurrence was likely. To avoid relapse, 1 month after surgery three cycles of mitomycin C 0.04% eye drops were applied q8h for 15 days on/15 days off. No local or systemic side effects were seen, and no recurrence was detected after 1 year of follow-up. Topical mitomycin C was successfully used as adjuvant local chemotherapy agent and prevented relapses owing to its cytostatic effect.

Relevance and novel information

SCCs are relatively common in feline patients, especially in the non-pigmented extremities of the nose, ears and eyelids, but with the cornea being a rare location. They rarely metastasise and they seldom relapse locally after surgical excision. Surgical-free margins of 2 cm are advisable to prevent relapses. Corneal tumours are rare, as the cornea is avascular; corneal transparency is essential to assure clear vision. In corneal SCC this margin is impossible to achieve without enucleation. In the present report, surgical removal of the neoplasm was combined with topical administration of the anticancer drug mitomycin C and a good prognosis was obtained. This combined treatment may be an appropriate therapeutic option for feline corneal SCC.
Relationship Between Balance, Gait, and Activities of Daily Living in Older Adults With Dementia
Authors: Lee Nam Gi , Kang Tae Woo , Park Hyun Ju
Published: May 2020

Introduction:

Gait characteristics are closely associated with executive functions including basic and high-level cognitive processes such as attention, working memory, decision-making, and problem-solving. Impaired cognitive function resulting from dementia is associated with loss of balance and poor activities of daily living (ADLs). If associations between gait parameters, balance, and ADLs are observed, then quantitative gait analysis may be optimal for reinforcing balance and ADL assessments in people with dementia. This study aimed to determine the association between balance, gait, and ADLs in older adults with dementia.

Materials and Methods:

A cross-sectional study was conducted in 46 older adults who have been diagnosed with dementia. Measurements including the Mini-Mental Statement Examination-Korean version (MMSE-K), Berg Balance Scale (BBS), 10-meter walk test (10MWT), Modified Barthel index (MBI), and GAITRite were used to assess cognitive function, balance, walking speed, ADLs, and gait parameters, respectively. The Pearson product correlation coefficient ( r) was used for correlation analysis.

Results and Discussion:

Among the gait parameters, velocity was positively associated with the BBS, 10MWT, and MBI ( r = 0.341-0.516, P > .05). Step length ( r = 0.301-0.586, P > .05), stride length ( r = 0.329-0.580, P > .05), and walk ratio ( r = 0.324-0.556, P > .05) were positively associated with the MMSE-K, BBS, 10MWT, and MBI. A moderate positive association between single support time and MBI was observed ( r = 0.308, P = .039). Additionally, a moderate negative association between double support time and the MBI was observed ( r = −0.349, P = .019). This study presents the first empirical evidence on the association between balance, gait, and ADLs in older adults with dementia.

Conclusions:

This study identified important associations between balance, gait, and ADL assessments in people with dementia. Further studies involving targeted interventions addressing gait parameters and improving balance and functional performance in people with dementia are required in the future.
An Exploration of Facilitators and Challenges to Young Adult Engagement in a Community-Based Program for Mental Health Promotion
Authors: Marie Creamer Anne , Hughes Jean , Snow Nicole
Published: May 2020

Adolescence and young adulthood can be particularly daunting for those with mental health concerns. In one Canadian city, a community-based drop-in psychosocial mental health center (Center) was designed specifically for youth who self-identified as struggling with mental health issues. The purpose of this study was to identify the features of the program that promoted or discouraged engagement. Narrative inquiry was used to guide the project. One-on-one interviews were conducted with 10 Center users. Four major categories were identified: (a) Reasons for Coming: Motivated to Work on Goals; (b) Facilitators of Engagement and Beyond; (c) Challenges to Engagement; and (d) Benefits of Engaging: Finding My Way. These categories were further delineated into themes. All participants had experienced trauma, and the Center assisted them in their coping. The researchers believe that to aid recovery, agencies working with this population need to use trauma-informed and healing-centered engagement.
Patients’ Experiences of Interprofessional Collaborative Practice in Primary Care: A Scoping Review of the Literature
Authors: Morgan Katherine H , Barroso Cristina Sofia , Bateman Sarah , Dixson Melanie , Brown Kathleen Conroy
Published: May 2020

Interprofessional collaboration (IPC) has been shown to improve patient safety and quality of care. Particularly, IPC assists health care providers to manage complex and chronic diseases. To this end, primary care centers around the world have begun practicing IPC; however, little is known about the patient’s experience of IPC in primary care (IPC-pc). The goals of this scoping review were to identify the studies exploring patients’ perspectives on IPC-pc and to reveal gaps in the literature for future research in order to inform policy and practice. A key word search strategy was conducted using PubMed to identify studies published from 1997 to 2017 on IPC-pc that included data collected from patients or their caregivers about patient experience or satisfaction. Seven studies met the inclusion criteria for the scoping review, and these studies were evaluated by interprofessional intervention, collaboration, and outcomes.
Volume of the rectus capitis posterior minor muscle in migraine patients: a cross-sectional structural MRI study
Authors: Hvedstrup Jeppe , Amin Faisal Mohammad , Hougaard Anders , Ashina Håkan , Christensen Casper Emil , Larsson Henrik Bo Wiberg , Ashina Messoud , Schytz Henrik Winther
Published: May 2020

Background

Neck pain in migraine patients is very prevalent between and during migraine attacks, but the underlying mechanism behind neck pain in migraine is unknown. The neck muscle rectus capitis posterior minor muscle (RCPmi) may be important since it is connected to the occipital dura mater. In this study, we examined the RCPmi volume in migraine patients and compared with controls.

Methods

We conducted a cross-sectional MRI study examining muscle volume in 40 episodic migraine patients and 40 controls in preexisting images from prior studies. Three-dimensional T1 weighted sequences were collected with a 3.0 T MRI Scanner. The volume of RCPmi was examined by manually tracing the muscle circumference with Horos medical image viewer. The observer was blinded to participant information. No information regarding neck pain status during or between migraine attacks were available.

Results

The mean RCPmi volume was 1.22cm3 in migraine patients and 1.17cm3 in controls (p = 0.549). We found no differences in RCPmi volume on the pain side vs. the non-pain side (p = 0.237) in patients with unilateral migraine. There were no association between the muscle volume and years with migraine, headache or migraine frequency, age or BMI.

Conclusions

We found no difference in RCPmi volume between migraine patients and controls, suggesting no structural RCPmi pathology in migraine.
The effect of uric acid and urinary sodium excretion on prehypertension: a nationwide population-based study
Authors: Lee Shina , Choi Kyu Bok , Kim Seung-Jung
Published: May 2020

Background

This study examined the effect of serum uric acid (SUA) level and urinary sodium excretion on blood pressure as well as their combined effect on prehypertension in a Korean population.

Method

Data from the 7th Korea National Health and Nutrition Examination Survey for adults (≥ 19 years of age) were used. The participants were classified into two groups, normotension and prehypertension, according to the JNC-7 definition. Logistic regression was carried out and adjusted for traditionally regarded confounders of blood pressure. All analyses considered a complex sampling design. A multivariate analysis was performed on subgroups defined according to their SUA level and urinary sodium excretion.

Results

The 4200 participants were divided into normotension (n = 2646) and prehypertension (n = 1554) groups. In the univariate analysis, patient age, male sex, concurrent comorbidity (diabetes mellitus, cardiovascular disease, stroke, dyslipidemia, and chronic kidney disease), uric acid, and urinary sodium excretion were associated with prehypertension. After adjusting for baseline covariates, both the SUA level and urinary sodium excretion were significant predictors of incident prehypertension (SUA, per 1 mg/dL increase, odds ratio [OR] 1.216, 95% confidence interval [95% CI] 1.131–1.309; urinary sodium excretion, per 1 g/day increase, OR 1.067, 95% CI 1.019–1.117). Additionally, simultaneously higher tertiles of SUA and urinary sodium excretion resulted in higher ORs for prehypertension.

Conclusion

Increased SUA is a significant risk marker for the development of prehypertension in normotensives. Simultaneously high SUA and urinary sodium excretion amplified the effect on the development of prehypertension. Our findings suggest that lowering SUA levels and reducing sodium intake will contribute to preventing hypertension.
Efficacy of a single dose versus a multiple dose regimen of Mebendazole against hookworm infections among school children: a randomized open-label trial
Authors: Eshetu Tegegne , Aemero Mulugeta , Zeleke Ayalew Jejaw
Published: May 2020

Background

Despite the existence of a population-based control program using single dose albendazole or mebendazole as a preventive chemotherapy, hookworm transmission remains high. It causes a negative impact on the growth and school performance of children. In connection to this preventive chemotherapy, different studies produced conflicting results. This study aimed at evaluating the efficacy of single (500 mg) versus multiple doses (100 mg twice a day during three consecutive days) of mebendazole against hookworm infections among school-aged children.

Methods

This randomized open-label clinical trial took place among school-aged children (6–14 years old) in Burie and Debre Elias towns, Northwest Ethiopia. Using simple randomization, eligible hookworm-positive children were allocated (1:1) to either a single or multiple dose treatment arms. Stool samples were collected and processed using McMaster method at baseline and follow-up period (14–21 days after treatment). Only laboratory technicians were blinded. The cure and egg reduction rates were the primary and secondary therapeutic outcome measures against hookworm infections, respectively. An independent t-test was used to compare group means, and logistic regression was used to calculate odds ratio (OR). P-value < 0.05 at 95% CI was considered statistically significant.

Result

One hundred eight children, 54 in each treatment arm had completed baseline data and received allocated treatment. One hundred three children had completed follow-up data records and included for the final efficacy analysis. Cure rate against hookworm was significantly higher in the multiple dose (96.1%) than in the single dose (30.8%) with OR = 55.125; 95% CI: 11.92–254.9; P < 0.001. The egg reduction rate in the multiple dose treatment arm (99.5%) was also significantly higher than in the single dose arm (68.9%) with difference t (101) =5.38; 95% CI 230.95–505.36; P < 0.001.

Conclusion

The single dose regimen of mebendazole for the treatment of hookworm infections showed poor cure and egg reduction rates, while the multiple doses revealed satisfactory. Although multiple dose regimen administration is a bit more complex than the single dose, we strongly encourage replacing it with multiple dose regimen during deworming programs in hookworm endemic areas.

Trial registration

This trial is retrospectively registered in www.pactr.org, number PACTR201911466695052 on November 26, 2019.
Intestinal parasitosis, anaemia and risk factors among pre-school children in Tigray region, northern Ethiopia
Authors: Wasihun Araya Gebreyesus , Teferi Mekonen , Negash Letemichal , Marugán Javier , Yemane Dejen , McGuigan Kevin G. , Conroy Ronan M. , Abebe Haftu Temesgen , Dejene Tsehaye Asmelash
Published: May 2020

Background

Intestinal parasitic infections (IPIs) and anaemia are major health problems. This study assessed the prevalence of intestinal parasitic infections, anaemia and associated factors among pre-school children in rural areas of the Tigray region, northern Ethiopia.

Methods

A community based cross-sectional study was conducted among 610 pre-school children in rural communities of Northern Ethiopia from June 2017 to August 2017. Stool specimens were examined for the presence of trophozoites, cysts, oocysts, and ova using direct, formal-ethyl acetate concentration, Kato–Katz, and Ziehl-Neelsen techniques. Haemoglobin was measured using a HemoCue spectrometer.

Results

Among the 610 participating pre-school children in the study, the prevalence of IPIs and anaemia were 58% (95% conference interval (CI): 54.1–61.9%) and 21.6% (95% CI: 18.5–25.1%), respectively. Single, double, and triple parasitic infections were seen in 249 (41, 95% CI: 37–45%), 83 (14, 95% CI: 11–17%), and 22 (3.6, 95% CI: 2.4–5.4%) children, respectively. Of the seven intestinal parasitic organisms recorded from the participants,Entamoeba histolytica/disparwas the most prevalent 220 (36.1%) followed byGiardia lamblia128 (20.1%), andHymenolepis nana102 (16.7%). Mixed infections were common amongG. lamblia, E. histolytica/disparandCryptosporidiumspp. oocyst. Intestinal parasitic infection prevalence increased from 47% in children aged 6–11 months to 66% in those aged 48–59 months; the prevalence ratio (PR) associated with a one-year increase in age was 1.08 (95% CI: 1.02–1.14,p = 0.009). Age-adjusted prevalence was higher in children who had been dewormed (PR = 1.2; 95% CI: 1.00–1.4,p = 0.045), and lower in households having two or more children aged under five (PR = 0.76, 95% CI: 0.61–0.95,p = 0.015). Anaemia rose from 28% in children aged 6–11 months to 43% in those aged 12–23 months, then fell continuously with age, reaching 7% in those aged 48–59 months. Age adjusted, anaemia was more prevalent in households using proper disposal of solid waste (PR = 1.5, 95% CI: 0.1–2.10,p = 0.009) while eating raw meat (PR = 0.49, 95% CI: 0.45–0.54,p = 0.000), any maternal education (PR = 0.64 95% CI: 0.52–0.79, p = 0.000), and household water treatment (PR = 0.75, 95% CI: 0.56–1.0,p = 0.044) were associated with lower prevalence of anaemia.

Conclusions

More than half of the children were infected with intestinal parasites, while anaemia prevalence was concentrated in the 12–23 month age group. This study has identified a number of potentially modifiable risk factors to address the significant prevalence of IPIs and anaemia in these children. Improvements in sanitation, clean water, hand hygiene, maternal education could address both short and long-term consequences of these conditions in this vulnerable population.
Prevalence and associated factors of scabies in Ethiopia: systematic review and Meta-analysis
Authors: Azene Abebaw Gedef , Aragaw Abiba Mihret , Wassie Gizachew Tadesse
Published: May 2020

Background

Scabies is an infectious disease that affects the skin caused by the mite Sarcoptes scabiei and it transmitted through close personal contact. Even though it is easily treatable disease, its prevalence is high and continuous as neglected tropical disease of resource-poor settings, and particularly affects young age groups. Despite of these facts, studies conducted in Ethiopia regarding to the prevalence and associated factors for scabies infestation have been highly variable and didn’t well compiled. Due to that, the aim of this systematic review and meta-analysis was to estimates the overall prevalence of scabies and associated factors in all age groups in Ethiopia.

Methods

International databases (PubMed/PMC/Midline, EMBASE, CINAHL, Web of Science, Google Scholar, Google and Science Direct) were systematically searched from December 1, 2019, to January 18, 2020. All observational studies noted the prevalence of human scabies and associated factors in Ethiopia were included. Two authors (AG and G.T) independently extracted all necessary data using a standardized data extraction format. The data which is extracted each study were analyzed using STATA Version 14.1. Heterogeneity among the included studies was assessed through the Cochrane Q test statistics and I2 test. Lastly, a random effects meta-analysis model was computed to fix overall prevalence and associated factors of scabies.

Results

Twelve studies were included in this meta-analysis after 410 articles retrieved. Of these, eight studies were analyzed for prevalence estimation. The overall prevalence of scabies infestation was 14.5% (95%CI: 1.5, 27.6%) in Ethiopia. Furthermore, the subgroup analysis revealed the highest prevalence was 19.6% in Amhara region. A person from a large family size (OR: 3.1, 95% CI: 1.76, 5.67), and sharing a bed (OR: 3.59, 95%CI: 2.88, 4.47) were significantly associated with scabies.

Conclusion

This study revealed the prevalence of scabies infestation was 14.5% in Ethiopia which was high. Persons from high family size and any contact with scabies case were factors associated with scabies.
The risk of eating disorder relapse during pregnancy and after delivery and postpartum depression among women recovered from eating disorders
Authors: Makino Mariko , Yasushi Mitsuo , Tsutsui Sueharu
Published: May 2020

Background

Studies have shown that women of reproductive age develop eating disorders (EDs). Few studies have examined EDs in women by performing long-term follow-ups during pregnancy and after delivery. Our study aimed to identify relapse of EDs during pregnancy and after delivery as well as postpartum depression in women who had complete remission of EDs.

Methods

Of the 1008 patients with EDs who visited our outpatient clinic between 1994 and 2004, 55 experienced ED remission and pregnancy. Of these, 25 (21 with BN and 4 with AN) consented to participate in this study. Finally, 24 patients were included in this study after 1 patient was excluded owing to a miscarriage. They were interviewed every 2 weeks both during pregnancy and after giving birth. We used the Eating Attitudes Test-26 (EAT-26) and Edinburgh Postnatal Depression Scale (EPDS) as reference scales for diagnosing the EDs and the postpartum depression, respectively. We used a two-sided unpaired test for the statistical analysis.

Results

Sixteen participants (67%) experienced ED relapse during pregnancy and twelve (50%) relapsed after birth. Twelve (50%) had postpartum depression, four of whom (33%) had low-birth-weight infants. Among the participants who did not have postpartum depression, there were no low-body-weight infants. There was no significant difference (p = 0.065) in birth weight between the postpartum depression and non-depression groups.

Conclusions

Our study revealed that recurrence of EDs and the occurrence of postpartum depression were higher in this population, indicating the need to closely monitor EDs both during pregnancy and after birth.
Prevalence of pneumonia and its associated factors among under-five children in East Africa: a systematic review and meta-analysis
Authors: Beletew Biruk , Bimerew Melaku , Mengesha Ayelign , Wudu Mesfin , Azmeraw Molla
Published: May 2020

Background

Pneumonia is defined as an acute inflammation of the Lungs’ parenchymal structure. It is a major public health problem and the leading cause of morbidity and mortality in under-five children especially in developing countries. In 2015, it was estimated that about 102 million cases of pneumonia occurred in under-five children, of which 0.7 million were end up with death. Different primary studies in Eastern Africa showed the burden of pneumonia. However, inconsistency among those studies was seen and no review has been conducted to report the amalgamated magnitude and associated factors. Therefore, this review aimed to estimate the national prevalence and associated factors of pneumonia in Eastern Africa

Methods

Using PRISMA guideline, we systematically reviewed and meta-analyzed studies that examined the prevalence and associated factors of pneumonia from PubMed, Cochrane library, and Google Scholar. Heterogeneity across the studies was evaluated using the Q and the I2 test. A weighted inverse variance random-effects model was applied to estimate the national prevalence and the effect size of associated factors. The subgroup analysis was conducted by country, study design, and year of publication. A funnel plot and Egger’s regression test were used to see publication bias. Sensitivity analysis was also done to identify the impact of studies.

Result

A total of 34 studies with 87, 984 participants were used for analysis. The pooled prevalence of pneumonia in East Africa was 34% (95% CI; 23.80–44.21). Use of wood as fuel source (AOR = 1.53; 95% CI:1.30–1.77; I2 = 0.0%;P = 0.465), cook food in living room (AOR = 1.47;95% CI:1.16–1.79; I2 = 0.0%;P = 0.58), caring of a child on mother during cooking (AOR = 3.26; 95% CI:1.80–4.72; I2 = 22.5%;P = 0.26), Being unvaccinated (AOR = 2.41; 95% CI:2.00–2.81; I2 = 51.4%;P = 0.055), Child history of Acute Respiratory Tract Infection (ARTI) (AOR = 2.62; 95% CI:1.68–3.56; I2 = 11.7%;P = 0.337) were identified factors of pneumonia.

Conclusion

The prevalence of pneumonia in Eastern Africa remains high. This review will help policy-makers and program officers to design pneumonia preventive interventions.
Associations between objective measures of physical activity, sleep and stress levels among preschool children
Authors: Eythorsdottir Dagny Y. , Frederiksen Peder , Larsen Sofus C. , Olsen Nanna J. , Heitmann Berit L.
Published: May 2020

Background

Cortisol is often used as a biological marker for stress. When measured in urine or serum, representing a short-term measurement of the hormone, it has been associated with unfavorable sleep characteristics and both low and high physical activity levels. However, cortisol in hair represents a long-term stress measure and has been suggested as a promising new marker for chronic stress. Therefore, we aimed to examine the association between objectively measured sleep, physical activity and hair cortisol levels in preschool children.

Methods

In order to obtain objective measures of physical activity and sleep habits, 54 children aged 2–6 years wore an ActiGraph for 5 consecutive days and nights. For chronic stress measurements of each child, hair was cut from the back of the head close to the scalp for analysis of cortisol levels. Associations between measured sleep quality and quantity and level of physical activity and hair cortisol levels were estimated using linear regression analysis, presented as β. Results were adjusted for sex, age and BMI z-score.

Results

We found no significant association between log-transformed cortisol (pg/mg) and sleep duration (hours) (β = − 0.0016,p = 0.99), sleep efficiency (β = − 3.1,p = 0.18), sleep latency (β = 0.015,p = 0.16) or physical activity level (100 counts per min) (β = 0.014,p = 0.22). However, sleep latency (min) was directly associated with physical activity (counts per min) levels (β = 35.2,p = 0.02), while sleep duration (hours) (β = − 142.1,p = 0.55) and sleep efficiency (%) (β = − 4087,p = 0.26) showed no significant associations.

Conclusions

In our study, a high physical activity level was associated with poorer sleep habits. Neither sleep quality nor physical activity were related to long term cortisol exposure. These results are among the first to study associations between objectively measured sleep, physical activity and chronic cortisol levels among preschool children. More and larger studies are therefore needed.
Clinical manifestations and associated disorders in children with celiac disease in southern Iran
Authors: Dehbozorgi Mahshid , Honar Naser , Ekramzadeh Maryam , Saki Forough
Published: May 2020

Background

Celiac disease (CD) is an immune mediated inflammatory enteropathy, triggered by gluten exposure in HLA-DQ2 and/or –DQ8 genetics. The presentation of celiac disease in children is changing, with increase in non-classical symptoms. We aim to evaluate the clinical presentations of celiac disease amongst children, diagnosed with CD.

Methods

In this cross sectional study, we investigated the clinical features of 130 celiac patients at hospitals affiliated with Shiraz University of Medical Sciences. We used their hospital charts and conducted an interview with patients and their parents to find out demographic data, symptoms, laboratory, and histopathology findings for Marsh grading.

Results

Celiac disease was detected more amongst females (63.8%). We found that 5.4% of the patients had BMI more than 95th percentile. The most common GI symptoms were abdominal pain, flatulence and constipation. Also, the most common extra intestinal manifestation included bone pain, long term fatigue and anemia. Flatulence, chronic diarrhea, and paresthesia were observed more amongst male participants. The most common comorbidities were type 1 diabetes mellitus and hypothyroidism.

Conclusion

The most common gastrointestinal symptoms amongst our patients were abdominal pain, flatulence and constipation. Furthermore, the most common extra intestinal manifestations included bone pain, long term fatigue and anemia. The most associated comorbidities with CD in our children were type 1 diabetes mellitus and hypothyroidism.