bluuebunny/crossref_metadata_2025 huggingface dataset:
Serum Phosphate: A Neglected Test in the Clinical Management of Primary Hyperparathyroidism
Authors: Castellano Elena , Attanasio Roberto , Boriano Alberto , Pellegrino Micaela , Borretta Giorgio
Published: September 2021

Background

Although the inverse correlation between serum PTH and phosphate (P) levels in patients with primary hyperparathyroidism (PHPT) is well known, the relationship between P levels and the clinical picture of the disease has not been well investigated. This was thus the aim of this paper.

Patients

A total of 472 consecutive patients with PHPT attending our center were retrospectively evaluated at diagnosis.

Results

P levels lower than 2.5 mg/dL (HypoP) were found in 198/472 patients (41.9%). HypoP was mild (2-2.5 mg/dL), moderate (1-1.9 mg/dL), and severe (<1 mg/dL) in 168 (84.9%), 30 (15.1%), and 0 cases, respectively. P levels were lower in males than females. Patients with more severe bone density impairment at the radial (but not the vertebral or femoral) site had P levels significantly lower than other patients. PHPT severity was worse in HypoP patients, both clinically (higher prevalence of renal stones, but not of osteoporosis) and biochemically (higher serum calcium and PTH levels). All patients in the moderate HypoP group were either symptomatic or asymptomatic reaching surgical indication according to the latest guidelines.

Conclusions

We observed a relationship between P levels and biochemical and clinical features of PHPT severity. In asymptomatic PHPT patients, even moderate HypoP is predictive of surgical indication, regardless of age and hypercalcemia severity.
Achievement of another landmark during 2020 by Pakistan Journal of Medical Sciences
Authors: Jawaid Shaukat Ali , Jawaid Masood
Published: September 2021

doi: https://doi.org/10.12669/pjms.37.7.5208

How to cite this:Jawaid SA, Jawaid M. Achievement of another landmark during 2020 by Pakistan Journal of Medical Sciences. Pak J Med Sci. 2021;37(7):1715-1718. doi: https://doi.org/10.12669/pjms.37.7.5208

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Getting our act together: a qualitative evaluation of the impact of a play on issues relating to women, sex work and substance use
Authors: Campbell Anne , Egan Jo , Murphy Paul , Blair Carolyn
Published: September 2021

Background: The arts have always sought to explore significant social issues through literature, performing arts and visual art. However, more recently there has been an increase in the use of theatre as a means of gauging audiences’ perception and understanding of key social issues. The primary aim of the current evaluation was to seek the views of audience members, service users of addiction services and expert commentators as regards their perception of a number of key issues related to the content of a play entitled Madame Geneva.

Methods: The evaluation used an exploratory qualitative design incorporating a dualistic approach to the research process: including post show discussion with panellists and members of the audience and a focus group comprising service users who had also viewed a live performance of the play.

Results: The topics elucidated by the performance of the play included women and sex work, women and substance use, and impact on policy and practice. The discussion of the issues raised reiterated that women still experience high levels of oppression and discrimination in areas of substance use, sex work and welfare ‘reform’ which are often couched within male dominated political discourses and structures in contemporary society.

Conclusions: The arts and specifically dramaturgical representations of substance use and related issues is an effective method of initiating important pragmatic and policy discussion of issues, which affect women
LA VISIÓN Y LA CONFIGURACIÓN A TRA´VES DEL DESTELLO POÉTICO EN EL POEMA ''SETENTA VENTANAS ITINERANTES'' DEL POETA KURDO SHERKO PEAKS. P
Authors: Hamid Kadhim Adnan Abdul , Shalan Sanaa
Published: September 2021

Este artículo estudia el poema ‘’Setenta ventanas itinerantes’’ del poeta de origen kurdo Sherko Peaks. Se estudia su forma y su contenido a través de la técnica del destello poético, así como las técnicas o herramientas que ha usado el autor para conectar con los receptores. Se dedica un espacio al estudio de la figura de la mujer dentro del poema y la visión del autor sobre el asunto.
EL DISCURSO ÉTICO DE AMPARO POCH Y GASCÓN: ANARCOFEMINISMO, DIVULGACIÓN CIENTÍFICA Y PACIFISMO.
Authors: Mellado Garcia Anna
Published: September 2021

Destacada figura de la historia del feminismo español, la doctora Amparo Poch y Gascón fue una activista libertaria responsable de organizaciones humanitarias, militante sindical y Consejera delegada del gobierno republicano que procuró la divulgación científica, proporcionó las claves para la emancipación de las mujeres y difundió el mensaje pacifista en un contexto de guerra.
Healthwise, Part 3. The importance of remaining active
Authors: Nazarko Linda
Published: September 2021

The old adage, ‘sitting will be the death of you’, is proving to be a grim prediction that is borne out by research. Globally, physical inactivity leads to approximately 5 million deaths per year and is the fourth leading cause of death and disability ( Kohl et al, 2012 ; World Health Organization (WHO), 2020 ). Evidence suggests that, in the UK, inactivity leads to around 69 000 preventable deaths annually ( Heron et al, 2019 ). This article, the third in a series, explores inactivity, its consequences and how readers can remain healthy and well by maintaining or increasing activity levels.
Quality improvement in practice—part two: applying the joy in work framework to healthcare
Authors: Shah Amar , Harken Joy , Nelson Zoe
Published: September 2021

As healthcare systems emerge from the COVID-19 pandemic and begin the process of recovery and rebuilding, it is more important than ever to find systematic ways to ensure that all healthcare staff are focusing on their wellbeing, are able to reflect on new ways of working and find methods to improve their experience at work. This article, the second in a three-part series on the practical application of quality improvement in healthcare, presents four case studies that demonstrate the learning from four healthcare systems that have been applying both quality improvement and the Institute for Healthcare Improvement's ‘joy in work’ framework to enhance staff wellbeing and experience. These case studies demonstrate the benefits of involving staff deeply in the process of understanding factors that impact on experience at work, developing and testing creative ideas that can make a difference. The ideas that emerged were diverse and highly contextualised to the local service. Ideas related most strongly to four areas: wellness and resilience, daily improvement, camaraderie and teamwork, and recognition and reward. The systematic approach that quality improvement brings is potentially replicable across all healthcare settings, and can provide a way for all teams to have greater ownership and control over their wellbeing and experience at work.
How equal is access to senior management and leadership roles in the NHS?
Authors: Chasma Farida , Khonat Zaheer
Published: September 2021

In 2015, the NHS was named the fifth largest employer in the world, comprising clinical and non-clinical staff from varying backgrounds, all of whom impact lives on a daily basis through their work. In 2020, over 20% of this workforce identified as Black, Asian or minority ethnic, yet less than 13% of senior positions in the NHS, including band 8A and higher, are held by individuals in this group. Although the Workforce Race Equality Standard was introduced in 2015 to help address this issue, there is still work to be done. Therefore, this article highlights racial and ethnic discrepancies in positions of leadership and management in the NHS, and explores the programmes available and the steps that Black, Asian and minority ethnic employees can take to help them progress to senior management roles.
Making a case for investment: a guide to pitching for better services
Authors: Disney Benjamin
Published: September 2021

Using their experience of effectively pitching for better bowel care pathways, the Bowel Interest Group provide comprehensive, step-by-step guidance on how to make a sound business case for creating or improving services in the NHS.
Reducing the risk of stroke: looking beyond lifestyle changes
Authors: Kasadha Bakita
Published: September 2021

Public health campaigns have led to more widespread awareness of the signs of stroke, but what can be done to raise awareness of stroke prevention interventions? Bakita Kasadha explores the actions that can be taken beyond individual lifestyle changes, and discusses the extent to which risk factors can be ‘modifiable’.
The need for better access to mental health support among young people with cancer
Authors: Soanes Louise
Published: September 2021

Cancer can have a significant impact on a young person's mental wellbeing, which can persist into later life. Louise Soanes of Teenage Cancer Trust highlights the need for tailored psychological support in this patient group.
The global elements of vital signs' assessment: a guide for clinical practice
Authors: Elliott Malcolm
Published: September 2021

The assessment of vital signs is critical for safe, high-quality care. Vital signs' data provide valuable insight into the patient's condition, including how they are responding to medical treatment and, importantly, whether the patient is deteriorating. Although abnormal vital signs have been associated with poor clinical outcomes, research has consistently found that vital signs' assessment is often neglected in clinical practice. Factors contributing to this include nurses' knowledge, clinical judgement, culture, tradition and workloads. To emphasise the importance of vital signs' assessment, global elements of vital signs' assessment are proposed. The elements reflect key principles underpinning vital signs' assessment and are informed by evidence-based literature.
General practice nurses' experiences of participation in an advanced nursing practice education programme
Authors: Mundy Jill , Pow Janette
Published: September 2021

In the UK, transformation of the nursing workforce, including development of the role of the advanced nurse practitioner within general practice, is essential to meet healthcare demands. This article presents the results of a small, qualitative study conducted among students at one university in Scotland, describing their experiences of participation in advanced practice education. Data were collected through semi-structured interviews to generate in-depth descriptions and to identify the facilitators and barriers to learning. The study identified that a shared responsibility for patient care creates opportunities for learning. The facilitators to learning were identified as foundation level education in history taking and clinical examination, finance, having a supportive network and mentorship. Barriers included pressure of work and a lack of clarity about roles and training needs. Given the key role that these nurses will have in future healthcare models, there is a requirement for a national education standard. It is recommended that the Nursing and Midwifery Council leads on defining advanced nurse practitioner in general practice programme learning outcomes. The overall aim of such courses is to enhance the experience for future nurses to encourage recruitment and transform the nursing workforce.
Addressing the current challenges of adopting evidence-based practice in nursing
Authors: Kerr Helen , Rainey Deborah
Published: September 2021

This aim of this article is to explore the current position of evidence-based practice (EBP) in nursing. The article provides an overview of the historical context and emergence of EBP with an outline of the EBP process. There is an exploration of the current challenges facing the nursing profession as it endeavours to adopt EBP into care delivery, along with actions to address these challenges. There will also be a discussion on how to integrate EBP into undergraduate nursing curricula as academic institutions implement the Future nurse standards of proficiency from the Nursing and Midwifery Council.
Providing post-lung transplant care during the time of COVID-19
Authors: Winward Sara , Lawrie Iain , Towell Susan Talbot , Sheridan Nina , Ging Patricia
Published: September 2021

The COVID-19 pandemic is a public health emergency of international concern. Solid organ transplant recipients have been identified as being at high risk of acquiring the virus SARS-CoV-2 and having a more severe COVID-19 disease. This article describes the experience of the National Lung Transplant Centre in Ireland in changing established care pathways for lung transplant recipients during the pandemic. The innovations which were put in place to protect this clinically vulnerable group are discussed. With the advancement of technology and remote monitoring systems available, patient-focused strategies and community-based interventions were implemented. Additional strategies have been implemented so that the new model of care can be safely maintained.
Compensating for clinical negligence: the need to go back to basics
Authors: Tingle John
Published: September 2021

John Tingle, Lecturer in Law, Birmingham Law School, University of Birmingham, discusses several reports looking at how our clinical negligence compensation system operates, and possible reform of this
Team working part 4: managing a team
Authors: Fowler John
Published: September 2021

John Fowler, Educational Consultant, explores the skills required to successfully manage a team
Meeting patients' mental health needs
Authors: Foster Sam
Published: September 2021

Sam Foster, Chief Nurse, Oxford University Hospitals, considers how nurses can provide better care to people with mental health conditions, who are often in a vulnerable position and require compassionate treatment
Actinomycosis: a case report of two patients treated for the condition who required stoma formation
Authors: Cronin Elaine Anne
Published: September 2021

Actinomycosis is a rare bacterial condition that is seen infrequently and no studies have examined its prevalence or incidence globally. The author, a stoma care clinical nurse specialist (CNS), found herself caring for two such patients 3 weeks apart, both of whom were diagnosed with pelvic actinomycosis. Both patients had been fitted with copper intrauterine devices (IUDs) 10 years previously and were not aware that leaving IUDs in situ for a prolonged period increased their risk of infection. This article gives an overview of the condition, with discussion around the two patients the author cared for within her own specialty; not all aspects of the condition are included as the she has no clinical experience in microbiology and is not a gynaecological CNS. The case studies show how both women presented and were treated, with interventions including emergency surgery, long-term antibiotic therapy and stoma formation. Pelvic actinomycosis is often associated with the use of an IUD, and greater awareness about the risk of leaving IUDs in situ for prolonged periods is needed among gastrointestinal, colorectal and gynaecological practitioners.
Virtual reality training in cardiopulmonary resuscitation in schools
Authors: Rees Nigel , Beever Lee , Vaughan Neil , Powell Carl , Fletcher Adam , John Nigel
Published: September 2021

The UK average survival rate from out of hospital cardiac arrest (OHCA) is 8.6%, which is significantly lower than in comparable countries where survival rates can exceed 20%. A cardiac arrest victim is two to four times more likely to survive OHCA with bystander cardiopulmonary resuscitation (CPR). Mandatory teaching of CPR in schools is an effective way, endorsed by the World Health Organization, to train the entire population and improve the bystander CPR rate. Despite this, as with other UK home nations, there is significant variation in provision of CPR training within schools in Wales. Virtual reality (VR) technology offers an accessible, immersive way to teach CPR skills to schoolchildren. Computer scientists at the University of Chester and the Welsh Ambulance Services NHS Trust developed Virtual Cardio Pulmonary Resuscitation (VCPR), which can be used to teach children CPR skills. There were three stages: identifying requirements and specifications; development of a prototype; and management—development of software, further funding and exploring opportunities for commercialisation.
Pulse oximetry to predict the onset of acute mountain sickness: a literature review
Authors: Bicknell Thomas
Published: September 2021

Acute mountain sickness (AMS) is a common illness affecting people ascending to high altitudes. AMS may progress rapidly, and can be fatal if symptoms are neglected, acclimatisation processes fail or if the ascent continues. For many patients with AMS or AMS symptoms, medical assistance is given by mountain rescue and allied health professionals. Currently, the prediction of AMS in the high-altitude environment relies upon recognising and tracking subjective symptoms. However, owing to psychophysical factors commonly associated with high-altitude travel, such as stress and fatigue, subjective symptom recall is innately at risk of bias. There is no objective method for predicting AMS. This scoping literature review analyses the accuracy of pulse oximetry as a tool for predicting the onset of AMS.
A dystopian new normal
Authors: Costello Barry
Published: September 2021

Looking back on his unconventional start in paramedicine, Barry Costello reflects on how to not only survive, but to thrive, as a paramedic despite the challenges of today's ‘new normal’
From qualified professional to student apprentice
Authors: Sweetlove Lee
Published: September 2021

As students prepare to return to their programmes this month, Lee Sweetlove provides insight into the struggles and joys of being one of the first students on the new tech to paramedic apprenticeship pathway in the East of England in this month's education edition of Paramedic Roles.
Long-term neurological and healthcare burden of adults with Japanese encephalitis: A nationwide study 2000-2015
Authors: Chen Hsuan-Ying , Yang Chen-Yi , Hsieh Cheng-Yang , Yeh Chun-Yin , Chen Chang-Chun , Chen Yen-Chin , Lai Chung-Chih , Harris Rebecca Claire , Ou Huang-Tz , Ko Nai-Ying , Ko Wen-Chien
Published: September 2021

Objective

To assess the healthcare utilization, economic burden, and long-term neurological complications and mortality of an adult population with Japanese encephalitis (JE).

Methods

This study utilized two nationwide datasets in Taiwan: the Notifiable Disease Dataset of confirmed cases from the Centers for Disease Control to identify JE patients, and the National Health Insurance Research Database to obtain patients’ healthcare utilization. Survival analyses were performed to identify prognostic factors associated with the all-cause mortality of patients.

Results

This study included 352 adult cases with JE (aged≥20 years). The mean age of JE patients was 45 years. Stroke (event rate: 3.49/100 person-years) was the most common neurological complication, followed by epilepsy/convulsions (3.13/100 person-years), encephalopathy/delirium (2.20/100 person-years), and parkinsonism (1.97/100 person-years). Among the 336 hospitalized patients at JE diagnosis, 58.33% required intensive care. Among 79 patients who died following JE diagnosis, 48.84% of death events occurred within the year of diagnosis. The medical costs increased considerably at JE diagnosis and subsequent-year costs remained significantly higher than the costs before diagnosis (p<0.05). Having a four-dose JE vaccination (i.e., born after 1976) versus no JE vaccination history (i.e., born before 1963) was significantly associated with lower all-cause mortality (hazard ratio: 0.221 [95% confidence interval: 0.067, 0.725]). Comorbid diabetes and incident epilepsy/convulsion events significantly increased the mortality risk by 2.47- and 1.85-fold, respectively (p<0.05).

Conclusion

A considerable medical burden associated with JE was observed in affected adults, even in the years following JE diagnosis. Vaccination should be considered to prevent this sporadic, but lethal, viral infection.
Individual corporate reputation and perception of collective corporate reputation regarding stock market investments
Authors: Blajer-Gołębiewska Anna
Published: September 2021

There are two different concepts of corporate reputation grounded in individual and collective perceptions, respectively. The aim of this study was to identify how these two ways of conceiving of corporate reputation affect investors’ decisions about whether or not to buy stock in a given company. As this problem tackles individual decision-making processes, we designed and applied an incentivised economic experiment based on vignette studies and focused on individual decisions of single investors. Subjects took part in an online game that imitates stock exchange conditions and that concerns corporate reputation and investing. We found that the individual propensity to invest is not directly based on an investor’s perception (rooted in historical share price and other objective metrics) of a firm’s reputation but rather on an investor’s subjective recognition of collective corporate reputation in the market. This suggests a need to rethink the popular measures of corporate reputation in the context of studies of stock market investor decisions.
Demographic, clinical characteristics and treatment outcomes of immune-complex membranoproliferative glomerulonephritis and C3 glomerulonephritis in Japan: A retrospective analysis of data from the Japan Renal Biopsy Registry
Authors: Nakagawa Naoki , Mizuno Masashi , Kato Sawako , Maruyama Shoichi , Sato Hiroshi , Nakaya Izaya , Sugiyama Hitoshi , Fujimoto Shouichi , Miura Kenichiro , Matsumura Chieko , Gotoh Yoshimitsu , Suzuki Hitoshi , Kuroki Aki , Yoshino Atsunori , Nakatani Shinya , Hiromura Keiju , Yamamoto Ryohei , Yokoyama Hitoshi , Narita Ichiei , Isaka Yoshitaka
Published: September 2021

The reclassification of membranoproliferative glomerulonephritis (MPGN) into immune-complex MPGN (IC-MPGN) and C3 glomerulopathy (C3G) based on immunofluorescence findings in kidney biopsies has provided insights into these two distinct diseases. C3G is further classified into dense deposit disease and C3 glomerulonephritis (C3GN) based on electron micrographic findings. Although these diseases have poor outcomes, limited Japanese literature confined to small, single-center cohorts exist on these diseases. We retrospectively analyzed 81 patients with MPGN type I and III from 15 hospitals in the Japan Renal Biopsy Registry to compare demographic, clinical characteristics and treatment outcomes of patients with IC-MPGN to those with C3GN. Of the 81 patients reviewed by immunofluorescence findings in kidney biopsies, 67 patients had IC-MPGN and 14 patients had C3GN. Age at diagnosis and systolic and diastolic pressure were higher and proteinuria and impaired renal function were significantly more prevalent in patients with IC-MPGN than those with C3GN. About 80% of the patients in both groups were treated with immunosuppressive therapy. At last follow-up (median 4.8 years), complete remission rate of proteinuria was significantly higher in patients with C3GN (64.3%) than in those with IC-MPGN (29.9%; P = 0.015). The renal survival rate was lower in patients with IC-MPGN when compared to C3GN (73.1% vs. 100%; log-rank, P = 0.031). Systolic blood pressure and renal function at baseline were independent predictors of progression to end-stage kidney disease. The overall prognosis of patients with C3GN is more favorable than for patients with IC-MPGN.
Comparison of revised EWGSOP2 criteria of sarcopenia in patients with cancer using different parameters of muscle mass
Authors: Trussardi Fayh Ana Paula , de Sousa Iasmin Matias
Published: September 2021

Calf circumference (CC) has been established as a marker of muscle mass (MM) with good performance for predicting survival in individuals with cancer. The study aims to determine the prevalence of sarcopenia according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criteria and to evaluate the accuracy of sarcopenia using low CC relative to MM assessment by computed tomography (CT) at third lumbar vertebra level (L3) as a reference. Cross-sectional study with cancer patients aged ≥ 60 years. Data included socio-demographic, clinical and anthropometric variables. MM was assessed by CC and by CT images at the L3. Sarcopenia was diagnosed according to the EWGSOP2 criteria: a) low handgrip strength (HGS) + reduced MM evaluated by CT; and b) low HGS + low CC. Pearson’s correlation, accuracy, sensitivity, specificity, positive predictive and negative predictive value were analyzed. A total of 108 patients were evaluated, age of 70.6 ± 7.4 years (mean ± standard deviation). The prevalence of sarcopenia was of 24.1% (low MM) and 25.9% (low CC). The Kappa test showed a substantial agreement (K = 0.704), 81% sensitivity, and 92% specificity. Although the EWGSOP2 advises that we should use CC measures in the algorithm for sarcopenia when no other MM diagnostic methods are available, the findings allow the use of CC instead of MM by CT in cancer patients.
The influence of neuromuscular blockade on phase lag entropy and bispectral index: A randomized, controlled trial
Authors: Jin Sohee , Baik Hee Jung , Cho Sooyoung , Chung Rack Kyung , Kong Kyoung Ae , Kim Youn Jin
Published: September 2021

The aim of this study is to compare the effects of neuromuscular blockade (NMB) on phase lag entropy (PLE) and the bispectral index (BIS). We recorded the BIS, electromyograph (EMG) activity on a BIS monitor (EMG_BIS), PLE, and EMG activity on a PLE monitor (EMG_PLE) in 40 patients receiving general anesthesia. During the awake state, we analyzed the changes in parameters before and 2 min after the eyes were closed. During sedation, we compared the changes in the parameters before and at 4 min after injecting rocuronium (group R) or normal saline (group C) between the two groups. During anesthesia, we compared the changes in parameters before and at 4 min after injecting sugammadex (group B) or normal saline (group D) between the two groups. During the awake state, the BIS, EMG_BIS, and EMG_PLE, but not PLE, decreased significantly with closed eyes. An effect of EMG on the BIS was evident, but not on PLE. During sedation, the BIS decreased with the decrease in EMG_BIS regardless of NMB caused by rocuronium, but NMB decreased PLE, although the degree of the decrease in EMG_PLE after NMB was similar to that after placebo. To determine the effect of NMB on electroencephalograms (EEGs) in groups R and C, we plotted the power spectra before and at 4 min after injecting rocuronium or normal saline. Changes in slow and delta frequency bands were observed at 4 min after injecting rocuronium relative to before injecting rocuronium. There was no effect of EMG on either the BIS or PLE during anesthesia. In conclusion, the effect of electromyograph activity and/or neuromuscular blockade on BIS or PLE depends on the level of consciousness.
Downgrading among higher education graduates in Italy and France: exploring regional differences
Authors: Carella Maria , Léger Jean-François
Published: September 2021

In France and Italy – like all the countries of the European Union – the proportion of higher education graduates in the working population has continued to increase. At the same time, the number of jobs requiring this level of education has not grown as quickly. In France and Italy, this has meant a decrease in the proportion of tertiary graduates who occupy managerial positions, and a growing share of these graduates hold jobs as middle and low ranking employees. Several studies have investigated the phenomenon of professional downgrading, focusing on its structural determinants and socio-economic implications at the national level and examining international differences. Nevertheless, only a few studies explore disparities in over-education and compare nations at the regional level. By addressing the need for a spatial approach to this subject, which is so far lacking in the scientific literature, this paper examines the downgrading of higher education graduates in Italy and France at the regional level and discusses the real occupational returns for high levels of education. Using data from the Italian and French censuses, the findings of this analysis show significant sub-regional heterogeneities regarding access to managerial positions for graduates according to the territorial unit observed.
Tuberculosis prevalence in animals and humans in the Republic of Kazakhstan
Authors: Turgenbayev Kairat Altynbekovich , Borsynbayeva Assiya Madenovna , Plazun Aleksandr A. , Turgenbayev Rauan K.
Published: September 2021

Background and Aim: Tuberculosis is an infectious disease that affects humans and animals. This study aimed to review the influence of economic and organizational, veterinary, and sanitary measures on the epizootic situation of animal tuberculosis and the epidemiological situation of human tuberculosis in the Republic of Kazakhstan.

Materials and Methods: The epizootic situation of cattle tuberculosis in Kazakhstan was studied based on the annual statistics of allergy testing of animals with tuberculosis by the Committee for Veterinary Control and Supervision of the Ministry of Agriculture of the Republic of Kazakhstan, according to the results of allergic, clinical, and pathological studies, including laboratory studies of biomaterials from animals that reacted to tuberculin. Tuberculinization of cattle in the country is performed twice in the spring and autumn using tuberculin purified protein derivative for mammals. In addition, mass diagnosis of human tuberculosis is conducted by radiology.

Results: The authors assessed the epizootic situation of tuberculosis in cattle in Kazakhstan from 1991 to 2019. The analysis results showed that at the beginning, the epizootic situation in cattle tuberculosis was challenging. However, since 2001, there has been a noticeable decrease in tuberculosis in animals in Kazakhstan, which has had a favorable effect on the epidemic situation of human tuberculosis.

Conclusion: According to the analysis results, the measures used in the Republic of Kazakhstan to prevent tuberculosis improved the well-being of livestock farms. The proper conduct by qualified veterinary specialists on allergy testing of animals and differential diagnosis of nonspecific tuberculin reactions allows establishing an accurate epizootic picture of tuberculosis. Furthermore, strict adherence to instructions on the diagnosis and prevention of tuberculosis, implementation of developed veterinary, sanitary, and organization, and economic measures can improve the epizootic picture of tuberculosis, reducing the risk of human tuberculosis.
Creencias maleables y esperanza en apoyo a concesiones del acuerdo con las FARC-EP en un contexto polarizado en Colombia
Authors:   Universidad del Norte, Barranquilla, Colombia, Rico Revelo Diana , Barreto Idaly ,   Universidad Católica de Colombia, Bogotá, Colombia, Mendoza Becerra Manuel ,   Universidad del Norte, Barranquilla, Colombia
Published: September 2021

Introducción: Este estudio analizó el papel de creencias maleables y esperanza en la disposición para apoyar concesiones del acuerdo con las FARC-EP en un contexto de polarización política. Método: Se desarrolló un estudio no experimental con 562 ciudadanos. Resultados: Los resultados confirman que la esperanza de paz surge de una percepción general del mundo como cambiante; y por lo tanto, las personas que creen que el conflicto colombiano con las FARC-EP puede cambiar, desarrollan una actitud esperanzadora, presentando más apoyo a concesiones sobre la justicia especial para la paz (JEP) y la participación en política de exguerrilleros. Asimismo, se encontró que las personas con orientación política de izquierda y de centro apoyan más las concesiones del acuerdo en comparación con personas con orientación política de derecha. Conclusiones: El estudio refleja que la polarización política constituye un obstáculo para el desarrollo de creencias maleables y actitudes esperanzadoras que favorecen la desescalada del conflicto. Se presentan las implicaciones prácticas sobre la formación de actitudes que favorecen salidas constructivas del conflicto, y sobre la responsabilidad de actores políticos en la formación de creencias rígidas que constituyen barreras para la paz.
Consecuencias reproductivas y sanitarias de los abortos bovinos en la cuenca lechera del Valle de Lerma, Salta, Argentina
Authors: SUAREZ Víctor H. , MARTÍNEZ Gabriela M.
Published: September 2021

Con el objetivo de investigar los efectos de los abortos bovinos en la cuenca lechera del Valle de Lerma se estudiaron los registros de datos de 128 vacas Holstein en ordeño obtenidos de software de 4 tambos. Los abortos se clasificaron en: vacas abortadas, vueltas a inseminar que continúan en lactancia (VAC, n= 36) y vacas que abortaron e iniciaron en una nueva lactancia (VAI, n=33), además se les sumaron los registros de vacas con partos normales (VPN, n= 59). Se registraron los litros de leche a los 305 días de lactancia (L/305), los días en lactancia (DEL), los intervalos entre partos (IPP), número de eventos de salud ocurridos pos aborto y el destino final de los animales (continúa en el tambo, descarte, muerte o sacrificio). Las variables continuas se sometieron a análisis de varianza en un modelo lineal mixto y las discretas a la prueba de Chi cuadrado y Odds Ratio (OR). No se hallaron diferencias entre los litros de leche producidos (L/305) por las vacas VPN (8640 l) y las VAC (8498 l) pero si (p<0,0001) entre éstas y el grupo VAI (5742), considerando las vacas de diferente número de lactancias y el tiempo gestacional del aborto. El grupo VAC tuvo DEL (p<0,0001) e IPP (p<0,0001) respectivamente más prolongados (639,7 e 441,2 d.) que las vacas del VAI (419,9 e 404,2 d.) y VPN (405,5 e 476,7 d.). Las vacas abortadas (VAC + VAI) tuvieron una mayor (p<0,0001) probabilidad de contraer respectivamente desórdenes sanitarios y reproductivos (OR= 6,5, IC 3,2 - 24,3) y descartes más muertes/sacrificios (OR= 6,72, IC 2,9 - 15,1) en comparación con VPN. Estos resultados muestran los graves efectos de los abortos sobre la performance productiva y la salud de las vacas lecheras.
Trees of Yadahalli Chinkara Wildlife Sanctuary, Bagalkot, Karnataka, India: A checklist
Authors: Koti Maheshwari , Kotresha K
Published: September 2021

Yadahalli Chinkara Wildlife Sanctuary is located in semi-arid zone of north Karnataka with heterogeneous vegetation types within it. The forest has variable geographical features such as rocky slopes, open grass lands, scrub forest, seasonal minor waterfalls and lakes. The present paper provides a checklist of tree species of Yadahalli Chinkara Wildlife Sanctuary, Bagalkot, which spreads over the Bilagi and Mudhol taluka. The list comprises of 80 tree species belonging to 67 genera of 34 families. The family Fabaceae contributes 23 species followed by Moraceae, Rubiaceae and Rutaceae 4 species each. Out of 80 species, three species are endemic to Peninsular India, four species are Vulnerable (VU), and one species is Near Threatened (NT) at global level. The present work is an inventory of tree species of Yadahalli Chinkara Wildlife Sanctuary, Bagalkot, in view to create awareness among the local people and to support the conservation activities in the forest.
Summary of the National Advisory Committee on Immunization (NACI) Seasonal Influenza Vaccine Statement for 2021–2022
Authors:   on behalf of the National Advisory Committee on Immunization (NACI), Sinilaite Angela , Young Kelsey , Harrison Robyn
Published: September 2021

Background: Several influenza vaccines are authorized in Canada and the evidence on influenza immunization is continually evolving. The National Advisory Committee on Immunization (NACI) provides recommendations regarding the use of seasonal influenza vaccines annually to the Public Health Agency of Canada (PHAC). Objective: To summarize NACI recommendations regarding the use of seasonal influenza vaccines for 2021–2022 and to highlight new recommendations. Methods: Annual influenza vaccine recommendations are developed by NACI's Influenza Working Group for consideration and approval by NACI. The development of the recommendations is based on the NACI evidence-based process. Results: The following new recommendations were made: 1) Influvac® Tetra may be considered as an option among the standard dose quadrivalent inactivated influenza vaccines (IIV4-SD) offered to adults and children three years of age and older; 2) Fluzone High Dose Quadrivalent (IIV4-HD) may be considered an option for individuals 65 years of age and older who are currently recommended to receive Fluzone® High Dose (trivalent); and 3) Flucelvax® Quad may be considered amongst the quadrivalent influenza vaccines offered to adults and children nine years of age and older for annual influenza immunization. Guidance for use of influenza immunizations during the coronavirus disease 2019 pandemic is also highlighted. Conclusion: NACI continues to recommend that an age-appropriate influenza vaccine should be offered annually to anyone six months of age and older who does not have contraindications to the vaccine. Vaccination should be offered as a priority to people at high risk of influenza-related complications or hospitalization, people capable of transmitting influenza to those at high risk of complications, and others as indicated.
Factors affecting the recovery of Kurdistan province COVID-19 patients: a cross-sectional study from March to June 2020
Authors: Zandkarimi Eghbal
Published: September 2021

Objectives

The Coronavirus disease 2019 (COVID-19) is a new viral disease of the coronavirus family that has a close relationship with SARS species. This study aims to identify factors affecting the recovery of COVID-19 patients in a population with a majority of Kurdish residents.

Methods

For this purpose, all clinical and demographic parameters were collected from patients with COVID-19 who were outpatients or hospitalized in Kurdistan province (located in western Iran) from March to June 2020. We used the binary logistic regression model to recognition affecting factors to recovery in the COVID-19.

Results

According to the results of this study, age, sex, coronary heart disease (CHD), cancer, and using antiviral drugs were associated with the chance of recovery.

Conclusions

Based on the findings of this study, it can be concluded that the chances of recovery of COVID-19 patients who are elderly or have underlying diseases such as CHD or cancer are low. On the other hand, viral drugs are effective in increasing the chances of recovery.
The Politics of Civil Procedure: The Curious Story of the Process for the Eviction of Tenants
Authors: Rosen-Zvi Issi , Rosenberg Israel
Published: September 2021

This article examines the process for the eviction of tenants (PET), which offers landlords a swift path for obtaining an eviction order against their tenants, as a case study exposing the politics of procedure. It shows that the PET is but one stage in a longstanding battle waged between two interest groups—landlords and tenants—involving both substantive law and procedural law. But while the story of their conflict over substantive law, fought in the parliament through the regular legislative process, is well-known, the story of the procedural amendments, despite their immense impact, remains shrouded in mystery and is told here for the first time. The reason for that, we argue, is that despite the vast impact of procedure on substantive right, many in the Israeli legal system mistakenly view civil procedure rules as highly technical and neutral directives for the day-to-day operation of the litigation process. The conclusion from such a view is that rulemaking should be left to expert legal technicians and court administrators and that transparency mechanisms or public participation are to be avoided as unnecessary due to the costs and burdens they impose on the rulemaking process. The article concludes with a call for overhauling the rulemaking process in Israel. We argue that the secretive and opaque process is anathema to democracy. Bearing in mind that procedural rules are inevitably imbued with substantive values and have an enormous effect on the substantive rights of the citizenry, the rulemaking process should be radically altered to enable all interested parties to take part in the process, making it far more transparent and subject to public scrutiny in all its stages.
Physicochemical stability of human insulin 1 I.U./mL infusion solution in 50 mL polypropylene syringes
Authors: Mohr André , Erdnüß Frank , Krämer Irene
Published: September 2021

Objectives

The objective of this study was to investigate the physicochemical stability of human insulin 1 I.U./mL injection solutions (Insuman® Rapid) diluted with 0.9% NaCl solution in 50 mL disposable three-piece polypropylene syringes and stored refrigerated or at room temperature.

Methods

1 I.U./mL test solutions were prepared with Insuman® Rapid and 0.9% sodium chloride infusion solution in 50 mL Original-Perfusor® syringes and BD® Perfusion syringes. Test solutions were stored for 90 days at 2–8 °C/dark or 48 h at 20–25 °C/diffuse room light in order to determine chemical stability. Additional test solutions were stored 28 days at 2–8 °C/dark followed by 24 h at 20–25 °C/diffuse room light to measure pH and particle counts. Human insulin concentrations were analysed by reversed-phase high-performance liquid chromatography at predefined time points. Test solutions were regularly inspected; subvisible particles and pH values were measured.

Results

Insuman® Rapid 1 I.U./mL injection solutions, stored at 2–8 °C/dark for 90 days showed a decrease of insulin content over time, regardless of the syringe type used. When kept at 20–25 °C/diffuse room light for 48 h, a slight decrease of the HI concentration was observed in both syringe types. No evidence of colour change, relevant particle formation or major pH-change was observed throughout the observation period in any test solution.

Conclusions

Insuman® Rapid 1 I.U./mL injection solutions can be prepared by dilution with 0.9% NaCl infusion solution in disposable 50 mL three-piece polypropylene syringes as suitable primary containers. Physicochemical stability has been demonstrated for at least 21 days stored at 2–8 °C/dark followed by 48 h at 20–25 °C/diffuse room light.
Ischemic stroke as a presenting manifestation of polycythemia vera: a narrative review
Authors: Burattini Marco , Falsetti Lorenzo , Potente Eleonora , Rinaldi Claudia , Bartolini Marco , Buratti Laura , Silvestrini Mauro , Viticchi Giovanna
Published: September 2021

Polycythemia vera (PV) is a myeloproliferative disorder associated with an increased risk of cerebrovascular diseases. In this narrative review, we aimed to analyze the relationships between acute ischemic stroke and PV. We conducted a PubMed/Medline and Web of Sciences Database search using MeSH major terms. We found 75 articles and finally considered 12 case reports and 11 cohort studies. The ischemic stroke resulted as the first manifestation of PV in up to 16.2% of cases; the cumulative rate of cerebrovascular events was up to 5.5 per 100 persons per year and stroke accounted for 8.8% of all PV-related deaths; age, mutations, and a previous history of thrombosis were the main risk factors. The best approach to reduce stroke recurrence risk is unclear, even if some evidence suggests a potential role of lowering hematocrit below 45%. Ischemic stroke represents one of the most common PV manifestations but, despite their relationship, patients with both diseases have a very heterogeneous clinical course and management. PV-related strokes often remain underdiagnosed, especially for the low prevalence of PV. An early diagnosis could lead to prompt treatment with phlebotomy, cytoreduction, and low-dose aspirin to decrease the risk of recurrences. Clinicians should be aware of PV as a risk factor for stroke when approaching the differential diagnosis of cryptogenic strokes. An early diagnosis could positively influence patients’ management and clinical outcomes. Further studies are required to evaluate the role of PV treatments in the prevention of cerebrovascular disease.
Aggiornamenti su Bartolomeo Varnucci
Authors: Guernelli Daniele
Published: September 2021

This article outlines the figure of the Florentine Bartolomeo Varnucci, an illuminator who for decades had his workshop in the Badia Fiorentina, where he was assisted by his brothers Giovanni and Chimenti. They where all cartolai, craftsmen able to take care of the production of manuscripts as a whole, from the preparation of the parchment to the binding. Active from the third to the eighth decade of the fifteenth century, Bartolomeo was able to interpret the rise of humanistic book production, with its typical decoration of white vine stems, but also to move through the vast requests of the devotional world, more inclined to conservative artistic solutions. This contribution gives a complete survey of the artist’s milieu and work, adding several new works to his catalogue.
“Malerische Dichtungen”: Two Landscape Paintings of 1916 by Ernst Ludwig Kirchner
Authors: Simmons Sherwin
Published: September 2021

During 1916 Ernst Ludwig Kirchner created a group of landscape paintings, based on his experiences at the Kohnstamm Sanatorium in Königstein, which were more symbolic in character than his previous landscapes. This essay shows that contact with Carl and Thea Sternheim, who encouraged a reengagement with Vincent van Gogh’s paintings and letters, played a role in this change. Kirchner’s recognition of how Van Gogh could express an affect through his painting was reinforced by Dr. Kohnstamm’s writings about empathy’s role in artistic expression. Artistic practice and aesthetic theory were joined in representations of Jena done during Fall 1916 in which Kirchner transformed the landscape through formal means into symbols of his emotional relationship to that space.
The Anachronic Madonna Lactans: Impersonations of the Nursing Virgin by Cindy Sherman, Catherine Opie, and Vanessa Beecroft
Authors: Sperling Jutta
Published: September 2021

This article examines Cindy Sherman’s Untitled #216 (1989), Catherine Opie’s Self-Portrait/ Nursing (2004), and Vanessa Beecroft’s White Madonna or VBSS.002 (2006) in relation to the medieval and Renaissance artworks these photos quote and re-instantiate: Jean Fouquet’s Virgin of Melun (1452–1455); Ambrogio Lorenzetti’s Madonna del Latte (1325–1335) and Leonardo da Vinci’s Litta Madonna (1490s); and Tino di Camaino’s Charity (1321) and Jan van Eyck’s Lucca Madonna (1436), respectively. This juxtaposition — framed by reference to Alexander Nagel’s and Christopher Wood’s concept of “anachronism” and to Aby Warburg’s notion of the Pathosformel — helps us ask new questions and gain new insights about the “old masters” under discussion.