bluuebunny/crossref_metadata_2025 huggingface dataset:
Is the psychological composition of the therapeutic group associated with individual outcomes in group cognitive behavioural therapy for chronic pain?
Authors: Wilson Dianne , Mackintosh Shylie , Nicholas Michael K , Moseley G Lorimer , Costa Daniel S J , Ashton-James Claire E
Published: December 2019

This study explored whether the psychological composition of a group, with respect to mood, catastrophising, fear of movement and pain self-efficacy characteristics at baseline, is associated with individuals’ treatment outcomes following group cognitive behavioural therapy (CBT)-based programmes for chronic pain. Retrospective analyses of outcomes from two independently run CBT-based pain management programmes (Programme A: N = 317 and Programme B: N = 693) were conducted. Mixed modelling analyses did not consistently support the presence of associations between group median scores of depression, catastrophising or fear avoidance with outcomes for individuals in either programme. These results suggest that the psychological profiles of groups are not robust predictors of individual outcomes in CBT groups for chronic pain. By implication, efforts made to consider group composition with respect to psychological attributes may be unnecessary.
An uncommon infectious etiology in an unlikely geographic location: A case report of cutaneous blastomycosis in Saskatchewan
Authors: Richels Lindsay , Holfeld Karen
Published: December 2019

Blastomycosis is a primary pulmonary mycosis of humans usually affecting patients geographically located near the Great Lakes, Lake-of-the-Woods and northern Ontario. We report a case of cutaneous blastomycosis in a patient with no environmental contact outside of Saskatchewan.
The decision of targeted, systematic or combined biopsy in a biopsy naïve patient for the diagnosis of prostate cancer, can be made on the basis of multiparametric magnetic resonance imaging
Authors: Sarkar Debashis , Nandi Debashis , Gangoli Sameer , Hicks James , Carter Paul
Published: December 2019

Introduction:

The current trend to implement multiparametric magnetic resonance imaging (mpMRI)-guided targeted biopsy (TB) as primary biopsy for the diagnosis of suspected prostate cancer and to avoid systematic biopsy (SB) is growing. However, concern remains regarding missing clinically significant (Cs) cancer on the normal mpMRI areas of the prostate. Therefore, we compared the normal and abnormal areas from mpMRI at the same prostate biopsy, using simultaneous SB and TB technique.

Methods:

A prospective, comparative effectiveness study included 134 patients initially referred for primary biopsy (from October 2017 to June 2018); 100 men were selected, mean age 68 years, with a median level of prostate specific antigen of 7.6, with average prostate volume of 52 cm3 (T3 disease and prostate imaging reporting and data system (PI-RADS) score < 3 were excluded). All underwent six cores TB (median), from an average of two lesions on mpMRI and also eight cores SB (median) from normal mpMRI areas of the prostate after informed consent.

Results:

The combined (SB + TB) biopsy cancer detection rate was 67%, 51% having Cs disease. For Cs cancer, 35 patients were detected by both techniques. TB missed four Cs cancer (95% confidence interval (CI), p < 0.0001). Fewer men in the TB group than in the SB group were found to have clinically insignificant (Ci) cancer (95% CI, p < 0.0001). No Cs cancer diagnosis was missed on TB from PI-RADS 5 lesion. Overall, 4% Cs cancers were missed on TB and avoided over diagnosis of 9% Ci cancer.

Conclusions:

Cognitive TB didn’t miss any Cs cancer from PI-RADS 5 lesion found on mpMRI. Only doing Cognitive TB on PI-RADS 5 lesion would save time, reduce workload and will be cost effective both for Urology and Pathology. PI-RADS 3 and 4 lesions on mpMRI will benefit from adding systematic samples.

Level of evidence:

4 Oxford Centre for Evidence-Based Medicine (CEBM).
Early recurrence and the need for re-resection following Photodynamic diagnosis–assisted Transurethral Resection of Bladder Tumours: Multi-centre real-world experience of the UK PDD Users Group
Authors: Mariappan Paramananthan , Bunce Colin , Cresswell Jo , Shamsuddin Altaf , Crundwell Malcolm , Donat Roland , Hurle Rhidian A , Zachou Alexandra , Stewart Sarah , Hartley Louise J , Mostafid Hugh ,   for the UK PDD Users Group
Published: December 2019

Objective:

This study aimed to investigate the association between Photodynamic Diagnosis (PDD) with hexaminolevulinate (HAL) and the rate of complete resection and disease persistence at first follow-up cystoscopy for non-muscle-invasive bladder cancer (NMIBC) in UK real-world practice.

Methods:

Audit data were pooled from six UK centres where HAL PDD was used in patients with a new NMIBC diagnosis undergoing transurethral resection of bladder tumours (TURBT) since 2008. Patients received adjunctive intra-vesical therapy and surveillance in line with European and UK guidelines, including early re-resection in high-grade NMIBC.

Results:

PDD-assisted TURBT was done in 837 patients with new NMIBC. The detrusor muscle was present in 69.4% of cases. At early re-TURBT in 207 high-risk patients, 13.0% had residual disease. Multifocal disease was the most significant factor in increasing the rate of residual disease (odds ratio excluding cases of CIS=4.1; 95% confidence interval 1.5–11.3). The recurrence rate at first follow-up cystoscopy (RRFFC) was 10.6% (8.9% in patients with complete initial TURBT). In the historical cohort undergoing good-quality white-light TURBT, RRFFC was 31%; 40.5% of high-risk patients had residual disease at early re-TURBT.

Conclusion:

HAL PDD may increase the rates of complete resection, reducing the risk of early recurrence and the need for routine re-resection in high-grade NMIBC.

Level of evidence:

2b.
Early perfusion changes in multiple sclerosis patients as assessed by MRI using arterial spin labeling
Authors: de la Peña Mar Jiménez , Peña Ignacio Casanova , García Pablo García-Polo , Gavilán Miguel López , Malpica Norberto , Rubio Margarita , González Rafael Arroyo , de Vega Vicente Martínez
Published: December 2019

Background

Gadolinium-perfusion magnetic resonance (MR) identifies gray matter abnormalities in early multiple sclerosis (MS), even in the absence of structural differences. These perfusion changes could be related to the cognitive disability of these patients, especially in the working memory. Arterial spin labeling (ASL) is a relatively recent perfusion technique that does not require intravenous contrast, making the technique especially attractive for clinical research.

Purpose

To verify the perfusion alterations in early MS, even in the absence of cerebral volume changes. To introduce the ASL sequence as a suitable non-invasive method in the monitoring of these patients.

Material and Methods

Nineteen healthy controls and 28 patients were included. The neuropsychological test EDSS and SDMT were evaluated. Cerebral blood flow and bolus arrival time were collected from the ASL study. Cerebral volume and cortical thickness were obtained from the volumetric T1 sequence. Spearman’s correlation analyzed the correlation between EDSS and SDMT tests and perfusion data. Differences were considered significant at a level of P < 0.05.

Results

Reduction of the cerebral blood flow and an increase in the bolus arrival time were found in patients compared to controls. A negative correlation between EDSS and thalamus transit time, and between EDSS and cerebral blood flow in the frontal cortex, was found.

Conclusion

ASL perfusion might detect changes in MS patients even in absent structural volumetric changes. More longitudinal studies are needed, but perfusion parameters could be biomarkers for monitoring these patients.
Encouraging Attention and Exploration in a Hybrid Recommender System for Libraries of Unfamiliar Music
Authors: Taylor John R. , Dean Roger T.
Published: December 2019

There are few studies of user interaction with music libraries comprising solely of unfamiliar music, despite such music being represented in national music information centre collections. We aim to develop a system that encourages exploration of such a library. This study investigates the influence of 69 users’ pre-existing musical genre and feature preferences on their ongoing continuous real-time psychological affect responses during listening and the acoustic features of the music on their liking and familiarity ratings for unfamiliar art music (the collection of the Australian Music Centre) during a sequential hybrid recommender-guided interaction. We successfully mitigated the unfavorable starting conditions (no prior item ratings or participants’ item choices) by using each participant’s pre-listening music preferences, translated into acoustic features and linked to item view count from the Australian Music Centre database, to choose their seed item. We found that first item liking/familiarity ratings were on average higher than the subsequent 15 items and comparable with the maximal values at the end of listeners’ sequential responses, showing acoustic features to be useful predictors of responses. We required users to give a continuous response indication of their perception of the affect expressed as they listened to 30-second excerpts of music, with our system successfully providing either a “similar” or “dissimilar” next item, according to—and confirming—the utility of the items’ acoustic features, but chosen from the affective responses of the preceding item. We also developed predictive statistical time series analysis models of liking and familiarity, using music preferences and preceding ratings. Our analyses suggest our users were at the starting low end of the commonly observed inverted-U relationship between exposure and both liking and perceived familiarity, which were closely related. Overall, our hybrid recommender worked well under extreme conditions, with 53 unique items from 100 chosen as “seed” items, suggesting future enhancement of our approach can productively encourage exploration of libraries of unfamiliar music.
The use of a non-medicated dressing for superficial-partial thickness burns in children: a case series and review
Authors: Kusu-Orkar Ter-Er , Islam Umar , Hall Benjamin , Araia Evan , Allorto Nikki
Published: December 2019

Background:

Cutimed® Sorbact® is a dressing marketed as having antimicrobial properties and easy application without the threat of antibiotic resistance and difficult accessibility. There is little evidence on the clinical outcomes of the use of Cutimed® Sorbact® in adults and currently no evidence of use of Cutimed® Sorbact® on superficial-partial thickness burn injuries in children.

Objective:

To summarise the clinical outcome of burn wounds in children with superficial-partial thickness burns in which Cutimed® Sorbact® was used.

Method:

An observational case series was conducted in Edendale Hospital, Pietermaritzburg, South Africa over the course of four weeks. Patients where included if they were aged < 10 years and had a ⩽ 15% superficial-partial burn. The primary outcome measure was time to 95% re-epithelialisation. Secondary outcome measures included wound complications, adverse healing and number of dressing changes.

Results:

Ten patients (five girls, five boys; age range = 11 months–8 years) were included in this case series. All participants had a type VI Fitzpatrick skin type and 80% of burns were hot water burns. Of all patients treated with Cutimed® Sorbact®, 50% healed within seven days, 70% within 14 days and 100% within 21 days. There was only one wound complication noted in this study and there was no adverse healing in any burn wounds. The mean number of dressing changes was 1.4 (range = 1–2) and length of hospital stay was in the range of 0–11 days (mean = 5.1 days).

Conclusion:

Cutimed® Sorbact® is a safe, useful and cost-effective dressing that should be used as an alternative for superficial-partial burns in children.
The pains of parole for life sentence prisoners in Ireland: Risk, rehabilitation and re-entry
Authors: Griffin Diarmuid , Healy Deirdre
Published: December 2019

The number of people serving life sentences in Irish prisons has increased substantially in recent years, such that one in nine sentenced prisoners is now serving a life sentence. Critical attention on the release of life sentence prisoners in Ireland has tended to focus on the political and informal nature of parole decision-making. Yet little is known about the experiences of those navigating the release process. This article begins to address the gap by offering a critical reflection on the parole process, focusing on the potential ‘pains’ experienced by life sentence prisoners when seeking parole. The analysis is organised into three themes that broadly fall under the umbrella of risk management: dealing with a serious criminal past, engaging with in-prison rehabilitation services, and reintegrating into society after release from custody. An analysis of this kind is timely given the growing concerns both nationally and internationally regarding the administration of life sentences and the appropriate mechanism of release.
Belgian release policies, rationales and practices
Authors: Beyens Kristel
Published: December 2019

Belgium has a two-track policy towards prison release: a quasiautomatic administrative release system for those with a prison sentence of up to three years, and a discretionary system operated by multidisciplinary Sentence Implementation Courts for persons with a prison term of more than three years. This article describes, discusses and compares both release systems, with a particular focus on their rationales and consequences and provides updated figures on the use of the different forms of release in Belgium. The principle of relative autonomy will be described as an important legitimation strategy of conditional release. The article explains how the sentence implementation rationale of reintegration is put forward as an important aim of sentence implementation in the law and how it is pursued in practice. The consequences of the increasing use of the ‘gradual system’ of release on the detention trajectory of long-term prisoners will be illustrated.
Marginal gains or diminishing returns? Penal bifurcation, policy change and the administration of prisoner release in England and Wales
Authors: Guiney Thomas
Published: December 2019

Prisoner release has emerged as a key site of penal policy contestation in England and Wales. A series of crises have undermined public confidence in the parole system and reopened longstanding debates over the confused normative basis of prisoner release policy and practice. This article attempts to locate current concerns within an ideational interpretation of penal policy change. It will argue that prisoner release has been fundamentally re-shaped by a bifurcated penal strategy that emerged as one possible response to the unique challenges of late-modern crime-control. Over time this strategy has provided an enduring guide to collective action and a political template for successive penal reform programmes. However, there are signs that we may now be reaching the conceptual limits of this strategy. While the logic(s) of bifurcation will continue to yield marginal political gains in the short-term, this article concludes that the long-term prognosis is one of diminishing returns with significant implications for the legitimacy, effectiveness and administrative coherence of prisoner release in this jurisdiction.
The Effect of Expected Income on Wealth Accumulation and Retirement Contribution of Thai Wageworkers
Authors: Ketkaew Chavis , Van Wouwe Martine , Vichitthamaros Preecha , Teerawanviwat Duanpen
Published: December 2019

Thailand has now become the aging society. However, the fact that the majority of Thai wageworkers do not effectively save for their retirement may result in several elderly living below the poverty threshold during retirement. The objectives of this research article were to find the factors determining Thai wageworkers’ retirement contribution. Founded on the theory of life-cycle hypothesis, this article employed a sample of 300 wageworkers in the Northeast of Thailand and performed a statistical analysis using the structural equation modeling (SEM) approach using age as a moderator. The empirical results revealed that expected income, wealth accumulation, career status, and health status were the main constructs influencing an individual’s ability to contribute to his or her retirement. This article suggested that a wageworker should first contribute his or her income through wealth accumulation schemes such as investment in financial assets, for example, stocks, bonds, mutual funds, and properties, investment in other business as a second job, and simply cash deposit. The results suggested that wealth accumulation was the most important mediator allowing a wageworker to contribute to retirement effectively in the long term. This article also proposed thoughtful research implications for wageworkers, employers, and the Thai government. This article recommended that the government and authorized bodies (e.g., the Bank of Thailand and the Stock Exchange of Thailand) should provide more investment alternatives and improve investment knowledge of the citizens. This would allow the citizens to have sufficient financial knowledge to invest in riskier financial instruments that potentially give better returns such as stocks.
Understanding Social Roles in a Continuum: An Experience From Two Cultural Groups in Ethiopia
Authors: Amsalu Desalegn
Published: December 2019

Based on an ethnographic fieldwork experience among two culturally different ethnic groups in Ethiopia, this article proposes an understanding of social roles in the field in a continuum. The two groups are known as Gumuz and Agaw. In my fieldwork with the Gumuz, I was an “outsider” and the Gumuz social boundary did not allow me to socialize unless through a certain institution known as mijim. In my fieldwork with the Agaw, I was an insider because I was born and grew up among this community. The Agaw social boundary was so open and, contrary to the Gumuz, I had to resist social roles. I propose that arguments that are advocated by scholars on extreme sides of taking or refusing social roles based on perceived advantages or disadvantages are untenable. Social roles are complex because social and cultural contexts do vary and are also complex. I argue that blanket suggestions of either acceptance or refusal of social roles cannot yield successful fieldwork. A social role is a continuum and fieldworkers fall on the line the fieldwork contexts require, and the use of them depends on personal skills of a researcher.
Effect of Nearly Isometric ACL Reconstruction on Graft-Tunnel Motion: A Quantitative Clinical Study
Authors: Wan Fang , Chen Tianwu , Ge Yunshen , Zhang Peng , Chen Shiyi
Published: December 2019

Background:

In anterior cruciate ligament (ACL) reconstruction, minimizing the graft-tunnel motion (GTM) will promote graft-to-bone healing and avoid graft loosening or tearing as well as potential bone tunnel enlargement. A nearly isometric state of the graft can be achieved by placing the tunnel properly to theoretically gain better graft-to-bone healing. However, little clinical evidence is available to quantify the relation between GTM and tunnel position.

Purpose:

To find the proper zones for the femoral and tibial tunnel apertures that minimize the GTM, referred to as the “nearly isometric zone,” through use of intraoperative GTM measurement and 3-dimensional computed tomography (3D-CT).

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

A total of 100 patients were enrolled in this study. Nearly isometric ACL reconstruction was performed, and an intra-articular GTM measuring device was designed to measure and record the amplitude of GTM while the knee was flexed from 0° to 120°. Postoperatively, the patients underwent multislice CT, and the images were used to create 3D-CT models. After tibial aperture examination, 5 patients were excluded due to the divergence of tibial aperture, and therefore 95 patients remained in the study. Patients were divided into 2 groups according to whether the lateral intercondylar ridge was absent or present. The Bernard-Hertel grid coordinates ( h, t) of the femoral tunnel were then quantified.

Results:

The maximal GTM (mGTM) was a mean ± SD of 1.06 ± 0.66 mm (range, 0.0-3.0 mm). The mGTM in patients with a lateral intercondylar ridge was significantly lower than that in patients without a lateral intercondylar ridge (0.81 ± 0.39 vs 1.59 ± 0.73 mm, respectively; P < .0001). The average h and t were 0.227 ± 0.079 and 0.429 ± 0.770, respectively. Notably, in 1 patient, the mGTM was 0 mm whereas the coordinates ( h, t) of the femoral tunnel were 0.250 and 0.255. The overall GTM slowly increased before 90° but increased significantly after the knee was bent 105° ( P = .010). Correlation analysis showed that the t coordiinate had significant correlation with mGTM ( R = 0.581; P < .001). A gradient pattern was created to show the nearly isometric blue zone (mGTM <0.5 mm), which was found to overlap with the IDEAL (isometric, direct insertion, eccentric, anatomic, low tension-flexion pattern) position.

Conclusion:

A method of measuring intraoperative GTM and quantifying femoral tunnel position on postoperative 3D-CT was successfully developed. The presence of a lateral condylar ridge can significantly reduce mGTM. A nearly isometric zone was described that was consistent with the IDEAL concept.
Use of Allografts in Orthopaedic Surgery: Safety, Procurement, Storage, and Outcomes
Authors: Beer Adam J. , Tauro Tracy M. , Redondo Michael L. , Christian David R. , Cole Brian J. , Frank Rachel M.
Published: December 2019

The use of allografts has become a vital option for orthopaedic surgeons in the treatment of a variety of musculoskeletal lesions, ranging from osteochondral defects in the glenohumeral joint to meniscal deficiency in the young athlete. Nevertheless, barriers to treating a patient with an allograft-based procedure may arise from concerns over disease transmission, the navigation of tissue banks that supply allografts, the process of obtaining insurance approval, or optimal storage methods. This review serves to support orthopaedic surgeons in the incorporation of allografts into their practice by quelling these potential concerns. Fresh osteochondral allografts, fresh-frozen meniscal allografts, soft tissue allografts, and off-the-shelf cartilage products are the focus of this review amid broad overviews of allograft safety and tissue bank practices in the United States.
Pakistan’s Strategic Culture and its Gordian Knot in Afghanistan
Authors: Parkes Aidan
Published: December 2019

A paradoxical element of Pakistan’s grand strategy exists in its approach to Afghanistan. Pakistan’s instrumentalisation of Islamist groups such as the Taliban has historically been the principal strategic method employed by the military to minimise Indian influence in Afghanistan. However, this strategy risks jeopardising Pakistan’s strategic partnership with China, which is another method used by Pakistan to counterbalance India. Beijing’s growing strategic interests in the region require stability in South Asia, whereas Pakistan’s strategic method in Afghanistan indicates a preference for instability. The destabilising effect of Pakistan’s support for Islamist groups, and China’s desire for political and economic stability in South Asia, indicate latent divergent interests in the Sino-Pakistan strategic partnership. Therefore, this study factors China as a looming constraint on Pakistan’s Afghanistan policy. This study also examines the psychological and strategic factors underpinning Pakistan’s support for Islamist groups in Afghanistan, and the strategic constraints on this policy. Advancing the notion of a ‘strategic culture’ in Pakistan’s military, this study canvasses the concept as an epiphenomenal explanatory factor of its Afghanistan policy, and more instructively, as a factor of strategic inflexibility.
Boycotting Japan: Explaining Divergence in Chinese and South Korean Economic Backlash
Authors: Vekasi Kristin , Nam Jiwon
Published: December 2019

Japan has a ‘cold politics, hot economics’ relationship with both China and South Korea where political relations are tense and business overall flourishes. Despite the similarities, the political mobilisation of consumers in response to Japanese business interests diverge: event, trade and tourism data show that South Koreans are less likely to link economic interests with their political grievances with Japan compared to their Chinese counterparts even though the sources of the tensions are largely parallel. The divergence arises from different ways economic globalisation has shaped national identity. In China, economic globalisation has strengthened a nativist identity with strong anti-foreign components. Korean national identity has been formed by economic integration and interdependence. While strong national identity and anti-foreign elements exist, they are delinked from economic interests. Survey and event data from South Korea and China show that the variation in consumer politics is driven by attitudinal differences in the population that is strongly anti-Japanese. Social media data shows how citizens link or delink politics and business to mobilise for collective action and provide qualitative evidence that how identities interact with globalisation explain country-level variation.
How 3D visualization can help us understand spatial inequality: On social distance and crime
Authors: Aharon-Gutman Meirav , Burg David
Published: December 2019

Virtual reality environments have created new opportunities for visualizing social spaces in three dimensions, which enable addition of a vertical dimension. This creates a topographical landscape based on socio-economic characteristics of the urban system. Quantification of the socio-economic disparities between city pairs in relation to the spatial distances is the social topography slope, where a steeper slope indicates greater inequality in dense environments. To illustrate the effect of this measure of social inequality, we ask, what is the relationship between the value of the slope (the interaction between social and geographical distance) and the rates of crimes committed by residents of neighboring localities in a major locality? We test the applicability of this new measure to explain spatial discrepancies in social problems and find that high social inequality is significantly correlated with crime (R2 = 0.50, P < 0.001) and mean income per capita to measure poverty (R2 = 0.36, P < 0.001).
Book review: Meghal Arya, Spatial Ecology of Water
Authors: Singh Priyaleen
Published: December 2019

Meghal Arya, Spatial Ecology of Water, Ahmedabad, India: AADI Centre, 2019, viii + 167 pp., ₹2200 (softbound), ₹2500 (hardbound), ISBN: 9788190852845.
The Dying Water Heritage of Sarkhej Roza
Authors: Mishra Gargi , Shukla Prasenjit , Iyer Mona
Published: December 2019

Sarkhej Roza, a fifteenth century complex comprising of the mausoleum, mosque and cascade of natural and man-made lakes, and located in peri-urban Ahmedabad, Gujarat, India, is presently a heritage site of national importance under the Archaeological Survey of India (ASI). Originally, the Sarkhej lake was excavated to serve the religious purpose of ablution, recreation and climate conditioning that were quite functional until the late twentieth century before rapid urbanization in the catchment of its adjacent interconnected feeder Makarba lake took place. Unfettered development in the past two decades has encroached the common catchment of Makarba–Sarkhej lake cascade by almost 50 per cent. The then perennial sacred Sarkhej lake is now a drying sewage disposal site. Sarkhej Roza has received considerable attention for conserving built heritage aesthetically in the past. Since it is the duty of all stakeholders including ASI, Ahmedabad Municipal Corporation, Sarkhej Roza Committee, civil society and communities to work in harmony towards sustaining their natural heritage, this research has undertaken detailed site and stakeholder assessment to understand challenges faced by the lake and its precincts, and derived learnings from the stakeholder’s perspectives on the impact of urbanization on this water heritage. This was done in order to chart out the possibilities of reviving the Markarba–Sarkhej lake cascade before it is too late.
Water Heritage and Urban Development: Lessons from Nepal’s Kathmandu Valley
Authors: Molden Olivia
Published: December 2019

Residents of the Kathmandu Valley in Nepal face growing water insecurities: too much at times and not enough at others coupled with constant worry about water quality and access. In this rapidly changing city, ancient water infrastructure is a critical mediator of urban water security. Drawing on six years of mixed methods research, I explain the vital role of water heritage for Kathmandu’s water security and urban development by critiquing three common assumptions about water heritage. First, so-called traditional water infrastructure is not a temporary alternative. Second, water heritage is not a living museum. Third, water heritage is not a panacea for modern woes. This article concludes with reflections on the potentials for Kathmandu’s water heritage to address persistent urban insecurities and inequities.
Compulsive Pornography Use in Late Life: A Case Report
Authors: Sousa Avinash De
Published: December 2019

Compulsive pornography use is on the rise and is a common compulsive sexual behavior being seen in the younger age groups between 18 and 30 years of age. The treatment of the same involves a combination of medical and behavioral management. We present herewith a case of a 69-year-old male who developed compulsive pornography usage for the first time and that responded well to psychotherapy and medication.
Sexting and Self-Esteem Among Youth: Preliminary Trend for Building Cyberliteracy
Authors: Sharma Manoj Kumar , Marimuthu P , Anand Nitin , N Suma , P Thamilselvan , Thakur Pranjali Chakraborty , Singh Priya , Gupta Hemant
Published: December 2019

Objectives: Online activities have influenced the expression and indulgence in sexual behavior. Sexting has become one of the modality to express sexual behavior. The present study explored sexting in the Indian context as well as its relationship with self-esteem.

Methods: 300 young adults in the age group of 17 to 20 years were assessed for sexting behaviors.

Results: Studies showed that males engaged more in sexting and that there was absence of a significant difference in self-esteem and sexting.

Conclusions: It has implications for screening sexting behavior among youth as well as for enhancing cyberliteracy among youth for sexting behaviors.
“Mirror, Mirror, on the Wall…Who is the Fairest of Them All?”—Body Image and Its Role in Sexual Health
Authors: Das Keya , Raman Rajesh
Published: December 2019

Changing times on a global scale have seen a paradigm shift in the perception of “idealness” of body shape and construct of beauty. This has far-reaching impacts on several spheres of life from psychological, physical, as well as sexual health. The influence of attitudes, beliefs, culture, art, geography, and technological advances has been explored with the premise of body image impacting sexual health and functioning. The role body image plays in sexual health has been studied widely from the Western perspective mostly in women, but studies in the Indian context are limited to weight, body mass index, eating disorders, body dysmorphic disorders, rather the relation between body image in sexuality or sexual functioning.
Integrating Cognitive Restructuring Within Psychodynamic Therapy for Erectile Dysfunction
Authors: Rao T. S. Sathyanarayana , Kakar Sona
Published: December 2019

The behavior of a human being in sexual matters is often a prototype for the whole of his other modes of reaction in life. 1

Erectile dysfunction due to psychogenic cause has been a highly researched area. Psychoanalytically, it has been seen as a symptom of an underlying conflict due to early developmental experiences. The attitude of parents especially at the time of a child’s emerging sexuality is considered important in perpetuating sexual inhibition and symptom. Sexual dysfunction has been found to be closely linked to anxiety and guilt and fears of punishment. This pattern of disturbance permeates into other areas of a person’s life and may continue to perpetuate his symptoms. Negative body attitude and shame have been found closely linked to sexual dissatisfaction. In this paper, a case is discussed where a patient is undergoing psychodynamic psychotherapy for depression reported along with erectile dysfunction. Distorted cognitions related to his and the partner’s body were addressed along with both current and past conflicts related to his current symptomatology.
Cost of chronic and episodic migraine patients in continuous treatment for two years in a tertiary level headache Centre
Authors: Negro Andrea , Sciattella Paolo , Rossi Daniele , Guglielmetti Martina , Martelletti Paolo , Mennini Francesco Saverio
Published: December 2019

Background

Migraine is one of the most common neurological diseases and an estimated 1.04 billion people worldwide have been diagnosed with migraine. Available data suggest that migraine is world widely associated with a high economic burden, but there is great variability in estimated costs that depends on the geographical, methodological and temporal differences between the studies. The purpose of this study was to quantify the annual direct cost of episodic migraine (EM) and chronic migraine (CM), both for the patient and for the National Health System (NHS), using data from subjects who attended an Italian tertiary headache centre. Furthermore, we evaluated comparatively the impact of gender and age on the economic burden of migraine.

Methods

We conducted a retrospective and non-interventional observational analysis of the electronic medical records of subjects with EM and CM who consecutively attended the Regional Referral Headache Centre of Rome and undergoing continuous treatment in the 2 years prior to 31 January 2019. This approach was intended to prevent distorsions due to natural fluctuations in migraine status over time. The collected data included demographic characteristics, number of specialist visits, consumption of medications, diagnostic tests, accesses in the emergency department (ED) and days of hospitalization due to the pathology.

Results

Our sample consisted of 548 patients (85.4% women and 14.6% men): 65.5% had CM and 34.5% had EM. The average annual expenditure per patient was €1482. 82.8% of the total cost (€1227) was covered by the NHS. The main item of expenditure were medications that represented 86.8% (€1286), followed by specialist visits (10.2%), hospitalizations for (1.9%), diagnostic tests for (1%) and ED visits for (0.1%). Costs were significantly higher for women than men (€1517 vs. €1274, p = 0.013) and increased with age (p = 0.002). The annual direct cost of CM was 4.8-fold higher than that of EM (€2037 vs. €427, p = 0.001).

Conclusion

Our results provide a valuable estimate of the annual direct cost of CM and EM patients in the specific setting of a tertiary headache centre and confirm the high economic impact of migraine on both the NHS and patients.
Composite genome sequence of Bacillus clausii, a probiotic commercially available as Enterogermina®, and insights into its probiotic properties
Authors: Khatri Indu , Sharma Gaurav , Subramanian Srikrishna
Published: December 2019

Background

Some of the spore-forming strains ofBacillusprobiotics are marketed commercially as they survive harsh gastrointestinal conditions and bestow health benefits to the host.

Results

We report the composite genome ofBacillus clausiiENTPro from a commercially available probiotic Enterogermina®and compare it with the genomes of otherBacillusprobiotics. We find that the members ofB. clausiispecies harbor high heterogeneity at the species as well as genus level. The genes conferring resistance to chloramphenicol, streptomycin, rifampicin, and tetracycline in theB. clausiiENTPro strain could be identified. The genes coding for the bacteriocin gallidermin, which prevents biofilm formation in the pathogensStaphylococcus aureusandS. epidermidis, were also identified. KEGG Pathway analysis suggested that the folate biosynthesis pathway, which depicts one of the important roles of probiotics in the host, is conserved completely inB. subtilisand minimally inB. clausiiand other probiotics.

Conclusions

We identified various antibiotic resistance, bacteriocins, stress-related, and adhesion-related domains, and industrially-relevant pathways, in the genomes of these probiotic bacteria that are likely to help them survive in the harsh gastrointestinal tract, facilitating adhesion to host epithelial cells, persistence during antibiotic treatment and combating bacterial infections.
Long-term impact of fecal transplantation in healthy volunteers
Authors: Goloshchapov Oleg V. , Olekhnovich Evgenii I. , Sidorenko Sergey V. , Moiseev Ivan S. , Kucher Maxim A. , Fedorov Dmitry E. , Pavlenko Alexander V. , Manolov Alexander I. , Gostev Vladimir V. , Veselovsky Vladimir A. , Klimina Ksenia M. , Kostryukova Elena S. , Bakin Evgeny A. , Shvetcov Alexander N. , Gumbatova Elvira D. , Klementeva Ruslana V. , Shcherbakov Alexander A. , Gorchakova Margarita V. , Egozcue Juan José , Pawlowsky-Glahn Vera , Suvorova Maria A. , Chukhlovin Alexey B. , Govorun Vadim M. , Ilina Elena N. , Afanasyev Boris V.
Published: December 2019

Background

Fecal microbiota transplantation (FMT) has been recently approved by FDA for the treatment of refractory recurrent clostridial colitis (rCDI). Success of FTM in treatment of rCDI led to a number of studies investigating the effectiveness of its application in the other gastrointestinal diseases. However, in the majority of studies the effects of FMT were evaluated on the patients with initially altered microbiota. The aim of our study was to estimate effects of FMT on the gut microbiota composition in healthy volunteers and to monitor its long-term outcomes.

Results

We have performed a combined analysis of three healthy volunteers before and after capsule FMT by evaluating their general condition, adverse clinical effects, changes of basic laboratory parameters, and several immune markers. Intestinal microbiota samples were evaluated by 16S rRNA gene and shotgun sequencing. The data analysis demonstrated profound shift towards the donor microbiota taxonomic composition in all volunteers. Following FMT, all the volunteers exhibited gut colonization with donor gut bacteria and persistence of this effect for almost ∼1 year of observation. Transient changes of immune parameters were consistent with suppression of T-cell cytotoxicity. FMT was well tolerated with mild gastrointestinal adverse events, however, one volunteer developed a systemic inflammatory response syndrome.

Conclusions

The FMT leads to significant long-term changes of the gut microbiota in healthy volunteers with the shift towards donor microbiota composition and represents a relatively safe procedure to the recipients without long-term adverse events.
Validation of serrated polyps (SPs) in Swedish pathology registers
Authors: Bozorg Soran R. , Song Mingyang , Emilsson Louise , Ludvigsson Jonas F.
Published: December 2019

Background

Little is known about the natural history of serrated polyps (SPs), partly due to the lack of large-scale epidemiologic data. In this study, we examined the validity of SP identification according to SNOMED (Systematised Nomenclature of Medicine) codes and free text from colorectal histopathology reports.

Methods

Through the ESPRESSO (Epidemiology Strengthened by histoPathology Reports in Sweden) study, we retrieved data on SPs from all pathology departments in Sweden in 2015–2017 by using SNOMED codes and free-text search in colorectal histopathology reports. Randomly selected individuals with a histopathology report of SPs were validated against patient charts using a structured, retrospective review.

Results

SPs were confirmed in 101/106 individuals with a histopathology report of SPs, yielding a positive predictive value (PPV) of 95% (95%CI = 89–98%). By year of diagnosis, the PPV was 89% (95%CI = 69–97%), 96% (95%CI = 81–99%) and 97% (95%CI = 89–99%) for individuals diagnosed before 2001 (n = 19), between 2001 and 2010 (n = 26) and after 2010 (n = 61), respectively. According to search method, the PPV for individuals identified by SNOMED codes was 100% (95%CI = 93–100%), and 93% (95%CI = 86–97%) using free-text search. Recorded location (colon vs. rectum) was correct in 94% of all SP histopathology reports (95%CI = 84–98%) identified by SNOMED codes. Individuals with SPs were classified into hyperplastic polyps (n = 34; 32%), traditional serrated adenomas (n = 3; 3%), sessile serrated adenomas/polyps (SSA/Ps) (n = 70; 66%), unspecified SPs (n = 3, 3%), and false positive SPs (n = 5, 5%). For individuals identified by SNOMED codes, SSA/Ps were confirmed in 49/52 individuals, resulting in a PPV of 94% (95%CI: 84–98%). In total, 57% had ≥2 polyps (1:n = 44, 2–3:n = 33 and ≥ 4:n = 27). Some 46% of SPs (n = 71) originated from the proximal colon and 24% were ≥ 10 mm in size (n = 37). Heredity for colorectal cancer, intestinal polyposis syndromes, or both was reported in seven individuals (7%). Common comorbidities included diverticulosis (n = 45, 42%), colorectal cancer (n = 19, 18%), and inflammatory bowel disease (n = 10, 9%).

Conclusion

Colorectal histopathology reports are a reliable data source to identify individuals with SPs.
Prevalence and predictors of Toxoplasma gondii infection in pregnant women from Dhamar, Yemen
Authors: Al-Adhroey Abdulelah H. , Mehrass Amat Al-Khaleq O. , Al-Shammakh Abdulqawi A. , Ali Abdullatif D. , Akabat Mohammed Y. M. , Al-Mekhlafi Hesham M.
Published: December 2019

Background

Toxoplasmosis is a common and serious parasitic infection caused by the ubiquitous obligatory intracellular protozoan organism,Toxoplasma gondii. Although infection withT. gondiiis usually asymptomatic in healthy individuals, it can lead to severe pathological effects in congenital cases and immunocompromised patients. This study aimed to determine the seroprevalence ofT. gondiiand its predictors among pregnant women seeking prenatal and medical care at the general maternal and child health facility in Dhamar district of Dhamar governorate, Yemen.

Methods

A total of 420 pregnant women were randomly selected for this cross-sectional study. Participants were screened for anti-T. gondiiantibodies (i.e. immunoglobulin M; IgM and immunoglobulin G; IgG) using electrochemiluminescence immunoassay. Demographic, socioeconomic, obstetric and behavioural data were collected using a pretested questionnaire via face-to-face interview. Univariate and multivariate analyses were used to identify the independent predictors ofT. gondiiseroprevalence.

Results

The overall seroprevalence of anti-T. gondiiantibodies (IgG and/or IgM) among the participants was 21.2% (89/420; 95% CI = 17.3–25.1). Anti-T. gondiiIgG antibodies were detected in 20.0% (84/420) of the women of which 12.9% (54/420) were positive for only IgG and 7.1% (30/420) were positive for both IgG and IgM antibodies. Moreover, 5 women (1.2%) were reactive only for IgM antibodies. Significant associations betweenT. gondiiseroprevalence and history of spontaneous abortion (P <  0.001), raw vegetables consumption (P = 0.036), and presence of cats in household (P = 0.049) were reported. Multivariate analysis confirmed that history of spontaneous abortion (AOR = 4.04; 95% CI = [2.46, 6.63]) and presence of cats in household (AOR = 1.77; 95% CI = [1.02, 3.07]) are significant predictors ofT. gondiiseroprevalence among the studied participants.

Conclusion

The study found a high seroprevalence (21.2%) ofT. gondiiinfection during pregnancy in Dhamar district, which is significantly associated with adverse pregnancy outcomes. The provision of adequate maternal healthcare and health education pertaining to the prevention ofT. gondiiinfection is therefore imperative to curtail the prevalence of infection among the studied population.
Perinatal outcomes in Finnish twins: a retrospective study
Authors: Rissanen Annu-Riikka Susanna , Jernman Riina Maria , Gissler Mika , Nupponen Irmeli Katriina , Nuutila Mika Erkki
Published: December 2019

Background

To establish the changes in perinatal morbidity and mortality in twin pregnancies in Finland, a retrospective register research was conducted. Our extensive data from a 28-year study period provide important information on the outcome of twin pregnancies in Finland that has previously not been reported to this extent.

Methods

All 23,498 twin pregnancies with 46,996 children born in Finland during 1987–2014 were included in the study. Data were gathered from the Medical Birth Register and the Hospital Discharge Register (Finnish Institute for Health and Welfare, Finland) regarding perinatal mortality (PNM) and morbidity. For statistical analysis, binomial regression analysis and crosstabs were performed. The results are expressed in means, percentages and ranges with comparison to singletons when appropriate. Odds ratios from binomial regression analysis are reported. A p-value <0.05 was considered statistically significant.

Results

There were 46,363 liveborn and 633 stillborn twins in Finland during 1987–2014. Perinatal mortality decreased markedly, from 45.1 to 6.5 per 1000 for twin A and from 54.1 to 11.9 per 1000 for twin B during the study period. Yet, the PNM difference between twin A and B remained. Early neonatal mortality did not differ between twins, but has decreased in both. Asphyxia, respiratory distress syndrome, need for antibiotics and Neonatal Intensive Care Unit (NICU) stay were markedly more common in twin B.

Conclusions

In Finland, PNM and early neonatal mortality in twins decreased significantly during 1987–2014 and are nowadays very low. However, twin B still faces more complications. The outline provided may be used to further improve the monitoring and thus perinatal outcome of twins, especially twin B.
Association between vitamin D plasma concentrations and VDR gene variants and the risk of premature birth
Authors: Dutra Letícia Veríssimo , Affonso-Kaufman Fernando Alves , Cafeo Fernanda Ramires , Kassai Milene Saori , Barbosa Caio Parente , Santos Figueiredo Francisco Winter , Suano-Souza Fabíola Isabel , Bianco Bianca
Published: December 2019

Background

Premature birth is the main cause of mortality in children under 1 year, and vitamin D deficiency during gestation is associated with prematurity. The effects of vitamin D are mediated by its receptor, which is encoded by the VDR gene. VDR variants—such as single nucleotide variation (SNV)—are associated with increased risk of prematurity, but there are conflicting results. We evaluated serum vitamin D concentrations and the frequency of TaqI/A > G, BsmI/C > T, ApaI/C > A, and FokI/A > T VDR variants in mothers and preterm (PTN) and full-term (FTN) newborns.

Methods

We conducted a case-control study comprising 40 pairs of mothers and their PTNs (gestational age < 32 weeks and/or weight < 1500 g), and 92 pairs of mothers and FTNs as controls. Genotyping was performed by real-time PCR, and plasma vitamin D concentrations were measured by electrochemiluminescence.

Results

Vitamin D levels were significantly lower in PTN mothers. Genotypes TaqI/GG and BsmI/TT, and haplotypes AAG (TaqI/A-ApaI/A-FokI/G) and GCA (TaqI/G-ApaI/C-FokI/A) were significantly more frequent in PTN mothers, and genotypes TaqI/AG, ApaI/AA, and FokI/AG resulted in significantly lower vitamin D levels. Genotypes BsmI/TT and ApaI/AA were associated with vitamin D deficiency and 2.36 and 7.99 times greater likelihood of PTB, respectively. Vitamin D levels were also lower in PTNs, although it was not statistically significant. Genotypes BsmI/TT, ApaI/AA, and FokI/GG, and haplotype GAG (TaqI/G-ApaI/A-FokI/G) were significantly more frequent in PTNs. Those with FokI/GG genotypes had significantly lower vitamin D levels.

Conclusions

VDR variants contribute to variations in vitamin D concentrations and the increased risk of prematurity.