bluuebunny/crossref_metadata_2025 huggingface dataset:
Collapse in an Accident and Emergency Department
Authors: McLaren Andrew J , Lear John , Daniels R G
Published: July 2022

Collapse is a common presenting complaint to accident and emergency (A & E) departments. This retrospective study of 4180 new attendances at a district general hospital A & E showed that this accounted for 2.9%. A wide disease spectrum was implicated. This patient group has a high admission rate (47.8%) and a high mortality rate (31.3%). The deaths occurred largely in the elderly and it is suggested that elderly patients should either be admitted for observation, or a careful screening carried out for underlying pathology. The diversity of disease precludes a standard management protocol.
How Long is Your Waiting List? Experience of a Urological Waiting List Initiative
Authors: Mobb Gillian E , Pugh Felicity , Peeling Brian
Published: July 2022

Experience with a urological waiting list initiative is presented, wherein a list of 231 non-urgent cases was cleared over a 5 month period by a single operator. Some patients had waited 10 years for surgery. Following a postal request, the waiting list was validated; 31.2% of patients wished to be removed. The remaining 68.8% desired surgery and consisted of 51 requiring minor surgical procedures and 108 who needed more major surgery mostly for the relief of bladder outflow obstruction. Minor cases received dates for surgery; however, only 68.2% of this group attended despite being given more than one date for admission. Major cases were reviewed in a pre-admission clinic. General and urological condition was assessed, improved where necessary and surgery booked or delayed accordingly. A small number of patients did not attend or only attended to be reassured that surgery was not needed. Following clinical review, 18.5% of this group did not require operation.

The long urological waiting list is a unique situation where patients listed may no longer require surgery. Reviewing these patients not only reduces numbers but also markedly increases percentage attendance for surgery.
Informed Consent: An Evaluation of Patients' Understanding and Opinion (with Respect to the Operation of Transurethral Resection of Prostate)
Authors: Saw K Chee , Wood Alison M , Murphy Karen , Parry John R W , Hartfall W Guy
Published: July 2022

The ability of patients to understand and recall information given prior to obtaining written consent was assessed in 55 patients who were due to undergo the operation of transurethral resection of prostate. The patients were also asked their opinion on informed consent. Most patients knew the position of the prostate and the purpose of the operation. Some aspects of the postoperative management and complications were less well remembered. In particular, 18% of the patients could not remember the possibility of retrograde ejaculation despite efforts to emphasize this. Of the patients who returned their questionnaires, 41% did not mind what happened to them provided they were made better; 54% trusted their doctor to do the right thing and did not think detailed explanation was important; 62% felt that consent forms are to protect the doctors' right; still most patients felt that consent forms were necessary. Sub-groups comparison showed no relationship between patients' attitude and their ability to recall information.
Coroner's Cases of Death Due to Errors in Prescribing or Giving Medicines or to Adverse Drug Reactions: Birmingham 1986–1991
Authors: Ferner R E , Whittington R M
Published: July 2022

The records for Coroner's Inquests in one district during a 6 year period were examined retrospectively to establish the number and nature of deaths which were due to errors in the prescription or administration of medicines, and those due to adverse drug reactions. The district has a population of 1.19 million (1991), and a total of 3277 inquests were opened during the period 1986–1991. Ten of the deaths were identified as due to errors of prescribing or giving drugs. During the same period, 36 deaths were caused by adverse drug reactions. These 46 deaths made up approximately one in 2000 of all deaths during the study period. About a fifth of deaths related to prescribing and administering drugs are due to errors and may be more easily preventable than deaths due to adverse reactions.
Informed Consent: What Do Patients Want to Know?
Authors: Dawes Patrick J D , Davison Pauline
Published: July 2022

Informed consent is an important aspect of surgery, yet there has been little inquiry as to what patients want to know before their operation. This study has questioned 50 patients within 3 months of an ENT (ear, nose and throat) operation. We found that most were happy to allow doctors to determine their treatment but they wanted to know about their condition, the treatment, and the important side effects. Fifty per cent of patients admitted worrying about some aspect of their recent surgery. More than two-thirds thought signing a consent form primarily signified agreement to undergo treatment and that it was a legal document; 54% thought there was an important medico-legal aspect. Over half thought information sheets would be reassuring, one-third thought they would provoke anxiety and 8% thought they would frighten them from having surgery.

Closer examination of the answers to our questions showed that those who were most worried about aspects of their surgery had a higher mean anxiety score, as did those who thought an information sheet would be either frightening or anxiety provoking. However, a higher anxiety score was not associated with a desire to know less about the proposed treatment.
Glutathione Synthetase Deficiency: A Family Report
Authors: Pejaver R Kumar , Watson A H
Published: July 2022

Glutathione synthetase deficiency is a rare inborn error of metabolism. Low levels of and at times unstable molecules of glutathione synthetase leads to glutathione deficiency affecting various systems of the body. The inheritance is thought to be of autosomal recessive variety.

We diagnosed the condition in a neonate and proceeded to investigate the family. The results are discussed below.
The Extent of Vitamin K Deficiency in Patients with Cholestatic Jaundice: A Preliminary Communication
Authors: O'Brien D P , Shearer M J , Waldron R P , Horgan P G , Given H F
Published: July 2022

Eleven patients with cholestatic jaundice had measurements of plasma vitamin K1 performed. Seven of these 11 (64%) had subnormal levels. The prothrombin time (PT) was prolonged in three of 15 patients with cholestasis (20%), the patient with the longest PT had the lowest vitamin K1 level. A single intramuscular (im) dose of 10 mg vitamin K1 lowered the PT in 9/15 patients (includes correcting the three prolonged PTs). The initial mean plasma vitamin K1 level rose 24 h later, to a mean plasma level which was 33 times the upper limit of the normal physiological range. These preliminary results suggest that a majority of patients presenting with cholestatic jaundice have low tissue reserves of vitamin K1, and that guidelines for vitamin K1 therapy in patients with cholestatic jaundice should be revised.
Biopsy Proven Polymyositis in Victoria 1982–1987: Analysis of Prognostic Factors
Authors: Lilley Helen , Dennett Xenia , Byrne Edward
Published: July 2022

Prognostic factors were analysed in 77 patients with idiopathic inflammatory myopathy identified over a 5 year period. Formal statistical tests did not differentiate useful prognostic indices and a polymyositis disability score was devised in an attempt to gain some prognostic information. Partial (47%) or full (31%) recovery were seen in most cases with no recovery of strength (9%) and death (11%) being less common outcomes. Onset before the age of 50 and duration of symptoms of less than 12 months prior to presentation were favourable prognostic features, and treatment with regimes other than steroid therapy alone a probable favourable indicator. Level of creatine kinase (CK) at presentation and histopathological separation of dermatomyositis or polymyositis failed to alter prognosis. Most patients who died did so within the initial 6 months of treatment. Four of five patients <50 years old with either a fatal outcome or no improvement were treated with steroids alone. Large multi-centre studies are required to provide reliable data about prognostic factors in idiopathic inflammatory myopathies and the methodology used in this study can only be regarded as providing pointers towards possible prognostic factors rather than being definitive.
Junior Doctors' Hours: What Do They Really Think?
Authors: West S , Weight S , Jenkins B J , Stephenson T P
Published: July 2022

Junior doctors' hours are one of the most controversial topics under debate in the health service today. We undertook a detailed postal questionnaire of hospital doctors in training within a major teaching unit in order to assess the awareness and perceived implications of the incipient changes and to elucidate how it was felt these changes would affect both the doctors and patients.

The questionnaire focused specifically on the effect of the changes on quality and continuity of patient care, junior training and socio-economic factors relating to the medical staff.

The questionnaire was entirely anonymous and carried only the first author name but provision was made to determine current grade, speciality, age, sex and career plans of the respondents. Importantly, space was included at the end for pertinent comments.

All junior staff in training in all specialities in the Cardiff area were circulated. Three hundred and twenty-six questionnaires were sent out and 202 were returned of which 192 were properly completed (59%).

Almost everyone was au fait with the proposed changes. There was a surprisingly high level of support for changes among non-surgical trainees, and half felt that quality of care would improve, though the more senior the trainee, the less enthusiastic they were in all aspects. Many felt that far too little consultation with junior staff had taken place and there was generalized criticism of general practitioner trainees by their specializing counterparts, partly because of a perceived lack of commitment and partly because of blame of this group for the inception of the changes.

Most importantly, there was solid opposition among surgeons in training because of a perceived reduction in patient care, compromise in quality of training and a belief that the system is unworkable [only 9% of registrars and senior registrars and 25% of senior house officers (SHOs) and housemen planning a surgical career were in favour of change].

It is clear that different specialities need to be assessed separately. For example, the requirements for covering a partial shift system for special baby care, or anaesthetics are very different from the on call requirements of dermatology or urology. It is inappropriate to put every speciality under the same umbrella and this should be rethought before the introduction of the 72 h week results in unnecessary but predictable chaos.
Anxiety and Depression in Migraine
Authors: Devlen Jennifer
Published: July 2022

The present study examined the prevalence and severity of anxiety and depression among people with migraine. To obtain a spectrum of migraine experience two potentially different samples were identified: over 600 patients attending migraine clinics and 87 migraine sufferers in the general population. International Headache Society criteria were used to establish the diagnosis of migraine. Anxiety and depression were measured using the Hospital Anxiety and Depression scale and studies using this scale in other patient groups were identified for comparison. Approximately 50% of subjects experienced anxiety and 20% experienced depression, rates which were consistent across the two study groups. This prevalence of psychological morbidity is unexpectedly high and comparable to that measured in patients with other diseases. There is no evidence that it is correlated with frequency of migraine attacks. Anxiety and depression are common among people with migraine and remain largely unrecognized. Future studies should identify contributory factors.
Cutaneous Nerve Fibre Depletion in Vibration White Finger
Authors: Goldsmith P C , Molina F Abadia , Bunker C B , Terenghi G , Leslie T A , Fowler Clare J , Polak J M , Dowd Pauline M
Published: July 2022

Vibration white finger or hand-arm vibration syndrome is the episodic blanching of the fingers in response to cold occurring in those who work with hand held vibrating tools. Clinically the condition differs from primary Raynaud's phenomenon as persistent paraesthesiae and pain are common in the hands and arms and these occur independently from the ‘white attacks’. Symptoms can become severe enough to warrant a change of occupation. Industrial compensation may be awarded for vibration white finger but, at present, no simple or reliable objective diagnostic test is available. Calcitonin gene-related peptide (CGRP) is a neuropeptide with powerful vasodilator properties. A deficiency of immunoreactive CGRP nerve fibres has been previously demonstrated in the digital cutaneous microvasculature of patients with primary and secondary Raynaud's phenomenon with the distribution and quantity of other types of nerve fibres not being significantly altered. To determine if the innervation of the cutaneous microvasculature in vibration white finger was also abnormal skin biopsy samples from the fingers of 15 patients with vibration white finger, six healthy age matched controls who worked with vibrating machinery and 26 healthy age matched controls who were heavy manual workers without exposure to vibrating machinery were examined by immunohistochemistry. To try to correlate any histological abnormalities with clinical neurological deficit sensory nerve conduction studies have so far been performed in six patients with vibration white finger. There was a significant reduction in both the number of CGRP and protein gene product 9.5 (PGP) immunoreactive nerve fibres in the digital cutaneous biopsies from the patients with vibration white finger when compared to the biopsies from the heavy manual workers and the healthy workers exposed to vibration. The pattern of the loss of CGRP immunoreactive nerve fibres was similar to that described previously in Raynaud's phenomenon and may account for the episodic vasospasm seen in both conditions. PGP is a constitutive protein of all nerves therefore the reduced PGP immunostaining indicates generalized structural neuronal damage which could account for the persistent pain and paraesthesiae characteristic of vibration white finger. The nerve conduction studies revealed sensory nerve action potentials within the low range of normal in five patients with vibration white finger and mild median nerve compression in the remaining patient implying that the neuronal damage in the patients with vibration white finger is confined mainly to the small unmyelinated nerve fibres. The immunohistochemical findings may provide the basis for a diagnostic test for vibration white finger.
The Oral Medicine Clinic — What is its Role?
Authors: Zakrzewska J M , Downer C , Lopes V
Published: July 2022

The total number of new patients seen over a period of 12 months in an oral medicine department was 963. Of these 587 were seen by an oral physician, 168 by a liaison psychiatrist, 137 by an oral immunologist and 71 by a dermatologist with a special interest in diseases of the mouth. The broad categories of disease seen were: 364 with orofacial pain of non-dental origin; 263 with benign diseases of the oral mucosa; 149 with potentially malignant lesions, six with frank carcinomas; 100 with oral manifestations of a systemic disease; and 81 patients with conditions considered to be normal.
The Soul and the Pneuma in the Function of the Nervous System after Galen
Authors: Quin C E
Published: July 2022

Galen's teaching on anatomy and physiology was generally accepted in the Middle Ages and this applies to the part he thought was played by the pneuma in the functions of the body. In this essay I have outlined the advances made after Galen in the study of the nervous system leading eventually to a time when the soul and the pneuma were no longer thought necessary for the proper functioning of the brain and nerves.
Acoustic Rhinometry in Rhinological Practice: Discussion Paper
Authors: Fisher Edward W , Lund Valerie J , Scadding Glenis K
Published: July 2022

Acoustic rhinometry is a new technique which evaluates nasal obstruction by analysing reflections of a sound pulse introduced via the nostrils. The technique is rapid, reproducible, non-invasive and requires minimal cooperation from the subject. Unlike rhinomanometry it does not require airflow. A graph of nasal cross-sectional area as a function of distance from the nostril is produced, from which several area and volume estimates of the nasal cavity can be derived. The reliability of the method is greatest in the anterior nasal cavity, which is the site of the nasal valve.

We have applied the technique to the study of normal nasal physiology in adults and children and to a range of pathological conditions. The role of acoustic rhinometry in diagnosis is somewhat limited compared to nasal endoscopy, but it is useful for nasal challenge and for quantifying nasal obstruction. Monitoring of medical and surgical therapy is a more promising application.

In future, acoustic rhinometry is likely to be of particular help in evaluating childhood nasal obstruction, as it is well tolerated by children as young as 3 years old - a group of patients to whom objective tests have hitherto been difficult to apply.
Quality of Life Measurements in Eating Disorders, Angina, and Transplant Candidates: Are They Comparable?
Authors: Keilen Matthias , Treasure Tom , Schmidt Ulrike , Treasure Janet
Published: July 2022

The measurement of health-related quality of life has attracted much attention and is now a component of most big clinical trials. As we evaluate and choose between treatments and make judgements about priorities in health care, it is important that the equivalent data are available for different patient groups.
Psychiatric Morbidity in Adults with Hypopituitarism
Authors: Lynch S , Merson S , Beshyah S A , Skinner E , Sharp P , Priest R G , Johnston D G
Published: July 2022

Forty-one adults with established hypopituitarism and deficiency of growth hormone (GHD) were compared to an age and sex-matched group with another chronic metabolic disorder (diabetes mellitus) using standardized psychiatric rating and diagnostic measures. Nineteen (46%) of the GHD group were identified as definite psychiatric cases compared with 10 (24%) of the diabetics (odds ratio 1:9:1). The most frequent DSM III-R axis I psychiatric diagnoses were major depression (32% GHD patients and 10% of diabetic patients) and dysthymia. The risk of being a psychiatric case showed an association with duration of illness in the diabetic group, but not in the GHD group. Biochemical indices were not related to the risk of being a case in either group. Hypopituitarism is associated with a higher prevalence of psychiatric disturbance than can be attributed solely to the presence of a chronic disorder.
National Industry's Interest in Colorectal Cancer Screening Programmes
Authors: Hart A R , Barone T L , Wicks A C B , Mayberry J F
Published: July 2022

The interest of the largest 200 British industries in developing and financing colorectal screening services for employees was determined. A standard questionnaire asked if the company would advertise screening supply names of employees to local hospitals and finance faecal occult blood testing. The reasons for rejection were noted. Eighty-six companies returned the questionnaire (43% response rate) of which 78 firms (39% of the total mailed) were prepared to advertise screening programmes at the workplace. A quarter of the companies were prepared to both advertise and release employee details. Companies willing to participate employed significantly more people (mean of 17 000 employees) than those rejecting screening (mean of 6100 employees, Mann-Whitney U test=7, P>0.05). Fifty-nine industries would consider financing screening, although only five made a definite decision to do so. All companies rejecting (36/36) were concerned about releasing employee information to hospitals. If screening does reduce mortality and community programmes are developed industry could and is prepared to advertise such programmes. If a partnership between hospitals and industry is developed, concerns about employee confidentiality needs to be addressed.
Auditing the British Medical Journal
Authors: Channer K S
Published: July 2022

The purpose of this study was to audit the outcome in terms of change in practice of the published research from one volume of the British Medical Journal. All original papers and short reports from one Volume 296 of the British Medical Journal ( BMJ) 1988 were read and classified into theoretical only, practical and theoretical and practical. Those papers with any practical message were reviewed by one of a panel of specialists in the subject of the paper to assess if the recommendation made by the paper had become common clinical practice. The results show that most papers originated from teaching centres and research institutes in the UK. Only 8% of main papers and 6% of short reports had a solely practical application, although a further 18% and 22% had practical elements. The majority of the recommendations aimed at changing practice were of relevance to hospital specialists rather than general practitioners (GPs). Of the papers with any practical implications 48% (12% of the total) of main papers and 41% (11% of the total) of short reports were considered to be current practice. The reasons why the papers failed to change practice are discussed. In conclusion, the majority of the original research papers published in the BMJ in 1988 were of a theoretical nature and only about 20% of papers made recommendations for a change in practice. About 50% of the recommendations are now current practice.
A Comparison of Stress Test Referral Rates and Outcome between Asians and Europeans
Authors: Lear J T , Lawrence I G , Burden A C , Pohl J E F
Published: July 2022

The Asian population is at greater risk from a myocardial infarction than their European counterparts. Fewer Asians are referred for coronary angiography. We studied referral rates for exercise stress testing following acute myocardial infarction in Asians and Europeans and also examined stress test outcome.

A retrospective analysis was performed using hospital activity analysis data, ward admission book and stress test referral forms and reports. There were 962 acute myocardial infarctions with 90% being European. Fewer Asian patients were referred for stress testing (32.3% versus 45%, P>0.001). Asian patients were more likely to have a positive test (42.9% versus 31.3%, P>0.02). Fewer Asian patients completed the test (14.3% versus 31.3%, P>0.001).

Possible reasons for the decreased referral rates include communication difficulties and real or perceived poor exercise tolerance. More Asian patients should be referred for stress testing. Interpreters and information leaflets in multiple languages may help achieve this aim.
Madness and Maastricht: A Review of Reactive Psychoses from a European Perspective
Authors: Taylor M
Published: July 2022

Brief reactive psychosis has had a chequered career as a valid diagnostic entity, and lack of an international consensus has undermined the concept, but clinical observation attests to its durability. As the European community derestricts its labour boundaries, resulting in psychiatrists increasingly practising outside their country of training, I would suggest that this examination of ‘brief reactive psychosis’ becomes particularly pertinent with respect to differing diagnostic trends across Europe and elsewhere.
Age-Related Geriatric Medicine: Relevance of Special Skills of Geriatric Medicine to Elderly People Admitted to Hospital as Medical Emergencies
Authors: Kafetz Kalman , O'Farrell Jeanne , Parry Anthea , Wijesuriya Vinitha , McElligott Geraldine , Rossiter Brian , Lugon Myriam
Published: July 2022

This study was carried out to find out how many patients aged 75 and over admitted to hospital as medical emergencies had features appropriate to care by physicians in geriatric medicine and to examine the extent of use of specialist facilities by these patients. The purpose was to examine criticisms of age-related admission policies which have focussed on misplacement of patients with single diagnoses and lack of access to specialist care. An analysis was made of admission, process and discharge characteristics relevant to the special skills of geriatric medicine, multiple pathology and use of specialist services by 554 patients aged 75 and over. These were collected prospectively, consecutively admitted as medical emergencies via the accident and emergency department of a large district general hospital with an age-related (75 and over) medical admissions policy. 84 patients (15%) had single pathology and no characteristics suggesting the need for specialist geriatric care. 177 (32%) had single pathology and one or more specialized characteristics. 66 (12%) had multiple pathology alone. 227 (41%) had multiple pathology and specialized characteristics. There were 142 specialist referrals in 121 patients (22% of the whole sample). We concluded that the special skills of general physicians specializing in the medical and associated community problems of elderly people are highly relevant to patients aged 75 and over presenting as medical emergencies. There was no evidence of lack of involvement of specialists in their care.
Risk Factors for HIV Infection Overlooked in Routine Antenatal Care
Authors: Hawken Jennifer , Chard T , Costeloe Kate , Jeffries D J , Hudson C N
Published: July 2022

We have ascertained the extent to which risk factors for HIV infection may escape detection by standard history-taking procedures in an antenatal clinic. This study was based on 1264 women from a multi-ethnic population in an inner London health district (City and Hackney). All had agreed to undergo attributable HIV testing and a detailed personal interview. Thirty-nine per cent (494 of 1264 women) reported risk factors contributed personally or by a partner. Most of these risk factors had not been earlier disclosed by routine history taking. In most cases the risk was residence and risk activity in a World Health Organization (WHO) Pattern 2 country. [HIV spread WHO categories: Pattern 1—principally homosexual/bisexual males and i.v. drug use (areas=North America, Western Europe, Australasia, parts of South America) with male to female ratio 10/1; Pattern 2—Heterosexual (areas=Sub Saharan Africa, Caribbean and part South America) with male to female 1/1.] Thirty-one subjects (2.4%) were aware that their partners had participated in bisexual activity. Only six subjects perceived themselves at risk through their own or partner's drug injecting activity.

The frequency of risk factors was substantially greater than that ascertained by the routine history. The findings highlight the potential risk of heterosexual spread resulting from travel to or residence in high prevalence territories. The contribution by male partners is significant and is particularly difficult to detect during a routine interview. These data support the recommendation that voluntary HIV serum testing should be universal rather than a selective offer based on risk factors determined at a routine history.
Inspecting the Colon from inside and Out to Solve Pyrexia of Unknown Origin
Authors: Dwarakanath A D , Chua E , Rhodes Jonathan M , Hershman M J
Published: July 2022

A man with longstanding intermittent symptoms of abdominal pain, diarrhoea and pyrexia of unknown origin was diagnosed with the novel technique of laparoscopic-assisted colonoscopy. At subsequent laparotomy, a longstanding perforation of sigmoid diverticular disease was resected, with resolution of his symptoms.
The Occupational Health of De-Miners in Afghanistan
Authors: Peel Michael
Published: July 2022

In the last few years there has been increasing awareness of the problems of landmines. This has focused on the ethics of landmine use, and the dangers to the local population of minefields. It has culminated in a much needed campaign for a moratorium on landmine manufacture. There are, however, millions of mines left in almost all parts of the world, which can create an indefinite hazard. The only solution is the slow and painstaking task of clearing these minefields. The health and safety of de-miners has not been previously discussed in any detail. This paper addresses the hazards to the people clearing minefields, with specific reference to the activities of the HALO trust in Afghanistan. De-miners are subject to the same hazards from mines as the general population, but put themselves at additional risk by entering minefields deliberately. These hazards can be controlled by a safe system of work and the appropriate use of personal protective equipment.
Epidural Anaesthesia and Urinary Dysfunction: The Risks in Total Hip Replacement
Authors: Williams A , Price N , Willett K
Published: July 2022

Epidural anaesthesia in total hip replacement is an established and safe practice. It may be used alone or in combination with general anaesthesia for analgesia.

Urethral catheterization in the perioperative period is known to greatly increase the complication of deep sepsis following total hip replacement. We assessed the effect on the incidence of urinary catheterization of using bupivocaine epidural anaesthesia in addition to general anaesthesia in total hip replacement. A prospective study was made of 113 total hip replacements. The incidence of catheterization in male patients who received an epidural was 67% compared to only 12% who had no epidural [ P=0.001]. In women the corresponding rates were 30% and 23%. We conclude that in men the use of supplementary epidural anaesthesia with bupivocaine is associated with a worrying increased need for urinary catheterization. This must be balanced against the claimed benefits of this form of anaesthesia.
Why Do People Go to Their Doctors?
Authors: Calnan Michael
Published: July 2022

The evidence presented here suggests for most people deciding to consult a doctor is not a common event and that they have ‘good’ reasons for consulting, when they do, which are tied up with their own personal and social circumstances. Their evaluation of the care they receive will be tied to how far their specific problems and associated needs are met.
Companion Animals and Human Health: An Overview
Authors: Edney Andrew T B
Published: July 2022

Domestic animals share our environment in a variety of ways. One of these ways is as companions in and around our homes. Although a wide variety of species are kept in households for this purpose, the great majority are dogs and cats. Sharing our environment with such animals has a profound effect on the health of the humans concerned. As keeping companion animals is a very widespread activity, about 50% of all households in the Western world have some sort of animal, the effects are far reaching.
Bartter's Syndrome Associated with Severe Retinopathy and Presenting as Pseudohypoaldosteronism in a Newborn
Authors: Eckhardt Susan , Dillon M J , Grant D B
Published: July 2022

Various pathophysiological explanations for Bartter's syndrome have been put forward since the condition was first described in 19621. It is currently thought that reduced reabsorbtion of sodium chloride in the distal tubule of the loop of Henle and the collecting ducts leads to secondary hyperkaluria and hypokalaemic metabolic alkalosis2. We describe a 9½-year-old boy with Bartter's syndrome and severe retinopathy whose features may be those of a previously unrecognized disorder.
Digital skills in context: Working with robots in lower-skilled jobs
Authors: Lloyd Caroline , Payne Jonathan
Published: July 2022

Digital skills are increasingly presented as essential for work and labour market inclusion, with fears the low-skilled could be left behind. Lack of clarity about these new skill demands and limited evidence from the workplace have prompted calls to unpack skill requirements in specific sectors and occupations. This article analyses digital skills in relation to wider skills and knowledge required in a job, and examines the influence of the workplace, sector and national institutional context. The study focuses on robotic technologies in lower-skilled jobs, drawing on the experience of food and drink processing operatives, and logistic porters and service workers in public hospitals, in Norway and the UK. The article contributes to the conceptualisation of digital skills, probes country differences, and offers a grounded understanding of the challenges presented for workers in lower-skilled jobs.
Development and Characteristics of Hearing Loss With the Progression of Endolymphatic Hydrops
Authors: Niu Yue , Chen Wei , Lin Mengyan , Sha Yan
Published: July 2022

Objectives

This study aims to explore how patients’ hearing loss developed with the progression of endolymphatic hydrops and the characteristics of hearing loss at different stages.

Materials and Methods

We collected 73 patients with definite or possible unilateral Meniere’s disease or sudden hearing loss who underwent magnetic resonance imaging after intravenous contrast agent injection. There were 25 cases of isolated cochlear hydrops, 24 cases of isolated vestibular hydrops, and 24 cases of cochlear and vestibular hydrops. Primary outcome analyses included their evaluation of endolymphatic hydrops and hearing thresholds at low and high frequencies.

Results

The overall hearing threshold of patients with vestibular and cochlear hydrops was significantly higher than that of patients with isolated cochlear hydrops and patients with isolated vestibular hydrops. There was a significant correlation between low-frequency hearing loss and cochlear hydrops, and the low-frequency hearing threshold was proportional to the grade of cochlear hydrops. At low frequency, the hearing threshold of patients with isolated vestibular hydrops was lower than that of patients with isolated cochlear hydrops and patients with both cochlear and vestibular hydrops. The audiogram configurations of patients with isolated cochlear hydrops consist largely of flat type and up-sloping type. The audiogram configurations of patients with isolated vestibular hydrops and patients with both cochlear and vestibular hydrops are mainly flat type and down-sloping type.

Conclusions

Patients present with low-frequency hearing loss in the early stage of endolymphatic hydrops. When the hydrops involves the whole cochlea and vestibule, the patients’ hearing is impaired at both low and high frequencies.
Potential Association Between COVID-19 Vaccination and Facial Palsy: Three Cases With Neuroimaging Findings
Authors: Hamid Rauf , Korkmazer Bora , Kochan Kizilkilic Esra , Arman Gokce Merve , Ozogul Murat , Kargın Osman Aykan , Arslan Serdar , Kizilkilic Osman
Published: July 2022

Acute onset Facial palsy was reported in four vaccinated participants in the BNT162b2 (Pfizer-BioNTech) vaccine clinical trials published on December 10, 2020. So far, few cases of Facial palsy among the mRNA vaccine groups have been previously documented in the literature. Facial palsy is cited as medically attended adverse event following immunization on April 12, 2021, after the first dose of the approved Pfizer-BioNTech COVID-19 vaccines for preventive immunization for SARS-CoV-2 is administrated to the population in Turkey. This study is aimed to describe clinical and magnetic resonance imaging features of three patients, who developed acute onset peripheral facial paralysis after administration of the BNT162b2 vaccine, without any previous medical condition. The first patient presented with right sided facial palsy within the same day following the vaccine was administrated, while the second patient presented with left sided facial palsy 2 months after vaccination. The third patient, on the other hand, presented with right sided facial palsy and abducens nerve (CN VI) paralysis two days after vaccine was administrated.
A large-scale study of patients with preoperative vocal cord paralysis associated with thyroid disease and related clinicopathological features
Authors: Li Wen-Hua , Zheng Wei-Hui , Zhao Jian-Qiang , Wang Ke-Jing , Han Chun
Published: July 2022

Background

The performance of thyroidectomies has been increasing over the last decade due to the growing prevalence of thyroid diseases. The purpose of this study was to investigate the clinical significance of preoperative vocal cord paralysis (VCP) associated with thyroid disease and other incidences of malignant or benign lesions, as well as different thyroid pathological features. Additionally, the epidemiological changes of thyroid diseases with preoperative VCP were investigated.

Methods

Ninety-nine out of 12,530 patients with preoperative VCP who had undergone thyroid surgery for various diseases in the Zhejiang Cancer Hospital from January 2007 to December 2015 were identified. Their clinicopathological data was recorded and case distributions from different years and intraoperative recurrent laryngeal nerve statuses were retrospectively analyzed.

Results

The incidence of preoperative VCP in 2007 was reported to be 1.53% (9/590) and had decreased to 0.53% (12/2,247) by 2015 ( P < 0.05). Among the 99 patients with preoperative VCP, 81 had malignancies (81.82%), while 18 (18.18%) had benign thyroid diseases. The incidences of preoperative VCP in malignant and benign diseases were 1.13% (81/7,159) and 0.35% (18/5,371), respectively ( P < 0.05). There were only 5 (0.04%, 5/12,530) cases of papillary thyroid microcarcinoma with preoperative VCP. There was no statistical difference between the incidence of preoperative hoarseness in malignant 69.14% (56/81) and benign diseases 61.11% (11/18) with preoperative VCP.

Conclusions

The preoperative VCP incidence rate had gradually decreased with an increased proportion of papillary thyroid cancer. Preoperative voice symptoms do not necessarily suggest a malignancy. Selective rather than routine preoperative laryngoscopic examinations should be performed on papillary thyroid microcarcinomas. The probability of preoperative VCP in malignancy was significantly higher than in benign lesions.
How Rice Fights Pandemics: Nature–Crop–Human Interactions Shaped COVID-19 Outcomes
Authors: Talhelm Thomas , Lee Cheol-Sung , English Alexander S. , Wang Shuang
Published: July 2022

Wealthy nations led health preparedness rankings in 2019, yet many poor nations controlled COVID-19 better. We argue that a history of rice farming explains why some societies did better. We outline how traditional rice farming led to tight social norms and low-mobility social networks. These social structures helped coordinate societies against COVID-19. Study 1 compares rice- and wheat-farming prefectures within China. Comparing within China allows for controlled comparisons of regions with the same national government, language family, and other potential confounds. Study 2 tests whether the findings generalize to cultures globally. The data show rice-farming nations have tighter social norms and less-mobile relationships, which predict better COVID outcomes. Rice-farming nations suffered just 3% of the COVID deaths of nonrice nations. These findings suggest that long-run cultural differences influence how rice societies—with over 50% of the world’s population—controlled COVID-19. The culture was critical, yet the preparedness rankings mostly ignored it.
Does “Precision” Matter? A Q Study of Public Interpretations of Gene Editing in Agriculture
Authors: Nawaz Sara , Satterfield Terre , Phurisamban Rapichan
Published: July 2022

Gene editing (GE) technologies are rapidly gaining traction as an alternative to genetically modified organisms (GMOs) in agriculture. While proponents claim the critical need for GE to address climate change and food security and assert its similarity to conventional breeding, critics argue that these technologies bring similar concerns to GMOs, such as supporting industrial agriculture and enhancing corporate control and ownership. But how do public groups make sense of these technologies? While incorporating public concerns is key to responsible and ethical innovation, minimal research explores how people make sense of emerging applications. We offer an exploratory Q study that investigates how one public group applies interpretive frames to understand applications of novel GE and related technologies. We find participants apply three different frames, invoking applications as (1) necessitating a system critical lens, (2) worthy of pragmatic of consideration, or (3) a deeply ambiguous prospect. These frames, we argue, articulate visions of particular sociotechnical futures, most of which are contrary or orthogonal to proponents’ assumptions. Instead, we find participants concerned less with the precision of techniques or the origin of genes used and more often with whether these applications reify dominant industrial practices and if viable alternatives exist.
Attention Deficit Hyperactivity Disorder Symptoms, Smoking Initiation, and Social Integration among Adolescents
Authors: Wise Barbara L. , Ford Jodi L.
Published: July 2022

This observational, longitudinal study’s purpose was to investigate whether social network integration has a moderating effect on smoking initiation among those with attention deficit hyperactivity disorder (ADHD). Data were drawn from the National Longitudinal Study of Adolescent to Adult Health, a nationally representative longitudinal dataset. Social network and smoking data were collected in schools, with a 6-year follow-up that included ADHD symptoms and reported smoking. Social integration was measured as peer friendship nominations (degree) and the influence of an individual on the entire social network (centrality). Multilevel logistic regression found a main effect for ADHD symptoms and low numbers of friendship nominations on smoking initiation, but social network measures were not significant moderators of the relationship between ADHD symptoms and smoking initiation among adolescents. Further investigation of the drivers of smoking initiation among those with ADHD is warranted.
Emerging technologies adoption in healthcare: A SOHI model
Authors: Ofori Philomina Pomaah , Wang Wenxin
Published: July 2022

The internet and emerging technologies have increased the utilisation of digital platforms. This study aims to draw on performance expectancy, social influence, and satisfaction to investigate a proposed model which is geared toward social media healthcare information (SOHI) adoption. The proposed model uses a structured online questionnaire, and 300 responses were evaluated using partial least squares and structural equation modelling [PLS-SEM]. From the findings, performance expectancy of social media (PESM) and satisfaction with social media (SATSM) were revealed to be significant predictors of behavioural intention towards social media (BISM). Satisfaction with social media (SATSM) had the greatest impact on BISM, accounting for 64.7 per cent of the variance in users' intentions to utilise SOHI. Similarly, PESM and social influence on social media (SISM) had the most predictive influence on SATSM, accounting for 50.5 per cent of the variance in users' social media satisfaction, which led to SOHI adoption. Unlike others, the social influence on social media (SISM) did not have a significant effect on BISM. BISM and satisfaction with social media (SATSM) were significant predictors of SOHI adoption, accounting for 54.5 per cent of the variance in SOHI adoption. The recommendations in this study would help healthcare professionals change their approach to digital healthcare engagement.
Intracranial dissemination of glioblastoma multiforme: a case report and literature review
Authors: Zhang Keke , Yang Yihang , Zhuang Jianfeng , Guo Gengyin , Chao Xin , Zhang Zhen
Published: July 2022

Intracranial dissemination is rare among patients with glioblastoma multiforme (GBM). Very few GBM patients develop symptoms from intracranial dissemination, as most do not surviving long enough for intracranial dissemination to become clinically evident. Herein, we report a case of GBM in a 39-year-old woman who underwent surgical resection, concomitant chemoradiotherapy, and seven courses of adjuvant chemotherapy with temozolomide. The patient then complained of an instable gait and hearing loss. Imaging studies demonstrated that although the primary intracranial tumors were well-controlled by treatment, contralateral cerebellopontine angle seeding dissemination was present. The patient died 3 months after the diagnosis of seeding dissemination. In light of a previous report and our current case, heightened awareness could promote surgical strategies that minimize the possibility of dissemination, including avoiding ventricular entry or a no-touch strategy.
How are you getting by? Coping in developmental coordination disorder versus attention-deficit/hyperactivity disorder
Authors: Meachon Emily J , Alpers Georg W
Published: July 2022

Objective

Developmental Coordination Disorder (DCD) and Attention-Deficit/Hyperactivity Disorder (ADHD) persist into adulthood; however, little research exists to describe how adults with DCD and/or ADHD cope with their symptoms. Therefore, the purpose of this study was to investigate coping mechanisms reported by adults with DCD, ADHD, or both conditions. We expected there would be strategies specific to each condition and a broader scope of mechanisms reported by those with co-occurring DCD+ADHD.

Method

N = 161 participants completed the online survey, including n = 31 with DCD only, n = 116 with ADHD only, and n = 14 with DCD+ADHD.

Results

Most participants reported adaptive strategies. Of these, behavioral adaptations were most relevant to ADHD, while environmental modifications were common in DCD. Cognitive reframing and social support were similarly relevant to those with DCD and DCD+ADHD. Coping strategy categories were most uniform for the DCD+ADHD group.

Conclusions

Coping profiles highlight several noteworthy differences between DCD and ADHD which may be relevant for treatment.
An evaluation of institutional repository development in African universities
Authors: Baro Emmanuel E , Nwabueze-Echedom Anthonia U
Published: July 2022

The purpose of this study is to evaluate the development of institutional repositories in university libraries in Africa. An online questionnaire and institutional repository site investigation methods were used to collect data from 134 university libraries in English-speaking countries in Africa. The study finds that there is an increasing wave of development of institutional repositories in English-speaking countries in Africa. The majority of the institutional repositories contain high numbers of theses and dissertations, followed by journal articles and conference and workshop papers. The challenges that are identified include inadequate facilities, unstable Internet connectivity, a lack of funds, an irregular power supply, collecting material for institutional repositories, a lack of skilled information and communications technology personnel, copyright issues and an absence of institutional repository policies. The results from the study provide important data and insight into the development of institutional repositories in university libraries in the context of developing countries, and offer suggestions for university librarians and management teams.