bluuebunny/crossref_metadata_2025 huggingface dataset:
Ultrasound-guided targeted biopsies of CT-based radiomic tumour habitats: technical development and initial experience in metastatic ovarian cancer
Authors: Beer Lucian , Martin-Gonzalez Paula , Delgado-Ortet Maria , Reinius Marika , Rundo Leonardo , Woitek Ramona , Ursprung Stephan , Escudero Lorena , Sahin Hilal , Funingana Ionut-Gabriel , Ang Joo-Ern , Jimenez-Linan Mercedes , Lawton Tristan , Phadke Gaurav , Davey Sally , Nguyen Nghia Q. , Markowetz Florian , Brenton James D. , Crispin-Ortuzar Mireia , Addley Helen , Sala Evis
Published: December 2020

Purpose

To develop a precision tissue sampling technique that uses computed tomography (CT)–based radiomic tumour habitats for ultrasound (US)-guided targeted biopsies that can be integrated in the clinical workflow of patients with high-grade serous ovarian cancer (HGSOC).

Methods

Six patients with suspected HGSOC scheduled for US-guided biopsy before starting neoadjuvant chemotherapy were included in this prospective study from September 2019 to February 2020. The tumour segmentation was performed manually on the pre-biopsy contrast-enhanced CT scan. Spatial radiomic maps were used to identify tumour areas with similar or distinct radiomic patterns, and tumour habitats were identified using the Gaussian mixture modelling. CT images with superimposed habitat maps were co-registered with US images by means of a landmark-based rigid registration method for US-guided targeted biopsies. The dice similarity coefficient (DSC) was used to assess the tumour-specific CT/US fusion accuracy.

Results

We successfully co-registered CT-based radiomic tumour habitats with US images in all patients. The median time between CT scan and biopsy was 21 days (range 7–30 days). The median DSC for tumour-specific CT/US fusion accuracy was 0.53 (range 0.79 to 0.37). The CT/US fusion accuracy was high for the larger pelvic tumours (DSC: 0.76–0.79) while it was lower for the smaller omental metastases (DSC: 0.37–0.53).

Conclusion

We developed a precision tissue sampling technique that uses radiomic habitats to guide in vivo biopsies using CT/US fusion and that can be seamlessly integrated in the clinical routine for patients with HGSOC.

Key Points

• We developed a prevision tissue sampling technique that co-registers CT-based radiomics–based tumour habitats with US images.

• The CT/US fusion accuracy was high for the larger pelvic tumours (DSC: 0.76–0.79) while it was lower for the smaller omental metastases (DSC: 0.37–0.53).
Assessment of nutritional status in children with kidney diseases—clinical practice recommendations from the Pediatric Renal Nutrition Taskforce
Authors: Nelms Christina L. , Shaw Vanessa , Greenbaum Larry A. , Anderson Caroline , Desloovere An , Haffner Dieter , Oosterveld Michiel J. S. , Paglialonga Fabio , Polderman Nonnie , Qizalbash Leila , Rees Lesley , Renken-Terhaerdt José , Tuokkola Jetta , Vande Walle Johan , Shroff Rukshana , Warady Bradley A.
Published: December 2020

In children with kidney diseases, an assessment of the child’s growth and nutritional status is important to guide the dietary prescription. No single metric can comprehensively describe the nutrition status; therefore, a series of indices and tools are required for evaluation. The Pediatric Renal Nutrition Taskforce (PRNT) is an international team of pediatric renal dietitians and pediatric nephrologists who develop clinical practice recommendations (CPRs) for the nutritional management of children with kidney diseases. Herein, we present CPRs for nutritional assessment, including measurement of anthropometric and biochemical parameters and evaluation of dietary intake. The statements have been graded using the American Academy of Pediatrics grading matrix. Statements with a low grade or those that are opinion-based must be carefully considered and adapted to individual patient needs based on the clinical judgment of the treating physician and dietitian. Audit and research recommendations are provided. The CPRs will be periodically audited and updated by the PRNT.
Association of age with incidence and timing of recurrence after microdiscectomy for lumbar disc herniation
Authors: Siccoli Alessandro , Schröder Marc L. , Staartjes Victor E.
Published: December 2020

Objective

Recurrent lumbar disc herniation (LDH) is the most frequent reason for reoperation after lumbar microdiscectomy. While several risk factors for recurrent LDH have been well-described, the effect of age on recurrence remains unclear, especially concerning the timing of recurrent LDH.

Methods

From a prospective registry, we identified all patients who underwent tubular microdiscectomy for LDH. Recurrent LDH was defined as reoperation for LDH at the same index level and side. The associations among age and incidence of recurrent LDH as well as on time to recurrent LDH were statistically evaluated using multivariable analysis of covariance, linear regression, and Cox proportional hazards modelling.

Results

Of the 3013 patients who underwent surgery for LDH, 166 (5.5%) had to undergo reoperation due to LDH recurrence. Uni- and multivariable analysis revealed no influence of age on the incidence of recurrent LDH (both p > 0.05). Linear regression indicated earlier reoperation in older patients, both with (β = −0.248) and without (β = −0.374) correction for confounders (both p < 0.05). An additional survival analysis found that patients aged over 35 years had recurrent LDH significantly earlier (hazard ratio 0.617, p = 0.013).

Conclusion

In an analysis of a large prospective database of patients undergoing microdiscectomy for lumbar disc herniation, we found that younger patients do not have a higher reoperation probability than their older counterparts, even after correcting for multiple confounders. However, older patients tend to experience recurrent LDH significantly earlier after the index surgery compared to younger patients.
Full genome sequence of bovine alphaherpesvirus 2 (BoHV-2)
Authors: Pfaff Florian , Neubauer-Juric Antonie , Krebs Stefan , Hauser Andreas , Singer Stefanie , Blum Helmut , Hoffmann Bernd
Published: December 2020

We present the complete genome sequence of bovine alphaherpesvirus 2 (BoHV-2), a member of the family Herpesviridae, subfamily Alphaherpesvirinae, genus Simplexvirus. BoHV-2 is the causative agent of bovine ulcerative mammillitis (bovine herpes mammillitis) and pseudo-lumpy skin disease. The genomic architecture of BoHV-2 is typical of most simplexvirus genomes and congruent with that of human alphaherpesvirus 1 (HHV-1). The genome comprises a total of 131,245 base pairs and has an overall G+C content of 64.9 mol%. A total of 75 open reading frames are predicted. The gene repertoire of BoHV-2 is analogous to that of HHV-1, although the coding region of US12 is missing. A phylogenetic analysis supported BoHV-2 as a member of the genus Simplexvirus.
Comparing multiband and singleband EPI in NODDI at 3 T: what are the implications for reproducibility and study sample sizes?
Authors: Bouyagoub Samira , Dowell Nicholas G. , Gabel Matt , Cercignani Mara
Published: December 2020

Objective

The reproducibility of Neurite orientation dispersion and density imaging (NODDI) metrics from time-saving multiband (MB) EPI compared with singleband (SB) has not been considered. This study aims to evaluate the reproducibility of NODDI parameters from SB and MB acquisitions, determine the agreement between acquisitions and estimate the sample sizes required to detect between-group change.

Methods

Brain diffusion MRI data were acquired using SB and MB (acceleration factors 2 (MB2) and 3 (MB3)) on 8 healthy subjects on 2 separate visits. NODDI maps of isotropic volume fraction (FISO), neurite density (NDI) and orientation dispersion index (ODI) were estimated. Region-of-interest analysis was performed; variability across subjects and visits was measured using coefficients of variation (CoV). Intraclass correlation coefficient and Bland–Altman analysis were performed to assess reproducibility and detect any systematic bias between SB, MB2 and MB3. Power calculations were used to determine sample sizes required to detect group differences.

Results

Both NDI and ODI were reproducible between visits; however, FISO was variable. All parameters were not reproducible across methods; a systematic bias was observed with the derived values decreasing as the MB factor increases. The number of subjects needed to detect a between-group change is not significantly different between methods; however, ODI needs considerably higher sample sizes than NDI.

Conclusions

Both SB and MB yield highly reproducible NDI and ODI measures, but direct comparison of these parameters between methods is complicated by systematic differences that exist between the two approaches.
The Role of Magnesium in Pregnancy and in Fetal Programming of Adult Diseases
Authors: Fanni Daniela , Gerosa C. , Nurchi V. M. , Manchia M. , Saba L. , Coghe F. , Crisponi G. , Gibo Y. , Van Eyken P. , Fanos V. , Faa G.
Published: December 2020

Magnesium is an essential trace metal and a necessary factor for multiple biochemical functions in humans. Its role in biology is fundamental in over 600 enzymatic reactions implicated in protein synthesis, mitochondrial functions, neuromuscular activity, bone formation, and immune system competence. Magnesium status is relevant in fetal development during gestation and in the newborn growth during the perinatal period. Moreover, magnesium is able to influence fetal programming and disease presentation in childhood or adulthood. The aim of this review is to focus on this metal homeostasis, analyzing its normal values, the causes of hypomagnesemia, the interaction with drugs and other conditions, and the diseases associated with magnesium value alteration during pregnancy, in order to study its role in fetal programming of adult diseases. The data here reported clearly indicated the existence of a connection between magnesium status and human pathology starting from intrauterine life and extending into childhood and adulthood.
Systematic review and updated network meta-analysis comparing open, laparoscopic, and robotic pancreaticoduodenectomy
Authors: Aiolfi Alberto , Lombardo Francesca , Bonitta Gianluca , Danelli Piergiorgio , Bona Davide
Published: December 2020

The treatment of periampullary and pancreatic head neoplasms is evolving. While minimally invasive Pancreaticoduodenectomy (PD) has gained worldwide interest, there has been a debate on its related outcomes. The purpose of this paper was to provide an updated evidence comparing short-term surgical and oncologic outcomes within Open Pancreaticoduodenectomy (OpenPD), Laparoscopic Pancreaticoduodenectomy (LapPD), and Robotic Pancreaticoduodenectomy (RobPD). MEDLINE, Web of Science, PubMed, Cochrane Central Library, and ClinicalTrials.gov were referred for systematic search. A Bayesian network meta-analysis was executed. Forty-one articles (56,440 patients) were included; 48,382 (85.7%) underwent OpenPD, 5570 (9.8%) LapPD, and 2488 (4.5%) RobPD. Compared to OpenPD, LapPD and RobPD had similar postoperative mortality [Risk Ratio (RR) = 1.26; 95%CrI 0.91–1.61 and RR = 0.78; 95%CrI 0.54–1.12)], clinically relevant (grade B/C) postoperative pancreatic fistula (POPF) (RR = 1.12; 95%CrI 0.82–1.43 and RR = 0.87; 95%CrI 0.64–1.14, respectively), and severe (Clavien-Dindo ≥ 3) postoperative complications (RR = 1.03; 95%CrI 0.80–1.46 and RR = 0.93; 95%CrI 0.65–1.14, respectively). Compared to OpenPD, both LapPD and RobPD had significantly reduced hospital length-of-stay, estimated blood loss, infectious, pulmonary, overall complications, postoperative bleeding, and hospital readmission. No differences were found in the number of retrieved lymph nodes and R0. OpenPD, LapPD, and RobPD seem to be comparable across clinically relevant POPF, severe complications, postoperative mortality, retrieved lymphnodes, and R0. LapPD and RobPD appears to be safer in terms of infectious, pulmonary, and overall complications with reduced hospital readmission We advocate surgeons to choose their preferred surgical approach according to their expertise, however, the adoption of minimally invasive techniques may possibly improve patients’ outcomes.
Artificial intelligence techniques support nuclear medicine modalities to improve the diagnosis of Parkinson’s disease and Parkinsonian syndromes
Authors: Palumbo Barbara , Bianconi Francesco , Nuvoli Susanna , Spanu Angela , Fravolini Mario Luca
Published: December 2020

Purpose

The aim of this review is to discuss the most significant contributions about the role of Artificial Intelligence (AI) techniques to support the diagnosis of movement disorders through nuclear medicine modalities.

Methods

The work is based on a selection of papers available on PubMed, Scopus and Web of Sciences. Articles not written in English were not considered in this study.

Results

Many papers are available concerning the increasing contribution of machine learning techniques to classify Parkinson’s disease (PD), Parkinsonian syndromes and Essential Tremor (ET) using data derived from brain SPECT with dopamine transporter radiopharmaceuticals. Other papers investigate by AI techniques data obtained by 123I-MIBG myocardial scintigraphy to differentially diagnose PD and other Parkinsonian syndromes.

Conclusion

The recent literature provides strong evidence that AI techniques can play a fundamental role in the diagnosis of movement disorders by means of nuclear medicine modalities, therefore paving the way towards personalized medicine.
Health-related quality of life assessment in eating disorders: adjustment and validation of a specific scale with the inclusion of an interpersonal domain
Authors: Meneguzzo Paolo , Todisco Patrizia , Calonaci Sofia , Mancini Cecilia , Dal Brun David , Collantoni Enrico , Donini Lorenzo Maria , Tenconi Elena , Favaro Angela
Published: December 2020

Purpose

Quality of life is a fundamental aspect of both clinical practice and research on eating disorders (ED) due to the significant impacts these disorders have on everyday life. Disorder-specific scales can improve the quality of research and findings and offer greater sensitivity and responsiveness. However, no specific instrument is available in Italian for ED. The aim of this paper is to adjust and to validate a reliable scale with specific items regarding physical and interpersonal well-being.

Methods

The Italian version of the Eating Disorder Quality of Life (IEDQOL) scale was developed, on the basis of the original English scale, with the addition of items pertaining to physical well-being and interpersonal interactions. In this study, 180 ED patients and 190 healthy controls from the community were enrolled both from inpatient units and outpatient services. A statistical analysis with an exploratory factorial approach was performed in order to validate the tool.

Results

The results showed that the IEDQOL has very good psychometric properties with test–retest validity and sensitivity between patients and controls (d = 2.17 for total score). Moreover, the interpersonal domain showed excellent psychometric values (Cronbach’sα > 0.70 in all the subgroups) and a robust correlation with other quality of life constructs.

Conclusion

Future studies on the Italian population should use IEDQOL as outcome element that can be useful also with other disorder-specific psychopathological constructs and corroborate the reliability of the data. Future research in the ED field should only use this specific tool.

Level of evidence

Case–control analytic study, Level III.
Staying-with the traces: mapping-making posthuman and indigenist philosophy in environmental education research
Authors: Cutter-Mackenzie-Knowles Amy , Brown Shae L. , Osborn Maia , Blom Simone M. , Brown Adi , Wijesinghe Thilinika
Published: December 2020

We acknowledge and pay respect to the people of the Yugambeh Nation on whose Land we work, meet and study. We recognise the significant role the past and future Elders play in the life of the University and the region. We are mindful that within and without the buildings, the Land always was and always will be Aboriginal Land.1

This paper introduces staying-with the traces of inter/intra-subjective experience, with and within place, in mapping-making philosophy in environmental education. Through a conceptualisation of philosophy as concepts or knots in an infinite composition of knowledge, rather than separate knowledges, we use staying-with the traces2as method, whereby our embodied patterns of human and more than human relationality across place and time may engage with philosophy. This grounding of philosophy foregrounds the diverse onto-epistemologies of posthumanism and indigenist3ways of knowing, acknowledging tensions and searching for the possibilities of connectivity between them. Through an embodied arts-based walking practice, our approach challenges the perpetuation of reductionist perspectives, including nature/culture binaries, within environmental education. We stay with the traces of bird, meeting, tree, watery and concrete in mutual inseparable relation and becoming.
Experiences of offenders with traumatic brain injury
Authors: Linden Mark A. , O’Rourke Conall , Monaghan Catherine , Rainey Deborah
Published: December 2020

Purpose:

Traumatic brain injury is recognised as a significant and pervasive health issue among offender populations. Despite this, no qualitative research exists exploring the experiences and perceptions of offenders with TBI in prison.

Methods:

Qualitative interviews were conducted with male and female offenders housed in a UK prison. Interviews examined what participants felt led them to offend, experiences of incarceration, and post-release plans. Presence of TBI was assessed via the Brain Injury Screening Index. Data were analysed by means of inductive content analysis.

Findings:

Both male and female prisoners primarily attributed their incarceration to drugs and alcohol use, with males also referencing more issues with aggression, while mental illness and past abuse were more commonly mentioned among females. A lack of recognition for the possible role of TBI was noted, with several males describing themselves as ‘stupid’ or prone to making ‘poor lifestyle choices’. Both groups indicated a desire to return to education or work post-release.

Conclusions:

Despite significant rates of injury, there is a clear lack of understanding and consideration of the role of TBI in the behaviour and presentation of offenders. There is need for improved identification and education around TBI early in the criminal justice process.
Cortical Excitability in Temporal Lobe Epilepsy with Bilateral Tonic-Clonic Seizures
Authors: Hu Lingli , Yin Houmin , Yang Linling , Chen Cong , He Chenmin , Chen Yi , Zhu Junming , Ding Yao , Wang Shuang , Ding Meiping , Wang Shan
Published: December 2020

Objective:

We investigated motor cortical excitability (CE) in unilateral temporal lobe epilepsy (TLE) and its relationship to bilateral tonic-clonic seizure (BTCS) using paired-pulse transcranial magnetic stimulation (TMS).

Methods:

In this cross-sectional study, we enrolled 46 unilateral TLE patients and 16 age-and sex-matched healthy controls. Resting motor thresholds (RMT); short-interval intracortical inhibition (SICI, GABAA receptor-mediated); facilitation (ICF, glutamatergic-mediated) with interstimulus intervals (ISIs) of 2, 5, 10, and 15 ms; and long-interval intracortical inhibition (LICI, GABAB receptor-mediated) with ISIs of 200–400 ms were measured via paired-pulse TMS. Comparisons were made between controls and patients with TLE, and then among the TLE subgroups (no BTCS, infrequent BTCS and frequent BTCS subgroup).

Results:

Compared with controls, TLE patients had higher RMT, lower SICI and higher LICI in both hemispheres, and higher ICF in the ipsilateral hemisphere. In patients with frequent BTCS, cortical hyperexcitability in the ipsilateral hemisphere was found in a parameter-dependent manner (SICI decreased at a stimulation interval of 5 ms, and ICF increased at a stimulation interval of 15 ms) compared with patients with infrequent or no BTCS.

Conclusions:

Our results demonstrate that motor cortical hyper-excitability in the ipsilateral hemisphere underlies the epileptogenic network of patients with active BTCS, which is more extensive than those with infrequent or no BTCS.
Intervention Time and Adverse Events in a Canadian Epilepsy Monitoring Unit
Authors: Li Jimmy , Toffa Dènahin Hinnoutondji , Bou Assi Elie , Mehrpouyan Sepehr , Forand Julie , Robert Manon , Keezer Mark , Flahault Adrien , Nguyen Dang Khoa
Published: December 2020

Background:

Intervention time (IT) in response to seizures and adverse events (AEs) have emerged as key elements in epilepsy monitoring unit (EMU) management. We performed an audit of our EMU, focusing on IT and AEs.

Methods:

We performed a retrospective study on all clinical seizures of admissions over a 1-year period at our Canadian academic tertiary care center’s EMU. This EMU was divided in two subunits: a daytime three-bed epilepsy department subunit (EDU) supervised by EEG technicians and a three-bed neurology ward subunit (NWU) equipped with video-EEG where patients were transferred to for nights and weekends, under nursing supervision. Among 124 admissions, 58 were analyzed. A total of 1293 seizures were reviewed to determine intervention occurrence, IT, and AE occurrence. Seizures occurring when the staff was present at bedside at seizure onset were analyzed separately.

Results:

Median IT was 21.0 (11.0–40.8) s. The EDU, bilateral tonic–clonic seizures (BTCS), and the presence of a warning signal were associated with increased odds of an intervention taking place. The NWU, BTCS, and seizure rank (seizures were chronologically ordered by the patient for each subunit) were associated with longer ITs. Bedside staff presence rate was higher in the EDU than in the NWU (p < 0.001). AEs occurred in 19% of admissions, with no difference between subunits. AEs were more frequent in BTCS than in other seizure types (p = 0.001).

Conclusion:

This study suggests that close monitoring by trained staff members dedicated to EMU patients is key to optimize safety. AE rate was high, warranting corrective measures.
Federal and Political Party Reforms in Asia: Is There a New Model of Federal Democracy Emerging in Ethnically Diverse Countries in Asia?
Authors: Breen Michael G.
Published: December 2020

How do ethnically divided countries create inclusive and stable democratic institutions? Why do some kinds of federalism fail while others evolve? Scholars looking for answers to these kinds of questions have tended to focus on the West. Yet there are important lessons arising from the substantial democratic and federal reforms that have taken place in Asia over the last few decades. These reforms signal a new model of federal democracy in Asia, comprising multilevel ethnoterritorial federalism, mixed-majoritarianism and a party system that includes both ethnic and multi-ethnic parties. This model has emerged as a response to ethnic conflict and secession risks and reflects the high diversity of clustered communities and cross-cutting cleavages. Despite its overarching majoritarianism, the federal model has led to highly fragmented party systems and coalition governments, with positive implications for democratic stability. Together, these features go some way towards blending otherwise conflicting consociational and centripetal paradigms.
Evaluation of antibiotic prescribing in emergency departments and urgent care centers across the Veterans’ Health Administration
Authors: Lowery James L. , Alexander Bruce , Nair Rajeshwari , Heintz Brett H. , Livorsi Daniel J.
Published: December 2020

Objective:

Assessments of antibiotic prescribing in ambulatory care have largely focused on viral acute respiratory infections (ARIs). It is unclear whether antibiotic prescribing for bacterial ARIs should also be a target for antibiotic stewardship efforts. In this study, we evaluated antibiotic prescribing for viral and potentially bacterial ARIs in patients seen at emergency departments (EDs) and urgent care centers (UCCs).

Design:

This retrospective cohort included all ED and UCC visits by patients who were not hospitalized and were seen during weekday, daytime hours during 2016–2018 in the Veterans Health Administration (VHA). Guideline concordance was evaluated for viral ARIs and for 3 potentially bacterial ARIs: acute exacerbation of COPD, pneumonia, and sinusitis.

Results:

There were 3,182,926 patient visits across 129 sites: 80.7% in EDs and 19.3% in UCCs. Mean patient age was 60.2 years, 89.4% were male, and 65.6% were white. Antibiotics were prescribed during 608,289 (19.1%) visits, including 42.7% with an inappropriate indication. For potentially bacterial ARIs, guideline-concordant management varied across clinicians (median, 36.2%; IQR, 26.0–52.7) and sites (median, 38.2%; IQR, 31.7–49.4). For viral ARIs, guideline-concordant management also varied across clinicians (median, 46.2%; IQR, 24.1–68.6) and sites (median, 40.0%; IQR, 30.4–59.3). At the clinician and site levels, we detected weak correlations between guideline-concordant management for viral ARIs and potentially bacterial ARIs: clinicians (r = 0.35; P = .0001) and sites (r = 0.44; P < .0001).

Conclusions:

Our findings suggest that, across EDs and UCCs within VHA, there are major opportunities to improve management of both viral and potentially bacterial ARIs. Some clinicians and sites are more frequently adhering to ARI guideline recommendations on antibiotic use.
Where Diasporas Met: Hunanese, Cantonese, and the State in Late-Qing Guangxi
Authors: Miles Steven B.
Published: December 2020

Drawing on physical and textual records of Hunanese and Cantonese active in Guangxi, as well as state archival sources, this article traces the expansion of these two diasporic cohorts in Guangxi from the early nineteenth century, through the mid-century wars, and into the postwar era, when they reintegrated this southwestern frontier province into the late-Qing empire.
Dietary iron intake and the risk of type 2 diabetes mellitus in middle-aged and older adults in urban China: a prospective cohort study
Authors: Li Shu-Yi , Wang Fan , Lu Xiao-Ting , Zhong Rong-Huan , Long Jing-An , Fang Ai-Ping , Zhu Hui-Lian
Published: December 2020

The association between dietary Fe intake and diabetes risk remains inconsistent. We aimed to explore the association between dietary Fe intake and type 2 diabetes mellitus (T2DM) risk in middle-aged and older adults in urban China. This study used data from the Guangzhou Nutrition and Health Study, an on-going community-based prospective cohort study. Participants were recruited from 2008 to 2013 in Guangzhou community. A total of 2696 participants aged 40–75 years without T2DM at baseline were included in data analyses, with a median of 5·6 (interquartile range 4·1–5·9) years of follow-up. T2DM was identified by self-reported diagnosis, fasting glucose ≥ 7·0 mmol/l or glycosylated Hb ≥ 6·5 %. Cox proportional hazard models were used to estimate hazard ratios (HR) and 95 % CI. We ascertained 205 incident T2DM cases during 13 476 person-years. The adjusted HR for T2DM risk in the fourth quartile of haem Fe intake was 1·92 (95 % CI 1·07, 3·46; Ptrend = 0·010), compared with the first quartile intake. These significant associations were found in haem Fe intake from total meat (HR 2·74; 95 % CI 1·22, 6·15; Ptrend = 0·011) and haem Fe intake from red meat (HR 1·86; 95 % CI 1·01, 3·44; Ptrend = 0·034), but not haem Fe intake from processed meat, poultry or fish/shellfish. The association between dietary intake of total Fe or non-haem Fe with T2DM risk had no significance. Our findings suggested that higher dietary intake of haem Fe (especially from red meat), but not total Fe or non-haem Fe, was associated with greater T2DM risk in middle-aged and older adults.
A success story of reduction in childhood stunting and underweight in India: analysis of pooled data from three rounds of Indian Demographic and Health Surveys (1998–2016)
Authors: Srivastava Swati , Upadhyay Ashish Kumar
Published: December 2020

This study used a series of individual-level datasets from National Family Health Surveys conducted in 1998–99, 2005–06 and 2015–16 to assess the factors behind the reduction in childhood stunting and underweight in India between the years 1998–99 and 2015–16. A multivariable decomposition regression analysis was performed. Results showed that the prevalence of childhood stunting declined from 49.4% in 1998–99 to 34.9% in 2015–16. Over the same period, the prevalence of childhood underweight declined from 41.9% in 1998–99 to 33.1% in 2015–16. The reduction in the prevalence of stunting was found to be contributed largely by a reduction in the combined prevalence of stunting and underweight (60%), followed by stunted only (21%) and the combined prevalence of stunting, underweight and wasting (19%). Likewise, the reduction in the prevalence of underweight was contributed by a reduction in the combined prevalence of stunting and underweight and the combined prevalence of stunting, underweight and wasting. Results of the decomposition analysis showed that over the period 1998–99 to 2015–16, improvement in wealth status and maternal education led to 13% and 12% declines, respectively, in childhood stunting and to 31% and 19% declines, respectively, in childhood underweight. Furthermore, reductions in childhood stunting and underweight were due to an increased average number of antenatal care visits, lower average birth order, decreased share of children with below-average birth size, increased use of clean fuel for cooking and a reduction in the practice of open defecation. These findings suggest that further reduction in the prevalence of childhood stunting and underweight could be attained through more equitable household economic growth, investment in girl’s education, greater access to improved toilet facilities, more widespread use of clean fuel for cooking, reduction in average birth order, increased antenatal care visits and greater consumption of IFA tablets by pregnant women. Policymakers need to prioritize these measures to further reduce malnutrition among Indian children.
Does Government Spending Crowd Out R&D Investment? Evidence from Government-Dependent Firms and Their Peers
Authors: Ngo Phong T. H. , Stanfield Jared
Published: December 2020

We provide evidence that managerial incentives to manipulate real activities can influence the effectiveness of fiscal policy. Increases in federal spending lead government-dependent firms to expand research and development (R&D) investment whereas industry-peer firms contract. The net result is a reduction in industry-level R&D investment. We find evidence of a novel mechanism for the crowding out of peer-firm investment: peer-firm managers respond to falling relative performance by cutting R&D to manage current earnings upward. We show that these differential responses manifest in firm value. These findings are robust to endogeneity and selection concerns as well as a battery of alternative explanations.
Jeremy Waldron and the Circumstances of Politics
Authors: Latham-Gambi Alexander
Published: December 2020

This article examines Jeremy Waldron's concept of the “circumstances of politics” (CoP), which he describes as the felt need for a common decision in the face of disagreement. Waldron uses the CoP to detach certain issues surrounding civic virtue and institutional design from questions about substantive principles such as justice and human rights. While emphasis is often placed on the fact of disagreement, I argue that the other aspect of the CoP, the need for collective action, is in fact the more fundamental. Waldron's arguments rely on an understanding that there is expressive value in citizens affirming commitment to the political community and on an awareness of how the nature of politics as public collective action is structured by the constitutional architecture. I argue that a lopsided focus on disagreement threatens to obscure the fact that the political sphere is itself a fragile achievement that is in need of continual support.
‘We go for a homely feel … not the clinical dementia side’: care home managers’ experiences of supporting residents with dementia to orientate and navigate care environments
Authors: Heward Michelle , Adams Amanda , Hicks Ben , Wiener Jan
Published: December 2020

Living with dementia can adversely affect people's spatial (orientation and navigation) and reality (time, date and place) orientation, which can detrimentally impact on their sense of social inclusion and wellbeing. This is an important challenge to address within United Kingdom (UK) care homes where around 70 per cent of the residents are living with dementia or severe memory problems. Care home managers have some autonomy in decision-making that impacts on the daily functioning of residents and are key in enacting the orientation and navigation agenda within a care home environment. Yet a paucity of literature explores their understanding and experiences of this issue. Contributing to this knowledge gap, our exploratory study examined managers’ current practice of supporting residents with dementia to minimise disorientation and their knowledge of dementia-friendly design principles, guidelines and audit tools. Semi-structured telephone interviews with 12 UK care home managers were conducted. Questions started generally targeting residents’ orientation and navigation abilities, followed by specific questions to draw out strategies used to support residents. Thematic analysis identified three higher-order themes: aligning strategies with needs, intuitive learning and managing within the wider business context. The findings demonstrated that managers perceive dementia to impact on a person's spatial and reality orientation. Consequently, the strategies they chose to adopt were tailored towards alleviating both challenges. However, although managers were aware of some design principles, they frequently relied on intuitive learning and past experiences to inform their choice of interventions, reporting a lack of knowledge and/or time to seek out orientation-specific training and guidance, resulting in a low uptake of guidelines and audit tools in practice. This gap between theory and practice highlights a need for accessible guidelines that integrate strategies with neuropsychological theory, and appropriate training to improve orientation and navigation in care home environments. Managers, staff, business owners, architects and designers all play a key role in implementing orientation guidelines into practice and ensuring dementia-friendly care home environments for residents.
The effects of mobile apps on stress, anxiety, and depression: overview of systematic reviews
Authors: Khademian Fatemeh , Aslani Azam , Bastani Peivand
Published: December 2020

Objectives

Despite a large number of mobile apps in the field of mental health, it is difficult to find a useful and reliable one, mainly due to the fact that the effectiveness of many apps has not been assessed scientifically. The present study aimed to assess the effects of mental health apps on managing the symptoms of stress, anxiety, and depression.

Methods

A comprehensive literature search was conducted in PubMed, Scopus, EMBASE, Cochrane, and Web of Science databases for the papers published from 2000 to 2019. Studies were included if they reviewed articles or mobile apps for their effectiveness in stress, anxiety, and depression. The reviews that had considered mobile apps or web-based mobile applications as an intervention or part of intervention were included, as well.

Results

A total of 4,999 peer-reviewed articles were identified, out of which nine systematic reviews met the inclusion criteria. Seven systematic reviews measured depression outcomes, three measured stress, and five systematic reviews measured anxiety symptoms. The applications that used behavior change strategies, such as Cognitive Behavioral Therapy, Acceptance and Commitment Therapy, and Behavioral Activation, reported significant effects on depression, anxiety, and stress.

Conclusion

It seems that mental health apps can be promising media for reducing depressive symptoms. This field is an emerging area of mobile health, and further research should be done in future in order to reach conclusive evidence.
The screening of congenital heart disease by cardiac auscultation and 12-lead electrocardiogram among Indonesian elementary school students
Authors: Dinarti Lucia K. , Murni Indah K. , Anggrahini Dyah W. , Dewanto Vera C. , Pritazahra Armalya , Hadwiono Muhammad R. , Fajarwati Prahesti , Hartopo Anggoro B.
Published: December 2020

Background:

Screening for congenital heart disease (CHD) in school students is well-established in high-income countries; however, data from low-to-middle-income countries including Indonesia are limited.

Aim:

This study aimed to evaluate CHD screening methods by cardiac auscultation and 12-lead electrocardiogram to obtain the prevalence of CHD, confirmed by transthoracic echocardiography, among Indonesian school students.

Methods:

We conducted a screening programme in elementary school students in the Province of Special Region of Yogyakarta, Indonesia. The CHD screening was integrated into the annual health screening. The trained general practitioners and nurses participated in the screening. The primary screening was by cardiac auscultation and 12-lead electrocardiogram. The secondary screening was by transthoracic echocardiography performed on school students with abnormal findings in the primary screening.

Results:

A total of 6116 school students were screened within a 2-year period. As many as 329 (5.38%) school students were detected with abnormalities. Of those, 278 students (84.49%) had an abnormal electrocardiogram, 45 students (13.68%) had heart murmurs, and 6 students (1.82%) had both abnormalities. The primary screening programme was successfully implemented. The secondary screening was accomplished for 260 school students, and 18 students (6.9%) had heart abnormalities with 7 (2.7%) who were confirmed with septal defects and 11 (4.2%) had valve abnormalities. The overall prevalence was 0.29% (18 out of 6116).

Conclusions:

The primary screening by cardiac auscultation and 12-lead electrocardiogram was feasible and yielded 5.38% of elementary school students who were suspected with CHD. The secondary screening resulted in 6.9% confirmed cardiac abnormalities. The cardiac abnormality prevalence was 0.29%.
Dengue disease in a pediatric patient with severe idiopathic pulmonary hypertension
Authors: Díaz Gabriel , Devia Claudia P. , De La Hoz Orlando M.
Published: December 2020

Dengue virus can affect the heart, with complications as bradycardia, arrhythmias, and death. We present a case of a 15-year-old patient, diagnosed 4 years before with severe idiopathic pulmonary hypertension, confirmed by catheterism, with continuous follow up. At that time, she was living in Bogotá (2640 m above sea level). Sildenafil and Macitentan were started. She was recommended to live at low altitude and she moved. The patient was transferred back to Bogota, from that place, due to flu-like symptoms and fever. Immunoglobulin M for dengue was confirmed and second-degree atrioventricular block Mobitz I with bradycardia (40 beats/minute) was documented throughout the clinical course. She recovered.
Micturition syncope with asystole in a paediatric patient
Authors: Trivedi Mira K. , Arora Gaurav
Published: December 2020

Syncope occurs frequently in children, and the differential includes situational syncope, specifically micturition syncope. We report the youngest child to our knowledge to have micturition syncope associated with a prolonged asystolic pause. He underwent a neurological and cardiovascular evaluation without additional findings. Behavioural modifications were instituted with no recurrent syncope.
Catheter ablation of focal atrial tachycardia in children using three-dimensional electroanatomic mapping system: a 6-year single-centre experience
Authors: Sahin Gulhan Tunca , Kafali Hasan Candas , Ozturk Erkut , Guzeltas Alper , Ergul Yakup
Published: December 2020

Objective:

This study demonstrates the clinical and electrophysiological details of catheter ablation conducted in children with focal atrial tachycardia using three-dimensional electroanatomic mapping systems.

Patients and methods:

Electrophysiological procedures were performed using the EnSite™ system.

Results:

Between 2014 and 2020, 60 children (median age 12.01 years [16 days–18 years]; median weight 41.5 kg [3–98 kg]) with focal atrial tachycardia and treated with catheter ablation were evaluated retrospectively. Tachycardia-induced cardiomyopathy was developed in 15 patients (25%). Most of the focal atrial tachycardia foci were right-sided (75%), and more than one focus was found in four patients. Radiofrequency ablation was performed in 47 patients (irrigated radiofrequency ablation in seven cases), cryoablation in 9, and radiofrequency ablation and cryoablation in the same session in 4 patients. The median procedural time was 163.5 minutes (82–473 minutes). Fluoroscopy was used in 29 of (48.3%) patients (especially for left-side substrate) with a mean time of 8.6 ± 6.2 minutes. The acute success rate was 95%. The procedure failed in three patients, and recurrence was observed in 3.5% of patients (2/57) during a median follow-up of 17 months (2–69 months). The second ablation was performed in four cases, of which three were successful. Overall success rate was 96.6% with no major complications observed, except in one patient with minimal pericardial effusion.

Conclusion:

Catheter ablation seems to be an effective and safe treatment in focal atrial tachycardia. Electroanatomic mapping system can facilitate the ablation procedure and minimise radiation exposure.
Proinflammatory biomarkers are associated with prediabetes in patients with schizophrenia
Authors: Møller Marco , Fredholm Simon , Jensen Mathias E. , Wörtwein Gitta , Larsen Julie R. , Vilsbøll Tina , Ødum Niels , Fink-Jensen Anders
Published: December 2020

Background

Treatment with antipsychotics is associated with an increased risk of type 2 diabetes mellitus (T2D), and increased levels of inflammatory biomarkers are present in patients with T2D. We previously demonstrated that the glucagon-like peptide-1 receptor agonist liraglutide significantly reduced glucometabolic disturbances and body weight in prediabetic, overweight/obese schizophrenia-spectrum disorder patients treated with clozapine or olanzapine. This study aims to assess the involvement of cytokines in the therapeutic effects of liraglutide.

Methods

Serum concentrations of 10 cytokines (interferon-γ [IFN-γ], tumor necrosis factor-α, interleukin 1β [IL-1β], IL-2, IL-4, IL-6, IL-8, IL-10, IL-12p70, and IL-13) from fasting prediabetic and normal glucose-tolerant (NGT) patients with schizophrenia-spectrum disorders were measured using multiplexed immunoassays. Prediabetic patients were randomized to 16 weeks of treatment with liraglutide or placebo, and cytokines were measured again at the end of the treatment.

Results

IFN-γ (1.98 vs 1.17 pg/ml, P = .001), IL-4 (0.02 vs 0.01 pg/ml, P < .001), and IL-6 (0.73 vs 0.46 pg/ml, P < .001) were significantly higher in prediabetic (n = 77) vs NGT patients (n = 31). No significant changes in cytokine levels following treatment with liraglutide (n = 37) vs placebo (n = 40) were found.

Conclusion

Prediabetic vs NGT patients with schizophrenia treated with clozapine or olanzapine had increased serum levels of several proinflammatory cytokines, further substantiating the link between inflammation and T2D. Treatment with liraglutide did not affect the investigated cytokines. Further testing of these findings in larger numbers of individuals is needed.
Right-Wing Populism and the Securitisation of Laïcité Narratives in French Education Policy
Authors: Peker Efe
Published: December 2020

This article traces the influence of Front National (FN) on the transformation of mainstream French narratives of laïcité since 1989, with particular attention to education policy. It argues that the FN’s right-wing populist rhetoric, particularly the systematic securitisation of Islam as a threat to the ‘people’, facilitated the more widespread reframing of laïcité as a Republican defence mechanism, operating primarily through the school system. Laïcité was increasingly deployed in mainstream discourses and legislative measures to address two interrelated security concerns: the immediate safety of the school by the promotion of neutrality, and the overall wellbeing of the Republic via the prevention of radicalisation. Analysing this process in two specific periods (1989–2004 and 2005–2019), the article demonstrates that the FN’s populist agenda came to be in a symbiotic relationship with the centre-right and centre-left parties. While established parties gradually incorporated the FN’s securitisation narrative in their policymaking, the FN went through a process of ‘normalisation’ by claiming ownership of laïcité as a way to frame its anti-Islam stance in a more acceptable Republican discourse.
A scoping review of studies exploring leisure-time physical activity in adults diagnosed with advanced cancer
Authors: Shallwani Shirin M. , Ranger Marie-Christine , Thomas Roanne , Brosseau Lucie , Poitras Stéphane , Sikora Lindsey , King Judy
Published: December 2020

Objectives

Despite improving survival rates, people with advanced cancer face several physical and psychosocial concerns. Leisure-time physical activity (LPA) has been found to be beneficial after cancer diagnosis, but little is known about the current state of research exploring LPA in advanced cancer. Our objectives were to (a) map the literature examining LPA in people with advanced cancer, (b) report on the terms used to describe the advanced cancer population within the literature, and (c) examine how the concept of LPA is operationalized within the literature.

Method

Our scoping review followed Arksey and O'Malley's methodological framework. We performed a search of 11 electronic databases and supplementary sources (February 2018; database search updated January 2020). Two reviewers independently reviewed and selected articles according to the inclusion criteria: English-language journal articles on original primary research studies exploring LPA in adults diagnosed with advanced cancer. Descriptive and thematic analyses were performed.

Results

Ninety-two articles met our criteria. Most included studies were published in the last decade (80%) and used quantitative methods (77%). Many study populations included mixed (40%), breast (21%), or lung (17%) cancers. Stages 3–4 or metastatic disease were frequently indicated to describe study populations (77%). Several studies (68%) described LPA programs or interventions. Of these, 78% involved structured aerobic/resistance exercise, while 16% explored other LPA types.

Significance of results

This review demonstrates a recent surge in research exploring LPA in advanced cancer, particularly studies examining exercise interventions with traditional quantitative methods. There remains insufficient knowledge about patient experiences and perceptions toward LPA. Moreover, little is known about other leisure activities (e.g., Tai Chi, dance, and sports) for this population. To optimize the benefits of LPA in people with advanced cancer, research is needed to address the gaps in the current literature and to develop personalized, evidence-based supportive care strategies in cancer care.