bluuebunny/crossref_metadata_2025 huggingface dataset:
Mudanças alimentares na coorte NutriNet Brasil durante a pandemia de covid-19
Authors: Steele Eurídice Martínez , Rauber Fernanda , Costa Caroline dos Santos , Leite Maria Alvim , Gabe Kamila Tiemann , Louzada Maria Laura da Costa , Levy Renata Bertazzi , Monteiro Carlos Augusto
Published: September 2020

OBJETIVO Descrever características da alimentação dos participantes da coorte NutriNet Brasil imediatamente antes e na vigência da pandemia de covid-19. MÉTODOS Os dados deste estudo provêm de coorte de adultos criada para investigar prospectivamente a relação entre alimentação e morbimortalidade por doenças crônicas não transmissíveis no Brasil. Para este estudo, foram selecionados os primeiros participantes (n = 10.116) que responderam por duas vezes a questionário simplificado sobre sua alimentação no dia anterior, a primeira vez ao ingressar no estudo, entre 26 de janeiro e 15 de fevereiro de 2020, e a segunda entre 10 e 19 de maio de 2020. O questionário indaga sobre o consumo de marcadores de alimentação saudável (hortaliças, frutas e leguminosas) e não saudável (alimentos ultraprocessados). Comparações de indicadores baseados no consumo desses marcadores antes e na vigência da pandemia são apresentadas para o conjunto da população estudada e segundo sexo, faixa etária, macrorregião de residência e escolaridade. Testes qui-quadrado e testes t foram utilizados para comparar proporções e médias, respectivamente, adotando-se p < 0,05 para identificar diferenças significantes. RESULTADOS Para o conjunto dos participantes, identificou-se aumento modesto, porém estatisticamente significante, no consumo de marcadores de alimentação saudável e estabilidade no consumo de marcadores de alimentação não saudável. Esse padrão favorável de mudanças na alimentação com a pandemia se repetiu na maior parte dos estratos sociodemográficos. Padrão menos favorável de mudanças, com tendência de aumento no consumo de marcadores de alimentação saudável e não saudável, foi observado nas macrorregiões Nordeste e Norte e entre pessoas com menor escolaridade, sugerindo desigualdades sociais na resposta à pandemia. CONCLUSÕES Caso confirmada, a tendência de aumento no consumo de alimentos ultraprocessados nas regiões economicamente menos desenvolvidas e por pessoas com menor escolaridade preocupa, pois a ingestão desses alimentos eleva o risco de obesidade, hipertensão e diabetes, cuja presença aumenta a gravidade e a letalidade da covid-19.
A Novel Recurrent
COL5A1
Genetic Variant Is Associated With a Dysplasia-Associated Arterial Disease Exhibiting Dissections and Fibromuscular Dysplasia
Authors: Richer Julie , Hill Hannah L. , Wang Yu , Yang Min-Lee , Hunker Kristina L. , Lane Jamie , Blackburn Susan , Coleman Dawn M. , Eliason Jonathan , Sillon Guillaume , D’Agostino Maria-Daniela , Jetty Prasad , Mongeon François-Pierre , Laberge Anne-Marie , Ryan Stephen E. , Fendrikova-Mahlay Natalia , Coutinho Thais , Mathis Michael R. , Zawistowski Matthew , Hazen Stanley L. , Katz Alexander E. , Gornik Heather L. , Brummett Chad M. , Abecasis Goncalo , Bergin Ingrid L. , Stanley James C. , Li Jun Z. , Ganesh Santhi K.
Published: September 2020

Objective:

While rare variants in the
COL5A1
gene have been associated with classical Ehlers-Danlos syndrome and rarely with arterial dissections, recurrent variants in
COL5A1
underlying a systemic arteriopathy have not been described. Monogenic forms of multifocal fibromuscular dysplasia (mFMD) have not been previously defined.

Approach and Results:

We studied 4 independent probands with the
COL5A1
pathogenic variant c.1540G>A, p.(Gly514Ser) who presented with arterial aneurysms, dissections, tortuosity, and mFMD affecting multiple arteries. Arterial medial fibroplasia and smooth muscle cell disorganization were confirmed histologically. The
COL5A1
c.1540G>A variant is predicted to be pathogenic in silico and absent in gnomAD. The c.1540G>A variant is on a shared 160.1 kb haplotype with 0.4% frequency in Europeans. Furthermore, exome sequencing data from a cohort of 264 individuals with mFMD were examined for
COL5A1
variants. In this mFMD cohort,
COL5A1
c.1540G>A and 6 additional relatively rare
COL5A1
variants predicted to be deleterious in silico were identified and were associated with arterial dissections (
P
=0.005).

Conclusions:

COL5A1
c.1540G>A is the first recurring variant recognized to be associated with arterial dissections and mFMD. This variant presents with a phenotype reminiscent of vascular Ehlers-Danlos syndrome. A shared haplotype among probands supports the existence of a common founder. Relatively rare
COL5A1
genetic variants predicted to be deleterious by in silico analysis were identified in ≈2.7% of mFMD cases, and as they were enriched in patients with arterial dissections, may act as disease modifiers. Molecular testing for
COL5A1
should be considered in patients with a phenotype overlapping with vascular Ehlers-Danlos syndrome and mFMD.
Diversity, Equity, and Inclusiveness in Medicine and Cardiology: Next Steps for
JAHA
Authors: London Barry , Ahmad Ferhaan , Eitzman Daniel T. , Gupta Ajay K. , Jneid Hani , Peterson Pamela , Remme Carol A. , Rice Kenneth , Schelbert Erik B. , Simon Marc A. , Sullivan Lisa M. , Weinberg Janice M.
Published: September 2020

We, the Editors of the
Journal of the American Heart Association
, sincerely regret the publication of the article “Diversity, Inclusion, and Equity: Evolution of Race and Ethnicity Considerations for the Cardiology Workforce in the United States of America From 1969 to 2019”.
1
We are aware that the publication of this flawed and biased article has caused a great deal of unnecessary pain and anguish to a number of parties, and reflects extremely poorly on us. We fully support the retraction of this article.
Authorship in top-ranked mathematical and physical journals: Role of gender on self-perceptions and bibliographic evidence
Authors: Mihaljević Helena , Santamaría Lucía
Published: September 2020

Despite increasing rates of women researching in math-intensive fields, publications by female authors remain underrepresented. By analyzing millions of records from the dedicated bibliographic databases zbMATH, arXiv, and ADS, we unveil the chronological evolution of authorships by women in mathematics, physics, and astronomy. We observe a pronounced shortage of female authors in top-ranked journals, with quasistagnant figures in various distinguished periodicals in the first two disciplines and a significantly more equitable situation in the latter. Additionally, we provide an interactive open-access web interface to further examine the data. To address whether female scholars submit fewer articles for publication to relevant journals or whether they are consciously or unconsciously disadvantaged by the peer review system, we also study authors’ perceptions of their submission practices and analyze around 10,000 responses, collected as part of a recent global survey of scientists. Our analysis indicates that men and women perceive their submission practices to be similar, with no evidence that a significantly lower number of submissions by women is responsible for their underrepresentation in top-ranked journals. According to the self-reported responses, a larger number of articles submitted to prestigious venues correlates rather with aspects associated with pronounced research activity, a well-established network, and academic seniority.
The genus Polemistus de Saussure in China with descriptions of four new species (Hymenoptera: Crabronidae)
Authors: MA LI , LI QIANG
Published: September 2020

The genus Polemistus de Saussure (Crabronidae: Pemphredoninae: Pemphredonini) from China is reviewed and a key to the Chinese species is provided. Four new species, Polemistus clypeisinuatus and Polemistus gutianus from Zhejiang Province, and Polemistus divaricatus and Polemistus pediflavidus from Yunnan Province are described and illustrated.
The Existential Dimension of Palliative Care: The Mirror Effect of Death on Life
Authors: Drillaud Frédérique , Saussac Camille , Keusch Florence , Lafaye Danièle , Bely Hélène , Averous Véronique , Frasca Matthieu , Baudry Patrick , Burucoa Benoît
Published: September 2020

The WHO has included the spiritual dimension in its definition of palliative care since 1990, but this dimension is frequently confused with notions of religion. Yet, the spiritual suffering experienced by palliative care patients is primarily a matter of existential suffering. The objective of this study was to examine the ways in which the existential dimension was manifested in the experiences of those present in a palliative care unit. This anthropological monograph was conducted in a palliative care unit in a French University Hospital. The existential dimension appears to reside in the connections between individuals and the proximity of death appears to shed new light on the meaning of life. The mirror effect of death on life, could serve to encourage greater appreciation of the value of our connections with others, and the desire to take care of others, which offers new insight into forms of solidarity and social organisation.
The Relationship Between Death and Do Not Resuscitation Attitudes Among Intensive Care Nurses
Authors: Safari Malak-Kolaei Farzaneh , Sanagoo Akram , Pahlavanzadeh Bagher , Akrami Forouzan , Jouybari Leila , Jahanshahi Reza
Published: September 2020

This study aimed to determine the relationship between death and DNR attitudes among ICNs. This descriptive-analytical study was performed on 156 ICNs in 2018. All nurses were enrolled in the study; data collection instruments included Death Attitude Profile-Revised (DAP-R) and the DNR attitude questionnaires. The mean scores of DAP-R and DNR items were 150.89/ ± 23.59 and 91.82 ± 11.41, respectively. There was a significant relationship between death attitude and DNR attitude Famong ICNs. All dimensions of DAP-R significantly predicted attitude toward DNR (P < 0.05). Among those, “neutral acceptance” (1.17 [95% CI (0.68--1.65)] was the strongest predictor and “death avoidance” was the weakest predictor (0.36 [95% CI (0.09--0.62)]. There was a significant relationship between the ICNs' work experience and attitude toward DNR (p = 0.03). The findings can be used in formulation of the national guideline for DNR order.
Nonlinear optimal control for synchronization of distributed hydropower generators
Authors: Rigatos Gerasimos , Siano Pierluigi , Abbaszadeh Masoud
Published: September 2020

Synchronization of distributed hydropower units is necessary for ensuring the quality of the electric power produced by renewable sources. In this article, a nonlinear optimal control approach is proposed for stabilization and synchronization of distributed hydropower generators. The dynamic model of the interacting hydropower generation units undergoes approximate linearization with the use of first-order Taylor series expansion and the computation of the associated Jacobian matrices. The linearization point is updated at each time-step of the control method. For the approximately linearized model of the distributed hydropower system an H-infinity feedback controller is designed. This controller achieves solution of the related optimal control problem under model uncertainty and external perturbations. For the computation of the controller’s feedback gains an algebraic Riccati equation is repetitively solved at each iteration of the control algorithm. The global asymptotic stability properties of the control method are proven through Lyapunov analysis. Finally, to achieve state estimation-based control for the system of the distributed hydropower generators the H-infinity Kalman Filter is used as a robust state estimator.
‘The very first thing that connected us to him’: adopters’ experiences of sharing photographs, ‘talking’ albums and other materials with their children prior to meeting
Authors: Blackmore Jenny , Burns Gemma , Waters Cerith S , Shelton Katherine H
Published: September 2020

Prospective adopters commonly share materials such as photographs of their family, ‘talking’ albums, DVDs, toys and blankets with their child prior to meeting them. This is often the first point of ‘introduction’ of the adoptive family to their child. The sharing of materials is also one of the earliest tasks in which foster carers and prospective adopters work together. This study investigates adopters’ experiences of sharing materials in the wider context of working with foster carers during these initial parent–child ‘introductions’. Thematic analysis of 24 interviews conducted with adoptive parents revealed three main themes: collaboration, familiarisation and connection. Further qualitative and quantitative data were subsequently gathered and analysed from surveys completed by 64 adoptive parents. Findings highlight the central role of the foster carer in preparing a child for a move to adoption, and the potential impact that the grief and loss experienced by a foster carer may have on this move. They also suggest that the sharing of materials could be an early indicator of a foster carer’s capacity to support a child’s transition to life with their adoptive family. Adopters’ perceptions of the impact of the materials, both at the time of introductions and their ongoing significance several years after placement, are explored.
Shorter Storage Time Is Strongly Associated With Improved Graft Survivorship at 5 Years After Osteochondral Allograft Transplantation
Authors: Merkely Gergo , Ackermann Jakob , Farina Evan M. , VanArsdale Courtney , Lattermann Christian , Gomoll Andreas H.
Published: September 2020

Background:

Current regulations surrounding the use of osteochondral allografts (OCAs) in the United States require delayed graft release after 14 days to complete infectious disease screening. With a generally accepted expiration time of 28 days in storage, a limited window from 14 to 28 days remains for implantation. Yet, the rates of graft survival and thus optimal time for transplantation within this window remain largely unknown.

Hypothesis:

OCAs transplanted within 19 to 24 days would have lower failure rates at 5 years than those transplanted at 25 to 27 days.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

In this retrospective case series, we analyzed data from patients who underwent OCA transplantation (N = 111) by a single surgeon between February 2014 and December 2016 with at least 2-year follow-up. In total, 56 patients received early transplant grafts (storage time, 19-24 days), and 55 received late transplant grafts (storage time, 25-27 days). Survival analysis with Kaplan-Meier curves was performed using log-rank analysis to compare the groups. Multivariable Cox regression analysis was used to assess the influence of OCA storage duration on graft survival while adjusting for age and defect size. Optimal storage time cutoff associated with graft failure was identified by performing receiver operating characteristic curve analysis and calculating the area under the curve.

Results:

Patients in the late transplant group had a significantly lower rate of graft survival at 5 years postoperatively (70.4%) as compared with patients in the early transplant group (93.1%; P = .027). When correcting for patient age and defect size, late transplant OCAs demonstrated a 3.4-times greater likelihood of failure versus early transplant OCAs. Receiver operating characteristic analysis suggested that OCA transplantation should ideally occur before 25 days of graft storage.

Conclusion:

OCA transplantation is a safe and successful treatment option for large osteochondral defects of the knee, with excellent rates of in situ graft survival at 5 years. Prioritizing early transplantation of OCAs to <25 days in storage improves rates of graft survival.
A Review of Peggy L. Chinn and Maeona K. Kramer’s textbook Knowledge Development in Nursing: Theory and Process (10th ed., 2018). Elsevier, Inc.
Authors: Morrow Mary R.
Published: September 2020

This is a book review of Peggy L. Chinn and Maeona K. Kramer’s textbook Knowledge Development in Nursing: Theory and Process (10th ed., 2018). Elsevier, Inc.
Optimal two-stage sampling for mean estimation in multilevel populations when cluster size is informative
Authors: Innocenti Francesco , Candel Math JJM , Tan Frans ES , van Breukelen Gerard JP
Published: September 2020

To estimate the mean of a quantitative variable in a hierarchical population, it is logistically convenient to sample in two stages (two-stage sampling), i.e. selecting first clusters, and then individuals from the sampled clusters. Allowing cluster size to vary in the population and to be related to the mean of the outcome variable of interest (informative cluster size), the following competing sampling designs are considered: sampling clusters with probability proportional to cluster size, and then the same number of individuals per cluster; drawing clusters with equal probability, and then the same percentage of individuals per cluster; and selecting clusters with equal probability, and then the same number of individuals per cluster. For each design, optimal sample sizes are derived under a budget constraint. The three optimal two-stage sampling designs are compared, in terms of efficiency, with each other and with simple random sampling of individuals. Sampling clusters with probability proportional to size is recommended. To overcome the dependency of the optimal design on unknown nuisance parameters, maximin designs are derived. The results are illustrated, assuming probability proportional to size sampling of clusters, with the planning of a hypothetical survey to compare adolescent alcohol consumption between France and Italy.
First-Time Mothers’ Expectations and Experiences of Postnatal Care in England
Authors: McLeish Jenny , Harvey Merryl , Redshaw Maggie , Henderson Jane , Malouf Reem , Alderdice Fiona
Published: September 2020

Postnatal care is the aspect of maternity care with which women in England are least satisfied. Little is known about first-time mothers’ expectations of postnatal care, or how these expectations relate to their experiences and appraisal of care. Thirty-two first-time mothers took part in a longitudinal qualitative descriptive study, based on two semi-structured interviews—the first in pregnancy, and the second 2 to 3 months after birth. Trajectory analysis was used to identify the thematic patterns in the relationships between postnatal care expectations, needs, experiences, and confidence. Five trajectories were identified, showing that mothers’ satisfaction with postnatal care and confidence were primarily influenced not by the extent to which their expectations were met but the varied extent to which their individual postnatal needs were met. Rapid and responsive assessment of needs both antenatally and postnatally, and appropriate adjustment of care, is key in supporting women effectively at this time.
Managing Severe Chronic Breathlessness in Chronic Obstructive Pulmonary Disease Is Challenging for General Practitioners
Authors: Politis John , Eastman Peter , Le Brian , Furler John , Irving Louis , Smallwood Natasha
Published: September 2020

Context:

Patients with advanced chronic obstructive pulmonary disease (COPD) can develop increasing breathlessness, which can persist despite optimal medical management—refractory breathlessness. Management can be challenging for all clinicians and requires a broad approach that includes optimization of disease directed therapies, non-pharmacological strategies to manage breathlessness and for some patients opioids.

Objectives:

To explore the approaches to breathlessness management and palliative care undertaken by Australian General Practitioners (GP) for patients with severe COPD and refractory breathlessness.

Methods:

A case-vignette based survey was conducted with Australian GPs to determine their approaches to breathlessness management and palliative care in COPD.

Results:

Of the 137 GPs, 66% recommended commencing an additional medication to manage refractory breathlessness. Thirty-eight GPs (28%) recommended opioids and 26 (19%) recommended guideline discordant treatments. Two-thirds of GPs had concerns regarding the use of opioids in COPD. Half (55%) of GPs were comfortable providing general palliative care to patients with COPD and 62 (45%) had referred patients with COPD to specialist palliative care services. Most respondents wanted further training to manage severe COPD and severe chronic breathlessness.

Conclusion:

Most GPs recognized and were willing to add specific treatments for severe chronic breathlessness. However, experience prescribing opioids for severe chronic breathlessness was low, with many practitioners holding significant concerns regarding adverse effects. Many GPs are uncomfortable offering a palliative approach to their COPD patients, yet these patients are not routinely referred to specialist palliative care services despite their immense needs. GPs therefore desire education and support to overcome these barriers.
Role of SMARCA4 (BRG1) and SMARCB1 (INI1) in Dedifferentiated Endometrial Carcinoma With Paradoxical Aberrant Expression of MMR in the Well-Differentiated Component: A Case Report and Review of the Literature
Authors: Kaur Ramandeep , Mehta Jay , Borges Anita M.
Published: September 2020

Introduction

Dedifferentiated endometrial carcinoma is an uncommon highly aggressive uterine tumor. It comprises 2 components: a well-differentiated, low-grade epithelial carcinoma and an undifferentiated carcinoma. The undifferentiated carcinoma frequently exhibits rhabdoid cytologic features. Many of these tumors are characterized by an aberrant switch/sucrose non-fermenting (SWI/SNF) complex. They may also exhibit aberrant expression of mismatch repair (MMR) proteins. Together, these play an important role in the pathogenesis and aggressive nature of the tumor.

Material and Methods

We present a case of dedifferentiated endometrial carcinoma in a 63-year-old female showing loss of expression of SWI/SNF-related, matrix-associated, actin-dependent regulator of chromatin, subfamily A, member 4 (SMARCA4/BRG1), and aberrant expression of MMR proteins. We also review the literature starting from the earliest recognition of this entity and the various studies done to explain its molecular pathogenesis and prognostic importance.

Results and Conclusions

Recognition of SWI/SNF complex-deficient dedifferentiated endometrial carcinoma is important as these tumors do not respond to platinum-based chemotherapy, and consideration of alternative therapies is often necessary. We also want to emphasize that though most of the studies have found MMR deficiency in the undifferentiated carcinoma component, it may be seen only in the low-grade, well-differentiated component, as observed in this case.
Cyto-SAT: A self-assessment tool for the safe handling of cytotoxic drugs adapted for use in low- and middle-income countries
Authors: von Grünigen Sandrine , Geissbühler Antoine , Bonnabry Pascal
Published: September 2020

Introduction

The handling of cytotoxic medicines is a high-risk process for human and environmental health. Considering the rising burden of cancer in low- and middle-income countries (LMICs), we aimed to develop, validate, and pilot test a self-assessment tool to support the implementation of safe handling practices and promote continuous quality improvement for cytotoxic drug management in LMICs.

Methods

First, the self-assessment tool Cyto-SAT was developed and validated. Key sources on the safe handling of cytotoxic medicines were reviewed to derive items addressing safety and quality aspects at every stage of the process. A two-round online Delphi survey was conducted to validate and prioritize the items. The validation rules in the first and second rounds were defined as ≥65% and ≥75% agreement, respectively. Then, intended users in healthcare facilities in LMICs evaluated the Cyto-SAT tool in a pilot test. They were asked to fill out an online evaluation questionnaire.

Results

Twenty-seven experts from 13 high-income countries and LMICs participated in the Delphi survey. Final expert consensus was achieved for 134/137 (97.8%) items. Consensus on priority was achieved for 52 of 134 (38.8%) items. The final Cyto-SAT tool comprises 134 items in 10 domains and 28 subdomains covering the whole cytotoxic drug handling process ( https://pharmed.datapharma.ch/cyto-sat_en/ ). Staff from 34 institutions in 28 LMICs completed the Cyto-SAT evaluation. Almost all of them reported total agreement or agreement with its usefulness (96%), applicability (94%), usability (98%), and acceptability (97%).

Conclusion

Cyto-SAT is the first self-assessment tool designed to assist professionals in LMICs in the safe handling of cytotoxic drugs. The pilot test revealed that Cyto-SAT is a useful and highly appreciated tool that supports practice improvement in LMICs. Cyto-SAT will be used in an international survey to obtain a global overview of handling practices in various LMIC settings.
It takes two to tango: Theorizing inter-corporeality through nakedness and eros in researching and writing organizations
Authors: Mandalaki Emmanouela , Pérezts Mar
Published: September 2020

Dance with us, on the dance-floor and with words, as we reenact our individual and shared tango autoethnographic experiences to develop an understanding of field inter-corporeality as a phenomenological experience of nakedness empowered by the transformational potential of eros. We write as we dance to discuss how eroticizing through the other’s presence our embodied nakedness, beyond sexual stereotypes, pushes us to meta-reflect on ourselves as organizational ethnographers and writers to reinvent our field and writing interactions as inter-corporeally relational and intersubjective. We problematize the sexual gaze that traditionally associates nakedness with shame and objectified vulnerability to stress the capacity of eroticizing our academic nakedness to enable free, embodied knowledge stripped of the traits of the dominant masculine academic order. In so doing, we join burgeoning autoethnographic and broader debates in the field of organization studies calling for the need to further unveil the embodied, erotic, and feminine aspects of organizational research and writing. Shall we dance?
A one-year follow-up of basic psychological need satisfactions in physical education and associated in-class and total physical activity
Authors: Gråstén Arto , Yli-Piipari Sami , Huhtiniemi Mikko , Salin Kasper , Hakonen Harto , Jaakkola Timo
Published: September 2020

This study examined basic psychological need satisfactions for competence, autonomy, and social relatedness in physical education (PE) and their contributions to accelerometer-based in-class and total moderate to vigorous physical activity (MVPA) across a one-year follow-up (T1). Participants were 523 students (girls 280, boys 243; mean age = 11.26 ± 0.31) and the data were collected using self-reports and waist-worn accelerometers. The key findings were: (a) competence and social relatedness need satisfaction at baseline (T0) predicted total MVPA at T1 via total MVPA at T0; (b) in-class MVPA at T0 predicted total MVPA at T1 via total MVPA at T0; (c) in-class MVPA was directly associated with total MVPA at T0 and T1; and (d) boys scored higher than girls on competence and relatedness need satisfaction at T0. These findings indicate that the need satisfactions for competence and social relatedness in PE are central components facilitating the greatest increases in total MVPA participation. To improve student outcomes, it is essential that all children receive positive and satisfying PE experiences. Enhancing the readiness and capability of pre- and in-service teachers through teacher training programmes is vital to raising awareness of the basic psychological need satisfactions behind autonomous motivation and greater MVPA engagement.
The Effect of Seeding on Tournament Outcomes: Evidence From a Regression-Discontinuity Design
Authors: Engist Oliver , Merkus Erik , Schafmeister Felix
Published: September 2020

Seeding in tournaments is a process of creating a schedule based on performance in the recent past. It is used in many athletic disciplines to ensure that particularly attractive match ups do not occur until the later stages of the tournament. We exploit the discontinuous nature of the seeding system in the UEFA Champions League and the UEFA Europa League as a natural experiment to estimate the causal effect of being seeded. We find no evidence that seeding itself contributes positively to the team’s success in the tournament. This finding is surprising given the substantial drop in average strength of the opponents for seeded teams and in striking opposition to the findings of previous studies.
A Retrospective Analysis of Microbiologic Profile of Foot Infections in Patients With Diabetic End-Stage Renal Disease
Authors: Körpinar Şefika
Published: September 2020

Objective

Individuals with diabetes and end-stage renal disease (ESRD) are at increased risk of foot ulceration and lower extremity amputation. Although risk factors and microbiologic analysis of diabetic foot infections ( DFIs) have been extensively studied, there are limited data available for this characteristic group.

Methods

Clinical, demographic, laboratory, microbiological data, and foot examination information were collected retrospectively regarding 94 patients with ESRD who were referred for DFI between 2006 and 2016 to hyperbaric oxygen therapy.

Results

In 6 of 94 patients with ESRD (mean age 60 years; 65 males [69.1%], 29 women [30.8%]; 91 undergoing hemodialysis [96.8%], one peritoneal dialysis [1%], two [2%] recent renal transplants), the lesions were bilateral; therefore, the evaluations were made over 100 DFIs. The most common pathogens isolated in deep wound cultures were Staphylococcus aureus and Pseudomonas aeruginosa, respectively, contributing to 27 (21.2%) and 16 (12.5%) of all 127 isolates. When the distribution of the isolates according to different Wagner grades were analyzed, it was found that the proportion of Gramnegative isolates increased statistically significantly with the ascending Wagner grade (P = .004).

Conclusion

DFIs indicate a serious complication associated with a high risk of amputation, prolonged antibiotic treatment, increased hospital and procedure demands, and the cost of health care, on patients with ESRD. The familiarization of causative pathogens underlying DFIs can aid the clinicians in the choice of appropriate empirical antibiotic treatment. This study emphasizes the need for greater attention to risk factors and the microbiologic profile of DFIs in this characteristic group.
The Nose Knows: Intranasal Midazolam To Treat Acute Seizures During Inpatient Epilepsy Monitoring
Authors: Vossler David G.
Published: September 2020

[Box: see text]
Current Mental Distress Among Men With a History of Radical Prostatectomy and Related Adverse Correlates
Authors: Ilie Gabriela , White Joshua , Mason Ross , Rendon Ricardo , Bailly Greg , Lawen Joseph , Bowes David , Patil Nikhilesh , Wilke Derek , MacDonald Cody , Rutledge Robert , Bell David
Published: September 2020

Recent reviews and observational studies have reported that patients with prostate cancer (PCa) are at increased risk of mental health issues, which in turn negatively affects oncological outcomes. Here, we examine possible explanatory variables of mental distress in a population-based cohort of men who have undergone radical prostatectomy (RP). Data were derived from a Maritimes-Canada online survey assessing patient-reported quality of life outcomes between 2017 and 2019 administered to 136 men (47–88 years old, currently in a relationship) who have undergone RP for their PCa diagnosis. The primary outcome was a validated assessment of mental distress, the Kessler Psychological Distress Scale (K10). Urinary function was assessed using the International Prostate Symptom Score, and relationship satisfaction was assessed using the Dyadic Assessment Scale. A multivariate logistic regression assessed the contribution of urinary function, relationship satisfaction, age, multimorbidity, additional treatments, medication for depression and/or anxiety, and survivorship time. A total of 16.2% men in this sample screened positive for mental distress. The severity of urinary problems was positively associated with increased mental distress ( OR = 4.79, 95% CI [1.04, 22.03]), while increased age ( OR = 0.87, 95% CI [0.78, 0.97]), relationship satisfaction ( OR = 0.14, 95% CI [0.3, .077]), and current medication for anxiety, depression, or both ( OR = 0.09, 95% CI [0.02, 0.62]) were protective factors. Survivorship time, the presence of additional comorbidities, or PCa treatments were not identified to be statistically significant contributions to the fitted model. Here, we report that RP survivors are prone to presenting with increased mental distress long after treatment. Screening for mental distress during RP survivorship is recommended.
Mycobacterial Infections of the Hand
Authors: Bilolikar Vivek K. , Ilyas Asif M.
Published: September 2020

Background

Hand infections caused by mycobacteria are relatively uncommon compared to infections caused by other pathogens; therefore, much of the available literature consists of case reports and limited case series. Broadly categorized into tuberculous and nontuberculous mycobacterial (NTM) infections, both tuberculous and NTM infections are typically insidious with long incubation periods and with the ability to remain dormant for prolonged periods.

Methods

We reviewed the most current literature on the epidemiology, presentations, treatment methods, and resistance patterns of mycobacterial infections of the hand focusing on the indications and outcomes of nonoperative as well as operative interventions.

Results

The worldwide burden of tuberculosis remains high and while the overall rate of new diagnosis drug resistant tuberculosis has been on the decline some regions of the world have demonstrated staggeringly high resistance rates to first-line tuberculosis therapies. Signs and symptoms of mycobacterial hand infection are typically inconsistent, and highly dependent on the specific structures of the hand that are affected; therefore, these infections may mimic other infections of the hand like tenosynovitis, joint space infections, and cutaneous infections. The main stay of treatment remains antimycobacterial therapies including but not limited to rifampin, isoniazid, pyrazinamide, and ethambutol.

Conclusions

The complications associated with mycobacterial hand infections can be significant. Prompt evaluation, including a thorough history to evaluate for potential exposures to infectious sources, followed by appropriate antibiotic choice and duration, with surgical management as needed, is key to reducing the chance that patients experience lasting effects of the infection.
Too Vulnerable to Participate? Challenges for Meaningful Participation in Research With Children in Alternative Care and Adoption
Authors: Garcia-Quiroga Manuela , Agoglia Irene Salvo
Published: September 2020

In recent years, a significant amount of research has been conducted with children from a rights perspective, especially concerning the right to be heard and participate. However, children living in alternative care and adoption have often been excluded from participating in research because they are viewed as vulnerable children who lack agency and also due to an adult-centric perspective of protection. In this article, we challenge this idea under the view that participation is a main component of protection, children are experts in their own experiences, and their views should be considered through participative research design and methods. Particular challenges that protection contexts impose for research are analyzed and several ways in which these challenges can be faced are outlined. We provide principles and examples that can be implemented to ensure that children who live in alternative care or adoption have the right as any child to be informed, be listened to, and have their views considered regarding topics that affect them.
Determinants of adherence to antihypertensive treatment among patients attending a primary care clinic with limited medical armamentarium in Delhi, India: A qualitative study
Authors: Basu Saurav , Engtipi Kajok , Kumar Rajesh
Published: September 2020

Objective

To determine perspectives on reasons for non-adherence to antihypertensive therapy and its socioeconomic determinants among patients attending a primary care center in a low-income area in Delhi, India.

Methods

We conducted in-depth interviews with a total of 30 patients having hypertension at a primary care facility located in a low-income urban area in Delhi.

Results

All the participants were aware that hypertension was a serious illness, and medication intake was necessary throughout life to prevent uncontrolled hypertension. All participants in varying quantities practiced salt restriction, but the consumption of fresh fruit and vegetables was low primarily due to economic reasons. The participants were unable to differentiate the concept of exercise from physical activity. Medication adherence was suboptimal, and significant reasons for non-adherence were forgetfulness, carelessness and running out of drug stocks. Blood pressure control was also suboptimal in a majority of the participants, but combination therapy was restricted due to limited medical armamentarium at the clinic. Laboratory investigations for monitoring target end-organ damage were either delayed or not conducted in most participants.

Discussion

Hypertensive patients undergoing treatment at primary care facilities often report suboptimal medical adherence and treatment outcomes, with socioeconomic causes being a major driver of non-adherence.
News media commercialization in Chindia: Changing theoretical perceptions
Authors: Mammadov Rashad
Published: September 2020

There are many descriptions of media realities in China and India. Few of them, however, look at these countries from the theoretical classification framework, and those who do often do not pay proper attention to the Western orientation of existing classifications. Denis McQuail’s models of dominance and pluralism are not frequently mentioned in global media studies, and this article adds to the scholarly discussion about their use to explain media environments in the countries like India, which uses Western standards of media system, although having a cultural and historical background that is different from the West, and China, which despite implementation of one part of the Western approach, such as commercialization, ignores or rejects the others.
Three-dimensional CT angiography for surgical planning in congenital hand malformations: a case series presentation
Authors: Morandi Evi M. , Rieger Michael , Baur Eva-Maria , Piza-Katzer Hildegunde
Published: September 2020

Between January 2000 and December 2019, three-dimensional computer tomographic (CT) angiography was used in a total of 140 hands (116 patients, mean age 6.8 years) with congenital hand malformation to assess the vascular and bony structures. Analysis showed overall satisfactory three-dimensional CT images for operative planning, including detailed abnormal vascular patterns and bony malformations. Among the 116 patients, six patients with typical findings of a few malformations are reported in detail. Pitfalls in interpretation of the images and the use of three-dimensional CT angiography in surgical planning are discussed. We conclude that three-dimensional CT angiography is useful for preoperative planning of complex congenital hand malformations.

Level of evidence: IV
Health outcomes and costs in patients with osteoarthritis and chronic pain treated with opioids in Spain: the OPIOIDS real-world study
Authors: Sicras-Mainar Antoni , Tornero-Tornero Carlos , Vargas-Negrín Francisco , Lizarraga Isabel , Rejas-Gutierrez Javier
Published: September 2020

Objective:

The objective of this study was to analyze health outcomes, resource utilization, and costs in osteoarthritis patients with chronic nociceptive pain who began treatment with an opioid in real-world practice in Spain.

Methods:

We designed a non-interventional, retrospective, longitudinal study with 36 months of follow-up using electronic medical records (EMRs) from primary care centers, of patients aged 18+ years who began a new treatment with an opioid drug in usual practice for chronic pain due to osteoarthritis. Health/non-health resource utilization and costs, treatment adherence, pain change, cognitive functioning, and dependence for basic activities of daily living (BADL) were assessed.

Results:

A total of 38,539 EMRs [mean age (SD); 70.8 (14.3) years, 72.3% female; 53.3% hip/knee, 25.0% spine, and 21.7% other sites] were recruited. A total of 19.1% of patients remained on initial opioid at 36 months, without significant differences by osteoarthritis site ( p = 0.125). Mean total adjusted cost was €17,915, with 27.7% corresponding to healthcare resources and 72.3% to lost productivity. Hospital admissions for osteoarthritis-related surgical interventions accounted for 15.8% of total healthcare cost. A slight mean pain reduction was observed: –1.3 points, –16.9%, p < 0.001, with increases in cognitive deficit (+3.3%, p < 0.001) and moderate to total dependence for BADL (+15.6%, p < 0.001) in a median duration of opioid use of 203 days (IQR: 89–696).

Conclusions:

In real-world practice in Spain, opioid use in osteoarthritis was high, but with low adherence. There were meaningful increases in resource use and costs for the National Health System. Pain reduction was modest, whereas cognitive impairment and dependence for BADL increased significantly.
Antifungal Activity and the Chemical and Physical Stability of Microemulsions Containing Citrus hystrix DC Leaf Oil
Authors: Pumival Piyapong , Tadtong Sarin , Athikomkulchai Sirivan , Chittasupho Chuda
Published: September 2020

Citrus hystrix DC (kaffir lime) leaf oil exhibited antifungal activities against Aspergillus niger and Candida albicans. This study aimed to evaluate the antifungal activity of kaffir lime leaf oil and microemulsions containing kaffir lime oil against Trichophyton mentagrophytes var. interdigitale. The chemical components of kaffir lime leaf oil were analyzed by gas chromatography coupled with mass spectrometry. Microemulsions containing kaffir lime oil were formulated using Tween 80, propylene glycol, and water using a phase titration method. The microemulsion of kaffir lime leaf oil was evaluated for droplet size, polydispersity index, and zeta potential using a dynamic light scattering technique. The antifungal activities of kaffir lime oil and its microemulsion were investigated through macrodilution and agar well diffusion methods, respectively. The degradation of citronellal in the microemulsion was analyzed by validated UV-Visible spectrophotometry. The minimum inhibitory concentration value of kaffir lime oil was 1.08 ± 0.00 mg/mL. The microemulsion of kaffir lime leaf oil exhibited potent antifungal activity against T. mentagrophytes var. interdigitale. The size, polydispersity index, and zeta potential of freshly prepared microemulsion were 12.82 ± 0.40 nm, 0.183 ± 0.072, and −7.87 ± 0.06 mV, respectively. The microemulsion of kaffir lime leaf oil also demonstrated good physical and chemical stability at specific temperatures. The kaffir lime oil microemulsion was highly stable when stored at 4 °C and 30 °C for 1 month but was unstable at 45 °C. The microemulsion of kaffir lime leaf oil may be an alternative therapeutic against tinea pedis caused by T. mentagrophytes var. interdigitale.
Role of the Hypoxia-Inducible Factor Pathway in Normal and Osteoarthritic Meniscus and in Mice after Destabilization of the Medial Meniscus
Authors: Stone Austin V. , Loeser Richard F. , Callahan Michael F. , McNulty Margaret A. , Long David L. , Yammani Raghunatha R. , Bean Sara , Vanderman Kadie , Chubinskaya Susan , Ferguson Cristin M.
Published: September 2020

Objective

Meniscus injury and the hypoxia-inducible factor (HIF) pathway are independently linked to osteoarthritis pathogenesis, but the role of the meniscus HIF pathway remains unclear. We sought to identify and evaluate HIF pathway response in normal and osteoarthritic meniscus and to examine the effects of Epas1 (HIF-2α) insufficiency in mice on early osteoarthritis development.

Methods

Normal and osteoarthritic human meniscus specimens were obtained and used for immunohistochemical evaluation and cell culture studies for the HIF pathway. Meniscus cells were treated with pro-inflammatory stimuli, including interleukins (IL)-1β, IL-6, transforming growth factor (TGF)-α, and fibronectin fragments (FnF). Target genes were also evaluated with HIF-1α and HIF-2α (Epas1) overexpression and knockdown. Wild-type ( n = 36) and Epas1+/− ( n = 30) heterozygous mice underwent destabilization of the medial meniscus (DMM) surgery and were evaluated at 2 and 4 weeks postoperatively for osteoarthritis development using histology.

Results

HIF-1α and HIF-2α immunostaining and gene expression did not differ between normal and osteoarthritic meniscus. While pro-inflammatory stimulation significantly increased both catabolic and anabolic gene expression in the meniscus, HIF-1α and Epas1 expression levels were not significantly altered. Epas1 overexpression significantly increased Col2a1 expression. Both wild-type and Epas1+/− mice developed osteoarthritis following DMM surgery. There were no significant differences between genotypes at either time point.

Conclusion

The HIF pathway is likely not responsible for osteoarthritic changes in the human meniscus. Additionally, Epas1 insufficiency does not protect against osteoarthritis development in the mouse at early time points after DMM surgery. The HIF pathway may be more important for protection against catabolic stress.
Prebiotic and Exercise Do Not Alter Knee Osteoarthritis in a Rat Model of Established Obesity
Authors: Rios Jaqueline Lourdes , Hart David A. , Reimer Raylene A. , Herzog Walter
Published: September 2020

Objective

Metabolic disturbance is a known risk factor for cardiovascular disease and has been identified as a risk factor for the development of knee osteoarthritis. In this study, we sought to determine the effects of prebiotic fiber supplementation, aerobic exercise, and the combination of the 2 interventions, on the progression of knee osteoarthritis in a high-fat/high-sucrose diet-induced rat model of metabolic disturbance.

Design

Twelve-week-old male CD-Sprague-Dawley rats were either fed a standard chow diet, or a high-fat/high-sucrose diet. After 12 weeks on diets, rats consuming the high-fat/high-sucrose diet were randomized into 4 subgroups: a sedentary, an aerobic exercise, a prebiotic fiber supplementation, and an aerobic exercise combined with prebiotic fiber supplementation group. The aerobic exercise intervention consisted of a progressive treadmill training program for 12 weeks, while the prebiotic fiber was added to the high-fat/high-sucrose diet at a dose of 10% by weight for 12 weeks. Outcome measures included knee joint damage, body mass, percent body fat, bone mineral density, insulin sensitivity, and serum lipid profile.

Results

Aerobic exercise, or the combination of prebiotic fiber and aerobic exercise, improved select markers of metabolic disturbance, but not knee joint damage. However, these results need to be considered in view of the fact that the chow-fed rats had similar knee OA-like damage as the high-fat/high-sucrose–fed rats.

Conclusion

Exercise or prebiotics did not increase joint damage and might be good strategies for populations with metabolic knee osteoarthritis to alleviate other health-related problems, such as diabetes or cardiovascular disorders.