bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence and Determinants of Underweight, Overweight, and Obesity: A Cross-Sectional Study of Sociodemographic, Dietary, and Lifestyle Factors Among Adolescent Girls in Jutiapa, Guatemala
Authors: Parra Kimberly L. , Alaofe Halimatou S. , Ehiri John E. , Nuño Velia Leybas , Mazariegos Manolo , Garcia Brenda , Martinez Estefania , Junkins Anna , Jolly Pauline
Published: June 2021

Background:

As the incidence of overweight continues to increase among children and adolescents in Guatemala, underweight remains a prominent health problem. However, the prevalence of overweight or underweight and associated risk factors has not been investigated among adolescent girls.

Objective:

To determine the prevalence of underweight and overweight/obesity and associated sociodemographic, dietary, and lifestyle factors among adolescent girls in Jutiapa, Guatemala.

Methods:

A cross-sectional study of a subsample of 392 girls aged 12 to 17 years from an agriculture-nutrition trial was conducted. Anthropometric data were obtained using standard methods. Sociodemographic, dietary, and lifestyle data were collected using a structured questionnaire. Multivariable logistic regression was conducted using underweight (body mass index [BMI] for age < 5th percentile) and overweight/obesity (BMI for age ≥ 85th percentile) as outcome variables.

Results:

The prevalence of underweight and overweight/obesity was 9.9% and 15.6%, respectively. Age (15-17 years), high waist circumference, high blood pressure, father being a farmer, large family (> 5 persons), hours spent watching TV, and high red meat consumption were significantly associated with underweight. Whereas being in school, high waist circumference, high blood pressure, overweight/obese mother, unemployed father, watching TV for more than 2 hours, having soft drinks at home, and meeting fruit recommendations were significantly associated with overweight/obesity.

Conclusions:

Our findings highlight the importance of concurrently addressing underweight and overweight/obesity among adolescent girls in rural Guatemala. Studies in various parts of the country are needed to confirm the results of the present study and for appropriate strategies to be implemented to reduce both underweight and overweight.
Retirement in Western Germany – How Workplace Tasks Influence Its Timing
Authors: Mertens Antje , Romeu-Gordo Laura
Published: June 2021

In this article, task data from the German Qualification and Career Survey (BIBB/IAB) is matched against the Sample of Integrated Labour Market Biographies (SIAB) to investigate what patterns are discernible in retirement between 1985 and 2005 in Western Germany. Set against a background of pension reforms and substantial structural change, the article asks whether the nature of occupational tasks has any significant effect on the timing of retirement. Through the use of event history analysis, the article reveals that having a large percentage of routine manual tasks in one’s job is associated with a greater likelihood of a job holder leaving employment, while having medium to high percentages of non-routine manual tasks in one’s job will tend to decrease that likelihood. There is also evidence that holding a job that includes a medium to high concentration of analytical and interactive tasks will tend to reduce the likelihood of early retirement.
Clinical situation of Venezuelan migrants living with HIV in a hospital in Lima, Peru
Authors: Huerta-Vera Genesis S , Amarista Manuel A , Mejía Fernando A , Graña Ana B , Gonzalez-Lagos Elsa V , Gotuzzo Eduardo
Published: June 2021

Due to a huge crisis extensive to health services many Venezuelan people living with HIV (PLWH) had migrated abroad, including Peru where favorable laws were in place until June 2019. We describe the health status and epidemiological trends of PLWH from Venezuela at an HIV program in Lima. We analyzed baseline and follow-up data of all Venezuelan PLWH enrolled in our HIV program from January 2017 to December 2019. A cross-sectional study in a subsample served to describe ARV adherence and context of migration. Between 2017-2019 our HIV Program registered 398 Venezuelan PLWH, representing 20% of the 2018 annual enrollments; numbers decreased since mid-2019. The median age was 30 years (IQR 26;37) and 90.5% were men. Between 2017 and 2019, the proportion with diagnosis in Peru increased from 14.3% to 60.9%; of AIDS stage at entry, from 8.8% to 27.2%. By December 2019, 182/250 (72.8%) were still in care, and 43 (10.8%) had not started ART. Viral suppression evaluated in 195, was achieved in 71.8%. From 2017 to 2019, migrant PLWH arrived in worsened clinical conditions, with increasing diagnosis in Peru; the flow of migrant PLWH entering care diminished with less favorable laws. Viral suppression rates were suboptimal.
Carvacrol hinders the progression of hepatic fibrosis via targeting autotaxin and thioredoxin in thioacetamide-induced liver fibrosis in rat
Authors: El-Gendy ZA , Ramadan A , El-Batran SA , Ahmed RF , El-Marasy SA , Abd El-Rahman SS , Youssef SAH
Published: June 2021

Fibrosis is a common outcome of nearly all chronic diseases of liver that results in changes of its functions which requires medical attention. The current research aims to investigate the potential anti-fibrotic efficacy of Carvacrol against thioacetamide (TAA)-induced liver fibrosis in male rats using Ursodeoxycholic acid (UDCA) as a reference anti-fibrotic product. Carvacrol (25 and 50 mg/kg) markedly declined TAA-increased serum liver enzymes; alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP) and gamma-glutamyl transferase (GGT) as well as total bilirubin (TB) and direct bilirubin (DB) levels as well as increased levels of total protein (TP) and albumin. Carvacrol significantly reduced glutathione depletion (GSH), Nitric oxide (NOX) and malondialdehyde (MDA) accumulation in liver tissue. Additionally, its anti-oxidant effect brightened up via affecting markers of stress found in the cell as nuclear factor erythroid 2-related factor 2 (Nrf-2) where it still had high content and decreased Thioredoxin (Trx) level. The anti-inflammatory effect of Carvacrol was confirmed by decreasing nuclear factor kappa B (NF-κB), interleukin-1beta (IL-1β) and inducible nitric oxide synthase (iNOS) contents. Carvacrol showed anti-fibrotic effect clarified by turning down fibrosis-related markers; TGF-β1, matrix metalloproteinase-3 and 9 (MMP-3 and 9) and Autotaxin (ATX) contents. Furthermore, it decreased alpha smooth muscle actin (α-SMA) and caspase-3 immune-expression. The overall outcome of aforementioned markers results showed that Carvacrol suppresses the progression of liver fibrosis via its anti-oxidant, anti-inflammatory, anti-apoptotic effect and its ability in lowering Thioredoxin and Autotaxin; hence it can be categorized as a hepatoprotective natural substance.
Synthesis and characterization of flame-retardant-wrapped carbon nanotubes and its flame retardancy in epoxy nanocomposites
Authors: Wang Jiangbo
Published: June 2021

A novel phosphorus-silicon containing flame-retardant DOPO-V-PA was used to wrap carbon nanotubes (CNTs). The results of FTIR, XPS, TEM and TGA measurements exhibited that DOPO-V-PA has been successfully grafted onto the surfaces of CNTs, and the CNTs-DOPO-V-PA was obtained. The CNTs-DOPO-V-PA was subsequently incorporated into epoxy resin (EP) for improving the flame retardancy and dispersion. Compared with pure EP, the addition of 2 wt% CNTs-DOPO-V-PA into the EP matrix could achieve better flame retardancy of EP nanocomposites, such as a 30.5% reduction in peak heat release rate (PHRR) and 8.1% reduction in total heat release (THR). Furthermore, DMTA results clearly indicated that the dispersion for CNTs-DOPO-V-PA in EP matrix was better than pristine CNTs.
The effects of a multimodal music program on young children’s facial expressions during controlled singing tasks
Authors: Bugos Jennifer A. , DeMarie Darlene , Torres Miranda Rose , Lamrani Darbi , Gbadamosi Ayo A.
Published: June 2021

Understanding children’s emotional perceptions of creative tasks can contribute to the optimal design of music programs. Little is known of how young children perceive vocal tasks, and whether music training changes their emotional perceptions. This research examined children’s facial expressions while performing vocal imitation and improvisation tasks before and after music training. Young children ( N=79) aged four to six years were randomly assigned to a multimodal music program, Lego training, or a no-treatment control group. Their facial expressions while performing the tasks were analyzed, and learning outcomes were assessed by measuring participants’ pitch accuracy and improvisation skills at pre-and post-training. The results yielded no significant differences among the groups’ facial expressions. There was, however, a significant main effect of time such that participants showed more Surprise while performing vocal improvisation tasks. While participants in the multimodal music program scored higher on measures of pitch accuracy and improvisation skill, it may be necessary to increase the duration of early childhood music programs to reduce their feelings of apprehension when performing vocal improvisation tasks.
Supported Decision-Making: Emerging Paradigm in Research, Law, and Policy
Authors: Blanck Peter
Published: June 2021

Supported decision-making (“SDM”) is an emerging paradigm in which people use friends, family members, and professionals to help them understand and address the situations and choices they encounter in everyday life. The aim of SDM is to empower individuals to make their own decisions to the maximum extent possible to increase self-determination. SDM is an alternative to overly restrictive guardianship or substitute decision-making regimes to which persons with cognitive and mental health disabilities historically have been relegated in law and policy. This special series examines emergent issues involving SDM in areas of research, law, and policy. It examines SDM from U.S. and comparative law, research, and policy perspectives, as recognized in Article 12 of the United Nations Convention on the Rights of Persons with Disabilities, and from the perspective of the lived experience.
Creative Self-Efficacy: An Essential Transition Skill for Students With Learning Disabilities
Authors: Smith Jennifer Elaine
Published: June 2021

The ability to think creatively is a vital transition skill for students with learning disabilities in the 21st century. Participation in careers with a high level of creative thinking ability not only sets the individual student up for success but also the community in which they live. Creative self-efficacy is the belief in one’s ability to be creative and is a basic component of creativity. A positive relationship is indicated between higher creative self-efficacy and higher creative production. Thus, the development of a positive creative self serves as a supportive element for students with learning disabilities in their current and future endeavors. This article describes the importance of and need for creative thinking and creative self-efficacy development in education and suggests the use of questioning techniques as a strategy for developing these important skills when working with students with learning disabilities.
Patient-Reported Outcomes of Surgically Treated Insertional Achilles Tendinopathy
Authors: Hörterer Hubert , Oppelt Sonja , Böcker Wolfgang , Gottschalk Oliver , Harrasser Norbert , Walther Markus , Polzer Hans , Baumbach Sebastian Felix
Published: June 2021

Background:

The aim of this study was to assess the patient-reported outcome measures (PROMs) in patients with insertional Achilles tendinopathy (IAT) treated surgically by debridement of all pathologies through a midline-incision trans-achillary approach (MITA).

Methods:

This is a retrospective cohort study with current follow-up. Patients treated surgically by a MITA, addressing all pathologies of IAT, with at least 12 months of follow-up were included. Demographics, medical history, surgical details, and complications were recorded. Patient-reported outcomes were assessed using the Foot Function Index (FFI), Victorian Institute of Sport Assessment–Achilles questionnaire (VISA-A-G), visual analog scale foot and ankle (VAS-FA), and 12-Item Short-Form Health Survey (SF-12). Longitudinal FFI data were available for 48% of the patients.

Results:

A total of 118 patients (63.4%) with a mean follow-up of 50 ± 25 months were included. The FFI improved from 53 (24) preoperatively to 2 (11) points at the final follow-up. The final VISA-A-G score was 93 (26), the VAS-FA score 93 (15), the SF-12 Physical Component Summary 56 (8), and the SF-12 Mental Component Summary 55 (12) points. There was an additional FFI improvement between 12 months and the final follow-up. Up to 47% (VISA-A-G) of patients had residual symptoms. A postoperative shoe conflict was the only parameter negatively affecting the PROMs ( P < .001).

Conclusion:

Addressing all pathologies of IAT by the MITA resulted in overall good postoperative PROMs after 4 years. But up to 47% of patients remained impaired. The only parameter correlating with an impaired PROM was a postoperative shoe conflict.

Level of Evidence:

Level IV, retrospective cohort study.
The effect of pore shape on the Poisson ratio of porous materials
Authors: Lutz Melanie P. , Zimmerman Robert W.
Published: June 2021

A brief review is given of the effect of porosity on the Poisson ratio of a porous material. In contrast to elastic moduli such as K, G, or E, which always decrease with the addition of pores into a matrix, the Poisson ratio [Formula: see text] may increase, decrease, or remain the same, depending on the shape of the pores, and on the Poisson ratio of the matrix phase, [Formula: see text]. In general, for a given pore shape, there is a unique critical Poisson ratio, [Formula: see text], such that the addition of pores into the matrix will cause the Poisson ratio to increase if [Formula: see text], decrease if [Formula: see text], and remain unchanged if [Formula: see text]. The critical Poisson ratio for spherical pores is 0.2, for prolate spheroidal pores is close to 0.2, and tends toward zero for thin cracks. For two-dimensional materials, [Formula: see text] for circular pores, 0.306 for squares, 0.227 for equilateral triangles, and again approaches 0 for thin cracks. The presence of a “trapped” fluid in the pore space tends to cause [Formula: see text] to increase, and for the range of parameters that may occur in rocks or concrete, this increase is more pronounced for thin crack-like pores than for equi-dimensional pores. Measurements of the Poisson ratio therefore may allow insight into pore geometry and pore fluid. If the matrix phase is strongly auxetic, small amounts of porosity will generally not cause the Poisson ratio to become positive.
Teaching Young Children to Make Bids to Play to Peers With Autism Spectrum Disorder
Authors: Dueñas Ana D. , D’Agostino Sophia R. , Plavnick Joshua B.
Published: June 2021

Peer-mediated intervention (PMI) within the inclusive early childhood setting increases social exposure between children with autism spectrum disorder (ASD) and typically developing peers. However, PMI research to date has provided limited data on the adherence of strategies taught to typically developing peers during training. The present study examined the extent to which a packaged intervention consisting of video modeling (VM) was an effective tool to promote bids to play by typically developing peers to children with ASD during unstructured indoor and outdoor play. A multiple probe across participants design demonstrated that (a) all three typically developing peers learned to invite children with ASD to play after observing video models and (b) children with ASD increased independent responses to initiations with least-to-most prompting from an adult.
To Partner with Human or Robot? Designing Service Coproduction Processes for Willingness to Pay More
Authors: Wu Laurie , Fan Alei , He Zeya , Her EunSol
Published: June 2021

Across two studies, this research presents a novel extension to the service coproduction literature, demonstrating when and why consumers with low- versus high-innovativeness tendencies are willing to pay more to coproduce hospitality and tourism services. Findings suggest that, in in-person coproduction settings, low-innovativeness consumers are willing to pay more to coproduce (vs. not) with human employees, while high-innovativeness consumers are willing to pay more to coproduce (vs. not) with robots. Such effects were attenuated in tech-enabled remote coproduction settings, where only high-innovativeness consumers were willing to pay more to coproduce. PROCESS analyses further revealed that self-competence mediated the conditional effect of coproduction involvement on willingness to pay more. In support of our theoretical framework, we demonstrated that lowering the challenging level of the coproduction task increased (decreased) low- (high-) innovativeness consumers’ willingness to pay more for coproduction involvement. These findings offer notable theoretical and managerial implications.
Re-Evaluate Fusion Genes in Prostate Cancer
Authors: Wei Ting , Lu Ji , Ma Tao , Huang Haojie , Kocher Jean-Pierre , Wang Liguo
Published: June 2021

Background:

Thousands of gene fusions have been reported in prostate cancer, but their authenticity, incidence, and tumor specificity have not been thoroughly evaluated, nor have their genomic characteristics been carefully explored.

Methods:

We developed FusionVet to dedicatedly validate known fusion genes using RNA-seq alignments. Using FusionVet, we re-assessed 2727 gene fusions reported from 36 studies using the RNA-seq data generated by The Cancer Genome Atlas (TCGA). We also explored their genomic characteristics and interrogated the transcriptomic and DNA methylomic consequences of the E26 transformation-specific (ETS) fusions.

Results:

We found that nearly two-thirds of reported fusions are intra-chromosomal, and 80% of them were formed between 2 protein-coding genes. Although most (76%) genes were fused to only 1 partner, we observed many fusion hub genes that have multiple fusion partners, including ETS family genes, androgen receptor signaling pathway genes, tumor suppressor genes, and proto-oncogenes. More than 90% of the reported fusions cannot be validated by TCGA RNA-seq data. For those fusions that can be validated, 5% were detected from tumor and normal samples with similar frequencies, and only 4% (120 fusions) were tumor-specific. The occurrences of ERG, ETV1, and ETV4 fusions were mutually exclusive, and their fusion statuses were tightly associated with overexpressions. Besides, we found ERG fusions were significantly co-occurred with PTEN deletion but mutually exclusive with common genomic alterations such as SPOP mutation and FOXA1 mutation.

Conclusions:

Most of the reported fusion genes cannot be validated by TCGA samples. The ETS family and androgen response genes were significantly enriched in prostate cancer–specific fusion genes. Transcription activity was significantly repressed, and the DNA methylation was significantly increased in samples carrying ERG fusion.
Utility of Cannulated Prolactin to Exclude Stress Hyperprolactinemia in Patients with Persistent Mild Hyperprolactinemia
Authors: Almazrouei Raya , Zaman Shamaila , Wernig Florian , Meeran Karim
Published: June 2021

Background:

Stress-induced hyperprolactinemia can be difficult to differentiate from true hyperprolactinema and may result in patients having unnecessary investigations and imaging. We report the results of cannulated prolactin tests with serial prolactin measurements from an indwelling catheter to differentiate true from stress-induced hyperprolactinemia in patients with persistently mildly elevated prolactin levels in both referral and repeat samples.

Methods:

Data were collected for 42 patients who had a cannulated prolactin test between January 2017 and May 2018. After cannula insertion, prolactin was measured at 0, 60, and 120 minutes. Normalization is defined as a decline in prolactin to gender-defined normal ranges.

Results:

The mean age was 33.8 years ( SD ± 9.9), and 37 (88%) were female. Menstrual irregularities were the main presenting symptom in 28.57% of the patients. Prolactin normalized in 12 (28.6%) patients of whom cannulated prolactin test was done. Repeat random prolactin levels were significantly higher in patients whose prolactin did not normalize during the cannulated prolactin test. MRI of the pituitary gland showed an abnormality in 23 out of 28 (82%) patients who did not normalize prolactin, a microadenoma in the majority of patients (18 patients).

Conclusion:

The cannulated prolactin test was useful in excluding true hyperprolactinemia in 28.6% of patients with previously confirmed mildly elevated random prolactin on two occasions, thus avoiding over-diagnosis and unnecessary imaging.
Mitigating the identity and health threat of COVID-19: Perspectives of middle-class South Asians living in the UK
Authors: Hanson Kristin , O’Dwyer Emma , Chaudhuri Sharmistha , Silva Souza Luiz Gustavo , Vandrevala Tushna
Published: June 2021

The recognition and representation of BAME community as ‘high risk’ of Covid-19 in the UK presents both a health and an identity threat to this ethnic group. This study employed thematic analysis to explore response to these threats as related by a sample of 13 middle class members of the South Asian community. This work advances both health and identity psychological theory by recognising the affinity between expressions of health efficacy and identity. Our findings identify South Asian intragroup stigmatisation and commonalities that have implications for the promotion of health behaviour and health communications for minority groups.
Too Muslim or not Muslim enough? Exploring identity negotiations for women visual artists in Australia
Authors: Ralph Elizabeth , Gibson Margaret
Published: June 2021

The title of this article is deliberately provocative aiming to trouble the imposition of identity fixations and reductive assumptions on creative endeavours and outputs. This article is based on a research project which investigated the identity negotiations and representational responsibilities of women visual artists of Muslim faith and/or cultural background practising and exhibiting their artwork in Australia. This article shows how artists sometimes embrace certain identity markers in order to gain opportunities and promote forms of visibility and debate. At the same time, artists can feel the limitations of being pigeonholed and scrutinised because they have not met the normative and moral expectations of their cultural and religious communities as well as those of communities and organisations associated with the arts sector they have been associated with or with which they may wish to have a future association.
Evaluation of Five Data-to-Action Workshops to Enhance Capacity for Tobacco Control
Authors: Garcia de Quevedo Isabel , Tripp Angela , Twentyman Evelyn , Smith Ruben , Ahluwalia Indu B.
Published: June 2021

Background

Five data-to-action workshops were conducted during 2016–2019 with participants from 38 countries. The purpose of the workshops is to use data to inform and disseminate tobacco prevention and control strategies. We evaluated the workshops using the Kirkpatrick Model for evaluation of trainings.

Methods

We evaluated the data-to-action workshops in three topic areas: (1) if the workshop was clear, useful, engaging, and relevant to the participant’s work, (2) self-reported knowledge and skills for tobacco control topics, and (3) intention to apply the knowledge learned. We used nonparametric tests (one-sided Wilcoxon signed-rank test) and conducted descriptive analysis to assess the difference between pre- and postworkshop scores in each topic area. Free text data from open-ended responses were analyzed in Excel using thematic content analysis.

Results

Participants reported the workshop had a clear purpose (93.6%, n = 73), was well organized (94.9%, n = 74), and relevant to their work (96.2%, n = 76). There was a statistically significant increase in median learning scores across all three knowledge and five skills topic areas ( p < 0.05); more than 95% of participants intended to apply the knowledge they obtained during the workshop and planned to perform new skills learned in the workshop.

Conclusions

Programs interested in replicating a similar successful model may incorporate a mix of modes of instruction and hands-on experiences, as well as focus on the selection of the right audience, for their workshops. These workshops pose an opportunity for countries to enhance use and dissemination of their tobacco control data.
Embolization for Carotid Blowout in Head and Neck Cancer: Case Report of Five Patients
Authors: Sánchez-Canteli Mario , Rodrigo Juan P. , Quintana Eduardo Murias , Vega Pedro , Llorente José Luis , López Fernando
Published: June 2021

Carotid blowout syndrome (CBS) is defined as a rupture of common carotid artery or its branches. Endovascular intervention has been advocated as first line of treatment for CBS. This Case Report describes 5 patients with prior history of head and neck cancer who presented with CBS. Two patients presented as acute, 2 as impending, and one as threatened CBS. The lesions found were pseudoaneurysm and focal vascular irregularities involving the common carotid artery, cervical internal carotid artery and lingual artery. Embolization and occlusion with detachable coils of the artery was used in all patients. Technical success and immediate hemostasis were achieved in all patients. One patient presented transient cranial nerve palsy. No recurrent CBS was reported during the follow-up. In our experience, coil embolization, if possible, is a safe and efficient technique in treatment of CBS secondary to head and neck cancers.
Impact of Missing Data on Identifying Risk Factors for Postoperative Complications in Hand Surgery
Authors: Aziz Keith T. , Nayar Suresh K. , LaPorte Dawn M. , Ingari John V. , Giladi Aviram M.
Published: June 2021

Background

The mismanagement of missing data in large clinical databases may lead to inaccurate findings. The purpose of this study was to demonstrate the effects of missing data on hand surgery research findings using an analysis of postoperative morbidity in patients undergoing hospital-based hand surgery.

Methods

The National Surgical Quality Improvement Program database was queried for patients undergoing common hand and upper extremity surgery between 2011 and 2016. Major and minor postoperative complications were identified. Demographics, comorbidity, and preoperative laboratory values were identified, and the percentage missing of each was tabulated. To demonstrate how missing data can alter analysis results, these variables were evaluated for an association with major complications using multivariable regression on 3 separate cohorts: (1) all patients; (2) all patients after exclusion of any patient entry with >10% of missing data; and (3) after removal of any patient entry with any missing data.

Results

Groups 1, 2, and 3 had 48 370, 23 118, and 6280 patients, respectively. There were 14 variables associated with increased odds of major complications in group 1, yet only 10 and 9 variables for groups 2 and 3, respectively. Six variables were associated with increased major complications across all 3 groups, whereas only 1 was associated with decreased odds of major complications across all groups.

Conclusions

Filtering patient cohorts according to the amount of missing patient information affected analyses of predictors for major complications associated with hospital-based hand surgery. These findings highlight the importance of considering and addressing missing data in large database studies.
Outcomes of different acute mesenteric ischemia therapies in the last 20 years: A meta-analysis and systematic review
Authors: Hou Li , Wang Tiehao , Wang Jiarong , Zhao Jichun , Yuan Ding
Published: June 2021

Objective

Acute mesenteric ischemia is a disease with high morbidity and mortality, and it is traditionally treated with open surgery. Endovascular therapy and hybrid techniques are alternative treatments that are also currently available. We performed a meta-analysis to evaluate the outcomes of the different treatment approaches in the last 20 years.

Methods

Studies on acute mesenteric ischemia that were indexed in PubMed, Embase, and MEDLINE databases (from January 1, 2000, to April 1, 2021) were reviewed. All related retrospective observational studies and case series were included. A random-effects model was used to calculate pooled estimates, and the results were reported as proportions and 95% confidence intervals (CIs).

Results

In our study, a total of 2369 patients (in 39 studies) underwent endovascular, open surgery, or retrograde open mesenteric stenting. The pooled mortality estimates for open surgery, endovascular therapy, and retrograde open mesenteric stenting were 40% (95% CI, 0.33–0.47; I2 = 84%), 26% (95% CI, 0.19–0.33; I2 = 33%), and 32% (95% CI, 0.21–0.44; I2 = 26%), respectively.

Conclusions

The mortality associated with open surgical treatment, endovascular therapy, and retrograde open mesenteric stenting tend to be similar in the last 20 years.
Challenges and opportunities for conducting a vaccine trial during the COVID-19 pandemic in the United Kingdom
Authors: Török M Estée , Underwood Benjamin R , Toshner Mark , Waddington Claire , Sidhom Emad , Sharrocks Katherine , Bousfield Rachel , Summers Charlotte , Saunders Caroline , McIntyre Zoe , Morris Helen , Piper Jo , Calderon Gloria , Dennis Sarah , Assari Tracy , de Rotrou Anita Marguerie , Shaw Ashley , Bradley John , O’Brien John , Rintoul Robert C , Smith Ian , Bullmore Ed , Chatterjee Krishna , Ribeiro Carla , Pickup Lorinda , de Jesus Ranalie , Brookes Karen , Vargas Phoebe , McMahon Caroline , Macor Chiara , Pasquale Ciro , Bermperi Areti , Kourampa Evgenia , Fabiculcana Marivic , Zerudo Julie Ann , Mendoza Vivien , Fuller Stewart , Glemas Claire , Baker Sharon , Lyons Greta , Bishop Marina , Coleman Siobhan , Thomas Naomi , Mlilo Vince , Stanton Edward , Michel Rachel , Philips Julie , Rice Heidi , Garner Lucie , Rosa Francesca , Victor Saji , Zamikula Julie , Mepham Sue , Hajee Fatima , Quijano-Campos Juan Carlos , Watson Laura , Georgiou Christopher , Worsley Jieniean , Shamtally-Amode Djamilla , Rahimi Ferishta , Jones Heather , Cruz Isabel , Lindsay Gayle , Sparke Christian , Chapman Anna , Keating-Fedders Katie , Fahey Codie , Johnson Danielle , Worboys Lucy , Hargreaves Simone , Bucke Ashlea , Carr Lindsay , Hampshire Jackie , Richardson Tracy , Sharpe Jenny , Whitehead Lynne , Vyse Naval , Kelleher Stephen , Sherwood Mary-Beth , Hughes Vicki , Giraud Kim
Published: June 2021

The COVID-19 pandemic has resulted in unprecedented challenges for healthcare systems worldwide. It has also stimulated research in a wide range of areas including rapid diagnostics, novel therapeutics, use of technology to track patients and vaccine development. Here, we describe our experience of rapidly setting up and delivering a novel COVID-19 vaccine trial, using clinical and research staff and facilities in three National Health Service Trusts in Cambridgeshire, United Kingdom. We encountered and overcame a number of challenges including differences in organisational structures, research facilities available, staff experience and skills, information technology and communications infrastructure, and research training and assessment procedures. We overcame these by setting up a project team that included key members from all three organisations that met at least daily by teleconference. This group together worked to identify the best practices and procedures and to harmonise and cascade these to the wider trial team. This enabled us to set up the trial within 25 days and to recruit and vaccinate the participants within a further 23 days. The lessons learned from our experiences could be used to inform the conduct of clinical trials during a future infectious disease pandemic or public health emergency.
Memorials’ politics: Exploring the material rhetoric of the Statue of Peace
Authors: Shim David
Published: June 2021

This paper discusses the material rhetoric of the Statue of Peace built in front of the Japanese Embassy in Seoul, South Korea. Installed in 2011 to commemorate so-called “comfort women”—the former sex slaves forced to work in brothels during Korea’s occupation by the Empire of Japan—, several identical-looking copies of the statue have since spread throughout the country and beyond. While many observers have noted the symbolic politics of the sculpture, I argue for taking into account its material dimension too—with the aim of furthering our understanding of how commemorative practices are enabled by mnemonic installations. Building on the scholarship that has addressed the rhetoric of objects and places of remembrance, I ask how the statue acts on and engages with its viewers. Among others, site visits, observations, own experiences, interviews, and visual documentation serve as the basis of the discussion.
Does Music Training Improve Emotion Recognition Abilities? A Critical Review
Authors: Martins Marta , Pinheiro Ana P. , Lima César F.
Published: June 2021

There is widespread interest in the possibility that music training enhances nonmusical abilities. This possibility has been examined primarily for speech perception and domain-general abilities such as IQ. Although social and emotional processes are central to many musical activities, transfer from music training to socioemotional skills remains underexplored. Here we synthesize results from studies examining associations between music training and emotion recognition in voices and faces. Enhancements are typically observed for vocal emotions but not for faces, although most evidence is cross-sectional. These findings are discussed considering the design features of the studies. Future research could explore further the neurocognitive mechanisms underlying musician-related differences in emotion recognition, the role of predispositions, and the implications for broader aspects of socioemotional functioning.
Systematic review and meta-analysis: the impact of co-occurring immune-mediated inflammatory diseases on the disease localization and behavior of Crohn’s disease
Authors: Attauabi Mohamed , Zhao Mirabella , Bendtsen Flemming , Burisch Johan
Published: June 2021

Background:

Patients with Crohn’s disease (CD) are at increased risk of co-occurring immune-mediated inflammatory diseases (IMIDs). As discrepancy exists regarding the phenotypic presentation of CD among patients with such co-occurring IMIDs, we aimed to conduct a systematic review with meta-analysis characterizing the phenotype of CD among this subgroup of patients.

Methods:

PubMed, Embase, and Scopus were searched from their earliest records to October 2019 for studies reporting the behavior and localization of CD according to the Vienna or Montreal Classifications and CD-related surgery in patients with co-occurring IMIDs. These studies were the subject of a random effect meta-analysis.

Results:

After reviewing 24,413 studies, we identified a total of 23 studies comprising 1572 and 35,043 CD patients with and without co-occurring IMIDs, respectively, that fulfilled our inclusion criteria. Overall, patients with co-occurring IMIDs were more likely to have upper gastrointestinal inflammation than were patients without co-occurring IMIDs [relative risk (RR) = 1.49 (95% confidence interval (CI) 1.09–2.04), p = 0.01, I2 = 7%]. In addition, presence of primary sclerosing cholangitis (PSC) was associated with a lower occurrence of ileal affection [RR = 0.44 (95% CI 0.24–0.81), p < 0.01, I2 = 32%], increased occurrence of colonic affection [RR = 1.78 (95% CI 1.33–2.38), p < 0.01, I2 = 32%] and an increased likelihood of non-stricturing and non-penetrating behavior [RR = 1.43 (95% CI 0.97–2.11), p = 0.07, I2 = 86%]. The latter reached significance when cumulating different IMIDs [RR = 1.30 (95% CI 1.09–1.55), p < 0.01, I2 = 88%]. CD patients with PSC also underwent fewer CD-related surgeries [RR = 0.55 (95% CI 0.34–0.88), p = 0.01, I2 = 0%], irrespective of CD location or behavior.

Conclusion:

This study emphasizes that CD patients with co-existing PSC are likely to have a unique inflammatory distribution primarily confined to the colon, while patients with IMIDs in general have higher likelihood of affection of upper gastrointestinal tract and a non-stricturing and non-penetrating behavior. As such a phenotype of CD is typically associated with a milder disease course; future studies are needed to confirm these results.
“Did you wash your hands?”: a prospective study of patient empowerment to prompt hand washing by healthcare providers
Authors: Eng Tony Y , Eng Nina L , Jenkins Carol A , Grota Patti G
Published: June 2021

Background:

Hand hygiene is paramount in preventing the spread of healthcare-associated infections especially during disease epidemics. Compliance rates with hand hygiene policies remain below 50% internationally and may be lower in the outpatient care setting. This study assessed the impact of the patient empowerment model on hand hygiene compliance among healthcare providers.

Methods:

From October 2016 to May 2017, patients from a large ambulatory oncology centre were prospectively enrolled. Patients were instructed to observe healthcare providers for hand hygiene compliance and to remind healthcare providers where it was not observed during at least three consecutive encounters. Healthcare provider reactions to this intervention were rated by patients. Patients’ hand hygiene knowledge and beliefs were objectively elicited pre and post-study.

Results:

Thirty patients with a median age of 52 years (range 5–91) completed the study for a total of 190 healthcare provider encounters. When initial hand hygiene was not observed, patients offered a reminder in 71 (37.4%) encounters, did not offer a reminder in 73 (38.4%) encounters and forgot to offer a reminder in 24 (14.2%) encounters. Patients perceived positive or neutral reactions in 76.8% of encounters and negative or surprised reactions in 23.2% of encounters. Healthcare provider compliance improved from 11.6% to 48.9% with intervention. Patient hand hygiene knowledge improved by 16% following the study.

Conclusions:

Patient-empowered hand hygiene may be a useful adjunct for improving hand hygiene compliance among healthcare providers and improving patient hand hygiene knowledge, although it may confer an emotional burden on patients.
Tuberculosis prevalence, knowledge of transmission and its association with vaccination of children
Authors: Das Anisha , Lakhan Tejal , Unisa Sayeed
Published: June 2021

Background:

Understanding the perceptions of patients regarding tuberculosis (TB) will enable better design of a comprehensive, client-oriented program for the disease.

Methods:

This study was conducted district-wise across India in 2015–2016 as part of the National Family Health Surveys (NFHS).

Results:

We discovered that the prevalence of TB remains significantly high, with quite a high percentage of people being unaware of the exact cause of disease proliferation. The majority of people believed that touching or sharing utensils can be a source of TB. This perception affected the participants’ responses about seeking diagnosis and treatment. However, it is a good sign that most people knew that TB is a curable disease that can be prevented to some extent if immunization with the Bacillus Calmette-Guérin (BCG) vaccine is done at the correct stage. So, a large section of the population had their children vaccinated. In addition, they would go for diagnosis if they had symptoms suggestive of the disease.

Conclusion:

Findings from this study are indicative of the fact that a large population is aware that health facilities can make a significant contribution to the treatment of tuberculosis. There is a need to further investigate how this information could potentially be used to enhance early seeking of appropriate services among TB patients.
Minimally invasive surgery for sternal and bilateral rib fractures
Authors: Nakagawa Tomoki , Masuda Ryota , Yamada Shunsuke , Iwazaki Masayuki
Published: June 2021

Sternal bone fractures with bilateral multiple rib fractures cause serious instability of the anterior chest wall, and prolonged mechanical ventilation may be required. A 45-year-old man was injured in a motor vehicle collision. He suffered from a bilateral flail chest injury accompanied by a transverse sternal fracture. Minimally invasive surgical stabilisation of the anterior chest wall was performed using two bars as per the Nuss procedure. Two days after surgery, he was extubated from artificial respiration and was ultimately discharged without any complications.
Sitagliptin on carotid intima-media thickness in type 2 diabetes and hyperuricemia patients: a subgroup analysis of the PROLOGUE study
Authors: Zhao Yipin , Wang Huawei , Ke Dazhi , Deng Wei , Ji Yingying , Yang Jiaojiao , Lin Zebin , Li Guoxing , Xiao Li , Tang Jianmin , Chen Qingwei
Published: June 2021

Background and Aims:

Studies have shown that dipeptidyl peptidase-4 (DDP-4) inhibitors have anti-atherosclerotic effects. However, in the PROLOGUE study, sitagliptin failed to slow the progression of carotid intima-media thickness (CIMT) relative to conventional therapy. We conducted a post hoc analysis of the PROLOGUE study and compared the effects of sitagliptin and conventional therapy on changes in CIMT in subgroups with or without hyperuricemia.

Methods:

The PROLOGUE study was a randomized controlled trial of 442 patients with type 2 diabetes mellitus (T2DM). Patients were randomized to receive sitagliptin added therapy or conventional therapy. Based on the serum uric acid levels of all study populations in the PROLOGUE study, we divided them into hyperuricemia subgroup ( n = 104) and non-hyperuricemia subgroup ( n = 331). The primary outcome was changed in carotid intima-media thickness (CIMT) parameters compared with baseline during the 24 months treatment period.

Results:

In the hyperuricemia subgroup, compared with the conventional therapy group, the changes in the mean internal carotid artery (ICA)-IMT and max ICA-IMT at 24 months were significantly lower in the sitagliptin group [−0.233 mm, 95% confidence interval (CI) (−0.419 to 0.046), p = 0.015 and −0.325 mm, 95% CI (−0.583 to −0.068), p = 0.014], although there was no significant difference in the common carotid artery CIMT.

Conclusion:

The results of our analysis indicated that sitagliptin attenuated the progression of CIMT than conventional therapy in T2DM and hyperuricemia patients.
Clozapine re-challenge and initiation following neutropenia: a review and case series of 14 patients in a high-secure forensic hospital
Authors: Silva Edward , Higgins Melanie , Hammer Barbara , Stephenson Paul
Published: June 2021

Objective:

Clozapine remains the most effective intervention for treatment resistant schizophrenia; however, its use is prohibited following neutropenias. We review neutrophil biology as applied to clozapine and describe the strategies to initiate clozapine following neutropenia used in a case series of 14 consecutive patients rechallenged in a United Kingdom (UK) high-secure psychiatric hospital. We examine outcomes including the use of seclusion and transfer.

Methods:

A case series of 14 male patients with treatment resistant schizophrenia treated with clozapine despite previous episodes of neutropenia between 2006 and 2015 is presented. Data were collected during 2015 and 2019. Using this routinely collected clinical data, we describe the patient characteristics, causes of neutropenia, the strategies used for rechallenging with clozapine and clinical outcomes.

Results:

Previous neutropenias were the result of benign ethnic neutropenia, clozapine, other medications and autoimmune-related. Our risk mitigation strategies included: granulocyte-colony stimulating factor (G-CSF), lithium and watch-and-wait. There were no serious adverse events; at follow up half of the patient’s had improved sufficiently to transfer them to conditions of lesser security. There were dramatic reductions in the use of seclusion.

Conclusion:

Even in this extreme group, clozapine can be safely and effectively re/initiated following neutropenias, resulting in marked benefits for patients. This requires careful planning based on an understanding of neutrophil biology and the aetiology of the specific episode of neutropenia.
Prevalence of Minimum Meal Frequency Practice and Its Associated Factors among Children Aged 6 to 23 Months in Ethiopia: A Systematic Review and Meta-analysis
Authors: Wake Addisu Dabi
Published: June 2021

Background. Inappropriate complementary feeding practices are amongst the key causes of child undernutrition. It rises the risk of undernutrition, illness, and mortality among children. Objectives. This study was aimed to determine the pooled prevalence of MMF practice and associated factors among children aged 6 to 23 months in Ethiopia. Methods. The search was conducted by using the following electronic databases; PubMed/MEDLINE, HINARI, EMBASE, Google Scholar, Web of Science, Scopus, African journals, and Google for grey literature. The publication bias was determined by using a funnel plot and Egger’s test. The heterogeneity between the studies was checked by using I2 statistic. The subgroup analysis was done by sample size, region, and year of publication. Result. A total of 20 studies with 12 656 study participants were included in the present systematic review and meta-analysis. The pooled prevalence of MMF practice among children aged 6 to 23 months in Ethiopia was estimated to be 63.80% (95%CI: 56.59, 71.01). PNC visit (AOR = 1.90, 95%CI [1.31, 2.49]), wealth index (AOR = 2.11, 95%CI [1.42, 2.81]) and age of child (AOR = 5.75, 95%CI [4.25, 7.26]) were factors significantly associated with MMF among children aged 6 to 23 months. Conclusion. The findings showed that the pooled prevalence of MMF among children aged 6 to 23 months in Ethiopia was relatively low. PNC visit, wealth index and age of child were factors significantly associated with MMF among children aged 6 to 23 months. Therefore, community-based health education concerning the recommended MMF among children aged 6 to 23 months is required to take place.
Anatomic Total Shoulder Arthroplasty With a Stemless Humeral Component
Authors: Walters Jordan D. , Brockmeier Stephen F.
Published: June 2021

Background:

This technique video reviews anatomic total shoulder arthroplasty (TSA) with a stemless humeral component using a representative case example.

Indications:

Stemless TSA is indicated for patients with symptomatic glenohumeral arthritis typically younger than 65 years of age. Stemless TSA may be used for other glenohumeral degenerative conditions such as avascular necrosis or posttraumatic arthropathy, provided acceptable humeral bone quality is confirmed intraoperatively using a thumb-press test. Poor bone quality is the primary contraindication.

Technique Description:

Preoperatively, computed tomography is typically used for planning, and intraoperative navigation through magnetic resonance imaging is also useful. The procedure’s critical elements include beach chair positioning, standard deltopectoral approach with lesser tuberosity osteotomy (LTO), freehand proximal humeral osteotomy, perpendicular proximal humeral exposure and subsequent preparation over a central guidewire, stemless implant and humeral head sizing, perpendicular glenoid exposure and implant placement, and final humeral implantation with LTO repair/fixation. A phased rehabilitation protocol includes 6-week sling immobilization to protect the subscapularis/LTO repair and return to normal activities between 3 and 6 months postoperatively.

Discussion/Conclusion:

Stemless TSA shows promising early and mid-term outcomes with complication rates, including humeral loosening rates, similar to standard stemmed components. Potential complications include neurovascular injury, infection, glenoid or humeral component loosening, and rotator cuff failure.