bluuebunny/crossref_metadata_2025 huggingface dataset:
The impact of the COVID-19 pandemic on individuals with eating disorders: the role of emotion regulation and exploration of online treatment experiences
Authors: Vuillier L. , May L. , Greville-Harris M. , Surman R. , Moseley R. L.
Published: January 2021

Objective

The Covid-19 pandemic has wrought disruption to everyday life and services, and emerging evidence suggests that those with eating disorders (EDs) are likely to experience marked distress and exacerbation of their symptoms. However, little is known around the most relevant factors to symptom change; whether certain emotion regulation and coping strategies are linked to better outcomes; and how people with EDs are adjusting to psychological interventions moving online.

Method

In a mixed-method design, we collected qualitative and quantitative data from 207 (76 males) self-selected UK residents with self-reported ED, who described and ranked impacts of the pandemic on their symptoms. Regression analysis examined whether emotion regulation strategies were associated with self-reported symptom change, ED symptomatology, and negative emotional states. Thematic analysis explored participants’ experiences of the pandemic, particularly factors affecting their ED, coping strategies used, and experiences of psychological intervention.

Results

Most participants (83.1%) reported worsening of ED symptomatology, though factors affecting symptom change differed between specific EDs. Emotion regulation, such as having fewer strategies, poorer emotional clarity, and non-acceptance of emotions, explained nearly half of the variance in emotional distress during the pandemic. Qualitative findings indicated that difficult emotions (such as fear and uncertainty), changes to routine, and unhelpful social messages were triggering for participants during the pandemic. While some participants described employing positive coping strategies (such as limiting social media exposure), many reported using ED behaviours (among other maladaptive strategies, like alcohol use) to cope with the pandemic. Finally, loss of treatment support, feeling underserving of support and experiencing a ‘detached connection’ online were further exacerbating factors for these participants.

Discussion

While our sample was self-selected and may not represent all people with EDs, our results suggest that people with EDs have been strongly affected by the pandemic. Some aspects of online treatment were found to be beneficial but our findings suggest it also needs some improvement. Our paper discusses implications for online treatment such as taking into account personal circumstances and, in a time where people have limited control over the antecedents of negative emotion, the need to develop skills to manage emotions when they arise.
Seed dispersal in Neuwiedia singapureana: novel evidence for avian endozoochory in the earliest diverging clade in Orchidaceae
Authors: Zhang Yu , Li Yuan-Yuan , Wang Miaomiao , Liu Jia , Luo Fanqiang , Lee Yung-I
Published: January 2021

Background

Seed dispersal allows plants to colonize new habitats that has an significant influence on plant distribution and population dynamics. Orchids produce numerous tiny seeds without endosperm, which are considered to be mainly wind-dispersed. Here, we report avian seed dispersal for an early diverging orchid species, Neuwiedia singapureana, which produces fleshy fruits with hard seed coats in the understory of tropical forests.

Results

Neuwiedia singapureana produced fleshy fruits that turned red in autumn, and birds were confirmed to be the primary seed dispersers. As compared to its sister species, N. veratrifolia with dehiscent capsular fruits, embryos of N. singapureana were larger and enclosed by thickened and lignified seed coats. After passing through the digestive tracts of birds, the seeds still stayed alive, and the walls of seed coat contained several cracks. The germination percentage increased significantly for digested seeds as compared with seeds from intact fruits.

Conclusion

The thickened and lignified seed coat may protect seeds as they passed through the digestive tracts of birds. Taken together with a recent report of insect-mediated seed dispersal system in the subfamily Apostasioideae, the animal-mediated seed dispersal may be an adaptive mechanism promoting the success of colonization in dark understory habitats.
Explore the genetics of weedy traits using rice 3K database
Authors: Lin Yu-Lan , Wu Dong-Hong , Wu Cheng-Chieh , Huang Yung-Fen
Published: January 2021

Background

Weedy rice, a conspecific weedy counterpart of the cultivated rice (Oryza sativaL.), has been problematic in rice-production area worldwide. Although we started to know about the origin of some weedy traits for some rice-growing regions, an overall assessment of weedy trait-related loci was not yet available. On the other hand, the advances in sequencing technologies, together with community efforts, have made publicly available a large amount of genomic data. Given the availability of public data and the need of “weedy” allele mining for a better management of weedy rice, the objective of the present study was to explore the genetic architecture of weedy traits based on publicly available data, mainly from the 3000 Rice Genome Project (3K-RGP).

Results

Based on the results of population structure analysis, we have selected 1378 individuals from four sub-populations (aus,indica,temperate japonica,tropical japonica) without admixed genomic composition for genome-wide association analysis (GWAS). Five traits were investigated: awn color, seed shattering, seed threshability, seed coat color, and seedling height. GWAS was conducted for each sub-population × trait combination and we have identified 66 population-specific trait-associated SNPs. Eleven significant SNPs fell into an annotated gene and four other SNPs were close to a putative candidate gene (± 25 kb). SNPs located in or close toRcwere particularly predictive of the occurrence of seed coat color and our results showed that different sub-populations required different SNPs for a better seed coat color prediction. We compared the data of 3K-RGP to a publicly available weedy rice dataset. The profile of allele frequency, phenotype-genotype segregation of target SNP, as well as GWAS results for the presence and absence of awns diverged between the two sets of data.

Conclusions

The genotype of trait-associated SNPs identified in this study, especially those located in or close toRc, can be developed to diagnostic SNPs to trace the origin of weedy trait occurred in the field. The difference of results from the two publicly available datasets used in this study emphasized the importance of laboratory experiments to confirm the allele mining results based on publicly available data.
A simulated patient study to evaluate community pharmacist assessment, management and advice giving to patients with asthma
Authors: Hasan Sanah , Al Oum Lujain , Hassan Nageeb AbdulGalil
Published: January 2021

Background

Research has shown that there is an increase in the global prevalence of asthma. Pharmacists are well positioned to screen and refer patients for better management of asthma. This study aimed to evaluate community pharmacists’ ability to assess the 3 C’s (Control, Compliance, Complications) and offer Management and Advice for patients with asthma in the UAE.

Methods

Three fifth year pharmacy students role played a mystery shopper visiting community pharmacies and requesting symptom relief from uncontrolled asthma. Incidence of cough syrup and reliever inhaler supply, physician referral rate, correction of inhaler technique, and counseling on the medications, adherence to the medications and adverse drug reactions were calculated.

Results

One hundred, ninety five pharmacies were visited, 27% of pharmacists asked about the need for cough syrup and 60% asked about the need for albuterol inhaler. Only 26% asked about other medications. Less than 20% assessed inhaler technique, only one pharmacist asked about regular use of preventer medications and if the patient was adhering to them and only 16% asked about side effects from medications. Most pharmacists (67%) supplied at least one of the medications, while 65% referred the patient to a physician. Only 21% gave information about correct inhaler technique, the majority (> 60%) being incomplete, only 16 pharmacists gave information about asthma and its triggers; the majority (63%) being incomplete. One third of the pharmacists counselled the patient on the medications with one giving complete information.

Conclusions

The study highlighted suboptimal assessment of control, compliance to preventer medications and complications of asthma and the medications that treat it. It also highlighted suboptimal Management and Advice giving and counseling on medication use by pharmacists. Training pharmacists in all aspects of asthma handling is clearly indicated. Despite the high rate of correct patient referral to a physician noted in this study, there is risk to it, as patients might not actually go to see their physician and continue to depend on symptom relief for the management of their asthma. This study highlighted the importance of improving patient education and information seeking attitude.
Music Use for Sedation in Critically ill Children (MUSiCC trial): a pilot randomized controlled trial
Authors:   the Canadian Critical Care Trials Group, Garcia Guerra Gonzalo , Joffe Ari R. , Sheppard Cathy , Hewson Krista , Dinu Irina A. , Hajihosseini Morteza , deCaen Allan , Jou Hsing , Hartling Lisa , Vohra Sunita
Published: January 2021

Objective

To demonstrate feasibility of a music medicine intervention trial in pediatric intensive care and to obtain information on sedation and analgesia dose variation to plan a larger trial.

Material and methods

Pilot randomized controlled trial (RCT) was conducted at the Stollery Children’s Hospital general and cardiac intensive care units (PICU/PCICU). The study included children 1 month to 16 years of age on mechanical ventilation and receiving sedation drugs. Patients were randomized in a 1:1:1 ratio to music, noise cancellation or control. The music group received classical music for 30 min three times/day using headphones. The noise cancellation group received the same intervention but with no music. The control group received usual care.

Results

A total of 60 patients were included. Average enrollment rate was 4.8 patients/month, with a consent rate of 69%. Protocol adherence was achieved with patients receiving > 80% of the interventions. Overall mean (SD) daily Sedation Intensity Score was 52.4 (30.3) with a mean (SD) sedation frequency of 9.75 (7.21) PRN doses per day. There was a small but statistically significant decrease in heart rate at the beginning of the music intervention. There were no study related adverse events. Eighty-eight percent of the parents thought the headphones were comfortable; 73% described their child more settled during the intervention.

Conclusions

This pilot RCT has demonstrated the feasibility of a music medicine intervention in critically ill children. The study has also provided the necessary information to plan a larger trial.
Energy expenditure and indirect calorimetry in critical illness and convalescence: current evidence and practical considerations
Authors: Moonen Hanneke Pierre Franciscus Xaverius , Beckers Karin Josephina Hubertina , van Zanten Arthur Raymond Hubert
Published: January 2021

The use of indirect calorimetry is strongly recommended to guide nutrition therapy in critically ill patients, preventing the detrimental effects of under- and overfeeding. However, the course of energy expenditure is complex, and clinical studies on indirect calorimetry during critical illness and convalescence are scarce. Energy expenditure is influenced by many individual and iatrogenic factors and different metabolic phases of critical illness and convalescence. In the first days, energy production from endogenous sources appears to be increased due to a catabolic state and is likely near-sufficient to meet energy requirements. Full nutrition support in this phase may lead to overfeeding as exogenous nutrition cannot abolish this endogenous energy production, and mitochondria are unable to process the excess substrate. However, energy expenditure is reported to increase hereafter and is still shown to be elevated 3 weeks after ICU admission, when endogenous energy production is reduced, and exogenous nutrition support is indispensable. Indirect calorimetry is the gold standard for bedside calculation of energy expenditure. However, the superiority of IC-guided nutritional therapy has not yet been unequivocally proven in clinical trials and many practical aspects and pitfalls should be taken into account when measuring energy expenditure in critically ill patients. Furthermore, the contribution of endogenously produced energy cannot be measured. Nevertheless, routine use of indirect calorimetry to aid personalized nutrition has strong potential to improve nutritional status and consequently, the long-term outcome of critically ill patients.
Asymmetry in the Earth’s magnetotail neutral sheet rotation due to IMF $$B_y$$ sign?
Authors: Pitkänen Timo , Kullen Anita , Cai Lei , Park Jong-Sun , Vanhamäki Heikki , Hamrin Maria , Aikio Anita T. , Chong G. Siung , De Spiegeleer Alexandre , Shi Quanqi
Published: January 2021

Evidence suggests that a non-zero dawn–dusk interplanetary magnetic field (IMF $$B_y$$

B
y

) can cause a rotation of the cross-tail current sheet/neutral sheet around its axis aligned with the Sun–Earth line in Earth’s magnetotail. We use Geotail, THEMIS and Cluster data to statistically investigate how the rotation of the neutral sheet depends on the sign and magnitude of IMF $$B_y$$

B
y

. In our dataset, we find that in the tail range of $$-30<$$

-
30
<

XGSM $$<-15$$

<
-
15

$$R_{\mathrm{E}}$$

R
E

, the degree of the neutral sheet rotation is clearly smaller, there appears no significant rotation or even, the rotation is clearly to an unexpected direction for negative IMF $$B_y$$

B
y

, compared to positive IMF $$B_y$$

B
y

. Comparison to a model by Tsyganenko et al. (2015, doi:10.5194/angeo-33-1-2015) suggests that this asymmetry in the neutral sheet rotation between positive and negative IMF $$B_y$$

B
y

conditions is too large to be explained only by the currently known factors. The possible cause of the asymmetry remains unclear.
Imaging of head and neck mucosa-associated lymphoid tissue lymphoma (MALToma)
Authors: Ko K. W. S. , Bhatia Kunwar S. , Ai Qi Yong H. , King Ann D.
Published: January 2021

Marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALToma) arises in extranodal sites in the head and neck. Chronic inflammatory, infectious or autoimmune conditions are implicated in its pathogenesis. Within the head and neck, MALToma is often multifocal and indolent and the imaging appearances may be mistaken for non-malignant disease in the head and neck. The aim of this article is to illustrate the varied radiological and clinical features of MALToma in the head and neck, an awareness of which is needed for timely and correct diagnosis to guide subsequent disease management.
Individual dosimetry system for targeted alpha therapy based on PHITS coupled with microdosimetric kinetic model
Authors: Sato Tatsuhiko , Furuta Takuya , Liu Yuwei , Naka Sadahiro , Nagamori Shushi , Kanai Yoshikatsu , Watabe Tadashi
Published: January 2021

Background

An individual dosimetry system is essential for the evaluation of precise doses in nuclear medicine. The purpose of this study was to develop a system for calculating not only absorbed doses but also EQDX(α/β) from the PET-CT images of patients for targeted alpha therapy (TAT), considering the dose dependence of the relative biological effectiveness, the dose-rate effect, and the dose heterogeneity.

Methods

A general-purpose Monte Carlo particle transport code PHITS was employed as the dose calculation engine in the system, while the microdosimetric kinetic model was used for converting the absorbed dose to EQDX(α/β). PHITS input files for describing the geometry and source distribution of a patient are automatically created from PET-CT images, using newly developed modules of the radiotherapy package based on PHITS (RT-PHITS). We examined the performance of the system by calculating several organ doses using the PET-CT images of four healthy volunteers after injecting 18F-NKO-035.

Results

The deposition energy map obtained from our system seems to be a blurred image of the corresponding PET data because annihilation γ-rays deposit their energies rather far from the source location. The calculated organ doses agree with the corresponding data obtained from OLINDA 2.0 within 20%, indicating the reliability of our developed system. Test calculations by replacing the labeled radionuclide from 18F to 211At suggest that large dose heterogeneity in a target volume is expected in TAT, resulting in a significant decrease of EQDX(α/β) for higher-activity injection.

Conclusions

As an extension of RT-PHITS, an individual dosimetry system for nuclear medicine was developed based on PHITS coupled with the microdosimetric kinetic model. It enables us to predict the therapeutic and side effects of TAT based on the clinical data largely available from conventional external radiotherapy.
Accuracy of guided surgery using the silicon impression and digital impression method for the mandibular free end: a comparative study
Authors: Nagata Koudai , Fuchigami Kei , Hoshi Noriyuki , Atsumi Mihoko , Kimoto Katsuhiko , Kawana Hiromasa
Published: January 2021

Background

Implant treatment using guided surgery is becoming widespread in clinical dental practice. Furthermore, the development of digital technology has enabled the use of intraoral scanners (IOSs) to fabricate surgical guide plates. The objective of this study was to compare the accuracy of guided surgery using the silicone impression method with a three-dimensional (3D) scanner and the digital impression method with IOS for one side of the mandibular free end. In addition, we compared the accuracy of tooth-supported vs tooth/mucosa-supported surgical guide plates.

Results

The accuracy of the tooth-supported surgical guide plate using the new IOS method instead of the method of obtaining impressions with conventional silicone resulted in better measurements of 3D deviation at the crest, 3D deviation at the apex, and angular deviation. In terms of the accuracy of the tooth/mucosa-supported surgical guide plate, there were no significant differences in all measurements. The surgical guide plate using an IOS and the tooth/mucosa-supported surgical guide plate may enable more accurate guided surgery.

Conclusion

Tooth/mucosa-supported guided surgery involving preparation with an IOS may result in more accurate implant surgery.
A difficult-to-diagnose fibromatosis-like metaplastic carcinoma of the breast: a case report
Authors: Takatsuka Daiki , Ogura Hiroyuki , Asano Yuko , Nakamura Akiko , Koizumi Kei , Shiiya Norihiko , Baba Satoshi
Published: January 2021

Background

Fibromatosis-like metaplastic carcinoma (FLMCa), classified as a metaplastic carcinoma of the breast, is a very rare type of metaplastic carcinoma. We report a case of FLMCa that was difficult to diagnose.

Case presentation

The patient was a 56-year-old postmenopausal woman who presented with a left-sided breast mass. A 1.3-cm irregular mass was found in the lower outer quadrant of the left breast on breast ultrasonography. She underwent core needle biopsy and vacuum-assisted biopsy, but the pathological findings only revealed inflammatory cell infiltration and a high level of fibrosis, with no malignant findings. At 3 months follow-up, she underwent a repeat breast ultrasonography, which revealed an increase in the size of the mass to 1.8 cm, and a repeat core needle biopsy, which showed a few spindle cells and squamous cells positive for cytokeratin (CK)5/6 and AE1/AE3, leading to the suspicion of FLMCa. Since the amount of tissue was insufficient to establish a definitive diagnosis, she underwent a lumpectomy. We found low-grade and slightly atypical spindle cells and partly atypical spindle cell carcinoma and squamous cell carcinoma. CK5/6 and α-SMA were positive, thus confirming FLMCa. Because the margins on the edge of the nipple side and anterior side were “ink on tumor”, she underwent a mastectomy and sentinel lymph node biopsy. After the surgery, she received adjuvant chemotherapy. At 3 years and 8 months of follow-up, no recurrent or metastatic lesions were identified in her body.

Conclusions

FLMCa should be considered in the differential diagnosis when collagenous fibers are proliferating and malignancy is clinically suspected. Immunohistochemical analysis may be helpful in confirming this diagnosis.
Assessment of monitoring systems in the management of severe acute malnutrition in northern Nigeria
Authors: Tuffrey Veronica , Mezger Cora , Nanama Simeon , Bulti Assaye , Olisenekwu Gloria , Umar Charles , Jones Emma , Namukasa Esther
Published: January 2021

Background

In northern Nigeria, UNICEF has supported introduction of a short message service (SMS) system for data transmission in the Community-based Management of Acute Malnutrition (CMAM) programme. The SMS system operates in parallel to the traditional paper-based system, and weekly data are transmitted directly from the health facilities to the federal level. For the paper system, monthly data summaries are passed through all levels of government. We assessed the data quality and performance of both CMAM information systems.

Methods

We undertook a contextualised study in one state in north-west Nigeria, with additional analysis of secondary data from five states. Fieldwork methods included: observation of the data system in nine selected facilities in three local government areas; recounting of data for admissions, exits, and ready-to-use therapeutic food (RUTF) utilisation; and interviews with health workers and government officials.

Results

While the small number of facilities does not enable robust generalisation of the quantitative findings, the strengths and weaknesses detected pertain to the whole programme, as they relate to how the system was designed and is operated. We found that the accuracy and reliability of CMAM data were deficient to a similar extent in the paper-based and SMS systems. For the audited month, we found large discrepancies between recounted data and paper records in regard to admissions, exits and RUTF cartons consumed in the majority of facilities visited. There was also a large discrepancy in the reported percentage of “deaths or defaulters” (6.5%) compared to 22% based on a recount of outpatient cards. Errors are mainly introduced during data collection and when completing tallies at facility level.

Conclusion

Our findings indicate the need for improvements in the design of the monitoring system, training and supervision of data management, and communication of results; as well as clear evidence on how measures to improve data quality may affect performance of individual CMAM clinics. The CMAM default and death rates currently reported in Nigeria are likely to be under-estimates, and therefore provide a misleadingly good impression of CMAM programme performance.
Peripheral retinal leakage in POEMS syndrome
Authors: Carey Andrew Rising , Jeyaseelan Praveen
Published: January 2021

Background

POEMS (polyneuropathy, organomegaly, endocrinopathy, myeloma protein, skin changes) syndrome is a rare blood disorder with multi-system involvement. The cause is unknown. It is marked by elevated plasma cells, platelets, & VEGF (vascular endothelial growth factor) levels. 52% of patients develop optic disc edema which may be vision threatening but the exact etiology of optic disc edema is uncertain. We report a rare finding of peripheral retinal leakage in POEMS syndrome.

Case presentation

A 60 year-old female with POEMS syndrome presented with bilateral blurred vision. Fundi showed grade 3 disc edema OU. Lumbar puncture showed normal opening pressure. CSF analysis showed elevated proteins with no cells. MRI brain and MR Venogram head were unremarkable. Wide field fluorescein angiography demonstrated multifocal tiny vascular leakage and significant anterior temporal leakage.

Conclusion

The authors hypothesize the disc edema in POEMS syndrome may be caused by increased vascular permeability at the optic disc secondary to increased VEGF (vascular endothelial growth factor) levels. Though disc leakage is a well-documented finding in fundus fluorescein imaging, peripheral retinal leakage in POEMS syndrome is not reported.
Anesthetic management for a patient with myotonic dystrophy with remimazolam
Authors: Morimoto Yasuhiro , Yoshimatsu Aya , Yoshimura Manabu
Published: January 2021

Background

Patients with myotonic dystrophy may have increased sensitivity to drugs used for anesthesia. We successfully managed general anesthesia in a patient with myotonic dystrophy using a novel intravenous anesthetic, remimazolam.

Case presentation

The patient was a 46-year-old man, 169 cm in height, and weighing 60 kg. He was diagnosed with myotonic dystrophy 5 years previously. Phacoemulsification for both eyes was scheduled under general anesthesia. Anesthesia was induced with remimazolam 6 mg/kg/h for 1 min and maintained by continuous infusion at 0.25 mg/kg/h during surgery, a 1/4 dose of the standard infusion rate, as indexed by a bispectral index (BIS). Six minutes after remimazolam discontinuation, the patient opened his eyes on verbal command with sufficient spontaneous respiration. Flumazenil (0.2 mg) was administered to boost the patient’s recovery.

Conclusion

In addition to the short-acting anesthetic remimazolam, the presence of the antagonist flumazenil enabled complete recovery from anesthesia, without postoperative complications.
“He lets me go although he does not go with me.”: Rwandan women’s perceptions of men’s roles in maternal health
Authors: Tuyisenge Germaine , Crooks Valorie A. , Berry Nicole S.
Published: January 2021

Background

Increasing men’s involvement in their pregnant partners’ wellness has been reported as one of the ways to improve access to and utilization of maternal health services, including birth preparedness and complication readiness. Men can play meaningful roles in the support systems that pregnant women need to achieve better maternal health outcomes. In Rwanda, the roles that men take vary, resulting in diverse expectations and responsibilities to support the health of women during this critical time. In this study, we aimed to examine the views, perspectives, and experiences of women on men’s involvement in maternal health and how this impacts access and utilization of maternal health services.

Methods

We conducted 21 interviews with pregnant and recently-pregnant women to gain an understanding of their views on men’s involvement in facilitating their partners’ health during pregnancy. Interviews were conducted across five Rwandan districts in both rural and urban settings of the country. Data analysis was guided by a thematic analysis approach. This started with independent transcript review by the investigators, after which a meeting was held to discuss emergent themes and to identify potential codes. A coding scheme was created and transcripts were coded in NVIVO™ software according to conceptual and practical topics that formed an understanding of men’s involvement in maternal care.

Results

Three key themes emerged during the analytic process that categorize the specific roles that men play in maternal health: 1) facilitating access to maternal health services, which involves assisting women with getting and or attending appointments jointly with men; 2) supporting women’s decisions, wherein men can support the decisions women make with regard to their maternal healthcare in a number of ways; and 3) evaluating information, including gathering information from multiple sources, especially from community health workers, to assist women with making informed decisions.

Conclusion

Rwandan men take on three types of roles in supporting women’s maternal health, and their responsibilities are experienced differently by women. Interventions involving men are encouraged to increase their understanding of the implications of their involvement in maternal health without compromising women’s autonomy in decision-making and to promote positive maternal health outcomes.
Changes in insomnia as a risk factor for the incidence and persistence of anxiety and depression: a longitudinal community study
Authors: Johansson Magnus , Jansson-Fröjmark Markus , Norell-Clarke Annika , Linton Steven J.
Published: January 2021

Background

The aim of this investigation was to examine the longitudinal association between change in insomnia status and the development of anxiety and depression in the general population.

Methods

A survey was mailed to 5000 randomly selected individuals (aged 18–70 years) in two Swedish counties. After 6 months, a follow-up survey was sent to those (n = 2333) who answered the first questionnaire. The follow-up survey was completed by 1887 individuals (80.9%). The survey consisted of questions indexing insomnia symptomatology, socio-demographic parameters, and the Hospital Anxiety and Depression Scale. Change in insomnia status was assessed by determining insomnia at the two time-points and then calculating a change index reflecting incidence (from non-insomnia to insomnia), remission (from insomnia to non-insomnia), or status quo (no change). Multivariate binary logistic regression analyses were used to examine the aim.

Results

Incident insomnia was significantly associated with an increased risk for the development of new cases of both anxiety (OR = 0.32, p < .05) and depression (OR = 0.43, p < .05) 6 months later. Incident insomnia emerged also as significantly associated with an elevated risk for the persistence of depression (OR = 0.30, p < .05), but not for anxiety.

Conclusions

This study extends previous research in that incidence in insomnia was shown to independently increase the risk for the development of anxiety and depression as well as for the maintenance of depression. The findings imply that insomnia may be viewed as a dynamic risk factor for anxiety and depression, which might have implications for preventative work.
The impact of moderate and severe asthma exacerbations on quality of life: a post hoc analysis of randomised controlled trial data
Authors: Briggs Andrew , Nasser Shuaib , Hammerby Eva , Buchs Sarah , Virchow J. Christian
Published: January 2021

Background

This paper reports the duration of moderate and severe exacerbations in patients with house dust mite induced allergic asthma and the impact on patients’ quality of life.

Methods

Post-hoc analyses were conducted using data collected during a phase III multi-national trial (MT-04) that investigated time to moderate or severe asthma exacerbation among 485 patients during withdrawal from inhaled corticosteroids. Patient diaries were analysed to ascertain duration of exacerbations. The impact on patients’ quality of life was measured by calculating utilities for five health states using the EuroQol-5 Dimension (EQ-5D-3L) and Asthma Quality of Life Questionnaire (AQL-5D). A regression analysis predicted the disutility of moving from ‘well controlled asthma’ to the other four health states: ‘partially controlled asthma’, ‘uncontrolled asthma’, ‘moderate exacerbation’ and ‘severe exacerbation’.

Results

Two hundred four patients experienced exacerbations. Moderate and severe exacerbations involved statistically significant reductions in lung function compared to the constant peak expiratory flow observed for patients without exacerbations. Lung function decline occurred for 28 days, decreasing approximately 14 days before an exacerbation followed by a return to baseline over 14 days. Asthma symptoms, the use of short-acting β2-agonists, and frequency of nocturnal awakening all increased, starting 10–14 days before an exacerbation, and returned to baseline within 10–28 days following exacerbations. Compared to ‘well controlled asthma’, the disutility of having a ‘moderate exacerbation’ ranged from − 0.0834 to − 0.0921 (EQ-5D-3L) and from − 0.114 to − 0.121 (AQL-5D); and of having a ‘severe exacerbation’ from − 0.115 to − 0.163 (EQ-5D-3L) and from − 0.153 to − 0.217 (AQL-5D), depending on the length of the observation period.

Conclusions

The impact of moderate and severe exacerbations in house dust mite induced allergic asthma extends 14 days before and 28 days after the peak exacerbation event. The impact of exacerbations on patients’ health-related quality of life (HRQoL) continues long after their occurrence.
A case series on the role of 18F-FDG PET/CT-guided biopsy of osseous metastases
Authors: Farrell Michael , Hyun Gina , Goold Michael P. , Krapiva Pavel
Published: January 2021

Purpose

This case series explores the utility of positron emission tomography (PET)/computed tomography (CT) guidance for biopsy of 18F-fludeoxyglucose (FDG)-avid osseous lesions that are inconspicuous on CT.

Methods

PET/CT-guided core biopsies were performed in four patients with suspected malignancies given 18F-FDG-avid osseous lesions that were inconspicuous on CT alone. The final diagnosis for each patient was determined by histopathological and molecular testing.

Results

PET/CT-guided biopsy yielded accurate sampling via core needle biopsy (CNB) with histopathological confirmation of osseous metastases of the primary malignancy as opposed to a secondary malignancy in three patients and ruled-out metastatic spread in the fourth.

Conclusion

PET/CT-guided biopsy of hypermetabolic osseous lesions that are inconspicuous on CT alone is an effective and safe diagnostic tool in patients with suspected malignancy.
Lymphadenectomy after a positive sentinel node biopsy in patients with cutaneous melanoma. A systematic review
Authors: Da Cunha Cosme Maribel L. , Liuzzi Samaterra Juan F. , Siso Cardenas Saul A. , Chaviano Hernández José I.
Published: January 2021

Complete lymph node dissection (CLND) following a positive sentinel lymph node biopsy (SLNB) has been the standard treatment for years. However, there is increasing evidence that CLND could be omitted. Approximately 80% of patients with a positive sentinel node biopsy do not have additional nodal involvement; in these contexts, the SLNB could be diagnostic and therapeutic. However, in this group of patients, the therapeutic effect of CLND is unclear.

A systematic search was performed in EMBASE and MEDLINE (PubMed), for studies published between January 1, 2014 and December 31, 2019. Studies were included when they compared immediate CLND and observation after a positive sentinel node. The outcomes of interest were: Overall Survival (OS), melanoma-specific survival (MSS), and disease-free survival (DFS).

Eleven studies met the inclusion criteria. Two randomized clinical trials reported no differences in OS or MSS when complete lymph dissection was compared with observation alone. An increase in regional relapse was observed in the CLND group, and in one randomized controlled trial (RCT) the rate of disease-free survival was superior in those patients.

Most populations in both RCTs had low sentinel lymph node biopsy (SLNB) metastatic deposits, and head and neck melanomas were not included or underrepresented. When CNLD was omitted, an active surveillance protocol was carried out.

The evidence supports that CLND in SLNB positive patients does not confer a survival benefit. Sentinel tumor burden, localization of primary tumor, and feasibility of active surveillance should be taken into account in treatment decisions.
Field persistence of certain new insecticides and their efficacy against black cutworm, Agrotis ipsilon (Hufnagel)
Authors: Ismail Seham M.
Published: January 2021

Background

Chemical control is used as a rapid and reliable method for insect control. Still, there is an ongoing need to replace older conventional insecticides with new insecticides to maintain efficacy and environmental protection. Emamectin benzoate, indoxacarb and chlorantraniliprole are broad-spectrum insecticides with a novel mode of actions. The effects of these compounds on some biological aspects of the black cutworm, Agrotis ipsilon, and their field persistence residues were estimated.

Results

The results showed that egg hatch was affected by high concentrations (50 and 100 ppm) of the tested compounds. Larvae that hatched from treated eggs were significantly affected at concentrations of 25 ppm and higher. 1st-instar larvae were the most susceptible developmental stage. There was strong suppression of adult formation; 65 and 91% at 25 and 50 mg L−1, respectively. Profoundly affected larvae died before pupation; slightly affected ones reached pupation 2–4 days later, were smaller than larvae in the untreated control, and were sometimes unable to develop into normal adults. Comparatively high concentrations (50 and 100 mg L−1) of the test compounds were necessary to affect adults by ingestion. According to the results, the tested insecticides could be arranged according to their potency descendingly as follows: emamectin benzoate, indoxacarb, and chlorantraniliprole, respectively. Based on the field application, emamectin benzoate proved to be the most effective in initial and residual activity, causing 100% mortality while indoxacarb was least effective. Data also indicated that emamectin benzoate had the longest half-life (Lt50) while indoxacarb recorded the shortest one.

Conclusions

The results obtained in this study indicate that emamectin benzoate, indoxacarb and chlorantraniliprole are potent compounds for controlling A. ipsilon. Therefore, these compounds are promising materials that can be used as alternative components in integrated pest management programs to reduce as possible the harmful of using conventional insecticides under field conditions.
Effects of aging on the skin and gill microbiota of farmed seabass and seabream
Authors: Rosado Daniela , Pérez-Losada Marcos , Pereira Ana , Severino Ricardo , Xavier Raquel
Published: January 2021

Background

Important changes in microbial composition related to sexual maturation have been already reported in the gut of several vertebrates including mammals, amphibians and fish. Such changes in fish are linked to reproduction and growth during developmental stages, diet transitions and critical life events. We used amplicon (16S rRNA) high-throughput sequencing to characterize the skin and gill bacterial microbiota of farmed seabass and seabream belonging to three different developmental age groups: early and late juveniles and mature adults. We also assessed the impact of the surrounding estuarine water microbiota in shaping the fish skin and gill microbiota.

Results

Microbial diversity, composition and predicted metabolic functions varied across fish maturity stages. Alpha-diversity in the seabass microbiota varied significantly between age groups and was higher in older fish. Conversely, in the seabream, no significant differences were found in alpha-diversity between age groups. Microbial structure varied significantly across age groups; moreover, high structural variation was also observed within groups. Different bacterial metabolic pathways were predicted to be enriched in the microbiota of both species. Finally, we found that the water microbiota was significantly distinct from the fish microbiota across all the studied age groups, although a high percentage of ASVs was shared with the skin and gill microbiotas.

Conclusions

We report important microbial differences in composition and potential functionality across different ages of farmed seabass and seabream. These differences may be related to somatic growth and the onset of sexual maturation. Importantly, some of the inferred metabolic pathways could enhance the fish coping mechanisms during stressful conditions. Our results provide new evidence suggesting that growth and sexual maturation have an important role in shaping the microbiota of the fish external mucosae and highlight the importance of considering different life stages in microbiota studies.
Outcome of manual thrombus aspiration for patients undergoing primary PCI for acute STEMI showing large thrombus burden
Authors: Elfekky Ehab Mohamed , Penjameen Michael Nabil , Nassar Ahmed Ibrahim , Elias Ramy Raymond
Published: January 2021

Background

Routine thrombus aspiration during primary PCI does not improve clinical outcomes. Although recent guidelines for management of patient presented by ST-elevation myocardial infarction treated by primary PCI does not recommend routine use of thrombus aspiration and ranking it as class III recommendation. However, there is remaining uncertainty about rule of TA in group of patients presented by STEMI and their initial coronary angiogram shows large thrombus burden as there is a logical rationale for greater benefit, and still, there are no clear guidelines for management of this group of patients; the aim of this study is to evaluate the in-hospital and short-term outcome of using manual thrombus aspiration in STEMI patients undergoing primary PCI and showing large thrombus burden.

Results

The study was prospective observational study included 209 patients referred to coronary care unit (CCU) with diagnosis of STEMI who had undergone primary PCI; their initial coronary angiography show totally occluded infarct-related artery with heavy thrombus burden. Patients were divided into 2 groups: group (B) which included 73 patients, who had undergone PTCA and manual thrombus aspiration followed by stent to culprit lesion, and group (A) which included 136 patients, who had undergone conventional PTCA and stent of culprit lesion within the period from November 2016 till July 2018. Patients had a pre-discharge echo and were followed up for 4 weeks for major adverse cardiac events (MACE) and echo repeated after 1 month of discharge.

It was found that thrombus aspiration in heavy thrombus burden cases had improved in-hospital mortality and in-hospital secondary endpoints (TIMI flow, MBG, ST-segment resolution), as well as 30-day MACE and LV systolic function.

Conclusion

In patients presented with STEMI and heavy thrombus burden culprit artery, manual thrombus aspiration has great value in reducing index hospitalization and 1 month mortality and improve TIMI flow, MBG, ST-segment resolution, and left ventricular systolic function.
Rhabdomyolysis following coronary angiography: an unexpected detection on 99mTc-methyl diphosphonate bone scintigraphy
Authors: Arumugam Kavita , Onny Muhammad Adib Abdul , Amran Iskandar Mirza , Suppiah Subapriya , Ng Chen Siew , Hashim Hazlin
Published: January 2021

Background

Bone scintigraphy is an appropriate tool in the management of cancers for the detection of bone metastasis. Technetium 99 m-methylene diphosphonate (99mTc-MDP) is commonly used as a bone-seeking agent. The bones take up 99mTc-MDP through a process called chemisorption, which is more evident in areas of increased osteoblastic activities. Nevertheless, extra-osseous 99mTc-MDP uptake is an infrequent occurrence, which warrants a thorough clinical assessment to evaluate such findings. An example of extraosseous uptake discovery is rhabdomyolysis, which requires prompt recognition and immediate management. Rhabdomyolysis secondary to an adverse reaction towards iodinated contrast material is a rare condition that warrants a high index of clinical suspicion.

Case presentation

We present a case of a 75-year-old gentleman with underlying benign prostatic hypertrophy, and chronic kidney disease who had undergone a coronary angiography examination and intervention for ischemic heart disease. Pre-scheduled bone scintigraphy with 99mTc-MDP for the work-up of raised serum prostate-specific antigen (PSA) was performed 2 weeks post coronary angiography examination. Whole-body bone scan with single-photon emission computed tomography/computed tomography (SPECT/CT) images showed an unexpected finding of extensive extra-osseous uptake in the muscles and soft tissues. Additional investigations confirmed the diagnosis of rhabdomyolysis. Nevertheless, despite the prompt recognition, administration of treatment and supportive care, the patient succumbed to life-threatening complications.

Conclusion

This case highlights the importance of recognising and identifying the pattern of extra-osseous uptake on bone scintigraphy imaging to ensure early intervention of severe and life-threatening conditions such as rhabdomyolysis.
The relationship between organizational environment antecedents and performance management in local government: evidence from Ghana
Authors: Abane Juliana Abagsonema , Brenya Edward
Published: January 2021

The study aimed to investigate the relationship between organizational environment antecedents and their impact on performance management among local government authorities and to further understand the role of the stakeholder and political support in the performance monitoring and review of local governments. The study used quantitative research design techniques in the data collection phase between May and August 2017 in the Greater Accra Region of Ghana. The sample included 850 middle level and senior managers of the Local Government Service. Multiple regression was used to analyze the data. The results of the findings indicate that there is a strong relationship between two organizational environment variables: “stakeholder participation”, political support, and performance management providing a variance of 31.8 percent of the changes in the dependent variable. However, the findings further suggest that stakeholder participation was a better predictor of performance management than political support. Additionally, employees’ age, gender, and organizational size were statistically significant in the model fit. This study is one of the first of its kind to link two organizational environment indicators (stakeholder support and political support) and their effect on two performance management dimensions (performance monitoring and evaluation, and performance review). Also, few studies have used the structural contingency theory in explaining the influence of the environment on internal business processes of organizations in the performance management literature.
E-commerce adoption in ASEAN: who and where?
Authors: Ayob Abu H.
Published: January 2021

As an economic bloc, the Association of Southeast Asia Nations (ASEAN) aims to leverage the usage of e-commerce for the benefits of all: government, enterprises, and citizens of its member countries. However, each country varies greatly in terms of economic development and cultural factors, which explains the uneven level of e-commerce adoption in the region. This paper seeks to provide empirical evidence by integrating individual and country-level characteristics to profile e-commerce users in ASEAN. By analyzing multi-source data from 5870 individuals in six countries in 2017, the results reveal that e-commerce adoption is more prevalent among female, younger, more educated, employed, and higher income users. Also, the adoption of e-commerce is found to be stronger in societies that exhibit high individualism, low masculinity and low uncertainty avoidance. This study proposes that e-commerce adoption shall not only be explained by individual characteristics and formal institutions, but also by country-level variables and national culture.