bluuebunny/crossref_metadata_2025 huggingface dataset:
“Why Can’t We Have Some Kind of Unity?” Cultural Contention Amongst Puerto Rican and Black Residents in Southern Suburbia
Authors: Dhuman Stephanie A.
Published: April 2023

This study examines Puerto Rican-Black intergroup relations in Poinciana, Florida, a new immigrant destination in the suburban south led by the country’s largest homeowners association. Drawing on ethnographic fieldwork and interviews with 47 residents, I interrogate interpersonal relationships, feelings of belonging, and how residents’ lack of sociopolitical agency contribute to perceptions of intergroup relations. Past research evidences both coalition and tensions between Puerto Rican and Black co-residents, including shared marginalization experiences leading to increased coalition, or economic competition leading to contention. As migration to new immigrant destinations continues to rise, this study suggests minoritized groups may hold discordant conceptualizations of their relationship, what I refer to as “cultural contention.” While Puerto Ricans describe a shared sense of marginalization and unity with their Black neighbors, Black residents express concerns over displacement. With the precarious status of the community, there are few opportunities for residents to coalesce, and further fragmentation is possible.
How Well Do Students Understand “Free Community College”? Promise Programs as Informational Interventions
Authors: Monaghan David B.
Published: April 2023

Given the low price of community college relative to need-based aid, last-dollar “free community college” (i.e., Promise) programs often only marginally reduce students’ real costs. Given this reality, some claim that these programs impact students largely through “messaging”: information conveying the affordability of community college. However, it is unclear how such messaging works in concept or practice. Drawing on a case study, I document the paradoxical ways last-dollar community college Promise programs alter students’ understanding of college affordability. Reflecting program marketing, students typically understood the program as simply “free college,” with little grasp of last-dollar structure or eligibility criteria. Many believed the Promise program paid their tuition, but administrative data showed the program funded very few students. Student misunderstanding of the program is traceable to a baseline conception of college as “expensive” and to a tenuous grasp of need-based aid. Promise programs’ “messaging effects” are predicated upon such prevalent misconceptions. The “message” is a mixture of clarification and misdirection, revealing a factual situation (that community college is often “tuition-free”) through an equivocation (that the Promise program is making it free).
(Mis)Alignment of Challenges and Strategies in Promoting Inclusive Racial Climates in STEM Graduate Departments
Authors: Perez Rosemary J. , Motshubi Rudisang , Rodriguez Sarah L.
Published: April 2023

This descriptive qualitative study used racialized organizations (Ray, 2019) as a lens to examine how 27 faculty, administrators, and postdoctoral fellows in STEM departments at two institutions understood the problems that underlie negative racial climate, the strategies they used to improve racial climate, and the alignment between problems and solutions. Participants did not discuss racism and White supremacy as factors that contribute to negative racial climate. Instead, they indicated a weak STEM pipeline, and lack of faculty engagement created negative climate. Because participants did not attend to how racism and White supremacy fostered negative climate, their strategies (e.g., increased recruitment, committees, workshops) left systemic racism intact and (un)intentionally amplified labor for racially minoritized graduate students and faculty champions who often led change efforts with little support. These findings can help move departments away from intervention-centered models of change and toward more systemic approaches that contest how racialized organizations operate.
Rising Coauthorship in Sociology, 1895 to 2022
Authors: Stoltz Dustin S.
Published: April 2023

More than 180,000 articles published in 110 sociology journals over 130 years reveal that coauthoring is increasingly a disciplinary norm in sociological publications. More than 55 percent of all articles published in 2022 were coauthored, and only five journals had lower average coauthoring in the past five years than their overall average. The sample includes both U.S. and non-U.S. journals, as well as specialist and generalist journals. The U.S. journals include those published by the American Sociological Association as well as various regional and specialty journals. When disaggregating the articles by these subcategories, the trend toward increased coauthoring remains.
Critical digital ischaemia in systemic sclerosis exacerbated by multiple myeloma: A case report
Authors: Franco Andre Silva , Polho Gabriel Berlingieri , Luppino Assad Ana Paula , Miossi Renata , Sampaio-Barros Percival Degrava
Published: April 2023

Introduction:

The overlapping of systemic sclerosis with hematologic malignancy has been described previously in the literature. This case report presents a patient with systemic sclerosis and multiple myeloma who had severe digital ischaemia that culminated in the amputation of several fingers.

Case report:

A 65-year-old White female patient was diagnosed with limited systemic sclerosis in 2002, smouldering multiple myeloma IgG/kappa in 2017 and liver cirrhosis in 2018 due to autoimmune hepatitis. In 2021, she was admitted to the emergency room with dry ischaemia of all fingers and toes despite optimized therapy, associated with visual blurring. The diagnostic hypothesis was hyperviscosity syndrome associated with multiple myeloma reactivation. The patient underwent chemotherapy and despite initial laboratory improvement, 19 digits required amputation.

Conclusion:

Although the association between systemic sclerosis and multiple myeloma is rare, it should be remembered in cases of significant worsening of Raynaud’s phenomenon. Causes unrelated to systemic sclerosis should also be considered in the presence of severe exacerbations in patients with other comorbidities.
Driving CSR and Sustainability Culture: Role of HR
Authors: Sarangi Ayaskant
Published: April 2023

Although Corporate Social Responsibility (CSR) has been an extremely critical pillar for many years now, the role that the human resources function plays in facilitating a more socially responsible and sustainable organisation remains unclear. In practice, this lack of clarity is due to the multiple factors including not integrating the human resources (HR) and CSR functions. This article provides a broader perspective on the role HR should play in CSR and Sustainability as well as its impact beyond organisational boundaries. The overall orientation of the HR leadership to ensure that it recognises the criticality of CSR and its own role in facilitating this charter in an organisation as a key metric for the function itself, is an important step in this direction.
Does the pronator-sparing approach improve functional outcome, compared to a standard volar approach, in volar plating of distal radius fractures? A prospective, randomized controlled trial
Authors: Thalhammer Gerhild , Hruby Laura A. , Dangl Theresia , Liebe Jonas , Erhart Jochen , Haider Thomas
Published: April 2023

Background

This study aimed to compare functional outcomes of a volar plate osteosynthesis for distal radius fractures (DRF) performed with either a standard volar approach (SVA), which required detachment of the pronator quadratus muscle, or a pronator-sparing approach (PqSA).

Materials and methods

This prospective randomized controlled study included 106 patients scheduled for volar plate osteosyntheses. Patients were allocated to either the SVA group (n = 53) or the PqSA group (n = 53). Patients were blinded to treatment until completion of the study. The primary outcome measure was the Patient-Rated Wrist Evaluation (PRWE). Secondary outcome parameters were the Disabilities of the Arm, Shoulder, and Hand (DASH) score and the Modified Mayo Wrist Score (MMWS). Follow-up examinations were performed at 8 weeks and 3, 6, and 12 months postoperatively.

Results

Overall, 91 patients were included in the final analysis: 48 in the SVA group and 43 in the PqSA group. The two cohorts were not significantly different in demographic characteristics, including age, sex, injuries on the dominant side, type of injury, and fracture classification. We found significant differences between groups at 6 months in the mean PRWE (SVA: 12.3 ± 10.4, PqSA: 18.9 ± 14.11 points) and in the mean DASH score (SVA: 12.3 ± 11.9, PqSA: 19.3 ± 16.7 points), which favoured the SVA. We found no significant differences between groups in the MMWS or in the PRWE and DASH scores at any other time points.

Conclusions

This randomized comparative clinical trial failed to demonstrate that a volar plate osteosynthesis performed with a PqSA could improve the outcome, compared to the SVA, in patients with DRF.

Level of evidence

II

Trial registrationComparison of Two Volar Plating Systems for Distal Radius Fractures, ClinicalTrials.gov (NCT03474445), registered 22 March 2018, retrospectively registered,https://clinicaltrials.gov/ct2/show/NCT03474445?cond=radius&cntry=AT&draw=2&rank=1
Investigating 3D-printed disk compressing against skin for pain relief in intradermal infiltration anesthesia: a randomized controlled trial
Authors: Yu Jiong , Chen Wenxuan , Liu Qianyuan , Mi Jingyi
Published: April 2023

Background

Pain intensity may be varied during the needle advancing through different skin layers, injection into the intradermal layer may exclude mixed pain from deeper planes. This study aimed to investigate whether compressing a three-dimensional (3D)-printed disk against the skin may relieve pain associated with intradermal injection of local anesthetic which mimics the skin test procedure.

Methods

After institutional review board approval, 3D-printed disks with projections were designed for this study. Enrolled patients were randomized to receive either a disk compressing against the axillary skin during the intradermal injection of local anesthesia (compressing disk group) or an intradermal injection of local anesthesia without any compression (no compressing disk group). The primary outcomes were pain intensity (100-mm visual analog scale) and satisfaction (5-point Likert scale) as assessed by patients.

Results

Ninety patients with American Society of Anesthesiologists I–II physical status receiving intradermal local anesthesia prior to an ultrasound-guided axillary approach were included. Eighty-seven patients completed the study, with 44 and 43 patients in disk and no disk groups, respectively. Pain scores were significantly different (P < 0.001) in compressing disk (median, 10; IQR, 5–20) and no compressing disk (median, 30; IQR, 20–40) groups. The median satisfaction score was 5 in both groups. No complications occurred during follow-up.

Conclusion

Compressing a 3D-printed disk against the skin may reduce intradermal needle pain and offers an effective alternative for nerve block induction.
A method for calculating left ventricular end-diastolic volume as an index of left ventricular preload from the pre-ejection period, ejection time, blood pressure, and stroke volume: a prospective, observational study
Authors: Hayabuchi Mitsuyo , Matsuki Yuka , Kidoguchi Shuhei , Shigemi Kenji
Published: April 2023

Background

Left ventricular end-diastolic volume (EDV) is a major determinant of cardiac preload. However, its use in fluid management is limited by the lack of a simple means to measure it noninvasively. This study presents a new noninvasive method that was validated against simultaneously measured EDV by transthoracic echocardiography (TTE). The goal of this study was to develop and validate a method to estimate EDV in humans non-invasively from left ventricular arterial coupling (Ees/Ea) and stroke volume (SV).

Methods

Ees/Ea can be calculated non-invasively from the four parameters of end-systolic arterial pressure (Pes), diastolic arterial pressure (DBP), pre-ejection period (PEP), and ejection time (ET), using the approximation formula. In addition, if SV can be assessed, EDV can be calculated. Therefore, using a vascular screening system (VaSera 1000/1500, Fukuda Denshi Co., Ltd., Tokyo, Japan), blood pressure, PEP, and ET were measured noninvasively, the SV value was obtained using an ultrasound diagnostic device, EDV was calculated (EDV calc), and it was compared with EDV obtained using the ultrasound diagnostic device (EDV echo). The results are shown as mean ± standard deviation values.

Results

There were 48 healthy subjects (40 men, 8 women), with a mean age of 24 ± 4 years, mean height of 169 ± 7 cm, and mean weight of 65 ± 12 kg. EDV echo was 91 ± 16 ml, and EDV calc was 102 ± 21 ml. There was a significant correlation between EDV echo and EDV calc (R2 = 0.81, p < 0.01). A Bland–Altman plot between EDV echo and EDV calc showed that the bias and limits of agreement were –11.2 ml (-36.6, + 14.2 ml).

Conclusions

The results suggest that EDV can be measured non-invasively from Ees/Ea and SV. This suggests that continuous measurements may potentially work, using equipment available in the intraoperative setting.
Liraglutide treatment is associated with progression of coronary artery fibrous plaque: a prospective 1-year follow-up study in asymptomatic patients with type 2 diabetes
Authors: Heinsen Laurits Juhl , Pararajasingam Gokulan , Andersen Thomas Rueskov , Auscher Søren , Sheta Hussam Mahmoud , Precht Helle , Engdam Kalle Brunebjerg , Hangaard Jørgen , Lambrechtsen Jess , Knop Filip Krag , Egstrup Kenneth
Published: April 2023

Objective

The objective of this study was to assess the association between clinically indicated liraglutide treatment and coronary artery plaque progression during 1-year follow-up in asymptomatic diabetes.

Methods

Patients were divided into a group receiving liraglutide (Lira+) and a group not receiving liraglutide (Lira-). Coronary computed tomography angiography (CCTA) was performed to assess total atheroma volume (TAV) and subtypes of plaque volumes (dense calcium, fibrous, fibrous-fatty, and necrotic core plaque) and the plaque progression during one year follow-up.

Results

Fifty-five patients (27%) receiving liraglutide and 149 (73%) how did not were included. Changes in TAV during 1-year of follow-up were similar in the two groups (38 ± 180 (Lira+) vs. -1 ± 160 mm3 (Lira-), P = 0.13). A greater increase in fibrous plaque volume was seen in the Lira + vs. the Lira- group (34 ± 129 vs. -2 ± 101 mm3, P = 0.04). Changes over 1-year in the other plaque subtypes were similar in the two groups. Treatment duration of liraglutide was not associated with changes in TAV.

Conclusion

In patients with T2D without known prior coronary artery disease, liraglutide treatment was associated with a significant increase in coronary artery fibrous plaque volume during 1-year follow-up.
Validity and reliability studies of the Indonesian version of Atrial Fibrillation Severity Scale (AFSS)
Authors: Yamin Muhammad , Salim Simon , Setiati Siti , Pudianto Angga Pramudita , Zulmiyusrini Putri , Nasution Sally Aman , Wijaya Ika Prasetya , Rusdi Lusiani , Karim Birry , Santoso Raden Fidiaji Hiltono , Silitonga Friska Anggraini Helena
Published: April 2023

Background

In the atrial fibrillation (AF) population, worsened quality of life (QOL) has been reported even before complications occur. Symptom-based questionnaires can be used to evaluate AF treatment. The Atrial Fibrillation Severity Scale (AFSS) was first developed in Canada in English, which is not the main language in Indonesia. This study aims to test the reliability and validity of the Indonesian version of the Atrial Fibrillation Severity Scale (AFSS).

Methods

Translation of the AFSS from English to Indonesian was done using forward and backward translation. The final version was then validated with the Short Form-36 (SF-36) questionnaire, and a test-retest reliability study was done in a 7-14-day interval.

Results

An Indonesian version of AFSS was achieved and deemed acceptable by a panel of researchers. This version is reliable and valid, with Cronbach’s α of 0.819, Intraclass Correlation Coefficient (ICC) ranging from 0.803 to 0.975, and total score correlation ranging from 0.333 to 0.895. Pearson’s analysis of AFSS and SF-36 revealed that the total AF burden domain was poorly correlated with role limitations due to emotional problems (r:0.427; p < 0.01) and pain (r:0.495; p < 0.01). The symptom severity domain was poorly correlated with physical functioning (r:-0.335; p < 0.01), role limitations due to emotional problems (r:0.499; p < 0.01), pain (r:0.458; p < 0.01), and total SF-36 score (r:-0.361; p < 0.01). Total AFSS score was moderately correlated with role limitations due to emotional problems (r:0.516; p < 0.01) and pain (r:0.538; p < 0.01). The total AFSS score was poorly correlated with the European Heart Rhythm Association (EHRA) score (r:0.315; p < 0.01).

Conclusion

The Indonesian version of AFSS has good internal and external validity with good reliability.
Non-alcoholic fatty liver disease in hemochromatosis probands with iron overload and HFE p.C282Y/p.C282Y
Authors: Barton James C. , Barton J. Clayborn , Acton Ronald T.
Published: April 2023

Background

The aim of this study was to identify characteristics of non-alcoholic fatty liver disease (NAFLD) in adults with HFE p.C282Y/p.C282Y.

Methods

We retrospectively studied non-Hispanic white hemochromatosis probands with iron overload (serum ferritin (SF) > 300 µg/L (M), > 200 µg/L (F)) and p.C282Y/p.C282Y at non-screening diagnosis who did not report alcohol consumption > 14 g/d, have cirrhosis or other non-NAFLD liver disorders, use steatogenic medication, or have diagnoses of heritable disorders that increase NAFLD risk. We identified NAFLD-associated characteristics using univariate and multivariable analyses.

Results

There were 66 probands (31 men, 35 women), mean age 49 ± 14 (SD) y, of whom 16 (24.2%) had NAFLD. The following characteristics were higher in probands with NAFLD: median SF (1118 µg/L (range 259, 2663) vs. 567 µg/L (247, 2385); p = 0.0192); prevalence of elevated ALT/AST (alanine/aspartate aminotransferase) (43.8% vs. 10.0%; p = 0.0056); and prevalence of type 2 diabetes (T2DM) (31.3% vs. 10.0%; p = 0.0427). Mean age, sex, and prevalences of human leukocyte antigen-A*03 positivity, body mass index ≥ 30.0 kg/m2, hyperlipidemia, hypertension, and metabolic syndrome in probands with/without NAFLD did not differ significantly. Logistic regression on NAFLD using variables SF, elevated ALT/AST, and T2DM revealed: SF (p = 0.0318; odds ratio 1.0–1.0) and T2DM (p = 0.0342; 1.1–22.3). Median iron removed to achieve iron depletion (QFe) in probands with/without NAFLD did not differ significantly (3.6 g (1.4–7.2 g) vs. 2.8 g (0.7–11.0 g), respectively; p = 0.6862).

Conclusions

NAFLD in hemochromatosis probands with p.C282Y/p.C282Y is associated with higher median SF and greater T2DM prevalence, after adjustment for other factors. NAFLD does not influence QFe significantly.
The relationship between fall incidents and place of birth in residential aged care facilities: a retrospective longitudinal cohort study
Authors: Huang Guogui , Wabe Nasir , Raban Magdalena Z. , Seaman Karla L. , Silva Sandun Malpriya , Westbrook Johanna I.
Published: April 2023

Background

Older populations in residential aged care facilities (RACFs) in many immigrant-receiving countries are now being increasingly culturally and linguistically diverse (CALD). CALD populations require tailored social and health services to support their needs and improve health outcomes. Falls among the elderly are common and can have significant health and psychosocial consequences. There is some evidence to suggest that country of birth may influence risk of falls among older people, but such evidence has been scarce. This study aimed to determine the association between place of birth and the incidence of falls in RACFs.

Methods

Routinely collected incident data relating to 5,628 residents aged ≥ 65 years in 25 RACFs in Sydney, New South Wales, Australia were used. RACF residents were classified into two groups, Australia-born (N = 4,086) and overseas-born (N = 1,542). Overseas-born RACF residents were further categorised into two subgroups: overseas-English-speaking-country (N = 743) and overseas-non-English-speaking-country (N = 799). Outcomes measures were rate of all falls, injurious falls and falls requiring hospitalisation. Multilevel binary negative regression was used to examine the relationship between fall risk and place of birth.

Results

Incidence rates of all falls, injurious falls and falls requiring hospitalisation were 8.62, 3.72 and 1.07 incidents per 1,000 resident days, respectively, among the Australia-born RACF residents, but were higher at 11.02, 4.13 and 1.65, respectively, among the overseas-born RACF residents. Within those born overseas, fall rates were higher among the overseas-non-English-speaking-country-born residents (11.32, 4.29 and 2.22, respectively) than those overseas-English-speaking-country-born (10.70, 3.96 and 1.05, respectively). After controlling for confounders, the overseas-born RACF residents overall experienced a higher risk of all three types of falls (incidence rate ratios: [IRR] = 1.278, 95% confidence interval [CI] = 1.131, 1.443; injurious falls: IRR = 1.164 [95% CI = 1.013, 1.338]; falls requiring hospitalisation: IRR = 1.460 [95% CI = 1.199, 1.777]) than the Australia-born RACF residents. Among the overseas-born RACF residents, males, respite residents and those overseas-non-English-speaking-country-born experienced higher rates of falls.

Conclusions

Fall incidence in RACFs varies significantly by place of birth. With increasingly diverse RACF populations, fall intervention and prevention programs should consider cultural and linguistical backgrounds of RACF residents. Greater attention to understand the mechanisms for the differences by place of birth in risk profiles is warranted.
Bridging the gap, how interprofessional collaboration can support emergency preparedness for children with disabilities and their families: an exploratory qualitative study
Authors: Flanagan Shelby K. , Sterman Julia J. , Merighi Joseph R. , Batty Rachael
Published: April 2023

Background

Children with disabilities and their families are at higher risk during emergencies and disasters, which is often attributed to the lack of disability inclusion in emergency response as well as disparities in preparedness. This disparity speaks to a need for emergency preparedness that centers children with disabilities and their families. The purpose of this study was to elicit the perspectives of health professionals (nurses, occupational therapists, social workers), disability advocates, and public safety personnel (e.g., fire fighters, police officers, emergency management administrators) on what would enable these types of professionals to support family-centered emergency preparedness for families who care for children with disabilities. One goal of this research is to provide recommendations for practice and policy to improve safety outcomes for children with disabilities and their families in emergency situations.

Methods

This study consisted of 46 qualitative interviews with nurses, occupational therapists, social workers, public safety personnel, and advocacy organization representatives about their role in emergency preparedness for families of children with disabilities. Qualitative content analysis was used to identify themes from participants’ responses.

Results

Participants expressed interest in family-centered emergency preparedness, and stated that greater awareness, more education and training, increased networking between professions, and institutional support would enable their involvement.

Conclusions

These findings have implications for the importance of interprofessional collaboration in supporting family-centered emergency preparedness for families of children with disabilities. Stronger interprofessional networks would help overcome many of the barriers identified by participants, and advocacy groups appear to be well-positioned to bridge the gap between these professionals and their areas of expertise.
Socioeconomic inequalities in sport participation: pattern per sport and time trends – a repeated cross-sectional study
Authors: Richard Viviane , Piumatti Giovanni , Pullen Nick , Lorthe Elsa , Guessous Idris , Cantoreggi Nicola , Stringhini Silvia
Published: April 2023

Background

Sport participation is an important component of a healthy lifestyle and is known to be more common among privileged individuals. However, few studies examined socio-demographic patterns of participation by type of activity. This study aims at quantifying socio-economic inequalities in sport participation by sport type, and to analyse their trend over 15 years.

Methods

We used 2005–2019 data from the Bus Santé study, a yearly population-based cross-sectional survey of Geneva adults. Sport participation was defined as reporting at least one sporting activity over the previous week; educational level, household income and occupational position were used as indicators of socio-economic position. Socio-economic inequalities in sport participation, and their trend over time, were examined using the relative and slope indexes of inequality (RII/SII).

Results

Out of 7769 participants (50.8% women, mean age 46 years old), 60% participated in a sporting activity. Results showed that the higher the socioeconomic circumstances, the higher the sport participation (RII = 1.78; 95% Confidence Interval (CI): 1.64–1.92; SII = 0.33; 95%CI: 0.29–0.37 for education). Relative inequalities varied per sport e.g., 0.68 (95%CI: 0.44–1.07) for football and 4.25 (95%CI: 2.68–6.75) for tennis/badminton for education. Yearly absolute inequalities in sport participation tended to increase between 2005 and 2019 for household income, especially among women and older adults.

Conclusions

We observed strong socio-economic inequalities in sport participation in Geneva, with different magnitude depending on the sport type. These inequalities seemed to increase over the 2005–2019 period. Our results call for tailored measures to promote the participation of socially disadvantaged populations in sporting activities.
Place of death in France: impact of the first wave (March–May 2020) of the Covid-19 epidemic
Authors: Aldea-Ramos Néstor , Le Strat Yann , Fouillet Anne
Published: April 2023

Background

The Covid-19 epidemic entailed a major public health issue in France challenging the efficiency of the public health system. The distribution of deaths by place in France may have been affected by the epidemic and mitigation actions. This article presents mortality rate ratios by place of death in France during the first lockdown (17 March – 10 May, 2020) of the Covid-19 epidemic.

Methods

We considered five places of death recorded in death certificates. Deaths in 2020 were compared to deaths from 2015 to 2019. We employed quasi-Poisson regressions in order to stablish mortality rate ratios (MRR) during the Covid-19 epidemic, for all-cause and non-Covid-19 deaths. Analysis was conducted in Metropolitan France, and for three groups of regions defined according to the intensity of the first COVID-19 epidemic wave.

Results

A significant increase in all-cause and non-COVID-19 mortality at home was observed for all age groups. Also, an increase in mortality was observed in nursing homes, mostly due to Covid-19. Non-covid-19 mortality in public hospitals decreased significantly in all the country. These trends were mainly observed for cancers.

Conclusions

Overall mortality increased during the first wave of the Covid-19 epidemic. Most Covid-19 deaths took place in public hospitals and nursing homes at old ages. There was a displacement of non-Covid-19 mortality from public hospitals to home and nursing homes, particularly in the most highly exposed area. Among hypotheses to explain such a displacement, population avoidance of hospital care, or redeployment of hospital activity in this emergent context can be cited. Further analysis is needed to understand the reasons of the increase in non-Covid-19 mortality in nursing homes and at home.
What is the impact of national public expenditure and its allocation on neonatal and child mortality? A machine learning analysis
Authors: Garcia Leandro Pereira , Schneider Ione Jayce Ceola , de Oliveira Cesar , Traebert Eliane , Traebert Jefferson
Published: April 2023

Background

Understanding the impact of national public expenditure and its allocation on child mortality may help governments move towards target 3.2 proposed in the 2030 Agenda. The objective of this study was to estimate the impacts of governmental expenditures, total, on health, and on other sectors, on neonatal mortality and mortality of children aged between 28 days and five years.

Methods

This study has an ecological design with a population of 147 countries, with data between 2012 and 2019. Two steps were used: first, the Generalized Propensity Score of public spending was calculated; afterward, the Generalized Propensity Score was used to estimate the expenditures’ association with mortality rates. The primary outcomes were neonatal mortality rates (NeoRt) and mortality rates in children between 28 days and 5 years (NeoU5Rt).

Results

The 1% variation in Int$ Purchasing Power Parity (Int$ PPP) per capita in total public expenditures, expenditure in health, and in other sectors were associated with a variation of -0.635 (95% CI -1.176, -0.095), -2.17 (95% CI -3.051, -1.289) -0.632 (95% CI -1.169, -0.095) in NeoRt, respectively The same variation in public expenditures in sectors other than health, was associates with a variation of -1.772 (95% CI -6.219, -1.459) on NeoU5Rt. The results regarding the impact of total and health public spending on NeoU5Rt were not consistent.

Conclusion

Public investments impact mortality in children under 5 years of age. Likely, the allocation of expenditures between the health sector and the other social sectors will have different impacts on mortality between the NeoRt and the NeoU5Rt.
Single-cell sequencing analysis fibrosis provides insights into the pathobiological cell types and cytokines of radiation-induced pulmonary fibrosis
Authors: Sun Zhiyong , Lou Yutao , Hu Xiaoping , Song Feifeng , Zheng Xiaowei , Hu Ying , Ding Haiying , Zhang Yiwen , Huang Ping
Published: April 2023

Background

Radiotherapy is an essential treatment for chest cancer. Radiation-induced pulmonary fibrosis (RIPF) is an almost irreversible interstitial lung disease; however, its pathogenesis remains unclear.

Methods

We analyzed specific changes in cell populations and potential markers by using single-cell sequencing datasets from the Sequence Read Archive database, PERFORMED from control (0 Gy) and thoracic irradiated (20 Gy) mouse lungs at day 150 post-radiation. We performed IHC and ELISA on lung tissue and cells to validate the potential marker cytokines identified by the analysis on rat thoracic irradiated molds (30 Gy).

Results

Single-cell sequencing analysis showed changes in abundance across cell types and at the single-cell level, with B and T cells showing the most significant changes in abundance. And four cytokines, CCL5, ICAM1, PF4, and TNF, were significantly upregulated in lung tissues of RIPF rats and cell supernatants after ionizing radiation.

Conclusion

Cytokines CCL5, ICAM1, PF4, and TNF may play essential roles in radiation pulmonary fibrosis. They are potential targets for the treatment of radiation pulmonary fibrosis.
Long-term Outcomes of Sleeve Gastrectomy in Adolescent Patients: The Effect of Weight Loss in Younger Years to Outcomes in Adulthood
Authors: Al Sabah Salman , Haddad Eliana Al , Shuaibi Sameera , Qadhi Iman , Al-Saidan Lulwah , Khayat Ali
Published: April 2023

Background

Childhood obesity is associated with a variety of complications that see their light throughout adulthood. Due to the serious side effects of these morbidities, early intervention is essential. Laparoscopic sleeve gastrectomy (SG) is a safe and effective procedure for the treatment of obesity, however, the long-term data on its use in adolescents is lacking in the literature.

Methods

A retrospective analysis was conducted on all patients that underwent SG aged between 12 and 21 years old at a public hospital in Kuwait. Data on their weight and comorbidities was collected and analyzed.

Results

164 adolescent patients with a mean age of 19 underwent SG. 71% of the patients were female, while the mean weight at surgery was 128.6 kg, corresponding to a BMI of 47.8 Kg/m2. 32% of patients had a starting BMI more than 50, while 6.7% had a BMI over 60. The highest weight loss was achieved at 18 months post-op, corresponding to an EWL of 82.66%. On long-term follow-up, weight loss was maintained over the 13 years post-op. Obstructive sleep apnea resolved in 75% of the patients while hypertension persisted in the 2 patients who were diagnosed with it pre-op. 21 patients developed gastro-esophageal reflux disease 5.7 years post-op, while 20 patients were treated for gall bladder stones 4.4 years post-op.

Conclusion

It is of ample importance to tackle obesity during childhood before complications ensue later in life. Bariatric surgery, specifically SG, has been found to be an effective and safe weight loss tool, with sustained long-term weight maintenance and resolution of early comorbidities.
Risk factors of acute renal failure in patients with protective ileostomy after rectal cancer surgery
Authors: Omar Marghich , Tarek Anis , Abdeslam Bouassria , Amouzou Efoé-Ga Yawod Olivier , Abdelmalek Ousadden , Khalid Ait Taleb , Hicham El Bouhaddouti , Ouadii Mouaqit , Khalid Mazaz , Amine Rahili Mohamed , Bachir Benjelloun El , Emmanuel Benizri
Published: April 2023

Background

Despite the potential benefits of protective ileostomy in rectal surgery, diverting loop ileostomy construction is not free of specific medical consequences implying unplanned hospital readmissions. The most common reason for readmission in these patients is a dehydration with a prevalence of acute renal failure (ARF) of 20%. The objective of this study was to establish the predictive factors of ARF in patients with protective ileostomy after surgery for rectal cancer from a bicentric study.

Methods

we conducted a bicentric retrospective cohort study to identify the risk factor of ARF. This study was carried out on 277 patients operated for rectal cancer with necessity of a protective ileostomy during the study period. ARF was measured at any endpoint between ileostomy creation and reversal. Multiple logistic regressions were performed to identify independent risk factors.

Results

A total of 277 patients were included, and 18% (n = 50) were readmitted for ARF. In multivariate logistic regression, increased age (OR 1.02, p = 0.01), Psychiatric diseases (OR 4.33, p = 0.014), Angiotensin II receptor blockers (OR 5.15, p < 0.001) and the ASA score ≥ 3 (OR 9.5, p < 0.001) were significantly associated with ARF.

Conclusion

Acute renal failure is a prevalent and significant event in the postoperative course of ileostomy patients. Patients at risk should be risk stratified before discharge and targeted for intensive preventive measures.
Clinical characteristics of patients with metastatic castration-resistant prostate cancer after treatment with combined androgen blockade
Authors: Obinata Daisuke , Hashimoto Sho , Uchida Hideaki , Nakahara Ken , Yoshizawa Tsuyoshi , Mochida Junichi , Yamaguchi Kenya , Takahashi Satoru
Published: April 2023

Background

Although the second-generation androgen receptor inhibitors and taxanes have recently been recommended for the initial treatment of metastatic prostate cancer, bicalutamide and flutamide are still used in a large number of cases. Therefore, it is important to elucidate the clinical characteristics of these treated CRPC cases and their sensitivity to the currently used therapeutic agents. We aimed to examine the outcomes of metastatic castration-resistant prostate cancer following combined androgen blockade as initial therapy at our institution.

Methods

Ninety-four patients who developed metastatic castration-resistant prostate cancer after hormonal treatment with combined nonsteroidal androgen receptor antagonists and continuous androgen deprivation therapy between January 2015 and December 2020 were included. The presence of visceral metastases, duration of efficacy of each treatment, and overall survival after castration-resistant prostate cancer were evaluated.

Results

Patients with a longer duration of castration-resistant prostate cancer tended to have a longer response duration to subsequent enzalutamide administration (p = 0.003). Patients who achieved a 90% reduction in prostate-specific antigen levels with enzalutamide had a significantly better castration-resistant prostate cancer prognosis (p = 0.002). Meanwhile, those with visceral metastases at the time of castration-resistant prostate cancer diagnosis had a significantly poorer prognosis (p < 0.001). A positive correlation was observed between the treatment efficacy of abiraterone and taxanes for castration-resistant prostate cancer.

Conclusion

The study provides scientific evidence to support that patients with longer time to castration-resistant prostate cancer are more sensitive to enzalutamide, and the use of abiraterone between docetaxel and cabazitaxel has favorable prognostic impact. These findings provide instrumental evidence that can enable better treatment selection for prostate cancer patients.
COVID-19 related risk factors and their association with non-syndromic orofacial clefts in five Arab countries: a case-control study
Authors: Sabbagh Heba Jafar , Alamoudi Rana A. , Zeinalddin Mohammad , Al Bulushi Taimoor , Al-Batayneh Ola B. , AboulHassan Mamdouh A. , Koraitim Mohamed , Quritum Maryam , Almuqbali Buthaina , Alghamdi Sultan Musaad , Refahee Shaimaa Mohsen , Alkharafi Lateefa , Taqi Fatemah Fahad , Albassam Bader , Ayed Mariam , Embaireeg Alia , Alnahdi Raqiya , AlSharif Mona Talal , Abdulhameed Fatma Dawood , Aljohar Aziza Johar , Alrejaye Najla Sulaiman , Almalik Manal Ibrahim , Viswapurna P S , Al Halasa Tamara , El Tantawi Maha
Published: April 2023

Background

The environmental etiology of non-syndromic orofacial clefts (NSOFCs) is still under research. The aim of this case-control study is to assess COVID-19 associated factors that may be related to the risk of NSOFC in five Arab countries. These factors include COVID-19 infection, COVID-19 symptoms, family member or friends infected with COVID-19, stress, smoking, socioeconomic status and fear of COVID-19.

Methods

The study took place in governmental hospitals in five Arab countries from November 2020 to November 2021. Controls are matched in the month of delivery and site of recruitment. A clinical examination was carried out using LASHAL classification. Maternal exposure to medication, illnesses, supplementation, COVID-19 infection during their pregestation and 1st trimester periods were evaluated using a validated questionnaire. Maternal exposure to stress was assessed using the Life Events scale, fear of covid-19 scale, family member or friend affected with covid-19 infection, pregnancy planning and threatened abortion.

Results

The study recruited 1135 infants (386 NSOFC and 749 controls). Living in urban areas, maternal exposure to medications 3-months pregestation, maternal exposure to any of the prenatal life events and maternal fear of COVID-19 significantly increased the risk of having a child with NSOFC. On the other hand, mothers exposed to supplementation 3-months pregestation, mothers suspected of having COVID-19 infection, family members or friends testing positive with COVID-19 significantly decreased the risk of having a child with NSOFC.

Conclusions

This study suggests that NSOFC may be associated with maternal exposure to lifetime stress and COVID-19 fear in particular, with no direct effect of the COVID-19 infection itself. This highlights the importance of providing psychological support for expecting mothers during stressful events that affect populations such as the COVID-19 pandemic, in addition to the usual antenatal care.
The effect of empowerment program to reduce Sugar Consumption based on the Multi-Theory Model on Body Mass Index and abdominal obesity in Iranian women
Authors: Joveini Hamid , Sharifi Nader , Meymary Batool Kalate , Mehri Ali , Shahrabadi Reza , Rahmanian Vahid , Hashemian Masoumeh
Published: April 2023

Background

Considering the prevalence of overweight and abdominal obesity in middle-aged women, this study was conducted to determine the effect of empowerment program to reduce sugar consumption based on the Multi-Theory Model (MTM) on Body Mass Index (BMI) and abdominal obesity in women aged 30–60 in Joven.

Methods

This quasi-experimental study (include descriptive and interventional sections) was conducted on the Joven city, Khorasan Razavi province, Iran country from October 2020 to August 2021. Sampling was performed as a multi-stage cluster. First, a descriptive study was performed among 400 women, and then 128 people who were eligible to enter the interventional phase of the study were selected. In the control group, 63 people and in the intervention group, 65 people were eligible to enter the study. The educational intervention was performed in five 60-minute sessions for groups of 12 people. The instruments included the demographic questionnaire, sugar consumption checklist and researcher-made questionnaire based on MTM constructs. Before the intervention, one, three and six months after the intervention, the questionnaire was completed by both intervention and control groups also measurement of waist circumference and BMI were performed using standard instruments. The obtained data were analyzed by SPSS 17.

Results

After the educational intervention, there was a significant difference between the intervention and control groups in all the MTM constructs. Also, six months after the educational intervention, BMI, waist circumference and amount of consumption of sugary substances decreased significantly in the intervention group (p < 0.05).

Conclusion

Educational intervention based on the MTM can be effective in reducing the consumption of sugary substances and shaping behaviors related to healthy lifestyle in women.
Association of complication of type 2 diabetes mellitus with hemodynamics and exercise capacity in patients with heart failure with preserved ejection fraction: a case–control study in individuals aged 65–80 years
Authors: Sugita Yousuke , Ito Katsuhiko , Yoshioka Yui , Sakai Satoshi
Published: April 2023

Background

Type 2 diabetes mellitus (T2DM) is a frequently observed complication in patients with heart failure with preserved ejection fraction (HFpEF). Although a characteristic finding in such patients is a decrease in objective exercise capacity represented by peak oxygen uptake (peakVO2), exercise capacity and its predictors in HFpEF with T2DM remain not clearly understood. This case–control study aimed to investigate the association between exercise capacity and hemodynamics indicators and T2DM comorbidity in patients with HFpEF aged 65–80 years.

Methods

Ninety-nine stable outpatients with HFpEF and 50 age-and-sex-matched controls were enrolled. Patients with HFpEF were classified as HFpEF with T2DM (n = 51, median age, 76 years) or without T2DM (n = 48, median age, 76 years). The peakVO2 and ventilatory equivalent versus carbon dioxide output slope (VE vs VCO2 slope) were measured by cardiopulmonary exercise testing. The peak heart rate (HR) and peak stroke volume index (SI) were measured using impedance cardiography, and the estimated arteriovenous oxygen difference (peak a-vO2 diff) was calculated with Fick's equation. The obtained data were compared among the three groups using analysis of covariance adjusted for the β-blocker medication, presence or absence of sarcopenia, and hemoglobin levels in order to determine the T2DM effects on exercise capacity and hemodynamics in patients with HFpEF.

Results

In HFpEF with T2DM compared with HFpEF without T2DM and the controls, the prevalence of sarcopenia, chronotropic incompetence, and anemia were significantly higher (p < 0.001). The peakVO2 (Controls 23.5 vs. without T2DM 15.1 vs. with T2DM 11.6 mL/min/kg), peak HR (Controls 164 vs. without T2DM 132 vs. with T2DM 120 bpm/min), peak a-vO2 (Controls 13.1 vs without T2DM 10.6 vs with T2DM 8.9 mL/100 mL), and VE vs VCO2 slope (Controls 33.2 vs without T2DM 35.0 vs with T2DM 38.2) were significantly worsened in patients with HFpEF with T2DM (median, p < 0.001). There was no significant difference in peak SI among the three groups.

Conclusions

Our results suggested that comorbid T2DM in patients with HFpEF may reduce exercise capacity, HR response, peripheral oxygen extraction, and ventilation efficiency. These results may help identify cardiovascular phenotypes of HFpEF complicated with T2DM and intervention targets for improving exercise intolerance.
Intrathoracic liver herniation after pericardial fenestration – a case report
Authors: Dubovan Peter , Tomáš Miroslav , Pavlendová Jana , Aziri Ramadan , Makovník Marek , Dolník Jozef , Pinďák Daniel
Published: April 2023

Background

Pericardial effusions with its potential life threatening progression towards cardiac tamponade have to be often managed with surgical intervention. In our case study we describe a complication after a common surgical procedure which has only scarce literature mentions.

Case presentation

We present a case of a 22-year-old male patient who underwent subxiphoidal pericardial fenestration, due to symptomatic pericardial effusion with the Chamberlain procedure and biopsy of enlarged mediastinal lymph nodes. The histology report confirmed classical Hodgkin lymphoma and subsequently the patient underwent oncological treatment. Later on he was admitted to the hospital with dyspnoea and chest pain. The initial examinations stated a suspicion for intrathoracic tumour arising from the pericardium or liver. Further investigation revealed symptomatic intrathoracic liver herniation for which the patient underwent laparoscopic surgery with the mobilisation of liver and placement of a perforated Parietene™ composite mesh.

Conclusion

The purpose of this case report is to describe a rare complication after pericardial fenestration with its potential clinical implications.