bluuebunny/crossref_metadata_2025 huggingface dataset:
Increased serum level of high sensitivity troponin T even prior to surgery can predict adverse events during carotid endarterectomy
Authors: Nagy Bálint , Engblom Elettra , Matas Marijana , Maróti Péter , Kőszegi Tamás , Menyhei Gábor , Lantos János , Szabó Péter , Molnár Tihamér
Published: January 2021

Objectives

Perioperative stress affects the outcome of carotid endarterectomy performed under regional anesthesia. Here we aimed to explore the temporal profile of the stress marker cortisol and its relationship to high-sensitivity troponin-T, matrix metalloproteinase-9, tissue inhibitor of metalloproteinase-1, and S100B as an indicator of blood–brain barrier alteration in the systemic circulation.

Methods

Prospective part of the study: a total of 31 patients with significant carotid stenosis scheduled for carotid endarterectomy in regional anesthesia were enrolled. Follow-up part of the study and retrospective analysis of the outcome: each patient was followed up to five years and morbidity as well as mortality data were collected from an electronic database. Blood samples from each patient were serially taken; prior to surgery (T1), at the time of reperfusion (T2), 24 h (T3) and 72 h later postoperatively (T4), then the plasma concentration of each biomarker was measured. Besides, the clinical and surgical factors and perioperative adverse events were recorded.

Results

More positive correlations were found between: the early change of S100B (T2–T1) and late change in plasma cortisol level (T4–T3) (r = 0.403; p < 0.05); the early change of cortisol (T2–T1) and the early postoperative change of plasma matrix metalloproteinase-9 level (T3–T2) (r = 0.432; p = 0.01); the plasma concentration of tissue inhibitor of metalloproteinase-1 at 24 postoperative hours and the late change in plasma high-sensitivity troponin-T level (T4–T3) (r = 0.705; p < 0.001). Five patients needed an intraoperative shunt in whom the high-sensitivity troponin-T was elevated even prior to surgery, but definitive stroke never occurred. Plasma matrix metalloproteinase-9 concentration at reperfusion independently predicted the five-year mortality with a cut-off value of 456 ng/ml (sensitivity: 86%, specificity: 84%, area 0.887, p = 0.002).

Conclusions

A higher intraoperative change in S100B level reflecting carotid endarterectomy induced acute silent brain ischemia was associated with more pronounced post-operative change of cortisol. An early elevation of cortisol was found to be associated with a delayed increase of matrix metalloproteinase-9. Importantly, an increased high-sensitivity troponin-T even prior to carotid endarterectomy may predict clamp intolerance, and elevated matrix metalloproteinase-9 at reperfusion suggests a poor outcome.
Rethinking the notion of the high-performing education system: A Daoist response
Authors: Tan Charlene
Published: January 2021

This article challenges the dominant notion of the ‘high-performing education system’ and offers an alternative interpretation from a Daoist perspective. The paper highlights two salient characteristics of such a system: its ability to outperform other education systems in international large-scale assessments; and its status as a positive or negative ‘reference society’. It is contended that external standards are applied and imposed on educational systems across the globe, judging a system to be high- or low- performing, and consequently worthy of emulation or deserving of criticism. Three cardinal Daoist principles that are drawn from the Zhuangzi are expounded: a rejection of an external and oppressive dao (way); the emptying of one’s heart-mind; and an ethics of difference. A major implication is a celebration of a plurality of high performers and reference societies, each unique in its own dao but converging on mutual learning and appreciation.
The modulation of object-based attentional selection by facial expressions
Authors: Hu Saisai , Zhang Tingkang , Wang Yongchun , Song Fangxing , Zhao Jingjing , Wang Yonghui
Published: January 2021

Human beings can show preferentially attentional bias to different facial expressions. However, it is unclear whether the modulation of selective attention by facial expressions is based on the face itself (object-based attention) or its location (space-based attention). This study aimed to test this problem by using faces with different emotional valences in the two-rectangle paradigm across three experiments. We found that there was no significant difference in space-based effect among the positive, neutral, and negative conditions. However, the object-based effect was larger for the negative condition than for the neutral and positive ones, because of its slower reaction times for the invalid different-object trials. The results indicated that the object-based attentional selection was modulated by facial expressions, and that faces expressing negative emotions hamper the disengagement of attention from the whole object (i.e., the face), instead of the certain location. Our study can further add support to the attentional prioritisation hypothesis over attentional spreading hypothesis.
PCl3-mediated transesterification and aminolysis of tert-butyl esters via acid chloride formation
Authors: Wu Xiaofang , Zhou Lei , Li Fangshao , Xiao Jing
Published: January 2021

A PCl3-mediated conversion of tert-butyl esters into esters and amides in one-pot under air is developed. This novel protocol is highlighted by the synthesis of skeletons of bioactive molecules and gram-scale reactions. Mechanistic studies revealed that this transformation involves the formation of an acid chloride in situ, which is followed by reactions with alcohols or amines to afford the desired products.
Command, control and communication (C3) during the COVID-19 pandemic; adapting a military framework to crisis response in a tertiary UK critical care centre
Authors: Hutchings SD , Perry J , Mills A , Bartley F , Bartley M , Park CL
Published: January 2021

The COVID-19 pandemic of 2020 imposed significant strain on critical care services worldwide. The South London region experienced the largest numbers of critical care admissions in the United Kingdom with King’s College Hospital one of the busiest centres. This article outlines, using a descriptive narrative, the significant changes that occurred within King’s Critical Care as a result of the pandemic and the decisions that were taken to provide effective co-ordination and control to the expanded service, in part drawing on the military experience of two of the authors. The wider context of crisis and major incident leadership and management is also discussed contrasting different approaches used in civilian and military settings.
The association between surgery for carpal and cubital tunnel syndrome: analysis of incidence and risk factors within a geographical area
Authors: Johnson Nick A. , Darwin Oliver , Chasiouras Dimitrious , Selby Anna , Bainbridge Chris
Published: January 2021

The relationship between surgery for cubital tunnel and carpal tunnel syndrome was examined in this retrospective study. Between 1997 and 2018, data from consecutive patients who underwent carpal tunnel release (8352 patients), cubital tunnel release (1681 patients) or both procedures (692 patients) were analysed. The relative risk of undergoing cubital tunnel release in the population who had carpal tunnel release compared with those with no carpal tunnel release was 15.3 (male 20.3; female 12.5). The relative risk of undergoing carpal tunnel release in the population who had cubital tunnel release compared with those who did not undergo carpal tunnel release was 11.5 (male 16.5; female 9.1). Our study showed that men and women who undergo carpal tunnel release are over 20 times and 10 times more likely to have cubital tunnel release than those who did not undergo carpal tunnel release, respectively. These findings suggest that the two conditions may share a similar aetiology.

Level of evidence: IV
Polydactyly of the thumb: a modification of the Wassel-Flatt classification
Authors: Kim Jae Kwang , Al-Dhafer Bassmh Abdullah A , Shin Young Ho , Joo Hyun Seok
Published: January 2021

Although the Wassel-Flatt classification system has been widely used for radial polydactyly, it has some limitations. We modified the classification system by introducing the hypoplastic types and refining the definition of triphalangeal thumb without changing the main structure of the original classification system. A total of 200 consecutive duplicated thumbs of 183 patients treated surgically from June 2016 to June 2018 were included. We evaluated intra-observer and inter-observer reliability using the kappa coefficient in the modified and original Wassel-Flatt classification systems (three examiners evaluated each case twice, with an interval of 4 weeks). We also evaluated the surgical methods according to the types of deformity in the modified and original Wassel-Flatt classification systems. The modified Wassel-Flatt classification system had good inter-observer reliability and provides useful information for determining the surgical plan according to the types of radial polydactyly.

Level of evidence: IV
Scaphoid alignment in dorsally displaced distal radial fracture: a radiographic study
Authors: Johnson Nick A. , Dias Rachel , Dias Joseph J.
Published: January 2021

We aimed to establish if fracture reduction will correct scapholunate angle in dorsally displaced distal radial fractures and to identify the relationship with other measures of distal radial position and carpal alignment. Radiographs of 131 patients with a distal radial fracture and of 50 patients with normal radiographs were reviewed. We measured the scapholunate, radiolunate, capitolunate and metacarporadial angles on the lateral views. Linear regression modelling showed that all parameters measured were significantly associated with scapholunate angle on the first radiograph following injury. Scapholunate angle increased following distal radial fracture. Reduction of the fracture improved scapholunate angle, and this was most strongly related to change in dorsal tilt. We conclude that scaphoid flexion is likely to compensate for the dorsal tilt of the lunate as an attempt to counter its dorsal tilt, and to stabilize the wrist to maintain hand function.

Level of evidence: IV
Long-term effectiveness, safety and immunogenicity of the biosimilar SB2 in inflammatory bowel disease patients after switching from originator infliximab
Authors: Fischer Sarah , Cohnen Sarah , Klenske Entcho , Schmitt Heike , Vitali Francesco , Hirschmann Simon , Ramming Andreas , Zundler Sebastian , Rath Timo , Krebs Sabine , Dörje Frank , Uter Wolfgang , Nagore Daniel , Meyer Sebastian , Neurath Markus F. , Atreya Raja
Published: January 2021

Background:

Long-term data on inflammatory bowel disease (IBD) patients switched from originator to biosimilar infliximab SB2 are lacking. The aim of the conducted study was to investigate the effectiveness, immunogenicity and safety of a large prospectively followed-up IBD patient cohort that was entirely switched from originator infliximab to biosimilar SB2 treatment.

Methods:

This was a prospective, single-center, longitudinal, observational study describing clinical outcomes in IBD patients, over an 80-week period following switch from originator infliximab to SB2. Primary outcome measures were change of disease activity [Harvey-Bradshaw Index for Crohn’s disease (CD), partial Mayo Score for ulcerative colitis (UC)], C-reactive protein (CRP), infliximab trough levels (TLs), anti-drug antibodies (ADAs) and adverse events.

Results:

One hundred and forty-four IBD patients (94 CD, 50 UC), with median duration of 30.5 months’ (range 2–110) treatment with originator infliximab were evaluated. Mean change of disease activity compared with baseline was −0.9 (SD 2.6), –0.4 (2.2) and –0.4 (2.0) in CD; 0.1 (1.1), 0.1 (1.1) and 0.1 (1.3) in UC patients at weeks 24, 48 and 72. Median infliximab TLs were 6.2 µg/ml (interquartile range 2.3–12.2), 5.0 µg/ml (2.7–10.0), 6.6 µg/ml (3.5–12.4) and 5.1 µg/ml (2.7–10.9) at baseline and weeks 24, 48 and 72. Median CRP levels were within normal ranges throughout the study. After the switch, 9.8% of the patients developed new ADAs. Persistence on SB2 was 90% (95% confidence interval 0.85–0.95), 79% (0.72–0.86), 72% (0.64–0.80) at weeks 26, 52 and 78. Serious adverse events occurred in 11 patients.

Conclusion:

Over the individual patient follow-up of 80 weeks, switch to biosimilar SB2 from originator infliximab does not result in increased disease activity or changed immunogenicity patterns. The switch to SB2 was well tolerated.
Prevalence of multidrug-resistant bacteria colonisation among asylum seekers in western Switzerland
Authors: Kenfak-Foguena Alain , Nahimana Tessemo Immaculée , Bertelli Claire , Merz Laurent , Cometta Alain , Blanc Dominique , Senn Laurence , Petignat Christiane
Published: January 2021

The recent increase of migration to Europe represents a risk of increased the prevalence of multidrug-resistant (MDR) bacteria. We conducted a cross-sectional study among asylum seekers admitted at two hospitals in Switzerland.

Of the 59 patients included, 9 (14%) were colonised by a MDR bacteria, including 5 (8.5%) methicilin-resistant Staphylococcus aureus (MRSA) and 4 (6.8%) extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae. No patient carried both ESBL-producing bacteria and MRSA. None of the patients carried a vancomycin-resistant Enterococcus (VRE) or a carbapenem-resistant Enterobacteriaceae (CRE). Colonisation with MDR bacteria was not associated with hospitalisation abroad or recent arrival in Switzerland. Whole genome sequencing analysis allowed us to exclude transmission between patients.

The prevalence of MDR bacteria carriage is moderate among asylum seekers in western Switzerland. Further surveillance studies are necessary to determine if there is a risk of dissemination of pathogens into the local population.
The management of displaced humeral shaft fractures – A survey of UK shoulder and elbow surgeons
Authors: Ahad Abdul , Haque Aziz , Armstrong Alison , Modi Amit , Pandey Radhakant , Singh Harvinder Pal
Published: January 2021

Introduction

Indications for surgical management of displaced humeral shaft fractures are not clearly established, leading to variations in practice. The aim of this study was to determine the scale of these variations in the UK practice to help design a future national trial.

Methods

An online survey was sent to all surgeon members of British Elbow and Shoulder Society to help define humeral shaft fractures, fracture displacement as well as indications for operative and non-operative management. Patient and injury related factors considered important when managing humeral shaft fractures were investigated.

Results

The survey achieved a response rate of 32% (104/327). There was a lack of consensus on definitions for humeral shaft fractures and fracture displacement. A functional brace was the most common form of non-operative treatment (63%). Majority immobilise humeral shaft fractures for 4–8 weeks or until callus are visible (62%) with a similar number considering operative treatment if adequate signs of healing are not present at around 12–16 weeks. Around half of our respondents exclusively use plates with variations in preference of approach and a minority (2%) exclusively use intra-medullary nails.

Conclusion

The significant variation in management of displaced humeral shaft fractures in the UK suggests a clear need to evaluate clinical and cost effectiveness through a multi-centre randomised trial.
Outcomes and Healthcare Provider Perceptions of Real-Time Continuous Glucose Monitoring (rtCGM) in Patients With Diabetes and COVID-19 Admitted to the ICU
Authors: Chow Kenneth W. , Kelly Danielle J. , Rieff Mary C. , Skala Patricia A. , Kravets Igor , Charitou Marina M. , Morley Eric J. , Gupta Rajarsi , Miller Joshua D.
Published: January 2021

Objective:

We assessed the clinical utility and accuracy of real-time continuous glucose monitoring (rtCGM) (Dexcom G6) in managing diabetes patients with severe COVID-19 infection following admission to the intensive care unit (ICU).

Methods:

We present retrospective analysis of masked rtCGM in 30 patients with severe COVID-19. rtCGM was used during the first 24 hours for comparison with arterial-line point of care (POC) values, where clinicians utilized rtCGM data to adjust insulin therapy in patients if rtCGM values were within 20% of point-of-care (POC) values during the masked period. An investigator-developed survey was administered to assess nursing staff ( n = 66) perceptions regarding the use of rtCGM in the ICU.

Results:

rtCGM data were used to adjust insulin therapy in 30 patients. Discordance between rtCGM and POC glucose values were observed in 11 patients but the differences were not considered clinically significant. Mean sensor glucose decreased from 235.7 ± 42.1 mg/dL (13.1 ± 2.1 mmol/L) to 202.7 ± 37.6 mg/dL (11.1 ± 2.1 mmol/L) with rtCGM management. Improvements in mean sensor glucose were observed in 77% of patients ( n = 23) with concomitant reductions in daily POC measurements in 50% of patients ( n = 15) with rtCGM management. The majority (63%) of nurses reported that rtCGM was helpful for improving care for patients with diabetes patients during the COVID-19 pandemic, and 49% indicated that rtCGM reduced their use of personal protective equipment (PPE).

Conclusions:

Our findings provide a strong rationale to increase clinician awareness for the adoption and implementation of rtCGM systems in the ICU. Additional studies are needed to further understand the utility of rtCGM in critically ill patients and other clinical care settings.
Transforming AADE7 for Use in an Evaluation Framework for Health Information Technology in Diabetes Mellitus
Authors: Kim Min Soon , Khan Uzma , Boren Suzanne A. , Narindrarangkura Ploypun , Ye Qing , Simoes Eduardo J.
Published: January 2021

There is no validated framework to evaluate health information technology (HIT) for diabetes self-management education and support (DSMES). AADE7 Self-Care Behaviors is a patient-centered DSMES designed by the American Association of Diabetes Educators (AADE). We developed a codebook based on the AADE7 Self-Care Behaviors principles as an evaluation framework. In this commentary, we demonstrate the real-life applications of this codebook through three diabetes research studies. The first study analyzed features of mobile diabetes applications. The second study evaluated provider documentation patterns in electronic health records (EHRs) to deliver ongoing patient-centered DSMES. The third study analyzed feedback messages from diabetes apps. We found that this codebook, based on AADE7, can be instrumental as a framework for research, as well as real-life use in HIT for DSMES principles.
Walking in Your Culture: A Study of Culturally Sensitive Outdoor Walking Space for Chinese Elderly Immigrants
Authors: Liu Pai , Powers Matthew , Dye Cheryl , Vincent Ellen , Padua Mary
Published: January 2021

Objectives:

This was a study conducted in Atlanta, GA, in the United States with Chinese elderly immigrants, examining the relationship between visual preference and motivation to walk in a particular outdoor space.

Backgrounds:

Outdoor walking promotes the well-being of older adults. However, their declined body functions impact their motivation to walk outside. For elderly immigrants living in a country with different cultural backgrounds from their homelands, it is important to find the ways to enhance their motivation of outdoor walking.

Method:

Visual preference survey was conducted to assess preferences of first-generation Chinese elderly immigrants attending a care facility setting. Preferences included Chinese classical walking spaces or American modern walking spaces. The data were interpreted using descriptive statistics and factorial experiment analysis.

Results:

A total of 95 Chinese elderly immigrants gave valid responses to the visual preference survey. Survey results revealed that respondents had a high preference for Chinese classical walking spaces even though they had an average time of 26 years as a U.S. resident. Although the functions and purposes of the walking spaces caused safety and comfort concerns, the interaction effects of design style, design function, and design purpose illustrated that Chinese classical style had high effectiveness to promote outdoor walking of Chinese elderly immigrants.

Conclusions:

These results support the significance of culturally sensitive care environments in promoting outdoor walking for elderly Chinese immigrants. It also indicates that spaces designed with an assigned cultural style had higher attractiveness to older adults from the same assigned cultural background.
Two-Year Outcomes of Posterior Ankle Arthroscopy: A Case Series
Authors: Rui Xiang Toh , Zhen Ning Yeo , Oon Thien Kevin Koo
Published: January 2021

The aim of this study was to investigate the outcomes and complications after posterior ankle arthroscopy for the treatment of posterior ankle impingement syndrome, in a local population with a single surgeon series. Two-portal posterior ankle or hindfoot arthroscopy is an alternative option to open surgery in cases of posterior ankle impingement, that showed similar results but with less morbidity and faster recovery. There has been increasing interest in minimally invasive surgical techniques. Indications include extra- and intra-articular conditions and range from bony, cartilaginous to soft tissue pathology. Posterior ankle arthroscopy has been shown to be a good option in cases that are refractory to a period of conservative therapy. Posterior ankle arthroscopy also has known complications of sural nerve damage laterally and neurovascular bundle injury medially and also a steep learning curve that has been studied in the context of os trigonum excision. There have been few or no studies on the local Singaporean population and this article seeks to describe the various indications, results, and complications in the local Singaporean population by a single surgeon.

Levels of Evidence: Level IV: Case series
Utilizing Academic–Community Partnerships With Nursing Students to Improve Hand Hygiene in Elementary Students to Reduce Transmission of COVID-19
Authors: Perry Julie , McClure Natasha , Palmer Rebecca , Neal Jeremy L.
Published: January 2021

Coronavirus disease 2019 (COVID-19) has raised awareness about the vital role school nurses have in improving the overall health of children. School nurses provide health promotion within schools, yet over 60% of schools have only a part-time nurse or no nurse. Nursing students may be valuable partners for health promotion and academic–community partnerships may be mutually beneficial to schools of nursing and local schools. Using a nursing student team to teach hand hygiene while school health staff were present provided an opportunity for hands-on training to help the staff master curriculum content and ensure competency. This article describes a collaborative partnership initiative that expanded access to health promotion education in schools to increase knowledge about reducing the spread of infectious disease, such as COVID-19, while providing valuable clinical experiences for nursing students.
The Impact of Payment Reform on Pediatric Craniofacial Fracture Care in Maryland
Authors: Yesantharao Pooja S. , Jenny Hillary E. , Lopez Joseph , Chen Jonlin , Lopez Christopher D. , Aliu Oluseyi , Redett Richard J. , Yang Robin , Steinberg Jordan P.
Published: January 2021

Study Design:

Retrospective, quasi-experimental difference-in-differences investigation.

Objective:

Pediatric craniofacial fractures are often associated with substantial morbidity and consumption of healthcare resources. Maryland’s All Payer Model (APM) represents a unique case study of the health economics surrounding pediatric craniofacial fractures. The APM implemented global hospital budgets to disincentivize low-value care and encourage preventive, community-based efforts. The objective of this study was to investigate how this reform has impacted pediatric craniofacial fracture care in Maryland.

Methods:

Children (≤18 years) receiving inpatient craniofacial fracture-related care in Maryland between January, 2009 through December, 2016 were investigated. New Jersey was used for comparison. Data were abstracted from the Kid’s Inpatient Database (Healthcare Cost and Utilization Project).

Results:

Between 2009–2016, 3,655 pediatric patients received inpatient care for craniofacial fractures in Maryland and New Jersey. Prior to APM implementation, around 20% of Maryland patients received care outside of urban teaching hospitals. After APM implementation, less than 6% of patients received care outside of urban teaching hospitals ( p = 0.003). Implementation of the APM in Maryland also resulted in fewer pediatric craniofacial fracture admissions than New Jersey, though this only reached borderline significance (adjusted difference-in-differences estimate: −1.1 fewer admissions, 95% confidence interval: −2.1 to 0.0, p = 0.05). Inpatient costs for pediatric craniofacial care and mean did not change post-APM.

Conclusions:

Maryland’s APM consolidated pediatric craniofacial fracture inpatient care at urban, teaching hospitals. Inpatient costs and lengths of stay did not change after policy implementation, but overall admission rates decreased. Such considerations are important when considering national expansion of global hospital budgeting.
The Authoritarian Dynamic During the COVID-19 Pandemic: Effects on Nationalism and Anti-Immigrant Sentiment
Authors: Hartman Todd K. , Stocks Thomas V. A. , McKay Ryan , Gibson-Miller Jilly , Levita Liat , Martinez Anton P. , Mason Liam , McBride Orla , Murphy Jamie , Shevlin Mark , Bennett Kate M. , Hyland Philip , Karatzias Thanos , Vallières Frédérique , Bentall Richard P.
Published: January 2021

Research has demonstrated that situational factors such as perceived threats to the social order activate latent authoritarianism. The deadly COVID-19 pandemic presents a rare opportunity to test whether existential threat stemming from an indiscriminate virus moderates the relationship between authoritarianism and political attitudes toward the nation and out-groups. Using data from two large nationally representative samples of adults in the United Kingdom ( N = 2,025) and Republic of Ireland ( N = 1,041) collected during the initial phases of strict lockdown measures in both countries, we find that the associations between right-wing authoritarianism (RWA) and (1) nationalism and (2) anti-immigrant attitudes are conditional on levels of perceived threat. As anxiety about the COVID-19 pandemic increases, so too does the effect of RWA on those political outcomes. Thus, it appears that existential threats to humanity from the COVID-19 pandemic moderate expressions of authoritarianism in society.
The Social Ecology of COVID-19 Cases and Deaths in New York City: The Role of Walkability, Wealth, and Race
Authors: Oishi Shigehiro , Cha Youngjae , Schimmack Ulrich
Published: January 2021

The present research examined the zip code level (177 zip codes) prevalence of and deaths associated with COVID-19 in New York City as of May 22, 2020. Walkable zip codes had consistently lower prevalence of ( r = −.49) and deaths ( r = −.15) associated with COVID-19. The mediation analysis showed that the degree of reduction in actual geographical mobility during the lockdown (measured by smartphone GIS data) accounted for geographical variations in the number of confirmed cases and deaths. Residents in wealthy zip codes and walkable zip codes were able to limit geographical mobility, whereas residents in poor zip codes and Black and Hispanic dominant zip codes were not. Finally, the spatial lag regression analysis showed that walkability was a robust predictor of zip code–level prevalence of and deaths associated with COVID-19. Overall, walkability seems to have provided protection against the spread of COVID-19.
Emotion Recognition Ability as a Predictor of Well-Being During the COVID-19 Pandemic
Authors: Schlegel Katja , Gugelberg Helene M. von , Makowski Lisa M. , Gubler Danièle A. , Troche Stefan J.
Published: January 2021

This study examined emotion recognition ability (ERA) as a predictor of positive and negative affect in two Australian and one German-speaking samples (total N = 469) during the first 2 weeks of major public life restrictions in the COVID-19 pandemic in March/April 2020. Individuals with higher ERA did not report more positive affect, but they felt less burdened and reported less negative affect. This association was fully mediated by lower COVID-19-related media consumption and less negative affect after reading an eyewitness report from an Italian city with a high COVID-19 death toll. However, higher ERA was also related to arguing more with close others. For low-to-medium ERA, an adaptive cognitive emotion regulation style predicted lower media consumption and for medium-to-high ERA, a maladaptive regulation style marginally increased the perceived likelihood of experiencing a similar situation as in Italy, suggesting that regulation style may moderate the ERA–affect relationship.
Discontinuation of the renin–angiotensin system inhibitors improves erythropoiesis in patients with lower-risk myelodysplastic syndromes
Authors: Pavlidis George , Papageorgiou Sotirios G. , Bazani Efthimia , Bouchla Anthi , Glezou Eirini , Gkontopoulos Konstantinos , Thomopoulos Thomas , Pappa Vasiliki , Vlahakos Demetrios V.
Published: January 2021

Renin–angiotensin system (RAS) blockade by angiotensin-converting enzyme inhibitors (ACEis) or angiotensin-receptor blockers (ARBs) has been related to anemia in various situations. We aimed to investigate whether discontinuation of RAS inhibitors improves erythropoiesis in patients with lower-risk myelodysplastic syndromes (LR-MDSs). Seventy-four patients with LR-MDS were divided into three groups matched for gender and age. Group A consisted of 20 hypertensive patients who discontinued RAS inhibitors and received alternative medications. Group B consisted of 26 patients who continued to receive ACEi/ARB and Group C included 28 patients (50% hypertensive) never exposed to ACEi/ARB. Half of the patients in each group were under treatment with recombinant human erythropoietin (rHuEPO). Data were collected at baseline and after 3, 6 and 12 months. Group A showed a significant increase in hemoglobin from 10.4 ± 1g/dL at baseline to 12.6 ± 1.2 g/dL after 12 months ( p = 0.035) and in hematocrit (31.4 ± 3% versus 37.9 ± 4%, p = 0.002). Incident anemia decreased from 100% at baseline to 60% at 12 months ( p = 0.043) despite a concomitant dose reduction in rHuEPO by 18% ( p = 0.035). No changes in hemoglobin and hematocrit were observed in both Group B and Group C. In the subset of patients not treated with rHuEPO, improvement of erythropoiesis was found only in Group A, as measured by changes in hemoglobin (11.5 ± 1 g/dL versus 12.4 ± 1.3 g/dL, p = 0.041) and hematocrit (34.5 ± 3% versus 37.1 ± 4%, p = 0.038) after 12 months. In contrast, Group B and Group C decreased hemoglobin and hematocrit after 12 months ( p < 0.05). In conclusion, discontinuation of ACEi/ARB in LR-MDS patients is followed by a significant recovery of erythropoiesis after 12 months.
Should metformin remain the first-line therapy for treatment of type 2 diabetes?
Authors: Baker Chelsea , Retzik-Stahr Cimmaron , Singh Vatsala , Plomondon Renee , Anderson Victoria , Rasouli Neda
Published: January 2021

Metformin is a biguanide that is used as first-line treatment of type 2 diabetes mellitus and is effective as monotherapy and in combination with other glucose-lowering medications. It is generally well-tolerated with minimal side effects and is affordable. Although the safety and efficacy of metformin have been well-established, there is discussion regarding whether metformin should continue to be the first choice for therapy as other anti-hyperglycemic medications exhibit additional advantages in certain populations. Despite a long-standing history of metformin use, there are limited cardiovascular outcomes data for metformin. Furthermore, the available studies fail to provide strong evidence due to either small sample size or short duration. Recent data from glucagon-like peptide-1 receptor agonist and sodium-glucose cotransporter-2 inhibitor cardiovascular and renal outcomes trials demonstrated additional protection from diabetes complications for some high-risk patients, which has impacted the guidelines for diabetes management. Post-hoc analyses comparing hazard ratios for participants taking metformin at baseline versus not taking metformin are inconclusive for these two groups. There are no data to suggest that metformin should not be initiated soon after the diagnosis of diabetes. Furthermore, the initiation of newer glycemic-lowering medications with cardiovascular benefits should be considered in high-risk patients regardless of glycemic control or target HbA1c. However, cost remains a major factor in determining appropriate treatment.
Managing everyday communication with strong, weak, and latent ties via WeChat: Availability, visibility, and reciprocal engagement
Authors: Zeng Skovhøj Fiona Huijie
Published: January 2021

This article examines how people utilize WeChat, the most popular multi-purpose mobile app in China, to manage their everyday communication with different social ties. Since Granovetter popularized the idea of social ties by noting the strength of weak ties, a long list of studies has extended social ties theory by following the quantification tradition, for instance, quantitatively examining the different functionalities of strong and weak ties. However, many aspects of social ties cannot be easily quantified. In this vein, this study, being a qualitative network analysis, offers a communicative conception and categorization of social ties. It is based on data from 39 distinctive Chinese respondents, collected through an interview-diary-interview method. WeChat, being more than a social media app, affords new technologies (e.g., mobile payment and virtual red packets), enabling users to manage and maintain their social networks in new and alternative ways. The empirical findings suggest that Chinese respondents differentiate between strong, weak, and latent ties, and they articulate three communication strategies: managing availability, managing visibility, and managing reciprocal engagement. Based on the empirical evidence, this article discusses further implications with reference to the concepts of imagined audiences and commercialization of social relations. Moreover, this study contributes to social ties theory by providing empirical insights into its cultural specifications in the context of China, such as the emphasis on the principle of reciprocity in guanxi culture.
Eternal sunshine of the spotless mind: Light and luminous being in Islamic theology
Authors: Lange Christian
Published: January 2021

For theologians, to conceive of God in terms of light has some undeniable advantages, allowing a middle-of-the road position between the two extremes of thinking about God in terms of a purely disembodied, unfathomable, unsensible being, and of crediting Him with a body, possibly even a human(oid) body. This paper first reviews the reasons why God, in early medieval Islam, was never fully theorized in terms of light. It then proceeds to discuss light-related narratives in two major, late-medieval compilations of hadiths about the afterlife, by al-Suyuti (Ash’ari, Egypt, d. 1505) and al-Majlisi (Persia, d. 1699), suggesting that eschatology was the area in which God’s light continued to shine in Islam, and the backdoor through which a theology of light, in the thought of al-Suhrawardi (Syria, d. 1191) and his followers, made a triumphant re-entry into Islamic thought.
Optical coherence tomography significance in managing complex neurofibromatosis 2-related papilledema: Report of a case
Authors: Maria Bacci Giacomo , Giordano Flavio , Sardi Iacopo , Evans Gareth , Pathmanaban Omar , Fonte Carla , Trabalzini Franco , Nappini Sergio , Mura Regina , Caputo Roberto
Published: January 2021

This case describes the strong utility of optical coherence tomography in multidisciplinary management of a complex case of type 2 neurofibromatosis.
Splenic flexure colonic lipoma causing intussusception
Authors: Moussally Moustafa , Mokalled Imad , Jamali Faek , Khalife Mohamad J
Published: January 2021

Lesson

Colonic lipomas are rare benign tumours that are usually asymptomatic. However, giant colonic lipomas tend to be symptomatic and can occasionally result in intussusception and intermittent colonic obstruction. As adult intussusception is an uncommon occurrence, the identification of the underlying aetiology is essential due to its high association with malignancy. Computed Tomography remains the tool of choice for the diagnosis of colonic lipomas. Surgical excision remains the mainstay treatment of giant symptomatic colonic lipomas. We hereby present the case of a 51-year-old male found to have a colonic lipoma causing recurrent intussusception. We discuss the approach, diagnostic tools and available treatment modalities for colonic lipomas. We also provide a brief literature review of intussusception in adults.
Spontaneous dissolution of a cyst located within the septum pellucidum in a patient with sarcoidosis: a case report
Authors: Loft Martina Kastrup , Rafaelsen Søren Rafael , Pedersen Malene Roland V
Published: January 2021

Sarcoidosis is a granulomatous multisystem disease of unknown etiology. Typically, the disease affects the lungs, causing enlargement of the mediastinal lymph nodes, but other organs can be affected. Neurosarcoidosis is reported in 5–10% of the patients. This case represents a 39-year-old male patient diagnosed with lung sarcoidosis. Due to neurological symptoms, a contrast-enhanced cerebral magnetic resonance imaging was performed. Neurosarcoidosis was presented with meningeal enhancement adjacent to a cyst located within the cavum septum pellucidum. The cyst dissolved spontaneously within six months. The finding of a cyst located within the septum pellucidum is rare.
Superspreaders: A Lurking Danger in the Community
Authors: Mohindra Ritin , Ghai Arushi , Brar Rinnie , Khandelwal Neha , Biswal Manisha , Suri Vikas , Goyal Kapil , Singh Mini P. , Bhalla Ashish , Rana Kirtan , Lakshmi P. V. M.
Published: January 2021

A “superspreader” refers to an unusually contagious organism infected with a disease. With respect to a human borne illnesses, a superspreader is someone who is more likely to infect other humans when compared to a typically infected person. The existence of human superspreaders is deeply entrenched in history; the most famous case being that of Typhoid Mary. Through contact tracing, epidemiologists have identified human superspreaders in measles, tuberculosis, rubella, monkeypox, smallpox, Ebola hemorrhagic fever, and SARS. The recent outbreak of Coronavirus disease (COVID-19) has shifted the focus back on the superspreaders. We herein present a case report of a COVID-19 superspreader with a hitherto unusually high number of infected contacts. The index case was a 33 year old male who resided in a low income settlement comprising of rehabilitated slum dwellers and worked as a healthcare worker (HCW) in a tertiary care hospital and had tested positive for COVID-19.On contact tracing, he had a total of 125 contacts, of which 49 COVID-19 infections had direct or indirect contact with the index case, qualifying him as a “superspreader.” This propagated infection led to an outbreak in the community. Contact tracing, testing and isolation of such superspreaders from the other members of the community is essential to stop the spread of this disease and contain the COVID-19 pandemic.
Rural Emergency Medical Service Providers Perceptions on the Causes of and Solutions to the Opioid Crisis: A Qualitative Assessment
Authors: Blue Heather , Dahly Ashley , Chhen Susan , Lee Julie , Shadiow Adam , Van Deelen Anna G. , Palombi Laura C.
Published: January 2021

Introduction:

The continuing opioid crisis poses unique challenges to remote and often under-resourced rural communities. Emergency medical service (EMS) providers serve a critical role in responding to opioid overdose for individuals living in rural or remote areas who experience opioid overdoses. They are often first at the scene of an overdose and are sometimes the only health care provider in contact with an overdose patient who either did not survive or refused additional care. As such, EMS providers have valuable perspectives to share on the causes and consequences of the opioid crisis in rural communities.

Methods:

EMS providers attending a statewide EMS conference serving those from greater Minnesota and surrounding states were invited to take a 2-question survey asking them to reflect upon what they believed to be the causes of the opioid crisis and what they saw as the solutions to the opioid crisis. Results were coded and categorized using a Consensual Qualitative Research approach.

Results:

EMS providers’ perceptions on causes of the opioid crisis were categorized into 5 main domains: overprescribing, ease of access, socioeconomic vulnerability, mental health concerns, and lack of resources and education. Responses focused on solutions to address the opioid crisis were categorized into 5 main domains: need for increased education, enhanced opioid oversight, increased access to treatment programs, alternative therapies for pain management, and addressing socioeconomic vulnerabilities.

Conclusion:

Along with the recognition that the opioid crisis was at least partially caused by overprescribing, rural EMS providers who participated in this study recognized the critical role of social determinants of health in perpetuating opioid-related harm. Participants in this study reported that education and increased access to treatment facilities and appropriate pain management, along with recognition of the role of social determinants of health in opioid dependency, were necessary steps to address the opioid crisis.
The Clinical Impact of Fracture Liaison Services: A Systematic Review
Authors: Barton David W. , Piple Amit S. , Smith C. Taylor , Moskal Sterling A. , Carmouche Jonathan J.
Published: January 2021

Introduction:

A fracture liaison service (FLS) is a coordinated system of care that streamlines osteoporosis management in the orthopaedic setting and can serve as an effective form of secondary preventative care in these patients. The present work reviews the available evidence regarding the impact of fracture liaison services on clinical outcomes.

Methods:

The literature was reviewed for studies reporting changes in the rates of bone mineral density scanning (DXA), antiresorptive therapy, new minimum trauma fractures, and mortality between cohorts with access to an FLS or not. Studies including intention to treat level data were retained. A Medline search for “fracture liaison” OR “secondary fracture prevention” produced 146 results, 98 were excluded based on the abstract, 38 were excluded based on full-text review. Ten level III studies encompassing 48,045 patients were included, of which 5 studies encompassing 7,086 were analyzed. Odds-ratios for DXA and anti-osteoporosis pharmacotherapy rates were calculated from data. Fixed and random effects analyses were performed using the Mantel-Haenszel method.

Results:

Four studies reported, on average, a 6-fold improvement in DXA scanning rates (Figure 1). Six studies reported, on average, a 3-fold improvement in antiresorptive therapy rates (Figure 2). Four large studies reported significant reductions in the rate of new fractures using time-dependent Cox proportional hazards models at 12 months (HR = 0.84, 0.95), 24 months (HR = 0.44, 0.65), and 36 months (HR = 0.67). Five large studies reported mortality improvements using time-dependent Cox proportional hazards models at 12 months (HR = 0.88, 0.84, 0.81) and 24 months (HR = 0.65, 0.67).

Conclusions:

The findings suggest that fracture liaison services improve rates of DXA scanning and antiresorptive therapy as well as reductions in the rates of new fractures and mortality among patients seen following minimum trauma fractures across many time points.
Characteristics and Outcomes of Hip Fracture Patients Hospitalized in an Orthogeriatric Unit Versus an Orthopedic Department: A Retrospective Cohort Study
Authors: Bugaevsky Yulia , Levy Yochai , Hershkovitz Avital , Ocheretny Irena , Nissenholtz Adaya , Cooper Lisa , Weissman Yaara Leibovici , Weiss Avraham , Velkes Steven , Beloosesky Yichayaou
Published: January 2021

Introduction:

Hip fractures are a significant health risk in older adults and a major cause of morbidity, functional decline and mortality. Our aim was to compare clinical outcomes of older patients hospitalized in an ortho-geriatric (OG) unit to those hospitalized in an orthopedic department (OD) for surgical treatment of a hip fracture.

Methods:

A retrospective cohort study of hip fractured patients hospitalized between 2015-2016 in a single tertiary university-affiliated medical center. Included were patients aged 65 and older who had undergone hip fracture surgery and were admitted to either a geriatric or orthopedic ward.

Results:

441 patients met the inclusion criteria (195 in the OG unit, 246 in the OD); 257 were transferred to an affiliated geriatric center hospital (107 from the OG unit and 127 from the OD) for rehabilitation. Patients in the OG unit were older, more cognitively and functionally impaired and with more comorbidities. The 1-year mortality rate was significantly lower in the OD group (OR 0.32, CI 95% 0.19-0.53, p < 0.001), however, after propensity matching, the 30-day and 1 year mortality rates were similar in both groups. No difference was found in the rehabilitation length of stay between the groups. The functional independence measure improvement was similar in both groups, with a non-significant trend toward better functional improvement among OG unit patients.

Conclusions:

Despite the higher complexity of patients, worse baseline functional capacity in the OG unit, improvement after rehabilitation was similar in both groups. These results demonstrate the advantages of the OG unit in treating and stabilizing frail older adults, thus maximizing their chances for a successful recovery after hip fractures.

Level of Evidence:

Level IV
Social Workers’ Attitudes on Social Justice in Taiwan
Authors: Chen Hsin-Yi , Tang I-Chen
Published: January 2021

As social justice is an essential social work concept, this study examined the factors that influenced the attitudes of social workers in Taiwan toward social justice through an analysis of Social Justice Scale-TW (SJS-TW) questionnaires conducted on a sample of 276 social workers. It was found that years of work experience, human rights training, and past participation in social protests were important moderating factors of supporting social justice. It was concluded that including a human rights–based approach in social work education has the potential to increase the social workers’ knowledge of and actions in support of social justice.
Money Multiplier Bias Due to Informal Sector: An Extension of the Existing Money Multiplier
Authors: Mughal Khurrum S. , Schneider Friedrich G. , Aslam Faheem , Tahir Alishba
Published: January 2021

To demonstrate the impact of informal economy on the official money multiplier in currency supply, we present an extension of the basic money multiplier model. The influence of economic policies may differ if they are based only on official statistics without considering the informal sector. Since most of the activities in informal sector are hidden from authorities, it is widely assumed that these activities are based on cash transactions, a part of total currency that cannot be attracted towards deposits due to the holder’s fear of prosecution and taxation, etc. Therefore, it is expected that such currency holdings can give biased results by playing a role in the money multiplier, a phenomenon that is usually ignored while attempting to alter money supply. The article also indicates that because of informal sector, the currency deposit ratio in the money multiplier is smaller than expected (depending on size of the informal sector), leading to a larger multiplier effect.

JEL Classifications: E26, E51, O17