bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychotherapy and Art Therapy: A pilot study of group treatment for patients with traumatic brain injury
Authors: Di Vita Antonella , Procacci Mario Augusto , Bellagamba Martina , Jacomini Maria , Massicci Roberta , Ciurli Maria Paola
Published: November 2020

Here we investigated the efficacy of group Psychotherapy and Art Therapy in rebuilding self-identity after traumatic brain injury (TBI), assessing their effects on psychological aspects in twelve patients with severe TBI. Overall, the results show an increased ability to adapt to the experiences of life as well as a higher level of awareness, social functioning and emotional autoregulation. Furthermore, patients exhibited a reduction in depressive symptoms and in the perception of physical problems. Results highlight the importance of treatments focusing on the patients’ emotional needs, in addition to the classic rehabilitation (i.e. physiotherapy, cognitive therapy).
Living Through It: Anger, Laughter, and Internet Memes in Dark Times
Authors: Griffin Hollis
Published: November 2020

In this article, the author examines online political discourse as it is made manifest in internet memes in order to illuminate the lived, felt dimensions of progressive politics at a historical moment when those politics seem especially imperiled. The author argues for an understanding of online engagements with politics as being borne of oscillation as users move between platforms as well as affective states. The goal: to underscore how anger and laughter provide progressives with different opportunities to weather, make fun of, and combat the ascendancy of right-wing populism. Rooted in literature on affect and scholarship on internet memes, especially feminist internet memes, the article examines several different memes that circulated between 2016 and 2020, including #pussygrabsback, #neverthelessshepersisted, Prankster Joe Biden memes, and Creepy Joe Biden memes.
Common currency, common identity? The impact of the Euro introduction on European identity
Authors: Negri Fedra , Nicoli Francesco , Kuhn Theresa
Published: November 2020

Does European state building go hand in hand with European nation building? This article engages with the scholarly debate on the dynamic relationship between the construction of supranational political institutions that exert key functions of sovereignty and collective identities by investigating the extent to which the adoption of the Euro as a currency is associated with a decrease in the share of Europeans who identify exclusively with their nation and not with the European Union. In detail, by using a dynamic panel-data model on 26 European Union countries in the post-Maastricht period (1996–2017), our results show that the Euro has fostered European identity, leading to a small but significant decrease (-3%) in the share of Europeans with exclusive national identity.
Legitimating falsehood in social media: A discourse analysis of political fake news
Authors: Igwebuike Ebuka Elias , Chimuanya Lily
Published: November 2020

Digital peddling of fake news is influential to persuasive political participation, with veritable social media platforms. Social media, with their instantaneous and widespread usage, have been exploited by ‘anonymous’ political influencers who fabricate and inundate internet community with unverified and false information. Using van Leeuwen’s Discourse Legitimation approach and insights from Discourse Analysis, this study analyses 120 purposively sampled fake news posts on Whatsapp, Facebook and Twitter, shared during the 2019 general elections in Nigeria. WhatsApp allows for the easy and fast sharing of fake news as it pulled the largest occurrence of legitimation strategies, followed by Facebook. Authorisation is the highest occurring legitimation strategy at 46.6% frequency; this is followed by Moralisation which has 27% and Rationalisation at 26.4%; while Mythopoesis did not feature at all in the sampled data, leaving it at 0%. In particular, expert and role model authority are most often deployed to validate fake news such as the demise and cloning of President Buhari, ruling party’s plan to rig and destabilise the 2019 election, massive corruption in the current administration and imminent ethnic violence. The study argues that these strategies are viable persuasive tools owing to their use of discourse markers like make-believe images, emotive language, appeal to emotions, rational conclusions, hateful comments, verbal indictment and coercive verbs.
How Body Size Cues Judgments on Person Perception Dimensions
Authors: Bryksina Olya , Wang Luming , Mai-McManus Trang
Published: November 2020

Many people in Western societies pursue a thin body. Among the multiple reasons to lose weight, concerns about social perceptions play a prominent role in the desire to shed pounds. Previous research associates thinness with attractiveness, especially in Western societies. The current work demonstrates that moderate deviations from the average body size cue judgments on person perception dimensions. Results from three studies show that whereas moderately thin (vs. heavy) individuals are rated as more competent, moderately heavy (vs. thin) people are rated as more warm. The studies present mediation- and manipulation-based evidence that these effects occur because a thin (vs. heavy) body signals self-control—a construct instrumental in drawing competence inferences—and that a heavy (vs. thin) body signals emotional expressiveness—a construct that triggers inferences of warmth.
Successful treatment and long-term follow up of idiopathic immune-mediated polyarthritis with mycophenolate mofetil in a cat
Authors: Tamura Yu , Nagamoto Tetsuro , Segawa Kazuhito , Neo Sakurako , Igarashi Hirotaka , Hisasue Masaharu
Published: November 2020

Case summary

A 7-year-old neutered male Norwegian Forest Cat was presented with decreased appetite and activity, weight loss, fever, neutrophilia and hyperglobulinaemia. A physical examination showed painful stifle joints and enlarged popliteal lymph nodes. Blood examination showed neutrophilia, hyperglobulinaemia and increased serum amyloid A. Urinalysis, thoracic and abdominal radiographs, and abdominal ultrasonography were unremarkable. Synovial fluid from the knee joints had diminished viscosity and revealed neutrophilic inflammation on the smear. There was no evidence of infection in a microbiological culture of the synovial fluid. A diagnosis of idiopathic immune-mediated polyarthritis (IMPA) was made. Prednisolone was initiated at 2 mg/kg q24h PO and tapered with additional immunosuppressants (leflunomide, ciclosporin A and methotrexate); however, prednisolone could not be discontinued. Informed consent was obtained from the owner and mycophenolate mofetil (MMF) at a dosage of 10 mg/kg q12h PO was initiated on day 798. There were no adverse effects of MMF and prednisolone was discontinued on day 1183. Clinical signs resolved and the cat’s general condition remained stable with MMF alone at a dosage of 10 mg/kg q48h PO on day 1600.

Relevance and novel information

There is limited information describing feline IMPA and its treatment options other than the use of prednisolone. This is the first report of the successful treatment and long-term follow-up of feline IMPA with MMF. MMF may be a safe and effective option as an additional immunosuppressant in feline IMPA.
Acute Recurrent Exacerbations of Mesenteric Panniculitis With Immunosuppressive Therapy: A Case Report and a Brief Review
Authors: Dahiya Dushyant Singh , Kichloo Asim , Singh Jagmeet , Albosta Michael Stanley , Wani Farah , Aljadah Michael , Haq Khwaja Fahad
Published: November 2020

Mesenteric panniculitis (MP) is a rare, benign, and idiopathic disorder characterized by chronic inflammation of the mesenteric adipose tissue of the small intestine. The exact etiology of MP is unknown and its associations with underlying malignancies continues to be poorly understood. In this case report, we describe a rare case of acute exacerbations of MP in a middle-age female with a known past medical history of non-Hodgkin’s lymphoma in remission and small bowel resection for a localized carcinoid tumor. The patient was diagnosed with MP 4 years ago and started on tamoxifen therapy with adequate control of her symptoms. Last year, she reported to the emergency department with multiple episodes of sudden-onset, severe, and localized right upper quadrant abdominal pain and nausea without vomiting. She was diagnosed with an acute exacerbation of MP and a decision was made to add 60 mg prednisone daily in addition to her tamoxifen regimen. She remained symptomatically stable for the next 6 months after the start of dual therapy with tamoxifen and prednisone. However, for the past 6 months, the patient reported to the emergency department on an average of 2 times/month with the same recurrent symptoms despite high compliance with tamoxifen and prednisone therapy. She was admitted for her pain management and her dose of prednisone was increased and she was subsequently discharged home with improvement of her symptoms. Her tamoxifen was switched to mycophenolate on her follow-up visit with gastrointestinal clinic, and her disease has remained stable for the past 2 months. Our case report discusses in-depth the literature on MP and its management. We also detail the steps in management of a rare case of recurrent acute exacerbations of MP despite the patient being on immunosuppressive therapy.
Stressful Events in Old Age: Who are Most Exposed and Who are Most Likely to Overcome Them
Authors: Herrera M. Soledad , Fernández M. Beatriz
Published: November 2020

Objectives: This study investigated self-reported events that were rated as stressful and being affecting wellbeing among older people. It also examined the variables associated with the perception of overcoming these stressful events. Methods: Face-to-face survey on a representative sample of 1,431 older people in Santiago-Chile. Instruments included open-ended questions for distinguishing events as losses, problems, conflicts, and others’ difficulties. The associations between the occurrence and overcoming of events with individual and social characteristics were examined through multivariate logistic regression. Results: 39.5% mentioned at least one stressful event, being mostly perceived as solvable problems rather than losses. Higher-income, better health, self-efficacy, and social support were associated with a higher perception of event overcoming. Conclusion: The occurrence and the probability of events’ overcoming does not increase in old-old age in this sample group. Better health and individual and social resources such as self-efficacy and social support, are protective resources for overcoming the stressful events, but they are not generally considered in public policies.
Genetic Mutations in Young Nonsmoking Patients With Oral Cavity Cancer: A Systematic Review
Authors: Bahethi Rohini R. , Stepan Katelyn O. , Pinotti Rachel , Li Ryan , Agrawal Nishant , Puram Sidharth V. , Miles Brett A. , Barber Brittany
Published: November 2020

Objective

This investigation aims to review the known genetic mutations associated with oral cavity squamous cell carcinoma (OCSCC) in young adults with limited environmental risk factors (YLERs).

Data Sources

A comprehensive search strategy was designed to identify studies in MEDLINE (Ovid), Embase (Ovid), and Scopus from database inception to May 2017 that included adults ≤50 years of age with OCSCC and minimal tobacco use history (≤10 pack‐years) who had their tumors genetically sequenced or mutational profiles analyzed.

Review Methods

Identified articles were screened by 2 reviewers. Quality of evidence was graded by the MINORS criteria for case‐control studies; other studies were graded by assigning a level of evidence for gene mutation literature.

Results

Thirteen studies met our inclusion criteria, and 130 patients met our criteria for age and tobacco history. TP53 was the most commonly evaluated gene (10 of 13 studies) and the most frequently observed mutation. One study reported that nonsmokers had significantly fewer TP53 mutations, while 9 studies found no difference in the prevalence of TP53 mutations. No other mutations were found specific to this cohort.

Conclusions

TP53 mutations may occur at a similar rate in YLERs with OCSCC as compared with older patients or those with risk factors. However, few studies have aimed to characterize the genetic landscape of oral cavity tumors in this population, often with small sample sizes. Future studies are needed to explore unidentified genetic alterations leading to tumor susceptibility or alternative mechanisms of carcinogenesis.
Imaging Features of a Retinal Detachment and Secondary Epiretinal Membrane Following Inadvertent Globe Penetration From Peribulbar Anesthesia
Authors: Lim Joshua , Tsai Andrew S.H. , Lee Shu Yen
Published: November 2020

Purpose:

We present imaging features of retinal detachment (RD) and secondary epiretinal membrane in a case of an inadvertent globe penetration following preoperative peribulbar anesthesia.

Methods:

A 60-year-old woman was referred for a localized RD and epiretinal membrane following uneventful cataract surgery. Widefield fundus photography and optical coherence tomography were used to assess and record the pathology. The current literature was reviewed.

Results:

Full-thickness breaks were noted in the neurosensory retina extending into the scleral wall. Vertical tracks were noted in the inferotemporal quadrant of the eye. The patient underwent trans pars plana vitrectomy, membrane peel, and gas. Her 1-month postoperative visual acuity was 20/30.

Conclusions:

Globe penetration with RD is a rare but potentially sight-threatening complication of peribulbar anesthesia. Diagnosis can be challenging because of the infrequency of occurrence and delays in presentation. A high index of suspicion is key alongside consideration of other likely differentials.
Salicylates enhance CRM1 inhibitor antitumor activity by induction of S-phase arrest and impairment of DNA-damage repair
Authors: Abeykoon Jithma P. , Wu Xiaosheng , Nowakowski Kevin E. , Dasari Surendra , Paludo Jonas , Weroha S. John , Hu Chunling , Hou Xiaonan , Sarkaria Jann N. , Mladek Ann C. , Phillips Jessica L. , Feldman Andrew L. , Ravindran Aishwarya , King Rebecca L. , Boysen Justin , Stenson Mary J. , Carr Ryan M. , Manske Michelle K. , Molina Julian R. , Kapoor Prashant , Parikh Sameer A. , Kumar Shaji , Robinson Steven I. , Yu Jia , Boughey Judy C. , Wang Liewei , Goetz Matthew P. , Couch Fergus J. , Patnaik Mrinal M. , Witzig Thomas E.
Published: November 2020

Chromosome region maintenance protein 1 (CRM1) mediates protein export from the nucleus and is a new target for anticancer therapeutics. Broader application of KPT-330 (selinexor), a first-in-class CRM1 inhibitor recently approved for relapsed multiple myeloma and diffuse large B-cell lymphoma, have been limited by substantial toxicity. We discovered that salicylates markedly enhance the antitumor activity of CRM1 inhibitors by extending the mechanisms of action beyond CRM1 inhibition. Using salicylates in combination enables targeting of a range of blood cancers with a much lower dose of selinexor, thereby potentially mitigating prohibitive clinical adverse effects. Choline salicylate (CS) with low-dose KPT-330 (K+CS) had potent, broad activity across high-risk hematological malignancies and solid-organ cancers ex vivo and in vivo. The K+CS combination was not toxic to nonmalignant cells as compared with malignant cells and was safe without inducing toxicity to normal organs in mice. Mechanistically, compared with KPT-330 alone, K+CS suppresses the expression of CRM1, Rad51, and thymidylate synthase proteins, leading to more efficient inhibition of CRM1-mediated nuclear export, impairment of DNA-damage repair, reduced pyrimidine synthesis, cell-cycle arrest in S-phase, and cell apoptosis. Moreover, the addition of poly (ADP-ribose) polymerase inhibitors further potentiates the K+CS antitumor effect. K+CS represents a new class of therapy for multiple types of blood cancers and will stimulate future investigations to exploit DNA-damage repair and nucleocytoplasmic transport for cancer therapy in general.
Global mRNA and microRNA expression dynamics in response to anthracnose infection in sorghum
Authors: Fu Fuyou , Girma Gezahegn , Mengiste Tesfaye
Published: November 2020

Background

Anthracnose is a damaging disease of sorghum caused by the fungal pathogenColletotrichum sublineolum.Genome-wide mRNA and microRNA (miRNA) profiles of resistant and susceptible sorghum genotypes were studied to understand components of immune responses, and fungal induced miRNA and target gene networks.

Results

A total of 18 mRNA and 12 miRNA libraries from resistant and susceptible sorghum lines were sequenced prior to and after inoculation withC. sublineolum. Significant differences in transcriptomes of the susceptible and resistant genotypes were observed with dispersion distance and hierarchical cluster tree analyses. Of the total 33,032 genes predicted in the sorghum genome, 19,593 were induced byC. sublineolum,and 15,512 were differentially expressed (DEGs) between the two genotypes. The resistant line was marked by significant reprogramming of the transcriptome at 24 h post inoculation (hpi), and a decrease at 48 hpi, whereas the susceptible line displayed continued changes in gene expression concordant with elevated fungal growth in the susceptible genotype. DEGs encode proteins implicated in diverse functions including photosynthesis, synthesis of tetrapyrrole, carbohydrate and secondary metabolism, immune signaling, and chitin binding. Genes encoding immune receptors, MAPKs, pentatricopeptide repeat proteins, and WRKY transcription factors were induced in the resistant genotype. In a parallel miRNA profiling, the susceptible line displayed greater number of differentially expressed miRNAs than the resistant line indicative of a widespread suppression of gene expression. Interestingly, we found 75 miRNAs, including 36 novel miRNAs, which were differentially expressed in response to fungal inoculation. The expression of 50 miRNAs was significantly different between resistant and susceptible lines. Subsequently, for 35 differentially expressed miRNAs, the corresponding 149 target genes were identified. Expression of 56 target genes were significantly altered after inoculation, showing inverse expression with the corresponding miRNAs.

Conclusions

We provide insights into genome wide dynamics of mRNA and miRNA profiles, biological and cellular processes underlying host responses to fungal infection in sorghum. Resistance is correlated with early transcriptional reprogramming of genes in various pathways. Fungal induced genes, miRNAs and their targets with a potential function in host responses to anthracnose were identified, opening avenues for genetic dissection of resistance mechanisms.
Can voucher scheme enhance primary care provision for older adults: cross-sectional study in Hong Kong
Authors: Cheung Johnny T. K. , Wong Samuel Y.S. , Chan Dicken C. C. , Zhang Dexing , Luk Lawrence H. F. , Chau Patsy Y. K. , Yip Benjamin H. K. , Lee Eric K. P. , Wong Eliza L. Y. , Yeoh E. K.
Published: November 2020

Background

The Hong Kong government has launched the Elderly Health Care Voucher (EHCV) scheme to facilitate primary care in the private sector for older adults. This study aimed to examine whether voucher use was associated with a shift of healthcare burden from the public to the private sector, vaccine uptake and continuity of care.

Methods

This cross-sectional survey recruited older adults with ≥3 chronic diseases through convenience sampling from seven general outpatient clinics, seven geriatric day hospitals, and five specialist outpatient clinics of the public healthcare sector in Hong Kong. We used multiple logistic regression to address the study objective.

Results

A total of 1032 patients participated in the survey. We included 714 participants aged 70 or above in the analysis. EHCV use was associated with higher utilization of private primary care services, including general practitioner and family doctor (Adjusted Odds Ratio (AOR) 2.67, 95% Confidence Interval (95%CI) 1.51–4.72) and Chinese medicine clinic (AOR 3.53, 95%CI 1.47–8.49). There were no significant associations of EHCV use with public general outpatient clinic attendance, Accident & Emergency attendance, and hospitalization. Furthermore, EHCV users were more likely to receive pneumococcal vaccination (AOR 2.17, 95%CI 1.22–3.85) and were less likely to visit the same doctors for chronic disease management (AOR 0.10, 95%CI 0.01–0.73).

Conclusions

While the EHCV may promote private primary care utilization and preventive care, older patients continue to rely on public services and the EHCV may worsen continuity of care. Policy-makers should designate voucher usage for chronic disease management and continuity of care.
Ongoing donor-transmitted diabetic kidney disease in kidney transplant recipients with fair sugar control: a single center retrospective study
Authors: Hsu Chia-Tien , Wen Mei-Chin , Chiu Hsien-Fu , Tsai Shang-Feng , Yu Tung-Min , Yang Cheng-Kuang , Wu Ming-Ju , Chen Cheng-Hsu
Published: November 2020

Background

Transplantation with a diabetic donor kidney may have some benefits compared to remaining on the waitlist for selected patients. However, we found that some kidney transplant recipients have ongoing donor-transmitted diabetic kidney disease (DT-DKD) despite fair blood sugar control. This study aimed to survey the incidence and clinical pattern of DT-DKD in kidney transplant recipients.

Methods

We retrospectively reviewed the medical records of kidney transplantations in our hospital. We found 357 kidney transplantations from February 2006 to April 2018. Among these, 23 (6.4%) diabetic donor kidney transplantations were done in the study period.

Results

Among the 23 recipients, 6 (26.1%) displayed biopsy-proven DKD. Recipients with biopsy-proven DKD had longer dialysis vintage, higher proteinuria amount, lower last estimated glomerular filtration rate (eGFR), and a more rapid decline in the eGFR. The median fasting blood sugar level in the biopsy-proven DKD group was unexpectedly lower than the non-DKD group. Most of the pre-implantation frozen sections in biopsy-proven DKD group showed diabetic lesions worse than diabetic nephropathy (DN) class IIa. In the biopsy-proven DKD group, 5 recipients had no history of diabetes before or after transplantation. Among the 23 recipients, 5 (21.7%) were diagnosed with DT-DKD. Serial post-transplant biopsies showed the histological progression of allograft DN.

Conclusions

To the best of our knowledge, this is the first study to report the phenomenon of ongoing DT-DKD in kidney transplant recipients with fair blood sugar control. The zero-time pre-transplant kidney biopsy may be an important examination before the allocation of diabetic donor kidneys. Further study is needed to elucidate the possible mechanism of ongoing DT-DKD in non-diabetic recipients with fair blood sugar control as well as the impaction of pre-implantation diabetic lesion on the graft outcome.
Evaluating documentation of social history in paediatric medical notes at a regional paediatric centre – a quality improvement initiative
Authors: Foley DJ , Hannon JK , O’Gorman CS , Murphy AM
Published: November 2020

Background

A child’s home and family environment plays a vital role in neuro-cognitive and emotional development. Assessment of a child’s home environment and social circumstances is an crucial part of holistic Paediatric assessment.

Aims

Our aim is to achieve full compliance with comprehensive documentation of biopsychosocial history, for all children medically admitted to the children’s inpatient unit in University Hospital Limerick.

Methods

We performed a retrospective chart review to audit documentation within our department. This was followed by teaching interventions and a survey on knowledge, attitudes and behaviour of paediatric non-consultant hospital doctors (NCHDs) towards the social history. We performed two subsequent re-audits to assess response to our interventions, and provided educational sessions to seek improvement in quality of care.

Results

Results showed a significant improvement in quality of documentation following interventions, demonstrated by a net increase of 53% in levels of documentation of some social history on first re-audit. Though this was not maintained at an optimum level throughout the course of the year with compliance reduced from 95% to 82.5% on second re-audit, there was nonetheless a sustained improvement from our baseline. Our qualitative survey suggested further initiatives and educational tools that may be helpful in supporting the ongoing optimisation of the quality of documentation of social history in our paediatric department.

Conclusion

We hope this quality improvement initiative will ultimately lead to sustained improvements in the quality of patient-centred care, and early identification and intervention for children at risk in our community.
Correlates of knowledge of family planning among people living in fishing communities of Lake Victoria, Uganda
Authors: Nanvubya Annet , Wanyenze Rhoda K. , Nakaweesa Teddy , Mpendo Juliet , Kawoozo Barbarah , Matovu Francis , Nabukalu Sarah , Omoding Geoffrey , Kaweesi Jed , Ndugga John , Kamacooko Onesmus , Chinyenze Kundai , Price Matt , Van Geertruyden Jean Pierre
Published: November 2020

Background

Knowledge of family planning (FP) is a key determinant of contraceptive use which ultimately plays a role in attainment of good health and in conduct of clinical research. People living in fishing communities (FCs) have limited access to health services including FP and are targeted for future clinical research but their knowledge of FP and its correlates are scantily known. We determined correlates of knowledge of FP among people living in FCs of L. victoria in Uganda to inform future FP education programs in FCs.

Methods

We conducted a comparative cross-sectional survey among participants aged 15–49 years from Kigungu and Nsazi. Participants were asked if they were aware of any FP method. All those who responded in the affirmative were further asked to mention what FP methods they had heard of or knew. Those who reported knowledge of at least one FP method were asked a series of questions about FP methods and their side effects. Knowledge was categorized into good or poor knowledge based on their mean total score. Poor knowledge constituted a score below the mean while good knowledge constituted a score of more than or equal to the mean total score. To further explore attitudes and perceptions of FP, ten in-depth interviews and four focus group discussions were conducted.

Results

Of the 1410 screened participants, 94.5% were aware of at least one FP method. Pills and injectable hormonal methods were the most commonly known methods. Slightly over a third (38%) had good knowledge of FP. Correlates of knowledge of FP were; being female (aOR: 1.92 95% CI: 1.39–2.67), residing in Kigungu (aOR: 4.01 95% CI: 2.77–5.81), being married (aOR: 1.59 95% CI: 1.11–2.28) and currently being in a sexual relationship (aOR: 1.75 95% CI: 1.18–2.60). Concerns about safety and effectiveness of some modern FP methods exist. Misconceptions on effects of FP like sterility, cancers and foetal abnormalities were common.

Conclusion

FP awareness among people living in FCs of L. Victoria in Uganda is high. However, good knowledge about specific methods tends to be low. Correlates of knowledge of FP include gender, residence, marital status and sexual engagement.
Factors associated with undernutrition among 20 to 49 year old women in Uganda: a secondary analysis of the Uganda demographic health survey 2016
Authors: Sserwanja Quraish , Mukunya David , Habumugisha Theogene , Mutisya Linet M. , Tuke Robert , Olal Emmanuel
Published: November 2020

Background

Women are at risk of undernutrition due to biological, socio-economic, and cultural factors. Undernourished women have higher risk of poor obstetric outcomes. We aimed to determine the prevalence and factors associated with undernutrition among women of reproductive age in Uganda.

Methods

We used Uganda Demographic and Health Survey (UDHS) 2016 data of 4640 women aged 20 to 49 years excluding pregnant and post-menopausal women. Multistage stratified sampling was used to select study participants and data were collected using validated questionnaires. We used multivariable logistic regression to determine factors associated with underweight and stunting among 20 to 49 year old women in Uganda.

Results

The prevalence of underweight and stunting were 6.9% (318/4640) and 1.3% (58/4640) respectively. Women who belonged to the poorest wealth quintile (Adjusted Odds Ratio (AOR) 3.60, 95% CI 1.85–7.00) were more likely to be underweight compared to those who belonged to the richest wealth quintile. Women residing in rural areas were less likely to be underweight (AOR 0.63, 95%CI 0.41–0.96) compared to women in urban areas. Women in Western (AOR 0.30, 95% CI 0.20–0.44), Eastern (AOR 0.42, 95% CI 0.28–0.63) and Central regions (AOR 0.42, 95% CI 0.25–0.72) were less likely to be underweight compared to those in the Northern region. Women belonging to Central (AOR 4.37, 95% CI 1.44–13.20) and Western (AOR 4.77, 95% CI 1.28–17.78) regions were more likely to be stunted compared to those in the Northern region.

Conclusion

The present study showed wealth index, place of residence and region to be associated with undernutrition among 20 to 49 year old women in Uganda. There is need to address socio-economic determinants of maternal undernutrition mainly poverty and regional inequalities.
A comparison study of percutaneous endoscopic decompression and posterior decompressive laminectomy in the treatment of thoracic spinal stenosis
Authors: Cheng Xiao-Kang , Bian Fu-Cheng , Liu Zhao-Yu , Yang Feng-Kai , Chen Bin
Published: November 2020

Background

Percutaneous endoscopic decompression (PED) is considered a minimally invasive and safe procedure in lumbar degenerative disease. Few authors report the success of PED for thoracic spinal stenosis (TSS) with thoracic myelopathy. The objective of this study was to compare the outcome of PED versus posterior decompressive laminectomy (PDL) for TSS.

Methods

We retrospectively reviewed 30 consecutive patients who underwent surgery for single-level TSS from January 1, 2015 to May 1, 2019.These patients were divided into PED (n = 16) and PDL(n = 14) group. Preoperative demographic characteristics and perioperative outcomes were reviewed. Pre- and postoperative neurological status was evaluated using the modified Japanese Orthopaedic Association (mJOA) score and the recovery rate (RR).

Results

The patients’ mean age was 57.3 years (27–76) in PED group and 58.8 years (34–77) in PDL group. No statistical difference was found between two groups with regards to neurological status at pre-operative and final follow-up. The RR in PED group achieved the same improvement as PDL group (87.5% vs 85.7%, P > 0.05), while the PED brought advantages in operative time(m) (86.4 vs 132.1, p < 0.05), blood loss (mL) (18.21 vs 228.57, p < 0.05),drainage volume(mL) (15.5 vs 601.4, p < 0.05), and hospital stay (d) (3.6 vs 5.6, p < 0.05).

Conclusions

Both PED and PDL showed favorable outcome in the treatment of TSS. Besides, PED had advantages in reducing traumatization. In terms of perioperative quality of life, PED could be an efficient supplement to traditional posterior decompressive laminectomy in patients with TSS.
Long-term outcomes of intervention between open repair and endovascular aortic repair for descending aortic pathologies: a propensity-matched analysis
Authors: Son Shin-Ah , Jung Hanna , Cho Joon Yong
Published: November 2020

Background

The long-term complication rates of open repair and thoracic endovascular aortic repair (TEVAR) have not yet been determined. Therefore, this study aimed to compare the long-term outcomes and aortic reintervention rates between open repair and TEVAR in patients with descending thoracic aortic pathologies.

Methods

Between January 2002 and December 2017, 230 patients with descending thoracic aortic pathologies underwent surgery. Of these, 136 patients were included in this retrospective study: 45 patients (10, 2, and 33 with dissection, penetrating atherosclerotic ulcer, and pseudoaneurysm, respectively) underwent open repair and 91 patients (27, 1, and 63 with dissection, penetrating atherosclerotic ulcer, and pseudoaneurysm, respectively) underwent TEVAR. The primary end points were in-hospital mortality, and short-term complications. The secondary end points were long-term mortality and reintervention rates. Based on the propensity score matching (PSM), 35 patients who underwent open repair were matched to 35 patients who underwent TEVAR (ratio = 1:1).

Results

The mean follow-up period was 70.2 ± 51.9 months. Shorter intensive care unit and hospital stay were seen in the TEVAR group than in the open repair group before and after PSM (p < 0.001 andp < 0.001, respectively). However, in-hospital mortality, and spinal cord ischemia were not significantly different among the two groups (before PSM:p = 0.068 andp = 0.211, respectively; after PSM:p = 0.303 andp = 0.314, respectively). The cumulative all-cause death and aorta-related death showed no significant differences between the two groups (before PSM:p = 0.709 andp = 0.734, respectively; after PSM:p = 0.888 andp = 0.731, respectively). However, aortic reintervention rates were higher in the TEVAR group than in the open repair group before and after PSM (p = 0.006 andp = 0.013, respectively).

Conclusion

The TEVAR group was superior in short-term recovery outcomes but had higher reintervention rates compared to the open repair group. However, there were no significant differences in long-term survival between the two groups.
US medical and surgical society position statements on physician-assisted suicide and euthanasia: a review
Authors: Barsness Joseph G. , Regnier Casey R. , Hook C. Christopher , Mueller Paul S.
Published: November 2020

Background

An analysis of the position statements of secular US medical and surgical professional societies on physician-assisted suicide (PAS) and euthanasia have not been published recently. Available statements were evaluated for position, content, and sentiment.

Methods

In order to create a comprehensive list of secular medical and surgical societies, the results of a systematic search using Google were cross-referenced with a list of societies that have a seat on the American Medical Association House of Delegates. Societies with position statements were identified. These statements were divided into 5 categories: opposed to PAS and/or euthanasia, studied neutrality, supportive, acknowledgement without statement, and no statement. Linguistic analysis was performed using RapidMinder in order to determine word frequency and sentiment respective to individual statements. To ensure accuracy, only statements with word counts > 100 were analyzed. A 2-tailed independentttest was used to test for variance among sentiment scores of opposing and studied neutrality statements.

Results

Of 150 societies, only 12 (8%) have position statements on PAS and euthanasia: 11 for PAS (5 opposing and 4 studied neutrality) and 9 for euthanasia (6 opposing and 2 studied neutrality). Although the most popular words used in opposing and studied neutrality statements are similar, notable exceptions exist (suicide,medicine, andtreatmentappear frequently in opposing statements, but not in studied neutrality statements, whereaspsychologists,law, andindividualsappear frequently in studied neutrality statements, but not in opposing statements). Sentiment scores for opposing and studied neutrality statements do not differ (mean, 0.094 vs. 0.104;P = 0.90).

Conclusions

Few US medical and surgical societies have position statements on PAS and euthanasia. Among them, opposing and studied neutrality statements share similar linguistic sentiment. Opposing and studied neutrality statements have clear differences, but share recommendations. Both opposing and studied neutrality statements cite potential risks of PAS legalization and suggest that good palliative care might diminish a patient’s desire for PAS.
Depression and cardiovascular risk—association among Beck Depression Inventory, PCSK9 levels and insulin resistance
Authors: Macchi C. , Favero C. , Ceresa A. , Vigna L. , Conti D. M. , Pesatori A. C. , Racagni G. , Corsini A. , Ferri N. , Sirtori C. R. , Buoli M. , Bollati V. , Ruscica M.
Published: November 2020

Background

Depression and cardiovascular disease (CVD) are among the most common causes of disability in high-income countries, depression being associated with a 30% increased risk of future CV events. Depression is twice as common in people with diabetes and is associated with a 60% rise in the incidence of type 2 diabetes, an independent CVD risk factor. Proprotein convertase subtilisin/kexin type 9 (PCSK9), a key regulator of low-density lipoprotein cholesterol, has been related to a large number of CV risk factors, including insulin resistance. Aim of this study was to investigate whether the presence of depression could affect PCSK9 levels in a population of obese subjects susceptible to depressive symptoms and how these changes may mediate a pre-diabetic risk.

Results

In 389 obese individuals, the Beck Depression Inventory (BDI-II) was significantly associated with PCSK9 levels. For every one-unit increment in BDI-II score, PCSK9 rose by 1.85 ng/mL. Depression was associated also with the HOMA-IR (homeostatic model assessment index of insulin resistance), 11% of this effect operating indirectly via PCSK9.

Conclusions

This study indicates a possible mechanism linking depression and insulin resistance, a well-known CV risk factor, providing evidence for a significant role of PCSK9.
Differential effects of antibiotics on neutrophils exposed to lipoteichoic acid derived from Staphylococcus aureus
Authors: Algorri Marquerita , Wong-Beringer Annie
Published: November 2020

Background

Persistent bacteremia occurs in at least 30% of patients withStaphylococcus aureusbloodstream infection (SAB) and may be attributable to a dysregulated host immune response. Neutrophils interact with a variety ofS. aureusmicrobial factors, including lipoteichoic acid (LTA), to activate phagocytic function in a concentration-dependent manner. Antibiotics have been shown to exert both direct antimicrobial action as well as immunomodulatory effects. In this study, we compared the effects of different anti-staphylococcal antibiotics on LTA-mediated immune activation of neutrophils.

Methods

Neutrophils obtained from healthy volunteers were exposed to two levels of LTA (1 and 10 μg/ml) with or without addition of antibiotics from different pharmacologic classes (vancomycin, daptomycin, ceftaroline). Neutrophil function was assessed by examining phagocytic response, activation (CD11b, CD62L expression), Toll-like receptor-2 expression, cell survival and apoptosis, and CXCL8 release.

Results

Differential LTA-mediated antibiotic effects on neutrophil function were observed primarily at the high LTA exposure level. Ceftaroline in the presence of 10 μg/ml LTA had the most prominent effects on phagocytosis and CD11b and CD62L expression, with trends towards increased neutrophil survival and preservation of CXCL8 release when compared to daptomycin and vancomycin with the latter significantly dampening PMN CXCL8 release.

Conclusions

Select antimicrobial agents, such as ceftaroline, exert immunostimulatory effects on neutrophils exposed toS. aureusLTA, which when confirmed in vivo, could be leveraged for its dual immunomodulatory and antibacterial actions for the treatment of persistent SAB mediated by a dysregulated host response.
Association between statin use and osteoporotic fracture in patients with chronic obstructive pulmonary disease: a population-based, matched case-control study
Authors: Chen Hung-Yi , Su Pei-Yu , Lin Tsung-Kun , Jong Gwo-Ping
Published: November 2020

Background

In the recent years, chronic obstructive pulmonary disease (COPD) has been found to be associated with a higher risk of new-onset osteoporotic fracture (NOF). However, the existence of such an association in the COPD patients receiving statin treatment remains unknown. The present study aimed to investigate the association between COPD and NOF in statin-treated patients.

Methods

The present study was conducted over a period of 10 years (January 2004 to December 2013) in Taiwan. COPD patients receiving statin treatment were included in the statin user group, whereas the randomly selected statin non-users, with 1:1 matching for sex, age, index date, and Charlson Comorbidity Index, were included in the statin non-user group. The hazard ratio (HR) of NOFs in COPD patients was estimated between statin user and non-user groups.

Results

A total of 86,188 cases were identified as the statin-treated patients, and 86,188 subjects were included in the control group of statin non-users. Initially, the risk of NOF was found to be higher among the statin users as compared to non-users [HR, 1.12; 95% confidence interval (CI), 1.01–1.25]. However, the calculation of risk for NOFs after the adjustment for age, sex, comorbidities, and concurrent medications indicated no association of NOF (HR, 0.81; 95% CI, 0.55–1.21) with COPD in patients receiving statin treatment as compared to statin non-users.

Conclusion

The results of the study provided first evidence for the absence of any association between COPD and NOFs in statin-treated patients during a follow-up period of 10 years. Thus, the findings of this study might support the hypothesis stating the potent pleiotropic effects of statins. In clinical practice, these drugs might prove beneficial for the patients with COPD.
Correction to: Isolation and genetic characterization of Toxoplasma gondii in Spanish sheep flocks
Authors: Fernández-Escobar Mercedes , Calero-Bernal Rafael , Benavides Julio , Regidor-Cerrillo Javier , Guerrero-Molina María Cristina , Gutiérrez-Expósito Daniel , Collantes-Fernández Esther , Ortega-Mora Luis Miguel
Published: November 2020

An amendment to this paper has been published and can be accessed via the original article.
The prevalence of metabolic syndrome in cardiovascular patients in Iran: a systematic review and meta-analysis
Authors: Salari Nader , Doulatyari Peyman Kaikhosro , Daneshkhah Alireza , Vaisi-Raygani Aliakbar , Jalali Rostam , Jamshidi Parnian kord , Abdi Alireza , Mohammadi Masoud , Kazeminia Mohsen
Published: November 2020

Background

Cardiovascular disease is the cause of more than 50% of mortalities globally, and this rate has grown by 8.6% since the 60 s. One of the risk factors associated with cardiovascular disease and its resulting mortality rate is the metabolic syndrome. Different studies have reported inconsistent rates for the metabolic syndrome. However, no comprehensive study has been conducted to combine the results of existing studies. Thus, the present study was performed with the aim of determining the prevalence of metabolic syndrome among cardiovascular patients in Iran through a systematic review and meta-analysis.

Method

: In this review study, the Scientific Information Database, Google Scholar, Science Direct, Scopus, PubMed, and Web of Science (ISI), databases were searched from January 2005 and until May 2020, to identify and extract related articles. To conduct the analysis, a random effects model was used, and the heterogeneity of the studies was examined using the I2index. Data analysis was performed within Comprehensive Meta-Analysis (version 2) software.

Results

The prevalence of metabolic syndrome in cardiovascular patients in Iran in the 27 papers examined with a sample size of 44,735 patients was 34.2% (95% CI: 26.8–42.6%). A sensitivity analysis was performed to ensure the stability of the results, these results show that by omitting the prevalence from each study, the overall prevalence (34.2%) does not change significantly. the highest prevalence of metabolic syndrome in studies conducted in the period between 2015 and 2020, and this was reported as 55.3 (95% CI: 47.9–62.3) and the highest prevalence of metabolic syndrome in studies conducted in the methods of diagnosis IDF, and the rate was reported as 48 (95% CI: 36.5–59.8). based on meta-regression as the year of research increased, the prevalence of metabolic syndrome in cardiovascular patients in Iran also increased. However, with the increase in sample size, this prevalence decreased (p < 0.05).

Conclusions

The results of this study indicate that metabolic syndrome is high in cardiovascular patients in Iran. Accordingly, by understanding its etiology and supervision at all levels, suitable solutions could be offered by providing feedback to hospitals.
Open defecation-free slippage and its associated factors in Ethiopia: a systematic review
Authors: Abebe Thomas Ayalew , Tucho Gudina Terefe
Published: November 2020

Background

Recent studies have shown an increase in open defecation and slippage of open defecation-free certified villages in Ethiopia, despite significant progress the country made on sanitation programs. Hence, realizing of existing facts, this study was conducted aiming at a critical review of available literature and to provide consolidated data showing the level of slippage and its associated factors in Ethiopia.

Methods

Systematic literature searches were performed from four international databases. The search involved articles published from December 1, 2013, up to June 4, 2019. The Cochran’s Q and I2 test statistics were used to check heterogeneity among the studies. To negotiate heterogeneity from qualitative data, we used a mixed-method approach. The researchers also conducted a publication bias assessment and sensitivity analysis. A random effect meta-analysis was employed to determine the pooled estimates of open defecation free slippage rate with a 95% confidence interval (CI). The data analysis was performed using the CMA V.3 software program.

Result

After screening 1382 studies, 12 studies were finally included in this systematic review. The estimated pooled rate of open defecation-free slippage in Ethiopia was 15.9% (95% CI 12.9–19.4%). The main contributing factors for open defecation-free slippage were lack of technical support, financial constraints, low-quality building materials, improper program implementation, and lack of sanitation marketing.

Conclusion

It was estimated that 1 out of 6 Ethiopian households engaged in open defecation after they have certified open defecation-free status, implying the low possibility of achieving sustainable development goals of 2030, which aims to ensure sanitation for all. Therefore, the government of Ethiopia and donors should better give special attention to the following options: (1) awareness for open defecation-free slippage, (2) launch a post-open defecation-free program, and (3) encourage research on pro-poor sustainable sanitation technologies.