bluuebunny/crossref_metadata_2025 huggingface dataset:
Coronary revascularization in patients with stable coronary disease and diabetes mellitus
Authors: Bhat Salman , Yatsynovich Yan , Sharma Umesh C
Published: April 2021

Purpose of Study:

Diabetes mellitus accelerates the development of atherosclerosis. Patients with diabetes mellitus have higher incidence and mortality rates from cardiovascular disease and undergo a disproportionately higher number of coronary interventions compared to the general population. Proper selection of treatment modalities is thus paramount. Treatment strategies include medical management and interventional approaches including coronary artery bypass graft (CABG) surgery and percutaneous coronary interventions (PCI). The purpose of this review is to assimilate emerging evidence comparing CABG to PCI in patients with diabetes and present an outlook on the latest advances in percutaneous interventions, in addition to the optimal medical therapies in patients with diabetes.

Key Methods:

A systematic search of PubMed, Web of Science and EMBASE was performed to identify prospective, randomized trials comparing outcomes of CABG and PCI, and also PCI with different generations of stents used in patients with diabetes. Additional review of bibliography of selected studies was also performed.

Main Conclusions:

Most of the trials discussed above demonstrate a survival advantage of CABG over PCI in patients with diabetes. However, recent advances in PCI technology are starting to challenge this narrative. Superior stent designs, use of specific drug-eluting stents, image-guided stent deployment, and the use of contemporary antiplatelet and lipid-lowering therapies are continuing to improve the PCI outcomes. Prospective data for such emerging interventional technologies in diabetes is however lacking currently and is the need of the hour.
Mechanism of MicroRNA-375 Promoter Methylation in Promoting Ovarian Cancer Cell Malignancy
Authors: Shu Junjun , Xiao Ling , Yan Sanhua , Fan Boqun , Zou Xia , Yang Jun
Published: April 2021

Objective:

Ovarian cancer (OC) ranks one of the most prevalent fatal tumors of female genital organs. Aberrant promoter methylation triggers changes of microRNA (miR)-375 in OC. Our study aimed to evaluate the mechanism of methylated miR-375 promoter region in OC cell malignancy and to seek the possible treatment for OC.

Methods:

miR-375 promoter methylation level in OC tissues and cells was detected. miR-375 expression in OC tissues and cell lines was compared with that in demethylated cells. Role of miR-375 in OC progression was measured. Dual-luciferase reporter gene assay was utilized to verify the targeting relationship between miR-375 and Yes-associated protein 1 (YAP1). Then, Wnt/β-catenin pathway-related protein expression was tested. Moreover, xenograft transplantation was applied to confirm the in vitro experiments.

Results:

Highly methylated miR-375 was seen in OC tissues and cell lines, while its expression was decreased as the promoter methylation increased. Demethylation in OC cells brought miR-375 back to normal level, with obviously declined cell invasion, migration and viability and improved apoptosis. Additionally, miR-375 targeted YAP1 to regulate the Wnt/β-catenin pathway protein expression. Overexpressed YAP1 reversed the protein expression, promoted cell invasion, migration and viability while reduced cell apoptosis. Overexpressed miR-375 in vivo inhibited OC progression.

Conclusion:

Our study demonstrated that demethylated miR-375 inhibited OC growth by targeting YAP1 and downregulating the Wnt/β-catenin pathway. This investigation may offer novel insight for OC treatment.
Prognostic Value of Site-Specific Metastases and Therapeutic Roles of Surgery and Chemotherapy for Patients With Metastatic Renal Pelvis Cancer: A SEER Based Study
Authors: Chen Wei-Kang , Wu Zhi-Gang , Xiao Yun-Bei , Wang Qin-Quan , Yu Dong-Dong , Cai Jian , Zhou Chao-Feng
Published: April 2021

Background and Aims:

There is a lack of research on metastatic renal pelvis cell carcinoma in the current literature. In this study, we aimed to detect distant metastatic patterns in renal pelvis cell carcinoma, and illustrated the affection of different metastatic sites, surgery to primary site and chemotherapy on prognosis outcomes in patients with diverse conditions.

Methods:

We collected data between 2010 and 2015 from the Surveillance, Epidemiology and End Results database. Kaplan–Meier analysis with log-rank test was used for survival comparisons. Multivariate Cox regression model was employed to analyze the effect of distant metastatic sites on overall survival (OS) and cancer-specific survival (CSS).

Results:

A total of 424 patients were included in the analysis, the median follow-up time was 5 months (interquartile range (IQR): 2-12) and 391 deaths (92.2%) in all patients were recorded. Among them, 192 (45.3%), 153 (36.1%), 137 (32.3%) and 127 (30.0%) patients were diagnosed with lung, bone, liver and brain metastases, respectively, while only 12 (2.8%) patients had brain metastases. The bi-organ, tri-organ and tetra-organ metastatic pattern was found in 135 (31.8%), 32 (7.5%) and 11 (2.6%) patients, respectively. The multivariate Cox analyses showed that distant lymph nodes (DL) metastases was not an independent prognostic factor for both OS and CSS (OS: Hazard ratios (HR) = 1.1, 95% CI = 0.8-1.4, P = 0.622; CSS: HR = 1.0, 95% CI = 0.8-1.3, P = 0.906). Besides, there was no significant difference of survival in patients with T3-T4 stage (OS: HR = 0.8, 95% CI = 0.5–1.2, P = 0.296; CSS: HR = 0.8, 95% CI = 0.5–1.2, P = 0.224), N2-3 stage (OS: HR = 0.8, 95% CI = 0.5–1.3, P = 0.351; CSS: HR = 0.7, 95% CI = 0.4–1.2, P = 0.259) and multi-organ metastases (OS: HR = 0.8, 95% CI = 0.5–1.3, P = 0.359; CSS: HR = 0.7, 95% CI = 0.4–1.2, P = 0.179) between surgery to primary site group and no-surgery to primary site group.

Conclusion:

we described the metastatic patterns of mRPCC and the prognosis outcomes of DL metastases, surgery to primary site and chemotherapy. Our findings provide more information for clinical therapeutic intervention and translational study designs.
Hydroethanolic Extracts of the Aristotelia Chilensis (Maqui) Berry Reduces Cellular Viability and Invasiveness in the Endometrial Cancer Cell Line Ishikawa
Authors: Mena Javier , Elgueta Estefanía , Espinola-Gonzales Francisca , Cardenas Hugo , Orihuela Pedro A.
Published: April 2021

Cancer of the reproductive tract includes diseases with higher prevalence in the female population. This investigation examined whether an anthocyanin-enriched extract of Aristotelia chilensis, commonly known as “maqui,” could affect some hallmarks of endometrial cancer. Cultures of the human endometrial cancer cell line Ishikawa were treated with a hydroethanolic maqui extract at 1, 3, 10, 30, 100, 300, or 1000 µg/mL to determine the effect on cell viability by MTT assay. Then, we used the 50% Effective Concentration (EC50) to evaluate whether the effect of the maqui extract is mediated via an arrest of the cell cycle or induction of apoptosis using flow cytometry or Annexin V-FITC assays, respectively. The effects of sublethal doses of the maqui extract on migration and invasiveness of Ishikawa cells were also evaluated by the wound healing and Boyden Chamber assay, respectively. Our results show that the hydroethanolic maqui extract inhibits the cell viability with an EC50 of 472.3 µg/mL via increased apoptosis, and that reduces the invasive capacity but not migration of Ishikawa cells. These findings suggest that the hydroethanolic maqui extract has antineoplastic properties for endometrial cancer and merits further studies to corroborate its efficiency as anticancer therapy in reproductive organs.
Association of plasma acylcarnitines with insulin sensitivity, insulin secretion, and prediabetes in a biracial cohort
Authors: Owei Ibiye , Umekwe Nkiru , Stentz Frankie , Wan Jim , Dagogo-Jack Sam
Published: April 2021

The ability to predict prediabetes, which affects ∼90 million adults in the US and ∼400 million adults worldwide, would be valuable to public health. Acylcarnitines, fatty acid metabolites, have been associated with type 2 diabetes risk in cross-sectional studies of mostly Caucasian subjects, but prospective studies on their link to prediabetes in diverse populations are lacking. Here, we determined the association of plasma acylcarnitines with incident prediabetes in African Americans and European Americans enrolled in a prospective study. We analyzed 45 acylcarnitines in baseline plasma samples from 70 adults (35 African-American, 35 European-American) with incident prediabetes (progressors) and 70 matched controls (non-progressors) during 5.5-year (mean 2.6 years) follow-up in the Pathobiology of Prediabetes in a Biracial Cohort (POP-ABC) study. Incident prediabetes (impaired fasting glucose/impaired glucose tolerance) was confirmed with OGTT. We measured acylcarnitines using tandem mass spectrometry, insulin sensitivity by hyperinsulinemic euglycemic clamp, and insulin secretion using intravenous glucose tolerance test. The results showed that progressors and non-progressors during POP-ABC study follow-up were concordant for 36 acylcarnitines and discordant for nine others. In logistic regression models, beta-hydroxy butyryl carnitine (C4-OH), 3-hydroxy-isovaleryl carnitine/malonyl carnitine (C5-OH/C3-DC), and octenoyl carnitine (C8:1) were the only significant predictors of incident prediabetes. The combined cut-off plasma levels of <0.03 micromol/L for C4-OH, <0.03 micromol/L for C5-OH/C3-DC, and >0.25 micromol/L for C8:1 acylcarnitines predicted incident prediabetes with 81.9% sensitivity and 65.2% specificity. Thus, circulating levels of one medium-chain and two short-chain acylcarnitines may be sensitive biomarkers for the risk of incident prediabetes among initially normoglycemic individuals with parental history of type 2 diabetes.
COVID-19 Incidence and Death Rate in Epilepsy: Too Early to Tell?
Authors: Vossler David G.
Published: April 2021

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Review on the 3-D simulation for weft knitted fabric
Authors: Sha Sha , Geng Anqi , Gao Yuqin , Li Bin , Jiang Xuewei , Tao Hui , Luo Lei , Yuan Xiaohong , Ke Huizhen , Hu Xinrong , Deng Zhongmin , Chen Zhi
Published: April 2021

There are different kinds of geometrical models and physical models used to simulate weft knitted fabrics nowadays, such as loop models based on Pierce, piecewise function, spline curve, mass-spring model, and finite element analyses (FEA). Weft knitting simulation technology, including modeling and yarn reality, has been widely adopted in fabric structure designing for the manufacturer. The technology has great potentials in both industries and dynamic virtual display. The present article is aimed to review the current development of 3-D simulation technique for weft knitted fabrics.
Women in Forensic Mental Health Services: Lived Experiences and Meanings Attributed to Activities in Rehabilitation Programs. Study Protocol
Authors: Traver-Edo Desiré , Escuder-Romeva Gemma , Talavera-Valverde Miguel-Ángel , Moruno-Miralles Pedro
Published: April 2021

Design:

Qualitative methodology, with an interpretative phenomenological analysis approach based on the analysis of the contents of the participants’ narratives.

Objective:

The main objective of this study is to interpret the meanings women attribute to lived experiences related to their participation in activities in the rehabilitation programs. Specific objectives: (1) To describe the meanings given to the activities in the rehabilitation programs of a forensic mental health setting. (2) To analyze the impact on health that participants attribute to those activities. (3) To identify possible situations of occupational deprivation.

Study Population and Total Number of Participants:

The study population is made up of women who participate in the rehabilitation program at Hospital Psiquiátrico Penitenciario de Alicante in Spain. The number of participants is established when saturation of data is reached.
Flow of nano-fluid over a sheet of variable thickness with non-uniform stretching (shrinking) and porous velocities
Authors: Alam Aftab , Marwat Dil Nawaz Khan , Ali Azhar
Published: April 2021

Nano-fluid flow is maintained over a non-uniform porous plate of variable thickness with non-uniform stretching (shrinking) velocity. In real engineering systems, the conduction resistance of sheets is necessarily important, whereas, in typical analysis very thin walls are undertaken. The surface thickness is ignored in the classical studies of flow, heat, and mass transfer problems. However, it the compulsory component in many physical problems, therefore, we thoroughly examined the perceptiveness of the wall thickness on the field variables and the transport of heat and nano-particle between solid surfaces and fluids. The phenomenon of variable wall thickness is extensively investigated with the combination of other boundary inputs. The variable stretching and shrinking velocities of the plate may have linear and non-linear forms and the sheet is uniformly heated whereas the nanoparticles are uniformly distributed over its surface. The diffusion of heat and nanoparticles in the fluid are governed using the boundary layer PDE’s, which satisfy certain BC’s. A set of unseen transformations is generated for solving the system of boundary value PDE’s. In view of these new variables, we obtained a system of boundary value ODE’s and it contains several dimensionless numbers (parameters). It is worthy noticeable that the problem describes and enhances the behavior of all field quantities in view of the governing parameters. All the field quantities, rates of heat and mass transfer are evaluated and effects all the parameters are seen on them and they are significantly changed with the variation of these dimensionless quantities. New results are presented in different graphs and tables and thoroughly examined. The Thermophoresis force enhances both the temperature and concentration profiles, however, the concentration distribution of nanoparticles is abruptly changed with a small variation in this force. The concentration profiles are bell-shaped on the right and behaves like a normal distribution. On the other hand, the addition of more nanoparticles into the base fluids increased (decreased) the temperature (concentration) profiles. Moreover, the two different attitudes of wall thickness are also examined on filed variables. The significant features and diversity of modeled equations are scrutinized and we recovered the previous problems of mass and heat transfer in Nano-fluid from a uniformly heated sheet of variable (uniform) thickness with variable (uniform) stretching/shrinking and injection/suction velocities. Moreover, two different numerical solutions of the modeled equations are found. These solutions are compared in a table and exactly matched with each other.
Design and analysis of a low crosstalk error nested structure two-dimensional micro-displacement stage
Authors: Jin Tao , Luo Siwei , Le Yanfen , Wu Junjie , Lei Lihua , Zhang Bo
Published: April 2021

In order to solve the low coupling displacement and high crosstalk error of multi-dimensional micro-displacement stage, a two-dimensional micro-displacement stage based on flexure hinges and piezoelectric ceramics is designed and analyzed. The whole stage adopts a nested parallel structure. The design parameters of flexure hinges are calculated using Pseudo-rigid body model. Those parameters are confirmed by a simulation before manufacturing the stage. A double frequency laser interferometer is used for measuring the displacement and crosstalk error of the stage when it’s driven. The experimental results show that the maximum crosstalk error of the two-dimensional displacement platform within full travel is 0.98%, the displacement coupling rate approaches 91.4%, and the remaining trajectory deviation caused by hysteresis asymmetry can be reduced to 0.79%.
Alternative models and randomization techniques for Bayesian response-adaptive randomization with binary outcomes
Authors: Proper Jennifer , Connett John , Murray Thomas
Published: April 2021

Background:

Bayesian response-adaptive designs, which data adaptively alter the allocation ratio in favor of the better performing treatment, are often criticized for engendering a non-trivial probability of a subject imbalance in favor of the inferior treatment, inflating type I error rate, and increasing sample size requirements. The implementation of these designs using the Thompson sampling methods has generally assumed a simple beta-binomial probability model in the literature; however, the effect of these choices on the resulting design operating characteristics relative to other reasonable alternatives has not been fully examined. Motivated by the Advanced R2 Eperfusion STrategies for Refractory Cardiac Arrest trial, we posit that a logistic probability model coupled with an urn or permuted block randomization method will alleviate some of the practical limitations engendered by the conventional implementation of a two-arm Bayesian response-adaptive design with binary outcomes. In this article, we discuss up to what extent this solution works and when it does not.

Methods:

A computer simulation study was performed to evaluate the relative merits of a Bayesian response-adaptive design for the Advanced R2 Eperfusion STrategies for Refractory Cardiac Arrest trial using the Thompson sampling methods based on a logistic regression probability model coupled with either an urn or permuted block randomization method that limits deviations from the evolving target allocation ratio. The different implementations of the response-adaptive design were evaluated for type I error rate control across various null response rates and power, among other performance metrics.

Results:

The logistic regression probability model engenders smaller average sample sizes with similar power, better control over type I error rate, and more favorable treatment arm sample size distributions than the conventional beta-binomial probability model, and designs using the alternative randomization methods have a negligible chance of a sample size imbalance in the wrong direction.

Conclusion:

Pairing the logistic regression probability model with either of the alternative randomization methods results in a much improved response-adaptive design in regard to important operating characteristics, including type I error rate control and the risk of a sample size imbalance in favor of the inferior treatment.
On the Problem of Nation(alism): Persistence and Absence in the Indian Post-Colony
Authors: Silva-Wijeyeratne Roshan de , Synot Edward
Published: April 2021

The search for an origin of the nation is destined to remain structured by an aporia that signals the productive irresolution of signification. In a sense, presence is always to arrive in the future, to be made anew. In post-colonial India the Muslim other embodies the ghostly trace of an undecidable figure that characterizes the aporia at the heart of the claim of Hindutva nationalism to a universal purchase on Mother India. The Muslim other then, as the ghost of the undecidable, becomes a metaphor for the fundamental fracture or split in the Hindutva nationalist imaginary, a specter which cannot be resolved and which indeed founds the very (im)possibility of the Hindutva Indian nation itself.
Report from a large and comprehensive single-center Women’s Health Cardiology Clinic
Authors: Schuchalter Ludmir Shlomit , Bental Tamir , Itzhaki Ben Zadok Osnat , Eisen Alon , Shochat Tzippy , Heruti Irit , Kornowski Ran , Porter Avital
Published: April 2021

Objective:

This article describes the women population and work at a unique Women’s Health Cardiology Clinic in order to raise cardiovascular disease awareness with an emphasis on women-specific risk factors, and thus to improve women’s clinical outcomes. This expectantly will aid in opening similar centers allowing more women to get superior care.

Methods:

Electronic medical records of women referred to the Women’s Health Cardiology Clinic were analyzed. The statistical analysis is descriptive in nature. Women’s Health Cardiology Clinic personnel work as a multidisciplinary team, and patients receive specialized diagnostic tests and treatments. Referrals are by physicians according to traditional and women’s specific risk factors for cardiovascular disease.

Results:

985 women visited the Women’s Health Cardiology Clinic, accumulating 2062 visits. Median age was 57.5 years. The majority of the women were menopausal (575 women, 58%), 62 pregnant with complications and 25 oncology patients. At least, 30% of women had diabetes/hypertension/or dyslipidemia. 72 women had a history of either cerebrovascular event or acute coronary syndrome, and 139 women had evidence of atherosclerosis. Overall, 388 women underwent endothelial function test, 40% of these women had a score indicating endothelial dysfunction. 277 women underwent a psychological intervention.

Conclusion:

Described here are the experiences from a multidisciplinary Women’s Health Cardiology Clinic using a gender-specific cardiovascular care approach for women geared toward improved health and wellbeing. It is of utmost importance that this report will raise women-specific cardiovascular disease risk factors awareness in order to promote women’s cardiovascular and overall health.
Diagnosis of gestational diabetes in Uganda: The reactions of women, family members and health workers
Authors: Zalwango Flavia , Seeley Janet , Namara Arthur , Kinra Sanjay , Nyirenda Moffat , Oakley Laura
Published: April 2021

Objectives:

In Uganda, as in many other low- and middle-income countries, screening for gestational diabetes mellitus is suboptimal and is rarely embedded in routine antenatal care. We describe the experiences of women in Uganda who underwent screening for gestational diabetes mellitus and were diagnosed with the condition as they navigate both the reaction of family members and their interaction with health workers.

Methods:

Pregnant women aged 18 years or older and between 24 and 28 weeks of gestation were enrolled from the antenatal clinics at one of the five hospitals between 13 June 2018 and 31 October 2019. Ten women with gestational diabetes mellitus, ten family members and six health workers were purposively selected to take part. Interviews and focus group discussions were used to collect data on the socio-cultural and health system factors that influence timely screening and effective management of gestational diabetes mellitus in Uganda. Data were analysed thematically.

Results:

Women generally reflected on the importance of gestational diabetes mellitus screening and felt that an early diagnosis helped them to get timely medical attention, and most reported a positive experience of the care provided by health workers. However, women who were diagnosed with gestational diabetes mellitus reported feeling fearful and anxious, and some were worried that the condition might be life-threatening. Many women reported that they were upset and largely unprepared to receive a gestational diabetes mellitus diagnosis. A gestational diabetes mellitus diagnosis not only stirred intense feelings of fear and anxiety in women but also affected their spouses and other family members. Many male partners were sympathetic and willing to provide support.

Conclusion:

Our findings highlight the need to understand the perceptions and emotions that accompany a gestational diabetes mellitus diagnosis to best support women and their family members. An improved recognition of these factors can inform the development of effective gestational diabetes mellitus screening and management programmes.
The effects of experimentally induced emotions on revising common vaccine misconceptions
Authors: Trevors Greg , Bohn-Gettler Catherine , Kendeou Panayiota
Published: April 2021

Knowledge revision is the process of updating incorrect prior knowledge in light of new, correct information. Although theoretical and empirical knowledge has advanced regarding the cognitive processes involved in revision, less is known about the role of emotions, which have shown inconsistent relations with key revision processes. This study examined the effects of experimentally induced emotions on online and offline knowledge revision of vaccination misconceptions. Before reading refutation and non-refutation texts, 96 individuals received a positive, negative, or no emotion induction. Findings showed that negative emotions, more than positive emotions, resulted in enhanced knowledge revision as indicated by greater ease of integrating correct information during reading and higher comprehension test scores after reading. Findings are discussed with respect to contemporary frameworks of knowledge revision and emotion in reading comprehension and implications for educational practice.
Antimicrobial and Anti-Inflammatory Effects of the Ethanol Extract of Polygonum cuspidatum as a Mouthwash Component
Authors: Kim Eun-Hee , Kim Jin-Cheon , Kim Hye Kyung , Jang Young-Ah
Published: April 2021

Polygonum cuspidatum (PC) has been used as traditional Korean medicine to treat various diseases including asthma, hypertension, cancer, and arteriosclerosis. In this study, we assessed the antibacterial and anti-inflammatory effects of PC ethanol extract. Persistent antibacterial activity against Streptococcus mutans for up to 23 days was observed when the extract was used at a concentration of 10 mg/mL. The minimum inhibitory concentration of PC against S. mutans was 0.2 mg/mL and the minimum bactericidal concentration was 10 mg/mL. We compared the antimicrobial activities of S. mutagens cultured with or without PC. Bacterial activity was observed only in the group where RE was not added. The anti-inflammatory effect of PC on RAW264.7 cells was assessed using the MTT assay; changes in nitric oxide (NO) production and inflammatory cytokine levels (tumor necrosis factor [TNF]-α and interleukin [IL]-6) were measured in the presence of PC. In lipopolysaccharide-induced RAW264.7 cells, PC inhibited NO production by 68.6% when used at a concentration of 50 µg/mL. The expression of TNF-α and IL-6 was reduced by PC in a concentration-dependent manner. These results suggest that the ethanol extract of PC could be used as a mouthwash component with antibacterial and anti-inflammatory effects.
Chemical Composition of the Essential Oils From Leaves and Flowers of Passiflora sexocellata and Passiflora trifasciata
Authors: della Cuna Francesco Saverio Robustelli , Giovannini Annalisa , Braglia Luca , Sottani Cristina , Grignani Elena , Preda Stefania
Published: April 2021

The chemical composition of the essential oils of Passiflora sexocellata and Passiflora trifasciata (Passifloraceae, subgenus Decaloba) were studied for the first time. Essential oils were obtained by steam distillation of fresh leaves and flowers. The chemical composition was assessed by using GC/FID and GC/MS. For P. sexocellata leaves, the optimized analytical procedure allowed the identification of 33 compounds (75% of the total oil composition) and 29 (74% of the total oil composition) in flowers. Regarding P. trifasciata, 35 compounds (76% of the total oil composition) were detected in leaves and 32 (71% of the total oil composition) in flowers. Terpenes and mono unsaturated hydrocarbons were quantified as major constituents of the volatile fraction in flowers (17.0 to 52.6%) and (13.7 to 20.0%). Organic acids were detected in both leaves and flowers with a percentage ranging from 3.3% to 32.0%. Aldehydes were also detected in leaves (12.6 to 41.4%) and in flowers (1.4 to 5.1%). The GC/MS analyzes allowed alcohols to be detected in leaves (20.6 to 42.9%) and in flowers (8.2 to 18.1%). These compounds represent the most important feature of the large Passiflora family. Moreover, a critical role in the coevolved mechanisms of pollinators' interaction has been investigated.
Hate crimes and the law: Introducing caste hatred as a public order offence
Authors: Akhtar Zia
Published: April 2021

The UK government has been provided with evidence that minorities who are of South Asian origin suffer discrimination based on ‘caste’ which is a particular characteristic of Indian sub-continental culture and society. It is prevalent in the Hindu diaspora in the UK and beyond. The issue that needs to be addressed is whether caste hatred can become part of any statutory definition of criminal law that will bring it on the same level as religious and racial hatred. This requires an analysis of the general category of hate crimes with a focus on the racial and religiously aggravated offences. The article examines several trends within the domestic legislative framework and case law as well as international law. It is proposed that caste should be considered as part of race for the purposes of hate crimes and that in the UK jurisdiction specifically Section 9 of the Equality Act 2010 should be amended to include caste as part of race which will then lead to caste hatred falling within the definition of a racially aggravated hate crime.
Predictive and prognostic relevance of immunohistochemical testing of estrogen and progesterone receptors in breast cancer in South East Nigeria: A review of 417 cases
Authors: Nzegwu Martin , Uzoigwe Joseph , Omotowo Babatunde , Ugochukwu Anthony , Ozumba Benjamin , Sule Emmanuel , Ezeome Emmanuel , Olusina Daniel , Okafor Okechukwu , Nzegwu Victor , Nzegwu Christie , Eluke Chidi , Ukekwe Francis I
Published: April 2021

ER/PgR testing are now routinely performed in breast cancer evaluation in Southeastern Nigeria. ER is predictive to show beneficiaries of hormonal therapy and a prognostic marker to establish tumors that will resist paclitaxel induced apoptosis so a cost effective combination of anthracylines can be used as treatment in our low resource setting thus improving survival, reducing recurrence, and cost. Four hundred seventeen cases of breast cancer seen over a period of 3 years were routinely tested for ER/PgR. ER positivity was defined as nuclear positivity of 1% in the presence of internal and external controls. Four hundred seventeen patients with Ductal Carcinoma participated. Majority were females 98.3%. Majority 60.2% were between 31 and 50 years old. Mean age was 33.5 ± 6.4 years. Two hundred fifty-seven (61.6%) were positive both for ER/PgR. 70.3% of age group 41–50 years had positive ER, age groups 20–30, and >70 years had positive ER also. ER positive cancer was 60.2%. Fifty-seven were 1%–9% positive. Most positive estrogen receptors were seen between 41 and 50 years at 70.3%. Least was seen at 31–40 years at 51.4%. Study provides an objective basis for using hormonal manipulation and makes cost affordable with appropriate chemotherapeutic agents in our low resource setting. Presentations were typically late. Seventy-six percent of stage 2 disease survived after 6 years compared with only 56% of stage 2 disease prior to immunotyping and radiotherapy in 2007. Both stage 3 and 4 had remarkable survival too at 55% and 33% respectively when compared with 2007 figures at 33% for stage 3 and 9.2% at stage 4.
Can you believe it? Examining the influence of safety behavior beliefs on speech task outcomes
Authors: Tutino Jessica S. , Ouimet Allison J.
Published: April 2021

Beliefs and expectations about treatment have been shown to significantly impact treatment outcomes in medical settings. However, researchers have seldom examined the role of beliefs within the context of cognitive behavioral therapy. Beliefs may be particularly salient for safety behavior (SB) use in exposure therapy, as clinicians often hold opinions about whether judicious SB use facilitates or inhibits treatment. These beliefs may consequently be relayed during psychoeducation, influencing client expectations of SB helpfulness and exposure efficacy. We investigated experimentally the influence of SB beliefs on working memory, speech predictions, speech duration, anxiety, performance, and speech acceptability. Speech anxious undergraduate participants ( N = 144) received psychoeducation on exposure and were told (using random assignment) either that SBs: increase anxiety (unhelpful), decrease anxiety (helpful), or were provided with no information on SBs (control). People in the helpful condition only believed the exposure would be more successful. Crucially, exposure expectancy mediated the relationship between the helpful (but not unhelpful) condition and willingness to engage in future exposures. There were no effects of condition on most cognitive, emotional, or behavioral outcomes, suggesting that SBs (and SB beliefs) may have less impact on exposure outcomes than is currently believed.
Pneumomediastinum in COVID-19: A series of three cases and review of literature
Authors: Machiraju Phani Krishna , Alex Neetu Mariam , Safinaaz  , Baby Nikita Mary
Published: April 2021

Coronavirus disease-19 caused by severe acute respiratory syndrome Corona virus-2 is characterised by wide heterogeneity in clinical presentation. The typical radiographic findings in COVID-19 include bilateral ground-glass opacities and/or consolidations predominantly affecting the lower lobes and posterior segments of lungs. Other rare abnormal radiographic findings include pneumothorax, pneumomediastinum and pneumopericardium. There has been an increased incidence of pneumomediastinum, a rare but potentially life-threatening complication during this pandemic. It may be spontaneous or secondary. Pneumomediastinum may be due to barotrauma, cytokine storm induced diffuse alveolar injury or direct viral infection of type I and type II pneumocytes. The presence of pneumomediastinum in COVID-19 patients may indicate extensive alveolar membrane destruction and those patients need close monitoring. There are no consensus guidelines in managing COVID-19 patients with pneumomediastinum. Higher mortality rates (70.58%) are reported in intubated COVID-19 patients with pneumomediastinum. The development of pneumomediastinum in COVID-19 should be considered as a poor prognostic factor.
The Importance of Practice Facilitation in Primary Care When Pandemic Takes Hold: Relationships of Resilience
Authors: Hatch Brigit A. , Ferrara Laura , Dickinson Caitlin , Stock Isabel , Carney Patricia A. , Fagnan Lyle J.
Published: April 2021

The COVID-19 pandemic is unprecedented in recent history as radically and forcefully changing healthcare delivery. Practice facilitators, who often use tools of improvement science, have long played a critical role in supporting routine primary care practice transformation when healthcare system and policy changes occur. However, current events have taken many healthcare systems to the brink of collapse. Our practice facilitation team, which has a long history of sustained primary care partnerships in rural under-resourced settings, is finding creative solutions to carry forward work in research and quality improvement, and the tools of improvement science are well-suited to address rapidly changing demands of primary care during such a crisis. We reflect here on practice facilitation through the pandemic—the value of applied improvement science, and the critical necessity of strong relationships, flexibility, and creativity to support ongoing primary care partnerships.
Prevalence and Detailed Experience of Nightmare and Nightmare Disorder in Chinese University Students
Authors: Wang Chu , Xu Jiayao , Wang Mufan , Shao Xu , Wang Wei
Published: April 2021

Nightmares influence the mental health of university students, but the prevalence of nightmare and nightmare disorder requires additional documentation. The data of detailed nightmare experience of nightmare disorder and related depressive mood in this population are also scarce. First, a total of 1,451 students in a comprehensive Chinese university were invited to report their nightmare frequency. Sixty-eight patients with nightmare disorder were diagnosed using a semi-structured clinical interview according to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, 2013). Second, 60 patients with nightmare disorder (8 of 68 patients were dismissed due to data incompletion) and 124 gender-matched, healthy students were invited to answer the Nightmare Experience Questionnaire (NEQ) and the Plutchik-van Praag Depression Inventory (PVP). Of 1,451 students, 923 reported nightmares (its annual prevalence was 63.61%), and 68 were diagnosed with nightmare disorder (its prevalence was 4.69%), with a female preponderance. The mean PVP and four NEQ scale scores in patients were higher than those in healthy students. The PVP scores were correlated with NEQ Physical Effect in patients, and with Negative Emotion in healthy students. This is the first report regarding nightmare disorder prevalence and detailed nightmare experience in university students. The findings of a high prevalence of nightmare disorder in women and elevated scores of nightmare experience among patients in the university population might help address the mechanisms and the management of patients with nightmare disorder.
Explaining Donation Behavior in Medical Crowdfunding in Social Media
Authors: Huang Zhengwei , Ouyang Jing , Huang Xiaohong , Yang Yanni , Lin Ling
Published: April 2021

Medical crowdfunding in social media is growing to be a convenient, accessible, and secure manner to cover medical expenses. It differs from traditional donation initiatives and medical crowdfunding on non-social media platforms in that projects are disseminated via social media network and among acquaintances. Through semi-structured in-depth interviews on donation behaviors of 52 respondents, this study uses grounded theory to extract seven main categories that affect medical crowdfunding donation behavior in social media, namely interpersonal relationship, reciprocity of helping, attitude toward donation, perceived behavior control, perceived trust, project information, and characteristics of patients. In the spirit of Elaboration Likelihood Model, we develop a theoretical framework that the seven factors influence donation behavior in medical crowdfunding in social media via a central and a peripheral route.
A resorbable hyaluronic acid hydrogel to prevent adhesion in porcine model under laparotomy pelvic surgery
Authors: Chen Pei-Chin , Chen Yen-Po , Wu Chang-Cheng , Tseng Chung-Chih , Yang Chi-Yu , Hung Yu-Wen , Wen Zhi-Hong
Published: April 2021

Surgical post-operative adhesions can lead to serious clinical complications. Barrier agent is the broad usage for the prevention of post-operative adhesions. This study aimed to evaluate the reducing adhesion efficacy of non-animal hyaluronic acid (HA) hydrogel in pigs undergoing conventional laparotomy pelvic surgery. HA hydrogel was applied to eighteen female pigs who underwent conventional laparotomy. The adhesion degrees and histopathology were evaluated in bilateral uterine horns as well as peritoneal sidewall excision. In the present study, all animals survived and had no complications after the surgery. The histopathological observations were demonstrated that HA obviously improved laparotomy pelvic surgery-induced adhesion in peritoneal sidewall and uterine horn. The anastomotic healing score of injury + HA group was significantly lower than the injury alone group. We conclude HA hydrogel can attenuate the post-operative adhesions in porcine.
The impact of sagittal imbalance on walking in patients with lumbar spinal canal stenosis
Authors: Murata Kazuma , Endo Kenji , Aihara Takato , Suzuki Hidekazu , Matsuoka Yuji , Nishimura Hirosuke , Takamatsu Taichiro , Yamamoto Kengo
Published: April 2021

Purpose:

Gait and posture disorder severely impedes the quality of life of affected patients with lumbar spinal canal stenosis (LSCS). Despite the major health concern, there is a paucity of literature about the relationships among spatiotemporal gait parameters and spinal sagittal parameters. This is a cross sectional study performed in a single tertiary referral center to determine the relationships among spatiotemporal gait parameters and spinal sagittal parameters in patients with LSCS.

Methods:

A total of 164 consecutive patients with LSCS, 87 men and 77 women with mean age of 70.7 years, were enrolled. Spatiotemporal gait parameters were studied using a gait analysis system. Spinal sagittal parameters were studied including sagittal vertical axis (SVA), thoracic kyphosis (TK), lumbar lordosis (LL), sacral slope (SS), pelvic inclination (PI), and pelvic tilt (PT) both in the neutral and stepped positions.

Results:

SVA was significantly larger in the stepped position than in the neutral position (neutral position, 72.5 mm; stepped position, 96.8 mm; p = 0.003). Parameters regarding the pelvis exhibited significant differences, which could represent pelvic anteversion in the stepped position. By stepwise multiple regression analysis, the prediction models, containing SVA (neutral) and PT (stepped) for double supporting phase, exhibited statistical significance, and accounted for approximately 50% of the variance.

Conclusions:

The present study provides statistically established evidence of correlation among spatiotemporal gait parameters and spinal sagittal parameters. Differences between sagittal parameters in neutral and stepped position may stand for the postural control during gait cycle, and increased SVA in neutral position and increased PT in stepped position may correlate with prolonged double supporting phase.
Inclination of the small laminar slope angle leads to lumbar spinal stenosis due to hypertrophy of the ligamentum flavum
Authors: Yu Xiaosheng , Zhao Junduo , Feng Fan , Han Yingchao , Zhong Guibin , Liu Zude , Chen Jianwei
Published: April 2021

Objective:

This study was designed to investigate the relationship between the laminar slope angle (LSA) and the lumbar disc degenerative grade, the cross-section area (CSA) of multifidus muscle, the muscle-fat index, and the thickness of the ligamentum flavum.

Methods:

Retrospective analysis of 122 patients who were scheduled to undergo a lumbar operation for diagnoses associated with degenerative lumbar disease between January and December 2017. The L4–L5 disc grade was evaluated from preoperative sagittal T2-weighed magnetic resonance imaging of the lumber region; the CSA of the multifidus and muscle-fat index were measured at the L4 level, while the thickness of the ligamentum flavum was measured at the L4–L5 facet level from axis T2-weighed magnetic resonance imaging. The slope of the laminar was evaluated from preoperative three-dimensional computer tomography at the tip level of the facet joints and selected by the axis plane. Independent-sample T-tests were used to assess the association between age and measurement indices.

Results:

Our results showed that age was positively connected with the LSA of L4 and L5 in different patients, although there was no significant difference between age and the difference of the two segment LSA. Partial correlation analysis, excluding the interference of age, revealed a strong negative relationship between the LSA of L4 and the thickness of the ligamentum flavum, irrespective of whether we considered the left or right. However, there was no correlation with lumbar disc degenerative grade, the CSA of the multifidus, and the muscle-fat index.

Conclusion:

The thickness of the ligamentum flavum showed changes with anatomical differences in the LSA, but not the lumbar disc degenerative grade, the CSA of the multifidus, and the muscle-fat index. A small change in LSA may cause large mechanical stress; this may be one of the causative factors responsible for lumbar spinal stenosis.
Nurses’ Actions to Protect Their Families from COVID-19: A Descriptive Qualitative Study
Authors: Widiasih Restuning , Ermiati  , Emaliyawati Etika , Hendrawati Sri , Susanti Raini Diah , Sutini Titin , Sari Citra Windani Mambang
Published: April 2021

As health service providers, nurses are at a high risk of COVID-19 infection, as are their family members who live with them. This study aimed to explore nurses’ actions to protect their families from COVID-19 in Indonesia. This qualitative descriptive study included seventeen nurses who were chosen using the snowball sampling technique. The semi structured interviews explored nurses’ actions and behavior, and comparative analysis was performed to analyze the data. The study identified four themes: nurses modified their behavior and environments to protect their families, provided supplements and nutritious food, enhanced their families’ knowledge and awareness of COVID-19, and protected their families from social stigma. Nurses play active roles in the health of their family members. The government should support nurses in their roles so that they can remain healthy while caring for COVID-19 patients, and not transmit COVID-19 to their own families.
Body Mass Index Trajectories and Duration of Obesity in Thai Children Diagnosed with Hypertension
Authors: Paksi Witchuri , Sirijunpen Suthatip , Nuntnarumit Pracha , Pirojsakul Kwanchai
Published: April 2021

This study explored the relationship between BMI trajectories and the duration of obesity in Thai children diagnosed with hypertension. Demographic and blood pressure data from 536 children (270 boys, 50.3%) from a school in Bangkok, Thailand were collected. Hypertension was defined as blood pressure above the cutoff values specified in the 2017 American Academy of Pediatrics guidelines on 3 occasions. Records of BMI over the previous 3 years were reviewed. The prevalence of hypertension was 2.61% (14/536). Complete data on BMI trajectories were available in 421 non-hypertensive and 12 hypertensive children. The increase in BMI z-score over the previous 3 years was significantly greater in the hypertensive group than the non-hypertensive group, 1.45 (95% CI 0.42 to 1.88) versus 0.09 (95% CI: −0.35, 0.65), P = .008. In conclusion, children with a confirmed diagnosis of hypertension had a greater increase in BMI over the past 3 years than non-hypertensive children.
Cannabinoid Receptor 1 rs1049353 Variant, Childhood Abuse, and the Heterogeneity of PTSD Symptoms: Results From the National Health and Resilience in Veterans Study
Authors: Korem Nachshon , Duek Or , Xu Ke , Harpaz-Rotem Ilan , Pietrzak Robert H.
Published: April 2021

Background

Accumulating evidence implicates the endocannabinoid system, including variants in the cannabinoid-1 receptor gene ( CNR1), in the pathophysiology of posttraumatic stress disorder (PTSD). The synonymous G1359A variant (rs1049353) in the CNR1 gene has been linked to PTSD in individuals exposed to childhood abuse. In this study, the effects of the rs1049353 genotype and childhood abuse on overall PTSD symptoms, as well as PTSD symptom clusters were examined in order to examine how this interaction relates to the phenotypic expression of this disorder.

Method

Data were analyzed from 1,372 Caucasian U.S. veterans who participated in the National Health and Resilience in Veterans Study. Multivariable analyses were conducted to evaluate the association between rs1049353 genotype, childhood abuse, and their interaction in relation to PTSD symptoms.

Results

A significant interaction between rs1049353 genotype and childhood abuse was observed, with A allele carriers with histories of childhood abuse reporting greater severity of PTSD symptoms, most notably anxious arousal, relative to G/G homozygotes. Significant main effects of childhood abuse on overall PTSD symptoms, and re-experiencing, emotional numbing, and dysphoric arousal symptom clusters, as well as of A allele carrier status on anxious arousal symptoms were observed.

Conclusions

Results of this study replicate prior work and suggest that the rs1049353-by-childhood abuse interaction is particularly associated with the manifestation of anxious arousal symptoms of PTSD. Taken together, these findings underscore the importance of considering the phenotypic heterogeneity of PTSD in gene-environment studies of this multifaceted disorder.