bluuebunny/crossref_metadata_2025 huggingface dataset:
Over my dead body: Self-determination, proxy consent, and proportionate reason in the treatment of a Jehovah's Witness patient with severe traumatic hemorrhagic shock
Authors: Alouidor Reginald , DePergola Peter A. , Lopez-Garena Milagros , Bungash Yasmin , Kelly Edward , Jabbour Nicolas
Published: September 2021

When a Jehovah’s Witness patient is traumatically injured, the lack of uniform professional consensus guidelines and the cultural knowledge deficit of many clinicians adds an additional layer of legal and ethical complexity to the inherent difficulty of managing a critically ill patient. We present here the case of an incapacitated Jehovah's Witness patient with severe traumatic hemorrhagic shock. We go on to discuss the historical and contemporary case law on proxy refusal of blood transfusion for the incapacitated adult, as well as the ethics of self-determination and the application of the principle of proportionate reason in the management of the critically injured Jehovah's Witness patient.
Emotion Regulation and Intimate Partner Violence Perpetration in Undergraduate Samples: A Review of the Literature
Authors: Neilson Elizabeth C. , Gulati Natasha K. , Stappenbeck Cynthia A. , George William H. , Davis Kelly Cue
Published: September 2021

Intimate partner violence (IPV) perpetration increases throughout young adulthood and is particularly widespread among college students, resulting in mental health and academic consequences. Deficits in emotion regulation (ER) are an important factor associated with IPV perpetration; the developmental tasks and challenges associated with college, including relationship stressors and hazardous alcohol use, implicate ER as a particularly relevant risk factor for IPV perpetration. Thus, college presents an important opportunity for intervention in order to change the trajectories of IPV perpetration across young adulthood. The purpose of this review was to synthesize findings regarding ER and psychological, physical, and sexual IPV perpetration among college students. Twenty-one articles met inclusion criteria. Studies were organized into five categories: (a) direct associations of ER with IPV perpetration, (b) qualitative assessment of ER and IPV, (c) ER in indirect effects models, (d) ER in moderation models, and (e) experiments with ER instructional sets. Overall, ER emerged as an important inhibiting factor for IPV perpetration, particularly impulse control and access to ER strategies. ER deficits in the context of impelling (e.g., negative affect, trauma history) and instigating (e.g., provocation) factors emerged as consistent predictors of psychological and physical IPV perpetration for both male and female students. Deficits in ER were associated with sexual IPV perpetration among men; however, very few studies examined sexual IPV. Experimental paradigms suggest cognitive reappraisal may reduce IPV perpetration, while suppression may, in some contexts, increase perpetration. Methodological strengths and weaknesses and implications for IPV prevention and interventions programming for college students are discussed.
Compare of Interfractional Setup Reproducibility Between Vacuum-Lock Bag and Thermoplastic Mask in Radiotherapy for Breast Cancer
Authors: Song Yaqi , Peng Jin , Chen Qianfeng , Luo Honglei
Published: September 2021

Background: This study aimed to analyze the difference of setup reproducibility between Vacuum-lock bag and Thermoplastic mask in the radiotherapy for breast cancer. Methods: A total of 100 invasive breast carcinoma patients were collected, among whom 50 patients were immobilized with Vacuum-lock bag (VB group), and the other 50 patients were immobilized with Thermoplastic mask (TM group). Set up reproducibility in different axes and comfort levels between two groups at three treatment progress points during the radiation therapy were collected and analyzed. Results: The linear regression model showed that fixed device was an independent factor of radiotherapy setup error (SE). Further subgroup analysis based on different axes showed that the SE caused by the fixed device was obvious in all directions. The comfort level in the VB group was significantly larger than that in the TM group at the beginning of treatment, reduced as the treatment progress going on, and finally disappeared within three weeks. Conclusions: Thermoplastic mask could significantly reduce positioning errors in the radiotherapy of breast cancer. Although more discomfort was found in the TM group, it could be eliminated as the treatment progresses.
Does Subthalamic Deep Brain Stimulation Impact Asymmetry and Dyscoordination of Gait in Parkinson’s Disease?
Authors: Ravi Deepak K. , Baumann Christian R. , Bernasconi Elena , Gwerder Michelle , Ignasiak Niklas K. , Uhl Mechtild , Stieglitz Lennart , Taylor William R. , Singh Navrag B.
Published: September 2021

Background. Subthalamic deep brain stimulation (STN-DBS) is an effective treatment for selected Parkinson’s disease (PD) patients. Gait characteristics are often altered after surgery, but quantitative therapeutic effects are poorly described. Objective. The goal of this study was to systematically investigate modifications in asymmetry and dyscoordination of gait 6 months postoperatively in patients with PD and compare the outcomes with preoperative baseline and to asymptomatic controls without PD. Methods. A convenience sample of thirty-two patients with PD (19 with postural instability and gait disorder (PIGD) type and 13 with tremor dominant disease) and 51 asymptomatic controls participated. Parkinson patients were tested prior to the surgery in both OFF and ON medication states, and 6-months postoperatively in the ON stimulation condition. Movement Disorder Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) I to IV and medication were compared to preoperative conditions. Asymmetry ratios, phase coordination index, and walking speed were assessed. Results. MDS-UPDRS I to IV at 6 months improved significantly, and levodopa equivalent daily dosages significantly decreased. STN-DBS increased step time asymmetry (hedges’ g effect sizes [95% confidence interval] between pre- and post-surgery: .27 [-.13, .73]) and phase coordination index (.29 [-.08, .67]). These effects were higher in the PIGD subgroup than the tremor dominant (step time asymmetry: .38 [-.06, .90] vs .09 [-.83, 1.0] and phase coordination index: .39 [-.04, .84] vs .13 [-.76, .96]). Conclusions. This study provides objective evidence of how STN-DBS increases asymmetry and dyscoordination of gait in patients with PD and suggests motor subtypes‐associated differences in the treatment response.
Knowledge of preconception care and associated factors among maternal health care providers working in urban public health institutions of Eastern Ethiopia
Authors: Sori Seboka Abebe , Teji Roba Kedir , Yadeta Tesfaye Assebe , Jiru Hirut Dinku , Metebo Keyredin Nuriye , Weldekidan Haregwa Asnake , Regassa Lemma Demissie
Published: September 2021

Background:

Provision of preconception care is significantly affected by the health care provider’s knowledge of preconception care. In Ethiopia, preconception care is rare, if even available, as part of maternal health care services. Thus, this study aimed to determine the level of knowledge of preconception care and associated factors among health care providers working in public health facilities in Eastern Ethiopia.

Methods:

A multicenter cross-sectional study was conducted from 1 March to 1 April 2020. A simple random sampling technique was used to select a total of 415 maternal health care providers. We utilized a structured, pretested, and self-administered questionnaire to collect data. Data were entered into EpiData (version 3.1) and exported to STATA (version 16) for analysis. Descriptive statistics and bivariate and multivariate logistic regression analyses were performed. All covariates with a p value ⩽0.20 in bivariate logistic regression were entered into a multivariate logistic regression analysis to control the confounding variables; variables with a p value <0.05 were considered statistically significant.

Results:

Out of 410 respondents, 247 (60.2%; 95% confidence interval: 55.4–65.1) had good knowledge of preconception care. Having an educational level of Bachelor of Science degree and above (adjusted odds ratio: 6.97, 95% confidence interval: 3.85–12.60), 5 or more years work experience (adjusted odds ratio: 2.60, 95% confidence interval: 1.52–4.49), working in a hospital (adjusted odds ratio: 2.50, 95% confidence interval: 1.25–4.99), reading preconception care guidelines (adjusted odds ratio: 3.06, 95% confidence interval: 1.40–6.68), and training on preconception (adjusted odds ratio: 2.90, 95% confidence interval: 1.37–6.15) were significantly associated with good knowledge of preconception care.

Conclusions and Recommendations:

Three out of five maternal health care providers in this study had good knowledge of preconception care. Facilitating continuous refreshment training and continuous professional development for health workers, preparing comprehensive preconception care guidelines for health institutions, and reading preconception care guidelines were highly recommended.
Exploring Decentralized Glucose and Behaviometric Monitoring of Persons with Type 2 Diabetes in the Setting of a Clinical Trial
Authors: Ali Zarqa , Valk Teske Jacqueline , Bjerre-Christensen Theis , Brandt Sigurd , Isberg Ari Pall , Jensen Morten Lind , Helledi Lise Sylvest , Kaas Anne , Thomsen Simon Francis , Andersen Anders Daniel , Robert Zibert John
Published: September 2021

Background:

Clinical trials often suffer from recruitment barriers and poor adherence, which increases costs and affects trial outcomes.

Objective:

To investigate the feasibility of Decentralized Clinical Trial (DCT) design elements to recruit, enroll, and engage patients with type 2 diabetes mellitus (T2DM).

Methods:

Patients with T2DM were recruited through a pharmacy and online recruitment using advert on Facebook, to 3 weeks monitoring of glucose and behaviometric parameters. Subjects recruited online could either complete an informed consent conversation in the pharmacy or through live video call managed by the study app. A continuous glucose monitoring (CGM) device to collect glucose data, and a hybrid smartwatch to monitor heart rate, track activity and sleep pattern were delivered by postal service to the participants’ home address. The devices were connected to a study specific app on the participant’s smartphone also capturing GPS data and questionnaire answers.

Results:

Twenty-six subjects (3 pharmacy, 23 online) with T2DM were recruited, 85% preferred online informed consent conversation. All participants were able to self-apply the CGM device, use the smartwatch, and download the app. GPS location was captured more than 100 times for each participant, and more than 90% completed all 3 questionnaires. All the participants felt safe with the informed consent process and they felt confident in participating from home. Three participants dropped-out during the study period leaving a retention rate at 87%.

Conclusions:

Use of DCT design elements to conduct a T2DM study is feasible regarding recruitment, data collection from various electronic devices, and participant engagement.
Basal cell adenocarcinoma of the maxillary sinus: A case report
Authors: Kojima Masataka , Ito Shin , Tou Miri , Sonoda Kenji , Yoshikawa Akihisa , Ohtsuji Naomi , Ikeda Katsuhisa , Higo Ryuzaburo
Published: September 2021

Basal cell adenocarcinoma is a low-grade malignancy of the salivary glands. Basal cell adenocarcinoma of the minor salivary gland is an extremely rare disease that originates from the maxillary sinus. The histopathological characteristics of basal cell adenocarcinomas are similar to those of basal cell adenomas. However, basal cell adenocarcinomas can be differentiated from basal cell adenomas based on their tendency to invade surrounding tissues. Surgical resection is the first-line treatment for basal cell adenocarcinomas. An 86-year-old man underwent operations for a maxillary sinus tumor twice in our department. The pathological results of the tumor at both times revealed basal cell adenoma. After 4 and 5 years since the last operation, the tumor recurred, and the patient was treated with partial maxillectomy using Weber–Ferguson incision. We observed invasions to the surrounding tissue, and based on immunohistochemical findings, the patient was diagnosed with basal cell adenocarcinoma. Herein, we present an extremely rare case of basal cell adenocarcinoma arising from the maxillary sinus, in detail.
Inclusive Education in Wales: Interpreting Discourses of Values and Practice Using Critical Policy Analysis
Authors: Knight Cathryn , Crick Tom
Published: September 2021

Purpose

This paper provides a detailed analysis of inclusive education policies in the context of major system reform in Wales, United Kingdom. Wales is currently undergoing the most significant changes to its education system since political devolution from the U.K. Government in 1999. Key to these changes is the new Curriculum for Wales and the Additional Learning Needs (ALN) regulations; alongside these and wider system-level reforms, there is an ambition to create an inclusive education system in Wales. This paper explores how inclusion is articulated and communicated within the key policy and guidance documents, using two continuums—“practice” and “values”—to map and interpret these documents.

Design/Approach/Methods

This paper uses critical policy analysis to make sense of these various inclusive education policy reforms in Wales.

Findings

The analysis reveals that despite a foregrounded commitment to inclusion, there is disparity both within and between the policy and guidance documents.

Originality/Value

The paper highlights the lack of coherence of key messages articulated through education policy documentation in Wales, providing insight into the emerging national education system reforms, as well as developing an approach for evaluating inclusive education systems in other jurisdictions.
Qualitative Olfactory Disorders: Patient Experiences and Self-Management
Authors: Philpott Carl , Dixon Joanne , Boak Duncan
Published: September 2021

Background

Qualitative olfactory disorders in the form of parosmia and phantosmia are very subjective and cannot be measured at present. They pose an unpleasant experience for patients and a therapeutic challenge for clinicians.

Objective

This study aimed to characterise the specific experiences of patients affected by the qualitative symptoms of parosmia and phantosmia including both triggers for symptoms and self-help measures they have tried.

Methods

A cross-sectional survey questionnaire was developed with the input of patient experts within the charity Fifth Sense. The survey was then open online for 3 months to charity members complaining of qualitative symptoms. The survey captured the frequency and impact of symptoms and self-management undertaken. Reflective feedback was also captured from a patient workshop.

Results

There were 100 participants; 61% female, age range 13-88. Common self-reported aetiology included sinonasal disease (17%), idiopathic (33%) and post-viral olfactory loss (26%) and post-traumatic olfactory loss (23%). Parosmia was reported as a daily symptom in 67% compared to 31% for phantosmia; 36% complained of suffering with both symptoms. Only 4% of respondents reported having received any successful treatment for their qualitative symptoms and 58% reported having received no treatment whatsoever. Olfactory training was the most common self-management method reported.

Conclusion

This study illustrates that qualitative disturbances remain problematic for those who experience them due to the duration of symptoms, the relative lack of experience or knowledge amongst medical professionals and the lack of therapeutic options. In future, consideration needs to be given to adaptation and coping strategies to help patients deal with these symptoms.
Linguistic Studies on Social Media: A Bibliometric Analysis
Authors: Sun Ya , Wang Gongyuan , Feng Haiying
Published: September 2021

This study aimed to present the status quo of linguistic studies on social media in the past decade. In particular, it conducted a bibliometric analysis of articles from the field of linguistics of the database of Web of Science Core Collection with the aid of the tool CiteSpace to identify the general characteristics, major strands of linguistics, main research methods, and important research themes in the area of linguistic studies on social media. The main findings are summarized as follows. First, the study reported the publication trend, main publication venues, researched social media platforms, and languages used in researched social media. Second, sociolinguistics and pragmatics were found to be major strands of linguistics used in relevant studies. Third, the study identified seven main research methods: discourse analysis, critical discourse analysis, conversation analysis, multimodal analysis, narrative analysis, ethnographic analysis, and corpus analysis. Fourth, important research themes were extracted and classified based on four dimensions of the genre framework of social media studies. They were the participation nature and technology affordances of social media in the dimension of compositional level, the researched topics of education, (language) policy and politics in the dimension of thematic orientations, the researched discursive practices of (im)politeness, humor, indexicality and multilingualism in the dimension of stylistic traits, and the researched communicative functions of constructing identity, communicating (language) ideology, and expressing attitude in the pragmatic dimension. Moreover, linguistic studies on social media tended to be characterized by cross-disciplinary and mixed-method approaches.
Association of Body Mass Index With Severity and Lesion Location in Adolescents With Osteochondritis Dissecans of the Knee
Authors: Rogers Davis L. , Klyce Walter , Kajstura Tymoteusz J. , Lee R. Jay
Published: September 2021

Background:

The association between body mass index (BMI) and severity of osteochondritis dissecans (OCD) of the knee at presentation is poorly understood.

Hypothesis:

We hypothesized that adolescents in higher BMI percentiles for age and sex would have OCD lesions that were more severe at their initial presentation and located more posteriorly on the condyle as compared with adolescents in lower BMI percentiles.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

This study included patients aged 10 to 18 years who were treated for knee OCD at a tertiary care hospital from 2006 to 2017. Patients with noncondylar OCD or missing BMI data within 3 months of presentation were excluded. Patients were stratified per the Centers for Disease Control and Prevention guidelines as underweight, normal weight, overweight, or obese, and the groups were compared according to age, side of lesion, 4 markers of lesion severity (cystic changes, loose fragments, subchondral fluid, and subchondral edema), and surgical treatment. Lesion angle was measured in reference to a line parallel to the femoral axis drawn through the center of a best-fit circle covering the distal condyle. Data were analyzed using chi-square tests, relative risk, Student t tests, analysis of variance, and linear regression of cumulative running percentages. Bonferroni correction was performed when applicable.

Results:

A total of 77 patients met our inclusion criteria (mean age, 14.2 years; range, 10.1-18.8): 2 were underweight, 50 had normal BMI, 13 were overweight, and 12 were obese. We found correlations between BMI percentile and surgical treatment ( R 2 = .732), subchondral fluid ( R 2 = .716), subchondral edema ( R 2 = .63), loose fragments ( R 2 = .835), and the presence of at least 1 marker of lesion severity ( R 2 = .857) ( P < .0001 for all). No correlation was observed for cystic changes ( R 2 = .026). There were significant associations between BMI ≥80th percentile and subchondral edema (risk ratio, 2.5; 95% CI, 1.3-4.8), medial condylar lesions (risk ratio, 1.3; 95% CI, 1.01-1.7), and lesions more anterior on the condyle ( P < .05).

Conclusion:

Higher BMI in adolescents was strongly correlated with multiple markers of severity of knee OCD at initial presentation as well as with more anterior lesions.
Working Through Marriage: Effects of Marital Inequalities on Perceptions of Women’s Employment
Authors: Karia Shubhangi , Mehta Tanvi
Published: September 2021

Women’s domestic responsibilities are often cited as the main barrier to their entry into the workforce. Drawing on a survey conducted across four cities in North India, we look within the household to evaluate the effects of marital inequalities on the perceptions held about women’s work. Respondents were asked questions about the personal value in working, women’s competence to excel in certain fields and the opportunity costs of working outside the house. We characterise marital inequality through differences in age and education between spouses and marriage type as well as through the distribution of power in household decision-making and the freedom of mobility outside the house enjoyed by women. Overall, we note that these markers tend to have the strongest effects on questions that explicitly note discord between work options and domestic responsibilities. The variation in these effects reveal the relative valence of certain powers within the house over others.
Management of pancreatic cysts and guidelines: what the gastroenterologist needs to know
Authors: Buerlein Ross C.D. , Shami Vanessa M.
Published: September 2021

The prevalence of pancreatic cysts has increased significantly over the last decade, partly secondary to increased quality and frequency of cross-sectional imaging. While the majority never progress to cancer, a small number will and need to be followed. The management of pancreatic cysts can be both confusing and intimidating due to the multiple guidelines with varying recommendations. Despite the differences in the specifics of the guidelines, they all agree on several high-risk features that should get the attention of any clinician when assessing a pancreatic cyst: presence of a mural nodule or solid component, dilation of the main pancreatic duct (or presence of main duct intraductal papillary mucinous neoplasm), pancreatic cyst size ⩾3–4 cm, or positive cytology on pancreatic cyst fluid aspiration. Other important criteria to consider include rapid cyst growth (⩾5 mm/year), elevated serum carbohydrate antigen 19-9 levels, new-onset diabetes mellitus, or acute pancreatitis thought to be related to the cystic lesion.
Calcitriol confers neuroprotective effects in traumatic brain injury by activating Nrf2 signaling through an autophagy-mediated mechanism
Authors: Cui Changmeng , Wang Changshui , Jin Feng , Yang Mengqi , Kong Lingsheng , Han Wenxiu , Jiang Pei
Published: September 2021

Background

The present study aimed to further explore the potential interaction between oxidative stress and autophagy in the progression of traumatic brain injury (TBI) and therapeutic mechanism of calcitriol, the active form of vitamin D (VitD).

Methods

Neuroprotective effects of calcitriol were examined following TBI. We further evaluated the impacts of TBI and calcitriol treatment on autophagic process and nuclear factor E2-related factor 2 (Nrf2) signaling.

Results

We found that treatment of calcitriol markedly ameliorated the neurological deficits and histopathological changes following TBI. The brain damage impaired autophagic flux and impeded Nrf2 signaling, the major regulator in antioxidant response, consequently leading to uncontrolled and excessive oxidative stress. Meanwhile, calcitriol promoted autophagic process and activated Nrf2 signaling as evidenced by the reduced Keap1 expression and enhanced Nrf2 translocation, thereby mitigating TBI-induced oxidative damage. In support, we further found that chloroquine (CQ) treatment abrogated calcitriol-induced autophagy and compromised Nrf2 activation with increased Keap1 accumulation and reduced expression of Nrf2-targeted genes. Additionally, both CQ treatment and Nrf2 genetic knockout abolished the protective effects of calcitriol against both TBI-induced neurological deficits and neuronal apoptosis.

Conclusions

Therefore, our work demonstrated a neuroprotective role of calcitriol in TBI by triggering Nrf2 activation, which might be mediated by autophagy.
CircRNAs as potent biomarkers in ovarian cancer: a systematic scoping review
Authors: Foruzandeh Zahra , Zeinali-Sehrig Fatemeh , Nejati Kazem , Rahmanpour Dara , Pashazadeh Fariba , Seif Farhad , Alivand Mohammad Reza
Published: September 2021

More powerful prognostic and diagnostic tools are urgently needed for identifying and treating ovarian cancer (OC), which is the most fatal malignancy in women in developed countries. Circular RNAs (circRNAs) are conservative and stable looped molecules that can regulate gene expression by competing with other endogenous microRNA sponges. This discovery provided new insight into novel methods for regulating genes that are involved in many disorders and cancers. This review focuses on the dysregulated expression of circRNAs as well as their diagnostic and prognostic values in OC. We found that studies have identified twenty-one downregulated circRNAs and fifty-seven upregulated ones. The results of these studies confirm that circRNAs might be potent biomarkers with diagnostic, prognostic and therapeutic target value for OC. We also consider the connection between circRNAs and OC cell proliferation, apoptosis, metastasis, and chemotherapy resistance and sensitivity.
Impact of a binary triage system and structural reorganization of emergency department on health care workers exposed to suspected COVID-19 patients—a single-centre analysis
Authors: Abd. Wahab Mahathar , Safaai Sufian , Mohd Saiboon Ismail
Published: September 2021

Background

A binary triage system based on infectivity and facilitated by departmental restructuring was developed to manage suspected COVID-19 patients with an aim to provide effective prevention and control of infection among health care workers (HCWs) in the emergency department. This study analyses the effectiveness of the new triage system and structural reorganization in response to the COVID-19 pandemic.

Methods

A cross-sectional observational study was conducted in the Emergency and Trauma Department, Hospital Kuala Lumpur (ETDHKL). The implementation of a binary triage system separates patients with risk of COVID-19 who present with fever and respiratory symptoms from other patients. Data on exposed HCWs to COVID-19 patients were captured pre-restructuring and post-restructuring of the emergency department and analysed using descriptive statistics.

Results

A total of 846 HCWs were involved in this study. Pre-restructuring reported 542 HCWs exposed to COVID-19 patients while post-restructuring reported 122. Using the four categorical exposure risks for HCWs which are no identifiable risk, low risk, medium risk, and high risk, the number of HCWs exposed during pre-restructuring were 15(1.8%), 504 (59.6%), 15 (1.8%), and 8 (0.9%), respectively, while post-restructuring the numbers were 122 (14.4%), 8 (0.9%), 109 (12.9%), and 5 (0.1%), respectively. There was a 77.5% reduction in the number of exposed HCWs after our implementation of the new system (542 vs 122).

Conclusion

A binary triage system based on severity and infectivity and supported with structural reorganization can be effective in reducing HCWs COVID-19 exposure.
Prostate biopsy: a survey of practice among Nigerian urologists
Authors: Mohammed Taofiq O. , Ajape Abdulwahab A. , Kuranga Suleiman A. , Olanipekun Hamid B. , Ogunfowora Tolulope T.
Published: September 2021

Background

Prostate biopsy is a commonly performed outpatient procedure in urology. It is a rapidly changing field with wide variation in practice pattern. The aim of this study is to document the current practice of prostate biopsy among Nigerian urologists.

Methods

A prospectively designed, self-administered, 16-item survey questionnaire was distributed among urologists and trainees at the 24th Annual General Meeting and Scientific Conference of the Nigerian Association of Urological Surgeons (NAUS). The survey covers various aspect of prostate biopsy including indications for biopsy, prophylactic antibiotic regimen use, methods of bowel preparation, number of biopsy cores taken, complications among others.

Results

Fifty-one completed questionnaires were returned, out of 76 distributed, giving a response rate of 67%. Majority of the respondents were Consultant urologist 47 (92%), most of them practice in the public health system 46 (90.2%), and performed more than 5 prostate needle biopsy per month 37 (72.5%). All respondents administer prophylactic antibiotics prior to biopsy, with intravenous Gentamycin being the most commonly administered prophylactics 14 (27.5%), only a few perform bowel preparations prior to biopsy 8 (15.7%) with Dulcolax suppository being the most commonly employed agents 5 (63%). Most of the biopsy were done under transrectal ultrasound guidance 29 (56.9%). None of the respondents performed MRI-guided transrectal biopsy. Most respondents take 8–12 core biopsy 20 (39.2%), using 18G trucut biopsy needle 31 (60.8%), with the patient in left lateral decubitus position 26 (51%), under 2% intrarectal xylocaine instillation 28 (54.9%). The commonest complication after the procedure was bleeding per rectum 20 (39.2%), followed by haematuria 9 (17.6%), and infection 8 (15.7%).

Conclusion

There is universal use of prophylactic antibiotic prior to biopsy. However, bowel preparation prior to biopsy is not common among Nigerian urologist, and MRI-guided biopsy is very rarely done for prostate biopsy. There is need for a prostate biopsy guideline among Nigerian urologists to ensure uniformity of practice, and enhance standardized service delivery.
Using sound to understand protein sequence data: new sonification algorithms for protein sequences and multiple sequence alignments
Authors: Martin Edward J. , Meagher Thomas R. , Barker Daniel
Published: September 2021

Background

The use of sound to represent sequence data—sonification—has great potential as an alternative and complement to visual representation, exploiting features of human psychoacoustic intuitions to convey nuance more effectively. We have created five parameter-mapping sonification algorithms that aim to improve knowledge discovery from protein sequences and small protein multiple sequence alignments. For two of these algorithms, we investigated their effectiveness at conveying information. To do this we focussed on subjective assessments of user experience. This entailed a focus group session and survey research by questionnaire of individuals engaged in bioinformatics research.

Results

For single protein sequences, the success of our sonifications for conveying features was supported by both the survey and focus group findings. For protein multiple sequence alignments, there was limited evidence that the sonifications successfully conveyed information. Additional work is required to identify effective algorithms to render multiple sequence alignment sonification useful to researchers. Feedback from both our survey and focus groups suggests future directions for sonification of multiple alignments: animated visualisation indicating the column in the multiple alignment as the sonification progresses, user control of sequence navigation, and customisation of the sound parameters.

Conclusions

Sonification approaches undertaken in this work have shown some success in conveying information from protein sequence data. Feedback points out future directions to build on the sonification approaches outlined in this paper. The effectiveness assessment process implemented in this work proved useful, giving detailed feedback and key approaches for improvement based on end-user input. The uptake of similar user experience focussed effectiveness assessments could also help with other areas of bioinformatics, for example in visualisation.
Enterococcus hirae bacteremia associated with acute pyelonephritis in a patient with alcoholic cirrhosis: a case report and literature review
Authors: Nakamura Tomoaki , Ishikawa Kazuhiro , Matsuo Takahiro , Kawai Fujimi , Uehara Yuki , Mori Nobuyoshi
Published: September 2021

Background

Infections caused by Enterococcus hirae are common in animals, with instances of transmission to humans being rare. Further, few cases have been reported in humans because of the difficulty in identifying the bacteria. Herein, we report a case of pyelonephritis caused by E. hirae bacteremia and conduct a literature review on E. hirae bacteremia.

Case presentation

A 57-year-old male patient with alcoholic cirrhosis and neurogenic bladder presented with fever and chills that had persisted for 3 days. Physical examination revealed tenderness of the right costovertebral angle. Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) of the patient’s blood and urine samples revealed the presence of E. hirae, and pyelonephritis was diagnosed. The patient was treated successfully with intravenous ampicillin followed by oral linezolid for a total of three weeks.

Conclusion

The literature review we conducted revealed that E. hirae bacteremia is frequently reported in urinary tract infections, biliary tract infections, and infective endocarditis and is more likely to occur in patients with diabetes, liver cirrhosis, and chronic kidney disease. However, mortality is not common because of the high antimicrobial susceptibility of E. hirae. With the advancements in MALDI-TOF MS, the number of reports of E. hirae infections has also increased, and clinicians need to consider E. hirae as a possible causative pathogen of urinary tract infections in patients with known risk factors.
Response to Sodium Channel blocking Antiseizure medications and coding polymorphisms of Sodium Channel genes in Taiwanese epilepsy patients
Authors: Lin Chih-Hsiang , Ho Chen-Jui , Lu Yan-Ting , Tsai Meng-Han
Published: September 2021

Background

Many antiseizure medications (ASMs) control seizures by blocking voltage-dependent sodium channels. Polymorphisms of sodium channel genes may affect the response to ASMs due to altering the effect of ASMs on blocking sodium channels.

Methods

We conducted a retrospective study of epilepsy patients followed up at the Neurological Department of Kaohsiung Chang Gung Memorial Hospital, Taiwan between January 2010 and December 2018. We categorized the patients into response, partial response, and failure to sodium channel blocking ASM groups. Sodium channel blocking ASMs included phenytoin, carbamazepine, lamotrigine, oxcarbazepine, lacosamide, zonisamide, topiramate, and valproic acid. A subgroup of predominant sodium channel blocking ASMs included phenytoin, carbamazepine, lamotrigine, oxcarbazepine, and lacosamide. Associations between the response of ASMs and single-nucleotide polymorphisms of SCN1A, SCN1B, SCN2A, and SCN9A were analyzed.

Results

Two hundred Taiwanese patients and 21 single-nucleotide polymorphisms among SCN1A, SCN1B, SCN2A, and SCN9A were evaluated. We found allele C of rs55742440 in SCN1B was statistically significantly associated with not achieving seizure-free with sodium channel blocking ASMs. For the predominant sodium channel blocking ASMs group, no SNPs were associated with the response of ASMs.

Conclusion

Single-nucleotide polymorphism in SCN1B was associated with the response to sodium channel blocking ASMs. This highlights the possibility that beta subunits may affect the function of sodium channels and resulted in different responsiveness to ASMs.
Intergenerational effects of violence on women’s perinatal wellbeing and infant health outcomes: evidence from a birth cohort study in Central Vietnam
Authors: Do Huyen Phuc , Baker Philip R. A. , Van Vo Thang , Murray Aja , Murray Linda , Valdebenito Sara , Eisner Manuel , Tran Bach Xuan , Dunne Michael P.
Published: September 2021

Background

Girls exposed to violence have a high risk of being victimized as adults and are more likely than non-abused women to have children who are treated violently. This intergenerational transmission may be especially serious when women suffer violence during pregnancy and early motherhood, as it impairs maternal wellbeing and infant health and development. This study examined the intergenerational effects of being exposed to childhood maltreatment (CM) and prenatal intimate partner violence (p-IPV) on perinatal mental distress and birth outcomes in central Vietnam.

Methods

A birth cohort study in Hue City, Vietnam was conducted with 150 women in the third trimester of pregnancy (Wave 1) and 3 months after childbirth (Wave 2). Using multivariable logistic regression models, augmented inverse-probability-weighted estimators and structural equation modelling (SEM), we analyzed a theoretical model by evaluating adjusted risk differences and pathways between CM, p-IPV and subsequent perinatal adversity and indicators of infant health problems.

Results

One in two pregnant women experienced at least one form of CM (55.03%) and one in ten pregnant women experienced both CM and p-IPV (10.67%). Mothers who experienced p-IPV or witnessed IPV as a child were approximately twice as likely to experience poor mental health during pregnancy [ARR 1.94, 95% CI (1.20–3.15)]. Infants had a two-fold higher risk of adverse birth outcomes (low birth weight, preterm birth, admission to neonatal intensive care) [ARR 2.45 95% CI (1.42, 4.25)] if their mothers experienced any form of p-IPV, with greater risk if their mothers were exposed to both CM and p-IPV [ARR 3.45 95% CI (1.40, 8.53)]. Notably, significant pathways to p-IPV were found via adverse childhood experience (ACE) events (β = 0.13), neighborhood disorder (β = 0.14) and partner support (β = − 1.3).

Conclusion

These results emphasize the detrimental and prolonged nature of the effect of violence during childhood and pregnancy. Exposure to childhood maltreatment and violence during pregnancy increases the risk of maternal mental health difficulties and adverse birth outcomes. Antenatal care systems need to be responsive to women’s previous experiences of violence and maternal mental health. The significant protective role of partner support and social support should also be considered when designing tailored interventions to address violence during pregnancy.
Mediating effects of self-stigma and depression on the association between autistic symptoms and recovery in patients with schizophrenia-spectrum disorders: a cross-sectional study
Authors: Komatsu Hiroshi , Ono Takashi , Onoguchi Goh , Tomita Hiroaki , Kakuto Yoshihisa
Published: September 2021

Background

Several studies have indicated that self-stigma is associated with depressive symptoms and could be a barrier to recovery in patients with schizophrenia-spectrum disorders. More recently, an association between autistic symptoms and self-stigma was found in schizophrenia-spectrum patients. This study aimed to investigate the association between self-stigma, autistic and depressive symptoms, and recovery in patients with schizophrenia.

Methods

In total, 105 participants were evaluated using the Autism Spectrum Quotient, the Internalized Stigma of Mental Illness Scale, the Quick Inventory of Depressive Symptomatology, and the Recovery Assessment Scale to investigate autistic symptoms, self-stigma, depressive symptoms, and recovery, respectively. The relationship between self-stigma, autistic symptoms, depressive symptoms, and recovery was assessed using structural equation modeling analysis.

Results

Impaired attention switching, one symptom of autism, was found to positively affect stereotype endorsement, which negatively influenced recovery through depressive symptoms. Moreover, problems with communication skills negatively affected recovery through depressive symptoms. Concerning self-stigma, stereotype endorsement and perceived discrimination had a negative effect on recovery through depressive symptoms, whereas stigma resistance had a direct negative effect on recovery.

Conclusions

This study may provide meaningful insight into the psychological structure of recovery and could inform effective interventions for patients with schizophrenia-spectrum disorders. This was a cross-sectionally designed study; therefore, further longitudinal studies are needed to identify the causal relationships between self-stigma, autistic and depressive symptoms, and recovery.
Frequency and determinants of domestic violence against Iranian women during the COVID-19 pandemic: a national cross-sectional survey
Authors: Yari Arezoo , Zahednezhad Hosein , Gheshlagh Reza Ghanei , Kurdi Amanj
Published: September 2021

Introduction

Domestic violence (social, legal, and health violence) is the most common type of violence against women. Due to factors such as the current quarantine, this type of violence has increased during the COVID-19 pandemic. The present study aimed to assess the frequency of domestic violence against women and identify the risk factor among Iranian women during the COVID-19 pandemic.

Methods

This online cross-sectional study was conducted on 203 Iranian women during May–June 2020. Data were collected using a domestic violence questionnaire, which measured three forms of violence, including physical, emotional, and sexual violence. A link of the questionnaire was distributed among anonymous subjects through social networking apps, such as WhatsApp and Telegram. The subjects were asked to complete the questionnaire based on their experiences during the COVID-19 pandemic. Data analysis was performed using descriptive statistics and a regression model.

Results

The descriptive results showed that the mean domestic violence against women in all the participants was 34.9 (SD: 17.28). In addition, 26.6% (n = 84), 26.1% (n = 53), and 21.2% of the subjects (n = 43) experienced high levels of physical, emotional, and sexual violence during the COVID-19 pandemic, respectively. The regression model also indicated that lower age, illiteracy/primary education, previous marriage(s), and unwanted/unwise marriage were the significant risk factors for domestic violence against women.

Conclusion

According to the results, domestic violence against women is common among Iranian women during the COVID-19 pandemic. Therefore, strategies are urgently needed to prevent and minimize such domestic violence, and such strategies could be adopted through providing educational opportunities, raising awareness, promoting wanted/wise marriage, and providing social support and rehabilitation opportunities to vulnerable social groups, especially vulnerable women.
Application of metagenomic next-generation sequencing in the diagnosis of severe pneumonia caused by Chlamydia psittaci
Authors: Wu Huan-huan , Feng Lan-fang , Fang Shuang-yan
Published: September 2021

Purpose

Psittacosis is a zoonotic infectious disease caused by the transmission of the bacterium Chlamydia psittaci (C. psittaci) from birds to humans. Infections in humans mainly present as community-acquired pneumonia (CAP). However, most cases are treated without diagnostic testing, and the importance of Chlamydia psittaci infection as a cause of CAP is therefore unclear. Diagnostic tools, including culture, serologic test, and PCR-based methods, are available but prone to false negative results. Metagenomic next-generation sequencing (mNGS) has been increasingly used in the diagnosis of infectious diseases, particularly when conventional diagnostic approaches have limitation.

Detection of nucleic acid sequence of C. psittaci in respiratory tract samples by metagenomic next-generation sequencing (mNGS) is effective for early diagnosis of severe C. psittaci pneumonia. Timely treatment based on tetracycline can reduce unnecessary use of antibiotics and improve prognosis of patients with severe C. psittaci pneumonia.

Methods

Clinical data of thirteen patients with severe C. psittaci pneumonia diagnosed by mNGS were collected. Clinical manifestations, treatment and prognosis of patients were summarized.

Results

The typical symptoms of pneumonia caused by C. psittaci include fever, headache, myalgia, cough, and dyspnea. In the current study, all patients met the criteria for severe C. psittaci pneumonia and received mechanical ventilation, including noninvasive mechanical ventilation (five/thirteen) and invasive mechanical ventilation (eight/thirteen). The findings showed that patients with C. psittaci pneumonia presented with normal or slightly increased leucocytes and procalcitonin, and high C-reactive protein levels. Computed tomography manifestations included consolidation of lung parenchyma, with air bronchogram and pleural effusion in some patients. mNGS analysis results were obtained within 48–72 h. Eleven patients fully recovered after targeted treatment, however, two patients died from secondary multidrug-resistant Pseudomonas aeruginosa infection.

Conclusions

The findings of the current study show that mNGS is effective in diagnosis of C. psittaci pneumonia, and has significant diagnosis value in patients with severe infection. Patients responds well to the timely use of appropriate antibiotics.
Health questionnaire on back care knowledge and spine disease prevention for 6–10 years old children: development and psychometric evaluation
Authors: Szilágyi Brigitta , Tardi Péter , Magyar Borbála , Tanács-Gulyás Nóra , Romhányi Fanny , Vida Elizabetta , Makai Alexandra , Járomi Melinda
Published: September 2021

Background

Back school programs, that improve back care and spine disease prevention knowledge are recommended at the age of 4-14 years. There is Health Questionnaire on Back Care Knowledge in the literature for children aged 14-17 years. At other ages, there is no questionnaire examining this knowledge. We aimed to develop a Health Questionnaire on Back Care and Spine Disease Prevention Knowledge for 6-10 years old children and validate its psychometric properties (internal consistency, test-retest reliability, agreement, convergent validity, discriminant validity) in 6-10 years old children, who attended back school program or not.

Methods

463 children took part in the research (6-10 years old). The development was performed according to the Delphi method. The final version contained 7 questions. 463 participants completed the questionnaire twice with an interval of 7 days to evaluate test-retest reliability. The internal consistency was tested by Cronbach’s alpha value, test–retest reliability was calculated by Intraclass Correlation Coefficients (ICC), Standard Error of Measurement (SEM) and 95% of Minimal Detectable Change (MDC95) and Bland–Altman plots. Convergent validity was tested against the age variable and discriminant validity was tested by Kruskal-Wallis tests among the different subgroups.

Results

Cronbach’s alpha of the total score was (α=0.797), showed a strong internal consistency with minimal SEM (0.606) and MDC95 (1.680). The test-retest result for the total score was strong (0.989), for the questions showed moderate to strong results (0.742-0.975), the limits of agreement of the Bland-Altman plot showed a narrow error of measurement range (-3.49-1.29), and the value of mean differences was −1.10 (SD ± 1.22). The convergent validity showed a weak, but significant relationship between total score and age (R=0.171; p < 0.001). The discriminant validity showed significantly different mean scores in non-back school and back school groups.

Conclusion

For the examination of back care and spine disease prevention knowledge of 6-10 years old children, the questionnaire proved to be a valid and reliable tool. The knowledge requested in the questionnaire covers the knowledge material of the theoretical part of the back school for children aged 4-10 years.