bluuebunny/crossref_metadata_2025 huggingface dataset:
The perils of authentic leadership theory
Authors: Einola Katja , Alvesson Mats
Published: March 2021

In this commentary, we discuss perils of authentic leadership theory (ALT) in a modest effort to help weed out one theory that has gone amiss to pave the way for new ideas. We make an argument for why ALT is not only wrong in a harmless manner, but it may be outright perilous to leadership scholars, scholarship and those who believe in it. It may undermine academic work, delegitimize university institutions, make false promises to organizations, and cause identity trouble through encouraging managers and others overeager to live up to the proposed formula. We argue that leadership and authenticity should be kept separate as interests and themes of study.
Systematic review and meta-analysis of surgical options for recurrent or persistent carpal tunnel syndrome: simple decompression versus coverage of the median nerve
Authors: de Roo Saskia F. , Sprangers Philippe N. , Walbeehm Erik T. , van der Heijden Brigitte
Published: March 2021

We performed a systematic review on the success of different surgical techniques for the management of recurrent and persistent carpal tunnel syndrome. Twenty studies met the inclusion criteria and were grouped by the type of revision carpal tunnel release, which were simple open release, open release with flap coverage or open release with implant coverage. Meta-analysis showed no difference, and pooled success proportions were 0.89, 0.89 and 0.85 for simple open carpal tunnel release, additional flap coverage and implant groups, respectively. No added value for coverage of the nerve was seen. Our review indicates that simple carpal tunnel release without additional coverage of the median nerve seems preferable as it is less invasive and without additional donor site morbidity. We found that the included studies were of low quality with moderate risk of bias and did not differentiate between persistent and recurrent carpal tunnel syndrome.
Common childhood exanthemata
Authors: Sachdev Ankush
Published: March 2021

Childhood exanthemata are a group of conditions that are characterised by an eruptive rash, typically caused by an infection. Six classic childhood exanthemata were defined in the early 20th century causing high rates of morbidity and mortality. With improvements in hygiene and living standards, and the development of vaccines, they are now a rare occurrence. However, in recent years with declining vaccination rates, there is a reported increase in incidence of such infections. As such, it is important for GPs to be able to identify such conditions and manage them appropriately.
Health promotion preparedness for health crises – a ‘must’ or ‘nice to have’? Case studies and global lessons learned from the COVID-19 pandemic
Authors: Levin-Zamir Diane , Sorensen Kristine , Su Tin Tin , Sentell Tetine , Rowlands Gillian , Messer Melanie , Pleasant Andrew , Saboga Nunes Luis , Lev-Ari Shahar , Okan Orkan
Published: March 2021

The current COVID-19 pandemic has exposed missing links between health promotion and national/global health emergency policies. In response, health promotion initiatives were urgently developed and applied around the world. A selection of case studies from five countries, based on the Socio-Ecological Model of Health Promotion, exemplify ‘real-world’ action and challenges for health promotion intervention, research, and policy during the COVID-19 pandemic. Interventions range from a focus on individuals/families, organizations, communities and in healthcare, public health, education and media systems, health-promoting settings, and policy. Lessons learned highlight the need for emphasizing equity, trust, systems approach, and sustained action in future health promotion preparedness strategies. Challenges and opportunities are highlighted regarding the need for rapid response, clear communication based on health literacy, and collaboration across countries, disciplines, and health and education systems for meaningful solutions to global health crises.
Anal and urinary incontinence in nulliparous women – Prevalence and associated risk factors
Authors: Okeahialam Nicola A , Thakar Ranee , Ilczyszyn Andrei , Sultan Abdul H
Published: March 2021

Objective

To establish the prevalence and risk factors of urinary and anal incontinence in nulliparous women.

Study design

Thirty-one catholic convents were sent a validated questionnaire to determine the prevalence and severity of urinary incontinence, and a similarly structured questionnaire to assess anal incontinence. Multivariable regression models were used to determine independent risk factors associated with the likelihood of urinary incontinence or anal incontinence.

Main outcome measures

Urine/faecal/flatal incontinence and symptom severity.

Results

Of 202 nuns, 167 (83%) returned the questionnaire. Twenty-two women were excluded due to history of childbirth. Of 145 nulliparous women, 56.2% reported urinary incontinence and 53.8% reported anal incontinence. Women aged 66–76 years had significantly increased odds of experiencing urinary incontinence in comparison to women aged 40–65 years: OR: 2.35 (95% CI: 1.02–5.45) ( p = 0.04). The risk of urinary incontinence was increased in women with a body mass index ≥ 30 in comparison to those with a body mass index < 19: OR: 6.25 (95% CI: 1.03–38.08) ( p = 0.04). With regards to anal incontinence, although none of the differences with age and body mass index groups reached statistical significance, there was a trend towards women in higher body mass index groups having an increased prevalence of anal incontinence. Current/previous hormonal replacement therapy was also associated with significantly increased odds of experiencing urinary incontinence: OR: 2.53 (95% CI: 1.01–6.36), ( p = 0.04). However, when adjusting for age and body mass index, there was no significant association with urinary incontinence.

Conclusions

This study highlights that while childbirth is an important risk factor, urinary incontinence and anal incontinence also occur in over 50% of nulliparous women. Additional studies are required to identify other risk factors that may be associated with incontinence in this population.
Systematic review of cost-effectiveness analysis of behavior change communication apps: Assessment of key methods
Authors: Hazel Cynthia Afedi , Bull Sheana , Greenwell Elizabeth , Bunik Maya , Puma Jini , Perraillon Marcelo
Published: March 2021

Objective

Evidence backing the effectiveness of mobile health technology is growing, and behavior change communication applications (apps) are fast becoming a useful platform for behavioral health programs. However, data to support the cost-effectiveness of these interventions are limited. Suggestions for overcoming the low output of economic data include addressing the methodological challenges for conducting cost-effectiveness analysis of behavior change app programs. This study is a systematic review of cost-effectiveness analyses of behavior change communication apps and a documentation of the reported challenges for investigating their cost-effectiveness.

Materials and methods

Four academic databases: Medline (Ovid), CINAHL, EMBASE and Google Scholar, were searched. Eligibility criteria included original articles that use a cost-effectiveness evaluation method, published between 2008 and 2018, and in the English language.

Results

Out of the 60 potentially eligible studies, 6 used cost-effectiveness analysis method and met the inclusion criteria.

Conclusion

The evidence to support the cost-effectiveness of behavior change communication apps is insufficient, with all studies reporting significant study challenges for estimating program costs and outcomes. The main challenges included limited or lack of cost data, inappropriate cost measures, difficulty with identifying and quantifying app effectiveness, representing app effects as Quality-adjusted Life Years, and aggregating cost and effects into a single quantitative measure like Incremental Cost Effectiveness Ratio. These challenges highlight the need for comprehensive economic evaluation methods that balance app data quality issues with practical concerns. This would likely improve the usefulness of cost-effectiveness data for decisions on adoption, implementation, scalability, sustainability, and the benefits of broader healthcare investments.
Arkansans’ Preferred COVID-19 Testing Locations
Authors: McElfish Pearl A. , Willis Don E. , Bryant-Moore Keneshia , Rojo Martha O. , Andersen Jennifer A. , Kaminicki Kyle F. , James Laura P.
Published: March 2021

Introduction:

A contributing factor to racial and ethnic disparities during the COVID-19 pandemic may be the accessibility and acceptability of COVID-19 testing. Previous studies found that access to testing has not been equitable across several sociodemographic indicators. This study documents the preferred testing locations and examines differences across sociodemographic factors with a specific focus on race and ethnicity.

Methods:

This study includes a primary analysis of cross-sectional data using a self-administered digital survey distributed to Arkansas residents using ARresearch, a volunteer research participant registry. The survey had 1288 responses, and 1221 met eligibility criteria for inclusion in the survey. Participants provided sociodemographic information and were asked to select up to 3 preferred testing locations from 12 options. Chi-square tests assessed differences in testing site preference across relevant sociodemographic groups.

Results:

Participants preferred drive-through clinics as their top location for COVID-19 testing, with 55% reporting this was their preferred method of testing. This pattern was consistent across all comparison groups (ie, age, sex, race/ethnicity, education, insurance status). Significant differences in testing location preference were observed across age, race and ethnicity, and education, with the most differences observed across race and ethnicity.

Conclusion:

This study reveals that race and ethnicity are important to consider when deciding where to offer COVID-19 testing. The preferences for testing locations among the most vulnerable demographics will be used to develop targeted responses aimed at eliminating disparities in COVID-19 in Arkansas.
The Development of a Novel Outpatient Infusion Therapy Center for Treatment of COVID-19 in a Rural Healthcare System
Authors: Malone Edward , Krien Joseph , Jorgenson Betty , Bishop Rachel , Tempelis Jenny , Gilmer Mary , Ring David , Kujak-Coon Heather , Jagim Andrew
Published: March 2021

Therapeutic interventions to manage symptoms of COVID-19 are continually evolving and being used in a variety of settings. In an attempt to reduce the potential for a high influx of hospital admissions for COVID-19 and mitigate the advancement of COVID-19 disease in infected patients, an outpatient therapy clinic for infusion therapy was established. The focus of the current paper is to outline the development of the outpatient treatment center, provide a detailed summary of workflow and discuss operational challenges and directions for the future.
When Ostrom Meets Blockchain: Exploring the Potentials of Blockchain for Commons Governance
Authors: Rozas David , Tenorio-Fornés Antonio , Díaz-Molina Silvia , Hassan Samer
Published: March 2021

Blockchain technologies have generated enthusiasm, yet their potential to enable new forms of governance remains largely unexplored. Two confronting standpoints dominate the emergent debate around blockchain-based governance: discourses characterized by the presence of techno-determinist and market-driven values, which tend to ignore the complexity of social organization; and critical accounts of such discourses which, while contributing to identifying limitations, consider the role of traditional centralized institutions as inherently necessary to enable democratic forms of governance. In this article, we draw on Ostrom’s principles for self-governance of communities to explore the transformative potential of blockchain beyond such standpoints. We approach blockchain through the identification and conceptualization of six affordances that this technology may provide to communities: tokenization, self-enforcement and formalization of rules, autonomous automatization, decentralization of power over the infrastructure, increasing transparency, and codification of trust. For each affordance, we carry out a detailed analysis situating each in the context of Ostrom’s principles, considering both the potentials of algorithmic governance and the importance of incorporating communities’ social practices into blockchain-based tools to foster forms of self-governance. The relationships found between these affordances and Ostrom’s principles allow us to provide a perspective focused on blockchain-based commons governance.
Does Game-Based Vocabulary Learning APP Influence Chinese EFL Learners’ Vocabulary Achievement, Motivation, and Self-Confidence?
Authors: Li Rui
Published: March 2021

Game-based vocabulary learning that is well documented to improve students’ vocabulary learning outcomes is gaining increasing attention. However, no consensus has been reached regarding the impact of game-based vocabulary learning application (APP) on the vocabulary learning achievement, motivation, and self-confidence among Chinese EFL (English as a foreign language) students, so large a population that should never be neglected. To address the issues, a total of 70 college students in two groups participated in a quasi-experiment. One is the experimental group in which students received the game-based vocabulary learning; the other is the control group in which students received the conventional paper-based wordlist learning. Each group consisted of 35 students. The experiment was carried out to evaluate how the implementation of game-based vocabulary learning influences students’ vocabulary learning achievement, motivation, and self-confidence. In addition, a regression analysis was exploited to examine the influence of motivation and self-confidence on vocabulary achievement. Results demonstrated that the game-based vocabulary learning APP benefited students in vocabulary achievement, motivation, and self-confidence. Furthermore, learning self-confidence and motivation did not predict learning achievement. Implications of the study were also given.
Engels and the Worker–Peasant Alliance
Authors: Patnaik Prabhat
Published: March 2021

Friedrich Engels’ bicentenary was celebrated in 2020. As a contribution to this celebration, this article argues that Engels, among his various other substantive contributions, must be credited with his conceptualization of the worker–peasant alliance. Given that this alliance was fundamental to democratic and socialist revolutions in the Third World in the twentieth century, and continues to be so in the twenty-first, it remains important to clarify its trajectory within classical Marxism. Engels turned his attention to the sixteenth-century peasant war in Germany so as to illuminate the challenges faced in the course of the 1848 revolutions that swept across Europe. He argued that, for large sections of the peasantry, the throwing off of their feudal yoke required an alliance with the proletariat. This, however, did not mean land redistribution via private landholdings but nationalization of the land. It also did not mean an alliance with the whole of the peasantry. These two questions and the antagonisms that they entailed were central to the development of Marxist theory and practice in the Bolshevik and Chinese revolutions, as well as others in the Third World. Today, neoliberal globalization has shifted the terrain of struggle further by the fact of corporate dominance over the whole of the peasantry. The massive agitation of the Indian agriculturists since the end of 2020 and the alliances that have emerged should be an eye-opener.
To err is system; a comparison of methodologies for the investigation of adverse outcomes in healthcare
Authors: Isherwood Peter , Waterson Patrick
Published: March 2021

Patient safety, staff moral and system performance are at the heart of healthcare delivery. Investigation of adverse outcomes is one strategy that enables organisations to learn and improve. Healthcare is now understood as a complex, possibly the most complex, socio-technological system. Despite this the use of a 20th century linear investigation model is still recommended for the investigation of adverse outcomes. In this review the authors use data gathered from the investigation of a real life healthcare near incident and apply three different methodologies to the analysis of this data. They compare both the methodologies themselves and the outputs generated. This illustrates how different methodologies generate different system level recommendations. The authors conclude that system based models generate the strongest barriers to improve future performance. Healthcare providers and their regulatory bodies need to embrace system based methodologies if they are to effectively learn from, and reduce future, adverse outcomes.
Possible Involvement of Central Nervous System in COVID-19 and Sequence Variability of SARS-CoV-2 Revealed in Autopsy Tissue Samples: A Case Report
Authors: Høy Marbjerg Lis , Jacobsen Christina , Fonager Jannik , Bøgelund Claus , Rasmussen Morten , Fomsgaard Anders , Banner Jytte , Vorobieva Solholm Jensen Veronika
Published: March 2021

The case presented here illustrates that interdisciplinary teamwork can be essential for the understanding of the COVID-19 disease presentation and enlightening of the pathophysiology. A 60-year-old woman without any comorbidities, apart from overweight, was found dead in her apartment after 14 days of home isolation due to suspicion of COVID-19. A forensic autopsy was performed. This revealed severely condensed, almost airless, firm lungs, and the cause of death was severe acute respiratory distress syndrome-associated with COVID-19 (SARS-CoV-2). In addition, SARS-CoV-2 was detected with reverse transcription polymerase chain reaction (RT-PCR) in cerebrospinal fluid, lung tissue, and tracheal sample and specific antibodies for SARS-CoV-2 were detected in cerebrospinal fluid and serum. Subsequent sequencing of the SARS-CoV-2 virus showed variation in nucleotides at 3 sites between SARS-CoV-2 isolates recovered from the tracheal sample, cerebrospinal fluid, and tissues from both lungs, and phylogenetic analysis revealed that the spinal fluid sample differed the most from the other 3 samples. This case supports the hypothesis that SARS-CoV-2 may be neuroinvasive and cause central nervous system infection.
Sex differences in the link between blood cobalt concentrations and insulin resistance in adults without diabetes
Authors: Chen Yong , Huang Haobin , He Xiaowei , Duan Weiwei , Mo Xuming
Published: March 2021

Background

Little is known about the effects of environmental cobalt exposure on insulin resistance (IR) in the general adult population. We investigated the association between cobalt concentration and IR.

Methods

A total of 1281 subjects aged more than 20 years with complete blood cobalt data were identified from the National Health and Nutrition Examination Survey (NHANES) 2015–2016 cycle. Blood cobalt levels were analyzed for their association with IR among all populations and subgroups by sex. Regression coefficients and 95% confidence intervals (CIs) of blood cobalt concentrations in association with fasting glucose, insulin and homeostatic model assessment of insulin resistance (HOMA-IR) were estimated using multivariate linear regression after adjusting for age, sex, ethnicity, alcohol consumption, body mass index, education level, and household income. A multivariate generalized linear regression analysis was further carried out to explore the association between cobalt exposure and IR.

Results

A negative association between blood cobalt concentration (coefficient = − 0.125, 95% CI − 0.234, − 0.015; P = 0.026) and HOMA-IR in female adults in the age- and sex-adjusted model was observed. However, no associations with HOMA-IR, fasting glucose, or insulin were found in the overall population. In the generalized linear models, participants with the lowest cobalt levels had a 2.74% (95% CI 0.04%, 5.50%) increase in HOMA-IR (P for trend = 0.031) compared with subjects with the highest cobalt levels. Restricted cubic spline regression suggested that a non-linear relationship may exist between blood cobalt and HOMA-IR.

Conclusions

These results provide epidemiological evidence that low levels of blood cobalt are negatively associated with HOMA-IR in female adults.
A cross-country study of skills and unemployment flows
Authors: Stijepic Damir
Published: March 2021

Using an international survey that directly assesses the cognitive skills of the adult population, I study the relation between skills and unemployment flows across 37 countries. Depending on the specifically assessed domain, I document that skills have an unconditional correlation with the log-risk-ratio of exiting to entering unemployment of 0.65–0.68 across the advanced and skill-abundant countries in the sample. The relation is remarkably robust and it is unlikely to be due to reverse causality. I do not find evidence that this positive relation extends to the seven relatively less advanced and less skill-abundant countries in the sample: Peru, Ecuador, Indonesia, Mexico, Chile, Turkey and Kazakhstan.
Lidocaine combined with magnesium sulfate preserved hemodynamic stability during general anesthesia without prolonging neuromuscular blockade: a randomized, double-blind, controlled trial
Authors: Paula-Garcia Waynice N , Oliveira-Paula Gustavo H , de Boer Hans Donald , Garcia Luis Vicente
Published: March 2021

Background

Lidocaine and magnesium sulfate have become increasingly utilized in general anesthesia. The present study evaluated the effects of these drugs, isolated or combined, on hemodynamic parameters as well as on the cisatracurium-induced neuromuscular blockade (NMB).

Methods

At a university hospital, 64 patients, ASA physical status I and II, undergoing elective surgery with similar pain stimuli were randomly assigned to four groups. Patients received a bolus of lidocaine and magnesium sulfate before the tracheal intubation and a continuous infusion during the operation as follows: 3 mg.kg− 1 and 3 mg.kg− 1.h− 1 (lidocaine - L group), 40 mg.kg− 1 and 20 mg.kg− 1.h− 1 (magnesium - M group), equal doses of both drugs (magnesium plus lidocaine - ML group), and an equivalent volume of isotonic solution (control - C group). Hemodynamic parameters and neuromuscular blockade features were continuously monitored until spontaneous recovery of the train of four (TOF) ratio (TOFR > 0.9).

Results

The magnesium sulfate significantly prolonged all NMB recovery features, without changing the speed of onset of cisatracurium. The addition of lidocaine to Magnesium Sulfate did not influence the cisatracurium neuromuscular blockade. A similar finding was observed when this drug was used alone, with a significantly smaller fluctuation of mean arterial pressure (MAP) and heart rate (HR) measures during anesthesia induction and maintenance. Interestingly, the percentage of patients who achieved a TOFR of 90% without reaching T1–95% was higher in the M and ML groups. Than in the C and L groups. There were no adverse events reported in this study.

Conclusion

Intravenous lidocaine plays a significant role in the hemodynamic stability of patients under general anesthesia without exerting any additional impact on the NMB, even combined with magnesium sulfate. Aside from prolonging all NMB recovery characteristics without altering the onset speed, magnesium sulfate enhances the TOF recovery rate without T1 recovery. Our findings may aid clinical decisions involving the use of these drugs by encouraging their association in multimodal anesthesia or other therapeutic purposes.

Trial registration

NCT02483611 (registration date: 06-29-2015).
Comparison of lidocaine, huffing maneuver and combination of both in prevention fentanyl induced cough before induction of anesthesia: a double-blind, prospective, randomized placebo-controlled study
Authors: Dehghanpisheh Laleh , Eghbal Mohammadhossein , Bagheri Baravati Fatemeh , Vatankhah Pooya
Published: March 2021

Background

Intravenous bolus injection of fentanyl has been frequently reported to be associated with cough reflex during patient anesthesia. However, the search for the most effective protocol continues. This study aimed to compare the effect of reducing cough reflex after injection of fentanyl in a fusion protocol by combining the injections of lidocaine and Huffing maneuver and comparing with a placebo control group, before anesthesia induction.

Methods

This prospective randomized controlled trial study was performed on 400 patients who were divided into four groups of combined protocol (group 1), lidocaine group (group 2), Huffing maneuver group (group 3), and the control receiving normal saline (group 4). Then patients were injected with 2. 5 μg /kg fentanyl and monitored for 2 min regarding their cough reflex, as well as the severity.

Results

In group one, 9 patients (9%), in group two, 45 patients (45%), 22 patients (22%) in group three, and in group four, 75 patients (75%), developed cough reflex following fentanyl injection. Also, 13 patients (13%) developed moderate and 4 (4%) developed severe coughs in the control group reported, while no reports of severe or moderate cough were among the intervention groups. There was a significant difference between the intervention group and the control group both in terms of the rate and severity of the fentanyl-induced cough.

Conclusion

By using a combination of lidocaine injection along and Huffing maneuver, better results can be obtained in reducing the frequency, and also the severity of cough followed by fentanyl injection.

Trial registration

The trial was registered with IRCT.IR (09/03/2018-No. IRCT20141009019470N74).
Frequency of providing a palliative approach to care in family practice: a chart review and perceptions of healthcare practitioners in Canada
Authors: Gallagher Erin , Carter-Ramirez Daniel , Boese Kaitlyn , Winemaker Samantha , MacLennan Amanda , Hansen Nicolle , Hafid Abe , Howard Michelle
Published: March 2021

Background

Most patients nearing the end of life can benefit from a palliative approach in primary care. We currently do not know how to measure a palliative approach in family practice. The objective of this study was to describe the provision of a palliative approach and evaluate clinicians’ perceptions of the results.

Methods

We conducted a descriptive study of deceased patients in an interprofessional team family practice. We integrated conceptual models of a palliative approach to create a chart review tool to capture a palliative approach in the last year of life and assessed a global rating of whether a palliative approach was provided. Clinicians completed a questionnaire before learning the results and after, on perceptions of how often they believed a palliative approach was provided by the team.

Results

Among 79 patients (mean age at death 73 years, 54% female) cancer and cardiac diseases were the top conditions responsible for death. One-quarter of patients were assessed as having received a palliative approach. 53% of decedents had a documented discussion about goals of care, 41% had nurse involvement, and 15.2% had a discussion about caregiver well-being. These indicators had the greatest discrimination between a palliative approach or not. Agreement that elements of a palliative approach were provided decreased significantly on the clinician questionnaire from before to after viewing the results.

Conclusions

This study identified measurable indicators of a palliative approach in family practice, that can be used as the basis for quality improvement.
Fatigue characteristics on dialysis and non-dialysis days in patients with chronic kidney failure on maintenance hemodialysis
Authors: Debnath Subrata , Rueda Rain , Bansal Shweta , Kasinath Balakuntalam S. , Sharma Kumar , Lorenzo Carlos
Published: March 2021

Background

Fatigue is prevalent in hemodialysis patients who for survival follow a strict dialysis treatment regimen – dialysis and non-dialysis days. As a result, the daily activities, symptom burden, and clinical outcomes of hemodialysis patients vary significantly between dialysis and non-dialysis days. Fatigue is one of the most reported debilitating symptoms by hemodialysis patients with profound negative impact on their quality of life. Prior studies assessed fatigue during the preceding 7 or 30 days and did not discriminate fatigue characteristics between dialysis and non-dialysis days. We aimed to characterize and compare fatigue severity and fatigue interference with daily activities between dialysis and non-dialysis days.

Methods

Hemodialysis patients self-reported fatigue on consecutive dialysis and non-dialysis days using the 9-item Brief Fatigue Inventory. The differences in fatigue characteristics between dialysis and non-dialysis days were analyzed using one-way ANCOVA.

Results

Global fatigue burden was worse on a dialysis day compared to a non-dialysis day (P for all < 0.001). Age and education were associated with fatigue, but hemodialysis-related variables were not. A significant inverse association of physical activity with fatigue severity observed on non-dialysis day; there was also a negative association between the normalized protein catabolic rate and fatigue severity on both dialysis and non-dialysis days. The positive association of depression with fatigue severity and fatigue interference were consistent on both dialysis and non-dialysis days. None of these factors, however, explained differences in fatigue characteristics between dialysis and non-dialysis days.

Conclusions

Fatigue, measured in severity and interference, was more pronounced on a dialysis day relative to a non-dialysis day. These differences were not explained by age, sex, education, hemodialysis-related variables, habitual exercise, nutritional status, and or depression. The quantitative measures of fatigue characteristics may facilitate future interventional trials design and better fatigue management for hemodialysis patients.
Individual and familial factors associated with caries and gingivitis among adolescents resident in a semi-urban community in South-Western Nigeria
Authors: Folayan Morenike Oluwatoyin , El Tantawi Maha , Chukwumah Nneka Maureen , Alade Michael , Oginni Olakunle , Mapayi Boladale , Arowolo Olaniyi , Sam-Agudu Nadia A.
Published: March 2021

Objectives

We describe the prevalence, and individual and familial risk indicators for dental caries and gingivitis among 10–19-year-old adolescents in Ile-Ife, South-West Nigeria.

Methods

This cross-sectional study collected data through household surveys conducted between December 2018 and January 2019. Adolescents were recruited through multistage sampling. Oral health outcomes were caries, measured by the ‘Decayed, Missing due to caries, and Filled Teeth’ (DMFT) index, and gingivitis, measured by the Loe and Silness gingival index. Explanatory variables were individual (sex, age, oral health perception) and familial (socioeconomic status, birth rank, family size and parental living status) factors. Oral health behaviors (daily tooth-brushing, use of fluoridated toothpaste, consuming refined carbohydrates in-between meals, use of dental floss, dental service utilization in past 12 months, and smoking habits) were treated as confounders. Poisson regression models with robust estimation were constructed to determine associations between explanatory factors and oral health outcomes.

Results

A total of 1472 adolescents were surveyed. Caries prevalence was 3.4%, with mean (standard deviation) DMFT of 0.06 (0.36) and plaque index of 0.84 (0.56). Only 128 (8.7%) adolescents brushed their teeth twice daily, 192 (16.1%) used dental floss daily, 14 (1.1%) utilized dental services in the last 12 months, and 508 (36.1%) consumed refined carbohydrates in-between meals less than once daily. The proportion of respondents who currently smoked cigarettes was 1.6%, and 91.7% of respondents used fluoridated toothpaste daily. The adjusted prevalence ratio of having caries increased by 18% for every additional age-year (APR: 1.18; 95% CI 1.004, 1.34). Additionally, participants with high socioeconomic status had significantly lower prevalence of caries compared to those with lower status (APR: 0.40; 95% CI 0.17, 0.91). Moderate/severe gingivitis was significantly associated with higher frequency of consuming refined carbohydrates in-between meals (APR: 2.33; 95% CI 1.36, 3.99) and higher plaque index scores (APR: 16.24; 95% CI 9.83, 26.82).

Conclusion

Caries prevalence increased with increasing age and was higher among Nigerian adolescents with low socioeconomic status, while moderate/severe gingivitis was associated with frequent consumption of refined carbohydrates and higher plaque index score. While behavioral interventions may reduce the risk of gingivitis, structural interventions may be needed to reduce the risk for caries in this population.
Low sensitivity of conventional fungal agars in fungemia by Rhodotorula mucilaginosa: description of two cases
Authors: Garcia-Gutiérrez Carmen Alicia , Cuétara-García María Soledad , Moragues María Dolores , Ligero Jorge , Quevedo Sara María , Buitrago María José
Published: March 2021

Background

Although most bloodstream yeast infections are caused by Candida spp., infections by rare or less common species have increased in recent years. Diagnosis of infections caused by these species is difficult due to the lack of specific symptoms and adequate diagnostic tools.

Cases presentation

We describe two cases of fungemia by Rhodotorula mucilaginosa within a few months of each other, in a secondary Spanish hospital. In both cases, diagnosis was challenging. Blood subcultures in conventional fungal media were persistently negatives and the use of non-conventional fungal media was essential for isolating the yeasts and achieving a correct diagnosis. 1–3 beta-d-glucan detection and a panfungal PCR assay were helpful techniques to confirm the diagnosis

Conclusion

It is highly important to establish an early diagnosis for fungemia. The process is challenging because often non-specific symptoms are presents. When yeasts grow in blood cultures other genera than Candida spp. could be the cause of infection. Patient risk factors should be assessed to incorporate alternative culture media and the available rapid diagnostic test, in order to provide an early recognition of the pathogen.
Application of auriculotemporal nerve block and dextrose prolotherapy in exercise therapy of TMJ closed lock in adolescents and young adults
Authors: Zhou Hongzhi , Xue Yang , Liu Ping
Published: March 2021

Background

Temporomandibular joint (TMJ) ‘closed lock’ is a clinical condition causing TMJ pain and limited mouth opening (painful locking). Recent studies suggest an increasing prevalence of degenerative joint disease associated with the onset of TMJ closed lock in adolescents and young adults. Early interventions are recommended, but the curative effect of standard therapies remains controversial. In this retrospective study, an alternative method of non-surgical treatment of TMJ closed lock is presented, and its long-term efficacy has been observed.

Methods

Forty adolescents and young adults, aged 16 to 30 years old, with distinct combination of symptoms of TMJ closed lock, were enrolled. Patients received anesthetic blockages of the auriculotemporal nerve, then performed mandibular condylar movement exercise for 10 min, and subsequently received hypertonic dextrose prolotherapy in retro-discal area of TMJ. Clinical assessments at baseline and at follow-up (2 weeks, 2 months, 6 months, and 5 years) included intensity and frequency of TMJ pain, mandibular range of motion, TMJ sounds, and impairment of chewing.

Results

Cone beam CT images of the TMJs revealed joint space changes in all patients and degenerative bone changes in 20% (8/40) of the patients. The patients were diagnosed as having disc displacement without reduction with limited opening. Successful reduction of displaced disc had been achieved in the treatment. And pain at rest and pain on mastication had substantially decreased in all patients and mandibular function and mouth opening had significantly improved since 2 weeks’ follow-up. The overall success rate kept at a high level of 97.5% (39/40) at 6 months and 5 years’ follow-up.

Conclusions

The technique combining mandibular condylar movement exercise with auriculotemporal nerve block and dextrose prolotherapy is straightforward to perform, inexpensive and satisfactory to young patients with TMJ closed lock.
Open reduction and internal fixation for displaced Salter-Harris type II fractures of the distal tibia: a retrospective study of sixty-five cases in children
Authors: Yuan Quanwen , Zhen Yunfang , Guo Zhixiong , Zhang Fuyong , Fang Jianfeng , Zhu Zhenhua , Zhu Lunqing , Shen Xiaofang , Yin Chunhua , Liu Yao , Yao Feng , Wu Lin , Wang Xiaodong
Published: March 2021

Background

The treatment for displaced Salter-Harris II (S-H II) distal tibia fractures remains controversial. The purpose of this study was to review S-H II distal tibia fractures and evaluate the rate of premature physeal closure (PPC) treated by open reduction and internal fixation (ORIF).

Methods

We reviewed the charts and radiographs of S-H II fractures of the distal tibia with displacement > 3 mm between 2012 and 2019 treated by ORIF. Patients were followed up for a minimum of 6 months. CT scans of injured side or contralateral ankle radiograph were obtained if there was any evidence of PPC. Any angular deformity or shortening of the involved leg was documented. Multivariable logistic regression was performed to identify risk factors for the occurrence of PPC.

Results

A total of 65 patients with a mean age of 11.8 years were included in this study. The mean initial displacement was 8.0 mm. All patients but one were treated within 7 days after injury and the mean interval was 3.7 days. Supination-external rotation injuries occurred in 50 patients, pronation-eversion external rotation in 13, and supination-plantar flexion in two. The residual gap was less than 1 mm in all patients following ORIF and all fractures healed within 4–6 weeks. Superficial skin infection developed in one patient. Ten patients complained of the cosmetic scar. The rate of PPC was 29.2% and two patients with PPC developed a varus deformity of the ankle. Patients with associated fibular fracture had 7 times greater odds of developing PPC. Age, gender, injured side, mechanism of injury, amount of initial displacement, interval from injury to surgery, or energy of injury did not significantly affect the rate of PPC.

Conclusions

ORIF was an effective choice of treatment for S-H II distal tibia fractures with displacement > 3 mm to obtain a satisfactory reduction. PPC is a common complication following ORIF. The presence of concomitant fibula fracture was associated with PPC.
Choosing the right timing for interval debulking surgery and perioperative chemotherapy may improve the prognosis of advanced epithelial ovarian cancer: a retrospective study
Authors: Wang Dengfeng , Zhang Guonan , Peng Chunrong , Shi Yu , Shi Xunwei
Published: March 2021

Background

Primary debulking surgery (PDS) is the main treatment for patients with advanced ovarian cancer, and neoadjuvant chemotherapy (NACT) is for bulky stage III-IV patients who are poor surgical candidates and/or for whom there is a low likelihood of optimal cytoreduction. NACT can increase the rate of complete cytoreduction, but this advantage has not translated to an improvement in survival. Therefore, we aimed to identify factors associated with the survival of patients who received NACT followed by interval debulking surgery (IDS).

Methods

A retrospective study was conducted in FIGO stage IIIC-IV epithelial ovarian cancer patients who underwent PDS or IDS in our center between January 1st, 2013, and December 31st, 2018.

Results

A total of 273 cases were included, of whom 20 were lost to follow-up. Progression-free survival (PFS) and overall survival (OS) of the IDS and PDS groups were found to be similar, although the proportion of patients in stage IV and serum carbohydrate antigen 125 (CA125) levels before treatment in the IDS group were significantly higher than that in the PDS group. Body mass index (BMI), CA125 level before IDS, residual disease after surgery, and the interval between preoperative and postoperative chemotherapy were all found to be independent prognostic factors for PFS; FIGO stage, residual disease after surgery, and CA125 level before IDS were independent prognostic factors for OS. We found that PFS and OS were both significantly longer in patients with normal CA125 levels before IDS and when the interval between preoperative and postoperative chemotherapy was < 35.5 days (IDS-3 group) than for patients in the PDS group.

Conclusions

The results suggested the importance of timely IDS and postoperative chemotherapy and potentially allowed the identification of patients who would benefit the most from NACT. Normal CA125 levels before IDS and an interval between preoperative and postoperative chemotherapy no longer than 5 weeks were associated with improved prognosis in advanced ovarian cancer patients.
Biomechanical adaptation to post-stroke visual field loss: a systematic review
Authors: Elfeky Adel , D’Août Kristiaan , Lawson Rebecca , Hepworth Lauren R. , Thomas Nicholas D. A. , Clynch Abigail , Rowe Fiona J.
Published: March 2021

Background

Homonymous visual field defects represent the most frequent type of visual field loss after stroke, affecting nearly 30% of individuals with unilateral post-chiasmal brain damage. This review aimed to gather the available evidence on the biomechanical changes to visual field loss following stroke.

Methods

A systematic review was conducted inclusive of randomised controlled trials, cohort studies, before-after studies and case-controlled studies. Studies including adult and paediatric participants that investigated eye, head, or body movements in post-stroke visual field loss during visual exploration tasks were included. Search terms included a range of MESH terms as well as alternative terms relating to stroke, visual field loss, hemianopia, visual functions and scanning behaviour. Articles were selected by two authors independently. Data were extracted by one author and verified by a second. All included articles were assessed for risk of bias using checklists appropriate to the study design.

Results

Thirty-six articles (1123 participants) were included in the overall review (Kappa 0.863) and categorised into simulated or true visual field loss (typically hemianopia). Seven studies identified the biomechanical alterations to simulated hemianopia compared to normal performance. Twenty-nine studies detailed eye, head and body movement parameters in true hemianopia. Hemianopic participants and healthy adults with simulated hemianopia differed significantly from controls in various fixation and saccade parameters as indicated by increased number and duration of fixations, number and duration of saccades and scan path length with shorter mean saccadic amplitude. Under simulated hemianopia, participants were consistently biased towards the sighted visual field while gaze behaviour in true hemianopia was biased in the direction of the blind hemifield.

Conclusions

There is considerable evidence on the altered eye movements that occur in true hemianopia and in healthy adults with simulated hemianopia. Successful performance in naturalistic tasks of visual exploration appears to be related to compensatory mechanisms of visual exploratory behaviour, namely, an increase in the amplitude and peak velocity of saccades, widening horizontally the distribution of eye movements, and a shift of the overall distribution of saccades into the blind field. This review highlights the lack of studies reporting head and other body movement parameters in hemianopia. Further studies with robust methodology and large sample sizes involving participants with post-stroke visual field loss are needed.

Systematic review registration

PROSPERO CRD42020194403
Effects of pollution on adolescent mental health: a systematic review protocol
Authors: Theron Linda C. , Abreu-Villaça Yael , Augusto-Oliveira Marcus , Brennan Caroline H. , Crespo-Lopez Maria Elena , de Paula Arrifano Gabriela , Glazer Lilah , Lin Liyuan , Mareschal Isabelle , Sartori Luke , Stieger Liesl , Trotta Andres , Hadfield Kristin
Published: March 2021

Background

Whilst there is little uncertainty about the deleterious impact of pollution on human and planetary health, pollution’s impact on adolescent mental health is less well understood. This is particularly true for young people in underdeveloped and developing world contexts, about whom research is generally lacking. Furthermore, although adolescent resilience continues to be a research priority, little attention has been paid to adolescent pathways of resilience in the face or aftermath of pollution exposure. The objective of this study will be to examine the associations between pollution and mental health in 10- to 24-year-olds (i.e. adolescents).

Methods

We designed and registered a study protocol for a systematic review of studies which link pollution and mental health in adolescents. We will include observational studies (e.g. cohort, case-control, time series analyses) that assess the associations between exposure to any form of pollution and the mental health of 10- to 24-year-olds. The primary outcome will be symptoms associated with neurodevelopmental disorders; disruptive, impulse-control, and conduct disorders; depressive disorders; anxiety disorders; substance disorders; and schizophrenia. No secondary outcomes will be considered. Literature searches will be conducted in multiple electronic databases (from inception onwards), including PubMed, MEDLINE, SCOPUS, Web of Science, CINAHL, PsycINFO, SciELO, ERIC, and Africa-Wide. Two investigators will independently screen all citations, full-text articles, and abstract data. The methodological quality (or bias) of included studies will be appraised using appropriate tools. We will provide a narrative synthesis of the evidence.

Discussion

This systematic review will evaluate the evidence on the associations between pollution and the mental health of 10- to 24-year-olds. Our findings will be of potential interest to multiple audiences (including adolescent patients/clients, their families, caregivers, healthcare professionals, scientists, and policy makers) and could be used to develop prevention and intervention strategies as well as focus future research. Results will be published in a peer-reviewed journal.

Systematic review registration

PROSPERO CRD42020176664