bluuebunny/crossref_metadata_2025 huggingface dataset:
A Prospective Study of Male Depression, Psychotropic Medication Use, and Fecundability
Authors: Yland Jennifer J. , McKinnon Craig J. , Hatch Elizabeth E. , Eisenberg Michael L. , Nillni Yael I. , Rothman Kenneth J. , Wise Lauren A.
Published: February 2022

We examined the associations of male depression and psychotropic medication use with fecundability in a North American preconception cohort study (2013–2020). Men aged ≥21 years completed a baseline questionnaire with questions on history of diagnosed depression, the Major Depression Inventory (MDI), and psychotropic medication use. Pregnancy status was updated via bimonthly female follow-up questionnaires until pregnancy or 12 menstrual cycles, whichever occurred first. Analyses were restricted to 2,398 couples attempting conception for ≤6 menstrual cycles at entry. We fit proportional probabilities models to estimate fecundability ratios (FRs) and 95% confidence intervals (CIs), adjusting for age (male and female), education, (male and female), race/ethnicity, physical activity, alcohol intake, body mass index, smoking, and having previously impregnated a partner. Nearly 12% of participants reported a depression diagnosis; 90.6% had low depressive symptoms (MDI <20), 3.5% had mild symptoms (MDI: 20–24), 2.7% had moderate symptoms (MDI: 25–29), and 3.3% had severe symptoms (MDI: ≥30). A total of 8.8% of participants reported current use of psychotropic medications. History of depression was associated with slightly reduced fecundability, although this result was also reasonably compatible with chance (FR = 0.89; 95% CI: [0.76, 1.04]). FRs for mild, moderate, and severe compared with low depressive symptoms were 0.89 (95% CI: [0.66, 1.21]), 0.90 (95% CI: [0.62, 1.31]), and 0.88 (95% CI: [0.65, 1.20]), respectively. This indicates little evidence of a dose–response relationship for depressive symptoms with fecundability, although estimates were imprecise. Current psychotropic medication use mediated 44% of the association between depressive symptoms and fecundability.
A Data-Driven Approach for Facility Use Definitions in Campus Recreation
Authors: Zegre Sera Janson , Hughes Rodney P. , Darling Andrew M. , Decker Craig R.
Published: February 2022

Existing research in campus recreation establishes a relationship between facility use and academic outcomes, but published studies define users differently. In response to inconsistent definitions of participants in campus recreation, this study uses a data-driven approach to compare facility use definitions. Authors illustrate the implications of choosing different participant definitions for relationships between campus recreation and two undergraduate academic outcomes, first-year retention and first-year cumulative grade point average (GPA). This study uses data from a three-year timeframe, linking sources of data on students’ recreation facility use, academic outcomes, and student records. Authors provide a summary of previous definitions, results from original regression analyses, results for specific student subgroups, and recommendations for defining users.
Wrist Arthroscopy Using the 2R Portal: Is It Safer Than the 1,2 Portal?
Authors: Hinchcliff Katharine M. , Munaretto Nicholas , Dutton Lauren K. , Ramazanian Taghi , Kakar Sanjeev
Published: February 2022

Backgroud:

The purpose of this study was to compare the 1,2 with a novel 2R portal in terms of proximity to critical structures.

Methods:

Wrist arthroscopy was performed on 8 fresh frozen cadavers via the 1,2 and 2R portals. External anatomy was then dissected under loupe magnification. The closest distance between the portals and surrounding anatomical structures was measured in millimeters using digital calipers.

Results:

The 1,2 portal was significantly closer to radial artery and first extensor compartment tendons than the 2R portal. The radial artery was on average 1.32 mm from the 1-2 portal and 14.25 mm from the 2R portal. The 2R portal was significantly closer to the second and third extensor compartment tendons. The closest branch of the superficial branch of the radial nerve (SBRN) was on average 2.04 mm from the 1-2 portal and 7.59 mm from the 2R portal, but this was not statistically significant.

Conclusions:

We advocate using the 2R portal preferentially to the 1,2 portal when treating radial sided wrist pathology to decrease the risk of iatrogenic radial artery and SBRN injury.
Safety and efficacy of endovascular treatment for tiny ruptured intracranial aneurysms with low-profile visualized intraluminal support stents
Authors: Jin Yazhou , Guo Xinbin , Quan Tao , Chen Zhen , Liu Chao , Guan Sheng
Published: February 2022

Background

Endovascular treatment for tiny ruptured intracranial aneurysms is known to be technically challenging. Thus, we aimed to investigate the safety and efficacy of low-profile visualized intraluminal support (LVIS) stents in the treatment of tiny ruptured intracranial aneurysms.

Methods

From April 2014 to June 2019, among 90 patients with tiny ruptured aneurysms who were treated at our institution endovascularly, 28 underwent stent-assisted coiling with LVIS stents. The clinical and angiographic results were reviewed.

Results

In the LVIS group, complete occlusion was achieved in 27 patients (96.4%). Intraprocedural thrombus formation occurred in 3 patients (10.7%). Follow-up angiography in 24 patients at 6–12 months showed complete occlusion in 23 patients (95.8%) and no aneurysm recurrence. In the coiling-only group, complete occlusion was achieved in 58 patients (93.5%). Intraprocedural aneurysm rupture occurred in 2 patients (3.2%), and postprocedural ischemia occurred in 4 patients (6.5%), with a complication rate of 9.7%. Follow-up angiography in 52 patients at 6–12 months showed complete occlusion in 43 patients (82.7%) and aneurysm recurrence in 7 patients (9.2%). No significant (p > 0.05) differences existed between the two groups.

Conclusions

The LVIS stent is safe and effective in the treatment of tiny ruptured intracranial aneurysms.
Maternal perspectives: The needs of Saudi families of children with Down’s syndrome
Authors: Alabri Waleed
Published: February 2022

Down syndrome (DS) is a chromosomal condition that is affecting an increasing number of infants born in Saudi Arabia. This study investigates the needs of families with children with DS in Saudi Arabia from mothers’ perspectives and in a cultural and religious context. An exploratory qualitative research design was used, and semi-structured interviews were conducted with 14 mothers of children with DS. Interview data were thematically analyzed. The most important need was found to be financial or tangible support. An increase in benefits or monthly financial allowances and social security insurance would address these concerns. Societal support is also needed; mothers want DS to be perceived differently and require more support, including better rehabilitation and education services. Informational support is needed to improve the conditions of children with DS. Recommendations for improving the quality of life of children with DS are discussed.
Social Inequalities in Argentina and Chile: A Comparative Analysis of Welfare Models, Labour Policies, and Occupational Trajectories from a Biographical Perspective
Authors: Muñiz Terra Leticia , Rubilar Gabriela
Published: February 2022

The article analyses the configurations of social inequality in Argentina and Chile between 2000 and 2019 through a comparative biographical approach that combines three dimensions: macro-social (welfare models), meso-social (labour policies), and micro-social (occupational trajectories). In Argentina, welfare schemes oscillated between moderate protectionism and a liberal approach; in Chile, a movement was observed between revised neoliberalism and a protectionist liberal welfare approach. Regarding labour policies, a transition from employment regulation to self-management was observed in the Argentine job market; in Chile, a meritocratic discourse remains that advocates for worker self-management, regardless of changes in welfare schemes. These differences have no appreciable impact on the configuration of class trajectories, which are similar in both countries. While the service classes generally construct advantageous trajectories, the intermediate classes are ambivalently affected by crises and insufficient protection and the working classes accumulate disadvantages since they are conditioned by welfare schemes and social-labour policies.
Respectful maternity care among laboring women in public hospitals of Benishangul Gumuz Region, Ethiopia: A mixed cross-sectional study with direct observations
Authors: Amsalu Bezabh , Aragaw Amanu , Sintayehu Yitagesu , Sema Alekaw , Belay Yalelet , Tadese Getasew , Kassie Nigus , Guta Alemu , Tibebu Abel , Tiruye Getahun
Published: February 2022

Objectives:

Promoting respectful maternity care is a fundamental strategy for enhancing facility birth, which significantly reduces maternal and newborn mortality and morbidity. Despite these effects, disrespect and abusive childbirth care remain a challenge in Ethiopia. Therefore, this study aimed to determine the prevalence of respectful maternity care and its associated factors among laboring women in public hospitals of Benishangul Gumuz region, Ethiopia.

Methods:

A facility-based cross-sectional study design was employed, and trained external assessors observed the care provided to 404 laboring women in public hospitals using structured observation checklists. A focus group discussion and two key informant interviews were also conducted. A structured pre-tested questionnaire and a semi-structured guide were used to generate quantitative and qualitative data, respectively. Seven verification criteria were employed, and the mean value and above for each criterion were used to measure respectful maternity care.

Results:

Of the 404 client–provider interaction observations during childbirth, only 12.6% ( n = 51) participants received respectful maternity care. Being from an urban area (adjusted odds ratio = 3.34, 95% confidence interval: 1.39, 8.08), giving childbirth at daytime (adjusted odds ratio = 2.59, 95% confidence interval: 1.26, 5.33), receiving the service from compassionate and respectful care trained provider (adjusted odds ratio = 4.54, 95% confidence interval: 1.63, 12.66), giving childbirth at general hospital (adjusted odds ratio = 3.03, 95% confidence interval: 1.39, 6.65) were positively associated with respectful maternity care. Staff workload, shortage of supply and equipment, partiality in providing timely care, yelling and insulting at clients and birth companions were also barriers to respectful maternity care.

Conclusion:

The observed respectful maternity care practices were low in the study area. Therefore, the findings of this study suggest that addressing respectful maternity care would require increased compassionate and respectful care trained providers, and sustained efforts to improve access to basic equipment and supply for maternity care with an emphasis on primary hospitals. Tailored interventions aimed at improving respectful maternity care should also target rural residents and nighttime parturients.
Incidence and predictors of attrition among children on antiretroviral therapy at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia, 2019: Retrospective follow-up study
Authors: Chanie Ermias Sisay , Tesgera Beshah Debrework , Ayele Amare Demsie
Published: February 2022

Objectives:

Retaining on antiretroviral therapy is essential for reducing HIV-related morbidity and mortality. However, attrition in HIV-positive children remains a critical challenge in resource-limited settings, including Ethiopia. This study aims to determine the incidence and predictors of attrition among children on antiretroviral therapy at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia.

Methods:

An institution-based retrospective follow-up study was conducted among 357 HIV-positive children at the University of Gondar Comprehensive Specialized Hospital from 1 January 2005 to 30 December 2018 (G.C.). Data were collected by chart review using a structured and pre-tested data abstraction checklist. SPSS 22 and STATA 14.0 were used for data entry and analysis, respectively. In the Cox proportional hazard model, bivariables had a 0.25 computed to multivariable, and variables with a p-value of 0.05 at a 95% confidence interval were considered statistically significant predictors of attrition incidence.

Results:

A total of 344 child records with a completeness rate of 96.4% were reviewed and included in the analysis. The median follow-up period was 4.3 (interquartile range = 4.3 ± 4.7) years, and the median survival time was 132 months. The incidence rate of attrition was 6.6 per 100 person year observation (PYO) (95% confidence interval = 5.5, 8.0). In all, 105 (30.5%) children were recorded as attrition in the follow-up period. Baseline WHO clinical staging 3 and 4 (adjusted hazard ratio = 2.3 (95% confidence interval = 1.3, 4.0)), baseline weight-for-age −2 Z-score (adjusted hazard ratio = 3.1 (95% confidence interval = 1.7, 5.3)), cotrimoxazole non-users (adjusted hazard ratio = 2.5 (95% confidence interval = 1.4, 4.3)), and baseline hemoglobin levels 10 mg/dL (adjusted hazard ratio = 2.7 (95% confidence interval = 1.5, 47)) were found to be a predictor of attrition.

Conclusion:

The overall incidence of the rate of attrition was high. Baseline WHO clinical staging 3/4, baseline hemoglobin 10 mg/dL, cotrimoxazole (cotrimoxazole preventive therapy) non-user, and underweight at baseline (weight-for-age 2 Z-score) were found to be the main predictors of attrition.
Outbreak of feline infectious peritonitis (FIP) in shelter-housed cats: molecular analysis of the feline coronavirus S1/S2 cleavage site consistent with a ‘circulating virulent–avirulent theory’ of FIP pathogenesis
Authors: Healey Eleni A , Andre Nicole M , Miller Andrew D , Whittaker Gary R , Berliner Elizabeth A
Published: February 2022

Case series summary

This case series describes three shelter-housed cats concurrently diagnosed with feline infectious peritonitis (FIP). The cats were from a cohort of seven surrendered from the site of a house fire. The three cats presented with mild upper respiratory signs. Within 10 days they clinically declined: progressive signs included pyrexia, icterus, lethargy, anorexia and cavitary effusions. Necropsy followed by histopathology and immunohistochemistry confirmed a diagnosis of FIP in all three. Molecular analysis of the causative feline coronavirus (FCoV) revealed varied amino acid alterations in the spike gene both between cats and between sample types in individual cats. A fourth cat from the cohort remained healthy in the shelter but succumbed to FIP 6 weeks post-adoption.

Relevance and novel information

This case series places FCoV genetic sequences in the context of clinical signs in a small shelter outbreak. Each of the three cats concurrently developed a slightly different clinical presentation. PCR amplification and genetic sequencing revealed that two cats shared an S1/S2 cleavage site mutation (R790S) previously described to be associated with the development of FIP; one of the cats had an additional S1/S2 cleavage site mutation (R793S). The third cat had a single, identical S1/S2 point mutation (R790G) unique from the other two cats; the R790G mutation has not been previously reported. This case series provides interesting data on point mutations associated with the development of FIP and provides support for a ‘circulating virulent–avirulent theory’ of FIP pathogenesis in a small shelter outbreak.
Primary pulmonary diffuse large B-cell lymphoma associated with feline leukaemia virus infection in a young cat
Authors: Ishikawa Kento , Nagashima Tomokazu , Machida Yukino , Yasuda Akiko , Yoshida Karin , Fujita Michio , Ochiai Kazuhiko , Azakami Daigo , Michishita Masaki
Published: February 2022

Case summary

A 4-year-old castrated male domestic shorthair cat with a continuous cough was brought to a private veterinary clinic for detailed examination. Radiography of the thoracic cavity revealed a severe radiopaque region in the caudal lobe of the right lung. At 108 days after the initial visit, CT showed a mass of 27 × 23 × 18 mm in the caudal lobe of the right lung. At that time, no abnormalities in other organs except for the lung were detected on CT and peripheral blood and blood biochemistry tests. The mass in the caudal lobe of the right lung was resected by lobectomy; it had a white surface and was firm. Histopathologically, the mass was non-encapsulated, showing an unclear boundary with surrounding tissues. The mass comprised large, round or polygonal neoplastic cells arranged in a diffuse pattern. Immunohistochemically, neoplastic cells were diffusely positive for CD20, feline leukaemia virus (FeLV) p27 and FeLV glycoprotein 70 but negative for CD3, CD204 and E-cadherin. Based on these findings, diffuse large B-cell lymphoma associated with FeLV infection was diagnosed. Although the cat showed no clinical signs of gastrointestinal or respiratory injury, a routine ultrasonography revealed thickening in the jejunum wall 196 days after lobectomy, and subsequent fine-needle aspiration examination confirmed high-grade lymphoma.

Relevance and novel information

This is the first report of primary pulmonary diffuse large B-cell lymphoma associated with FeLV infection in a young cat.
Re-focusing explainability in medicine
Authors: Arbelaez Ossa Laura , Starke Georg , Lorenzini Giorgia , Vogt Julia E , Shaw David M , Elger Bernice Simone
Published: February 2022

Using artificial intelligence to improve patient care is a cutting-edge methodology, but its implementation in clinical routine has been limited due to significant concerns about understanding its behavior. One major barrier is the explainability dilemma and how much explanation is required to use artificial intelligence safely in healthcare. A key issue is the lack of consensus on the definition of explainability by experts, regulators, and healthcare professionals, resulting in a wide variety of terminology and expectations. This paper aims to fill the gap by defining minimal explainability standards to serve the views and needs of essential stakeholders in healthcare. In that sense, we propose to define minimal explainability criteria that can support doctors’ understanding, meet patients’ needs, and fulfill legal requirements. Therefore, explainability need not to be exhaustive but sufficient for doctors and patients to comprehend the artificial intelligence models’ clinical implications and be integrated safely into clinical practice. Thus, minimally acceptable standards for explainability are context-dependent and should respond to the specific need and potential risks of each clinical scenario for a responsible and ethical implementation of artificial intelligence.
Non-governmental organization global, volunteerism local: An exploration of moral anthropology
Authors: Fang Hongxin
Published: February 2022

This paper is an exploratory study of moral anthropology focused on the local practices of global non-governmental organizations. For more than 10 years, Ruili Women and Children Development Center (the Center) in the southwest border region of China has developed itself into a non-governmental organization that adopts transnational humanitarianism and fosters a spirit of grassroots volunteer dedication. In this paper, two anthropologists’ analytic framework of morality will be examined and my own views on morality/ethics will be discussed in three aspects: morality as norms, morality as doing good, and ethics as affect. The Center came into existence in response to the decline and uncertainty of local morality (morality as norms). Under such conditions, the Center allies itself with transnational humanitarianism to provide much-needed medical care for the sick in the region (morality as doing good). In the process, the Center, mainly consisting of female members, has created a “life-environment” that is in tune with global humanitarianism and an army of devoted volunteers, especially among local HIV-infected women, who have found “ joie” in life itself (ethics as affect). This study hopes to broaden our theoretical and experiential understanding of non-governmental organizations, and of how to improve quality of life in times of social change.
Making Food Decisions Together: Physiological and Affective Underpinnings of Relinquishing Preferences and Reaching Decisions
Authors: Stevanovic Melisa , Tuhkanen Samuel , Järvensivu Milla , Koskinen Emmi , Lindholm Camilla , Paananen Jenny , Savander Enikö , Valkeapää Taina , Valkiaranta Kaisa
Published: February 2022

We used a novel interdisciplinary experimental paradigm where two types of dyads—15 dyads with one depressed and one non-depressed participant and 15 dyads with two non-depressed participants—engaged in a series of food-decision-making tasks. We examined how different communicative events during the decision-making process were reflected in the affective responses of the interacting participants, as indicated in their skin conductance (SC) response rates. The participants’ SC response rates were found to be higher during the emergence of the final decision, compared to the other segments during the process. Furthermore, relinquishing one’s initially expressed preferences was associated with SC response rates higher than the baseline. However, during the relinquishment segments, there was a negative interaction between depression diagnosis and SC response rates, which suggests that, compared to their non-depressed comparisons, it is affectively less arousing for the participants with depression to give up their previously expressed preferences.
Whole Health Use and Interest Across Veterans With Co-Occurring Chronic Pain and PTSD: An Examination of the 18 VA Medical Center Flagship Sites
Authors: Reed David E. , Bokhour Barbara G. , Gaj Lauren , Barker Anna M. , Douglas Jamie H. , DeFaccio Rian , Williams Rhonda M. , Engel Charles C. , Zeliadt Steven B.
Published: February 2022

Objective

Veterans Healthcare Administration (VHA) conducted a large demonstration project of a holistic Whole Health approach to care in 18 medical centers, which included making complementary and integrative health (CIH) therapies more widely available. This evaluation examines patterns of service use among Veterans with chronic pain, comparing those with and without PTSD.

Methods

We assessed the use of Whole Health services in a cohort of Veterans with co-occurring chronic pain and PTSD (n = 1698; 28.9%), comparing them to Veterans with chronic musculoskeletal pain only (n = 4170; 71.1%). Data was gathered from VA electronic medical records and survey self-report. Whole Health services were divided into Core Whole Health services (e.g., Whole Health coaching) and CIH services (e.g., yoga). Logistic regression was used to determine whether Veterans with co-occurring chronic pain and PTSD utilized more Whole Health services compared to Veterans with chronic pain but without PTSD.

Results

A total of 40.1% of Veterans with chronic pain and PTSD utilized Core Whole Health services and 53.2% utilized CIH therapies, compared to 28.3% and 40.0%, respectively, for Veterans with only chronic pain. Adjusting for demographics and additional comorbidities, Veterans with comorbid chronic pain and PTSD were 1.24 ( 95% CI: 1.12, 1.35, P ≤ .001) times more likely than Veterans with chronic pain only to use Core Whole Health services, and 1.23 ( 95% CI: 1.14, 1.31, P ≤ .001) times more likely to use CIH therapies. Survey results also showed high interest levels in Core Whole Health services and CIH therapies among Veterans who were not already using these services.

Conclusion

Early implementation efforts in VHA led to high rates of use of Core Whole Health and CIH therapy use among Veterans with co-occurring chronic pain and PTSD. Future assessments should examine how well these additional services are meeting the needs of Veterans in both groups.
Organizational Justice and Employee Well-being in India: Through a Psychological Lens
Authors: Majumdar Anjali , Kumar Satishchandra
Published: February 2022

This research paper reports the relationship of organizational justice, work engagement, and psychological capital of employees with their well-being. The predictive strength of organizational justice was tested for employee well-being. Along with this, the mediating effect of work engagement and the moderating effect of psychological capital of employees were tested on this relationship. Out of 479 participants who were asked to fill the organizational justice scale, Utrecht work engagement scale, psychological capital questionnaire, and mental health continuum, the data of 458 (269 males and 189 females) were retained after data screening. Regression analyses and structural equation modeling were conducted to test the relationship between the three predictor variables and one criterion variable. Results indicated that all three predictor variables predict well-being significantly. The relationship between organizational justice and employee well-being was completely mediated by work engagement and moderated by psychological capital of employees. The mediation effect of work engagement and the moderation effect of psychological capital on the relationship between organizational justice and employee well-being have not been explored previously. The possibility of self-reporting bias due to the self-report nature of questionnaires used is a major limitation of this study.
Ambient Room Temperatures in a Burn Intensive Care Unit—A Quality Improvement Project
Authors: Rogers Alan , Ho George , Mosa Adam , Cartotto Robert
Published: February 2022

Introduction: Patients with major burn injuries are particularly susceptible to hypothermia. The ability to maintain and rapidly increase ambient temperatures may reduce the impact of hypothermia and the hypermetabolic response. The purpose of this study was to determine ambient patient room temperatures in a burn intensive care unit (ICU) and to evaluate our ability to adjust these temperatures. Methods: The ambient temperatures of 9 burn ICU patient rooms were recorded hourly over a 6-month period in an American Burn Association-verified burn centre. Temperatures were recorded using wall-mounted smart sensors, transmitted to a mobile smartphone application via Bluetooth, and then exported to Excel for analysis. On 2 predetermined dates, thermostats in all rooms were simultaneously set to maximum, and monitored over 3 h. This represented a sound change initiative, and replicated a medical order to increase the ambient temperature during critical stages of patient care. Results: We recorded 4394 individual hourly temperature measurements for each of the 9 rooms. The mean ambient temperature was 23.5 ± 0.3 °C (range 22.8-24). After intervention 1, ambient temperatures increased <2 °C in 7 rooms and by only 2 °C-3 °C in the other 2 rooms. The overall mean increase in temperature over 3 h across all rooms was 1.03 °C ± 1.19 °C (range −0.88 to 3.26). Following intervention 2, temperatures could be increased by ≥2 °C in only 2 rooms with an overall mean increase in temperature of only 0.76 °C ± 0.99 °C (range −0.29 to 2.43) across all rooms. Conclusions: The burn ICU rooms were relatively cool and our ability locally to adjust ambient temperatures quickly was limited. Burn centres should have regular facility assessments to assess whether ambient temperatures can be adjusted expeditiously when required.
Shoulder Pathology on Magnetic Resonance Imaging in Asymptomatic Elite-Level Rock Climbers
Authors: Cooper Joseph D. , Seiter Max N. , Ruzbarsky Joseph J. , Poulton Ricky , Dornan Grant J. , Fitzcharles Eric K. , Ho Charles P. , Hackett Thomas R.
Published: February 2022

Background:

The prevalence of findings on shoulder magnetic resonance imaging (MRI) is high in asymptomatic athletes of overhead sports.

Purpose/Hypothesis:

The purpose of this study was to determine the prevalence of atypical findings on MRI in shoulders of asymptomatic, elite-level climbers and to evaluate the association of these findings with clinical examination results. It was hypothesized that glenoid labrum, long head of the biceps tendon, and articular cartilage pathology would be present in >50% of asymptomatic athletes.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

A total of 50 elite climbers (age range, 20-60 years) without any symptoms of shoulder pain underwent bilateral shoulder examinations in addition to dedicated bilateral shoulder 3-T† MRI. Physical examinations were performed by orthopaedic sports medicine surgeons, while MRI scans were interpreted by 2 blinded board-certified radiologists to determine the prevalence of abnormalities of the articular cartilage, glenoid labrum, biceps tendon, rotator cuff, and acromioclavicular joint.

Results:

MRI evidence of tendinosis of the rotator cuff, subacromial bursitis, and long head of the biceps tendonitis was exceptionally common, at 80%, 79%, and 73%, respectively. Labral pathology was present in 69% of shoulders, with discrete labral tears identified in 56%. Articular cartilage changes were also common, with humeral pathology present in 57% of shoulders and glenoid pathology in 19% of shoulders. Climbers with labral tears identified in this study had significantly increased forward elevation compared with those without labral tears in both active ( P = .026) and passive ( P = .022) motion.

Conclusion:

The overall prevalence of intra-articular shoulder pathology detected by MRI in asymptomatic climbers was 80%, with 57% demonstrating varying degrees of glenohumeral articular cartilage damage. This high rate of arthritis differs significantly from prior published reports of other overhead sports athletes.
Bilateral Ptosis, Zosteriform Rash and Flaccid Bladder in a 10-Year-old boy
Authors: Adducchio Sara , Reyes Irma , Chikkannaiah Mahesh , Rasch Matthew , Kumar Gogi
Published: February 2022

We present a case report of a 10-year-old completely immunized boy presenting with a 2-week history of bilateral eyelid drooping, fatigue followed by bladder and bowel paralysis. This was followed by the appearance of a vesicular painful and itchy rash which directed further diagnosis and treatment as it was consistent with a varicella reactivation rash. This case is a very important addition to the current body of literature on varicella-related neurological complications. It outlines that varicella reactivation can present in completely vaccinated, immunocompetent young children as a neurological syndrome affecting the autonomic nervous system primarily and the rash can occur a few weeks later after presentation of the neurological symptoms.
Understanding Dr B. R. Ambedkar’s Idea of Social Democracy and Higher Education through Siddharth College, Bombay
Authors: Sangole Minal
Published: February 2022

Dr B. R. Ambedkar was a staunch believer in parliamentary democracy. He viewed that the most precedent condition for working it is the participation of the educated public opinion. By placing the features of Siddharth College of Arts and Science, Bombay (1946), the article explores the interface between Dr B. R. Ambedkar’s ideas of social democracy and higher education pragmatically. The article predominantly draws from the secondary data, especially from the annual magazine of the college from 1946 to 1981. It uses document analysis as a method of inquiry. The article shows the significance of Siddharth College and outlines Dr B. R. Ambedkar’s attempts to develop an alternative as well as an emancipatory educational model. For him, decentralisation of the educational system through the process of social endosmosis was requisite in the reformation of a democratic society, thus an integral part of his nation-building project.
The effect of motor relearning on balance, mobility and performance of activities of daily living among post-stroke patients: Study protocol for a randomised controlled trial
Authors: Ghrouz Amer , Marco Ester , Muñoz-Redondo Elena , Boza Roser , Ramirez-Fuentes Cindry , Duarte Esther
Published: February 2022

Background

Balance and gait impairments are the most common motor deficits due to stroke, limiting the patients' daily life activities and participation in society. Studies investigating effect of task-specific training using biomechanical balance and gait variables (i.e. kinetic and kinematic parameters) as well as posturography after stroke are scarce.

Objectives

The primary aim of this study is to assess the efficacy and long-term outcome of task-specific training based on motor relearning program (MRP) on balance, mobility and performance of activities of daily living among post-stroke patients.

Methods

In this two-armed randomised controlled clinical trial, a total of 66 sub-acute stroke patients who meet the trial criteria will be recruited. The patients will randomly receive task-specific training based on MRP or a conventional physical therapy program (CPT). Twenty-four physiotherapy sessions will be conducted, divided into three training sessions per week, 1 h per session, for 8 weeks, followed by an analysis of changes in patient’s balance, gait and performance of activates of daily living at three time periods; baseline, post-intervention and follow-up after 3-months, using clinical outcome measures and instrumental analysis of balance and gait.

Discussion

The results of this study can guide to better understanding and provide an objective clinical basis for the use of task-specific training in stroke rehabilitation. Also, it intends to help bridge the current knowledge gap in rehabilitation and training recommendations to provide a therapeutic plan in post-stroke rehabilitation.

Trial registration

ClinicalTrials.gov (NCT05076383). Registered on 13 October 2021 (Protocol version: v2.0).
Repoliticising national policy mobilities: Resisting the Americanization of universal healthcare
Authors: Lorne Colin
Published: February 2022

Policy mobilities scholarship has comprehensively challenged the methodological nationalism and rational orthodoxies of policy studies. Contributing to recent debates on policy mobilities and post-politics, this paper examines how struggles over the ‘national’ shape policy on the move. Focussing on attempts to embed accountable care models across the English National Health Service (NHS), I consider how ‘integration’ has been mobilised as a seemingly irresistible solution to the failures of market-orientated healthcare reforms in times of austerity. Yet, I foreground how campaigners slowed down the local contracting of accountable care through repoliticising circulating policy as the ‘Americanization’ of the NHS. The paper emphasises the ongoing, yet shifting and politically contested, role of the state and national spatial imaginaries in the making and translating of globally mobile policy. Rethinking the times and spaces of politics and policy in the current conjuncture, I conclude by warning of the limits of nostalgia for the post-war national welfare state when pushing for universal healthcare as a right for all.
Comparative safety of inhaled corticosteroids and macrolides in Medicare enrolees with bronchiectasis
Authors: Henkle Emily , Daley Charles L. , Curtis Jeffrey R. , Chan Benjamin , Aksamit Timothy R. , Winthrop Kevin L.
Published: February 2022

Introduction

Bronchiectasis is an increasingly common chronic inflammatory airway disease. We evaluated secondary safety outcomes in a comparative effectiveness study of chronic inhaled corticosteroids (ICS) and macrolide monotherapy in bronchiectasis patients.

Methods

We conducted a retrospective study using US Medicare Parts A, B and D (but not C) 2006–2014 datasets. Among those with a pulmonologist-associated bronchiectasis claim (ICD-9-CM 494.0 or 494.1), without cystic fibrosis, we identified the first new use of either chronic (>28 days) ICS or macrolide monotherapy. For each drug exposure, we calculated crude incidence rates of the secondary safety outcomes: arrhythmia, myocardial infarction, sensorineural hearing loss, hip fracture and opportunistic infections. We calculated a propensity score (PS) for ICS use using demographic, clinical and utilisation characteristics and compared risks of macrolidesversusICS for each outcome using PS decile-adjusted Cox regression models.

Results

Of 285 043 Medicare patients with bronchiectasis, we identified 6500 (2%) macrolide and 83 589 (29%) ICS new users. Key covariates were balanced across exposure groups within decile. Myocardial infarction, hip fracture and opportunistic infection were not significantly associated with treatment. Macrolides were associated with a decreased risk of arrhythmia (adjusted hazard ratio (aHR) 0.87, 95% CI 0.80–0.94) and an increased risk of sensorineural hearing loss (aHR 1.38, 95% CI 1.56–1.22) compared to ICS.

Conclusions

Macrolides were not associated with an elevated risk of acute cardiac events compared to ICS. The increased risk of hearing loss in macrolide users compared to ICS users in older bronchiectasis patients should be balanced against known benefits of macrolides.
Determining if T cell antigens are naturally processed and presented on HLA class I molecules
Authors: Friedman Jay , Gunti Sreenivasulu , Lee Maxwell , Bai Ke , Hinrichs Christian , Allen Clint T.
Published: February 2022

Background

Determining T cell responses to naturally processed and presented antigens is a critical immune correlate to determine efficacy of an investigational immunotherapeutic in clinical trials. In most cases, minimal epitopes and HLA restriction elements are unknown.

Results

Here, we detail the experimental use of ex vivo expanded autologous B cells as antigen presenting cells to overcome the limitation of unknown HLA restriction, and the use of electroporated full length mRNA encoding full length parental proteins to ensure that any observed T cell responses are specific for antigens that are naturally processed and presented.

Conclusions

This technique can serve as useful experimental approach to determine the induction or enhancement of specific responses to naturally processed and presented antigens on HLA class I molecules in peripheral blood or tumor infiltrating T cells.
Severe coronary artery spasm during left atrial appendage closure plus catheter ablation for atrial fibrillation: case presentation
Authors: Xie Xin , Chen Zijun , Luo Yu , Li Xiaorong , Zhou Jian , Yu Jinbo , Yang Bing
Published: February 2022

Background

Left atrial appendage closure (LAAC) combined with radiofrequency catheter ablation (RFCA) as a hybrid procedure is commonly performed to treat atrial fibrillation (AF). Although this treatment carries a low risk of coronary artery spasm (CAS), and has never been observed in LAAC procedure, caution still needed to be taken. We presented a case of CAS that occurred in an AF patient during the hybrid procedure.

Case presentation

The patient was a 65-year-old man with paroxysmal AF who developed CAS during RFCA and LAAC. In this case, LAAC was performed ahead of RFCA. After atrial septal puncture, the occluder was advanced into left atrium through delivery sheath, and successfully deployed in the LAA. After verifying the assessment of “PASS” criteria, we decided to release the device. However, before releasing the occluder in LAAC, the patient’s blood pressure (BP) fell to 70/45 mmHg with heart rate (HR) drop and ST-segment elevation in II, III, and aVF and reciprocal ST-segment depression in I and aVL. Isotonic sodium chloride load was administered. After 3 min, the BP and HR raised, and ST-segment returned to normal. The occluder was successfully released after the stable condition of the patient. Then, RFCA was sequentially performed. When isolating the right pulmonary veins, the patient’s BP and HR fell again with ST-segment elevation in inferior leads. Spontaneous ventricular tachycardia and fibrillation developed rapidly and defibrillation was performed immediately with success. Coronary angiography revealed the obstruction of the right coronary artery which disappeared completely after intracoronary nitroglycerin injection (1 mg). Under systemic diltiazem infusion, the RFCA procedure was accomplished. After the procedure, the patient recovered without any neurologic deficit, and CAS has never recurred with isosorbide mononitrate treatment during follow-up.

Conclusions

CAS is a rare complication associated with AF hybrid procedure. Attention should be paid to this rare but potentially life-threatening complication.
Dyslipidemia and its associated factors among adult diabetes outpatients in West Shewa zone public hospitals, Ethiopia
Authors: Abdissa Daba , Hirpa Delessa
Published: February 2022

Purpose

Dyslipidemia is a major risk factor for cardiovascular disease (CVD) in diabetic patients and early detection and treatment can reduce its morbidity and mortality. There is little information on the lipid profile of diabetic patients at West Shewa Public Hospitals, Ethiopia. Therefore, this study aimed to investigate the prevalence and related factors of dyslipidemia among adult diabetes on their follow up at West Shewa Public Hospitals, Ethiopia.

Methods

A facility-based cross-sectional study was conducted from June 1 to September 30, 2020. Data were collected using pre-tested interviewer-administered structured questionnaire. The participants were recruited using a systematic random sampling method. Bivariable and multivariable binary logistic regression were employed to identify the factors associated with dependent variable. Adjusted odds ratios (AOR) were calculated at 95% confidence interval (CI) andpvalue of < 0.05 was considered as statistically significant.

Results

A total number of 390 participants with a mean age of 46.45 (± 15.6) years participated in the study. The overall prevalence of dyslipidemia was 81.5% [95% CI 77.4, 85.4] and the most common lipid abnormality was elevated triglycerides (63.3%). According to multivariate analysis being female gender (AOR = 2.93; 95% CI 1.65, 5.23), age above 50 years (AOR = 3.24; 95% CI 1.54, 6.80) and alcohol consumption (AOR = 2.68; 95% CI 1.33, 5.411) were significantly associated with dyslipidemia.

Conclusion

The majority of study participants had dyslipidemia. Gender, alcohol intake, and age over 50 years were significantly associated with it. Therefore, the results of this study should be taken into account in order to implement appropriate interventions for the identified risk factors.
Impact of prenatal and childhood adversity effects around World War II on multimorbidity: results from the KORA-Age study
Authors: Arshadipour Ava , Thorand Barbara , Linkohr Birgit , Rospleszcz Susanne , Ladwig Karl-Heinz , Heier Margit , Peters Annette
Published: February 2022

Background

While risk factors for age-related diseases may increase multimorbidity (MM), early life deprivation may also accelerate the development of chronic diseases and MM.

Methods

This study explores the prevalence and pattern of MM in 65–71 year-old individuals born before, during, and after World War II in Southern Germany based on two large cross-sectional KORA (Cooperative Health Research in the Region of Augsburg) -Age studies in 2008/9 and 2016. MM was defined as having at least two chronic diseases, and birth periods were classified into five phases: pre-war, early war, late war, famine, and after the famine period. Logistic regression models were used to analyze the effect of the birth phases on MM with adjustment for sociodemographic and lifestyle risk factors. Furthermore, we used agglomerative hierarchical clustering to investigate the co-occurrence of diseases.

Results

Participants born during the late war phase had the highest prevalence of MM (62.2%) and single chronic diseases compared to participants born during the other phases. Being born in the late war phase was significantly associated with a higher odds of MM (OR = 1.83, 95% CI: 1.15–2.91) after adjustment for sociodemographic and lifestyle factors. In women, the prevalence of joint, gastrointestinal, eye diseases, and anxiety was higher, while heart disease, stroke, and diabetes were more common in men. Moreover, three main chronic disease clusters responsible for the observed associations were identified as: joint and psychosomatic, cardiometabolic and, other internal organ diseases.

Conclusions

Our findings imply that adverse early-life exposure may increase the risk of MM in adults aged 65–71 years. Moreover, identified disease clusters are not coincidental and require more investigation.
Recovery and long term functional outcome in people with critical illness polyneuropathy and myopathy: a scoping review
Authors: Intiso Domenico , Centra Antonello Marco , Bartolo Michelangelo , Gatta Maria Teresa , Gravina Michele , Di Rienzo Filomena
Published: February 2022

Background

Intensive care unit acquired weakness (ICUAW), embraces an array of disorders labeled “critical illness polyneuropathy” (CIP), “critical illness myopathy” (CIM) or “critical illness polyneuromyopathy” (CIPNM). Several studies have addressed the various characteristics of ICUAW, but the recovery is still unclear.

Objective

The present review investigated the recovery and the long-term functional outcome of subjects with ICUAW, whether the types of ICUAW have different outcomes and whether there is any supporting evidence.

Methods

Literature search was performed from MEDLINE/PubMed, CINAHL, EMBASE, PeDro, Web of Science and Scopus. Inclusion criteria were: i) sample size including five or more subjects; ii) subjects who suffered from ICUAW and/or CIP, CIM and CIP/CIM; iii) ICUAW ascertained by EMG. Follow-ups longer than one year were defined as long-term.

Results

Twenty-nine studies met the inclusion criteria. In total, 788 subjects with ICUAW were enrolled: 159 (20.1%) died and 588 (74.6%) were followed. Of all the included patients, 613 (77.7%) had CIP, 82 (10.4%) CIM and 56 (7.1%) CIP/CIM. Overall, 70.3% of the subjects with ICUAW fully recovered. Seven (24.1%) studies had a follow-up longer than 1 year (range 2–8) with 173 (21.9%) subjects enrolled globally and 108 followed. Of these subjects, 88.8% gained full recovery. Most of the studies did not use proper functional scales and only 4 and 3 studies employed the Barthel scale and the Functional Independence Measure (FIM) scale. Differentiation between the types of ICUAW was performed in 7 studies, but only 3 studies reported that subjects with CIM had a better prognosis and earlier recovery than subjects with CIP/CIM.

Conclusions

Subjects with ICUAW could achieve good recovery and could improve at follow-up. However, the quality of the published studies due to short follow-ups and the paucity of defined outcome measures require confirms.