bluuebunny/crossref_metadata_2025 huggingface dataset:
Хірургія біліарних стриктур при хронічному панкреатиті
Authors: Ярешко В. Г. , Міхеєв Ю. О. , Скрипко В. Д. , Шпиленко О. Ф.
Published: February 2022

Мета роботи: визначити оптимальні терміни виконання операції для профілактики біліарної стриктури при хронічному панкреатиті, оптимальний вид втручання на жовчних протоках, оптимальну комбінацію операції на жовчних протоках та на підшлунковій залозі, встановити показання для останніх.
Матеріали і методи. Ретроспективний аналіз історій хвороби пацієнтів, оперованих із діагнозом хронічний панкреатит з 2001 до 2020 р. Біліарні стриктури діагностували при механічній жовтяниці та при дилатації гепатикохоледоха ≥10 мм. Біліарні стриктури підтверджували за допомогою інтраопераційної холангіографії. Виконували холедоходуоденостомію, гепатикоентеро-, холедохоентеростомію, трансдуоденальну папілосфінктеротомію, дуоденозберігальні резекції головки підшлункової залози. Ефективність операцій оцінена за відсутністю холангіту/механічної жовтяниці при спостереженні. Статистичний аналіз виконували з допомогою IBM SPSS Version27. Для аналізу категоріальних даних застосовували χ² Пірсона, точний критерій Фішера. Рівень статистичної значущості встановлено на рівні p<0,05.
Результати досліджень та їх обговорення. Відсутність рецидиву біліарних стриктур спостерігали у 85,7 % пацієнтів. Рецидив біліарних стриктур (холангіт/жовтяниця) спостерігали у 8 пацієнтів (14,3 %). Ознаки рецидиву виявлено: в групі, де використовували трансдуоденальну папілосфінктеротомію у 33,3 %, у 16,7 % пацієнтів з холедоходуоденостомію, у 9,7 % хворих з дуоденозберігальними резекціями головки підшлункової залози. Щодо останніх, то цим хворим резекційну декомпресію доповнювали фенестрацією холедоха в резекційну порожнину. Біліарні стриктури спостерігали у 18,8 % пацієнтів із тривалістю симптомів до 3 років та у 33,8 % – більше 3 років.
Поліморфізм екзофітних форм папіломавірусної інфекції у хворих на гострокінцеві кондиломи аногенітальної ділянки
Authors: Слєпічко А. М. , Дейкало І. М.
Published: February 2022

Мета роботи: визначення патоморфологічних особливостей і клінічних форм вірусу папіломи людини у хворих на гострокінцеві кондиломи аногенітальної ділянки.

Матеріали і методи. Обстежено та надано хірургічну допомогу 105 хворим на гострокінцеві кондиломи аногенітальної ділянки: 63 (60 %) жінки та 42 (40 %) чоловіки. Кондиломи висікали методом електрокоагуляції з використанням апарата BOWA (Німеччина) з обов’язковою гістологічною верифікацією видалених тканин. Вперше зверталися до лікаря 67 (63,81 %) хворих. Серед 38 (36,19 %) хворих із рецидивами захворювання 26 (68,42 %) раніше проходили деструктивну терапію, 12 (31,58 %) – противірусну та деструктивну. Усі хворі не вакциновані проти вірусу папіломи людини.

Результати досліджень та їх обговорення. Серед обстежених хворих поодинокі гострокінцеві кондиломи діагностовано у 36 (34,29 %), множинні – у 66 (62,86 %), кондиломи Бушке – Левенштейна – у 3 (2,86 %). У 77 (73,33 %) хворих спостерігали поєднання гострокінцевих кондилом аногенітальної ділянки з іншими вегетативними формами вірусу папіломи людини, які розташовувались в аногенітальній та інших частинах тіла, що свідчить про інфікування декількома типами вірусу папіломи людини. Поєднання вірусу папіломи людини, бактеріальної та грибкової контамінації встановлено у 62 (59,05 %) випадках, що сприяло реалізації альтеративного запального процесу та підвищувало вірогідність ускладнень в перебігу післяопераційного періоду. При гістологічному дослідженні спостерігали койлоцити – великі світлі (майже білі) балоноподібні клітини, що є резервуаром вірусу папіломи людини, гіперкератоз, дискаріоз та гіперхроматоз ядер.
Ультразвуковий скринінг гострого апендициту у вагітних
Authors: Стець М. М. , Войтюк Н. В. , Черненко В. М. , Фіночко В. В.
Published: February 2022

Мета роботи: профілактика передчасних родорозрішень шляхом удосконалення методів діагностики з використанням ультразвукового скринінгу та вибору хірургічної тактики у вагітних з гострою хірургічною патологією залежно від результатів скринінгу.

Матеріали і методи. проведено ретроспективний огляд історій хвороби та амбулаторних карт пацієнтів із підозрою на гостру хірургічну патологію органів черевної порожнини у  КНП «Київська міська клінічна лікарня № 1» з 2016 року до 2021 р.

Результати досліджень та їх обговорення. Всім вагітним проводили необхідні клініко-лабораторні та інструментальні методи дослідження відповідно до оновлених клінічних протоколів надання хірургічної допомоги вагітним. В окремих випадках було виконано магнітно-резонансну діагностику та комп’ютерну томографію для деталізації поширення патологічного процесу та відповідно вибору методу операційного втручання.

Особливості клінічної картини ГА зумовлені анатомо-фізіологічними особливостями вагітних жінок.  Із збільшенням терміну гестації ми спостерігали більш виражену зміну клінічних проявів ГА з більш стрімким перебігом захворювання. Певне значення в діагностиці ГА у вагітних мають показники лабораторних досліджень. Лейкоцитоз, нейтрофільний зсув лейкоцитарної формули вліво, лімфоцитопенія свідчать на користь апендициту.

Токолітичну терапію використовували як при передопераційній підготовці, так і інтраопераційно, що суттєво впливає на профілактику передчасних пологів та ускладнень вагітності.

Післяопераційних ускладнень у даній популяції не спостерігали.

Деталізація діагнозу у вагітних із гострою хірургічною патологією за допомогою новітніх методів діагностики дала можливість вибору тактики та методології хірургічного лікування. Ультразвукове сканування є високочутливим та специфічним у 71 % вагітних при гострому апендициті.

Впровадження мініінвазивних методів дало можливість скоротити кількість перебування вагітних у стаціонарі та використання їх в ІІІ триместрі вагітності  (8 % від загальної кількості оперованих).
Pinnularia hustedtii (Bacillariophyta): Notes on specimens from Wuling Mountains, China and from type material
Authors: WILLIAMS DAVID M. , LIU BING , TAXBÖCK LUKAS
Published: February 2022

N/A
Taxonomic notes on genera Bourrellyodesmus and Xanthidium (Zygnematophyceae) from Chapada Diamantina, Bahia, Brazil
Authors: DOS SANTOS MARIA APARECIDA , PEIXOTO RAMOS GERALDO JOSÉ , DO NASCIMENTO MOURA CARLOS WALLACE
Published: February 2022

Here, we report some interesting periphytic desmids, collected in the Chapada Diamantina region, Caatinga domain, northeastern Brazil. Overall, seven taxa were identified, including two species (Bourrellyodesmus comperei, Xanthidium verrucosum) and one variety (Xanthidium concinnum var. longispinum), which are taxonomic novelties, in addition to other taxa of the desmid flora of Brazil. Taxonomic notes and ecological information were provided for each taxon.
A new putative natural hybrid of Cyrtopodium (Orchidaceae) from the south coast of Brazil
Authors: BATISTA JOÃO A. N. , MEDEIROS ALEXANDRE DA SILVA
Published: February 2022

A new putative natural hybrid of Cyrtopodium, C. × flavopunctatum, from sandy coastal plain vegetation, known as restinga, in the state of Santa Catarina in southern Brazil is described and illustrated. It was found growing among a population of C. flavum and is similar to that species in vegetative and overall floral morphology, but distinguished by the sepals and petals with brown spots, lateral lobes of lip and base of the central lobe orange or orange-spotted, very short isthmus (1–2 mm long), lip midlobe margins slightly verrucose and flowers slightly citrusy-scented. In the color of the flowers, it is intermediate between C. flavum, with completely yellow flowers, and C. gigas or C. palmifrons, epiphytic species with profusely dotted flowers that occur in the same region and bloom at the same time as C. flavum. Additional studies with genetic data are needed to confirm the possible hybrid origin and the identity of the second parental species.
Taxonomic notes on the genus Cyphococcus Laing (Hemiptera: Coccomorpha: Coccidae), with description of a new species from India
Authors: JOSHI SUNIL , GUPTA ANKITA , RAJGOPAL N.N. , VENKATESAN T.
Published: February 2022

The adult female, first-instar nymph, male pupa and adult male of a new species of the genus Cyphococcus Laing (Hemiptera: Coccomorpha: Coccidae) from India, C. williamsi Joshi & Rajgopal sp. n., are described and illustrated. This is the first record of the genus Cyphococcus and the subfamily Cyphococcinae from the Oriental region. Information on distribution, biology, host plants, associated coccinellid predators and hymenopteran parasitoids is given.
On the morphological variability of Limotettix (Limotettix) striola (Fallén, 1806) (Homoptera: Auchenorrhyncha: Cicadellidae: Deltocephalinae: Limotettigini) with notes on the taxonomic status and distribution of L. striola ferganensis Dubovskiy, 1966
Authors: TISHECHKIN DMITRI YU.
Published: February 2022

Investigation of the male calling signals of Limotettix (Limotettix) striola (Fallén, 1806) in populations from central and southern European Russia, Northern Caucasus, and West Tien Shan, Kyrgyzstan demonstrated that they belong to the same species. Males of L. striola from West Tien Shan have a somewhat different penis shape and belong to a separate subspecies, L. striola ferganensis Dubovskiy, 1966. L. striola ferganensis from West Tien Shan differs from L. ferganensis sensu Hamilton (1983, 1994) from the Nearctic in the shape of penis in dorsal view. Apparently, L. ferganensis sensu Hamilton (1983, 1994) is a separate, possibly, undescribed Nearctic taxon.
A new species of Chetoneura Colless from Borneo (Diptera: Keroplatidae)
Authors: KAZANDZHIEVA SVETLOZARA , BECHEV DIMITAR
Published: February 2022

A new species of Keroplatidae—Chetoneura lagangеnsis sp. n. from Lagang cave in Sarawak, Borneo is described and illustrated based on a single male specimen. An identification key to the species of the genus Chetoneura Colless is provided. A distribution map of the five known species of Chetoneura is presented—Ch. cavernae Colless, Ch. shennonggongensis Amorim & Niu, Ch. oligoradiata (Papp), Ch. davidi Ševčík, Hippa & Burdiková and Ch. lagangensis Kazandzhieva & Bechev, sp. n.
Mountain Waves Produced by a Stratified Shear Flow with a Boundary Layer. Part III: Trapped Lee Waves and Horizontal Momentum Transport
Authors: Soufflet Clément , Lott François , Deremble Bruno
Published: February 2022

The boundary layer theory for nonhydrostatic mountain waves presented in Part II is extended to include upward-propagating gravity waves and trapped lee waves. To do so, the background wind with constant shear used in Part II is smoothly curved and becomes constant above a “boundary layer” height d, which is much larger than the inner layer scale δ. As in Part II, the pressure drag stays well predicted by a gravity wave drag when the surface Richardson number J > 1 and by a form drag due to nonseparated sheltering when J < 1. As in Part II also, the sign of the Reynolds stress is predominantly positive in the near-neutral case (J < 1) and negative in the stable case (J > 1) but situations characterized by positive and negative Reynolds stress now combine when J ∼ 1. In the latter case, and even when dissipation produces positive stress in the lower part of the inner layer, a property we associated with nonseparated sheltering in Part II, negative stresses are quite systematically found aloft. These negative stresses are due to upward-propagating waves and trapped lee waves, the first being associated with negative vertical flux of pseudomomentum aloft the inner layer, the second to negative horizontal flux of pseudomomentum downstream the obstacle. These results suggest that the significance of mountain waves for the large-scale flow is more substantial than expected and when compared to the form drag due to nonseparated sheltering.
Lived Experiences and Challenges of the Families of COVID-19 Victims: A Qualitative Phenomenological Study in Tehran, Iran
Authors: Yoosefi Lebni Javad , Irandoost Seyed Fahim , Safari Hossein , Xosravi Tareq , Ahmadi Sina , Soofizad Goli , Ebadi Fard Azar Farbod , Hoseini Ava Sadat , Mehedi Nafiul
Published: February 2022

Being COVID-19 positive and then dying causes a slew of personal, familial, and social issues for family members. Therefore, the current study was carried out to analyze the lived experiences and issues of COVID-19 victims' families in Tehran, Iran. The phenomenological approach was used in the qualitative analysis of 21 first-degree relatives of COVID-19 victims. From August 22 to October 21, 2020, data was gathered by phone (4 people) and in-person (17 people) using semi-structured interviews. The subjects were chosen through purposeful and snowball sampling. The MAXQDA-2018 program was used to organize the data, and the Colaizzi analytical technique was used to analyze it. Guba and Lincoln’s criteria were also used to assess the findings' quality. After analyzing the data, 2 main categories and 14 subcategories were extracted, including (1) challenges in caring for a COVID-19 patient (being rejected, limited access to medical facilities, dissatisfaction with the behavior of medical staff, disruption of family life, the challenge of managing family members' behavior with the patient, and living with doubts and worries (2) challenges after a COVID-19 patient’s death (incomplete farewell to the corpse, unbelievability of the death, ambiguity and tension in the burial process, lonely burial, the twinge of conscience, worry about not respecting the deceased, incomplete condolences, and abandonment). The troubles of victims' families can be ameliorated by developing the skills of caring for COVID-19 patients at home, providing medical and psychological services to families before and after the patient’s death, appropriately informing the families to guarantee them about dignity and respect and respect of the deceased at the interment, and developing a culture of virtual condolence to provide emotional support to survivors.
Understandings of the Role of the One-to-One Writing Tutor in a U.K. University Writing Centre: Multiple Perspectives
Authors: Liu Chang , Harwood Nigel
Published: February 2022

This article presents findings from a study of a U.K. university writing centre regarding understandings of tutor roles, involving 33 Chinese international students, 11 writing tutors, and the centre director. The research used interviews and audio-recorded consultations as data to analyze and explore participants’ beliefs and understandings. The most common roles associated with tutors were proofreader, coach, commentator, counsellor, ally, and teacher. Mismatches were found in understandings of the proofreader role and counsellor role when comparing students’ views, tutors’ views, and the writing centre policy. Policy recommendations are made in light of the findings regarding how writing centres frame the tutor’s role and the function of writing consultations, in terms of (1) interrogating traditional conceptualizations of tutor role, (2) disseminating the centre’s aims to the student population and to the wider university, (3) expanding the centre’s activity across the university, and (4) strengthening tutor training and development.
Adverse Childhood Experiences and Diabetes: Testing Violence and Distress Mediational Pathways in Family Medicine Patients
Authors: Strenth Chance R. , Mo Albert , Kale Neelima J. , Day Philip G. , Gonzalez Leo , Green Ronya , Cruz Inez I. , Schneider F. David
Published: February 2022

Type 2 diabetes mellitus (diabetes) is increasing in frequency and creating a significant burden on the United States healthcare system. Adverse childhood experiences (ACE) and interpersonal violence (IV) have been shown to have detrimental effects on mental and physical health. How ACE can influence IV as an adult and how this can influence the management of diabetes is not known. The purpose of the current study is to understand the relationship between violence and social determinants of health (SDoH), and its effect on patients with type 2 diabetes mellitus. A practiced-based research network (PBRN) of family medicine residency programs was utilized to collect cross-sectional data from seven family medicine residency program primary care clinics. In total, 581 participants with type 2 diabetes were recruited. A serial/parallel mediation model were analyzed. The majority of participants (58.3%) had a Hemoglobin A1c (HbA1c) that was not controlled. ACE was associated with an increase in Hurt-Insult-Threaten-Scream (HITS) scores, which in turn was positively associated with an increase in emotional burden, and finally, emotional burden decreased the likelihood that one’s HbA1c was controlled (Effect = −.054, SE = .026 CI [−.115, −.013]). This indirect pathway remained significant even after controlling for several SDoH and gender. The impact of ACE persists into adulthood by altering behaviors that make adults more prone to experiencing family/partner violence. This in turn makes one more emotionally distressed about their diabetes, which influences how people manage their chronic condition. Family physicians should consider screening for both ACE and family/partner violence in those patients with poorly controlled diabetes.
Conditional Direction of Dependence Modeling: Application and Implementation in SPSS
Authors: Li Xintong , Martens Matthew P. , Wiedermann Wolfgang
Published: February 2022

Conditional Direction Dependence Analysis (CDDA) has recently been proposed as a statistical framework to test reverse causation ( x → y vs. y → x) and potential of confounding ( x ← c → y) of variable relations in linear models when moderation is present. Similar to standard DDA, CDDA assumes that the “true” predictor is a continuous, non-normal, exogenous variable. Under non-normality, a conditional causal effect of one variable does not only change means, variances, and covariances, but also the distributional shape (i.e., skewness, kurtosis, co-skewness, and co-kurtosis) of another variable given the moderator. Such distributional changes can be used to study underlying mechanisms of heterogenous causal effects. The present study introduces conditional direction of dependence modeling and presents SPSS macros to make CDDA easily accessible to applied researchers. A real-world data example from the field of gambling addiction research is used to introduce the functionality of CDDA SPSS macros. Limitations of CDDA due to violated assumptions and poor data quality are discussed. The CDDA installation package is available at no charge from www.ddaproject.com .
Making sense of an irregular adoption. Subjective trajectories of four French adoptees born in Romania in the 1980s and 1990s
Authors: Hernandez Mylène
Published: February 2022

This article presents the results of qualitative research conducted with 20 adoptees, specifically the experiences of four French adoptees from Romania, who discovered significant irregularities in their adoptions. In the form of four ethnographic cases followed by a discussion, it describes the adoptees' bewilderment at their pre-adoptive trajectories and discusses the absence of collective frameworks and narratives in France through which they could apprehend their individual trajectories.
Flight dynamics analysis of a small tandem helicopter considering aerodynamic interference
Authors: Duan Dengyan , Li Yujun , Ding Zhiwei , Li Jianbo
Published: February 2022

The interference calculation is essential to the flight dynamic analysis especially for multi-rotors configurations. To analyze the flight dynamic characteristics of a small tandem helicopter precisely, a vortex method is utilized to obtain the aerodynamic interaction between the tandem rotors and the fuselage. Specially, the unsteady air loads and the wake of the rotors are developed using a lifting surface method and the viscous vortex particle theory, respectively, and the fuselage is modeled by the panel method to simulate the blocking effect on the rotors. Then the aerodynamic interference of the small tandem helicopter is analyzed under the conditions of different vertical or horizontal distance between the rear and front rotors. Subsequently, to save calculation time during flight dynamic analysis, a hybrid optimization trimming method combining the equilibrium optimizer and the improved delta method is proposed. At last, the flight dynamic analysis for the small tandem helicopter with different configurations are carried out and the results indicate that configuration in which the rear rotor is located higher than the front rotor and the one with larger longitudinal distance between tandem rotors are beneficial to increase the stability in lateral and longitudinal directions, respectively.
Aspiration pneumonia and anesthesia techniques in hip fracture surgery in elderly patients: A retrospective cohort study using administrative data
Authors: Fukuda Taeko , Imai Shinobu , Shimoda Shunji , Maruo Kazushi , Nakadera Masaya , Horiguchi Hiromasa
Published: February 2022

Purpose: Aspiration pneumonia is a critical issue. General anesthesia may suppress the airway’s protective reflex. However, aspiration pneumonia is also observed in patients who undergo hip fracture surgery under spinal anesthesia. The aim of this study was to investigate the relationship between anesthesia methods and aspiration pneumonia as well as the predictive factors of aspiration pneumonia in elderly patients undergoing hip fracture surgery. Methods: The medical records of 19,809 patients aged ≥60 years who underwent hip fracture surgery under general or spinal anesthesia were reviewed. After propensity score matching, the anesthesia methods affecting the occurrences of aspiration pneumonia and other complications were investigated via logistic regression and instrumental variable analyses. Predictive factors of aspiration pneumonia were also investigated in all subjects using a multivariable logistic regression analysis. Results: Among the 11,673 general anesthesia patients and 8136 spinal anesthesia patients, aspiration pneumonia occurred in 356 patients (1.8%). Post-propensity score matching the incidences of aspiration pneumonia with general and spinal anesthesia were 1.8% and 1.5%, respectively ( p = 0.158); other pulmonary complications were 1.5% and 1.5%, respectively ( p = 0.893); and the mortality rates were 1.4% and 1.2%, respectively ( p = 0.219). The predictive factors of aspiration pneumonia were advanced age, male sex, lean body, cerebrovascular disease, dementia, and dependency for activities of daily living (eating). Conclusion: Spinal and general anesthesia showed similar incidences of aspiration pneumonia in elderly hip fracture surgery. Regardless of the anesthesia method, great care should be taken, especially in elderly patients with the identified predictive factors.
Historical trauma and oppression: Associations with internalizing outcomes among American Indian adults with type 2 diabetes
Authors: Gillson Stefanie L. , Hautala Dane , Sittner Kelley J. , Walls Melissa
Published: February 2022

American Indian (AI) people experience disproportionate exposure to stressors and health inequities, including type 2 diabetes (T2D) and mental health problems. There is increasing interest in how historical trauma and ongoing experiences of discrimination and marginalization (i.e., historical oppression) interact to influence AI health. The purpose of this study is to examine the relationships between historically traumatic experiences (i.e., boarding schools, relocation programs, and foster care), current reports of historical cultural loss, microaggressions, and their relationship to internalizing symptoms among AI adults living with T2D. This community-based participatory research study with five AI tribal communities includes data from 192 AI adults with T2D recruited from tribal clinics. Results from structural equation modeling revealed that personal experiences in foster care and ancestral experiences in boarding schools and/or relocation were associated with increased reports of historical loss, and indirectly associated with internalizing symptoms through racial microaggressions and historical losses. The findings highlight the importance of considering multiple dimensions of historical trauma and oppression in empirical and practice-based assessments of mental health problems.
Proverbs in Recent Research
Authors: Ogden Bellis Alice
Published: February 2022

This article briefly surveys major commentaries and monographs, as well as significant articles, on the book of Proverbs. The broader genre of wisdom literature, of which Proverbs is a key component, has been undergoing intense scrutiny. The question was whether there is a wisdom genre at all and if so how should it be defined. 2011–2020 was a period of intense research during which a paradigm shift was in progress. Other issues include structure and rhetorical features, divine retribution, and theology more broadly, moral self-development, pedagogy, corporal punishment, and economic and social justice. Non-western and indigenous readings and research from a gender-sensitive perspective have continued to be significant.
Evaluation of carotid artery stiffness in patients with coronary artery disease using acoustic radiation force impulse elastography
Authors: Alan Bircan , Alan Sait
Published: February 2022

Objectives

We evaluated carotid artery stiffness in patients with coronary artery disease (CAD) using acoustic radiation force impulse (ARFI) elastography and investigated the relationship between stiffness and CAD.

Methods

This study examined 76 CAD patients (aged 60.7 ± 11) and 70 healthy individuals (aged 59.6 ± 9). The left common carotid artery mean shear wave velocity (LCmeanSWV) and the right common carotid artery mean shear wave velocity (RCmeanSWV) of the anterior walls were measured using ARFI elastography, and the results of the patient group and the healthy group were compared. The common carotid intima-media thickness (CIMT) was measured in both groups and compared with mean SWV.

Results

The RCmeanSWVs in the patient and healthy groups were 3.47 ± 1 m/s and 2.69 ± 0.90 m/s, respectively ( p < 0.001). The LCmeanSWVs in the patient and healthy groups were 3.60 ± 0.9 m/s and 2.90 ± 0.80 m/s, respectively ( p < 0.001). A significant correlation was found between the RCmeanSWV and the right CIMT values and between the LCmeanSWV and the left CIMT values (r = 0.231, p = 0.03 and r = 0.331, p = 0.002, respectively).

Conclusions

The mean SWV values of carotid arteries of CAD patients measured with ARFI elastography were significantly higher than the mean SWV values of the carotid arteries of healthy individuals. Thus, measurement of the carotid artery SWV could be a potential tool in the risk evaluation of cardiovascular disease. Nonetheless, new studies are required to determine whether this method serves as a useful additional tool.
What will it take to achieve the sexual and reproductive health and rights of women living with HIV?
Authors: Dunaway Keren , Brion Sophie , Hale Fiona , Alesi Jacquelyne , Assan Happy , Chung Cecilia , Moroz Svitlana , Namiba Angelina , Ouma Joyce , Owomugisha Immaculate B , Ross Violeta , Strachan Sophie , Tholanah Martha , Yuvaraj Anandi , Welbourn Alice
Published: February 2022

This article outlines progress in realizing the sexual and reproductive health and rights of women and girls living with HIV over the last 30 years from the perspective of women living with HIV. It argues that the HIV response needs to go beyond the bio-medical aspects of HIV to achieve our sexual and reproductive health and rights, and considers relevant Joint United Nations Programme on HIV/AIDS (UNAIDS), World Health Organization, United States President’s Emergency Plan for AIDS Relief (PEPFAR), Global Fund and other guidelines, what engagement there has been with women living with HIV and whether guidelines/strategies have been adopted. It has been written by women living with HIV from around the world and a few key supporters. Co-authors have sought to collate and cite materials produced by women living with HIV from around the world, in the first known effort to date to do this, as a convergence of evidence to substantiate the points made in the article. However, as the article also argues, research led by women living with HIV is seldom funded and rarely accepted as evidence. Combined with a lack of meaningful involvement of women living with HIV in others’ research on us, this means that formally recognized evidence from women’s own perspectives is patchy at best. The article argues that this research gap, combined with the ongoing primacy of conventional research methods and topics that exclude those most affected by issues, and the lack of political will (and sometimes outright opposition) in relation to gender equality and human rights, adversely affect policies and programmes in relation to women’s rights. Thus, efforts to achieve an ethical, effective and sustainable response to the pandemic are hindered. The article concludes with a call to action to all key stakeholders.
Transitions of care in Clostridioides difficile infection: a need of the hour
Authors: Khanna Sahil , Lett James , Lattimer Cheri , Tillotson Glenn
Published: February 2022

Clostridioides difficile infection (CDI) is a complex disease that by virtue of both its initial virulence and proclivity toward recurrent episodes causes a high morbidity, mortality, and financial burden. This burden is felt by patients and their families as well as the U.S. healthcare system. Recurrent CDI episodes can occur in 25–65% of patients, with a cycle of multiple recurrences in a single patient contributing to the complexity of care. Patients with or suspected of having CDI will receive treatment and their care will be managed across multiple healthcare settings and will include many different levels of healthcare workers. The understanding of this infection is essential for all who are involved in the care of these patients. A well-structured and implemented Transition of Care process can ease the burden on the healthcare system, patients, and their families; reduce the cost of care; and improve patient outcomes. We review the development of Transitions of Care processes, resource guides, and their relevance to improving the management of CDI.
Is Chinese herbal formula (nourishing Yin therapy) effective and well tolerated as an adjunct medication to hydroxychloroquine in the treatment of primary Sjögren’s syndrome? A meta-analysis of randomised controlled trials
Authors: Li Shaowei , Ou Rui , Liu Dandan , Chen Zhihuang , Wei Song , Li Xiaohao , Zhang Xianxian , Liu Yingwan , Hou Chunfu
Published: February 2022

Background:

Previously, data mining methodology was used to identify 71 patented prescriptions in Chinese patent databases, indicating that Yin-nourishing therapy (YNT) may be an adjunct medication to hydroxychloroquine in the treatment of primary Sjögren’s syndrome (pSS). The purpose of this study was to investigate effects of the addition of YNT, which includes tonifying liver and kidney therapy (TLKT) and replenishing Qi and nourishing Yin therapy (RQNYT), in the treatment of pSS.

Methods:

Fourteen databases (including Chinese, English, Japanese, Korean and Latin databases) were searched to identify randomised controlled trials (RCTs) of YNT plus hydroxychloroquine (YNTPH) versus hydroxychloroquine alone in patients with pSS. Relevant publications up to June 2021 were selected. A meta-analysis and trial sequential analysis (TSA) were performed using Review Manager 5.3, Stata 14.0 and TSA 0.9 software. The quality of identified studies was assessed based on the Cochrane risk of bias tool and GRADE (grading of recommendations, assessment, development and evaluation) criteria.

Results:

We included five RCTs with a total of 345 participants. Pooled results indicated significant differences in short-term outcomes, which were assessed via European League Against Rheumatism (EULAR) Sjögren’s Syndrome Patient Reported Index (ESSPRI), EULAR Sjögren’s Syndrome Disease Activity Index (ESSDAI), tear production, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and immunoglobulin G (IgG) results when YNTPH was compared with hydroxychloroquine use alone ( p < 0.05). No significant difference in salivary flow rate was reported. The most common side effect reported for both groups was gastrointestinal reaction. Sensitivity analyses suggested that heterogeneity might be ascribed to clinical methodology. Subgroup analyses revealed heterogeneities regarding salivary flow rate were eliminated. TLKT appeared to be better than RQNYT for improving salivary flow rate. TSA only supported changes in ESSPRI, ESSDAI and ESR values. For all studies, the quality of evidence was low.

Conclusion:

YNTPH may be an effective complementary therapy. Current evidence, however, is insufficient for determining whether YNTPH is more effective than hydroxychloroquine alone. Well-designed RCTs are needed to determine the role of YNT in pSS treatment.
A case of sudden mixed hearing loss in SARS-CoV-2
Authors: Sadiq Abid M , Katundu Denis R , Akrabi Huda F
Published: February 2022

The current global pandemic caused by coronavirus has uncovered multiple symptoms, including sudden hearing loss in either one or both ears, with different outcomes. We present a 68-year-old female with sudden onset bilateral hearing loss, fever, generalized body weakness, and gastrointestinal disturbances. She tested positive for severe acute respiratory syndrome coronavirus 2, was isolated, and was treated with a variety of medications for 5 days before being discharged home to self-isolate. The audiological assessment revealed both sensorineural and conductive hearing loss with a progressive favorable outcome on follow-up visits, with resolution occurring approximately 2 months after the onset. The majority of cases have reported sensorineural hearing loss. However, this case is one of the few that has reported mixed hearing loss. This report highlights an alternate clinical feature of the coronavirus that requires a comprehensive audiological examination by clinicians to ensure proper identification and treatment.
Complications in the Elderly Population Undergoing Spinal Deformity Surgery: A Systematic Review and Meta-Analysis
Authors: Alvarez Reyes Angelica , Jack Andrew S. , Hurlbert R. John , Ramey Wyatt L.
Published: February 2022

Study Design

Systematic Review and Meta-Analysis.

Objectives

The elderly have an increased risk of perioperative complications for Adult Spinal Deformity (ASD) corrections. Stratification of these perioperative complications based on risk type and specific risk factors, however, remain unclear. This paper will systematically review perioperative risk factors in the elderly undergoing ASD correction stratified by type: medical, implant-related, proximal junctional kyphosis (PJK), and need for revision surgery.

Methods

A systematic review was performed using the PRISMA guidelines. A query of PubMed was performed to identify publications pertinent to ASD in the elderly. Publications included in this review focused on patients ≥65 years old who underwent operative management for ASD to assess for risk factors of perioperative complications.

Results

A total of 734 unique citations were screened resulting in ten included articles for this review. Pooled incidence of perioperative complications included medical complications (21%), implant-related complications (16%), PJK (29%), and revision surgery (13%). Meta-analysis calculated greater preoperative PT (WMD 2.66; 95% Cl .36–4.96; P = .02), greater preoperative SVA (WMD 2.24; 95% Cl .62–3.86; P = .01), and greater postoperative SVA (WMD .97; 95% Cl .03–1.90; P = .04) to significantly correlate with development of PJK with no evidence of publication bias or concerns in study heterogeneity.

Conclusions

There is a paucity of literature describing perioperative complications in the elderly following ASD surgery. Appropriate understanding of modifiable risk factors for the development of medical and implant-related complications, proximal junctional kyphosis, and revision surgeries presents an opportunity to decrease morbidity and improve patient outcomes.
Tiger atmospheres and co-belonging in mangrove worlds
Authors: Lobo Michele , Alam Ashraful , Bandyopadhyay Sumana
Published: February 2022

This article adopts a place-based approach to explore tiger atmospheres in the Sundarbans, a transboundary environmental commons and major climatic hotspot in the Ganges-Brahmaputra-Meghna delta of India and Bangladesh. We argue that affective intensities of greed ( lobh), fear ( bhaya), respect ( srodhya), trust ( biswas) and empathy ( karuna) sensed by the tiger subject contribute to novel theoretical as well as empirical insights into co-belonging and intersectional multispecies justice. We explore these animal atmospheres through multi-sited ethnographic research that include embodied observations, photographs, 31 in-depth interviews and focus groups with impoverished as well as racialised low-caste Hindus (Dalits/Scheduled Castes), Adivasis (Indigenous peoples) and Muslim forest-dwellers in India and Bangladesh. This attention to more-than-human geographies, animal atmospheres and subaltern stories situated in the Bengal delta unsettles macro-narratives of forest conservation and wildlife management that reduce animals to passive subjects or alternatively make them killable.
Current endoscopic closure techniques for the management of gastrointestinal perforations
Authors: Staudenmann Dominic , Choi Kevin Kyung Ho , Kaffes Arthur John , Saxena Payal
Published: February 2022

Acute gastrointestinal perforations occur either from spontaneous or iatrogenic causes. However, particular attention should be made in acute iatrogenic perforations as timely diagnosis and endoscopic closure prevent morbidity and mortality. With the increasing use of diagnostic endoscopy and advances in therapeutic endoscopy worldwide, the endoscopist must be able to recognize and manage perforations. Depending on the size and location of the defect, a variety of endoscopic clips, stents, and suturing devices are available. This review aims to prepare and guide the endoscopist to use the right tools and techniques for optimal patient outcomes.
Monitoring cardiopulmonary resuscitation quality in emergency departments: a national survey in China on current knowledge, attitudes, and practices
Authors: Zheng Kang , Du Lanfang , Cao Yu , Niu Zhendong , Song Zhenju , Liu Zhi , Liu Xiaowei , Xiang Xudong , Zhou Qidi , Xiong Hui , Chen Fengying , Zhang Guoqiang , Ma Qingbian
Published: February 2022

Background

To investigate current knowledge, attitudes, and practices for CPR quality control among emergency physicians in Chinese tertiary hospitals.

Methods

Anonymous questionnaires were distributed to physicians in 75 tertiary hospitals in China between January and July 2018.

Results

A total of 1405 respondents answered the survey without obvious logical errors. Only 54.4% respondents knew all criteria of high-quality CPR. A total of 91.0% of respondents considered CPR quality monitoring should be used, 72.4% knew the objective method for monitoring, and 63.2% always/often monitored CPR quality during actual resuscitation. The main problems during CPR were related to chest compression: low quality due to fatigue (67.3%), inappropriate depth (57.3%) and rate (54.1%). The use of recommended monitoring methods was reported as follows, ETCO2 was 42.7%, audio-visual feedback devices was 10.1%, coronary perfusion pressure was 17.9%, and invasive arterial pressure was 31.1%. A total of 96.3% of respondents considered it necessary to participate in regular CPR retraining, but 21.4% did not receive any retraining. The ideal retraining interval was considered to be 3 to 6 months, but the actual interval was 6 to 12 months. Only 49.7% of respondents reported that feedback devices were always/often used in CPR training.

Conclusion

Chinese emergency physicians were very concerned about CPR quality, but they did not fully understand the high-quality criteria and their impact on prognosis. CPR quality monitoring was not a routine procedure during actual resuscitation. The methods recommended in guidelines were rarely used in practice. Many physicians had not received retraining or received retraining at long intervals. Feedback devices were not commonly used in CPR training.
Methylated septin 9 gene is an important prognostic marker in stage II and stage III colorectal cancer for evaluating local recurrence or distant metastasis after surgery
Authors: Huang Mingliang , He Jiehua , Lai Wei , Liu Lu , Xu Heyang , Zeng Yujie , Lan Qiusheng , Lin Xiangan , Chu Zhonghua
Published: February 2022

Background

Abnormal hypermethylation of the septin 9 gene was an inchoate incident in some cancers. Though latest several researches had paid attention to its value in prognosis, the consequences were not distinctly, especially in colorectal cancer (CRC) with stage II and stage III.

Purpose

The aim of this research was to pick up the prognostic value of the methylated septin 9 gene (mSEPT9) in CRC patients, particularly in TNM stage II—III.

Methods

Blood samples before surgery were obtained from 144 CRC patients, of which there were 94 with stage II and stage III. mSEPT9 was considered positive when the cycle number of the peak reaction (Ct) was lower than the threshold value (41.0) for two times during three times PCR test. mSEPT9 and other relative factors of prognosis were estimated by survival analysis. The level of septin 9 in tissues was tested by immunohistochemical (IHC).

Results

Stage II and stage III patients with mSEPT9 positive (mSEPT9+) had a lower disease-free survival (DFS) rate than those with mSEPT9 negative (mSEPT9-) (2-year DFS rates, 52.1% vs 73.9%, P = 0.014). In multivariate regression analysis, mSEPT9 was also an independent predictor of prognosis (HR = 2.741, P = 0.009). The risk of local recurrence or distant metastasis in CRC patients after surgery was mSEPT9+ with stage III, mSEPT9- with stage III/mSEPT9+ with stage II, and mSEPT9- with stage II (P = 0.001), from highest to lowest. In addition, mSEPT9 was strongly associated with TNM staging, tumor immersion depth, distant metastasis, differentiation degree, vascular invasion and microsatellite. When we explored the associations between septin 9 protein level revealed by IHC and other elements, recurrence/progression (R = − 0.523, P = 0.001), mSEPT9 status (R = − 0.451, P = 0.004) and T stage (R = − 0.375, P = 0.017) showed significant correlations.

Conclusions

Positive mSEPT9 is a poor prognostic marker for CRC patients in stage II and III. It is also a powerful complement to TNM staging in predicting postoperative DFS of CRC patients of stage II and III.
Social support and subsequent cognitive frailty during a 1-year follow-up of older people: the mediating role of psychological distress
Authors: Wang Yi , Li Jie , Fu Peipei , Jing Zhengyue , Zhao Dan , Zhou Chengchao
Published: February 2022

Background

Frailty and cognitive impairment are two common geriatric symptoms linking adverse health-related outcomes. However, cognitive frailty, a new definition defined by an international consensus group, has been shown to be a better predictor of increased disability, mortality, and other adverse health outcomes among older people than just frailty or cognitive impairment. This study estimated the prospective association between social support and subsequent cognitive frailty over 1 year follow-up, and whether psychological distress mediated the association.

Methods

The data was drawn from a prospective repeated-measures cohort study on a sample of participants aged 60 and over. A total of 2785 older people who participated in both of the baseline and 1-year follow-up survey were included for the analysis. Cognitive frailty was measured by the coexistence of physical frailty and cognitive impairment without dementia. Control variables included sex, age, education, marital status, economic status, smoking status, alcohol drinking status, chronic conditions, and functional disability. Path analyses with logistic function were performed to examine the direct effects of social support (predictors) on subsequent cognitive frailty (outcome) at 1-year follow-up and the mediating role of psychological distress (mediator) in this link.

Results

After adjusting for covariates and prior cognitive frailty status, social support was negatively associated with psychological distress (β = − 0.098, 95% CI = − 0.137 to − 0.066, P < 0.001) and was negatively associated with the log-odds of cognitive frailty (β = − 0.040, 95% CI = − 0.064 to − 0.016, P < 0.001). The magnitude of mediation effects from social support to cognitive frailty via psychological distress was a*b = − 0.009, and the ratio of a*b/(a*b + c’) was 24.32%.

Conclusions

Lower social support is associated with increased rates of subsequent cognitive frailty over 1-year follow-up, and this link is partially mediated through psychological distress, suggesting that assessing and intervening psychological distress and social support may have important implications for preventing cognitive frailty among older people.
Factors associated with family caregiver burden among frail older persons with multimorbidity
Authors: Ding Teck Yong Gabriel , De Roza Jacqueline Giovanna , Chan Cheuk Ying , Lee Poay Sian Sabrina , Ong Sin Kee , Lew Kaiwei Jeremy , Koh Hui Li , Lee Eng Sing
Published: February 2022

Introduction

Singapore is facing an ageing population and the care needs of the population will increase in tandem. A segment of this population would be living with multimorbidity and frailty. Frailty is defined as an age-related state characterised by reduced strength and physiologic malfunctioning. Multimorbidity refers to the coexistence of multiple chronic conditions in an individual. Older adults are more likely to have frailty and multimorbidity, and this would increase the burden of their caregiver. Our study aimed to determine the prevalence of caregiver burden for primary family caregivers of frail older adults with multimorbidity. We also investigated the factors that were associated with primary family caregiver burden.

Methods

This was an interviewer-administered, cross-sectional study of primary family caregivers of frail older patients with multimorbidity that was conducted in two National Healthcare Group polyclinics. Convenience sampling was used. The 12-item Zarit Burden Index (ZBI) was used to assess primary family caregiver burden. The scores of the ZBI range from 0 to 48, with a score of 10 or above indicating that the primary family caregiver perceives burden. Descriptive statistics were used to provide information regarding the caregivers and the care recipients. Multivariable logistic regression was used to investigate the factors affecting primary family caregiver burden.

Results

One hundred eighty-eight family caregivers were interviewed and 71.8% of them perceived burden on the ZBI. 59.6% were caregivers to their parents and 18.1% of them had multimorbidity. Almost two-thirds of the caregivers interviewed were female. After adjusting for other factors via multivariable analysis, the ethnicity of the caregiver and the increase in time spent caregiving per week were the two factors positively associated with family caregiver burden. A Chinese primary family caregiver had almost three times the odds of perceiving burden when compared to a non-Chinese primary family caregiver.

Conclusion

Caregiver burden was high amongst primary family caregivers of frail older adults with multimorbidity. Being a Chinese primary family caregiver compared to non-Chinese ethnic groups as well as being a primary family caregiver who spent increased time caregiving per week were the two factors positively associated with family caregiver burden. Further exploratory, qualitative studies can be done to find out the reasons to Chinese primary family caregivers being more burdened compared to the non-Chinese primary family caregivers. In addition, the specific factors related to increased time caregiving per week and family caregiver burden can also be studied.