bluuebunny/crossref_metadata_2025 huggingface dataset:
The Association Between Burnout and Pediatrician Management of Adolescent Depression
Authors: LaLonde Leah , Bruni Teryn , Lancaster Blake , Maragakis Alexandros
Published: July 2020

Objective: Given the increased demand for pediatric primary care providers to manage adolescent depression, the current study examines the association between burnout and provider comfort and perception of feasibility managing adolescent depression. Method: Data were collected from 52 pediatricians at a Midwest academic health center. Results: Higher scores on depersonalization were associated with lower provider-reported comfort managing adolescent depression. Emotional exhaustion and personal accomplishment were not associated with provider-reported comfort managing adolescent depression. None of the burnout domains were associated with the provider-reported perception of the feasibility managing adolescent depression in this setting. Limitations and recommendations for future research regarding the impact of behavioral health training on burnout are discussed. Conclusions: The interpersonal stress dimension of burnout is associated with less comfort managing depression. Adding positive systematic interventions, such as behavioral health trainings that support pediatricians in the management of behavioral health may have impact on burnout.
The Impact of Health Belief Model Based Educational Intervention on Women’s Knowledge, Beliefs, Preventive Behaviors and Clinical Outcomes About Osteoporosis
Authors: Pinar Gul , Pinar Tevfik
Published: July 2020

This study was conducted to assess the impact of health belief model based educational intervention on knowledge, health beliefs, preventive behaviors, and biochemical levels of women about osteoporosis. The study was design as a population-based and randomized experimental study by pretest and posttest design between July 2014 and July 2015. The sample ( N = 1,792) of women were aged 18 to 49 years, who resided in Cubuk, Ankara, Turkey, and 75 women ( nintervention = 45; ncontrol = 30) with a high risk of osteoporosis constituted the intervention group of the study. The questionnaires on osteoporosis knowledge and health beliefs were given to the participants before the intervention, immediately after the intervention, and repeated 3, 6, and 12 months. Women in the intervention group had received education and consultation, while those in the control group had not. Bone mineral density and clinical outcomes measured at the lumbar spine and femur before, immediately after the intervention, and 12 months after the intervention to measured osteo-protective performance. The average age of the women in the study was 33.49 ± 9.8 (min = 18, max = 49) years. After the intervention, a significant increase was found in the intervention group’ knowledge and health beliefs scores ( p < .05). Sunlight exposure and physical activity increased ( p < .05) but the levels of the bone mineral density (BMD), ionized Ca and 25 (OH) vitamin D, calcium intake, and smoking did not change after the intervention ( p. > .05). This study showed that the health belief model based educational intervention had a positive effect on increasing knowledge, beliefs, and risk reduction behaviors to prevent osteoporosis.
Local anesthesia combined with intra-articular ropivacaine can provide satisfactory pain control in ankle arthroscopic surgery: A retrospective cohort study
Authors: An Mingyang , Su Xiangzheng , Wei Min , Zhang Baiqing , Gao Feng , Hu Bo , Dong Chenhui , Liu Yujie , Qi Wei , Li Chunbao
Published: July 2020

Background:

Local anesthesia (LA) is widely used in knee arthroscopic surgery but not in ankle arthroscopy.

Objective:

To understand the effectiveness and safety of LA combined with ropivacaine in pain control for ankle arthroscopy.

Study Design:

Retrospective cohort.

Methods:

We retrospectively collected data for patients who underwent ankle arthroscopy from April 2012 to April 2017. Patients were grouped by anesthesia method: LA, LA with ropivacaine (LA+R), spinal anesthesia (SA), and SA with ropivacaine (SA+R). Intra- and postoperative visual analog scale (VAS) scores, complications, doses of supplemental pain medication, hospitalization cost and duration, and satisfaction with pain control during hospitalization were analyzed.

Results:

The study included 276 patients (LA: 93; LA+R: 124; SA: 31; SA+R: 28). The LA and LA+R groups had significantly higher intraoperative VAS scores (LA vs. SA, p = 0.001; LA vs. SA+R, p = 0.002; LA+R vs. SA, p = 0.00; LA+R vs. SA+R, p = 0.00), but fewer complications, than the SA and SA+R groups. The LA+R and SA+R groups had significantly better outcomes for postoperative pain control (LA vs. LA+R, p = 0.01; LA vs. SA+R, p = 0.01; SA vs. SA+R, p = 0.01; SA vs. LA+R, p = 0.03) and required less supplemental pain medication. Hospitalization cost was lower and duration shorter in the LA and LA+R groups than in the SA and SA+R groups. There was no significant difference in satisfaction among the four groups.

Limitations:

This was a single-center retrospective and relatively short-term study.

Conclusions:

LA+R which could be safely applied in ankle arthroscopy provided satisfactory pain control, reduced postoperative pain intensity, fewer complications, shorter hospital stay, and good cost-effectiveness. It can be safely applied in ankle arthroscopy for the specific patients with ankle osteoarthritis.
Incidence of silent venous thromboembolism after total hip arthroplasty: A comparison of rivaroxaban and enoxaparin
Authors: Rahman Wael A. , Habsa Gamal H , Al-Mohrej Omar A. , Hammad Mohammed , Selim Naser M. , Hammad Akram
Published: July 2020

Propose:

Total hip arthroplasty (THA) is associated with a significant risk of venous thromboembolism (VTE). Different thromboprophylaxis strategies have been used to prevent VTE. The primary aim of this study was to report the incidence of VTE and compare the efficacy and safety of rivaroxaban to enoxaparin. The secondary outcome was to report the incidence of silent deep venous thrombosis (DVT) using computed tomography venography.

Methods:

One hundred sixty patients who underwent THA were enrolled in a prospective study. Patients were randomized into two groups as follows: those who received rivaroxaban 10 mg oral daily (group RXE) and those who received enoxaparin 40 IU/day subcutaneously for 14 days (group ENO).

Results:

Both groups were matched for age, sex, comorbidities, special habits and preoperative laboratory investigations. The overall incidence of DVT was 5% ( n = 8), which included four patients clinically diagnosed as having DVT and four with silent DVT. All the DVT cases occurred in veins below the knee and in the group RXE; none of the cases occurred in group ENO ( p = 0.04). The incidence of DVT was significantly higher in patients with high body mass indexes ( p < 0.001), older age ( p = 0.024) and medical comorbidities ( p = 0.14). No mortality, pulmonary embolism, stroke, wound infection or major bleeding occurred in either group.

Conclusions:

Among the patients who underwent hip arthroplasty, rivaroxaban prophylaxis was found to be associated with lower efficacy and similar safety outcomes as compared with enoxaparin anticoagulants.
Outcomes of arthroscopic femoroplasty in patients with cam lesions: Minimum 2-year follow-up
Authors: Ha Yong-Chan , Lim Jae-Young , Won Yoo-Sun , Lee Young-Kyun , Koo Kyung-Hoi , Kim Jin-Woo
Published: July 2020

Purpose:

Successful arthroscopic femoroplasty in patients with cam lesions have been reported in Western countries in the last two decades. However, the outcomes after arthroscopic femoroplasty in Asia have thus far only been reported in patients with borderline dysplasia and in the military population. This retrospective study was designed to evaluate the short-term clinical outcomes and radiologic outcomes after hip arthroscopy in patients with cam-type femoroacetabular impingement (FAI) at a minimum postoperative follow-up of 2 years.

Methods:

From January 2013 to December 2016, 204 hip arthroscopy procedures were performed. Of these cases, 62 patients (73 hips) underwent hip arthroscopy for cam-type FAI.

Results:

Of the 73 hips, 65 (89.0%) achieved gratified reduction or elimination of preoperative pain. The clinical outcomes showed improvement in scores from before surgery to the last follow-up: 67.1 ± 15.0 to 90.2 ± 6.3 for the modified Harris hip score ( p < 0.001), 4.7 ± 2.5 to 7.1 ± 1.4 for the University of California Los Angeles score ( p < 0.001), and 7.4 ± 1.9 to 1.8 ± 1.5 for the visual analog scale score ( p < 0.001). In radiologic assessments, significant improvement was observed in the alpha angle from a mean 60.9° to 49.5° ( p < 0.001) and in the head–neck offset from a mean of 3.3 mm to 6.3 mm ( p < 0.001). Of the 73 hips, 65 (89.0%) achieved satisfactory reduction or elimination of preoperative pain. In subgroup analysis for the sufficiency of femoroplasty (alpha angle < 55°), the clinical outcomes were not different between the two groups.

Conclusion:

Arthroscopic femoroplasty resulted in an 89% satisfaction at the 2-year follow-up. Therefore, hip arthroscopic femoroplasty might be an excellent alternative to open surgery and offers a greater probability of good to excellent results.
Measuring credit risk in family firms
Authors: Abinzano Isabel , Corredor Pilar , Martinez Beatriz
Published: July 2020

This article attempts to identify the default risk measure which best reflects the idiosyncratic context of public family firms. Seven accounting- and market-based measures are compared over a sample of 981 US family and non-family firms for the period 2000–2016. The results show that the Black–Scholes–Merton (BSM) measure gives the best fit in both types of firm. However, all the accounting-based measures, especially Altman’s Z-score, come closest to the market-based measures when used to assess the credit risk of family firms. The two types of measures also coincide more closely in their default risk orderings of family than of non-family firms. Useful practical implications can be drawn from these findings, which show that accounting-based measures can be used reliably in the absence of market data for family firms with similar characteristics to those in our sample.

JEL CLASSIFICATION: G32; G33; G13; C52; M21; M41
Can reactive attachment disorder persist in nurturing placements? A systematic review and clinical case series
Authors: Nelson Rebecca , Chadwick Guy , Bruce Molly , Young-Southward Genevieve , Minnis Helen
Published: July 2020

Reactive Attachment Disorder (RAD), is characterized by failure to seek and accept comfort in maltreated children. This lack of activation of the attachment system has profound developmental disadvantages yet, in early childhood, usually resolves quickly after placement in nurturing care. Persistence of RAD into middle childhood has been demonstrated in children reared in Romanian Institutions but, in family-reared children older children, there is controversy regarding whether RAD-like behaviors are genuinely attachment-related and stable from early childhood or are, in fact, related to PTSD. We conducted two pieces of research to investigate this: 1. a systematic review to examine persistence/resolution of RAD and 2. a case series of three boys whose RAD symptoms persisted despite living in placements judged by both social and child health services to be of good quality. Our systematic review revealed a paucity of longitudinal data. Except in atypical institutionalized samples, RAD had not been evidenced beyond pre-school. All three boys in the case series met DSM 5 criteria for RAD in late childhood/early adolescence and had stable RAD symptoms since before age 5. Qualitative interviews with their families revealed common themes of family strain, frustration and resentment at the lack of support from services. This paper provides the first opportunity to generate testable hypotheses about environmental circumstances and coexisting symptomatology that may influence RAD trajectories. Persistence of RAD has profoundly negative implications for children and their families. Recognition of RAD symptoms is challenging but crucial in order to improve care of these children and their families.
The proliferating pains of imprisonment
Authors: Haggerty Kevin D , Bucerius Sandra
Published: July 2020

The “pains of imprisonment” is one of the most prominent concepts in the social study of incarceration. First introduced by Gresham Sykes in 1958, it has subsequently been taken up by generations of authors and applied to an increasingly diverse range of contexts, populations, and activities. This article details how the “pains of imprisonment” concept has evolved and expanded. It is based on an analysis of 50 academic works (books, articles, and chapters) that used some variation of the “pains of…” formulation. We identified four main trajectories in the literature that have contributed to this expansion, which we document in the first section through the use of illustrative examples. This is followed by a more critical series of reflections that seek to appreciate some of the organizational and political factors that might account for the appeal of this concept. Finally, we conclude by questioning whether the “pains” framing might paradoxically be a victim of its own success, with its analytical and political purchase potentially blunted through overuse and overextension.
Rethinking confinement through Canada’s alternatives to detention program
Authors: Gidaris Constantine
Published: July 2020

This article examines Canada’s immigration and detention system through its newly established alternatives to detention (ATD) program. As a program that relies rather extensively on mobile carceral technologies such as electronic monitoring and voice reporting, I argue that we should consider these alternatives not only as extensions of carceral apparatuses and the detention system but as pervasive, far-reaching, and more abstract manifestations of control and confinement. I introduce the term “techno-carcerality” to theorize how we might understand the shift from traditional modes of confinement to less traditional ones, grounded in mobile, electronic, and digital technologies. I contend that the use of mobile carceral technologies in the context of immigration and detention imposes physical, psychological, spatial, and data-driven modes of control and confinement in private, public, and digital space, which are veiled behind notions and misconceptions of increased freedom, mobility, and autonomy. While the ATD program may offer some better options than those available within detention centers or other carceral institutions, it is a program that involves immense surveillance dataveillance techniques that lead to profound carceral effects and anxieties, affecting everyday life in ways that experientially mimic and transcend conventional confinement.
Management of pyruvate kinase deficiency in children and adults
Authors: Grace Rachael F. , Barcellini Wilma
Published: July 2020

Pyruvate kinase deficiency (PKD) is an autosomal-recessive enzyme defect of the glycolytic pathway that causes congenital nonspherocytic hemolytic anemia. The diagnosis and management of patients with PKD can be challenging due to difficulties in the diagnostic evaluation and the heterogeneity of clinical manifestations, ranging from fetal hydrops and symptomatic anemia requiring lifelong transfusions to fully compensated hemolysis. Current treatment approaches are supportive and include transfusions, splenectomy, and chelation. Complications, including iron overload, bilirubin gallstones, extramedullary hematopoiesis, pulmonary hypertension, and thrombosis, are related to the chronic hemolytic anemia and its current management and can occur at any age. Disease-modifying therapies in clinical development may decrease symptoms and findings associated with chronic hemolysis and avoid the complications associated with current treatment approaches. As these disease-directed therapies are approved for clinical use, clinicians will need to define the types of symptoms and findings that determine the optimal patients and timing for initiating these therapies. In this article, we highlight disease manifestations, monitoring approaches, strategies for managing complications, and novel therapies in development.
Expansion of Single Cell Transcriptomics Data of SARS-CoV Infection in Human Bronchial Epithelial Cells to COVID-19
Authors: Zolfaghari Emameh Reza , Nosrati Hassan , Eftekhari Mahyar , Falak Reza , Khoshmirsafa Majid
Published: July 2020

Background

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of coronavirus disease 19 (COVID-19) that was emerged as a new member of coronaviruses since December 2019 in Wuhan, China and then after was spread in all continentals. Since SARS-CoV-2 has shown about 77.5% similarity to SARS-CoV, the transcriptome and immunological regulations of SARS-CoV-2 was expected to have high percentage of overlap with SARS-CoV.

Results

In this study, we applied the single cell transcriptomics data of human bronchial epithelial cells (2B4 cell line) infected with SARS-CoV, which was annotated in the Expression Atlas database to expand this data to COVID-19. In addition, we employed system biology methods including gene ontology (GO) and Reactome pathway analyses to define functional genes and pathways in the infected cells with SARS-CoV. The transcriptomics analysis on the Expression Atlas database revealed that most genes from infected 2B4 cell line with SARS-CoV were downregulated leading to immune system hyperactivation, induction of signaling pathways, and consequently a cytokine storm. In addition, GO:0016192 (vesicle-mediated transport), GO:0006886 (intracellular protein transport), and GO:0006888 (ER to Golgi vesicle-mediated transport) were shown as top three GOs in the ontology network of infected cells with SARS-CoV. Meanwhile, R-HAS-6807070 (phosphatase and tensin homolog or PTEN regulation) showed the highest association with other Reactome pathways in the network of infected cells with SARS-CoV. PTEN plays a critical role in the activation of dendritic cells, B- and T-cells, and secretion of proinflammatory cytokines, which cooperates with downregulated genes in the promotion of cytokine storm in the COVID-19 patients.

Conclusions

Based on the high similarity percentage of the transcriptome of SARS-CoV with SARS-CoV-2, the data of immunological regulations, signaling pathways, and proinflammatory cytokines in SARS-CoV infection can be expanded to COVID-19 to have a valid platform for future pharmaceutical and vaccine studies.
Polyvalent therapeutic vaccine for type 2 diabetes mellitus: Immunoinformatics approach to study co-stimulation of cytokines and GLUT1 receptors
Authors: Muhammad Syed Aun , Ashfaq Hiba , Zafar Sidra , Munir Fahad , Jamshed Muhammad Babar , Chen Jake , Zhang Qiyu
Published: July 2020

Background

Type 2 diabetes mellitus (T2DM) is a worldwide disease that have an impact on individuals of all ages causing micro and macro vascular impairments due to hyperglycemic internal environment. For ultimate treatment to cure T2DM, association of diabetes with immune components provides a strong basis for immunotherapies and vaccines developments that could stimulate the immune cells to minimize the insulin resistance and initiate gluconeogenesis through an insulin independent route.

Methodology

Immunoinformatics based approach was used to design a polyvalent vaccine for T2DM that involved data accession, antigenicity analysis, T-cell epitopes prediction, conservation and proteasomal evaluation, functional annotation, interactomic and in silico binding affinity analysis.

Results

We found the binding affinity of antigenic peptides with major histocompatibility complex (MHC) Class-I molecules for immune activation to control T2DM. We found 13-epitopes of 9 amino acid residues for multiple alleles of MHC class-I bears significant binding affinity. The downstream signaling resulted by T-cell activation is directly regulated by the molecular weight, amino acid properties and affinity of these epitopes. Each epitope has important percentile rank with significant ANN IC50 values. These high score potential epitopes were linked using AAY, EAAAK linkers and HBHA adjuvant to generate T-cell polyvalent vaccine with a molecular weight of 35.6 kDa containing 322 amino acids residues. In silico analysis of polyvalent construct showed the significant binding affinity (− 15.34 Kcal/mol) with MHC Class-I. This interaction would help to understand our hypothesis, potential activation of T-cells and stimulatory factor of cytokines and GLUT1 receptors.

Conclusion

Our system-level immunoinformatics approach is suitable for designing potential polyvalent therapeutic vaccine candidates for T2DM by reducing hyperglycemia and enhancing metabolic activities through the immune system.
Mortality at the pediatric emergency unit of the Mohammed VI teaching hospital of Marrakech
Authors: Lahmini W. , Bourrous M.
Published: July 2020

Background

The death of a child at the emergency ward is one of the most difficult problems that the clinicians of these wards have to deal with. In our country the published data concerning the causes and the factors related to pediatric mortality especially in the pediatric emergency wards is very rare. This study aimed to study the epidemiology of the pediatric mortality in the pediatric emergency department (PED), to determine its rate and identify its most frequent causes.

Methods

It is a retrospective and descriptive study, over five years (1st January 2012 and 31st December 2016) including all children aged from 0 to 15 years old who died at the PED in the Mohamed VI Hospital in Marrakech.

Results

During the period of the study a total of 172.691 patients presented to the PED, among which 628 died (pediatric mortality rate: 3.63%). The masculine gender was predominant (n = 383) with a gender ratio of 1.59. Two-thirds of the patients died in the first 24 h (n = 421). The median of time from admission to death was around 12 h. Majority of the deceased children (n = 471, 75%) were from a low socioeconomic status. The most frequent cause of admissions for deceased patients in the PED was respiratory distress (n = 296, 47%) followed by neurological disorders (n = 70, 11%). Neonatal mortality (≤ 1 month of age) was predominant (n = 472, 75.1%), followed by postnatal mortality (1 month to 1 year old) (n = 73, 11.6%). The most frequent causes of pediatric mortality, whatever the age range, were dominated by neonatal pathologies (n = 391, 62.3%), followed by infecious causes bronchopulmonary infections included (n = 49, 7.7%), birth deformities (n = 46, 7.3%) while traumas were merely at 0.9% (n = 6). The most frequent causes of neonatal mortality were neonatal infections (n = 152, 32.2%) and prematurity (n = 115, 24.4%).

Conclusion

Our data once again underline the crucial importance of prevention. This requires correct follow-up of the pregnancies, an adequate assistance of births, and perfecting healthcare provision to newborns in order to attain proper assistance.
Exploring the relationship between Nutrition, gUT microbiota, and BRain AgINg in community-dwelling seniors: the Italian NutBrain population-based cohort study protocol
Authors: Prinelli Federica , Jesuthasan Nithiya , Severgnini Marco , Musicco Massimo , Adorni Fulvio , Correa Leite Maria Lea , Crespi Chiara , Bernini Sara
Published: July 2020

Background

Epidemiological evidence suggests that healthy diet is associated with a slowdown of cognitive decline leading to dementia, but the underlying mechanisms are still partially unexplored. Diet is the main determinant of gut microbiota composition, which in turn impacts on brain structures and functions, however to date no studies on this topic are available. The goal of the present paper is to describe the design and methodology of the NutBrain Study aimed at investigating the association of dietary habits with cognitive function and their role in modulating the gut microbiota composition, and brain measures as well.

Methods/design

This is a population-based cohort study of community-dwelling adults aged 65 years or more living in Northern Milan, Italy. At the point of presentation people are screened for cognitive functions. Socio-demographic characteristics along with lifestyles and dietary habits, medical history, drugs, functional status, and anthropometric measurements are also recorded. Individuals suspected to have cognitive impairment at the screening phase undergo a clinical evaluation including a neurological examination and a Magnetic Resonance Imaging (MRI) scanning (both structural and functional). Stool and blood samples for the gut microbiota analysis and for the evaluation of putative biological markers are also collected. For each subject with a confirmed diagnosis of Mild Cognitive Impairment (MCI), two cognitively intact controls of the same sex and age are visited. We intend to enrol at least 683 individuals for the screening phase and 240 persons for the clinical assessment.

Discussion

The NutBrain is an innovative study that incorporates modern and advanced technologies (i.e. microbiome and neuroimaging) into traditional epidemiologic design. The study represents a unique opportunity to address key questions about the role of modifiable risk factors on cognitive impairment, with a particular focus on dietary habits and their association with gut microbiota and markers of the brain-aging process. These findings will help to encourage and plan lifestyle interventions, for both prevention and treatment, aiming at promoting healthy cognitive ageing.

Trial registration

Trial registration numberNCT04461951, date of registration July 7, 2020 (retrospectively registered,ClinicalTrials.gov).
An outbreak of acute respiratory infection at a training base in Beijing, China due to human adenovirus type B55
Authors: Lu Guilan , Peng Xiaomin , Li Renqing , Liu Yimeng , Wu Zhanguo , Wang Xifeng , Zhang Daitao , Zhao Jiachen , Sun Ying , Zhang Li , Yang Peng , Wang Quanyi
Published: July 2020

Background

Twelve students experienced symptoms of acute respiratory infection (ARI) at a training base in Beijing from August 26 to August 30, 2015. We investigated the cause of this ARI outbreak.

Methods

In partnership with the local center for disease control, we collected a total of twelve pharyngeal swab specimens as well as demographic information for the affected patients. We used multiplex real-time PCR to screen for sixteen common respiratory viruses in these samples. To isolate HAdV, we inoculated Hep-2 cells with the human adenovirus (HAdV)-positive samples and then carried out sequencing and phylogenetic analysis of the hexon, fiber, and penton genes of the isolated adenoviruses. In addition, we analyzed the entire genome of one strain isolated from the index case to identify single-nucleotide substitutions.

Results

We identified ten HAdV-positive students using multiplex real-time PCR. None of the students were co-infected with other viruses. We successfully isolated seven HAdV strains from the pharyngeal swab specimens. The coding sequences of the hexon, fiber, and penton genes of these seven HAdV strains were identical, suggesting that they represented seven strains from a single virus clone. One HAdV isolate obtained from the index case, BJDX-01-2015, was selected for whole genome analysis. From this isolate, we obtained a 34,774-nucleotide sequence. The genome of BJDX-01-2015 clustered with HAdV-B55 in phylogenetic analyses and had 99.97% identity with human adenovirus 55 isolate HAdV-B/CHN/BJ01/2011/55 (GenBank accession no. JX491639).

Conclusions

We identified HAdV-B55 as the strain associated with the August 2015 ARI outbreak at a training base in Beijing. This was the first reported outbreak in Beijing due to HAdV-B55. Continuous surveillance of respiratory adenoviruses is urgently needed to understand the epidemiological and evolutionary features of HAdV-B55, and an epidemiological modeling approach may provide further insights into this emerging public health threat. Furthermore, the clinical laboratory data from this outbreak provides important reference for the clinical diagnosis and may ultimately aid in informing the development of strategies to control and prevent respiratory tract infections caused by HAdV-B55.
Scent dog identification of samples from COVID-19 patients – a pilot study
Authors: Jendrny Paula , Schulz Claudia , Twele Friederike , Meller Sebastian , von Köckritz-Blickwede Maren , Osterhaus Albertus Dominicus Marcellinus Eras , Ebbers Janek , Pilchová Veronika , Pink Isabell , Welte Tobias , Manns Michael Peter , Fathi Anahita , Ernst Christiane , Addo Marylyn Martina , Schalke Esther , Volk Holger Andreas
Published: July 2020

Background

As the COVID-19 pandemic continues to spread, early, ideally real-time, identification of SARS-CoV-2 infected individuals is pivotal in interrupting infection chains. Volatile organic compounds produced during respiratory infections can cause specific scent imprints, which can be detected by trained dogs with a high rate of precision.

Methods

Eight detection dogs were trained for 1 week to detect saliva or tracheobronchial secretions of SARS-CoV-2 infected patients in a randomised, double-blinded and controlled study.

Results

The dogs were able to discriminate between samples of infected (positive) and non-infected (negative) individuals with average diagnostic sensitivity of 82.63% (95% confidence interval [CI]: 82.02–83.24%) and specificity of 96.35% (95% CI: 96.31–96.39%). During the presentation of 1012 randomised samples, the dogs achieved an overall average detection rate of 94% (±3.4%) with 157 correct indications of positive, 792 correct rejections of negative, 33 incorrect indications of negative or incorrect rejections of 30 positive sample presentations.

Conclusions

These preliminary findings indicate that trained detection dogs can identify respiratory secretion samples from hospitalised and clinically diseased SARS-CoV-2 infected individuals by discriminating between samples from SARS-CoV-2 infected patients and negative controls. This data may form the basis for the reliable screening method of SARS-CoV-2 infected people.
An unusual cause of metabolic alkalosis: hiding in plain sight
Authors: Cervantes Carmen Elena , Menez Steven , Jaar Bernard G. , Hanouneh Mohamad
Published: July 2020

Background

Sodium bicarbonate, in the form of baking soda, is widely used as a home remedy, and as an additive for personal and household cleaning products. Its toxicity has previously been reported following oral ingestion in the setting of dyspepsia. However, its use as a non-ingested agent, like a toothpaste additive, has not been reported as a potential cause of toxicity.

Case presentation

We are reporting a case of an 80-year-old woman who presented with chronic metabolic alkalosis and hypokalemia secondary to exogenous alkali exposure from baking soda as a toothpaste additive, which might have represented an underreported ingestion of the substance.

Conclusions

Considering that one teaspoon of baking soda provides approximately 59 m-equivalents (mEq) of bicarbonate, specific questioning on its general use should be pursued in similar cases of chloride resistant metabolic alkalosis.
Association of provider advice and gestational weight gain in twin pregnancies: a cross-sectional electronic survey
Authors: WHITAKER Kara M. , BARUTH Meghan , SCHLAFF Rebecca A. , CONNOLLY Christopher P. , LIU Jihong , WILCOX Sara
Published: July 2020

Background

Little is known about patient-provider communication on gestational weight gain among women pregnant with twins, a growing population at high risk for adverse maternal and neonatal outcomes. We examined if women’s report of provider advice on gestational weight gain was consistent with the Institute of Medicine (IOM) weight gain guidelines for twin pregnancies, and the association of provider advice on weight gain with women’s weight gain during their twin pregnancy.

Methods

We conducted a cross-sectional survey of 276 women who delivered twins and received prenatal care in the United States. The 2009 IOM provisional weight gain guidelines for twin pregnancies defined whether provider advice on weight gain and women’s weight gain were below, within, or above guidelines. Multinomial logistic regression examined associations between provider advice on weight gain with women’s weight gain, after adjustment for maternal age, gestational age at delivery, education, parity, twin type, use of assisted reproductive technologies and pre-pregnancy BMI category.

Results

Approximately 30% of women described provider advice on weight gain below the IOM guidelines, 60% within, and 10% above guidelines. Compared to women who reported weight gain advice within guidelines, women who reported advice below guidelines or who reported no advice were 7.1 (95% CI: 3.2, 16.0) and 2.7 (95% CI: 1.3, 5.6) times more likely to gain less than recommended, respectively. Women who reported provider advice above guidelines were 4.6 (95% CI: 1.5, 14.2) times more likely to exceed guidelines.

Conclusions

Provider advice on gestational weight gain may be an important predictor of women’s weight gain during twin pregnancies, highlighting the critical need for accurate provider counseling to optimize health outcomes.
A prospective feasibility study of one-year administration of adjuvant S-1 therapy for resected biliary tract cancer in a multi-institutional trial (Tokyo Study Group for Biliary Cancer: TOSBIC01)
Authors: Itano Osamu , Takemura Yusuke , Kishida Norihiro , Tamagawa Eiji , Shinozaki Hiroharu , Ikeda Ken , Urakami Hidejiro , Ei Shigenori , Hayatsu Shigeo , Suzuki Keiichi , Sakuragawa Tadayuki , Ishii Masatsugu , Shito Masaya , Aiura Koichi , Fujisaki Hiroto , Takano Kiminori , Matsui Junichi , Minagawa Takuya , Shinoda Masahiro , Kitago Minoru , Abe Yuta , Yagi Hiroshi , Oshima Go , Hori Shutaro , Kitagawa Yuko
Published: July 2020

Background

Although surgery is the definitive curative treatment for biliary tract cancer (BTC), outcomes after surgery alone have not been satisfactory. Adjuvant therapy with S-1 may improve survival in patients with BTC. This study examined the safety and efficacy of 1 year adjuvant S-1 therapy for BTC in a multi-institutional trial.

Methods

The inclusion criteria were as follows: histologically proven BTC, Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1, R0 or R1 surgery performed, cancer classified as Stage IB to III. Within 10 weeks post-surgery, a 42-day cycle of treatment with S-1 (80 mg/m2/day orally twice daily on days 1–28 of each cycle) was initiated and continued up to 1 year post surgery. The primary endpoint was adjuvant therapy completion rate. The secondary endpoints were toxicities, disease-free survival (DFS), and overall survival (OS).

Results

Forty-six patients met the inclusion criteria of whom 19 had extrahepatic cholangiocarcinoma, 10 had gallbladder carcinoma, 9 had ampullary carcinoma, and 8 had intrahepatic cholangiocarcinoma. Overall, 25 patients completed adjuvant chemotherapy, with a 54.3% completion rate while the completion rate without recurrence during the 1 year administration was 62.5%. Seven patients (15%) experienced adverse events (grade 3/4). The median number of courses administered was 7.5. Thirteen patients needed dose reduction or temporary therapy withdrawal. OS and DFS rates at 1/2 years were 91.2/80.0% and 84.3/77.2%, respectively. Among patients who were administered more than 3 courses of S-1, only one patient discontinued because of adverse events.

Conclusions

One-year administration of adjuvant S-1 therapy for resected BTC was feasible and may be a promising treatment for those with resected BTC. Now, a randomized trial to determine the optimal duration of S-1 is ongoing.

Trial registration

UMIN-CTR, UMIN000009029. Registered 5 October 2012-Retrospectively registered, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000009347
Viewing an alpine environment positively affects emotional analytics in patients with somatoform, depressive and anxiety disorders as well as in healthy controls
Authors: Hüfner Katharina , Ower Cornelia , Kemmler Georg , Vill Theresa , Martini Caroline , Schmitt Andrea , Sperner-Unterweger Barbara
Published: July 2020

Background

Patients with somatoform, depressive or anxiety disorders often don’t respond well to medical treatment and experience many side effects. It is thus of clinical relevance to identify alternative, scientifically based, treatments. Our approach is based on the recent evidence that urbanicity has been shown to be associated with an increased risk for mental disorders. Conversely, green and blue environments show a dose-dependent beneficial impact on mental health.

Methods

Here we evaluate the effect of viewing stimuli of individuals in an alpine environment on emotional analytics in 183 patients with psychiatric disorders (mostly somatoform, depressive and anxiety disorders) and 315 healthy controls (HC). Emotional analytics (valence: unhappy vs happy, arousal: calm vs excited, dominance: controlled vs in control) were assessed using the Self-Assessment Manikin. Further parameters related to mental health and physical activity were recorded.

Results

Emotional analytics of patients indicated that they felt less happy, less in control and had higher levels of arousal than HC when viewing neutral stimuli. The comparison alpine>neutral stimuli showed a significant positive effect of alpine stimuli on emotional analytics in both groups. Patients and HC both felt attracted to the scenes displayed in the alpine stimuli. Emotional analytics correlated positively with resilience and inversely with perceived stress.

Conclusions

Preventive and therapeutic programs for patients with somatoform, depressive and anxiety disorders should consider taking the benefits of natural outdoor environments, such as alpine environments, into account. Organizational barriers which are preventing the implementation of such programs in clinical practice need to be identified and addressed.
Evaluating real-time momentary stress and affect in police officers using a smartphone application
Authors: Ryu Gi Wook , Yang Yong Sook , Choi Mona
Published: July 2020

Background

Police officers work under stressful conditions, and the resulting occupational stress may impact their health and well-being through changes in positive affect (PA) and negative affect (NA). It is therefore important to assess officers’ stress, PA, and NA while it is experienced. This study evaluates police officers’ momentary stress and affect in real-world settings using an ecological momentary assessment, and examines the within-person (W) and between-person (B) factors that influence momentary affect.

Methods

Eighty-nine police officers were recruited in South Korea. Participants completed questionnaires about their momentary stress and affect using a smartphone application. The associations between momentary stress, momentary contextual environment, momentary PA, and momentary NA were examined using mixed modeling.

Results

Social overload (W: -.37), work discontent (W: −.45, B: −.73), social tension (W: −.79, B: −.67), and pressure to perform (W: −.29, B: −.49) were significantly associated with lower PA. Work overload (B: .33) and social isolation(W: .48, B: .31) were significantly associated with higher PA. Being with family (W: .71, B: .91) and friends (W: 1.89, B: 2.45) were significantly associated with higher PA. Being at home or other places away from the work place were significantly associated with higher PA (W: 1.01) and when patrolling or investigating were associated with lower PA (B: − 1.13). Lack of social recognition (W: 1.74, B: 2.33), work discontent (W: 1.59, B: 1.88), social tension (W: 1.74, B: 2.92), and pressure to perform (W: .78, B: 1.92) were significantly associated with higher NA. Being with colleagues (W: − 1.43), family (W: -1.38, B: − 2.66) and friends (W: -1.78, B: − 2.45) were associated with lower NA.

Conclusions

Momentary within-person and between-person stress factors and contextual factors influenced police officers’ momentary affect. These factors should be considered when developing interventions to mitigate stress and improve affect in police officers.
The effect of knowledge brokering on nurses’ empathy with patients receiving cardiac care: a study protocol
Authors: Galehdarifard Atefeh , Radfar Moloud , Gholami Mohammad , Khademi Mojgan , Ebrahimzadeh Farzad , Imani-Nasab Mohammad-Hasan
Published: July 2020

Background

Hospitalization could be an unpleasant experience for patients with cardiovascular disease leading to some negative emotional reactions. These emotions can be managed by nursing empathy. There are different methods for improving empathy, but some evidence indicates a dramatic drop in nurses’ empathy. In this study, we aim to provide a protocol for investigating the effect of knowledge brokering on nurses’ empathy with patients receiving cardiac care.

Methods

This study protocol is developed based on SPIRIT checklist with an experimental design. The study population are nurses working in cardiac wards of three educational hospitals in western Iran, Khorramabad. The quota sampling method is used. The sample size is 100 individuals. The samples will be assigned to two intervention and comparison groups using stratified random allocation method. Permuted block randomization is used in each stratum. To prevent contamination between participants; firstly, the measurements of the comparison group is done. Knowledge brokering intervention is performed in 7 stages based on Dobbins’ knowledge translation framework 2009. Monica’s Empathy Construct Self-Rating Scale is used for measuring empathy. Statistical analyses are performed using SPSS (SPPS Inc. Chicago, Il, version 21). P value below 0.05 is considered as statistically significant.

Discussion

To our knowledge, there is no similar study using an experimental design to examine the efficacy of a knowledge brokering method to improve humanistic knowledge. It helps nurses to improve their empathy in caring relationships.
Peer support for disadvantaged parents: a narrative review of strategies used in home visiting health interventions in high-income countries
Authors: Kåks Per , Målqvist Mats
Published: July 2020

Background

Disparities in health persist even in high-income countries, and healthcare systems do not reach disadvantaged families as needed. A number of home-visiting interventions in high-income countries offering peer support for parents have been implemented to bridge the gaps in health in a cost-effective way. The lack of standard for intervention design has however resulted in a large variety of the strategies used. The objective for this article is to conduct a review of peer support home visiting interventions for parents and children in high-income countries, aiming to assess the strategies used, their outcomes and the challenges faced by peer supporters.

Methods

Relevant articles published in English between January 2004 and August 2019 were identified using PubMed, and reference lists were reviewed to identify additional articles. Studies were included if they reported on individual peer support health interventions, delivered at home to socioeconomically disadvantaged parents in high-income countries. Nineteen studies were found that met the inclusion criteria, and data were extracted on study characteristics, intervention design and outcomes. Data on intervention design was characterized iteratively to generate overarching categories of strategies used in the programs.

Results

Most studies used healthcare facilities for recruitment, even when the interventions were not delivered by the formal healthcare system. The strategies used to engage supported parents included (1) connection in the form of emotional support, relationship building and matching for background, (2) flexibility in regards to content, intensity, location and mode of contact, and (3) linking through referrals and facilitation of other contacts. A number of significant quantifiable improvements could be demonstrated. Due to large heterogeneity of outcomes, meta-analyses were not viable. Peer supporters experienced challenges with involving other family members than the supported parent as well as with finding their role in relation to other support structures.

Conclusions

Peer support delivered as home visiting interventions have been used for hard-to-reach parents in a variety of high-income contexts and for a multitude of health concerns. Overall, despite variation in intervention design, the strategies employed followed common themes and were generally well received.
International norm development and change: can international law play a meaningful role in curbing the lifestyle disease pandemic?
Authors: Stoeva Preslava
Published: July 2020

Background

The magnitude of the noncommunicable epidemic is difficult to overstate. The projected cost of the epidemic is substantial. It disproportionately affects people in low- and middle-income countries as well as poorer and marginalised communities in high-income countries. The international community has taken various steps to address the four modifiable risk factors causing the majority of noncommunicable diseases (NCDs), however, action has so far fallen short of expectations. Both analysts and international institutions are advocating the adoption of a new international legal norm to address the NCD crisis.

Main text

Drawing on existing knowledge from international relations and international legal studies, this article argues that a new international treaty is not only currently improbable, but also not strictly desirable. In-depth critical analysis and reflection is needed regarding the strengths and weaknesses of a legal approach to addressing the NCD pandemic. The argument is set out in three sections - the first reviews contributions of agentic constructivism, which focus on the process of normative emergence and change, and draws on empirical examples to highlight overlooked aspects of normative development and how they relate to NCD politics. The second engages with the critique of legal principles. Critical approaches to law seek to expose the myths that legal principles are neutral, objective, good. The third section discusses the characteristics of practice in the NCD field and its implications on process and principles for the pursuit of a legal solution to the NCD crisis.

Conclusions

Any advocacy for an international norm to address NCDs needs to be nuanced and demonstrate awareness of the nature and character of both the norm development process and resulting international legal principles. As analysts, we are responsible for advocating inclusive and ethical norms, but also for highlighting the implications of inequalities and differences between and within states and societies. There may be a viable international legal instrument that would support dedicated policies to curb the NCD epidemic, but such an instrument needs to be actively advocated for and negotiated with a wide range of stakeholders, navigating a complex international framework of existing norms and conflicting, powerful interests.