bluuebunny/crossref_metadata_2025 huggingface dataset:
Civil Society and Social Movements in East Asia
Authors: Haddad Mary Alice
Published: October 2020

Civil society in East Asia emerged from two community-generated needs: Rural villages relying primarily on rice farming had to work together to manage collective water supplies, and urban residents in densely packed housing similarly required neighborhood-based associations to fight fire, promote public health, and alleviate intense poverty. Mutual aid organizations rooted in these premodern traditions have not died off and continue to thrive across the region in the form of neighborhood associations, volunteer fire departments, and the like. With the introduction of Christian churches, democratic thought, and the increasingly diverse and complex lifestyles associated with capitalist development, the region has also seen the introduction of other forms of civil society organizations emerge, such as charity groups, reading circles, hobby groups, nonprofit welfare service organizations, ethnic and identity-based mutual aid groups, and advocacy organizations. Because East Asia did not experience the European Enlightenment, with its ideas of separating the public sphere from private interests, and has continued to be strongly influenced by Confucian traditions that emphasize the importance of self-cultivation and social order, civil society in East Asia has tended to be less confrontational toward the state than in other parts of the world. Laws across the region often require that nonprofit organizations register with a “supervising” government ministry, there are strict limits on political lobbying, and personal and corporate donations are often not tax-free. As with other parts of the world, individual citizens and communities do organize and engage in protests, demanding government accountability after corruption scandals, cleaner air and water, and increased protection for ethnic and social minorities, as well as organizing to promote specific policy outcomes. These grassroots movements have sometimes been successful, and both South Korea and Taiwan experienced peaceful transitions to democracy directly as a result of democratic social movements. In East Asia today, we find the same range of civil society organizations that exist across all advanced capitalist societies. As with counterparts elsewhere, civil society in the region is constantly evolving, combining the unique culture of the place in which it operates with influences from abroad.
Political Economy of China
Authors: Tsang Eileen Yuk-ha
Published: October 2020

This article explores why the younger generation of China’s emergent middle class embraces conspicuous consumption but is not interested in politics. Collectively, this behavior is motivated by the quest for social recognition and status, but there are also signs the behavior is sanctioned—if not subtly guided—by the ruling Communist party’s logic of governing. Using the Foucauldian concept of “governmentality,” this article posits that the authoritarian Chinese regime tacitly utilizes noncoercive means to direct the middle class away from activism toward conspicuous consumption. Specifically, through tactics like real name registration (RNR) and value-laden mass media ads and programs, an environment is created that encourages conspicuous consumption as a form of calculated “pastoral” control. This allows government to guide without confrontation. Consequently, the emergent middle class is confronted with the pressure to navigate their own consumption patterns to align with the government’s quasi-veiled preferences that the citizenry should engage with materialist consumption rather than politics. China uses governmentality to orient the new middle-class citizen to consume and to steer away from political engagement that poses a possible threat to the communist regime. Despite insightful arguments about both consumption and governmentality and a growing scholarly interest in the rise of the middle class in China few studies examine the relationship between the conspicuous consumption habits of the Chinese middle class and the governmentality of the ruling party, the Chinese Communist Party (CCP). Mass media and consumer culture reinforce each other to create a stable climate based upon market rationality and consumerism. The CCP has two roles in indoctrinating the new middle class through noncoercive ways. The mobilization of mass media in terms of real name registration and traditional media outlets such as newspapers reflect a way of life that allows middle class citizens to maintain their good life and status to pursue their dreams under Xi’s regime. This status persists through consumption for the self and others (as a practice of gift giving) alongside apolitical involvement. The CCP focuses on entrepreneurs’ success stories as the epitome of good citizenship. Participation in political activities is discouraged by removing it from even being mentioned, discussed, or even shown in any of these accounts. This indirectly positions apolitical involvement as a lifestyle that allows citizens to be cosmopolitan individuals and quality (suzhi素質) citizens in post-Reform China.
UK Public Health Systems
Authors: Hunter David
Published: October 2020

Within the UK there are four public health systems covering each of four countries making up the UK: England is the largest country, followed by Scotland, Wales, and Northern Ireland. There are many commonalities between the systems in terms of their functions and workforce terms and conditions as well as the challenges each faces. But in keeping with the devolved systems of government enjoyed by each country, the public health systems are organized differently and their structures and priorities reflect the differing contexts in which they are located. Drawing on the three domains outlined by Griffiths, Jewell, and Donnelly in their seminal 2005 paper and comprising health protection, health improvement, and health service delivery and quality, UK public health systems exist to protect and promote health improvement and well-being in the population and do so through devising policies and strategies and providing services as well as contributing to the evidence base in regard to what works to improve health. The definition of a public health system is clearly contingent on the definition and scope of public health. The UK public health systems have adopted the definition of public health advanced by the UK Faculty of Public Health and other bodies and first produced by a former Chief Medical Officer for England, Sir Donald Acheson, in 1998: “Public health is the science and art of preventing disease, prolonging life and promoting health through organised efforts of society.” A slightly extended version appeared in a review of public health carried out for the UK government by its appointed independent adviser, Sir Derek Wanless, in 2004: “Public health is the science and art of preventing disease, prolonging life, and promoting health through the organised efforts and informed choices of society, organisations, public and private, communities and individuals.” These definitions share important characteristics including: public health is both a science and an art, essentially and always a combination of knowledge and action; the core purposes of public health are to prevent disease, prolong life, and promote health; public health is an organized societal function. Several aspects of these definitions can be highlighted as being especially pertinent to public health systems. Notable among these is the desire for closer links across health and the environmental sector; addressing social and political determinants of health as an essential and legitimate public health action; and the importance of health systems for public health improvement. Given these definitions with their whole-of-society focus, a public health system is wider and more inclusive than a health system. An effective public health system can be judged by the extent to which relevant groups, organizations, and sectors work effectively together on specific issues.
Hayao Miyazaki
Authors: Greenberg Raz
Published: October 2020

Japanese animator Hayao Miyazaki (b. 1942) is arguably the most admired figure of Japan’s postwar animation industry (commonly known as anime). Deeply moved in his youth by his country’s first color feature-length animated film Hakujaden (Panda and the Magic Serpent, 1958, directed by Taiji Yabushita), Miyazaki decided to seek a career in animation after receiving his BA degree in politics and economy. Most of his output during the first sixteen years of his work as an animator consisted of working on other directors’ films and television shows. Miyazaki made his directorial debut, sharing credit and duties with his colleague Isao Takahata, on the television series Rupan Sansei (Lupin the Third, 1971–1972), an adaptation of a popular manga (comics) series about the exploits of a daring thief. The year 1979 saw the release of Miyazaki’s feature-length debut Rupan Sansei: Kariosuturo no Shiro (Lupin the Third: The Castle of Cagliostro), a spin-off of the television series, which gained attention for its spectacular action sequences. His second feature, Kaze no Tani no Naushika (Nausicaä of the Valley of the Wind, 1984), a theatrical feature adaptation of his own long-running manga series about the quest of a pacifist princess to save a war-torn world destroyed in an environmental apocalypse, hailed for its beautiful animation, design, and environmental subtext. The success of Nausicäa of the Valley of the Wind led to the foundation of Studio Ghibli, under the creative management of Miyazaki and Takahata. A string of critically acclaimed works solidified his position as a leading director in Japan’s animation industry: the Victorian-flavored adventure Tenkū no Shiro Rapyuta (Castle in the Sky, 1986), the nostalgic children’s fantasy Tonari no Totoro (My Neighbor Totoro, 1988), the coming-of-age fantasy Majo no Takkyūbin (Kiki’s Delivery Service, 1989) and the historical comedy-adventure Kurenai no Buta (Porco Rosso, 1992). At the turn of the century, Miyazaki directed the acclaimed historical fantasy Mononoke Hime (Princess Mononoke, 1997) and the modern-day fantasy Sen to Chihiro no Kamikakushi (Spirited Away, 2001), and each became the highest-grossing film in the history of Japanese cinema, an evidence of the important position that Miyazaki has achieved in Japan’s postwar culture. Spirited Away also won the Academy Award for Best Animated Feature in 2002. Miyazaki’s later films in the 21st century met with a more mixed reception. Hauru no Ugoku Shiro (Howl’s Moving Castle, 2004), Gake no Ue no Ponyo (Ponyo, 2008), and Kaze Tachinu (The Wind Rises, 2013) were praised for their visuals, but came under criticism for their narrative qualities. The ongoing debate as to who is going to be Miyazaki’s successor as Japan’s leading animator demonstrates the deep cultural influence that his work continues to have on other animators and filmmakers.
Africa and Transnational Constitutionalism
Authors: Fombad Charles Manga
Published: October 2020

Africa’s experience with constitution making in general and constitutionalism in particular is quite short and dates from the immediate postindependence period. The independence constitutions were virtually imposed by the departing colonial powers with minimal participation in their making by the people and their leaders. They were essentially transplants of the constitutional traditions of the main colonizers—namely the British, the French, and the Portuguese. For the inexperienced Africans assuming the role of leadership, these constitutional documents were simply too complex, and perceived as too badly adapted to address the immediate postindependence problems of underdevelopment. Under the pretext of promoting national unity among the diverse communities which had been artificially forced together as states during the partition of Africa in 1884, and to promote a sense of political identity and thus facilitate nation building and development, many of the liberal principles contained in the independence constitutions were progressively repealed. By the end of the 1980s the independence constitutions had not only become emasculated but had given rise to repressive, corrupt, and incompetent authoritarian regimes along with political instability and the collapse of most economies. However, since the 1990s, there has been a revival of constitutionalism in Africa. A new generation of ‘made in Africa’ constitutions have emerged after new or substantially revised constitutions were adopted. While all these constitutions have retained the strong imprint of their colonial roots they also reflect the adoption of many other features of transnational constitutionalism. Many African constitutions also reflect the considerable efforts at the supranational level by the African Union (AU), influenced by contemporary ideas of transnational constitutionalism, to promote constitutionalism on the continent. Perhaps one of the most significant developments has been the growing influence of an intra-African cross-fertilization of constitutional ideas centered around the South African 1996 Constitution that has influenced the direction and content of the constitution of other African countries such as the 2010 Kenyan and 2013 Zimbabwean Constitutions. Nevertheless, appreciating the extent of transnational constitutionalism in Africa must be understood in the context of the historical heritage of the different African countries. Accounts must also be taken of the complex history of these countries, the ethnic and religious diversity of the population, and the challenges encountered in the continuous attempts to entrench a culture of constitutionalism, good governance, and respect for the rule of law in the face of ominous threats of an authoritarian revival.
Liu Zongzhou
Authors: Wong Simon Man Ho
Published: October 2020

Liu Zongzhou 劉宗周 (personal name Xianzhang 憲章, courtesy name Qidong 起東, literary names Niantai 念台, Jishan 蕺山; b. 1578–d. 1645) was an important Neo-Confucian thinker in the late Ming dynasty (1368–1644) of China. Born as a posthumous child in Shanyin (Shaoxing) of the Zhejiang province, he was brought up by his mother, educated by his maternal grandfather and became a successful candidate of the metropolitan and palace examination in 1601. In 1621, as the Supplementary Secretary in the Ministry of Rites, he began to impeach the corrupt but powerful eunuch Wei Zongxian. In 1624, he declined the offer to be Junior Vice Commissioner of the Office of Transmission, and his status was reduced to that of a commoner. In 1629, he resumed office as the governor of Shuntian Prefecture, and resigned the next year to establish the Zhengren 證人 Association and to lecture at the Shigui 石匱 Academy. In 1636, he became Senior Vice Minister of Works. Yet he soon resigned to criticize the Senior Grand Secretary Wen Tiren 溫體仁, and this led to the degradation of his status to a commoner again. In 1642, he was promoted to Censor-in-chief, but he was relieved of his office when he antagonized the emperor by trying to save two censorial officials. During the fall of Beijing, he resumed his office as Censor-in-chief. He attacked the corrupt officials Ma Shiying 馬士英 and Ruan Dacheng 阮大鋮 and finally left his office. His official career lasted for forty-five years, during which he had held office six and a half years, was in active service at court only four years, and had been degraded to the status of commoner three times. With the fall of Nanjing and Hangzhou in succession to the Manchus and his decision to express his loyalty and patriotism to the country, he ended his life by fasting for twenty days. Liu distinguished himself as a Neo-Confucian philosopher and scholar. The main doctrines of his teaching are “vigilance in solitude” (shendu慎獨) and “sincerity of will” (chengyi誠意), which originate from the two Confucian classics Doctrine of the Mean and Great Learning. Huang Zongxi 黃宗羲 (b. 1610–d. 1695), his important disciple and a well-known intellectual historian, placed him and his school of thought in the last part of Huang’s influential work, The Records of Ming Scholars. Huang not only compared him to the most significant Neo-Confucian philosophers, but also hinted that his philosophy signified the final summation of the Neo-Confucian tradition from the Song to Ming dynasties. He is commonly regarded as one of the most important Song-Ming Neo-Confucian thinkers. It is the creativity and depth of his philosophy that deserves scholars’ attention.
Luca della Robbia (or the Della Robbia Family)
Authors: Kupiec Catherine
Published: October 2020

Florentine sculptor Luca della Robbia (b. 1399/1400–d. 1482) is best remembered as the inventor of a popular new form of glazed terracotta sculpture and as founder of the flourishing family workshop that produced it for roughly a century. He has long ranked among the greatest artists of the early Florentine Renaissance: tellingly, Leon Battista Alberti celebrated him as one of five exceptional modern artists in the dedication to his 1436 treatise On painting (Della pittura), alongside Filippo Brunelleschi, Donatello, Lorenzo Ghiberti, and Masaccio. Luca was a consummate craftsman, praised by writers during and after his lifetime for his activity in marble, bronze, terracotta, and even goldsmithery. Modern scholarship on the artist is substantial and has consistently sounded two notes, celebrating his exemplary classicizing style and recognizing that the story of his artistic success is also, simultaneously, that of a new sculptural medium. While the exact details of its initial development (accomplished by the year 1441) remain unknown, Luca’s glazed terracotta art soon attracted eminent patrons, such as Piero de’ Medici, and was praised by contemporaries as an invention. In the tradition of artistic family dynasties, Luca passed the secrets of his new art to his nephew, Andrea della Robbia (b. 1435–d. 1525), who succeeded him as head of the workshop. Andrea conducted a brisk business in glazed sculpture and taught the family craft to five of his sons: Marco (Fra Mattia, b. 1468–d. 1534), Giovanni (b. 1469–d. 1529/1530), Luca “il giovane” (b. 1475–d. 1548), Francesco (Fra Ambrogio, b. 1477–d. 1527/1528), and Girolamo (b. 1488–d. 1566). Andrea and Giovanni are the best-studied among these artists, while the others long suffered from general neglect owing to their geographically disperse activity and a perception that production quality fell with the later generations. Similarly under-studied are two final artists who made glazed sculptures: the Florentine Benedetto Buglioni (b. 1459/1460–d. 1521), who likely trained under Andrea and opened his own shop around 1480, and his adopted ward, Santi Buglioni (b. 1494–d. 1576). Recent scholarship has illuminated the ongoing efforts of the later artists in both families to integrate workshop traditions forged under Luca with new contexts and artistic innovations, all while serving patrons ranging from Franciscan friars to King François I of France.
A self-report questionnaire to detect hand dermatitis in nurses
Authors: Parsons V , Williams H C , English J , Llewellyn J , Ntani G , Madan I
Published: October 2020

Background

Hand dermatitis is highly prevalent among nurses due to their frequent exposure to wet work. Providing cost-effective dermatological health surveillance for this occupational group presents a challenge to health service providers.

Aims

To ascertain the predictive value of nurses’ self-assessment of whether they had current hand dermatitis using a screening questionnaire when compared with the assessment made by a dermatologist of the nurses’ hand photographs.

Methods

We conducted a cross-sectional study comparing the self-report decision made by student and intensive care nurses using a single hand dermatitis screening question with the clinical assessment of their hand photographs made by dermatologists using a standardized photographic guide.

Results

We analysed data collected at study baseline (n = 1599). The results showed that the screening question had a high negative predictive value (91%; 95% CI 89–93), but a low positive predictive value (39%; 95% CI 34–45). It demonstrated acceptable accuracy in distinguishing those with and without the disease (area under the receiver operator curve = 0.7) and had a high specificity (86%; 95% CI 84–88) but a sensitivity of only 52% (95% CI 46–59) in identifying hand dermatitis.

Conclusions

We found that nurses were able to accurately self-assess themselves as not having any signs of hand dermatitis. By contrast, they were less able to accurately self-assess positive cases suggesting under-recognition of early disease. We propose that a questionnaire containing a single hand dermatitis screening question should be considered as a tool for screening out clear cases as part of a workplace health surveillance programme for detecting hand dermatitis.
A survey of current levels of trace minerals and vitamins used in commercial diets by the Brazilian pork industry—a comparative study
Authors: Dalto Danyel Bueno , da Silva Caio Abércio
Published: October 2020

This study identified the levels of trace minerals and vitamins used in commercial diets by the Brazilian pork industry and compared these levels against the Brazilian reference tables and those from the North American pork industry. Animal feed companies (n = 15) and cooperatives/agro-industries (n = 15) from the Brazilian pork sector participated in this study. Levels of vitamin A, D, E, and K, thiamine, riboflavin, niacin, pantothenic acid, pyridoxine, biotin, folic acid, vitamin B12, choline, vitamin C, cobalt, copper, chromium, iodine, iron, manganese, selenium, and zinc were collected. Data were compiled by feeding phase to determine descriptive statistics. Ratios were calculated comparing the observed levels to those from the Brazilian reference tables and those from the North American pork industry. Average levels of trace minerals and vitamins used by the Brazilian pork industry were between 40% and 240% higher than the recommendations of the Brazilian reference tables. Compared to the North American pork industry, Brazilian levels for trace minerals were overall higher but for water-soluble vitamins they were significantly lower. Large between-companies variations were observed for most of the studied nutrients, especially for water-soluble vitamins. In conclusion, the Brazilian pork industry adds a significant margin of safety for trace minerals and vitamins supplementation. The large between-companies variations, especially for water-soluble vitamins, reflect the limited knowledge available on precise levels of supplementation for trace nutrients for pigs.
Visual Field Artifacts in Glaucoma With Face Mask Use During the COVID-19 Pandemic
Authors: El-Nimri Nevin W. , Moghimi Sasan , Fingeret Murray , Weinreb Robert N.
Published: October 2020

Purpose:

The coronavirus (COVID-19) pandemic has changed how outpatient care is delivered in ophthalmology clinics, particularly with glaucoma care. This case series highlights the need for awareness of fogging and improper face mask fit as causes of standard automated perimetry artifacts in patients with ocular hypertension and glaucoma.

Clinical Presentations:

Six patients with the diagnosis of ocular hypertension, glaucoma suspect, or glaucoma underwent standard automated perimetry (24-2 or 10-2 SITA, Humphrey Field Analyzer) while wearing ear-loop surgical face masks. Due to patient complaints of fogging during the testing, low test reliability, and unexpected results, the tests were repeated after taping securely the mask to the bridge of the nose.

Clinical Findings:

Fogging may reduce visual field (VF) test reliability and induce artifacts that mimic glaucomatous defects. VF test reliability can be improved and artifacts minimized following mask taping. In 1 case there was worsening of VF defects after mask taping. This suggests that fogging may also disguise true VF defects.

Conclusions:

Fogging can result in unreliable VF testing with glaucoma-like artifacts. Secure taping of the face mask to the nose bridge may minimize this problem and reduce unnecessary additional testing and follow-up visits.
Nonsurgical Secondary Prophylaxis of Esophageal Variceal Bleeding in Cirrhotic Patients
Authors: Jing Liwei , Zhang Qiumeng , Chang Ziwei , Liu Hui , Shi Xuan , Li Xingyu , Wang Jing , Mo Yanbo , Zhang Xiujing , Ma Lizhuan , Li Zhiting , Zhang Chao
Published: October 2020

Introduction:

The aim of this study was to evaluate the effectiveness of nonsurgical secondary prophylaxis interventions for esophageal varices (EV) rebleeding in cirrhotic patients using network meta-analysis.

Materials and Methods:

Secondary prophylaxis of EV rebleeding in cirrhosis is searched on PubMed, Embase, and the Cochrane Library databases. The quality of literatures was extracted by 2 independent investigators according to the requirements of Cochrane Handbook for Systematic Reviews of Interventions, Version 5.0.0. Meta-analysis was performed on Review Manager 5.3 software for the incidence of cirrhosis EV rebleeding, rebleeding-related mortality, and overall mortality; and STATA 15.1 software was used for network meta-analysis.

Results:

In all, 57 randomized controlled trials were reviewed. Endoscopic band ligation (EBL)+argon plasma coagulation has not been recommended by guidelines, and it is rarely used; the number of existing studies and the sample size are small. Considering poor stability of the combined results, these studies were excluded; 55 literatures were included. In terms of reducing the incidence of rebleeding, transjugular intrahepatic portosystemic shunt (TIPS) surface under the cumulative ranking curve (SUCRA) (94.3%) was superior to EBL+endoscopic injection sclerotherapy (EIS) (84.4%), EIS+β-blockers (77.9%), EBL (59.8%), EBL+β-blockers+isosorbide-5-mononitrate (52.7%), EBL+β-blockers (51.4%), EIS (34.2%), β-blockers+isosorbide-5-mononitrate (23.7%), β-blockers (20.8%), and placebo (0.8%). In reducing rebleeding-related mortality, TIPS SUCRA (87.2%) was more efficacious than EBL+EIS (83.5%), EIS (47.9%), EBL+β-blockers (47.4%), β-blockers (41.8%), EBL (34.5%), and placebo (7.6%). In reducing overall mortality, TIPS SUCRA (81.1%) was superior to EBL+EIS (68.9%), EIS+β-blockers (59.2%), EBL+β-blockers (55.4%), EIS (48.8%), EBL (48.7%), β-blockers (34.2%), placebo (3.6%).

Conclusions:

TIPS was more effective in reducing the incidence of cirrhosis EV rebleeding, rebleeding-related mortality, and overall mortality in cirrhosis. Combined with the above results, TIPS is more likely to be recommended as a secondary prophylaxis intervention for EV in cirrhosis.
Helicobacter pylori Infection and Serum Pepsinogen Level With the Risk of Gastric Precancerous Conditions
Authors: Zhou Xianzhu , Zhu Huiyun , Zhu Chunping , Lin Kun , Cai Quancai , Li Zhaoshen , Du Yiqi
Published: October 2020

Background and Aim:

Gastric precancerous conditions are generally considered to play an essential role in the gastric carcinogenesis cascade. This study identified risk factors of gastric precancerous conditions in a nationwide multicenter cross-sectional study.

Methods:

Individuals who made their visit to 115 hospitals in China for gastric cancer screening were recruited. Lifestyle habits and personal information were collected through a series of questionnaires. Serum biomarker test (pepsinogen I, pepsinogen II, gastrin-17, and anti-Helicobacter pylori immunoglobulin G antibody) and endoscopy were then performed. Risk factors for gastric precancerous conditions were identified by univariate and multivariate analyses.

Results:

Of 14,929 subjects eligible for analysis, 4477 (30.0%) developed gastric precancerous conditions and 405 (2.71%) developed gastric cancer. In multiple logistic regression, precancerous conditions were associated with advanced age [odds ratio (OR)=1.027; 95% confidence interval (Cl), 1.023-1.032; P<0.001], male gender (OR=1.303; 95% Cl, 1.188-1.429; P<0.001), H. pylori infection (OR=1.377; 95% Cl, 1.272-1.490, P<0.001), and smoking (OR=1.142; 95% Cl, 1.005-1.298, P=0.004), whereas they were inversely correlated with white meat intake (OR=0.731; 95% Cl, 0.673-0.794; P<0.001) and pepsinogen I level (30 to 70 subgroup OR=1.536; 95% Cl, 1.163-2.028; P=0.002; <30 subgroup OR=1.354; 95% Cl, 1.206-1.520; P<0.001). Also, the authors observed a statistically lower prevalence of reflux esophagitis (2.8% vs. 4.7%) and of gastric polyps (11.0% vs. 13.7%) in H. pylori-infected population.

Conclusions:

Patients with H. pylori have a 1.4-fold higher risk of having gastric precancerous conditions. Besides, precancerous conditions were associated with advanced age, male gender, H. pylori infection, and smoking in a large population. However, regular white meat intake and higher pepsinogen I level were associated with reduced risk of having precancerous lesions.
High Prevalence of Gastrointestinal Manifestations of COVID-19 Infection in Hospitalized Patients With Cancer
Authors: Grover Shilpa , Redd Walker D. , Zhou Joyce C. , Nije Cheikh , Wong Danny , Hathorn Kelly E. , McCarty Thomas R. , Bazarbashi Ahmad N. , Shen Lin , Chan Walter W.
Published: October 2020

Background and Aim:

Gastrointestinal (GI) symptoms have been reported with SARS-CoV-2 infection, but data on the prevalence and severity of GI symptoms in patients with cancer are limited. We sought to characterize the GI manifestations of coronavirus disease-19 (COVID-19) in oncology patients.

Materials and Methods:

We performed a multicenter cohort study of adult patients hospitalized with COVID-19 in 9 Massachusetts medical centers and identified those with an active malignancy. We evaluated the prevalence and severity of GI symptoms among hospitalized COVID-19 patients with cancer.

Results:

Of 395 hospitalized patients with COVID-19, 36 (9%) had an active malignancy. Of the 36 cancer patients, 23 (63%) reported ≥1 new GI symptom. The most prevalent symptoms were anorexia (12, 52%), diarrhea (9, 39%), and vomiting (8, 35%). GI symptoms were the initial symptom in 4/36 (11%) patients, were the predominant symptom in 5/36 (14%) patients, and were severe in 4/23 (17%) patients. Four of 5 patients with GI symptoms at presentation reported concurrent fever; notably 1 patient had no fever or respiratory symptoms. Twelve (33%) patients had elevations in liver transaminases at presentation; patients with elevated transaminases were more likely to have associated GI symptoms (83% vs. 54%, P=0.04).

Conclusions:

Acute GI symptoms associated with COVID-19 are highly prevalent in hospitalized cancer patients and can occur as a presenting symptom without respiratory symptoms. Symptoms are severe in a small subset of patients.
EEC-LM-ADULT syndrome caused by R319H mutation in TP63 with ectrodactyly, syndactyly, and teeth anomaly
Authors: Otsuki Yuki , Ueda Koichi , Nuri Takashi , Satoh Chisei , Maekawa Ryuta , Yoshiura Koh-ichiro
Published: October 2020

Rationale:

Ectrodactyly ectodermal dysplasia-cleft lip/palate (EEC) syndrome, limb-mammary syndrome (LMS), and acro-dermato-ungual-lacrimal-tooth (ADULT) syndrome are caused by a TP63 gene disorder and have similar features. In the present article, a R319H mutation in TP63 is reported, and the correlation between genotype and phenotype is discussed based on the current case and previous literature.

Patient concerns:

A 13-year-old Japanese boy had ectrodactyly in the right hand and left foot and syndactyly in the left and right foot, and tooth shape abnormalities.

Diagnoses:

Peripheral blood samples were obtained, and mutation analysis was performed. A heterozygous G>A transition at cDNA position 956 of the TP63 gene was found. The patient was diagnosed with ELA (EEC/LM/ADULT) syndrome based on his clinical features and mutation analysis results.

Interventions:

The patient underwent surgery to correct the left foot malformation at 1 year of age and the right foot syndactyly at 11 years of age.

Outcomes:

No complications were observed after the first and second operations. He can walk comfortably after them, and no additional interventions will be planned in him. We continued to follow up with him up to the present.

Lessons:

The concept of ELA syndrome, which is the original concept of combining 3 syndromes (EEC syndrome/LMS/ADULT syndrome) into a unique clinical entity, can help clinicians to better understand TP63-related syndromes and improve the differential diagnosis of these syndromes.
Chinese herbal compound combined with western medicine therapy in the treatment of plasma cell mastitis
Authors: Zhang Jindan , Xu Jianzhong , Zhang Jiao , Ren Yun
Published: October 2020

Background:

Plasma cell mastitis (PCM) is a benign suppurative disease of the breast based on the expansion of mammary ducts and infiltration of plasma cells. It is relatively rare clinically, and its main manifestations include nonperiodic breast pain, nipple discharge, areola lump, nipple depression, nipple fistula, among others. Modern medicine is mainly surgical treatment, which is easy to recur. The clinical practice shows that the overall treatment of patients with TCM syndrome differentiation using oral medicine combined with western medicine therapy, combined internal and external treatment, can significantly improve the curative effect, prevent recurrence, has a certain therapeutic advantage, but lack of evidence of evidence-based medicine. The purpose of this study is to study the efficacy and safety of oral traditional Chinese medicine (TCM) combined with western medicine therapy in the treatment of PCM.

Methods:

Use computer to retrieve English databases (PubMed, Embase, Web of Science, the Cochrane Library) and Chinese databases (CNKI, Wan Fang, VIP, Chinese biomedical database), from the establishment of database to September 2020, for randomized controlled trials(RCTs) of oral TCM combined with western medicine therapy in the treatment of PCM, two researchers independently extracted the data and evaluated the quality of the included research, and meta-analysis was conducted on the included literatures using RevMan5.3 software.

Results:

This study evaluated the efficacy and safety of oral TCM combined with western medicine therapy in the treatment of PCM from the aspects of effective rate, symptom score, recurrence rate, adverse reaction rate, and patient satisfaction.

Conclusion:

This study will provide reliable evidence-based evidence for the clinical application of oral TCM combined with western medicine therapy in the treatment of PCM.

Ethics and dissemination:

The purpose of this study is to sort out and analyze the literature. This systematic review also does not involve endangering participant rights. Ethical approval was not required. The results may be published in a peer-reviewed journal or disseminated at relevant conferences.

OSF Registration number:

doi 10.17605/OSF.IO/K9A78.
A novel mutation in the ubiquinol-cytochrome c reductase synthesis-like gene associated with complex III deficiency and Björnstad syndrome
Authors: Liu Xuncan , Zhang Yanfeng , Liang Jianmin , Yang Si , Chen Chen
Published: October 2020

Rationale:

The ubiquinol-cytochrome c reductase synthesis-like (BCS1L) gene is located on chromosome 2 (2q35) and encodes an ATPase that is associated with various cellular activities and is embedded in the mitochondrial inner membrane; this ATPase is presumed to facilitate the insertion of the Rieske Fe/S protein into precursors of Complex III (CIII) during the assembly of the respiratory chain. We report the first case of a compound heterozygous mutation in the BCS1L gene in China.

Patient concerns:

A 7-month-old girl presented with a 3-month history of psychomotor developmental retardation and a 1-month history of epilepsy combined with parallel psychomotor developmental deterioration. The clinical manifestations in the patient included psychomotor developmental retardation, infantile spasms, pili torti, tubulopathy, hepatic pathologies and lactic acidosis.

Diagnosis:

Combined with her clinical presentation, the patient was diagnosed with CIII deficiency and Björnstad syndrome caused by a novel mutation in the BCS1L gene after molecular biological examination. Whole exome sequencing revealed a compound heterozygous mutation with a missense mutation (c.548G > A/p. R183H) inherited from her mother and an insertion mutation (c.1061_1062insCTA/p. G354delinsGY) inherited from her father.

Interventions:

Before admission, the patient had received oral topiramate for 1 month. After admission, additional intravenous arginine hydrochloride was administered for five days in the acute metabolic disorder phase, and persistent cocktail therapy was introduced, including coenzyme Q10 (20 mg/d), carnitine (1 g/d) and vitamins (vitamin B1, vitamin B2, vitamin B6, and vitamin C).

Outcomes:

The spasm seizures were decreased by 50% after 2 weeks of treatment. The blood ammonia, myocardial enzyme and urine glucose levels declined to normal levels. At a 1-month follow-up, the patient improved clinically with a decrease in spasm seizures of 75%, stronger sucking and more voluntary activities. However, she still had mild lactic acidosis and mild hepatic damage.

Lessons:

We reported the first patient with CIII deficiency and Björnstad syndrome in China and identified 1 novel mutation (C.1061_1062insCTA and P. G354delinsGY) in the BCS1L gene. This finding expands the BCS1L gene mutation profile and will be beneficial for genetic diagnosis.
Identification of Genomic Alterations in Sporadic Pancreatic Neurogenic Tumors
Authors: Wang Xi-Yu , Cai Jian-Peng , Song Le-Le , Huang Chen-Song , Chen Wei , Huang Xi-Tai , Chen Shi-Fu , Liu Xin-Yi , Yin Xiao-Yu
Published: October 2020

Pancreatic neurogenic tumors, including schwannoma and neurofibroma, are rare, and their genetic aberrances have not been defined. The present study aimed at investigating the genomic alterations of pancreatic schwannoma and neurofibroma. Two patients with pancreatic schwannoma and 1 patient with neurofibroma, who underwent surgical resection at the First Affiliated Hospital, Sun Yat-sen University between June 2016 and April 2019, were recruited into the study. Their tumor tissues were analyzed by exome sequencing and genome sequencing. Exome sequencing revealed a MUTYH likely pathogenic germline variant in 1 schwannoma with somatic NF2del and NOTCH1 amplification. Pathway enrichment analysis on the other schwannoma case showed that the main abnormal function involved DNA damage repair, mitosis, and cell cycle. In addition, genome sequencing showed the inversion (INV) variant of SPIRE gene and multiple mitochondrial INV variants in both schwannoma cases. Furthermore, exome sequencing revealed NF1del, single nucleotide variation, TP53, and ERBB3 amplification in neurofibroma, whereas genomic duplication/deletion variants and mitochondrial abnormalities were much less than that in schwannoma. In conclusion, variants in NF1 and NF2 genes, amplification of key driver genes, and somatic and mitochondrial INV variants may play important roles in the development of pancreatic schwannoma and neurofibroma.
Lewis Antigen Phenotype and Survival of Patients With Pancreatic Cancer
Authors: Kwon Sohee , Kim Sungsoo , Giovannucci Edward L. , Hidalgo Manuel , Markey Mia K. , Bovik Alan C. , Kwon Man Jae , Kim Kwang Joon , Im Hyungsoon , Park Jeong Youp , Bang Seungmin , Park Seung Woo , Song Si Young , Chung Moon Jae
Published: October 2020

Objectives

The association of Lewis antigen phenotype with survival of patients with pancreatic ductal adenocarcinoma was investigated.

Methods

A total of 1187 patients diagnosed with pancreatic ductal adenocarcinoma were evaluated in a prospective cohort. Patients were classified into 3 different groups according to Lewis antigen phenotype: Lewis antigen (1) A positive [Le(a+b−)], (2) B positive [Le(a−b+)], and (3) negative [Le(a−b−)]. Risk of mortality was analyzed with Cox regression after adjusting for other predictors.

Results

The risk of mortality increased in the order of Le(a+b−), Le(a−b+), and Le(a−b−) [reference; hazard ratio (HR), 1.27; 95% confidence interval (CI)], 1.03–1.57; P = 0.02; and HR, 1.65; 95% CI, 1.31–2.09; P < 0.001] after adjusting for other predictors. Among patients with serum carbohydrate antigen (CA) 19-9 lower than 37 U/mL, the association seemed more apparent (reference; HR, 1.50; 95% CI, 0.77–2.29; P = 0.22; and HR, 2.10; 95% CI, 1.10–4.02; P < 0.02).

Conclusions

The risk of mortality increased in the order of Le(a+b−), Le(a−b+), and Le(a−b−). The difference in prognosis according to the Lewis antigen phenotype was more pronounced in the low CA 19-9 group, which suggests that the Lewis antigen phenotype works as a biomarker predicting the prognosis of patients with pancreatic cancer with undetectable CA 19-9 level.
Interferon-Induced Protein With Multiple Tetratricopeptide Repeats 3 Is Associated With Response to Chemotherapy and Recurrence but Not With Survival
Authors: Popp Marie Christine , Klippstein Maximilian , Lohneis Philipp , Kalinski Thomas , Li Jiahui , Quaas Alexander , Bludau Marc , Wang Zhefang , Waldschmidt Dirk , Kunzmann Volker , Damanakis Alexander , Gebauer Florian , Zhao Yue , Bruns Christiane J. , Popp Felix C.
Published: October 2020

Objectives

The interferon-induced protein with multiple tetratricopeptide repeats 3 (IFIT3) seems to be associated with the prognosis in pancreatic cancer. Here we clarify whether the heterogeneity of IFIT3 expression affects previous IFIT3 analysis.

Methods

This retrospective study analyzes pancreatic cancer tissue samples retrieved by surgery from 2 independent patient cohorts. Patients underwent either primary surgery (n = 72) or received neoadjuvant chemotherapy (n = 12). Immunohistochemistry assessed IFIT3 expression and its heterogeneity. Complementarily, we analyzed publicly available transcriptomic data (n = 903).

Results

Of the primarily resected tumors, 16.4% were heterogeneous. Patients with IFIT3-negative tumors did not survive longer compared with patients with IFIT3-positive tumors. An analysis of publicly available data confirmed this result. Patients developing lung metastases had the best prognosis (4.8 years) with significantly lower IFIT3 expression compared with liver metastasis (P = 0.0117). Patients receiving neoadjuvant therapy who are IFIT3 negative had a longer disease-free survival (1.2 vs 0.3 years, P = 0.0081).

Conclusions

Low IFIT3 expression is not associated with longer survival. Divergent results from tissue microarray analyses could be explained with tumor heterogeneity. As a single biomarker, IFIT3 is not suitable for predicting disease prognosis. Recurrence of lung metastases and response to neoadjuvant chemotherapy are associated with low IFIT3 expression.
Parent–Child Dyad’s Collective Family Efficacy and Risky Adolescent Health Behaviors
Authors: Kao Tsui-Sui Annie , Ling Jiying , Dalaly Mimi , Robbins Lorraine B. , Cui Yuehua
Published: October 2020

Background

Parents play an influential role in their children’s health behaviors. Research has shown that individuals’ efficacy beliefs (personal and collective efficacy) are closely related to their behaviors and can be modified to improve health outcomes. Existing evidence confirms the effect of self-efficacy on various health outcomes. However, the effects of parent–child dyads’ collective efficacy beliefs on adolescents’ health outcomes are less clear. Bandura and his colleagues postulated that family members’ perceived collective family efficacy plays an important role in their psychological well-being and possibly their health behaviors. However, few study results have delineated the relationship between collective family efficacy and risky adolescent health behaviors.

Objectives

This study was conducted to examine the relationships among parent–adolescent dyads’ collective family efficacy, satisfaction with family functioning, depressive symptoms, personal efficacy beliefs, and adolescent risky health behaviors.

Methods

This cross-sectional study surveyed 158 parent–adolescent dyads from the Midwestern region of the United States. Linear regression and path modeling were conducted to examine the influences of dyads’ personal and collective efficacy beliefs on the adolescents’ negative attitudes toward healthy lifestyle practices, injury prevention, safe sex practices, substance use prevention, and depressive symptoms.

Results

Risky adolescent health behaviors were strongly correlated with higher depressive symptoms. The dyads’ personal and collective efficacy beliefs emerged as protective factors for adolescent health risks directly and indirectly through depressive symptoms. Both adolescents’ and parents’ perceived collective family efficacy buffered the effect of parent–adolescent dyads’ depressive symptoms on adolescent risky health behaviors with significant direct and indirect effects. Adolescents’ family efficacy, satisfaction with family functioning, and filial efficacy significantly mediated the relationship between depressive symptoms and risky health behaviors.

Discussion

Parent–adolescent dyads’ perceived collective family efficacy buffers adolescents from depressive symptoms and risky health behaviors. This finding suggests that family interventions should not only address adolescents’ personal-level efficacy but also their collective aspects of efficacy beliefs within the family context.
Use of the Handgrip Strength Test in the Identification of Osteosarcopenic Obesity in Older Women
Authors: dos Santos Vanessa Ribeiro , Gobbo Luís Alberto
Published: October 2020

The aim this study was to analyze the sensitivity and specificity of functional tests in the identification of osteosarcopenic obesity (OSO), as well as other abnormalities related to low bone mineral density in older women in 24-month follow-up. The study included 152 older women. It was observed that the handgrip strength test presented sensitivity and specificity to identify OSO (0.63 and 0.76), respectively, and that older women with low performance in this test had a higher risk (hazard ratio: 3.05; 95% confidence interval: 1.04-8.96) of presenting OSO. The application of the handgrip strength test could be an alternative instrument for identification of OSO in older women.
Serial Cast Method in the Treatment of Knee Flexion Contractures in the Elderly
Authors: Brunet Fanny , Coulomb Yves
Published: October 2020

Knee flexion contracture is observed sometimes in the elderly walking. The serial cast method has been successful in treating knee contracture secondary to neurological diseases after injection of botulinum toxin. We focus on 3 cases: all patients were unable to walk because of knee flexion contracture. They have benefited from our protocol of serial casts and at the end of the treatment, knee flessum was less. All patients have recovered the ability to walk. Our method is simple and fast. For these 3 patients, we could discuss percutaneous needle tenotomies but it requires a trained team.
Relationship Between Balance Status and Risk of Falling Among Elderly Patients in Northern Turkey
Authors: Koç Zeliha , Sağlam Zeynep
Published: October 2020

Objective:

This descriptive cross-sectional study was conducted to determine the relationship between balance status and risk of falling among elderly patients in northern Turkey.

Methods:

A total of 436 volunteer elderly inpatients in a university hospital were included in the study. In this study, fall risk among the elderly patients was determined by using the Hendrich II Fall Risk Model. The Berg Balance Scale was used to evaluate the elderly patients' ability to maintain their balance while performing daily activities.

Results:

The mean Berg Balance Scale scores were 31.9 ± 18.6 and 39.4 ± 15.1 among the falling and nonfalling elderly patients, respectively, and a statistically significant difference was found between these 2 groups (t = 3.868, P = .000). The mean scores on the Hendrich II Fall Risk Model were 2.1 ± 0.1 and 1.7 ± 0.1 in the falling and nonfalling groups, respectively, but this difference was not statistically significant (t = 1.567, P = .119).

Conclusion:

A negative correlation was identified between scores on the Hendrich II Fall Risk Model and the Berg Balance Scale among elderly patients who experienced falls. As the balance scale scores decreased, the risk of falling increased (r = −0.183, P = .05).