bluuebunny/crossref_metadata_2025 huggingface dataset:
Dual-energy computed tomography vs ultrasound, alone or combined, for the diagnosis of gout: a prospective study of accuracy
Authors: Singh Jasvinder A , Budzik Jean-François , Becce Fabio , Pascart Tristan
Published: December 2020

Objective

To examine the accuracy of dual-energy CT (DECT) vs ultrasound or their combination for the diagnosis of gout.

Methods

Using prospectively collected data from an outpatient rheumatology clinic at a tertiary-care hospital, we examined the diagnostic accuracy of either modality alone or their combination, by anatomical site (feet/ankles and/or knees), for the diagnosis of gout. We used two standards: (i) demonstration of monosodium urate crystals in synovial fluid (gold), and (ii) modified (excluding DECT and ultrasound) 2015 ACR–EULAR gout classification criteria (silver).

Results

Of the 147 patients who provided data, 48 (33%) had synovial fluid analysis performed (38 were monosodium urate-crystal positive) and mean symptom duration was 9.2 years. One hundred (68%) patients met the silver standard. Compared with the gold standard, diagnostic accuracy statistics for feet/ankles DECT, feet/ankles ultrasound, knees DECT and knees ultrasound were, respectively: sensitivity: 87%, 84%, 91% and 58%; specificity: 100%, 60%, 87% and 80%; positive predictive value: 100%, 89%, 97% and 92%; negative predictive value: 67%, 50%, 70% and 33%; area under the receiver operating characteristic curve: 0.93, 0.72, 0.89 and 0.66. Combining feet/ankles DECT with ultrasound or knees DECT with ultrasound led to a numerically higher sensitivity compared with DECT alone, but overall accuracy was lower. Similarly, combining imaging knees to feet/ankles also yielded a numerically higher sensitivity and negative predictive values compared with feet/ankles DECT alone, without differences in overall accuracy. Findings were replicated compared with the silver standard, but with lower numbers.

Conclusions

Feet/ankles or knees DECT alone had the best overall accuracy for gout diagnosis. The DECT–US combination or multiple joint imaging offered no additional increase in overall diagnostic accuracy.
Sleep during menopausal transition: a 10-year follow-up
Authors: Kalleinen Nea , Aittokallio Jenni , Lampio Laura , Kaisti Matti , Polo-Kantola Päivi , Polo Olli , Heinonen Olli J , Saaresranta Tarja
Published: December 2020

Study Objectives

A 10-year observational follow-up study to evaluate the changes in sleep architecture during the menopausal transition.

Methods

Fifty-seven premenopausal women (mean age 46 years, SD 0.9) were studied at baseline and after a 10-year follow-up. At both time points, polysomnography (PSG) was performed, and the serum follicle-stimulating hormone (S-FSH) concentration was measured. Linear regression models were used to study the effects of aging and menopause (assessed as change in S-FSH) on sleep.

Results

After controlling for body mass index, vasomotor, and depressive symptoms, higher S-FSH level was associated with longer sleep latency (B 0.45, 95% confidence interval [CI]: 0.07 to 0.83). Aging of 10 years was associated with shorter sleep latency (B −46.8, 95% CI: −77.2 to −16.4), shorter latency to stage 2 sleep (B −50.6, 95% CI: −85.3 to −15.9), decreased stage 2 sleep (B −12.4, 95% CI: −21.4 to −3.4), and increased slow-wave sleep (B 12.8, 95% CI: 2.32 to 23.3) after controlling for confounding factors.

Conclusions

This study suggests that PSG measured sleep of middle-aged women does not worsen over a 10-year time span due to the menopausal transition. The observed changes seem to be rather age- than menopause-dependent.
Truncal tetanus: a case report
Authors: Bağcı Zafer
Published: December 2020

Introduction

Localized tetanus is a rare form of tetanus that can progress to generalized tetanus.

Case

In this report, we present a case of localized tetanus in a 9-year-old boy who had never been vaccinated against tetanus. He had an interesting clinical presentation and was successfully treated.

Discussion

This case is the first case reported in the literature that is characterized by tetanus localized in the chest, abdomen and back muscles. This clinical condition of tetanus being localized only in the trunk without the involvement of the head and extremities is so characteristic that it can be described as ‘truncal tetanus’.

Conclusion

Localized tetanus can be found in many different parts of the body, depending on location of the injury. Owing to the risk of progression to generalized tetanus, it is important to obtain a full history and perform careful physical examination for an early and accurate diagnosis.
Phytophthora Species Differ in Response to Phosphorous Acid and Mefenoxam for the Management of Phytophthora Root Rot in Rhododendron
Authors: Weiland Jerry E. , Scagel Carolyn F. , Grünwald Niklaus J. , Davis E. Anne , Beck Bryan R.
Published: December 2020

Phytophthora root rot, caused by many soilborne Phytophthora spp., is a significant disease affecting the $42 million rhododendron nursery industry. Rhododendron growers have increasingly reported failure by two systemic fungicides, phosphorous acid and mefenoxam, to adequately control root rot. Both fungicides may be applied as a foliar spray or soil drench but it is unknown how application method, fungicide chemistry, or pathogen diversity affects disease control. Therefore, two experiments were conducted to (i) determine whether differences in application method or fungicide chemistry affect control of root rot caused by P. cinnamomi and P. plurivora and (ii) evaluate the sensitivity of Phytophthora spp. and isolates from the rhododendron industry to each fungicide. Results demonstrated that soil drenches of either fungicide were more effective than foliar sprays for control of P. cinnamomi but were ineffective for P. plurivora. Furthermore, Phytophthora spp. and isolates varied in sensitivity to phosphorous acid and mefenoxam, and there were multiple fungicide-insensitive isolates, especially within P. plurivora. Differences in sensitivity were also observed among isolates from different nurseries and production systems, with some nurseries having less sensitive isolates than others and with container systems generally having less sensitive isolates than field systems. Our results provide three potential reasons for why fungicide control of Phytophthora root rot might fail: (i) the fungicide can be applied to the wrong portion of the plant for optimal control, (ii) there are differences in fungicide sensitivity among soilborne Phytophthora spp. and isolates infecting rhododendron, and (iii) fungicide-insensitive isolates are present in the rhododendron nursery industry.
Artificial stone silicosis
Authors: Hoy Ryan F.
Published: December 2020

Purpose of review

This review details recent findings related to the health effects of occupational exposure to artificial stone dust and the rapid increase in cases of artificial stone associated silicosis around the world.

Recent findings

High crystalline silica content artificial stone is now commonly used for the production of kitchen benchtops. Reports of artificial stone silicosis from many countries have noted that workers were typically employed at small workplaces and were often diagnosed in their 30s or 40s. Poor exposure control measures were common, including the practice of ‘dry processing’. Dust generated from artificial stone has been noted to have properties that influence toxicity, including high silica content, generation of nanosized particles and presence of metals and resins. Artificial stone silicosis differs from silicosis associated with other occupational settings including shorter latency and rapid disease progression. High-resolution computed tomography (CT) chest imaging of artificial stone silicosis has often noted the presence of ground glass opacities, which may not be detected in chest x-ray screening. Increased prevalence of autoimmune disease, such as scleroderma, has also been reported in this industry.

Further evaluation of the safety of work with artificial stone is required, including the effectiveness of dust control measures. Current reports of artificial stone silicosis indicate the potential for widespread undiagnosed respiratory disease in this industry. Provision of more sensitive health screening methods for all at-risk workers and the development of new treatment options particularly for this form of silicosis is urgently required.
Discharge Communication: A Multi-Institutional Survey of Internal Medicine Residents’ Education and Practices
Authors: Trivedi Shreya P. , Kopp Zoe , Tang Alice J. , Mammen Albin , Pandya Dharmini , Horwitz Leora I. , Schwartz Mark D.
Published: December 2020

Purpose

To characterize residents’ practices around hospital discharge communication and their exposure to transitions-of-care instruction in graduate medical education (GME).

Method

In 2019, internal medicine residents at 7 academic medical centers completed a cross-sectional survey reporting the types of transitions-of-care instruction they experienced during GME training and the frequency with which they performed 6 key discharge communication practices. The authors calculated a mean discharge communication score for each resident, and, using multiple logistic regression, they analyzed the relationship between exposure to types of educational experiences and discharge communication practices residents reported they performed frequently (> 60% of time). The authors used content analysis to explore factors that motivated residents to change their discharge practices.

Results

The response rate was 63.5% (613/966). Resident discharge communication practices varied. Notably, only 17.0% (n = 104) reported routinely asking patients to “teach-back” or explain their understanding of the discharge plans. The odds of frequently performing key discharge communication practices were greater if residents received instruction based on observation of and feedback regarding their communication (adjusted odds ratio 1.73; 95% confidence interval [CI], 1.07–2.81) or if they received explicit on-rounds teaching (adjusted OR 1.46; 95% CI, 1.04–2.23). In open-ended comments, residents reported that experiencing adverse patient events at some point in the postdischarge continuum was a major impetus for practice change.

Conclusions

This study exposes gaps in hospital discharge communication with patients, highlights the benefits of workplace-based instruction on discharge communication skills, and reveals the influence of adverse events as a source of hidden curricula. The results suggest that developing faculty to incorporate transitions-of-care instruction in their rounds teaching and integrating experiences across the postdischarge continuum into residents’ education may foster physicians-in-training who are champions of effective transitions of care within the fragmented health care system.
New insights into modeling exposure measurements below the limit of detection
Authors: Ortega-Villa Ana Maria , Liu Danping , Ward Mary H. , Albert Paul S.
Published: December 2020

Background:

In environmental epidemiology, it is of interest to assess the health effects of environmental exposures. Some exposure analytes present values that are below the laboratory limit of detection (LOD). There have been many methods proposed for handling this issue to incorporate exposures subject to LOD in risk modeling using logistic regression. We present a fresh look at proposed methods to handle exposure analytes that present values that are below the LOD.

Methods:

We performed comparisons through an extensive simulation study and a cancer epidemiology example. The methods we considered were a maximum-likelihood approach, multiple imputation, Cox regression, complete case analysis, filling in values below the LOD with

JOURNAL/enep/04.03/01984727-202102000-00001/inline-graphic1/v/2023-11-15T211757Z/r/image-tiff

, and a missing indicator method.

Results:

We found that the logistic regression coefficient associated with the exposure (subject to LOD) can be severely biased when underlying assumptions are not met, even with a relatively small proportion (under 20%) of measurements below the LOD.

Conclusions:

We propose the use of a simple method where the relationship between the analyte and disease risk is modeled only above the detection limit with an intercept term at the LOD and a slope parameter, which makes no assumptions about what happens below the LOD. In most practical situations, our results suggest that this simple method may be the best choice for analyzing analytes with detection limits.
Pharmacobezoar After Venlafaxine and Oxazepam Overdose: How Pharmacokinetics Could Help?—A Grand Round
Authors: Laurent Raphaël , Varvat Cécile , Goudard Delphine , Delavenne Xavier , Gauthier Vincent , Launay Manon
Published: December 2020

The authors present here a case of a pharmacobezoar after drug overdose, diagnosed using multiple blood samples for TDM. This grand round highlights the importance of a dialog between a clinician and a TDM consultant for the optimal care of a patient.
Missed Physical Therapy Treatments in the Acute Hospital: Toward a More Complete Understanding
Authors: Shan Guogen , Johnson Stephen Lee , Fertitta Joseph , Kim Jesse , Williams Patrick , Wu Qing , Ge Kan , Daruwalla Jehangir , Benning Stephen D. , Young Daniel L.
Published: December 2020

Introduction:

Therapy sessions that do not result in treatment (nontreatment) occur in 15% to 26% of scheduled sessions. The relationship between therapist personality and nontreatment is unknown.

Objective:

To determine the relationship between physical therapist personality and nontreatment events in the acute hospital.

Methods:

The relationship between physical therapist personality (Big Five Inventory) and nontreatment was statistically modeled adjusting for other therapist and patient factors.

Results:

There were 522 patients and 34 physical therapists with 918 scheduled physical therapy sessions included. The average age of patients was 71 (SD = 16, range = 17-99) and 41 (SD = 7, range 27-54) for therapists. Therapists with higher openness had lower nontreatment, odds ratio 0.93; 95% confidence interval 0.87 to 0.99; P = .045.

Conclusions:

The positive effect of physical therapy is minimized when scheduled treatment does not occur. Lower nontreatment is associated with more trait openness. Attributes related to openness (eg, inquisitiveness and problem-solving) should be cultivated. More research is needed to understand nontreatment and guide therapists in hospital patient care.
Weaning the patient: between protocols and physiology
Authors: Haaksma Mark E. , Tuinman Pieter R. , Heunks Leo
Published: December 2020

Purpose of review

Ventilator weaning forms an integral part in critical care medicine and strategies to shorten duration are rapidly evolving alongside our knowledge of the relevant physiological processes. The purpose of the current review is to discuss new physiological and clinical insights in ventilator weaning that help us to fasten liberation from mechanical ventilation.

Recent findings

Several new concepts have been introduced in the field of ventilator weaning in the past 2 years. Approaches to shorten the time until ventilator liberation include frequent spontaneous breathing trials, early noninvasive mechanical ventilation to shorten invasive ventilation time, novel ventilatory modes, such as neurally adjusted ventilatory assist and drugs to enhance the contractile efficiency of respiratory muscles. Equally important, ultrasound has been shown to be a versatile tool to monitor physiological changes of the cardiorespiratory system during weaning and steer targeted interventions to improve extubation outcome.

A thorough understanding of the physiological adaptations during withdrawal of positive pressure ventilation is extremely important for clinicians in the ICU. We summarize and discuss novel insights in this field.
Point-of-care ultrasound in nephrology
Authors: Soomro Qandeel H. , Amerling Richard
Published: December 2020

Purpose of review

The use of POCUS has grown tremendously with the introduction of innovative, easy-to-carry and maneuver hand-held devices. This review focuses on nephrology-centric applications of POCUS that can be incorporated on a daily basis to make impactful and prompt clinical decisions.

Recent findings

We review articles covering use of POCUS in the dialysis unit, the Emergency Department, office, and ICU for assessment of volume status, access issues, stones, obstruction, and to help manage patients with AKI, shock, and heart failure.

POCUS is a welcome addition to our bedside diagnostic armamentarium and has great utility in nephrology. Trials are ongoing in evaluating outcomes with POCUS and physicians’ clinical experience using it has been extremely positive.
Impact drugs targeting cardiometabolic risk on the gut microbiota
Authors: Balvers Manon , van den Born Bert-Jan H. , Levin Evgeni , Nieuwdorp Max
Published: December 2020

Purpose of review

Alterations in the gut microbiome composition or function are associated with risk factors for cardiometabolic diseases, including hypertension, hyperlipidemia and hyperglycemia. Based on recent evidence that also oral medications used to treat these conditions could alter the gut microbiome composition and function and, vice versa, that the gut microbiome could affect the efficacy of these treatments, we reviewed the literature on these observed interactions.

Recent findings

While the interaction of metformin with the gut microbiome has been studied most, other drugs that target cardiometabolic risk are gaining attention and often showed associations with alterations in microbiome-related features, including alterations in specific microbial taxa or pathways, microbiome composition or microbiome-derived metabolites, while the gut microbiome was also involved in drug metabolism and drug efficacy. As for metformin, for some of them even a potential therapeutic effect via the gut microbiome is postulated. However, exact mechanisms remain to be elucidated.

There is growing interest in clarifying the interactions between the gut microbiome and drugs to treat hypertension, hyperlipidemia and hyperglycemia as well as the first pass effect of microbiome on drug efficacy. While mostly analysed in animal models, also human studies are gaining more and more traction. Improving the understanding of the gut microbiome drug interaction can provide clinical directions for therapy by optimizing drug efficacy or providing new targets for drug development.
Updates in the cause of sinonasal inverted papilloma and malignant transformation to squamous cell carcinoma
Authors: Tong Charles C.L. , Palmer James N.
Published: December 2020

Purpose of review

The purpose of this study was to give an overview of recently published articles investigating the cause of inverted papilloma and possible mechanisms mediating malignant transformation into squamous cell carcinoma (SCCa).

Recent findings

Inverted papilloma is a sinonasal tumour that is benign in nature, but has a tendency for local invasion, recurrence and malignant degeneration. Its pathogenesis has not been elucidated and the etiological role for human papillomavirus virus (HPV) has been controversial. Recent reports have varied in detection method (mRNA ISH, DNA ISH and PCR amplification of highly conserved regions of the viral genome), ranging from 0 to 100%. Advances in meta-genomics have permitted detection of HPV viral signatures that were previously cost-prohibitive, and there appears to be a potential role for both low-risk and high-risk in the cause of the disease. Activating EGFR mutations have also been identified to be correlated with malignant transformation, which may be exclusive of HPV infection. Furthermore, more comprehensive approaches in detecting genomic markers have been reported, with HOX-related genes and epithelial-mesenchymal-transition-related gene sets appear to be differentially upregulated.

Sinonasal inverted papilloma is a diverse disease that is predominantly benign, but it harbours the potential for malignant degeneration in the SCCa with cause yet to be elucidated. Current evidence supports a potential role for high-risk HPV in a subset of SCCa, with the role of low-risk HPV yet to be defined. Historic studies of individual and small groups of molecular markers have not consistently adequate characterize signalling pathways underpinning the oncogenesis, and comprehensive genomic studies are needed to better understand the disease.
Do Unmet Health Needs Drive Pediatric Emergency Department Utilization?
Authors: Sojar Sakina , Gjelsvik Annie , Tsao Hoi See , Amanullah Siraj
Published: December 2020

Objective

Lack of access to basic health services is thought to increase emergency department (ED) utilization. This study assessed the relationship between unmet health care needs and pediatric ED utilization in the United States.

Methods

The National Survey of Children's Health was used (2016–2017; n = 71,360). Parent/guardians reported number of ED visits and the presence of unmet health needs (medical, dental, mental health, vision, hearing, other) in the last 12 months. Associations were analyzed using multinomial logistic regression modeling and accounted for the weighting and complex survey design of the National Survey of Children's Health.

Results

Children with 2 or more unmet health needs had 3.72 times (95% confidence interval, 2.25–6.16) risk of ≥2 ED visits when compared with those with 0 unmet health needs. This risk became nonsignificant when adjusted for race, ethnicity, age, insurance, having asthma, current medication status, health description, number of preventative health visits, and place to go for preventative health (aRR, 1.77; 95% confidence interval, 0.96–3.27). The adjusted association was also nonsignificant for specific types of unmet needs. Race, insurance status, age 0 to 3 years, current medication status, having asthma, ≥2 preventative visits, and poorer health were associated with ≥2 ED visits.

Conclusions

Unmet health needs were not found to be a significant driving force for ED utilization. Other factors were found to be more strongly associated with it. Future studies to understand the perception, motives, and complex interaction of various factors leading to ED use in high-risk populations may optimize care for these children.
Emergency Department Health Care Utilization and Opioid Administration Among Pediatric Patients With Sickle Cell Vasoocclusive Pain Crisis and Coexisting Mental Health Illness
Authors: Leuche Viviane Tchonang , Cutler Gretchen J. , Nelson Stephen C. , Jin Jing , Bergmann Kelly R.
Published: December 2020

Objectives

To determine whether patients with sickle cell disease (SCD) who present to the emergency department (ED) with vasoocclusive pain crises (VOC), and have coexisting mental health (MH) diagnoses, are more likely to have increased health care utilization and more frequent opioid administration compared with those without coexisting MH conditions.

Methods

This is a retrospective study of patients aged 5 to 18 years with SCD who presented to a tertiary care ED with a primary complaint of VOC between January 1, 2013, and December 31, 2017. We excluded patients with sickle cell trait and without a pain management plan in the electronic medical record. Outcomes included ED length of stay (LOS), admission rate, and opioid administration in the ED. Morphine equivalents were used to standardize opioid dosing. Mann-Whitney U and χ2 tests were used for univariate analysis. Multivariable logistic was performed for categorical and continuous outcomes, respectively, after adjusting for confounding factors.

Results

We identified 978 encounters. We excluded 196 without a pain management plan and one with inaccurate ED LOS, resulting in 781 encounters (148 patients) for analysis. Coexisting MH diagnoses were present in 75.0% of encounters, with anxiety (83.0%) and depressive disorders (55.9%) being most common. Compared with SCD patients without coexisting MH diagnoses, those with coexisting MH diagnoses had significantly longer ED LOS (252 ± 139 minutes vs 232 ± 145 minutes, P = 0.03), longer median hospital LOS (1.4 ± 3.2 days vs 0.3 ± 2.4 days, P < 0.001) in univariate analyses, but these differences were no longer significant in adjusted regression models. Patients with coexisting MH diagnoses had higher frequency of opioid administration in the ED (85.6% vs 71.4%, P < 0.0001) and higher odds of receiving opioids (adjusted odds ratio, 2.07; 95% confidence interval, 1.28–3.33).

Conclusions

Patients with SCD and coexisting MH diagnoses presenting with VOC have greater odds of receiving opioids compared with patients with SCD without coexisting MH diagnoses. Our results indicate a need for more MH resources in this vulnerable population and may help guide future management strategies.
Nonviral sexually transmitted infections in pregnancy: current controversies and new challenges
Authors: Waltmann Andreea , McKinnish Tyler R. , Duncan Joseph A.
Published: December 2020

Purpose of review

This review provides an update of nonviral, curable sexually transmitted infections (STIs) in pregnancy and summarizes our understanding of the current issues and controversies surrounding risk factors, screening, and treatment of STIs in pregnancy primarily in high-income countries (using the United States and the United Kingdom as examples). The infections covered in this review are syphilis, gonorrhea, chlamydia, trichomoniasis, and Mycoplasma genitalium infections.

Recent findings

Overall, limited modern data is available to update researchers and clinicians on the epidemiology and care of STIs in pregnancy. Though common risk factors can be identified among these STIs, like socioeconomic status and inadequate antenatal care, specific screening and treatment challenges vary by geography and pathogen. Wherever available, surveillance data and research evidence are often limited to nonpregnant patients, leading to imperfect pregnancy-specific risk estimates and obstetric lags in the development and adoption of new guidelines. We have identified three areas of opportunity that may enhance the effectiveness of current approaches and inform new ones: improved data collection and evidence-based screening practices; prompt and comprehensive therapy, including partner services, and evaluations of new treatment modalities; and equitable antenatal and sexual healthcare for all pregnant persons and their partners.

These findings highlight the need to revisit standards of screening and management of STIs in pregnancy in high-income countries.
Conjunctival cancer in people living with HIV
Authors: Muchengeti Mazvita , Bohlius Julia , Dhokotera Tafadzwa G.
Published: December 2020

Purpose of review

Historically, conjunctival cancer has been associated with HIV particularly in sub-Saharan Africa. The human papilloma virus (HPV) has been implicated as a potential causative agent without conclusive evidence. This review covers recent evidence of the epidemiology, diagnosis and treatment of conjunctival cancer in people living with HIV (PLWH).

Recent findings

HIV infection has been attributed to 33% of squamous cell carcinoma of the conjunctiva in sub-Saharan Africa. Although clear evidence of the effect of immunodeficiency on conjunctival cancer risk has been demonstrated, the role of HPV on conjunctival cancer development is still unclear. Biomarkers such as the p16 protein are not always indicative of HPV infection. The Epstein–Barr virus (EBV) might potentially be another infectious agent of interest in the development of conjunctival cancer. There is some evidence of increased conjunctival cancer recurrence post treatment as well as increased probability of metastasis in PLWH.

Immunodeficiency increases the risk of conjunctival cancer in PLWH. Symptomatic screening of conjunctival cancer in PLWH should be encouraged. Research on HPV involvement should remain a priority and EBV considered as another etiologic agent of interest. More studies on treatment modalities in PLWH should be considered.
Liver Stiffness Is Increased in Polycystic Ovary Syndrome and Related With Complement C1q/Tumor Necrosis Factor–Related Protein 3 Levels
Authors: Gulumsek Erdinc , Pekoz Burcak Cakir , Koc Ayse Selcan , Aslan Muhammed Zubeyir , Ali Ozturk Huseyin , Arici Fatih Necip , Sumbul Hilmi Erdem
Published: December 2020

Nonalcoholic fatty liver disease is very common in patients with polycystic ovary syndrome (PCOS). In patients with PCOS, the clinical use of liver stiffness (LS) and whether LS increases or decreases are still unclear. The purpose of this study was to determine the parameters related to LS and whether there is an increase in LS in patients with PCOS compared with healthy controls. Thirty-eight women diagnosed with PCOS according to Rotterdam criteria and 28 healthy age- and sex-matched controls were included in this study. In addition to routine follow-up parameters for all patients, serum homeostatic model assessment of insulin resistance (HOMA-IR) and complement C1q/tumor necrosis factor–related protein 3 (CTRP3) levels were measured, and point shear wave elastography was performed. Body mass index; waist circumference; systolic blood pressure; serum glucose, alanine aminotransferase, highly sensitive C-reactive protein, and dehydroepiandrosterone sulfate, testosterone, and HOMA-IR levels; and luteinizing hormone/follicle-stimulating hormone ratio were higher in PCOS group compared with healthy controls (P < 0.05). Serum CTRP3 levels were lower in patients with PCOS (P < 0.05). Liver stiffness value was significantly higher in PCOS group than healthy controls (P < 0.001). Positive correlation was found between LS and waist circumference as well as calcium, dehydroepiandrosterone sulfate, testosterone, and HOMA-IR levels (P < 0.05 for each one). Negative correlation was found between LS and CTRP (P < 0.01 for each one). In linear regression analysis, only CTRP3 level was found to be related to LS (P < 0.001 and β = 0.734). Liver stiffness value obtained by point shear wave elastography increases in patients with PCOS compared with healthy controls and is closely and negatively related to serum CTRP3 levels.
An excuse to misuse? Evaluating the use of prophylactic antibiotics in elective skin graft surgery: a systematic review and meta-analysis
Authors: Sinha Vikram , Borrelli Mimi R. , Landin Madeleine L. , Echlin Kezia , MacKenzie Ross Alastair
Published: December 2020

Introduction:

Plastic surgeons may opt to administer prophylactic perioperative antibiotics in elective skin graft surgeries to curtail the risk of surgical site infections (SSI). However, the use of antibiotics brings the risk of adverse events or antibiotic resistance and evidence comparing the risk versus benefit is still lacking. Thus, there are no specific guidelines regarding the use of antibiotics prophylaxis in skin graft surgery and the potential for misuse of antibiotics is high.

Methodology:

A systematic literature search was conducted to retrieve all articles comparing the use versus nonuse of “prophylactic antibiotics” in “skin graft surgery” on March 29, 2020. All comparative study designs were considered for inclusion. The primary outcome was occurrence of SSI. A meta-analysis using the Mantel-Haenszel method with random effect model was used to pool the effect estimates from included studies.

Result:

A total of 1403 articles were identified, of which, 6 were included in the meta-analysis. The 6 articles included were all comparative studies (5 RCTs and 1 cohort study) and reported the outcomes of 391 patients and 404 grafts. A total of 202 patients received prophylactic antibiotics and 202 patients did not receive antibiotics. All 6 studies were included in the meta-analysis. The overall pooled effect estimates comparing treatment groups showed no significant difference for outcomes in terms of SSI (odds ratio: 0.43; 95% confidence interval: 0.18, 1.02; I
2 0%; P=0.06).

Conclusion:

Incidence of SSI in elective skin graft surgery is relatively low. Our data shows there is limited utility in the use of prophylactic antibiotics to prevent clinically significant SSI in patients undergoing elective skin graft surgery. However, there are still only a small number of studies conducted on the topic to date, and more work is required before definitive conclusions can be used.
Improving ceiling of care decisions and documentation for oncology patients
Authors: Khan Ameer Hamid A. , Al Omran Yasser , James Harry , Bhattacharya Madhumita
Published: December 2020

Hospitalized medically unwell patients can be at risk of in-hospital cardiac arrest and previous studies have demonstrated poor survival after in-hospital cardiac arrests, even despite cardiopulmonary resuscitation (CPR). The rate of success is even lower in patients with metastatic malignancy. Since CPR remains the standard treatment for in-hospital cardiac arrest patients, a “do not attempt cardiopulmonary resuscitation” order (DNACPR) needs to be in place to avoid inappropriate resuscitations in patients with poor chances of in-hospital cardiac arrest survival. More recently, ceiling of care documents such as a Medical Advance Plan have also been developed to provide clinicians a framework for individualised treatment escalation. In this study, we examined the uptake of both national National Confidential Enquiry into Patient Outcome and Death (NCEPOD) and local guidelines to ensure that all acutely admitted oncology patients at a single centre had a CPR status and a Medical Advance Plan.
Availability and cost of gluten-free products in Moroccan supermarkets and e-commerce platforms
Authors: Guennouni Morad , El Khoudri Noureddine , Bourrouhouate Aicha , Hilali Abderraouf
Published: December 2020

Purpose

The prevalence of celiac disease is increasing alarmingly. The only and effective treatment for this disease is a strict gluten-free diet Efforts have been made by industrialists to produce gluten-free products (GFPs); however, their low availability and high cost, compared to gluten-containing products (GCPs) still remain among the factors that cause gluten-free adherence failure. The objective of this survey is to compare the availability and cost of GFPs in supermarkets in two Moroccan cities, Marrakech and Casablanca, and on e-commerce platforms and see how they compare to GCPs.

Design/methodology/approach

This is a cross-sectional study that targets supermarkets and e-commerce websites that sell GFPs food and their GCPs equivalents. The price of each product is recorded per 100 g.

Findings

The study surveys 271 GFPs and their 579 GCPs equivalents that were subsequently divided into six categories. The “GF Cookie and Cakes” category came on top of the list of products. GFPs were more available on e-commerce websites than at supermarkets in two Moroccan cities (p = 0.003). The GFPs are 364% (115–1309%) more expensive than their GCPs counterparts. Also, the authors recorded a significant price difference between GFPs sold in supermarkets and those sold on online.

Originality/value

This study reveals that labeled GFPs are less available and more expensive than their equivalents GCPs in Morocco. This affects GF diet adherence and quality of life of celiac patients. The patients who use GFPs need financial compensation from the national government.
How effective are national quality strategies for business – empirical evidence from Switzerland
Authors: Mann Stefan
Published: December 2020

Purpose

Over the last decades, Swiss core actors in the administration, the parliament and the food chain, have developed a national quality strategy for the agri-food sector. The effectiveness of such symbolic actions is unclear.

Design/methodology/approach

By dividing the average export prices by the average import prices of commodities on a four-digit tariff-line level, the study tests how price ratios have evolved between 1997 and 2017.

Findings

Based on examples where these ratios turn systematically upward or downward, the study shows that the export–import price ratio generally follows a decreasing trend over time. The author concludes that the national quality strategy for business suffers from a weak level of operationalisation.

Originality/value

To the best of the author’s knowledge, the indicator used in the study is new.
An ideological analysis of sustainable careers: identifying the role of fantasy and a way forward
Authors: Bal P. Matthijs , Matthews Lee , Dóci Edina , McCarthy Lucy P.
Published: December 2020

Purpose

Scholarly and general interest in sustainable careers is flourishing. Sustainable careers are focused on the long-term opportunities and experiences of workers across dynamic employment situations, and are characterized by flexibility, meaning and individual agency. The current paper analyzes and challenges the underlying ideological assumptions of how sustainable careers are conceptualized and advocates the inclusion of the ecological meaning of sustainability and the notion of dignity into the sustainable careers concept.

Design/methodology/approach

Using Slavoj Žižek's (1989, 2001) conceptualization of ideology as fantasy-construction, the authors explore how the use of sustainable careers is influenced by fantasies about the contemporary workplace and the role of the individual in the workplace. This is a conceptual method.

Findings

The authors argue that the concept of sustainable careers is grounded in the neoliberal fantasy of the individual. The paper concludes by presenting an alternative concept of sustainable careers grounded in a dignity-perspective on sustainability, which offers an alternative theoretical understanding of sustainable careers in the contemporary workplace, sharpening its contours and usefulness in theorizing careers.

Originality/value

This paper is the first to systematically analyze the use and conceptualization of sustainable careers in the literate and to expose the ideological underpinnings of the concept. Propositions are developed to be explored by future research.
Library Review 1989–2017: publication and citation statistics
Authors: Willett Peter
Published: December 2020

Purpose

The purpose of this paper is to provide a bibliometric review of the journal Library Review (LR) from 1989 until its relaunch in 2018 as global knowledge, memory and communication.

Design/methodology/approach

Bibliometric analysis of 1,084 articles published in LR in the period 1989–2017.

Findings

Authors from 69 different countries have published in the journal, with Scotland providing the largest single contribution in terms of authors and institutions. Articles in the journal have been extensively cited, with the citations coming not only from the core library and information science literature but also from journals in a very broad range of disciplines.

Originality/value

This paper extends previous work on articles published in the journal and provides the first detailed study of citations to those published articles.
Western educational historiography and the institutionalization of normal schools in modern China (1901–1944)
Authors: Chen Wang , Wei Luo , Yuefei Wu
Published: December 2020

Purpose

This paper traces the incorporation of western educational histories in the development of normal-school curricula during the late Qing Dynasty and the Republic of China (1901–1944). It uses publication networks to show how the study of comparative educational history facilitated the international circulation of knowledge in the teaching profession, and how the “uses” of educational history were shaped by larger geopolitical forces.

Design/methodology/approach

This paper analyzes the international exchange of texts between normal schools in China and Japan and, subsequently, between normal schools in China and the United States. A database of 107 publications in the field of western educational history that were adopted in China reveals specific patterns of textual citation, cross-reference, and canon-formation in the field of educational historiography.

Findings

With conclusions derived from a combination of social network analysis and clustering analysis, this paper identifies three broad stages in China's development of normal-school curricula in comparative educational history: “Japan as Teacher,” “transitional period” and “America as Teacher.”

Research limitations/implications

Statistical analysis can reveal citation and reference patterns but not readers' understanding of the deeper meaning of texts – in this case, textbooks on the subject of western educational history. In addition, the types of publications analyzed in this study are relatively limited, the articles on the history of education in journals have not become the main objects of this study.

Originality/value

This paper uses both quantitative and qualitative methods to uncover the transnational circulation of knowledge in the field of comparative educational history during its formative period in China.
Impact of social media on the academic performance of college students in Kashmir
Authors: Palla Ishfaq Ahmad , Sheikh Arslan
Published: December 2020

Purpose

The use of social media is prevalent and having the largest number of members than any other online platform available on the internet. Members of all age groups use social media websites according to their needs. This study aims to investigate the impact of social media usage on the academic performance of college students in Kashmir.

Design/methodology/approach

A structured questionnaire was formulated and a survey was carried out to collect data from the undergraduate students of different government colleges in Kashmir. The questionnaires were distributed randomly among both, male and female of the first, second and third year students of different undergraduate programs.

Findings

The findings show a majority of the students use social media networking sites to fulfill their educational needs. YouTube is the most largely used social media network among undergraduate students. A majority of the students feel that social media networks are easy to use and they have been using these sites for the past three years. The use of social media greatly helps the students to share knowledge and information with others, to improve their academic grades and to improve their reading and writing skills. A majority of the students spend an hour in using social media networks. Students use their laptops, mobile phones and personal computers to access social media websites.

Social implications

This study will help to highlight the important role of social media networks in the pedagogical activities of students.

Originality/value

This study affirms that students do use social media networking sites for academic purposes, which is a good factor to improve their academic skills and grades. Teachers must encourage their students to make the best use of social media networking sites for recreational and academic purposes.
Health professionals confront the intentional harms of indefinite immigration detention: an Australian overview, evaluation of alternative responses and proposed strategy
Authors: Dudley Michael , Young Peter , Newman Louise , Gale Fran , Stoddart Rohanna
Published: December 2020

Purpose

Indefinite immigration detention causes well-documented harms to mental health, and international condemnation and resistance leave it undisrupted. Health care is non-independent from immigration control, compromising clinical ethics. Attempts to establish protected, independent clinical review and subvert the system via advocacy and political engagement have had limited success.

The purpose of this study is to examine the following: how indefinite detention for deterrence (exemplified by Australia) injures asylum-seekers; how international legal authorities confirm Australia’s cruel, inhuman and degrading treatment; how detention compromises health-care ethics and hurts health professionals; to weigh arguments for and against boycotting immigration detention; and to discover how health professionals might address these harms, achieving significant change.

Design/methodology/approach

Secondary data analyses and ethical argumentation were employed.

Findings

Australian Governments fully understand and accept policy-based injuries. They purposefully dispense cruel, inhuman and degrading treatment and intend suffering that causes measurable harms for arriving asylum-seekers exercising their right under Australian law. Health professionals are ethically conflicted, not wanting to abandon patients yet constrained. Indefinite detention prevents them from alleviating sufferings and invites collusion, potentially strengthening harms; thwarts scientific inquiry and evidence-based interventions; and endangers their health whether they resist, leave or remain. Governments have primary responsibility for detained asylum-seekers’ health care. Health professional organisations should negotiate the minimum requirements for their members’ participation to ensure independence, and prevent conflicts of interest and inadvertent collaboration with and enabling systemic harms.

Originality/value

Australia’s aggressive approach may become normalised, without its illegality being determined. Health professional colleges uniting over conditions of participation would foreground ethics and pressure governments internationally over this contagious and inexcusable policy.
Integrating work–family conflict and enrichment: understanding the moderating role of demographic variables
Authors: Jain Sarika , Nair Shreekumar K.
Published: December 2020

Purpose

For more than a decade, efforts to integrate the two major perspectives of work–family studies, namely, work–family conflict and work–family enrichment have started advancing not only in western context but also in non-western contexts as well. However, both conflict and enrichment emerging from the family front have often been neglected in previous studies. The purpose of this paper is to test the integration of two major work–family perspectives, that is, work–family conflict and work–family enrichment in an Indian context.

Design/methodology/approach

The current study involves a multi-sectoral survey of sales employees belonging to manufacturing, information technology, fast-moving consumer goods, pharmaceuticals and financial services using standard scales. The sample consisted of 330 sales employees working in some of the major firms coming under these sectors. Structural equation modelling (SEM) using analysis of a moment structures was used to test the integrated model. In addition, multi-group SEM was used to test the impact of select demographic variables on the integrated model.

Findings

Results of SEM suggested that for sales employees in Indian organizations, work–family conflict follows a matching domain principle, whereas, work–family enrichment follows both matching and cross-domain principles. Further, it was found that marital status and annual salary emerge as moderators in the integrated model.

Research limitations/implications

The present study confirmed that similar-domain relationships are stronger than cross-domain relationships, supporting findings from previous research with regard to work–family conflict. In addition, the results contradicted the studies conducted in western countries wherein the same domain effect is observed with respect to both types of enrichment, that is, work to family enrichment (WFE) and family to work enrichment (FWE). The present study confirms a similar and cross-domain relationship in the case of both types of enrichment. It means that both WFE and FWE have a positive impact on both jobs and family satisfaction.

Practical implications

Organizations so far have been trying ways to reduce stress to reduce work to family conflict. However, there is a need to incorporate policies that facilitate work–family enrichment. Such policies may focus more on support for both married and unmarried employees’ sales employees.

Originality/value

This study contributes to work–family literature by attempting to integrate both conflict and enrichment perspectives, which has rarely been done in the Indian context.