bluuebunny/crossref_metadata_2025 huggingface dataset:
Self-assumed Neurologic Related Condition Deviated Metoclopramide-Induced Acute Dystonic of Oculogyric Crisis in a Woman of Childbearing Age: A Case Report
Authors: Ismail Nahlah Elkudssiah , Jha Ambika Nand , Goh Khang Wen , Ming Long Chiau , Wahab Mohd Shahezwan Abd. , Shah Nehal J. , Shah Akshay H. , Hermansyah Andi
Published: January 2023

A 26-year-old Malaysian woman (childbearing age) attended a private primary care clinic with a known case of gastroesophageal reflux disease (GERD) and complained of persistent nausea and a few episodes of vomiting. She had no known drug allergy, no surgical history, no hospitalization in the last two years, was a non-smoker, and no history of drug or alcohol abuse. The patient was prescribed Tab metoclopramide 10 mg TDS and Tab ranitidine 150 mg BD for five days. About 30 min after oral administration of both medicines, her eyes rolled involuntary upward, leading to lateral deviation of the eyes, and mouth jaws clenched as if “dislocated jaws.” The patient was immediately brought into an emergency department (ED) of a public tertiary care hospital. A drug challenge test was done which resulted in the withdrawal of metoclopramide. The accompanied sister later disclosed that the patient had taken metoclopramide and ranitidine from a private clinic earlier in the day. The patient self-assumed to have a sudden seizure, due to excessive hot weather and dehydration. A slow intravenous infusion of 50 mg/mL diphenhydramine hydrochloride in 0.9% w/v NaCl 100 mL was administered stat. Consequently, the symptoms vanished after approximately 30 min of the therapy, devoid of relapse. The patient was discharged from ED post 8 hours of monitoring with complete recovery. Physicians frequently prescribe metoclopramide to treat nausea and vomiting, which may cause adverse drug reaction of acute dystonic oculogyric crisis (OGC). Due to its unwanted and unpredictable extrapyramidal symptoms, metoclopramide should be prescribed and dispensed with caution. Thorough history taking at ED is imperative for correct early diagnosis and treatment, as metoclopramide-induced dystonic OGC has a high probability of confusion with other causes of dystonia such as conversion and seizures, encephalitis, tetanus, and hypercalcemic tetany.
The Older Adult Migrant and Support Systems: A Focus on Haatso and Agbogbloshie Yam Markets’ Communities in Ghana
Authors: Ndubajam Lois Nambu , Salifu Yendork Joana , Mills Abigail Adubea
Published: January 2023

Social support is an important resource in old age. However, recent research shows that familial support, which used to be the primary source of care for older adults in Ghana has weakened. Using a qualitative descriptive approach and semistructured interviews, this study explored the nature and sources of social support available to 21 older adults who migrated from the northern part of Ghana to live in Haatso and Agbogbloshie Yam Markets. Findings show that the nature of familial support was mainly material and unstructured, irregular, inadequate, conditional, seasonal, and sometimes completely unavailable. External support systems from the community, religious organizations, nongovernmental organizations, and the government were unavailable, inadequate, or seasonal. The findings underscore the need for families to be educated about the needs of older adults and be empowered to help care for their older relatives.
Older People’s Perception and Experience Regarding Health Promotion in Turkey: A Qualitative Study
Authors: Koç Kerime Kübra , Korkmaz Aslan Gülbahar
Published: January 2023

The aim of this study is to examine the perceptions and experiences of older people regarding health promotion. Using a phenomenological design, semi-structured in-depth interviews were conducted with 22 older people. Data analysis was carried out according to the Colaizzi’s method. The analysis revealed five themes (health-promoting activities, outcome expectations, triggers for activities, supporting factors, perceived obstacles). Older people emphasized healthy eating, walking, avoiding stress, and having health checkups as health-promoting behaviors. It was determined that the older people made efforts to display health-promoting behaviors, but they performed the activities insufficiently. The study findings show that interventions to be developed to improve the health of older people should aim at both cognitive and behavioral changes. Nurses should plan multidisciplinary and community-based interventions to reduce the socioeconomic and environmental factors that prevent older people from participating in health-promoting activities.
Well-differentiated Papillary Mesothelial Tumour of the Tunica Vaginalis Testis – A Rare Lesion, but one Pathologists Should Know About Two Patient Reports and a Review of the Literature
Authors: Kläger Johannes , Oberndorfer Felicitas , Brunel Cristophe , Veser Julian , Compérat Eva
Published: January 2023

Besides malignant mesothelioma, benign mesothelial neoplasms do exist in the tunica vaginalis testis. However, histological criteria remain controversial, thus leading to diagnostic uncertainty and difficulty in their classification according to their biological behavior. In recent years, molecular markers have emerged that aid in the differentiation of benign and malignant mesothelial proliferations throughout the body. Here, we present two middle-aged men with well-differentiated papillary mesothelial tumors and a review of the literature. By now, more than a year after surgery, one patient showed no recurrence of disease after partial or complete orchiectomy without further treatment, for the second no information is available. In conclusion, well-differentiated papillary mesothelial tumors represent rare lesions in the tunica vaginalis testis, but one pathologists should know about to prevent unnecessary treatment and suffering of patients.
The Effect of Victim Attractiveness and Type of Abuse Suffered on Attributions of Victim Blame and Credibility in Intimate Partner Violence: A Vignette-Based Online Experiment
Authors: Hall Maisie , Debowska Agata , K. Hales George
Published: January 2023

Victims of intimate partner violence (IPV) are frequently blamed and disbelieved, which may affect their willingness to report their abuse experiences. This vignette-based online experiment examines whether victim attractiveness (attractive vs. unattractive) and the type of abuse suffered (psychological vs. psychological plus physical abuse) may impact attributions of victim blame or victim credibility. The final sample included 167 UK residents (79% females) aged between 18 and 66 years ( M = 33.17, SD = 11.26). Results indicated that the attractive victim was judged as being more credible than the unattractive victim. Results are discussed in light of societal attitudes toward IPV.
Fate of Exhaled Droplets From Breathing and Coughing in Supermarket Checkouts and Passenger Cars
Authors: Nishandar Sanika Ravindra , He Yucheng , Princevac Marko , Edwards Rufus D
Published: January 2023

The global pandemic of COVID-19 has highlighted the importance of understanding the role that exhaled droplets play in virus transmission in community settings. Computational Fluid Dynamics (CFD) enables systematic examination of roles the exhaled droplets play in the spread of SARS-CoV-2 in indoor environments. This analysis uses published exhaled droplet size distributions combined with terminal aerosol droplet size based on measured peak concentrations for SARS-CoV-2 RNA in aerosols to simulate exhaled droplet dispersion, evaporation, and deposition in a supermarket checkout area and rideshare car where close proximity with other individuals is common. Using air inlet velocity of 2 m/s in the passenger car and ASHRAE recommendations for ventilation and comfort in the supermarket, simulations demonstrate that exhaled droplets <20 μm that contain the majority of viral RNA evaporated leaving residual droplet nuclei that remain aerosolized in the air. Subsequently ~ 70% of these droplet nuclei deposited in the supermarket and the car with the reminder vented from the space. The maximum surface deposition of droplet nuclei/m2 for speaking and coughing were 2 and 819, 18 and 1387 for supermarket and car respectively. Approximately 15% of the total exhaled droplets (aerodynamic diameters 20-700 µm) were deposited on surfaces in close proximity to the individual. Due to the non-linear distribution of viral RNA across droplet sizes, however, these larger exhaled droplets that deposit on surfaces have low viral content. Maximum surface deposition of viral RNA was 70 and 1.7 × 103 virions/m2 for speaking and 2.3 × 104 and 9.3 × 104 virions/m2 for coughing in the supermarket and car respectively while the initial airborne concentration of viral RNA was 7 × 106 copies per ml. Integrating the droplet size distributions with viral load distributions, this study helps explain the apparent importance of inhalation exposures compared to surface contact observed in the pandemic.
Does high-speed railway affect the cost behavior of tourism firms? Evidence from China
Authors: Wang Fangjun , Ma Lizhu , Gao Baojun , Liu Yang S
Published: January 2023

Cost stickiness, which is also termed cost asymmetry, describes the asymmetric relationship between revenue and cost. In this study, we examine whether high-speed railway (HSR) connection affects the cost stickiness of tourism firms. Employing a sample of 324 Chinese tourism firms from 2003 to 2018 and applying a difference-in-difference (DID) method, we find that the cost stickiness of tourism firms increases after HSR connection. Our results also reveal that the relationship between HSR connection and cost stickiness is more pronounced in firms with higher free cash flow (FCF), higher labor costs, and in state-owned enterprises (SOEs). Our research advances an in-depth understanding of the cost behavior in tourism firms and sheds light on the policy effect of HSR connection.
‘Bella ciao’: A portable monument for transnational activism
Authors: Salerno Daniele , van de Warenburg Marit
Published: January 2023

‘Bella ciao’ is one of the best-known partisan songs of the Italian anti-fascist Resistance (1943–5) and is part of the repertoire of protest of many movements across the globe. In 2018, the song was revived by its use in the popular TV series La casa de papel. This article examines how ‘Bella ciao’ is adopted by activists worldwide. It does so by analyzing the song through the concept of ‘portability’: the capacity of a cultural artifact to be a model that can be adapted to different contexts. After an examination of ‘Bella ciao’'s historical uses, the article focuses on the song's feminist versions for supporting different causes and in particular abortion rights. The reuses of the song speak of memory in terms of not only a product – what we remember – but also a process: the creative use of the cultural legacy of past movements for the shaping of new stories.
Representative government as anti-imperialism: Edward Carpenter's radical critique of Victorian civilization
Authors: Deslauriers Théophile
Published: January 2023

This paper examines the relationship between the critique of civilization, anti-imperialism, gender and representative government in the political thought of the neglected communist, environmentalist, and gay liberationist Edward Carpenter (1844–1929). In recent years, there has been a dramatic growth in the historical literatures on anti-imperialism and representative government, yet these two topics are rarely connected. Meanwhile, a voluminous literature on the concept of civilization and its role in British imperialism has largely ignored its role in justifying social and political domination in Britain itself. Carpenter's writings on these topics are important because he offers a defense of the value of representative government that is grounded in his anti-imperialism. Furthermore, his critique of civilization led him to connect problems of social domination in India to the struggles of women, homosexuals, and the working class. These groups ought in turn to be enfranchised and given roles in the functioning of the state.
Manipulating the Gut Microbiome as a Therapeutic Strategy to Mitigate Late Effects in Childhood Cancer Survivors
Authors: Oh Lixian , Ab Rahman Syaza , Dubinsky Kailey , Azanan Mohamad Shafiq , Ariffin Hany
Published: January 2023

Recent studies have identified causal links between altered gut microbiome, chronic inflammation, and inflammation-driven conditions such as diabetes and cardiovascular disease. Childhood cancer survivors (CCS) show late effects of therapy in the form of inflammaging-related disorders as well as microbial dysbiosis, supporting a hypothesis that the conditions are interconnected. Given the susceptibility of the gut microbiome to alteration, a number of therapeutic interventions have been investigated for the treatment of inflammatory conditions, though not within the context of cancer survivorship in children and adolescents. Here, we evaluate the potential for these interventions, which include probiotic supplementation, prebiotics/fiber-rich diet, exercise, and fecal microbiota transplantation for prevention and treatment of cancer treatment-related microbial dysbiosis in survivors. We also make recommendations to improve adherence and encourage long-term lifestyle changes for maintenance of healthy gut microbiome in CCS as a potential strategy to mitigate treatment-related late effects.
Trismus Occurrence and Link With Radiotherapy Doses in Head and Neck Cancer Patients Treated With Chemoradiotherapy
Authors: Faravel Kerstin , Jarlier Marta , Senesse Pierre , Huteau Marie-Eve , Janiszewski Chloé , Stoebner Anne , Boisselier Pierre
Published: January 2023

Background:

Chemoradiotherapy (CRT) for head and neck cancer (HNC) induces side-effects, including trismus, which impairs quality of life by causing difficulty to eat, speak, and maintain good oral hygiene, and by altering social life. Given the wide variation of reported trismus prevalence and as a first mandatory step for the preventive physiotherapy OPEN program (NCT03979924) this study evaluated trismus occurrence and its link with radiation doses.

Methods:

Study population was non-larynx HNC patients with epidermoid carcinoma treated with CRT, with or without surgery. A physiotherapist measured maximal interincisal distance before, during and after CRT, at 10 weeks and 6 months. The proportion of patients with trismus (with a 95% confidence interval) was estimated. Irradiation doses were analyzed between patients with and without trismus using non-parametric Kruskal-Wallis test.

Results:

We included 45 patients (77.8% male), median age 61 years (range 41-77). The proportion of trismus at baseline was 24.4%, 26.8% at 10 weeks and 37.1% at 6 months. During radiotherapy, it was 27.9% at week 3 and increased to 41.9% at week 6. Trismus occurrence at 10 weeks was higher when the radiation dose to the ipsilateral lateral pterygoid muscle was above the median value, that is, 36.8 grays.

Conclusion:

Trismus occurrence differed according to radiation dose and cancer location. These findings highlight the necessity of early preventive physiotherapy programs to reduce trismus occurrence. The second step, of the interventional multicenter OPEN program, is currently evaluating the impact of preventive physiotherapy and patient education on trismus in a sample of 175 patients.
The Efficacy of Reminiscence Therapy in Cancer-Related Symptom Management: A Systematic Review and Meta-Analysis
Authors: Sun Jie , Jiang Jieting , Wang Yiyan , Zhang Mingyue , Dong Lu , Li Kunpeng , Wu Caiqin
Published: January 2023

Background:

At present, simple reminiscence has been widely used in the field of neurocognitive disorders, life review/life review therapy has been widely used in the field of cancer, and both simple reminiscence and life review/life review therapy are suitable for psychological disorders such as depression and anxiety. However, the efficacy of reminiscence in treating cancer-related symptom has not been fully assessed.

Objectives:

To evaluate the effect of reminiscence therapy (RT) on relieving cancer-related symptoms such as anxiety and depression in cancer survivals.

Methods:

China National Knowledge Infrastructure (CNKI), VIP database, Wanfang Data Knowledge Service Platform, China Biomedical Database, PubMed, Cochrane Library, Embase, EBSCO, Scopus, and Ovid databases were searched. To collect clinical randomized controlled trials (RCT) on RT and cancer-related studies published from the establishment of the database to October 05, 2021. Two researchers independently evaluated the articles that met the inclusion criteria, meta-analysis was performed using RevMan5.4 software.

Results:

A total of 20 RCTs published in 2010 to 2021 were included, with a total of 1853 cancer patients. Meta-analysis results showed that the anxiety scale (HADS-A and HAMA and SAS) and depression scale (HADS-D and HAMD and SDS) scores of the RT group were significantly lower than those of the control group (HADS-A: P = .0002; HAMA: P < .00001; SAS: P = .0010; HADS-D: P = .01; HAMD: P < .00001; SDS: P = .0001). Meta-analysis results showed that RT can improve overall quality of life of cancer patients of RT group to a certain extent hope ( P < .00001). Meta-analysis results showed that the scores on the hope and dignity were significantly increased, and the difference were statistically significant ( P < .001).

Conclusion:

This review indicates that RT has significant efficacy on cancer-related symptoms such as anxiety and depression. RT for cancer survivals can effectively improve quality of life, self-hope, and self-esteem. The findings of this meta-analysis can provide direction for future symptom management research.
An empirical study to accelerate machine learning and artificial intelligence adoption in pharmaceutical manufacturing organizations
Authors: Pazhayattil Ajay Babu , Konyu-Fogel Gyongyi
Published: January 2023

The quantitative study investigated factors that influence the initiation, the convergence prospects, the highest return on investment sector, and the variables that can delay machine learning and artificial intelligence in the pharmaceutical industry. The study population constituted individuals from the US FDA pharmaceutical sites registry, representing all sectors of the industry. The study reports the trends and preferences identified by the industry executives who participated in the survey. The first hypothesis utilized Kruskal Walli confirming a statistically significant difference in the applicability of Rogers’s diffusion of innovation theory in the pharmaceutical industry. The second hypothesis test utilized Kendall’s τ identified that machine learning and artificial intelligence convergence is imminent. Spearman’s rank-order correlation test was used for the third hypothesis, providing insights into the high return-on-investment areas, namely, operations efficiency, product quality, supply chain integrity, market identification, and penetration, and engineering and maintenance sectors of the industry. The fourth hypothesis applied Spearman’s rank-order correlation test that confirmed that the five artificial intelligence (AI) implementation delay factors, namely, lack of strategy, finding talent, functional silos, management commitment, and behavioral change using the output can cause delays in machine learning and AI projects in the pharmaceutical industry.
Anterior locking plate versus non-operative treatment in different age groups with distal radial fractures: a systematic review and meta-analysis
Authors: Linnanmäki Lasse , Hevonkorpi Teemu , Repo Jussi , Karjalainen Teemu
Published: January 2023

This meta-analysis compared anterior locking plate and non-operative treatment for distal radial fractures and assessed if the age of the patients is associated with the treatment effect. We searched the MEDLINE, Embase and CENTRAL databases and included 12 studies with 1366 patients. Compared with non-operative care, anterior locking plate treatment does not seem to provide clinically important benefits in mean DASH score, mean pain or their mean quality of life at 12 to 24 months if the patients’ ages are not considered (moderate to low certainty evidence). However, the younger the patients, the larger the benefit for surgery. Meta-regression with the DASH score suggested that while people over 70 likely experience no clinically relevant benefit from surgery, the mean effects cannot be generalized to people under 60. The evidence regarding the risk of adverse events is too uncertain to make firm conclusions.
Definitions of positive health: a systematic scoping review
Authors: Bodryzlova Yuliya , Moullec Gregory
Published: January 2023

An agreed definition, model, and indicators of positive health would contribute to a better understanding and wider use of the term, thus favoring the development of the positive health approach in public health. However, there is no consensus even on the definition of positive health. In this study, we systematically reviewed its definitions. We conducted a scoping review as per PRISMA guidelines. We queried the MEDLINE, Embase, PsychINFO, and Web of Science databases. The PubMed search equation was: ‘positive health’ [Title/Abstract] AND (‘health’ [MeSH] OR ‘health status’ [MeSH] OR ‘health status indicators’ [MeSH]). Definitions of positive health referring to a ‘one-dimensional’ conceptualization of health are: (i) positive health as a state ‘far beyond a mere absence of disease’; (ii) positive health as wellbeing; and those referring to a ‘two-dimensional’ conceptualization are (iii) positive health as resilience and (iv) positive health as (a reserve in) capacities. This work contributes to the refining of the salutogenic vocabulary. At this stage of the ongoing discussion on health promotion vocabulary, we propose the ‘reserve in capacities’ as the candidate for the definition of positive health.
Adolescents’ Social Comparisons, Subjective Social Status, and Coping to Maintain Well-Being: A Qualitative Study
Authors: Vidal Carol , Wissow Lawrence S.
Published: January 2023

Income inequality has increased in the United States over the past decades and, more recently, social media has expanded adolescents’ reference groups and their field of social comparison. These parallel societal changes may influence adolescents’ social identity development and affect their well-being. We interviewed adolescents in contact with health services to understand their experiences with social status differences and social comparisons. In this sample of adolescents, social comparisons varied, based on context and individual characteristics, and were associated with a range of feelings and coping mechanisms. We highlight the implications of the findings in the context of changing societal dynamics.
Influence of Reduced-Gravity Treadmill Running on Sensor-Derived Biomechanics
Authors: Santos Brian P. , DeJong Lempke Alexandra F. , Higgins Michael J. , Hertel Jay
Published: January 2023

Background:

Reduced gravity treadmills have become increasingly prevalent in clinical settings. The purpose of this study was to assess the influence of manipulated levels of bodyweight during reduced gravity treadmill running on sensor-derived spatiotemporal, kinematic, and kinetic measures.

Hypotheses:

Reduced gravity conditions would result in significantly altered biomechanical measures compared with 100% gravity conditions, with the most pronounced effects anticipated in the 20% condition.

Study Design:

Cross-sectional clinic-based study.

Methods:

A total of 16 runners (8 male [M; age, 28.88 ± 5.69 years; body mass index [BMI], 25.08 ± 3.74 kg/m2], 8 female [F; age, 28.75 ± 5.23 years, BMI, 21.05 ± 3.46 kg/m2]) participated in this study. Participants wore commercially available sensors on their shoelaces and ran in a reduced gravity treadmill at a self-selected pace for 5 minutes each at 100%, 80%, 60%, 40%, and 20% bodyweight in a randomized order. The pace remained constant across all conditions, and rating of perceived exertion (RPE) was obtained following each condition. Step-by-step spatiotemporal, kinematic, and kinetic metrics were extracted to calculate mean outcome measures for each bodyweight condition. Repeated measures analyses of variance were conducted to assess the influence of the different bodyweight reduction levels on RPE and runners’ biomechanics.

Results:

Higher pressure creating lower bodyweight conditions resulted in significantly increased stride length and decreased cadence, contact time, impact g, and RPE, along with a shift toward forefoot strike types compared with higher body weight conditions ( P < 0.01). All other outcomes were comparable across conditions.

Conclusion:

Reduced bodyweight running significantly altered spatiotemporal measures and reduced the vertical component of loading.

Clinical Relevance:

Our findings offer objective information on expected biomechanical changes across pressure levels that clinicians should consider when incorporating reduced gravity treadmill running into rehabilitation plans.
Online food delivery technology and family food traditions: A sociocultural perspective
Authors: Aiswarya Balachandar , Ramasundaram Gurusamy
Published: January 2023

Good food isn’t just about the taste. It’s about where and with whom you eat -Natsumi Ando. This case explores the impact of online food delivery app technology on socializing commensality, communicative expectations, symbolic, moral, and sentimental meanings of food and eating. Ethnographic evidence shows how foods prepared at home and consumed are rooted in practices and ideologies of local communities and cultures. The case examines how the unfettered proliferation of on-demand services such as online food delivery platforms has affected an essential household activity namely home cooking and dining behavior in a country like India. In addition, the study examines how the continuous practice of evading cooking at home impacts food, life, culture, and society on a social and cultural level.
Evaluation of quality of life and depression in family caregivers of patients with type 1 diabetes in Iran: A case–control study
Authors: Ghorbani Raheb , Foroutan Majid , Kassaeian Seyed Saeed , Sadat Kia Naim , Gholizade Bajandi Babak , Haji Ghanbari Alireza , Ghods Elahe
Published: January 2023

Objective:

Diabetes as a silent epidemic and one of the top four causes of death in the world. This study was designed to evaluate the quality of life and depression in family caregivers of patients with type 1 diabetes in Iran.

Methods:

The study was case–control study (cases, n = 50; controls, n = 50). The cases consisted of family caregivers of patients with type 1 diabetes who referred to the endocrinology clinic of Kosar Hospital in Semnan in 2020. The controls were a random sample from among family caregivers of non-diabetic patients who had referred to the same center in the same year. Demographic and family variables, the 36-Item Short Form Survey questionnaire, and Beck’s Depression Inventory were used to collect data. Univariate and multivariable logistic regression models with receiver operator characteristic (ROC) curve were used to data analysis in STATA 14.

Results:

The multivariable logistic regression model showed a significant association between existence of a patient with type 1 diabetes with number of caregivers’ children (odds ratio (OR) = 1.77; 95% confidence interval (CI): 1.06–2.94), quality of life (OR = 0.82; 95% CI: 0.74–0.90), sex (OR = 10.04; 95% CI: 2.29–43.99), and income level of caregivers (OR = 6.49; 95% CI: 1.35–31.08); however, it did not show a significant relationship with depression (OR = 1.02; 95% CI: 0.94–1.10).

Conclusion:

The quality of life in family caregivers of type 1 diabetics is low and gender, income level, and number of caregivers’ children were the most important factors predicting it. Therefore, psychological interventions to manage stress and improve the quality of life of family caregivers are recommended.
Rifampicin resistant Mycobacterium tuberculosis and associated factors among presumptive pulmonary tuberculosis patients in Mogadishu, Somalia
Authors: Ali Mohamed Muhumed , Weldegebreal Fitsum , Kabew Getachew , Urgesa Kedir
Published: January 2023

Background:

Multi-drug resistant Mycobacterium tuberculosis is a growing public health problem in developing countries including Somalia. Although, the prevalence of multi-drug resistant tuberculosis among new and retreated cases is high, data on GeneXpert- Mycobacterium tuberculosis/rifampicin-resistant assay, which is a surrogate marker for multidrug resistance, is not well explored in Mogadishu.

Objectives:

To determine the prevalence of rifampicin-resistant Mycobacterium tuberculosis and its associated factors among presumptive pulmonary tuberculosis patients visiting tuberculosis centers in Mogadishu, Somalia.

Methods:

A multicenter cross-sectional study was conducted in three tuberculosis treatment centers from March 12 to April 30, 2021. Laboratory professionals collected sputum sample consecutively from presumptive pulmonary tuberculosis participants and performed a GeneXpert assay to determine the rifampicin resistance. Socio-demographic and clinical data were collected using structured questionnaire. Logistic regression analyses were performed to assess factors associated with rifampicin resistance using an adjusted odds ratio at a 95% confidence interval. Statistical significance was considered at a p-value of less than 0.05.

Results:

A total of 370 presumptive tuberculosis suspects were included; of whom 58.4% were females and the mean age of the participants was 44.3 ± 14 years. Mycobacterium tuberculosis was detected in 63 (17%) (95% confidence interval = 13.2–20.8) suspects. Of these the prevalence of rifampicin-resistant Mycobacterium tuberculosis was 35% (95% confidence interval = 30.2–39.8). Anti-tuberculosis treatment history (adjusted odds ratio = 4.1; 95% confidence interval = 1.91–6.75), monthly income less than $100 USD (adjusted odds ratio = 2.2; 95% confidence interval = 1.77–5.98) and being diagnosed with Asthma (adjusted odds ratio = 2.63; 95% confidence interval = 1.3–7.3) were significantly associated with rifampicin-resistant tuberculosis.

Conclusion:

A considerable proportion of rifampicin-resistant tuberculosis is reported in these study settings. The strong association between multidrug resistance tuberculosis and patients’ retreatment history of tuberculosis, low income, and co-morbidity with asthma highlights the need for more efforts in tuberculosis treatment and monitoring programs to limit the emergence of multi-drug resistant strain in the study areas.
Postoperative hematoma in cervical spondylosis patient complicated with Huntington’s disease: Case report and literature review
Authors: Zhang Zifan , Xu Chen , Wen Guoqing , Dong Minjie , Shen Xiaolong , Gong Baofeng , Sun Baifeng , Qi Min , Tian Ye , Liu Yang , Yuan Wen
Published: January 2023

Hematoma is a life-threatening complication of anterior surgery in cervical spondylosis patients. Herein, we report a cervical spondylosis patient complicated with Huntington’s disease, who developed unexpected neck hematoma after anterior cervical discectomy and fusion (ACDF) surgical treatment. During the debridement, we found no noticeable vessel lesions and concluded that the occurrence of postoperative hematoma might be due to the drainage displacement caused by excessive uncontrolled movements of the neck after the operation. The patient recovered well, and further literature review suggests that chorea secondary to Huntington’s disease likely increases mechanical stress on the cervical spine, indicating an internal relationship between degenerative cervical spondylosis and Huntington’s disease. Cervical spondylotic patients complicated with Huntington’s disease can be treated with surgical intervention but need to be immobilized and under close observation.
Endorsements from Republican politicians can increase confidence in U.S. elections
Authors: Clayton Katherine , Willer Robb
Published: January 2023

Since the 2020 U.S. presidential election, perceptions of the validity of the outcome and broader trust in the American electoral process have reached historically low levels among Republicans. While this trend has potentially harmful consequences for democratic stability, there is little research on how beliefs that an election was fair—and trust in the electoral process more generally—can be restored. In a preregistered survey experiment ( n = 2101), we find that viewing real messages from Republican politicians defending the legitimacy of the 2020 election increased faith in the election’s outcome and in the broader electoral process among Republican voters, compared to either a neutral control condition or to comparable messages from Democratic politicians. These effects are statistically mediated by shifts in voters’ perceptions of elite Republican opinion about the 2020 election, highlighting a potentially useful intervention for efforts to restore faith in elections going forward. Notably, exposure to messages from Republican politicians affirming the election’s legitimacy did not significantly decrease support for the Republican Party, suggesting that Republican politicians who endorse the 2020 election results might not face backlash from voters.
Prematurity, birth weight, and access to a medical home among school-aged children in the US: A cross-sectional survey
Authors: Eubanks Jessica , Tumin Dmitry , Peedin Leslie
Published: January 2023

Introduction

Prematurity and low birth weight (LBW) are associated with higher health care needs and higher health care utilization in the first few years of life. The aim of this cross-sectional study was to determine how prematurity and LBW were correlated with access to a medical home later in childhood, at ages 6–17 years.

Methods

Data were analyzed from the 2016–2018 National Survey of Children's Health. Non-institutionalized US children 6–17 years of age who had been born preterm were classified as very low birth weight (VLBW, <1500 g), LBW (1500–2500 g), and normal weight (NBW, >2500 g). Term-born NBW children were included as a reference group. Medical home access was determined according to caregiver report.

Results

The analysis included 64,597 infants (preterm VLBW n  =  737; preterm LBW n  =  2869; preterm NBW n  =  3942; and term NBW n  =  57,049). Based on this sample, 44% of children ages 6–17 years were estimated to receive care meeting the criteria of a medical home. On multivariable analysis, none of the preterm groups had higher likelihood of receiving care in a medical home compared to children born at term and NBW (odds ratios ranging from 0.75 to 0.95).

Conclusions

School-aged children born preterm and LBW were equally or less likely to receive care meeting the criteria of a medical home than children born at term and NBW. Although prematurity and LBW are associated with increased health care use early in the life course, this does not appear sufficient to help children establish and maintain access to a medical home.
Risk Factors of AKI in Acute Respiratory Distress Syndrome: A Time-Dependent Competing Risk Analysis on Severe COVID-19 Patients
Authors: Marchiset Antoine , Serazin Valerie , Ben Hadj Salem Omar , Pichereau Claire , Lima Da Silva Lionel , Au Siu-Ming , Barbier Christophe , Loubieres Yann , Hayon Jan , Gross Julia , Outin Herve , Jamme Matthieu
Published: January 2023

Introduction:

Acute kidney injury (AKI) is frequently observed in patients with COVID-19 admitted to intensive care units (ICUs). Observational studies suggest that cardiovascular comorbidities and mechanical ventilation (MV) are the most important risk factors for AKI. However, no studies have investigated the renal impact of longitudinal covariates such as drug treatments, biological variations, and/or MV parameters.

Methods:

We performed a monocentric, prospective, longitudinal analysis to identify the dynamic risk factors for AKI in ICU patients with severe COVID-19.

Results:

Seventy-seven patients were included in our study (median age: 63 [interquartile range, IQR: 53-73] years; 58 (75%) men). Acute kidney injury was detected in 28 (36.3%) patients and occurred at a median time of 3 [IQR: 2-6] days after ICU admission. Multivariate Cox cause-specific time-dependent analysis identified a history of hypertension (cause-specific hazard (CSH) = 2.46 [95% confidence interval, CI: 1.04-5.84]; P = .04), a high hemodynamic Sequential Organ Failure Assessment score (CSH = 1.63 [95% CI: 1.23-2.16]; P < .001), and elevated Paco2 (CSH = 1.2 [95%CI: 1.04-1.39] per 5 mm Hg increase in Pco2; P = .02) as independent risk factors for AKI. Concerning the MV parameters, positive end-expiratory pressure (CSH = 1.11 [95% CI: 1.01-1.23] per 1 cm H2O increase; P = .04) and the use of neuromuscular blockade (CSH = 2.96 [95% CI: 1.22-7.18]; P = .02) were associated with renal outcome only in univariate analysis but not after adjustment.

Conclusion:

Acute kidney injury is frequent in patients with severe COVID-19 and is associated with a history of hypertension, the presence of hemodynamic failure, and increased Pco2. Further studies are necessary to evaluate the impact of hypercapnia on increasing the effects of ischemia, particularly in the most at-risk vascular situations.
Predicting readmission to the cardiovascular intensive care unit using recurrent neural networks
Authors: Kessler Steven , Schroeder Dennis , Korlakov Sergej , Hettlich Vincent , Kalkhoff Sebastian , Moazemi Sobhan , Lichtenberg Artur , Schmid Falko , Aubin Hug
Published: January 2023

If a patient can be discharged from an intensive care unit (ICU) is usually decided by the treating physicians based on their clinical experience. However, nowadays limited capacities and growing socioeconomic burden of our health systems increase the pressure to discharge patients as early as possible, which may lead to higher readmission rates and potentially fatal consequences for the patients. Therefore, here we present a long short-term memory-based deep learning model (LSTM) trained on time series data from Medical Information Mart for Intensive Care (MIMIC-III) dataset to assist physicians in making decisions if patients can be safely discharged from cardiovascular ICUs. To underline the strengths of our LSTM we compare its performance with a logistic regression model, a random forest, extra trees, a feedforward neural network and with an already known, more complex LSTM as well as an LSTM combined with a convolutional neural network. The results of our evaluation show that our LSTM outperforms most of the above models in terms of area under receiver operating characteristic curve. Moreover, our LSTM shows the best performance with respect to the area under precision-recall curve. The deep learning solution presented in this article can help physicians decide on patient discharge from the ICU. This may not only help to increase the quality of patient care, but may also help to reduce costs and to optimize ICU resources. Further, the presented LSTM-based approach may help to improve existing and develop new medical machine learning prediction models.
COVID-19 and Changes in Reported Social Risk Factors at a Primary Care Practice in the South Bronx
Authors: Azan Alexander , Stephens Joseph , Xie Xianhong , Fiori Kevin , Gover Mary
Published: January 2023

Introduction:

Historically, Black and Hispanic patient populations in the Bronx Borough of New York City have experienced the highest rates of social risk factors, and associated poor health outcomes, in New York State. During the pandemic, Bronx communities disproportionately experienced high rates of COVID-19 illness and death. To date, little is known regarding the COVID-19 pandemic’s impact on social risk factors in urban, at-risk communities. This study aimed to determine how social risk factors changed during the pandemic in a Bronx-based patient population.

Methods:

Study participants were adult patients seen at a Federally Qualified Health Center in the South Bronx. Using a paired longitudinal study design, 300 participants were randomly selected for telephonic outreach during the pandemic from a sample of 865 participants who had been offered a social risk factor screener in the year prior to the pandemic. The outreach survey used included the social risk factor screener and questions regarding COVID-19 illness burden and prior engagement in social services. The McNemar test was used to analyze trends in reported social risks.

Results:

Housing quality needs, food insecurity, and legal care needs significantly increased during the pandemic. Participants who reported COVID-19 illness burden were 1.47 times more likely to report a social risk factor ( P = .02). No significant relationship was found between prior enrollment in clinic-based social services and degree of reported social risk ( P = .06).

Conclusion:

Housing quality needs, food insecurity, and legal care needs increased during the COVID-19 pandemic in a predominantly Black and Hispanic identifying urban patient population. Urgently addressing this increase is imperative to achieving health equity in ongoing COVID-19 mitigation efforts.
The Effect of Naloxone Access Laws on Fatal Synthetic Opioid Overdose Fatality Rates
Authors: Tabatabai Mohammad , Cooper Robert L. , Wilus Derek M. , Edgerton Ryan D. , Ramesh Aramandla , MacMaster Samuel A. , Patel Parul N. , Singh Karan P.
Published: January 2023

Background:

Increases in fatal synthetic opioid overdoses over the past 8 years have left states scrambling for effective means to curtail these deaths. Many states have implemented policies and increased service capacity to address this rise. To better understand the effectiveness of policy level interventions we estimated the impact of the presence of naloxone access laws (NALs) on synthetic opioid fatalities at the state level.

Methods:

A multivariable longitudinal linear mixed model with a random intercept was used to determine the relationship between the presence of NALs and synthetic opioid overdose death rates, while controlling for, Good Samaritan laws, opioid prescription rate, and capacity for medication for opioid use disorder (MOUD), utilizing a quadratic time trajectory. Data for the study was collected from the National Vital Statistics System using multiple cause-of-death mortality files linked to drug overdose deaths.

Results:

The presence of an NAL had a significant (univariate P-value = .013; multivariable p-value = .010) negative relationship to fentanyl overdose death rates. Other significant controlling variables were quadratic time (univariate and multivariable P-value < .001), MOUD (univariate P-value < .001; multivariable P-value = .009), and Good Samaritan Law (univariate P-value = .033; multivariable P-value = .018).

Conclusion:

Naloxone standing orders are strongly related to fatal synthetic opioid overdose reduction. The effect of NALs, MOUD treatment capacity, and Good Samaritan laws all significantly influenced the synthetic opioid overdose death rate. The use of naloxone should be a central part of any state strategy to reduce overdose death rate.
Sedative-hypnotic Co-prescribing with Opioids in a Large Network of Community Health Centers
Authors: Hartung Daniel M. , Lucas Jennifer A. , Huguet Nathalie , Bailey Steffani R. , O’Malley Jean , Voss Robert W. , Chamine Irina , Muench John
Published: January 2023

Objective:

When prescribed with opioids, sedative-hypnotics substantially increase the risk of overdose. The objective of this paper was to describe characteristics and trends in opioid sedative-hypnotic co-prescribing in a network of safety-net clinics serving low-income, publicly insured, and uninsured individuals.

Methods:

This retrospective longitudinal analysis of prescription orders examined opioid sedative-hypnotic co-prescribing rates between 2009 and 2018 in the OCHIN network of safety-net community health centers. Sedative-hypnotics included benzodiazepine and non-benzodiazepine sedatives (eg, zolpidem). Co-prescribing patterns were assessed overall and across patient demographic and co-morbidity characteristics.

Results:

From 2009 to 2018, 240 587 patients had ≥1 opioid prescriptions. Most were White (65%), female (59%), and had Medicaid insurance (43%). One in 4 were chronic opioid users (25%). During this period, 55 332 (23%) were co-prescribed a sedative-hypnotic. The prevalence of co-prescribing was highest for females (26% vs 19% for males), non-Hispanic Whites (28% vs 13% for Hispanic to 20% for unknown), those over 44 years of age (25% vs 20% for <44 years), Medicare insurance (30% vs 21% for uninsured to 22% for other/unknown), and among those on chronic opioid therapy (40%). Co-prescribing peaked in 2010 (32%) and declined steadily through 2018 (20%). Trends were similar across demographic subgroups. Co-prescribed sedative-hypnotics remained elevated for those with chronic opioid use (27%), non-Hispanic Whites (24%), females (23%), and those with Medicare (23%) or commercial insurance (22%).

Conclusions:

Co-prescribed sedative-hypnotic use has declined steadily since 2010 across all demographic subgroups in the OCHIN population. Concurrent use remains elevated in several population subgroups.
Development and Evaluation of the School Counseling Internship Competency Scale
Authors: Burgess Melanie , Goodman-Scott Emily , Gülşah Kemer  , Carlisle Kristy , Carlisle Robert
Published: January 2023

According to the American School Counselor Association, school counseling interns’ competence should be measured by an instrument grounded in professional standards. However, no valid and reliable instrument exists to assess school counseling interns’ competencies. We created and validated a school counseling supervision instrument with four subscales: Foundational Skills and Dispositions, Multicultural Considerations and Student Services, General Education and Special Education Process, and Classroom Management and Collaboration/Consultation. We provide implications for interns, site supervisors, and university supervisors/faculty.
Prevalence of Potential Dropout Thoughts and Their Influential Factors Among Saudi Medical Students
Authors: Abdulghani Hamza Mohammad , Alanazi Khulud , Alotaibi Raghad , Alsubeeh Najlaa Abdulrahman , Ahmad Tauseef , Haque Shafiul
Published: January 2023

To investigate the incidence and accountable factors for the potential dropout thoughts among Saudi medical students. A cross-sectional survey questionnaire based study was conducted among Saudi medical students enrolled at the College of Medicine, King Saud University. A total number of 587 (39.13%) medical students out of ∼1,500 filled the questionnaire. Among them 302 (51.4%) reported incidence(s) of dropout thoughts at least once. However, only 17 (5.6%) have thought of dropping out very seriously. The majority of the students (67.5%) thought for withdrawal only on stressful days. The first year of the medical school was the most common year for all the students (49.3%) for thinking of dropout and academic problems were the most common reasons behind dropout thoughts (37.8%). The students, whose decision for entering in the medical school was influenced by the surroundings were at higher risk of dropout thoughts than their peers ( OR = 1.912, CI 1.33–2.75). A significant amount of dropout thoughts was prevalent among Saudi medical students, but serious thinker about dropout were less in numbers. A well-structured academic guidance program supported with psychological teaching method must be designed and offered to diagnose the symptomatic students before actually they get affected with dropout thought which might lead to actual dropout.