bluuebunny/crossref_metadata_2025 huggingface dataset:
Gut microbiota and cardiovascular disease: opportunities and challenges
Authors: Kazemian Negin , Mahmoudi Morteza , Halperin Frank , Wu Joseph C. , Pakpour Sepideh
Published: March 2020

Coronary artery disease (CAD) is the most common health problem worldwide and remains the leading cause of morbidity and mortality. Over the past decade, it has become clear that the inhabitants of our gut, the gut microbiota, play a vital role in human metabolism, immunity, and reactions to diseases, including CAD. Although correlations have been shown between CAD and the gut microbiota, demonstration of potential causal relationships is much more complex and challenging. In this review, we will discuss the potential direct and indirect causal roots between gut microbiota and CAD development via microbial metabolites and interaction with the immune system. Uncovering the causal relationship of gut microbiota and CAD development can lead to novel microbiome-based preventative and therapeutic interventions. However, an interdisciplinary approach is required to shed light on gut bacterial-mediated mechanisms (e.g., using advanced nanomedicine technologies and incorporation of demographic factors such as age, sex, and ethnicity) to enable efficacious and high-precision preventative and therapeutic strategies for CAD.
Medication assisted treatment (MAT) in criminal justice settings as a double-edged sword: balancing novel addiction treatments and voluntary participation
Authors: Hyatt Jordan M. , Lobmaier Philipp P.
Published: March 2020

Medication-Assisted Treatment (MAT) provides an opportunity to address opioid addiction among justice-involved individuals, an often difficult to reach population. This potential has been increasingly recognized by agencies, policymakers and pharmaceutical companies. The result has been a marked increase in the number of drug courts, prisons and agencies in which MAT, notably with long-acting injectable medications, is offered. While this is a positive development, ensuring that vulnerable individuals are in a position voluntarily participation within the complex criminal justice environment is necessary. The unequal authority and agency inherent in the nature of these environments should be recognized. Therefore, rigorous protections, mirroring the goals of the consent processes required for medical or sociobehavorial research, should be employed when MAT is offered to protect individual autonomy.
Association between HEXACO personality traits and medical specialty preferences in Mexican medical students: a cross-sectional survey
Authors: Barbosa-Camacho Francisco José , Miranda-Ackerman Roberto Carlos , Vázquez-Reyna Itzel , Jimenez-Ley Vania Brickelia , Barrera-López Francisco Javier , Contreras-Cordero Vianca Seleste , Sánchez-López Veronica Alexandra , Castillo-Valverde Tom Jilmer , Lamas-Abbadie Claudina del Carmen , González-Adán Brenda Alicia , Cortes-Flores Ana Olivia , Morgan-Villela Gilberto , Cervantes-Cardona Guillermo Alonso , Cervantes-Guevara Gabino , Fuentes-Orozco Clotilde , González-Ojeda Alejandro
Published: March 2020

Background

Medical specialty is a critical choice in a physician’s life because it determines their professional future and medical practice. While some are motivated to choose a specific specialty based on the monetary gain it can provide, others are inspired by seeing the work performed by a physician or by a patient’s recovery. It is common to stereotype doctors’ personalities by their specialty.

Methods

This was a cross-sectional survey study in which we administered the 100-item HEXACO Personality Inventory-Revised to 292 medical students between September 2018 and March 2019. We evaluated six different domains of personality traits. We also included questions about their medical specialty of choice, their least preferred specialty, and the motivation behind these choices. The participants included 175 women (59.9%) and 117 men (40.1%).

Results

When the participants were asked about their preferred type of medical specialty, 52.4% indicated a preference for surgical specialties (surgical group) vs 47.6% who preferred clinical specialties (clinical group). We found that the surgical group showed significantly higher scores for Extraversion and Organization domains, while the clinical group showed significantly higher scores on the Honesty–Humility, Emotionality, and Agreeableness domains. We identified critical differences within the overall group of medical students by their medical specialty preference.

Conclusions

Some classical stereotypes were confirmed by our results, such as surgical specialists tending to be more extroverted and organized, whereas clinical specialists were prone to being more introverted, anxious, and more emotionally attached to their patients.
The use of a psychological testing instrument as an indicator of dissatisfaction with aesthetic dental treatment – a preliminary study
Authors: Dudley James , Richards Lindsay , Mahmud Melati
Published: March 2020

Background

The use of psychological testing to indicate the potential for dissatisfaction with dental treatment has many potential patient and clinician benefits but has been rarely investigated. The study aimed to explore the use of the Symptom Checklist-90-Revised (SCL-90-R) psychological testing instrument in describing the relationship between pre-treatment psychological traits and aesthetic restorative treatment satisfaction.

Methods

Thirty patients requiring aesthetic restorative dental treatment completed three questionnaires, namely 1) a pre-treatment expectation assessment, 2) an SCL-90-R analysis pre-treatment and 3) an outcome assessment post-treatment to assess patient’s expectations and satisfaction of the proposed dental treatment relating to function, aesthetics, comfort and tissue preservation. Logistic regression models were used to assess the impact of psychological variables on patient satisfaction after adjusting for baseline expectations (P < 0.05).

Results

The satisfaction for the aesthetic component of treatment was significantly associated with psychoticism and positive symptom distress index. The satisfaction for the comfort component of treatment was significantly associated with obsessive compulsive symptoms, depression and anxiety. Following adjustment for baseline expectation, tissue preservation satisfaction was associated with somatization, obsessive compulsive, interpersonal sensitivity, depression and global severity index. No baseline psychological measures were significantly associated with chewing satisfaction.

Conclusions

The SCL-90-R shows initial promise in assisting clinicians to identify and understanding patients who have a high risk of dissatisfaction with aesthetic dental treatment. The ability to indicate aesthetic restorative treatment dissatisfaction is of great benefit to clinicians in maximising success and mitigating risk.
A randomized controlled trial of a six-session cognitive behavioral treatment of emotional disorders in adolescents 14–17 years old in child and adolescent mental health services (CAMHS)
Authors: Lorentzen Veronica , Fagermo Kenneth , Handegård Bjørn Helge , Skre Ingunn , Neumer Simon-Peter
Published: March 2020

Background

This study aims to investigate effectiveness of a 6-week, transdiagnostic cognitive behavioral therapy (CBT) for anxiety and depression in adolescents, the Structured Material for Therapy (SMART), in naturalistic settings of child and adolescent mental health outpatient services (CAMHS).

Methods

A randomized controlled trial with waiting list control (WLC) was performed at three community CAMHS in Norway. Referred adolescents (N = 163, age = 15.72, 90.3% girls) scoring 6 or more on the emotional disorders subscale of the Strengths and Difficulties Questionnaire (SDQ) were randomly assigned to SMART or to WLC.

Results

In the treatment group (CBT), 32.9% improved in the main outcome measure (SDQ), compared to 11.6% in the WLC. Clinically significant and reliable change was experienced by 17.7% in the CBT condition, compared to 5.8% in the WLC. No patients deteriorated. Statistically significant treatment effects were achieved for internalization symptoms, anxiety symptoms and general functioning.

Conclusions

These promising findings indicate that SMART may be considered as a first step in a stepped care model for anxiety and/or depression treatment in CAMHS. The recovery rates imply that further investigations into the effectiveness of brief treatments should be made. Furthermore, there is a need for more comprehensive second-stage treatments for some of these patients.

Trial registration

ClinicalTrials.govIdentifier:NCT02150265. First registered May 292,014.
All inside full thickness quadriceps tendon ACL reconstruction: Long term follow up results
Authors: Galan Hernan , Escalante Mateo , Della Vedova Franco , Slullitel Daniel
Published: March 2020

Purpose

The aim of this study is to evaluate results of anterior cruciate ligament reconstruction (ACL) using an All-Inside Full Thickness Quadriceps Reconstruction technique at 5 years follow up.

Methods

This is a Retrospective cohort study of patients undergoing ACL reconstruction. Inclusion criteria for this report were isolated primary ACL reconstructions without chondral lesions (Grade III/IV Outerbridge), using autologous full-thickness quadriceps tendon (FQT) graft with bone block, with an “all-inside” technique. Functional scales of Lysholm, IKDC, Tegner and objective results of side to side difference (KT1000) were used for this evaluation. Additionally, complications and comorbidities were also analyzed.

Results

Two hundred and ninety-one ACL reconstructions were retrospectively reviewed at 5 years postoperatively; 268 (92.1%) were men and 23 (7.90%) women. Lysholm Score improved from 64 (SD = 6.09) to 91 (SD = 6.05) points average. IKDC showed 59.79%, excellent and 3.4% good results. Arthrometric analysis showed that 259 knees (89%) had a difference of less than 3 mm. Median pre-injury Tegner score was 9 (Range 4–10), while final median Tegner activity level at 5 years was 8 (Range 4–10). Among comorbidities, 5.15% of the patients presented anterior knee pain. No visualization difficulties or significant hematomas were found.

Conclusion

Use of all inside FQT for ACL reconstruction in a young, high demand sports population, present at 5 years, good to excellent results, functionally and objectively, with low rates of complications and comorbidities.
New automated analysis to monitor neutrophil function point-of-care in the intensive care unit after trauma
Authors: Hesselink Lillian , Spijkerman Roy , de Fraiture Emma , Bongers Suzanne , Van Wessem Karlijn J. P. , Vrisekoop Nienke , Koenderman Leo , Leenen Luke P. H. , Hietbrink Falco
Published: March 2020

Background

Patients often develop infectious complications after severe trauma. No biomarkers exist that enable early identification of patients who are at risk. Neutrophils are important immune cells that combat these infections by phagocytosis and killing of pathogens. Analysis of neutrophil function used to be laborious and was therefore not applicable in routine diagnostics. Hence, we developed a quick and point-of-care method to assess a critical part of neutrophil function, neutrophil phagosomal acidification. The aim of this study was to investigate whether this method was able to analyze neutrophil functionality in severely injured patients and whether a relation with the development of infectious complications was present.

Results

Fifteen severely injured patients (median ISS of 33) were included, of whom 6 developed an infection between day 4 and day 9 after trauma. The injury severity score did not significantly differ between patients who developed an infection and patients who did not (p = 0.529). Patients who developed an infection showed increased acidification immediately after trauma (p = 0.006) and after 3 days (p = 0.026) and a decrease in the days thereafter to levels in the lower normal range. In contrast, patients who did not develop infectious complications showed high-normal acidification within the first days and increased tasset to identify patients at risk for infections after trauma and to monitor the inflammatory state of these trauma patients.

Conclusion

Neutrophil function can be measured in the ICU setting by rapid point-of-care analysis of phagosomal acidification. This analysis differed between trauma patients who developed infectious complications and trauma patients who did not. Therefore, this assay might prove a valuable asset to identify patients at risk for infections after trauma and to monitor the inflammatory state of these trauma patients.

Trial registration

Central Committee on Research Involving Human Subjects, NL43279.041.13. Registered 14 February 2014. https://www.toetsingonline.nl/to/ccmo_search.nsf/Searchform?OpenForm.
Clinical relevance between sodium-glucose co-transporter 2 inhibitors and lipid profiles in Asian patients with type 2 diabetes mellitus: a systematic review with a meta-analysis of randomized controlled trials
Authors: Mukai Junichi , Yoshiyama Ayano , Kubota Rie
Published: March 2020

Background

Few systematic reviews have examined the effects of sodium-glucose co-transporter 2 inhibitors (SGLT2is) on lipid profiles in Asian patients with type 2 diabetes mellitus. We conducted a systematic review with a meta-analysis to summarize the available literature and confirm the effects of SGLT2is on lipid profiles in these patients.

Methods

We searched the electronic databases MEDLINE, CENTRAL, and Ichushi-web for studies from the dates of their earliest publication to July 2018, and there was no language restriction. Trials were included if they were randomized controlled trials (RCTs) (1) comparing the effects of SGLT2is with a placebo in Asian patients with type 2 diabetes mellitus (18 years or older), and (2) reporting HbA1c and at least one lipid parameter, such as triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), or low-density lipoprotein cholesterol (LDL-C). The weighted mean difference with a 95% confidence interval (CI) was calculated using a random-effects model.

Results

Among the 630 studies retrieved, 17 RCTs that included 4485 patients were ultimately included in our review. Fourteen RCTs were conducted in Japan. The durations of RCTs ranged between 12 and 24 weeks. SGLT2is significantly improved HbA1c [mean difference − 0.80 (95%CI − 0.96 to − 0.64)%, p < 0.00001], TG [mean difference − 16.42 (95%CI − 22.71 to − 10.12) mg/dL, p < 0.00001], and HDL-C [mean difference 3.36 (95%CI 2.73 to 3.98) mg/dL, p < 0.00001], but significantly deteriorated LDL-C [mean difference 3.00 (95%CI 1.18 to 4.82) mg/dL, p < 0.001]. The LDL-C/HDL-C ratio was not significantly different between SGLT2is and a placebo [mean difference − 0.01 (95%CI − 0.08 to 0.06), p < 0.74].

Conclusion

The present results suggest that in Asian patients with type 2 diabetes mellitus, TG and HDL-C values were better, while LDL-C values were worse with SGLT2is than with a placebo. However, the negative impact of SGLT2is on lipid profiles was modest. Further RCTs with a longer duration or conducted in other Asian countries are needed to provide further evidence to support the clinical relevance of changes in lipid profiles. The present results will be informative for SGLT2is users with concerns regarding the effects of SGLT2is on lipid profiles.
Reading the news on Twitter: Source and item memory for social media in younger and older adults
Authors: Bourne Kimberly A. , Boland Sarah C. , Arnold Grace C. , Coane Jennifer H.
Published: March 2020

Background

Social media content is well-remembered, possibly because of its personal relevance and gossipy nature. It is unclear whether the mnemonic advantage of social media extends to a population less familiar with these platforms and whether knowing the content is from social media sources influences memory. This study examined how the presentation of news-like content in social media affected both item and source memory across two age groups. Younger adults (n= 42) and older adults (n= 32) studied tweets and news headlines that appeared in the format of Twitter posts or CNN headlines - these items were designed to be either congruent (e.g., tweets formatted as Twitter posts) or incongruent (e.g., tweets formatted as CNN headlines).

Results

For item memory, both age groups correctly recognized tweets more than headlines. Source identification was more accurate when format and content were congruent than incongruent. Signal detection analyses indicated that the source advantage for congruent items was largely driven by a bias to select the format that matched the content’s original source and that this tendency was stronger in older adults.

Conclusions

These results replicate previous literature on the mnemonic advantage of social media content. Although both younger and older adults remembered the content of social media better than the content of news sources, older adults were more sensitive than younger adults to congruency effects in source memory. These findings suggest that older adults rely more on their prior knowledge of conventional language and style in traditional and social media.
The Brazilian Society of Rheumatology guidelines for axial spondyloarthritis – 2019
Authors: Resende Gustavo Gomes , Meirelles Eduardo de Souza , Marques Cláudia Diniz Lopes , Chiereghin Adriano , Lyrio Andre Marun , Ximenes Antônio Carlos , Saad Carla Gonçalves , Gonçalves Célio Roberto , Kohem Charles Lubianca , Schainberg Cláudia Goldenstein , Campanholo Cristiano Barbosa , Bueno Filho Júlio Silvio de Sousa , Pieruccetti Lenise Brandao , Keiserman Mauro Waldemar , Yazbek Michel Alexandre , Palominos Penelope Esther , Goncalves Rafaela Silva Guimarães , Lage Ricardo da Cruz , Assad Rodrigo Luppino , Bonfiglioli Rubens , Anti Sônia Maria Alvarenga , Carneiro Sueli , Oliveira Thauana Luíza , Azevedo Valderílio Feijó , Bianchi Washington Alves , Bernardo Wanderley Marques , Pinheiro Marcelo de Medeiros , Sampaio-Barros Percival Degrava
Published: March 2020

Spondyloarthritis is a group of chronic inflammatory systemic diseases characterized by axial and/or peripheral joints inflammation, as well as extra-articular manifestations. The classification axial spondyloarthritis is adopted when the spine and/or the sacroiliac joints are predominantly involved. This version of recommendations replaces the previous guidelines published in May 2013.

A systematic literature review was performed, and two hundred thirty-seven studies were selected and used to formulate 29 recommendations answering 15 clinical questions, which were divided into four sections: diagnosis, non-pharmacological therapy, conventional drug therapy and biological therapy. For each recommendation the level of evidence supporting (highest available), the strength grade according to Oxford, and the degree of expert agreement (inter-rater reliability) is informed.

These guidelines bring evidence-based information on clinical management of axial SpA patients, including, diagnosis, treatment, and prognosis.
Real - rheumatoid arthritis in real life - study cohort: a sociodemographic profile of rheumatoid arthritis in Brazil
Authors: Sacilotto Nathália de Carvalho , Giorgi Rina Dalva Neubarth , Vargas-Santos Ana Beatriz , de Albuquerque Cleandro Pires , Radominski Sebastião Cezar , Pereira Ivânio Alves , Guimarães Maria Fernanda Brandão Resende , Bértolo Manoel Barros , Louzada Paulo , Sauma Maria de Fátima Lobato da Cunha , Bonfiglioli Karina Rossi , Brenol Claiton Viegas , da Mota Licia Maria Henrique , Castelar-Pinheiro Geraldo da Rocha
Published: March 2020

Background

In Brazil, socioeconomic differences in the incidence of rheumatoid arthritis (RA) have been demonstrated, which are important in the formulation of hypotheses regarding the association between environmental factors, lifestyle and the risk of disease development. This study examines how the socioeconomic condition of the patient with RA in Brazil, assessed according to social class, educational level, employment situation and use of caregivers, affects the times between the beginning of symptoms and diagnosis and the beginning of the use of disease-modifying antirheumatic drugs, as well as the presence of erosive disease and functional status.

Methods

This work is part of a multicentric study called REAL - Rheumatoid Arthritis in Real Life in Brazil, which is a prospective observational cohort study.

Results

As described in the REAL study, we included a total of 1115 patients. It was noted that patients with an educational classification of up to second grade incomplete presented with erosion percentages above those with a higher grade complete. Patients with caregivers presented a higher percentage of erosion than patients without caregivers. We verified that patients from economic classes above B2 presented fewer occurrences of erosion than those from classes C2, D-E. We also analyzed the average time differences from the beginning of symptoms and diagnosis and the beginning of treatment, according to academic level, erosion and economic classification. Patients with first grade complete showed an HAQ-DI averages higher than those with second grade complete. The patients who had employment showed lower HAQ-DI averages than patients who were not employed. The patients with erosion showed an HAQ-DI value higher than those without erosion. Patients with caregivers showed an HAQ-DI average higher than that of without caregivers.

Conclusion

This study showed that the therapeutic window of RA is not being reached, and therefore we should have a policy to expand and ensure access to public health for all patients, especially those with lower levels of education and income.

Trial registration

This study was approved by the National Commission of Ethics in Research.
Relations between serum magnesium and calcium levels and body composition and metabolic parameters in women with fibromyalgia
Authors: Andretta Aline , Schieferdecker Maria Eliana Madalozzo , Petterle Ricardo Rasmussen , dos Santos Paiva Eduardo , Boguszewski César Luiz
Published: March 2020

Objective

Correlate serum magnesium (Mg) and Calcium (Ca) levels with body composition and metabolic parameters in women with fibromyalgia (FM).

Patients and methods

Cross-sectional study compared with a control group paired by age and body mass index (BMI) of adult women diagnosed with fibromyalgia. All participants went through assessment of their body composition through dual-energy X-ray absorptiometry (DXA) and had blood samples collected for dosing of Mg, Ca, C-reactive Protein (CRP), lipidogram and glycemia. Results: 53 women with FM (average age 48.1 ± 8.2 years, average BMI 26.6 ± 4.5 kg/m2) and 50 control women (average age 47.1 ± 9.9 years, average BMI 25.6 ± 3.6 kg/m2) participated in the study. Serum levels turned out to have inverse correlation with CRP in the FM group (r = − 0.29, p = 0.03) and with BMI and glycemia in the control group (r = 0.31; p = 0.02 and r = 0.48; p = 0.0004 respectively). Serum levels of calcium correlated with triglycerides (r = 0.29; p = 0.03) in the FM group and with glycemia in the control group (r = 0.64; p = 0.0001).

Conclusions

In patients with FM, magnesemia turned out to have inverse correlation with CRP and calcemia had positive association with triglycerides.
Diabetes Screening: Detection and Application of Saliva 1,5-Anhydroglucitol by Liquid Chromatography–Mass Spectrometry
Authors: Jian Chaohui , Zhao Aihua , Ma Xiaojing , Ge Kun , Lu Wei , Zhu Wei , Wang Yufei , Zhou Jian , Jia Wei , Bao Yuqian
Published: March 2020

Context

Unlike other commonly used invasive blood glucose–monitoring methods, saliva detection prevents patients from suffering physical uneasiness. However, there are few studies on saliva 1,5-anhydroglucitol (1,5-AG) in patients with diabetes mellitus (DM).

Objective

This study aimed to evaluate the effectiveness of saliva 1,5-AG in diabetes screening in a Chinese population.

Design and Participants

This was a population-based cross-sectional study. A total of 641 subjects without a valid diabetic history were recruited from September 2018 to June 2019. Saliva 1,5-AG was measured with liquid chromatography–mass spectrometry.

Main outcome measures

DM was defined per American Diabetes Association criteria. The efficiency of saliva 1,5-AG for diabetes screening was analyzed by receiver operating characteristic curves, and the optimal cutoff point was determined according to the Youden index.

Results

Saliva 1,5-AG levels in subjects with DM were lower than those in subjects who did not have DM (both P < .05). Saliva 1,5-AG was positively correlated with serum 1,5-AG and negatively correlated with blood glucose and glycated hemoglobin (HbA1c) (all P < .05). The optimal cutoff points of saliva 1,5-AG0 and 1,5-AG120 for diabetes screening were 0.436 μg/mL (sensitivity: 63.58%, specificity: 60.61%) and 0.438 μg/mL (sensitivity: 62.25%, specificity: 60.41%), respectively. Fasting plasma glucose (FPG) combined with fasting saliva 1,5-AG reduced the proportion of people who required an oral glucose tolerance test by 47.22% compared with FPG alone.

Conclusion

Saliva 1,5-AG combined with FPG or HbA1c improved the efficiency of diabetes screening. Saliva 1,5-AG is robust in nonfasting measurements and a noninvasive and convenient tool for diabetes screening.
Genetic Architecture Associated With Familial Short Stature
Authors: Lin Ying-Ju , Cheng Chi-Fung , Wang Chung-Hsing , Liang Wen-Miin , Tang Chih-Hsin , Tsai Li-Ping , Chen Chien-Hsiun , Wu Jer-Yuarn , Hsieh Ai-Ru , Lee Ming Ta Michael , Lin Ting-Hsu , Liao Chiu-Chu , Huang Shao-Mei , Zhang Yanfei , Tsai Chang-Hai , Tsai Fuu-Jen
Published: March 2020

Context

Human height is an inheritable, polygenic trait under complex and multilocus genetic regulation. Familial short stature (FSS; also called genetic short stature) is the most common type of short stature and is insufficiently known.

Objective

To investigate the FSS genetic profile and develop a polygenic risk predisposition score for FSS risk prediction.

Design and Setting

The FSS participant group of Han Chinese ancestry was diagnosed by pediatric endocrinologists in Taiwan.

Patients and Interventions

The genetic profiles of 1163 participants with FSS were identified by using a bootstrapping subsampling and genome-wide association studies (GWAS) method.

Main Outcome Measures

Genetic profile, polygenic risk predisposition score for risk prediction.

Results

Ten novel genetic single nucleotide polymorphisms (SNPs) and 9 reported GWAS human height-related SNPs were identified for FSS risk. These 10 novel SNPs served as a polygenic risk predisposition score for FSS risk prediction (area under the curve: 0.940 in the testing group). This FSS polygenic risk predisposition score was also associated with the height reduction regression tendency in the general population.

Conclusion

A polygenic risk predisposition score composed of 10 genetic SNPs is useful for FSS risk prediction and the height reduction tendency. Thus, it might contribute to FSS risk in the Han Chinese population from Taiwan.
Clinical and Genetic Characterization of 153 Patients with Persistent or Transient Congenital Hyperinsulinism
Authors: Männistö Jonna M E , Maria Maleeha , Raivo Joose , Kuulasmaa Teemu , Otonkoski Timo , Huopio Hanna , Laakso Markku
Published: March 2020

Context

Major advances have been made in the genetics and classification of congenital hyperinsulinism (CHI).

Objective

To examine the genetics and clinical characteristics of patients with persistent and transient CHI.

Design

A cross-sectional study with the register data and targeted sequencing of 104 genes affecting glucose metabolism.

Patients

Genetic and phenotypic data were collected from 153 patients with persistent (n = 95) and transient (n = 58) CHI diagnosed between 1972 and 2015. Of these, 86 patients with persistent and 58 with transient CHI participated in the analysis of the selected 104 genes affecting glucose metabolism, including 10 CHI-associated genes, and 9 patients with persistent CHI were included because of their previously confirmed genetic diagnosis.

Main outcome measures

Targeted next-generation sequencing results and genotype–phenotype associations.

Results

Five novel and 21 previously reported pathogenic or likely pathogenic variants in ABCC8, KCNJ11, GLUD1, GCK, HNF4A, and SLC16A1 genes were found in 68% (n = 65) and 0% of the patients with persistent and transient CHI, respectively. KATP channel mutations explained 82% of the mutation positive cases.

Conclusions

The genetic variants found in this nationwide CHI cohort are in agreement with previous studies, mutations in the KATP channel genes being the major causes of the disease. Pathogenic CHI-associated variants were not identified in patients who were both diazoxide responsive and able to discontinue medication within the first 4 months. Therefore, our results support the notion that genetic testing should be focused on patients with inadequate response or prolonged need for medication.
Toward a Treatment Normalizing Ovulation Rate in Adolescent Girls With Polycystic Ovary Syndrome
Authors: Ibáñez Lourdes , Díaz Marta , García-Beltrán Cristina , Malpique Rita , Garde Edurne , López-Bermejo Abel , de Zegher Francis
Published: March 2020

Adolescent polycystic ovary syndrome (PCOS) is characterized by androgen excess and oligomenorrhea, and commonly driven by hepato-visceral fat excess (“central obesity”) ensuing from a mismatch between prenatal and postnatal nutrition, on a background of genetic susceptibility. There is no approved treatment for adolescent PCOS.

We report the pooled results of 2 pilot studies in nonobese girls with PCOS (N = 62, age 15.8 years) that compared the effects of randomized treatment for 1 year, either with an oral estro-progestogen contraceptive (OC), or with a low-dose combination of spironolactone-pioglitazone-metformin (SPIOMET, targeting the excess of ectopic fat).

Auxological and endocrine-metabolic variables (including fasting insulin, androgens, high-molecular-weight adiponectin [HMW-adiponectin], and microRNA [miR]-451a), body composition (dual x-ray absorptiometry) and hepato-visceral fat (magnetic resonance imaging) were assessed on- and posttreatment. Data from menstrual diaries were combined with weekly salivary progesterone measurements to infer ovulation rates during the second and fourth quarter of the posttreatment year.

OC and SPIOMET treatment reduced the androgen excess comparably, and had no differential effects on total-body lean or fat mass. However, SPIOMET was accompanied by more broadly normalizing effects, including on hepato-visceral fat and on circulating insulin, HMW-adiponectin, and miR-451a. On average, there were 3-fold more ovulations post-SPIOMET than post-OC; normovulation was only observed after SPIOMET; anovulation was >10-fold more prevalent post-OC.

Pooled results of randomized studies in nonobese adolescent girls with PCOS indicate that SPIOMET treatment leads to an overall healthier, more insulin-sensitive condition—with less ectopic fat—than OC treatment, and to a more normal posttreatment ovulation rate.
Clinical Significance of the Maximum Body Mass Index Before Onset of Type 2 Diabetes for Predicting Beta-Cell Function
Authors: Ozawa Harutoshi , Fukui Kenji , Komukai Sho , Hosokawa Yoshiya , Fujita Yukari , Kimura Takekazu , Tokunaga Ayumi , Kozawa Junji , Iwahashi Hiromi , Shimomura Iichiro
Published: March 2020

Objective

This study aimed to clarify the clinical significance of the maximum body mass index (BMI) before the onset of type 2 diabetes (MBBO) for predicting pancreatic beta-cell function.

Methods

This was a cross-sectional observational study. Of 1304 consecutively admitted patients with type 2 diabetes, we enrolled 410 patients satisfying the criteria in this study. The correlations between the C-peptide index (CPI), which is one of the parameters that reflects beta-cell function, and various clinical parameters, including MBBO and duration of diabetes, were analyzed in multiple linear regression analyses.

Results

The analyses revealed that MBBO was correlated with CPI independently after adjustment for age, sex, HbA1c, and duration of diabetes. When we divided the subjects into three subgroups by MBBO (MBBO < 25 kg/m2; 25 kg/m2 ≤ MBBO < 30 kg/m2; MBBO ≥ 30 kg/m2), CPI was negatively correlated with duration of diabetes in each subgroup, while the rates of CPI based on the duration of diabetes were not different among the three MBBO subgroups. In contrast, the declining rates of CPI were higher in the BMI ≥ 25 kg/m2 group on admission than in the BMI < 25 kg/m2 group on admission.

Conclusions

MBBO may be an independent factor correlating with beta-cell function and may predict insulin secretion capacity at diagnosis, but it does not seem to affect the rate of decline in insulin secretion capacity after diagnosis. It is important to preserve beta-cell function by decreasing a patient’s BMI during treatment after diagnosis regardless of MBBO.
Effects of Semaglutide Versus Dulaglutide on Epicardial Fat Thickness in Subjects with Type 2 Diabetes and Obesity
Authors: Iacobellis Gianluca , Villasante Fricke Alexandra C
Published: March 2020

Background and Aims

Epicardial adipose tissue (EAT), the visceral fat depot of the heart, is a modifiable cardio-metbolic risk factor and therapeutic target. Semaglutide and dulaglutide, glucagon-like peptide-1 (GLP-1) receptor agonists, are indicated for the treatment of type 2 diabetes mellitus (T2DM). GLP-1 receptor agonists have recently shown to reduce cardiovascular risk. Epicardial adipose tissue expresses GLP-1 receptors (GLP-1Rs). GLP-1 receptor agonist liraglutide is known to significantly decrease EAT thickness. However, the effects of GLP-1 receptor agonists semaglutide and dulaglutide on EAT thickness are unknown.

Materials and Methods

We performed a 12-week, controlled, parallel study in 80 subjects with T2DM and obesity. Patients received either semaglutide, up to 1 mg subcutaneous (sc) weekly, or dulaglutide, up to 1.5 mg sc weekly, as the standard of care in addition to their usual medication regimen. Twenty subjects with T2DM and obesity were started on metformin and a diet and served as the control group. Ultrasound-measured EAT thickness was measured at baseline and at the 12-week follow-up.

Results

Epicardial adipose tissue thickness significantly decreased in both semaglutide and dulaglutide groups (P < 0.001) after 12 weeks, accounting for a 20% reduction. There was no EAT reduction in the metformin group. Body mass index (BMI) and HbA1c improved in all groups without reaching statistical significance. Epicardial adipose tissue thickness reduction was significantly greater (P < 0.01) with the higher doses of semaglutide (1 mg) and dulaglutide (1.5 mg), respectively.

Conclusion

Weekly administration of either GLP-1 receptor agonists semaglutide or dulaglutide causes a rapid, substantial, and dose-dependent reduction in EAT thickness.
Factors That Influence Conversion to Resectability and Survival After Resection of Metastases in RAS WT Metastatic Colorectal Cancer (mCRC): Analysis of FIRE-3- AIOKRK0306
Authors: Modest Dominik Paul , Heinemann Volker , Folprecht Gunnar , Denecke Timm , Pratschke Johann , Lang Hauke , Bemelmans Marc , Becker Thomas , Rentsch Markus , Seehofer Daniel , Bruns Christiane J. , Gebauer Bernhard , Held Swantje , Stahler Arndt , Heinrich Kathrin , von Einem Jobst C. , Stintzing Sebastian , Neumann Ulf P. , Ricard Ingrid
Published: March 2020

Background

Tumor assessments after first-line therapy of RAS wild-type mCRC with cetuximab (cet) versus bevacizumab (bev) in combination with FOLFIRI were evaluated for factors influencing resectability, conversion to resectability, and survival after best response.

Methods

Conversion to resectability was defined as conversion of initially unresectable to resectable disease at best response as determined by retrospective assessment. Univariate and multivariate logistic models were fitted with resectability at best response as response variable. A Cox model comparing the survival from best response was used to measure the influence of treatment, resectability at best response, and resection. Interaction of resection and treatment arm on survival was tested by likelihood ratio test.

Results

Overall, 270 patients were evaluable (127 cet-arm, 143 bev-arm). Lung metastases (odds ratio [OR] 0.35, 95% confidence response [CI] 0.19–0.63), BRAF mutation (OR 0.33, 95% CI 0.12–0.82), and elevated alkaline phosphatase (OR 0.42, 95% CI 0.18–0.9) before randomization were associated with less chance of successful conversion and were integrated into a nomogram. Early tumor shrinkage (OR 1.86, 95% CI 1.06–3.3; p 0.034) and depth of response (OR 1.02, 95% CI 1.01–1.03; p < 0.001) were associated with successful conversion therapy. Resection of metastases improved post-best-response survival (hazard ratio 0.53, 95% CI 0.29–0.97; p = 0.039), predominantely in cet-treated patients (interaction test, p = 0.02).

Conclusions

Conversion to resectability is significantly associated with baseline characteristics that can be used in a nomogram to predict conversion. Moreover, early efficacy parameters (ETS and DpR) are associated with successful conversion therapy. In FIRE-3, resection of metastases was associated with improved post-best response survival, this effect originated predominantly from the cetuximab-based study arm.
The system of personnel training in the internal Affairs bodies of the Russian Federation
Authors: Serdyuk Natal'ya , Semchenko Aleksandr
Published: March 2020

The article discusses the system of organization of training in the internal affairs bodies of Russia, substantiates the principles of its functioning. Object of study - continuing education of employees of the internal affairs bodies of the Russian Federation.

The subject of the study is the training system in the internal affairs bodies of the Russian Federation and methods for its optimization.

Research hypothesis: the construction and implementation of individual educational paths will help optimize the training system in the internal affairs bodies of the Russian Federation.

Methodology and research methods: general scientific theory of dialectic and historical materialism, acmeological, hermeneutic and situational-environmental methodological approaches; methods of content analysis of scientific literature and regulatory legal acts in the field of education, included observation, informal interviews, conversation, pedagogical experiment.

The theoretical significance lies in the analysis and assessment of the state of departmental training system for the internal affairs bodies of the Russian Federation and in determining ways to optimize it.

The practical significance lies in the analysis and interpretation of statistical data in the field of departmental education of the Ministry of Internal Affairs of Russia, and in this connection the justification of priority tasks in the near future.
The Staff Attitude to Coercion Scale (SACS) – Polish adaptation
Authors: Kiejna Andrzej , Jakubczyk Marta , Gondek Tomasz , Rajba Beata
Published: March 2020

Cel pracy

Celem badania było przygotowanie polskiej adaptacji kwestionariusza SACS. Skala ta jest narzędziem samooceny przeznaczonym do mierzenia stosunku pracowników do bezpośredniego przymusu wobec pacjentów oddziałów psychiatrycznych.

Metoda

Próba składała się z 120 pracowników 7 oddziałów psychiatrycznych. Kwestionariusz SACS to narzędzie stworzone w Norwegii przez Tonje Husum, składające się z 15 pozycji opisujących podejście pracowników psychiatrycznej służby zdrowia do bezpośredniego przymusu. Procedura walidacji obejmowała trzy podstawowe metody, które należy zastosować w analizie niezawodności - porównanie podwójnych testów za pomocą tej samej metody, statystyczną analizę właściwości pozycji testowych oraz analizę relacji pozycji i podskal z ogólnym wynikiem testu.

Wyniki

Po badaniu pilotażowym typu "Think aloud" i adaptacji językowej oceniono rzetelność. Alfa Cronbacha w podskalach mieściła się w przedziale od 0,57 do 0,81, a dla ogólnego wyniku wynosiła 0,82. Najlepszym rozwiązaniem uzyskanym w eksploracyjnej analizie czynnikowej był model trójczynnikowy, prawie identyczny z oryginalnym, potwierdzający podział na trzy podskale: przymus jako urąganie pacjentowi (postawa krytyczna), opieka i bezpieczeństwo (postawa pragmatyczna) oraz forma leczenia (postawa pozytywna).

Wnioski

Właściwości psychometryczne polskiej adaptacji kwestionariusza SACS są podobne do tych opisanych w wersji oryginalnej. Wyniki pozwalają uznać metodę za odpowiednią do potrzeb badań naukowych. Jednak dalsze analizy są konieczne, aby ocenić trafność i moc dyskryminacyjną w większych grupach badanych.
ICD-11 vs. ICD-10 – a review of updates and novelties introduced in the latest version of the WHO International Classification of Diseases
Authors: Krawczyk Piotr , Święcicki Łukasz
Published: March 2020

W czerwcu 2018 Światowa Organizacja Zdrowia (WHO) opublikowała 11-tą edycję Międzynarodowej Klasyfikacji Chorób (ICD-11). W nowej edycji klasyfikacji wprowadzono liczne zmiany. Jedną z najważniejszych było przebudowanie systemu kodowania oraz przystosowanie go do wyłącznie cyfrowego użytku. Przebudowa systemu kodowania umożliwia także pełniejsze oddanie za pomocą kodu alfanumerycznego nawet bardzo złożonej sytuacji klinicznej – przyczyniło się do tego wprowadzenie kodowania zgrupowanego. Zmianom uległ także rozdział dotyczący zaburzeń psychicznych. ICD-11 zaktualizowano uwzględniając wyniki międzynarodowej współpracy ekspertów oraz nowe informacje dotyczące zaburzeń psychicznych. Wiele spośród drugorzędnych dotychczas kategorii klinicznych przesunięto wyżej w hierarchii, tworząc tym samym nowe podrozdziały. Liczne kategorie przesunięto do innych podrozdziałów. Uwzględniając współczesną epidemiologię i wiedzę o etiologii zaburzeń psychicznych zdecydowano o usunięciu niektórych kategorii z Klasyfikacji, ale także kilka spośród niewystępujących w istniejących Klasyfikacjach schorzeń zostało dodanych. W artykule podsumowujemy i omawiamy najważniejsze zmiany jakie zaszły w ICD wraz z wprowadzeniem ICD-11 zarówno w zakresie systemu kodowania, jak i w poszczególnych podrozdziałach obejmujących zagadnienia zdrowia psychicznego.
Polish version of the White Bear Suppression Inventory (WBSI) by Wegner and Zanakos: factor analysis and reliability
Authors: Cichoń Ewelina , Szczepanowski Remigiusz , Niemiec Tomasz
Published: March 2020

Cel pracy

Celem niniejszego badania była adaptacja polskiej wersji kwestionariusza White Bear Suppression Inventory (WBSI), stworzonego przez Wegnera i Zanakos [1] do pomiaru chronicznego tłumienia.

Metoda

Polska wersja skali WBSI została opracowana za pomocą procedury tłumaczenia zwrotnego. Dwieście czterdzieści sześć osób z populacji ogólnej wypełniło opracowany kwestionariusz. Następnie przeprowadzono analizę struktury czynnikowej skali WBSI. W końcowym etapie wykonano analizę rzetelności polskiej wersji WBSI oraz dwóch podskal, wchodzących w jej skład.

Wyniki

Polska wersja narzędzia cechuje się zadowalającymi właściwościami psychometrycznymi. Wyniki eksploracyjnej analizy czynnikowej wykazały dwuczynnikową strukturę testu w postaci czynników takich jak tłumienie i intruzje. Zarówno wyniki obu czynników, jak również pomiar dokonywany za pomocą pełnej skali WBSI, wykazują bardzo wysoką rzetelność.

Wnioski

Rzetelność polskiej wersji kwestionariusza WBSI jest porównywalna z wersją oryginalną. Analiza pozwoliła wyodrębnić nową podskalę, która może odnosić się do zjawiska doświadczania intruzji. Polska wersja skali WBSI charakteryzuje się bardzo dobrymi właściwościami psychometrycznymi i może być stosowana jako skala do oceny intruzji oraz tłumienia.
Polish adaptation of the Daily Heterosexist Experiences Questionnaire
Authors: Mijas Magdalena , Koziara Karolina
Published: March 2020

Cel pracy

Celem przeprowadzonego badania była adaptacja i weryfikacja psychometrycznych właściwości polskiej wersji Kwestionariusza Codziennych Doświadczeń Heteroseksizmu (Daily Heterosexist Experiences Questionnaire - DHEQ) stworzonego przez amerykański zespół pracujący pod kierunkiem Kimberly Balsam (2013). Zastosowany kwestionariusz w oryginalny sposób ujmuje przejawy uprzedzeń i dyskryminacji w codziennym funkcjonowaniu osób LGBT (lesbijek, gejów, osób biseksualnych i transpłciowych).

Metoda

W badaniu internetowym zgromadzono dane pochodzące od 197 osób LGBT. Średni wiek uczestników badania wyniósł 31 lat (M = 31,93; SD = 8,37). Blisko 17% (N = 33) osób określiło się jako transpłciowe, nieco ponad 19% (N = 38) jako nieheteroseksualne kobiety, podczas gdy pozostali uczestnicy (N = 127; 64%) opisali się jako homoseksualni, biseksualni lub panseksualni mężczyźni.

Wyniki

Najwyższe średnie wyniki uzyskano w obrębie czynnika Zastępczej traumy, co sugeruje, że dowiadywanie się o przemocy i dyskryminacji dotykającej inne osoby LGBT jest ważnym stresorem w życiu osób LGBT. Innymi kluczowymi przejawami heteroseksizmu okazały się czynniki Wyobcowania oraz Czujności, które opisują uczucia samotności oraz wysiłek wkładany w ukrywanie tożsamości LGBT. Z wszystkich grup osoby transpłciowe okazały się w największym stopniu eksponowane na przejawy heteroseksizmu.

Wnioski

Polska adaptacja kwastionariusza DHEQ charakteryzuje się dobrymi właściwościami psychometrycznymi. Większość czynników kwestionariusza znajduje zastosowanie na gruncie polskim.
Acute decompensated heart failure: a study of nursing care
Authors: Loftus Nicholas Woolfe , Bowden Tracey
Published: March 2020

This care study focuses on the initial acute phase of care for a patient with acutely decompensated heart failure. Heart failure is a syndrome characterised by clinical signs, such as pulmonary oedema, and symptoms, such as dyspnoea. Acute heart failure develops rapidly and requires urgent medical attention, unlike the slower insidious onset of chronic heart failure. Acute heart failure can be either new or acute decompensation of chronic heart failure. The patient presented with cardiogenic pulmonary oedema because of acute decompensation of his chronic heart failure. He agreed to medical management, which included continuous positive airway pressure, intra-arterial cannulation and a furosemide infusion. This treatment proved largely effective, but it may have been better if his furosemide infusion had been stopped sooner. The implications for practice are explored in this care study.
Occupational performance coaching: goal barriers and beneficial facilitators
Authors: Kahjoogh Mina Ahmadi , Kessler Dorothy , Khankeh Hamid Reza , Akbarfahimi Nazila , Hosseini Seyed Ali , Sanei Fatemeh , Havaei Naser
Published: March 2020

Background/aims

Occupational performance coaching is a family-centred approach that helps mothers who have children with occupational performance challenges. This study sought to identify the barriers and facilitators to goal achievement and engagement with occupational performance coaching based on the experiences of mothers of children with cerebral palsy who were receiving occupational performance coaching.

Methods

This qualitative study was embedded within a randomised control trial. Twelve mothers of children with cerebral palsy who had received occupational performance coaching were interviewed using a semi-structured interview technique. Their responses were analysed using inductive content analysis.

Results

The most important barriers to goal achievement and engagement with coaching were societal, family-related and mother-related factors. The facilitators were new resources, family cohesion, mother-related factors and child-related factors.

Conclusions

Different factors can affect the outcomes of occupational performance coaching based on the viewpoint of mothers of children with cerebral palsy. Occupational therapists should consider societal, family and individual factors when using this intervention with clients.