bluuebunny/crossref_metadata_2025_split huggingface dataset:
Urinary C3d is elevated in patients with active Lupus nephritis and a fall in its level after 3 months predicts response at 6 months on follow up
Authors: Ganguly Sujata , Majumder Sanjukta , Kumar Sandeep , Gupta Ranjan , Muhammed Hafis , Shobha Vineeta , Aggarwal Amita , Misra Ramnath 
Published: August 2020

Introduction Complement activation is central to the pathogenesis of lupus nephritis (LN). Low serum complement C3 and C4, are traditionally used as markers of lupus disease activity in general and LN in particular. In this study we prospectively measured plasma and urine C3d and C4d, degradation products of C3 and C4 corrected to creatinine in a cohort of biopsy proven LN in a longitudinal fashion for its correlation with disease activity. Methods Twenty eight biopsy proven active lupus nephritis (AN) were recruited along with four inactive nephritis (IN) and 10 healthy controls (HC). Plasma and urine were collected at baseline, prior to induction treatment and 3 months later. Clinical measures of disease activity, Systemic lupus erythematosus disease activity index 2000 (SLEDAI 2K), renal SLEDAI, serum C3, C4 and antibodies to ds DNA, urine protein and creatinine excretion (UP/UC) were collected. Plasma and urine C3d and C4d were measured using ELISA and normalized to spot urine creatinine value. Results Twenty eight AN of median age of 26.5 (20–31.50) years and disease duration of 3 (0.7–5) years were enrolled. The median urinary C3d/creatinine before treatment was 388.20 (48.98–1296) ng/mg which fell significantly to 62.69 (28.04–502.4) ng/mg at 3 months followup (p-0.01). The baseline values for the active renal disease was significantly different from IN group (9.9 (4.5–46.53 ng/mg) p-0.00). Treatment responders (partial and complete) at 6 months showed a significant fall in urinary C3d at 3 months whereas non responders had a non significant change in value. There was a significant correlation of urine C3d/creatinine with SLEDAI2K (r-0.433, p-0.00), renal SLEDAI (r-0.356, p-0.00), UP/UC ratio (r-0.489, p-<0.0001) but no significant correlation with C3 or C4. There was a significant fall in the median values of plasma C3d from 791.1 (516.0.00–1550.43) µg/ml to 338.52 (211.35–525.82) (p-0.00) µg/ml at the end of 3 months. The values showed a significant correlation with SLEDAI 2K, renal SLEDAI, UP/UC along with a significant negative correlation with C3 and C4. Conclusion Urinary C3d/creatinine levels and plasma C3d levels can be used as biomarker of disease activity and treatment response.
Cut off point of neutrophil-to-lymphocyte ratio as a marker of active disease in systemic lupus erythematosus
Authors: Firizal Akhmad Syaikhu , Sugianli Adhi Kristianto , Hamijoyo Laniyati 
Published: August 2020

Aim We aimed to measure sensitivity, specificity, and to determine the cut-off value (COV) ratio of neutrophil-to-lymphocyte (NLR) in patients with active systemic lupus erythematosus (SLE). Methods A cross sectional study was conducted using the retrospective data from Hasan Sadikin Lupus Registry (HSLR). The inclusion criteria were SLE patients aged 18 years or older who had documented data of neutrophil, lymphocyte, and SLE disease activity index (SLEDAI). Patients with infections, malignancies, and other inflammatory diseases recorded in registry were excluded. SLEDAI with a score of ≤ 4 is considered inactive and score of > 4 is considered active. The neutrophil-to-lymphocyte ratio was calculated by dividing the absolute number of neutrophils by the absoulte number of lymphocytes. Receiver Operating Characteristic (ROC) curve was used to analyze and determine optimal COV of NLR. Results The total sample in this study were 112 subjects with a dominant of female (95.54%) and the mean age of 34.45 ± 9.40 years. The median of SLEDAI was 4.5 with a range from 0 to 16, while the median of NLR was 2.68 with a range of 0.59 to 19.02. The ROC analysis showed the optimal cut-off in this study was 2.94 with sensitivity and specificity as high as 60.71% and 76.79%, respectively. Conclusion Neutrophil-to-lymphocyte ratio with cut off value of 2.94 can be used to determine active disease of systemic lupus eythematousus.
A community survey of adults with attention deficit hyperactivity disorder (ADHD) and their experience of medication effectiveness
Authors: Sandhu Adrian , Toll Joy , Poulton Alison 
Published: August 2020

Objective: Survey of ADHD-affected adult participants attending educational meetings of ‘ADDults with ADHD’, to ascertain age of diagnosis and treatment effects of psychostimulant medication on symptoms across functional and emotional domains. Method: From 2016 to 2019, self-assessments of functional impairment were collected from ADHD-affected adults attending educational meetings of an Australian community support organisation (ADDults with ADHD). Participants were asked to rate their functioning on and off medication. Some demographic and treatment details were also collected. Results: Questionnaires were collected from 117 attendees of five meetings. Their mean age was 42.5 (SD 15.0) years; their age of diagnosis and of starting treatment were 31.9 (SD 16.6) and 32.8 (SD 16.4) years, respectively, with no significant differences between men and women. Most (93%) reported symptom onset before age 18. Ninety (77%) had been treated medically, with self-ratings indicating significantly less impairment on treatment ( p < 0.001). Conclusion: Adults with ADHD reported substantial impairment but significant benefit from medication. Despite a mean age of over 30 at diagnosis, most recalled being symptomatic in childhood. This suggests many may experience a prolonged period of impaired function before starting treatment.
A Toolbox of Surgical Techniques for Palatal Fistula Repair
Authors: Rothermel Alexis T. , Lundberg Jaclyn N. , Samson Thomas D. , Tse Raymond W. , Allori Alexander C. , Bezuhly Michael , Beals Stephen P. , Sitzman Thomas J. 
Published: August 2020

Objective: To provide an inventory of oronasal fistula repair techniques alongside expert commentary on which techniques are appropriate for each fistula type. Design: A 4-stage approach was used to develop a consensus on surgical techniques available for fistula repair: (1) in-person discussion of oronasal fistula cases among cleft surgeons, (2) development of a schema for fistula management using transcripts of the in-person case discussion, (3) evaluation of the preliminary schema via a web-based survey of additional cleft surgeons, and (4) revision of the management schema using survey responses. Participants: Six cleft surgeons participated in the in-person case discussion. Eleven additional surgeons participated in the web-based survey. Participants had diverse training experiences, having completed residency and fellowship at 20 different hospitals. Results: A schema for fistula management was developed, organized by fistula location. The schema catalogues all viable approaches for each location. For fistulae involving the soft palate, the schema stresses the importance of evaluating for velopharyngeal insufficiency (VPI) and incorporating VPI management into fistula repair. For fistulae involving the hard palate, the schema separately enumerates the techniques available for nasal lining repair and for oral lining repair in each region. The schema also catalogues the diversity of approaches to lingual- and labioalveolar fistula, including variation in timing, orthodontic preparation, and simultaneous alveolar bone grafting. Conclusions: This study employed consensus methods to create a comprehensive inventory of available fistula repair techniques and to identify preferential techniques among a diverse group of surgeons.
Prevention and Management of Genital Mycotic Infections in the Setting of Sodium-Glucose Cotransporter 2 Inhibitors
Authors: Engelhardt Kristin , Ferguson McKenzie , Rosselli Jennifer L. 
Published: August 2020

Objective To review the incidence, risk factors, prevention, and management of genital mycotic infections (GMIs) associated with sodium-glucose cotransporter 2 (SGLT2) inhibitors. Data Sources A literature search of PubMed and Reactions Weekly was performed in February 2020 with updated searches monthly through July 2020 to identify relevant data regarding SGLT2 inhibitors and GMIs. Manufacturers of each agent were contacted, and clinical practice guidelines were consulted. Study Selection and Data Extraction All available literature was evaluated for inclusion based on relevance to the research question, timeliness of the publication, validity, and impact on current practice. A date limit was not set; however, publications from 2010 to July 2020 were prioritized. Data Synthesis The 3- to 4-fold increased incidence of GMIs is considered a classwide effect of SGLT2 inhibitors. Female sex and a prior history of GMIs are factors associated with the highest risk, whereas circumcised males are at the lowest risk of SGLT2 inhibitor–induced GMI. Personal hygiene advice can reduce the infection risk. When candidiasis occurs, it is often mild and responsive to treatment and often does not require discontinuation of the medication. Relevance to Patient Care and Clinical Practice This narrative review can assist in shared decision-making discussions with patients who may benefit from SGLT2 inhibitors and provides guidance for health care professionals managing SGLT2 inhibitor–associated GMIs. Conclusions SGLT2 inhibitors predispose patients to developing mild GMIs. Strong consideration should be given to avoid SGLT2 inhibitors in female patients with a history of severe, recurrent infections. Preventive strategies are optimized diabetes management and personal hygiene advice.
3D Printed Total Talus Replacement for Avascular Necrosis of the Talus
Authors: Kadakia Rishin J. , Akoh Craig C. , Chen Jie , Sharma Akhil , Parekh Selene G. 
Published: August 2020

Background: Talus avascular necrosis (AVN) is a challenging entity to treat. Management options depend on disease severity and functional goals. Total talus replacement (TTR) is a treatment option that maintains joint range of motion. The literature on TTR is limited with variability in implant design and material. The purpose of this study was to evaluate outcomes following TTR with a custom 3D printed metal implant. Methods: Patients who underwent TTR were retrospectively reviewed over a 3-year period. Basic demographic data and comorbidities were collected. Medical records were reviewed to obtain postoperative and preoperative visual analog scale (VAS) scores, Foot and Ankle Outcome Scores (FAOSs), ankle range of motion, and postoperative complications. Statistical analysis was conducted to compare clinical and patient-reported outcomes pre- and postoperatively. Twenty-seven patients underwent TTR for talar AVN with a mean follow-up of 22.2 months. Results: Ankle range of motion remained unchanged postoperatively. VAS pain scores improved postoperatively from 7.1 to 3.9 ( P < .001). FAOSs improved postoperatively with regard to pain ( P < .001), symptoms ( P = .001), quality of life ( P < .001), and activities of daily living ( P < .001). There were 3 complications requiring reoperation in this cohort. Conclusion: 3D printed TTRs represent a unique surgical option for patients with severe talar AVN. Patients in this cohort demonstrated significant improvements in pain scores and patient-reported outcomes. TTR allows for symptomatic improvement with the preservation of motion in individuals with talar collapse and AVN. Level of Evidence: Level IV, retrospective case series.
The Adaptation of the Substance Use Stigma Mechanism Scale (SU-SMS) Into Turkish: A Validity and Reliability Study
Authors: Can Gür Ganime , Tanriverdi Derya , Ariti Mahsun , Özgün Öztürk Fatma 
Published: August 2020

Background: Substance users are among the most highly stigmatized individuals by both the public and health care providers. However, no multidimensional scale for measuring substance use stigma for substance use disorders (SUDs) currently exists in Turkey. Aims: The aim of this study was to determine the validity and reliability of the Turkish version of the Substance Use Stigma Mechanism Scale (SU-SMS). Method: The study was conducted at the AMATEM (Alcohol and Substance Addiction Treatment Center Clinic). The sample group of this methodological study consisted of 156 participants with SUDs who met the inclusion criteria. “Social-demographics Questionnaire,” “The Substance Use Stigma Mechanism Scale,” and “Internalized Stigma of Mental Illness Scale” were used for data collection. In the validity–reliability analysis of the scale, language and content validity, explanatory and confirmatory factor analysis, criterion-concurrent validity, Cronbach’s alpha coefficient, item–total score correlation, split-half reliability analysis, and test–retest reliability methods were used. Results: Using exploratory factor analysis, it was found that the SU-SMS has five factors. Its five-factor structure was confirmed using confirmatory factor analysis. Its Cronbach’s alpha coefficient was .828, and factor loading was between .402 and .971. Analyses indicated that each of the factors of the Turkish version of the scale had high internal consistency. The test–retest correlation value was .752, p = .000. Conclusions: It was concluded that the Turkish version of the SU-SMS is a reliable and valid instrument for assessing substance use-related stigma in individuals with SUDs.
Framing Food Access: Do Community Gardens Inadvertently Reproduce Inequality?
Authors: Butterfield Katie L. , Ramírez A. Susana 
Published: August 2020

Background Alternative food programs have been proposed as solutions to food insecurity and diet-related health issues. However, some of the most popular programs—farmers markets and community-supported agriculture—overwhelmingly serve White and upper-middle-class individuals, exacerbating food security and health disparities. One explanation for the mismatch is the way in which alternative food programs are framed: Language used to encourage participation may reflect priorities of upper-middle-class and White populations who create and run these programs while lacking resonance with food-insecure populations. This literature, however, lacks consideration of how lower-cost, more participatory programs—community gardens—are framed. We therefore explore the framing of community gardens through a quantitative content analysis of the descriptions, missions, and goals provided by community garden managers across Minnesota ( N = 411). Results Six frames were consistently present in the community garden statements: greater good, community orientation, healthy food access, food donation, self-empowerment, and symbolic food labels. Greater good and community orientation were significantly more likely to be used than any other frames. Conclusions Taken together, our findings suggest that community gardens may be welcoming toward a diversity of participants but still have room to improve the inclusivity of their frames. The common use of a community orientation suggests the unique ability of community gardens among alternative food programs to benefit Black, Latino, and working-class populations. However, the most common frame observed was “greater good,” suggesting one mechanism through which community gardens, like other types of alternative food programs, may be reproducing inequality through alienation of food-insecure populations.
Sex Hormones, BDNF, Leptin, and TGF-β1 in Females With IBS: A Pilot Investigation
Authors: Weaver Kristen R. , Boulineaux Christina M. , Robinson Jeffrey M. , Butler Kierra , Heitkemper Margaret M. , Henderson Wendy A. 
Published: August 2020

Background: Irritable bowel syndrome (IBS) is a chronic gastrointestinal condition predominantly affecting the female sex, and is characterized by brain-gut axis dysregulation. Relevance of hormones along the hypothalamic-pituitary gonadal axis and hypothalamic-pituitary adrenal axis to IBS symptomatology remain unclear, as does the significance of other modulators including brain derived neurotrophic factor (BDNF), leptin, and transforming growth factor βeta 1 (TGF-β1). Methods: Females with IBS were compared with female healthy controls (HC) on age, race, hormonal contraceptive use, body mass index, adrenocorticotropic hormone, cortisol, estradiol, follicular stimulating hormone, luteinizing hormone, progesterone, total cholesterol, Center for Epidemiological Studies Depression Scale (CES-D) and Perceived Stress Scale (PSS). BDNF, leptin, and TGF-β1 were quantified using enzyme-linked immunosorbent assay. Descriptive statistics, non-parametric techniques, and regression analyses were performed. Results: Participants with IBS (n = 12) displayed higher estradiol ( p = .027) than did HC (n = 21). Direction of associations among study variables often differed between groups: BDNF and progesterone in HC (rs = .623) and in IBS (rs = −.723). The relationship between log (CES-D) and log (estradiol) varied by IBS status (interaction term p = 0.019). Discussion: Elevated estradiol in participants with IBS, and differential patterns of biological and psychological indices between groups, encourages further inquiry on the relevance of sex hormones, BDNF, leptin, and TGF-β1 to symptoms of IBS. Future research endeavors should conduct longitudinal quantification of sex hormones with subjective symptom assessment to facilitate insight on the pathophysiology and female sex bias in IBS.
Do workplace health-promotion interventions targeting employees with poor health reduce sick-leave probability and disability rates?
Authors: Nielsen Roy A. , Midtsundstad Tove I. 
Published: August 2020

Aims: This study aimed to investigate whether introducing workplace health-promotion interventions targeting employees with health problems or reduced work ability affected overall sick leave and disability risk. Methods: The study population comprised data from an establishment survey from 2010 identifying who had introduced workplace health promotion (the intervention) linked to register data on all employees and their sickness absence and disability pension uptake from 2000 through 2010. Results: Interventions had moderate effects due to varying efficacy in different parts of the labour market. Intervention success was more likely among white-collar workers (e.g. in public administration) compared to blue-collar workers (e.g. in manufacturing), probably due to variations in both organisational and technological constraints. Effects were small among men and moderate among older workers, particularly among women. Overall, disability risk reduction was accompanied by an increase in sickness absence. Sometimes, sickness absence increased in groups with no change in disability risk, suggesting that presenteeism in one group may increase absenteeism in other groups. Conclusions: Introducing workplace health-promotion interventions may prolong work careers in some labour-market segments. Financial incentives for Norwegian establishments to continue offering workplace health-promotion interventions may be improved, given the current financial model for disability pension and sickness benefits.
Challenges of diagnosis of COVID-19 in trauma patients: A case series
Authors: Sabetian Golnar , Feiz Farnia , Shakibafard Alireza , Fard Hossein Abdolrahimzadeh , Sefidbakht Sepideh , Jafari Seyed Hamed , Abbasi HamidReza , Zare Masoomeh , Roudgari Amir , Zand Farid , Masjedi Mansoor , Paydar Shahram 
Published: August 2020

Background Diagnosis of COVID-19 can be challenging in trauma patients, especially those with chest trauma and lung contusion. Methods We present a case series of patients from February and March 2020 who were admitted to our trauma center at Rajaee Hospital Trauma Center, in Shiraz, Iran and had positive SARS-CoV-2 PCR test or chest CT scan suggestive of COVID-19 and were admitted to the specific ICU for COVID-19. Results Eight COVID-19 patients (6 male) with mean age of 40 (SD = 16.3) years old, were presented. All patients were cases of trauma injuries, with multiple injuries including chest trauma and lung contusion, admitted to our trauma center for management of their injuries, but they were diagnosed with COVID-19 as well. Two of them had coinfection of influenza type-B and SARS-CoV-2. All patients were treated for COVID-19 and three of them died; the rest were discharged from hospital. Conclusion Since PCR for SARS-CoV-2 is not always sensitive enough to confirm the cause of pneumonia, chest CT manifestations can be helpful, though, they are not always differentiable from lung contusion. Therefore, both the CT scan and the clinical and paraclinical presentation and course of improvement can be beneficial in diagnosing COVID-19 in the trauma setting.
Societies’ hostility, anger and mistrust towards Migrants: A vicious circle
Authors: da Silva Rebelo Maria José , Fernández Mercedes , Meneses Carmen 
Published: August 2020

Summary Anger, hostility and mistrust towards refugees, asylum-seekers and immigrants (hereafter migrants) are increasing across most Western societies. Media discourse, tough migration laws, and the escalation of right-wing views across Europe, all manifest a desire to exclude those who are seen as a threat to national interests and identities. The literature repeatedly confirms that discrimination has a harmful impact on the general well-being of migrants, while often weakening their trust on helping professionals. Social workers are among the professionals most often in contact with migrants, making them important actors in the field of migration. Findings This qualitative study was conducted in Madrid (Spain) and follows the interpretative phenomenological analysis approach. Findings revealed that Muslims and Blacks are the groups facing the most intense racial hostility. Emotions like fear, sadness, learned helplessness, frustration, rejection, anger, and general mistrust were underlined by participants. Some migrants highlighted negative coping mechanisms like isolation, aggressive impulses, approaching mafias, and risk behaviours, leading to further rejection from host societies, and thus initiating a vicious circle of hostility. Application These findings constitute a modest contribution to the literature, as they result from an integration of migrants’ and helping professionals’ perspectives. Several suggestions are put forward for social workers and other professionals. The two most significant suggestions are that professionals (a) use their field experience to raise awareness about racial hostility towards this population, and (b) help identify migrants who may rely on negative coping strategies and so prevent adverse consequences for both migrants and host societies.