bluuebunny/crossref_metadata_2025_split huggingface dataset:
Not belonging where others do: a cross-sectional analysis of multi-level social capital interactions on health and mental well-being in Wales
Authors: Saville Christopher W N 
Published: November 2020

Background
Social capital may be a social good in health terms, but it is not necessarily a universal good. Several studies have shown that while there is a positive association between ecological social capital and health in people with high individual-level social capital, this relationship is weaker or even reversed in those with low individual-level social capital. Such studies, however, have used relatively coarse levels of geography for quantifying ecological social capital. The present study looks at this relationship at a more fine-grained spatial scale.

Methods
Data from the National Survey for Wales (n=27 828, weighted mean age=48.4) were linked to previously published small-area estimates (n=410) of ecological social capital for Wales. Mixed effects models were then used to assess whether the relationship between mental well-being and self-reported health on one hand, and ecological social capital (sense of belonging) on the other, was moderated by individual-level social capital.

Results
The models found the same moderation of the relationship that has been demonstrated previously: Although ecological social capital is positively associated with health in respondents with high individual-level social capital, the relationship is negative in those with low individual-level social capital.

Conclusion
This study replicates this association at a spatial scale orders of magnitude more fine-grained than had been shown previously. Ecological social capital is not an unambiguously positive factor for public health, and may be a risk factor for marginalised people.
Prevention, screening, assessing and managing of non-adherent behaviour in people with rheumatic and musculoskeletal diseases: systematic reviews informing the 2020 EULAR points to consider
Authors: Ritschl Valentin , Stamm Tanja A , Aletaha Daniel , Bijlsma Johannes W J , Böhm Peter , Dragoi Razvan , Dures Emma , Estévez-López Fernando , Gossec Laure , Iagnocco Annamaria , Negrón José B , Nudel Michal , Marques Andréa , Moholt Ellen , Skrubbeltrang Conni , Van den Bemt Bart , Viktil Kirsten , Voshaar Marieke , Carmona Loreto , de Thurah Annette 
Published: November 2020

ObjectiveTo analyse how non-adherence to prescribed treatments might be prevented, screened, assessed and managed in people with rheumatic and musculoskeletal diseases (RMDs).MethodsAn overview of systematic reviews (SR) was performed in four bibliographic databases. Research questions focused on: (1) effective interventions or strategies, (2) associated factors, (3) impact of shared decision making and effective communication, (4) practical things to prevent non-adherence, (5) effect of non-adherence on outcome, (6) screening and assessment tools and (7) responsible healthcare providers. The methodological quality of the reviews was assessed using AMSTAR-2. The qualitative synthesis focused on results and on the level of evidence attained from the studies included in the reviews.ResultsAfter reviewing 9908 titles, the overview included 38 SR on medication, 29 on non-pharmacological interventions and 28 on assessment. Content and quality of the included SR was very heterogeneous. The number of factors that may influence adherence exceed 700. Among 53 intervention studies, 54.7% showed a small statistically significant effect on adherence, and all three multicomponent interventions, including different modes of patient education and delivered by a variety of healthcare providers, showed a positive result in adherence to medication. No single assessment provided a comprehensive measure of adherence to either medication or exercise.ConclusionsThe results underscore the complexity of non-adherence, its changing pattern and dependence on multi-level factors, the need to involve all stakeholders in all steps, the absence of a gold standard for screening and the requirement of multi-component interventions to manage it.
An Extension of the Double

G

′

/
G
,

1
/
G

-Expansion Method for Conformable Fractional Differential Equations
Authors: Al-Shawba Altaf A. , Abdullah Farah A. , Azmi Amirah , Akbar M. Ali 
Published: November 2020

The phenomena, molecular path in a liquid or a gas, fluctuating price stoke, fission and fusion, quantum field theory, relativistic wave motion, etc., are modeled through the nonlinear time fractional clannish random Walker’s parabolic (CRWP) equation, nonlinear time fractional SharmaTassoOlver (STO) equation, and the nonlinear space-time fractional KleinGordon equation. The fractional derivative is described in the sense of conformable derivative. From there, the

G

′

/
G
,

1
/
G

-expansion method is found to be ensuing, effective, and capable to provide functional solutions to nonlinear models concerning physical and engineering problems. In this study, an extension of the

G

′

/
G
,

1
/
G

-expansion method has been introduced. This enhancement establishes broad-ranging and adequate fresh solutions. In addition, some existing solutions attainable in the literature also confirm the validity of the suggested extension. We believe that the extension might be added to the literature as a reliable and efficient technique to examine a wide variety of nonlinear fractional systems with parameters including solitary and periodic wave solutions to nonlinear FDEs.
Proximal Left Main Coronary Artery Aneurysm Presenting as ST-Elevation Myocardial Infarction Treated by Stenting
Authors: Vinod Vijay Chander , Yousif Zuhair Eltayeb , Salim Najat Omer , Majwal Talib 
Published: November 2020

Coronary artery aneurysm (CAA) is a rare cardiac anomaly with a reported incidence of 0.3-4.9% of patients who undergo coronary angiography. The term is used when the coronary artery diameter exceeds more than 50% or 1.5 times the reference diameter. It can be congenital or acquired. The commonest acquired cause in an adult is atherosclerosis and in a child is Kawasaki’s disease. The commonest culprit vessel is the Right Coronary Artery (RCA), followed by Left Circumflex (LCx) and Left Anterior Descending (LAD). Left main coronary aneurysms are extremely rare in clinical practice. Coronary angiography is the gold standard procedure, both for diagnosis and treatment. We report a 49-year-old male who presented with anterior wall ST-Elevation Myocardial Infarction (STEMI). The initial angiography showed LAD stent thrombosis, but when the second angiography was done, there was spontaneous recanalization of the LAD. Coronary angiography was performed at our hospital, which revealed a long left main coronary artery aneurysm measuring 9.8 mm—maximum diameter. This was treated with a size

5
×
24

mm

Begraft coronary stent.
Frailty as a Predictor of Postoperative Morbidity and Mortality Following Liver Resection
Authors: McKechnie Tyler , Bao Tyler , Fabbro Matthew , Ruo Leyo , Serrano Pablo E. 
Published: November 2020

Background Liver resection is commonly performed among patients at risk of being frail. Frailty can be used to assess perioperative risk. Thus, we evaluated frailty as a predictor of postoperative complications following liver resection using a validated modified frailty index (mFI). Methods A retrospective cohort of consecutive patients undergoing liver resection (2011-2018) were stratified according to the mFI and classified as the following: high (≥.27) and low mFI (<.27). The effect of mFI on postoperative complications (Clavien-Dindo) was evaluated using multiple logistic regression, expressed as odds ratios (OR) and 95% CI. Results Of 409 patients, 58 (14%) had high mFI. There were no differences in type of liver resection (laparoscopic: 57% vs 55%, P = .766), number of segments resected (3 vs 4, P = .417), or operative time (257 vs 293 minutes, P = .097) between the high and low mFI groups, respectively. High mFI patients had a longer median length of hospital stay (9.5 vs 5 days, P < .001) and higher proportion of postoperative complications (79% vs 46%, P < .001), including minor complications (69% vs 42%, P < .001), major complications (50% vs 13%, P < .001), and 90-day postoperative mortality (12% vs 3.4%, P = .04). On multivariable analysis, longer operating time (OR 1.15, 95% CI, 1.03 to 1.27), higher number of segments resected (OR 1.43, 95% CI, 1.12 to 1.82), and high mFI (OR 6.74, 95% CI, 2.76 to 16.51) were independent predictors of major postoperative complications. Discussion mFI predicts postoperative outcomes following liver resection and can be used as a risk stratification tool for patients being considered for surgery.
Patient Outcomes in Mesenteric Venous Thrombosis Treated With Empiric Antibiotics
Authors: Lewcun Joseph A. , Khatun Rahima , Allen Steven , Hazelton Joshua P. , Cooper Amanda 
Published: November 2020

Background Mesenteric venous thrombosis (MVT) is typically associated with poor prognosis. Although prophylactic antibiotics are sometimes given with the intent of limiting bacterial luminal load and translocation in patients with MVT, this approach has not been universally adopted. The aim of this study is to analyze whether utilizing antibiotics empirically in those with MVT improves patient outcomes and survival when compared to those who do not receive empiric antibiotics. Methods A retrospective review of patients admitted with MVT between 2002 and 2019 at a single academic institution was performed. Demographics and rates of mortality need for bowel resection, readmission, and Clostridium difficile ( C. diff) infection were compared between patients treated with empiric antibiotics and patients not treated with antibiotics. Results Eighty-three patients (mean age 64.5 years and 55.4% male) who were admitted for MVT were included. Empiric antibiotics were utilized in 53% (n = 44) of MVT patients while 47% (n = 39) received supportive treatment without empiric antibiotics. Death occurred in 4 patients treated with antibiotics and 6 patients treated without antibiotics (9.1% vs. 15.3%, P = .50). Readmissions occurred in 12 patients (27.3%) treated with antibiotics and 10 patients (25.6%) not treated with antibiotics (27.3% vs. 25.6%, P = .87). C. diff infection occurred in 6 patients treated with antibiotics and in no patients not treated with antibiotics (13.6% vs. 0%, P = .03). Conclusions Empiric antibiotic usage may not improve rates of mortality or hospital readmission in patients with MVT and may unnecessarily expose patients to an increased risk of C. diff infection.
Clinical Utility of Bile Duct Axis Deviation for Differential Diagnosis Between Pancreatic Head Cancer and Bile Duct Cancer
Authors: Shirakawa Toru , Tomimaru Yoshito , Hayashi Shiro , Noguchi Kozo , Nishida Tsutomu , Dono Keizo 
Published: November 2020

Backgrounds Differential diagnosis between pancreatic head cancer (PHC) and intrapancreatic bile duct cancer (BDC) is important, but no clinical standard has been established. Here we examine the diagnostic utility of bile duct axis deviation and other clinical factors for this differential diagnosis. Methods This study enrolled patients who underwent pancreaticoduodenectomy for PHC or BDC at our center between 2009 and 2016. PHCs in groove or uncinate portions were excluded from analysis. From contrast-enhanced computed tomography images, the bile duct angle (BDA) was measured using three points: the junction of intrahepatic bile ducts, upper pancreatic edge, and Vater papilla. Logistic regression was performed to evaluate the diagnostic performance of BDA and other clinical factors for differential diagnosis. Results During the study period, 22 PHCs and 31 BDCs were resected. The combination of BDA ≤ 130°, main pancreatic duct diameter ≥ 4.3 mm, and absence of jaundice predicted PHC rather than BDC with an area under the curve of the receiver-operator characteristics curve of .856 (95% confidence interval, .766-.947). Conclusion Clinical findings of larger bile duct axis deviation, main pancreatic duct dilation, and the absence of jaundice may be useful for distinguishing PHC from BDC.
Impact of COVID-19 Outbreak on the Emergency Presentation of Acute Appendicitis
Authors: Kumaira Fonseca Mariana , Trindade Eduardo N. , Costa Filho Omero P. , Nácul Miguel P. , Seabra Artur P. 
Published: November 2020

Background The global crisis resulting from the coronavirus pandemic has imposed a large burden on health systems worldwide. Nonetheless, acute abdominal surgical emergencies are major causes for nontrauma-related hospital admissions and their incidences were expected to remain unchanged. Surprisingly, a significant decrease in volume and a higher proportion of complicated cases are being observed worldwide. Methods The present study assesses the local impact of the coronavirus pandemic on the emergency presentation of acute appendicitis in a Brazilian hospital. A retrospective analysis was conducted on patients undergoing emergency surgery for the clinically suspected diagnosis of acute appendicitis during the 2-month period of March and April 2020 and the same time interval in the previous year. Data on demographics, timing of symptom onset and hospital presentation, intraoperative details, postoperative complications, hospital length of stay, and histological examination of the specimen were retrieved from individual registries. Results The number of appendectomies during the pandemic was 36, which represents a 56% reduction compared to the 82 patients operated during the same period in 2019. The average time of symptom onset to hospital arrival was significantly higher in 2020 (40.6 vs. 28.2 hours, P = .02). The classification of appendicitis revealed a significant higher proportion of complicated cases than the previous year (33.3% vs. 15.2%, P = .04). The rate of postoperative complications and the average length of stay were not statistically different between the groups. Conclusion Further assessment of patients’ concerns and systematic monitoring of emergency presentations are expected to help us understand and adequately address this issue.
Cartilage Sparing Septal Perforation Repair using Rotation Flaps and a Collagen Interposition Graft: A Case Series
Authors: Hunter Benjamin G. 
Published: November 2020

Objective: Septal Perforations may be asymptomatic or can cause significant problems including nasal obstruction, crusting, bleeding, whistling and in severe cases a change in nasal shape and even pain. Method: The author would like to present a single surgeon case series of septal perforation repairs, managed using an endo-nasal technique, with no external scars. There were 54 consecutive cases between 2011 and 2017. The repair was carried out using mucosal rotation flaps with an interposition graft of porcine collagen matrix. Patients were grouped according to the size of the perforation as measured at the time of the surgery. The patients were then clinically followed up for 1 year, and the recorded outcome measures were: the success of the surgical repair and the patient reported symptoms. Results: Surgical success was 70% up to 1 cm diameter, 77% from 1 to 2 cm and 82% in perforations from 2 to 3 cm in diameter. No perforation over 3 cm in diameter was successfully closed. Patients were rendered asymptomatic even if the perforation was not closed in between 81% and 91% of patients up to perforations 3 cm in size. Over 3 cm in size 50% of patients reported being asymptomatic. Conclusions: This technique is an effective and low morbidity option for patients with small to medium sized septal perforations. For perforations over 3 cm in diameter other options may be more suitable.
Combination Surgical Procedure for Fourth Branchial Anomalies: Operative Technique and Outcomes
Authors: Maksimoski Matthew , Maurrasse Sarah E. , Purkey Matthew , Maddalozzo John 
Published: November 2020

Objective: Branchial apparatus anomalies of the fourth cleft are the rarest subtype of anomaly and occasionally present with suppurative thyroiditis or thyroid abscess due to their relationship with the thyroid gland. Surgical approaches vary and some surgeons favor cauterization of associated pyriform sinus tracts alone versus complete surgical excision. Currently, the literature is scarce and there is limited data on surgical outcomes and procedural steps. Here we describe a combination surgical technique for fourth branchial anomalies including: (1) surgical excision of the cyst and any external pit, (2) hemithyroidectomy, and (3) direct laryngoscopy with cauterization of pyriform apex tract, if present. Methods: A retrospective review was performed on all patients who underwent surgical excision of fourth branchial apparatus lesions (including fistulae, cysts, and sinus tracts) at an urban pediatric university hospital from 2000 to 2019. Data regarding demographics, medical history, surgical methods, complications, and surgical cure rates were collected. Results: A total of 16 patients (9 female, 7 male) underwent a combination surgical procedure for fourth branchial apparatus lesions. Success rate after primary surgery was 94%. One patient had residual disease requiring re-operation. Two patients had post-operative complications: 1 transient vocal fold paresis and 1 seroma, both managed conservatively. A consensus surgical algorithm was created based on operative steps present in the majority of cases. Conclusion: A combination approach to fourth branchial apparatus lesions—including endoscopic cauterization, external excision, and hemithyroidectomy—is safe and provides a high rate of primary cure. Although less invasive options exist, remnants of the branchial lesion, especially in the thyroid, may remain and cause recurrent issues. Therefore, we advocate for complete surgical excision of this rare developmental anomaly, especially when obvious thyroid involvement exists.
The association between Twitter content and suicide
Authors: Sinyor Mark , Williams Marissa , Zaheer Rabia , Loureiro Raisa , Pirkis Jane , Heisel Marnin J , Schaffer Ayal , Redelmeier Donald A , Cheung Amy H , Niederkrotenthaler Thomas 
Published: November 2020

Objective: A growing body of research has established that specific elements of suicide-related news reporting can be associated with increased or decreased subsequent suicide rates. This has not been systematically investigated for social media. The aim of this study was to identify associations between specific social media content and suicide deaths. Methods: Suicide-related tweets ( n = 787) geolocated to Toronto, Canada and originating from the highest level influencers over a 1-year period (July 2015 to June 2016) were coded for general, putatively harmful and putatively protective content. Multivariable logistic regression was used to examine whether tweet characteristics were associated with increases or decreases in suicide deaths in Toronto in the 7 days after posting, compared with a 7-day control window. Results: Elements independently associated with increased subsequent suicide counts were tweets about the suicide of a local newspaper reporter (OR = 5.27, 95% CI = [1.27, 21.99]), ‘other’ social causes of suicide (e.g. cultural, relational, legal problems; OR = 2.39, 95% CI = [1.17, 4.86]), advocacy efforts (OR = 2.34, 95% CI = [1.48, 3.70]) and suicide death (OR = 1.52, 95% CI = [1.07, 2.15]). Elements most strongly independently associated with decreased subsequent suicides were tweets about murder suicides (OR = 0.02, 95% CI = [0.002, 0.17]) and suicide in first responders (OR = 0.17, 95% CI = [0.05, 0.52]). Conclusions: These findings largely comport with the theory of suicide contagion and associations observed with traditional news media. They specifically suggest that tweets describing suicide deaths and/or sensationalized news stories may be harmful while those that present suicide as undesirable, tragic and/or preventable may be helpful. These results suggest that social media is both an important exposure and potential avenue for intervention.
The effect of concomitant benzodiazepine use on neurocognition in stable, long-term patients with bipolar disorder
Authors: Cañada Yolanda , Sabater Ana , Sierra Pilar , Balanzá-Martínez Vicent , Berk Michael , Dodd Seetal , Navalón Pablo , Livianos Lorenzo , García-Blanco Ana 
Published: November 2020

Objective: Neurocognitive dysfunction is a common feature of bipolar disorder even in euthymia, and psychopharmacological treatment could have an effect on cognition. Long-term prescription of benzodiazepines in bipolar disorder is a common practice, and their effect on neurocognition has not been well studied in this population. The aim of this study was to evaluate the impact of concomitant benzodiazepine long-term use on neurocognitive function in stable euthymic bipolar disorder patients. Methods: Seventy-three euthymic bipolar disorder outpatients and 40 healthy individuals were assessed using a neurocognitive battery. Patients were classified in two groups according to the presence of benzodiazepines in their treatment: the benzodiazepine group ( n = 34) and the non- benzodiazepine group ( n = 39). Neurocognitive performance was compared between the groups using a multivariate analysis of covariance, considering age, number of depressive episodes, adjuvant antipsychotic drugs, Young Mania Rating Scale score and Hamilton Depression Rating Scale score as covariates. Results: Both bipolar disorder groups (benzodiazepine and non-benzodiazepine) showed an impairment in memory domains (Immediate Visual Memory [ p = 0.013], Working Memory [ p < 0.001], and Letter-Number Sequence [ p < 0.001] from the Wechsler Memory Scale-Revised-III) and slower processing speed functions (Stroop Colour [ p < 0.001]) relative to the control group. Nevertheless, the benzodiazepine group showed a greater impairment in executive functions (Conceptual Level Responses [ p = 0.024] from the Wisconsin Card Sorting Test and Frontal Assessment Battery [ p = 0.042]). Conclusion: Although memory and processing speed impairments were found in bipolar disorder, regardless of their benzodiazepine treatment, benzodiazepine users presented additional neurocognitive impairments in terms of executive functioning. These findings support restricted prescription of benzodiazepines in individuals with bipolar disorder.
Emotions and professional reflections in a post-war community: Teachers’ perspectives from Kosovo
Authors: Berisha Kida Edona , Butler Cathal 
Published: November 2020

Background: Teaching is more complex than dealing with the cognitive aspects of learning alone and is also influenced by affective states. Because of this, more research is needed into the role of teachers’ emotions in classroom interaction. Of special importance is research into reflective thinking and the extent to which it may be disturbed by the prior experience of trauma. Purpose: This study aimed to shed light on these issues by analysing reports of Kosovan teachers’ emotional arousal when speaking about and/or teaching topics related to war experiences, their beliefs about these experiences, their opinions about students’ reactions and their reports on professional reflective practices. Methods: Descriptive study. Data were collected by means of a structured questionnaire completed by 70 teachers. Results: Teachers reported strong emotions were triggered by discussion of topics linked to the war. Their beliefs influenced how they engaged with sensitive and emotionally charged topics, but they interpreted their professional behaviour using reflective and critical thinking. Conclusion: Both external and internal factors affect post-war teachers cognitively and emotionally. Further research is needed to identify the extent to which this impacts teachers’ ability to use critical reflection and critical emotional reflexivity in school-based practice.