bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cardiac surgeons between apprehension and ethical duty in the COVID-19 pandemic
Authors: Bakry Ahmed MA , Sobhy Ehab , Abdelmohty Hysam 
Published: July 2020

Background Cardiothoracic surgeons are facing a big challenge in their surgical practice in the era of the COVID-19 pandemic. The attitude towards performing surgery is influenced by the pandemic. Setting special recommendations for safe cardiothoracic surgery is of extreme importance. Methods This was an observational cross-sectional survey that included 77 Egyptian cardiothoracic surgeons. The survey consisted of a self-administered constructed questionnaire with six sections, and was delivered as a Google Forms questionnaire ( https://www.google.com/forms/about ) that was sent to individuals via social networks and email. Results More than 80% of Egyptian cardiothoracic surgeons believe they and their patients are at risk. Out of all participants, none had actually been infected with COVID-19 but 26% had encountered a positive COVID-19 person in their surgical team. Although 51% were testing patients before surgery, they reported 9 confirmed cases postoperatively. Computed tomography was the most recommended investigation prior to surgery (by 69%). Most had postponed elective surgeries and only one-third of all surgeons recommended performing elective surgeries cautiously with pretesting for COVID-19 and maximizing protective measures, while more than 40% recommended not performing high-risk elective surgeries. Conclusion We are committed to the safety of our patients, ourselves, our staff, and our families. Planning for the new phase of reopening, whether total reopening or step-by-step reopening, should carefully consider how we should utilize our resources, respect social distancing, and prevent exposure to untested patients or health workers who might turn out to be an undetected positive case.
A Cross-sectional Study of Psychiatric Comorbidity and Severity of Addiction in Patients with Early- and Late-Onset Alcohol Dependence
Authors: Das Anamika , Kar Sujita Kumar , Gupta Pawan Kumar , Dalal Pronob Kumar 
Published: July 2020

Background: Alcohol use disorder is a serious health problem with high comorbidities. Early-onset alcohol use has been associated with greater impulsivity, increased severity of dependence, frequent alcohol withdrawal complications, externalizing symptoms, and antisocial behaviors. We aimed to evaluate the psychiatric comorbidities and severity of addiction in early- and late-onset alcohol dependence. Methods: This was a cross-sectional study. All patients fulfilling the diagnostic criteria of alcohol dependence as per International Classification of Diseases (10th edition) were included in it. Semi-Structured Assessment for Genetics of Alcoholism IV was applied to find the age of onset of dependence as per the lifetime frame and also to find comorbidities. Composite International Diagnostic Interview 3.0. was used to find other comorbidities. The severity of addiction was evaluated with Addiction Severity Index, 5th edition. All the sociodemographic and clinical parameters were compared between patients with the early- and late-onset alcohol dependence. Results: Out of the 112 patients screened, 57 met the selection criteria, 26 were with early-onset and 31 with late-onset alcohol dependence. The patients were all males. The patients with early-onset alcohol dependence had a higher family history (P = 0.006) and were nonearning (P = 0.002) in comparison to the group with late-onset dependence. The comorbidity among all patients was 59.6% and 84.2% in current and lifetime frames, respectively. It was significantly higher in the early-onset group, both for current (P = 0.015) and lifetime (P = 0.031) frames. On the domains of Addiction Severity Index 5th edition, the early-onset group had a more severe profile of addiction in all domains except the medical domain. Conclusion: Comorbidity is high among patients with alcohol dependence and is even higher for the early-onset group. The family history was higher in the early-onset group and they have more severe profile of substance use.
Can Cancer Diagnosis Help in Quitting Tobacco? Barriers and Enablers to Tobacco Cessation Among Head and Neck Cancer Patients from a Tertiary Cancer Center in South india
Authors: Mathew Bincy , Vidhubala E. , Krishnamurthy Arvind , Sundaramoorthy C. 
Published: July 2020

Background: Tobacco use contributes to almost 40% of the cancers in India. Considering the potential threat, many preventive measures have been instigated in the country. However, tobacco cessation for hospitalized cancer patients is an unexplored territory in India. This study aims to understand the quit status and to explore the reasons to quit or continue the use of tobacco after the diagnosis of head and neck cancer (HNC). Methods: HNC patients admitted between February and April 2016 were assessed for their tobacco use status. A DT was used to assess the psychological distress. Users were assessed for their readiness to quit and dependence on tobacco. An in-depth interview was conducted among 25 patients (seven current users and 18 recent quitters), and themes that emerged were discussed. Results: Of the 119 HNC patients, 71 were tobacco users and 48 had quit tobacco after the diagnosis. The reasons to quit were the perceived benefits of quitting, advice from the physicians, and awareness about cancer and its association with tobacco. In contrast, the reasons to continue the use of tobacco were attributed to coping mechanisms, nihilistic perception about the outcome of the cancer, and a lack of understanding about cancer and its association with tobacco. Conclusion: The recent quitters comprehended the benefits of quitting and were able to prioritize their needs after the diagnosis. However, one-third of the HNC patients continued to use tobacco even after the diagnosis of cancer. Hence, tobacco cessation services need to be integrated into oncology services for achieving better treatment outcomes.
A Behavioural-economic Perspective on Conflicts of Interest Among Shareholders, Debtholders, and Directors
Authors: Asaoka Daisuke 
Published: July 2020

Corporations have conflicts of interest among shareholders, debtholders and directors, and, corporate law gives each party avenues to pursue others, while protecting themselves. While debtholders are exposed to excessive risk-taking by directors and abuse of limited liability by shareholders, they are protected by legal institutions like directors’ liabilities to third parties and piercing of the corporate veil. Shareholders are subject to the risk of veil-piercing and director negligence, but they are protected by derivative suits. And directors, while under threat of liability suits by debtholders and shareholders, are protected by the business judgement rule, liability exemption and liability insurance of directors and officers (D&O). This web of legal institutions comprises a dual structure of economic and psychological factors, built upon economic incentives but also upon such psychological factors as bounded rationality, the chilling effect, the desire for certainty, loss aversion and the sense of fairness. Any change in the balance will affect their behaviour; greater protection of directors, for example, provokes greater risk-taking, both economically and psychologically. JEL: K22, G41, D91
Radiofrequency ablation versus traditional liver resection and chemotherapy for liver metastases from gastric cancer
Authors: Tang Kezhong , Zhang Bo , Dong Linping , Wang Lantian , Tang Zhe 
Published: July 2020

Objective To compare the short- and long-term outcomes of radiofrequency ablation (RFA) versus liver resection and chemotherapy for liver metastases from gastric cancer. Methods We retrospectively evaluated 50 patients who underwent curative gastrectomy and local treatments for liver metastases (RFA, n = 20; liver resection, n = 20; and chemotherapy, n = 10) from 2008 to 2018. Results The short- and long-term outcomes of each local treatment were evaluated. The median overall survival (OS) after RFA was similar to that after liver resection (20 vs. 20 months, respectively) and longer than that after chemotherapy (20 vs. 10 months, respectively). The 3-year OS and progression-free survival (PFS) rates after RFA were 20% and 10%, respectively, while those in the liver resection group were 23.5% and 23.5%, respectively. The 3-year OS rate after chemotherapy was 10%. The size and number of metastases were prognostic factors for patients with gastric cancer with liver metastasis without statistical significance. Conclusions Among patients with liver metastasis from gastric cancer, OS and PFS were satisfactory and comparable between RFA and liver resection but better than those of chemotherapy. RFA is an appropriate option for patients with gastric cancer who have a solitary liver metastasis measuring ≤3.0 cm.
A Pragmatic Study of the Impact of a Brief Mindfulness Intervention on Prisoners and Staff in a Category B Prison and Men Subject to Community-Based Probation Supervision
Authors: Davies Jason , Ugwudike Pamela , Young Hayley , Hurrell Chloe , Raynor Peter 
Published: July 2020

Objectives: This article presents two studies assessing the impact of mindfulness in prison (prisoners and staff) and non-custodial settings. Method: Study 1—prisoners ( n = 17) and staff ( n = 15) in a UK prison completed a mindfulness program; 16 individuals acted as a single time point comparison. Data were collected using self-report, computer based and physiological measurement. Study 2—men under community probation supervision were allocated to mindfulness (completed, n = 28) or TAU ( n = 27). Data were collected using self-report mindfulness measures. Results: Study 1—statistically significant (increases in mindfulness skills (η2 p = .234 to η2 p = .388), cognitive control (η2 p = .28), and heart rate variability (SDNN; η2 p = .41) along with significant decreases in stress (η2 p = .398) were found. In study 2, the mindfulness group showed non-significant improvements in mindfulness skills. Conclusion: The findings suggest brief mindfulness interventions could make an important contribution to offender rehabilitation and custodial staff wellbeing.
Occupational Therapy for South Asian Older Adults in the United Kingdom: Cross-Cultural Issues
Authors: Yam Nichole , Murphy Angela , Thew Miranda 
Published: July 2020

Introduction There is limited understanding of the cultural needs of diverse Black and Minority Ethnic populations such as South Asian older adults, which may be perpetuating occupational injustices and health inequalities faced by these groups. Although cultural considerations are intrinsic to person-centred occupational therapy and increasingly relevant to the changing landscape of health and social care, the profession is criticised for its western-centric focus. This study aimed to gain understanding of the current cross-cultural issues in supporting South Asian older adults in the UK, as perceived by occupational therapists. Method A constructivist qualitative design supported by thematic analysis was used, involving seven occupational therapists in the United Kingdom who participated in semi-structured interviews via Skype/telephone. Findings Cross-cultural issues were illustrated through the following themes: ‘when the barriers go down’ – cultural mismatch in individualist vs. collectivist worldviews; ‘invasion of the family home’ – cultural inappropriateness of standard interventions; and ‘I go into every assessment assuming nothing’ – recognition of and response to challenges. Conclusion This study provides insight into cross-cultural issues in occupational therapy for South Asian older adults, revealing a gap between theory and practice in integrating cultural humility. It highlights the need for a more inclusive, person-centred approach to support culturally diverse populations.
Effect of Novel Anteromedial Approach on Wound Complications Following Ankle Arthroplasty
Authors: Halai Mansur M. , Pinsker Ellie , Daniels Timothy R. 
Published: July 2020

Background: The purpose of this study was to evaluate all wound complications following total ankle arthroplasty (TAA) before and after the implementation of a novel extensile anteromedial surgical approach. We further investigated patients and operative factors associated with wound complications. Methods: A series of 660 TAAs were collected. The median follow-up was 84 months (range, 12-204 months). Minor wound complications included discoloration, swelling, or clinical concern that merited bringing the patient back sooner for review. Major wound complications included plastic surgical consultation, debridement by the nurse specialist, negative pressure therapy, or reoperation. All major complications initially had a course of empirical oral antibiotics. Since 2011, higher-risk patients have had their TAA performed through an extensile anteromedial approach. Results: Fifty-six patients (8.5%) had wound healing issues (17 major [2.6%], 39 minor [5.9%]). All issues became evident <21 days postoperatively. Inflammatory arthritis, smoking, and coronary disease were patient factors associated with major wound complications. Four patients were treated with negative pressure therapy, 4 with debridement in the operating room, and 2 eventually converted to fusions. Fourteen patients (82%) who had major complications had an ancillary procedure to balance the TAA through a separate incision. All major wound complications had an anterior surgical approach for their TAA. Before 2011, there were 13 major wound complications. Since 2012, there have been 4 major wound complications overall, with no wound complications in the anteromedial approach cohort. Conclusion: We recommend an extensile anteromedial approach for smokers and patients with heart disease or inflammatory arthritis undergoing TAA. If a wound complication developed, a multidisciplinary team to evaluate wounds was useful. Level of Evidence: Level III, retrospective comparative series.
Real-world data on patients with metastatic non-small-cell lung cancer treated with checkpoint inhibitors in an Italian Teaching Hospital in 2015–2018
Authors: Veraldi Marianna , Esposito Stefania , Naturale Maria D. , Oradei Marco , Cosco Donato , Francesco Adele E. De , Cicchetti Americo , Bidino Rossella Di 
Published: July 2020

Background Non-small-cell lung carcinoma (NSCLC) accounts for 85–90% of all forms of lung cancer. Immuno-oncology represents a valid new approach but the high cost requires a specific evaluation of the health outcomes. This study describes the real-world efficacy, safety and cost profiles of the new anti-PD-1 immune-checkpoint inhibitors nivolumab and pembrolizumab on a cohort of 56 selected patients with advanced NSCLC. Methods A retrospective, observational analysis was conducted on patients treated with immune checkpoint inhibitors from September 2015 to September 2018 at Azienda Ospedaliera Universitaria “Mater Domini” in Catanzaro, Italy. Data sources were medical records, internal prescription cards and reports of adverse reactions. Results Fifty-six patients were diagnosed with advanced NSCLC, 64.3% characterized by a non-squamous histology, 30.3% squamous and 5.4% not specified. First-line treatment with pembrolizumab was administered to 11 patients for an average of 4.4 months, while 45 patients were treated with nivolumab for an average of 8.6 months. Data showed a survival rate of 95% after 6 months and 88% after 12 months. Most patients received immunotherapy as a second-line or subsequent treatment. In terms of prior therapy among all the patients, 43 had received platinum-based treatments. Indirect comparison with other real-world data studies showed variability in methodologies and an alignment in terms of results. Conclusion This study, based on real-world data, was a first step in the assessment of the impact of the introduction of a significant new class of treatments, i.e. immunotherapy, and covers patients, treatments and outcomes, as well as organizational and economic variables.
Aflatoxin B1-Induced COX-2 Expression Promotes Mitophagy and Contributes to Lipid Accumulation in Hepatocytes In Vitro and In Vivo
Authors: Ren Xin-Lu , Han Peiyu , Meng Yiteng 
Published: July 2020

Aim: Aflatoxin B1 (AFB1) is hepatotoxic. Numerous studies have shown that mitochondria play an essential role in AFB1-induced steatosis. However, the mechanisms of AFB1-induced steatosis via mitochondria are still obscure. The present study aimed to confirm that AFB1 causes hepatocyte steatosis regulated by cyclooxygenase-2 (COX-2)-induced mitophagy, both in vivo and in vitro. Methods: Adult male C57BL/6 mice were randomly divided into control group with the same volume of peanut oil and exposure group administered 0.6 mg/kg AFB1 once in 2 days for 1 month. HepG2 and Cas9-PTGS2 cells were treated with 5 μM AFB1 for 48 hours. Then, various indicators were evaluated. Results: Aflatoxin B1 causes liver injury and steatosis with increased alanine aminotransferase, aspartate aminotransferase, total cholesterol, total triglyceride levels in vivo and in vitro, and elevated lipid droplets in HepG2 cells. Cyclooxygenase-2 and mitophagy pathway were induced by AFB1 in both liver tissues and cultured HepG2 cells. Further studies have shown that knockout of COX-2 with the CRISPR/Cas9 system inhibited the AFB1-induced mitophagy and steatosis in HepG2 cells. Also, the inhibition of PTEN-induced putative kinase with RNA interference attenuated the AFB1-induced steatosis. Conclusions: The results of the current study suggested that AFB1 increases the expression of COX-2, which, in turn, elevates the level of mitophagy, thereby disrupting the normal mitochondrial lipid metabolism and causing steatosis. Thus, this study implies that COX-2 may be a potential target for therapy against AFB1-induced steatosis.
Pilot study assessing the use of cabergoline for the treatment of cats with hypersomatotropism and diabetes mellitus
Authors: Scudder Christopher J , Hazuchova Katarina , Gostelow Ruth , Church David B , Forcada Yaiza , Fowkes Robert C , Niessen Stijn JM 
Published: July 2020

Objectives An affordable and effective treatment is needed to manage feline hypersomatotropism. The aim of this study was to assess whether treatment with oral cabergoline for 90 days in cats with hypersomatotropism and diabetes mellitus improved diabetic and insulin-like growth factor 1 (IGF-1) control. Methods This was a prospective cohort non-blinded pilot study enrolling client-owned cats with spontaneously occurring diabetes mellitus and hypersomatotropism. Cats received oral cabergoline (5–10 µg/kg q24h) for 90 consecutive days. Serum IGF-1 and fructosamine concentrations were measured on days 1, 30 and 90. Quality of life was determined using the DIAQoL-pet questionnaire on days 1 and 90. Results Nine cats were enrolled and eight completed the study. There was no significant change in the following: IGF-1 (day 1 median 2001 ng/ml [range 890–2001 ng/ml]; day 30 median 2001 ng/ml [range 929–2001 ng/ml]; day 90 median 1828 ng/ml [range 1035–2001 ng/ml]; χ2(2) = 0.667, P = 0.805); fructosamine (day 1 median 499 µmol/l [range 330–887 µmol/l], day 30 median 551 µmol/l [range 288–722 µmol/l], day 90 median 503 [range 315–851 µmol/l]; χ2(2) = 0.581, P = 0.764); or DIAQoL-pet score (median on day 1 –2.79 [range –4.62 to –0.28], median on day 90 –3.24 [range –4.41 to –0.28]; P = 0.715). There was a significant change of insulin dose (χ2(2) = 8.667, P = 0.008) with cats receiving higher insulin doses at day 90 compared with day 1 (median on day 1 was 0.98 [range 0.63–1.49] and median on day 90 was 1.56 [range 0.49–2.55] units/kg q12h; P = 0.026). Conclusions and relevance Cabergoline did not improve diabetic control or normalise insulin-like growth factor concentration, or improve patient quality of life.
Brain-derived neurotrophic factor in non-proliferative diabetic retinopathy with diabetic macular edema
Authors: Jun Yong Hyun , Kim Seong Taeck 
Published: July 2020

Purpose: To investigate aqueous humor (AH) and serum levels of brain-derived neurotrophic factor (BDNF) in non-proliferative diabetic retinopathy (NPDR) patients with diabetic macular edema (DME). Methods: The prospective study consists of 20 patients with DME NPDR, 20 patients with no-DME NPDR, and 20 healthy control subjects. Serum and AH samples were obtained during cataract surgery and intravitreal injection. Serum and AH levels of BDNF were measured by enzyme-linked immunosorbent assay. Results: The mean serum levels of BDNF were lower in both NPDR groups compared to the control group (DME NPDR group, p = 0.015; no-DME NPDR group, p = 0.024). Furthermore, the mean serum level of BDNF was lower in the DME NPDR group compared to the no-DME NPDR group ( p = 0.041). The mean AH levels of BDNF were significantly reduced in both NPDR groups compared to the control group (DME NPDR group, p < 0.001; no-DME NPDR group, p = 0.006). Further, the mean AH level of BDNF was significantly lower in the DME NPDR group compared to the no-DME NPDR group ( p = 0.037). Conclusion: Serum and AH levels of BDNF were reduced in NPDR patients with DME than without DME.
Corneal collagen cross-linking for management of keratoconus in patients affected by Tourette syndrome
Authors: Knutsson Karl Anders , Paganoni Giorgio , Ambrosio Oriella , Ferrari Giulio , Rama Paolo 
Published: July 2020

Purpose: To present a series of two patients affected by Tourette syndrome (TS) and progressive keratoconus. Case series: Two young male patients with keratoconus and TS were referred to our center. In both patients eye rubbing was present and in one patient, an ocular tic was present determining blepharospasm. Progression of keratoconus occurred in both cases and corneal collagen cross-linking (CXL) was performed. All treated eyes showed topographic stability with stable refraction and conserved visual acuity, with a follow-up period ranging from 1.5 to 2.5 years. Conclusion: Patients with keratoconus and TS should be observed frequently to document topographical and refractive changes, and in case of progressing disease, CXL should be performed in order to prevent further progression.
High myopia is protective against diabetic retinopathy via thinning retinal vein: A report from Fushun Diabetic Retinopathy Cohort Study (FS-DIRECT)
Authors: Lin Zhong , Li Dong , Zhai Gang , Wang Yu , Wen Liang , Ding Xiao Xia , Wang Feng Hua , Dou Yu , Xie Cong , Liang Yuan Bo 
Published: July 2020

Purpose: To investigate the association between high myopia and diabetic retinopathy, and its possible mechanism, in a northeastern Chinese population with type 2 diabetic mellitus. Methods: Patients were included from Fushun Diabetic Retinopathy Cohort Study. High myopia was defined as spherical equivalent of autorefraction less than −5D. Results: A total of 1817 patients [688 (37.9%) diabetic retinopathy, 102 (5.6%) high myopia] were included. Compared to eyes without high myopia, the frequency of diabetic retinopathy and non-proliferative diabetic retinopathy was significantly less in eyes with high myopia (23.5% vs 38.7%, p = 0.002; 22.5% vs 35.3%, p = 0.005). Eyes with high myopia were less likely to have diabetic retinopathy (multivariate odds ratio, 95% confidence interval: 0.39, 0.22–0.68) or non-proliferative diabetic retinopathy (odds ratio, 95% confidence interval: 0.40, 0.23–0.70). High myopia was negatively associated with central retinal venular equivalent (multivariate β, 95% confidence interval: −37.1, −42.3 to −31.8, p < 0.001). Furthermore, central retinal venular equivalent (per 10 μm increase) had a significant association with diabetic retinopathy (odds ratio, 95% confidence interval: 1.24, 1.17–1.31) as well as non-proliferative diabetic retinopathy (odds ratio, 95% confidence interval: 1.24, 1.18–1.31). Conclusions: High myopia was negatively associated with both diabetic retinopathy and non-proliferative diabetic retinopathy in this northeastern Chinese population. This protective effect may have been partially achieved via thinning retinal veins.