bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors associated with social isolation and being homebound among older patients with diabetes: a cross-sectional study
Authors: Ida Satoshi , Kaneko Ryutaro , Imataka Kanako , Okubo Kaoru , Shirakura Yoshitaka , Azuma Kentaro , Fujiwara Ryoko , Takahashi Hiroka , Murata Kazuya 
Published: November 2020

ObjectiveWe aimed at investigating factors associated with social isolation and being homebound in older patients with diabetes.DesignCross-sectional study.SettingsThose undergoing outpatient treatments at Ise Red Cross Hospital, Mie Prefecture.ParticipantsPatients with diabetes aged ≥65 years.Primary and secondary outcome measuresSocial isolation was defined as indulging in less than one interaction per week with individuals other than cohabiting family members. We defined homebound as going outside home less than once a day. To identify factors associated with social isolation and being homebound, we performed logistic regression analysis. The dependent variable was social isolation or homebound and independent variables were basic attributes, glycaemic parameters, complications and treatment details.ResultsWe analysed 558 cases (320 men and 238 women). Among these, 174 (31.2%) were socially isolated; meanwhile, 87 (15.6%) were homebound. The glycoalbumin/haemoglobin A1c ratio (OR 4.52; 95% CI 1.07 to 19.1; p=0.040) and the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC) scores (OR 0.72; 95% CI 0.57 to 0.90; p=0.006) had significant associations with social isolation. TMIG-IC scores (OR 0.78; 95% CI 0.66 to 0.92; p=0.003) and insulin use (OR 4.29; 95% CI 1.14 to 16.1; p=0.031) were associated with being homebound.ConclusionIn older patients with diabetes, glycaemic fluctuations and insulin use are associated with social isolation and being homebound, respectively. In addition, a decline in higher level functional capacity is a common factor associated with social isolation and being homebound. Thus, it is important to pay attention to social isolation and being homebound when a decline in higher level functional capacity, increased glycaemic fluctuations and insulin use in older patients with diabetes are observed.
Patient needs and priorities for patient navigator programmes in chronic kidney disease: a workshop report
Authors: Guha Chandana , Lopez-Vargas P , Ju Angela , Gutman Talia , Scholes-Robertson Nicole Jane , Baumgart Amanda , Wong Germaine , Craig Jonathan , Usherwood Tim , Reid Sharon , Cullen Vanessa , Howell Martin , Khalid Rabia , Teixeira-Pinto Armando , Wyburn Kate , Sen Shaundeep , Smolonogov Tanya , Lee Vincent W , Rangan Gopala K , Matus Gonzales Andrea , Tong Allison 
Published: November 2020

Background and objectivePatients with early chronic kidney disease (CKD) face challenges in accessing healthcare, including delays in diagnosis, fragmented speciality care and lack of tailored education and psychosocial support. Patient navigator programmes have the potential to improve the process of care and outcomes. The objective of this study is to describe the experiences of patients on communication, access of care and self-management and their perspectives on patient navigator programmes in early CKD.Design, setting and participantsWe convened a workshop in Australia with 19 patients with CKD (all stages including CKD Stage 1 to 5 not on dialysis, 5D (dialysis), and 5T (transplant)) and five caregivers. All of them were over 18 years and English-speaking. Transcripts from the workshop were analysed thematically.ResultsFour themes that captured discussions were: lost in the ambiguity of symptoms and management, battling roadblocks while accessing care, emotionally isolated after diagnosis and re-establishing lifestyle and forward planning. Five themes that focussed on patient navigator programmes were: trust and credibility, respecting patient choices and readiness to accept the programme, using accessible language to promote the programme, offering multiple ways to engage and communicate and maintaining confidentiality and privacy. Of the 17 features identified as important for a patient navigator programme, the top five were delivery of education, psychosocial support, lifestyle modification, communication and decision-making support and facilitating care.ConclusionPatient navigator services can address gaps in services around health literacy, communication, psychosocial support and coordination across multiple healthcare settings. In comparison to the existing navigator programmes, and other services that are aimed at addressing these gaps, credible, accessible and flexible patient navigator programmes for patients with early CKD, that support education, decision-making, access to care and self-management designed in partnership with patients, may be more acceptable to patients.
Associations between vision impairment and driving and the effectiveness of vision-related interventions: protocol for a systematic review and meta-analysis
Authors: Nguyen Helen , Di Tanna Gian Luca , Coxon Kristy , Brown Julie , Ren Kerrie , Ramke Jacqueline , Burton Matthew J , Gordon Iris , Zhang Justine H , Furtado João M , Mdala Shaffi , Kitema Gatera Fiston , Keay Lisa 
Published: November 2020

IntroductionDriving is one of the main modes of transport with safe driving requiring a combination of visual, cognitive and physical skills. With population ageing, the number of people living with vision impairment is set to increase in the decades ahead. Vision impairment may negatively impact an individual’s ability to safely drive. The association between vision impairment and motor vehicle crash involvement or driving participation has yet to be systematically investigated. Further, the evidence for the effectiveness of vision-related interventions aimed at decreasing crashes and driving errors has not been synthesised.Methods and analysisA search will be conducted for relevant studies on Medline (Ovid), EMBASE and Global Health from their inception to March 2020 without date or geographical restrictions. Two investigators will independently screen abstracts and full texts using Covidence software with conflicts resolved by a third investigator. Data extraction will be conducted on all included studies, and their quality assessed to determine the risk of bias using the Joanna Briggs Institute Critical Appraisal Tools. Outcome measures include crash risk, driving cessation and surrogate measures of driving safety (eg, driving errors and performance). The results of this review will be reported using the Preferred Reporting Items for Systematic Review and Meta-Analysis guideline. Meta-analysis will be undertaken for outcomes with sufficient data and reported following the Meta-analyses of Observational Studies in Epidemiology guideline. Where statistical pooling is not feasible or appropriate, narrative summaries will be presented following the Synthesis Without Meta-analysis in systematic reviews guideline.Ethics and disseminationThis review will only report on published data thus no ethics approval is required. Results will be included in the Lancet Global Health Commission on Global Eye Health, published in a peer-reviewed journal and presented at relevant conferences.PROSPERO registration numberCRD42020172153.
Nicotinamide combined with gemcitabine is an immunomodulatory therapy that restrains pancreatic cancer in mice
Authors: Selvanesan Benson Chellakkan , Meena Kiran , Beck Amanda , Meheus Lydie , Lara Olaya , Rooman Ilse , Gravekamp Claudia 
Published: November 2020

BackgroundTreatments for pancreatic ductal adenocarcinoma are poorly effective, at least partly due to the tumor’s immune-suppressive stromal compartment. New evidence of positive effects on immune responses in the tumor microenvironment (TME), compelled us to test the combination of gemcitabine (GEM), a standard chemotherapeutic for pancreatic cancer, with nicotinamide (NAM), the amide form of niacin (vitamin B3), in mice with pancreatic cancer.MethodsVarious mouse tumor models of pancreatic cancer, that is, orthotopic Panc-02 and KPC (KrasG12D, p53R172H, Pdx1-Cre) grafts, were treated alternately with NAM and GEM for 2 weeks, and the effects on efficacy, survival, stromal architecture and tumor-infiltrating immune cells was examined by immunohistochemistry (IHC), flow cytometry, Enzyme-linked immunospot (ELISPOT), T cell depletions in vivo, Nanostring analysis and RNAscope.ResultsA significant reduction in tumor weight and number of metastases was found, as well as a significant improved survival of the NAM+GEM group compared with all control groups. IHC and flow cytometry showed a significant decrease in tumor-associated macrophages and myeloid-derived suppressor cells in the tumors of NAM+GEM-treated mice. This correlated with a significant increase in the number of CD4 and CD8 T cells of NAM+GEM-treated tumors, and CD4 and CD8 T cell responses to tumor-associated antigen survivin, most likely through epitope spreading. In vivo depletions of T cells demonstrated the involvement of CD4 T cells in the eradication of the tumor by NAM+GEM treatment. In addition, remodeling of the tumor stroma was observed with decreased collagen I and lower expression of hyaluronic acid binding protein, reorganization of the immune cells into lymph node like structures and CD31 positive vessels. Expression profiling for a panel of immuno-oncology genes revealed significant changes in genes involved in migration and activation of T cells, attraction of dendritic cells and epitope spreading.ConclusionThis study highlights the potential of NAM+GEM as immunotherapy for advanced pancreatic cancer.
Different indirect immunofluorescence ANA substrate performance in a diagnostic setting of patients with SLE and related disorders: retrospective review and analysis
Authors: Choi May Y , Cui Jing , Costenbader Karen , Rydzewski David , Bernhard Lisa , Schur Peter 
Published: November 2020

ObjectiveGiven the increasing relevance of the ANA assay to classification of SLE and the uncertainty and variation surrounding different ANA assay performance, we compared the human epithelial type 2 (HEp-2) to mouse liver (ML) substrate in our local cohort and provided a review of the evidence for their use in autoimmune rheumatic diseases (ARDs).MethodsElectronic health record data (2003–2008) were used to identify patients who had concurrent HEp-2 and ML ANA, and a diagnosis of SLE or other ARDs. We determined the agreement between HEp-2 and ML ANA regarding positivity, titre and pattern, and their predictors. Sensitivity of HEp-2 ANA, ML ANA, repeating HEp-2 ANA, and combining HEp-2 and ML ANA assays was assessed.ResultsThere were 961 patients with concurrent HEp-2 and ML ANA samples, including 418 SLEs. There was generally fair to moderate agreement in HEp-2 and ML ANA (kappa (κ)=0.35–0.79), titres (κ=0.34–0.79) and patterns (κ=0.35–0.93). In SLE, the presence of anti-dsDNA antibodies was predictive of ANA agreement between HEp-2 and ML ANA (adjusted OR 6.27, 95% CI 1.45 to 27.20, p=0.01). The ANA sensitivity for most ARDs was highest when the HEp-2 test was repeated, followed by when the HEp-2 and ML ANA were combined and when only the HEp-2 or ML ANAs were used.ConclusionIn keeping with prior studies, we demonstrated that there was fair to moderate agreement between HEp-2 and ML assays in the largest comparison of HEp-2 and ML as substrates for ANA testing in various ARDs. Furthermore, ANA sensitivity was higher when the HEp-2 assay was repeated rather than combining HEp-2 and ML.
Replication of Top Loci From COL4A1/2 Associated With White Matter Hyperintensity Burden in Patients With Ischemic Stroke
Authors: Li Jiang , Abedi Vida ,   on behalf of Regeneron Genetic Center, Zand Ramin , Griessenauer Christoph J. 
Published: November 2020

Background and Purpose:
The purpose of this study was to replicate the top loci associated with white matter hyperintensity (WMH) phenotypes identified by large genome-wide association studies and the loci identified from the previous candidate gene studies.

Methods:
A total of 946 Geisinger MyCode patients with acute ischemic stroke with validated European ancestry and magnetic resonance imaging data were included in this study. Log-transformed WMH volume, as a quantitative trait, was calculated by a fully automated quantification process. The genome-wide association studies was carried out by a linear mixed regression model (GEMMA). A candidate-single nucleotide polymorphism analysis by including known single nucleotide polymorphisms, reported from a meta-analysis and several large GWAS for WMH, was conducted in all cases and binary converted extreme cases.

Results:

No genome-wide significantly associated variants were identified. In a candidate-single nucleotide polymorphism study, rs9515201 (
COL4A2
) and rs3744028 (
TRIM65
), 2 known genetic loci, showed nominal or trend of association with the WMH volume (β=0.13 and
P
=0.001 for rs9515201; β=0.094 and
P
=0.094 for rs3744028), and replicated in a subset of extreme cases versus controls (odds ratio=1.78,
P
=7.74×10
−
4
for rs9515201; odds ratio=1.53,
P
=0.047 for rs3744028, respectively). MTHFR677 cytosine/thymine (rs1801133) also showed an association with the binary WMH with odds ratio=1.47 for T allele (
P
=0.019).

Conclusions:
Replication of COL4A1/2 associated with WMH reassures that the genetic risk factors for monogenic and polygenic ischemic stroke are shared at gene level.
Implementing the Law of khulʿ in Egypt
Authors: Lindbekk Monika 
Published: November 2020

Abstract
This article aims to contribute to the growing scholarly literature on the implementation of shariʿa-based family law codes by describing and analyzing the gender implications of religiously inspired judicial activism in relation to judicial divorce through khulʿ. The article highlights two functions played by family court judges and other legal professionals. First, I argue that Egyptian family court judges and other court personnel, such as court experts and court-appointed arbiters from al-Azhar, enjoy considerable discretion in interpreting and implementing the personal status codes. Second, the article argues that legal professionals sometimes use the court and other legal spaces as a platform to articulate alternative visions of family and marriage, as well as to voice anxieties over a perceived increase in female-initiated divorce. The article situates these contradictory practices against the background of the contestation of early twenty-first-century reforms, which challenged male authority in the family, in particular the 2000 law of judicial khulʿ.
Intimacy Under Surveillance: Illicit Sexuality, Moral Policing, and the State in Contemporary Malaysia
Authors: Mohd. Razif Nurul Huda 
Published: November 2020

Abstract
Malaysia’s Malay-Muslim majority adheres to heteronormative forms of sexuality that recognise marriage as the only means of securing access to lawful sexual intimacy. Islam, Malay customs (adat), and the Malaysian state impose strict sanctions on pre- and extramarital intimacy in its Syariah criminal laws. A Vice Prevention Unit responsible for moral policing is legally authorised to arrest couples who violate Islamic rules of behaviour, including sexual offences such as khalwat (illicit proximity)—a crime of passion punishable by a fine and/or imprisonment. This article compares two khalwat trials in Kota Bharu and Kuala Lumpur’s Syariah court to illustrate what Peletz (2002) calls the judges’ “cultural logic of judicial reasoning”. In these trials, Syariah judges extend beyond a narrowed focus on gender to also consider cultural understandings of age, profession, family circumstances, and marital status, thus reproducing Malay adat understandings of intimacy, marriage, and personhood. In an effort to steer young couples away from forbidden sexual temptations, the Malaysian state liberalises access to marriage by recognising cross-border marriages contracted in Southern Thailand, offering financial incentives to young couples intending to marry and defending existing legal provisions allowing the marriage of minors. The Malaysian state’s mix of punitive, preventative, and pro-marriage policies, I suggest, are various ways of surveilling sexuality by bringing uncontrolled desires under the purview of matrimony, where it may find its lawful expression.
Distrust in government and its relationship with mental health after the Fukushima nuclear power plant accident
Authors: Fukasawa Maiko , Kawakami Norito , Umeda Maki , Akiyama Tsuyoshi , Horikoshi Naoko , Yasumura Seiji , Yabe Hirooki , Suzuki Yuriko , Bromet Evelyn J 
Published: November 2020

Background: Distrust in authorities has negative effects on mental health. Aims: In this study, we aimed to explore whether the impact of distrust in government on mental health became stronger in the area heavily affected by the 2011 Fukushima nuclear power plant accident. Methods: We examined the effects of distrust in the national government on depressive symptoms three years after the accident among community residents in Fukushima prefecture using those in the Kanto area (the area surrounding Tokyo) as a control. A questionnaire survey was administered to a random sample of 1000 residents in Fukushima prefecture and 1650 residents in the Kanto area. Distrust in the national government was assessed using a four-point single-item scale. Depressive symptoms were measured using the Patient Health Questionnaire-9. The associations of residential area (i.e. living in Fukushima prefecture or in the Kanto area) and distrust in the national government with depressive symptoms were examined, controlling for socio-demographic characteristics and disaster-related experiences using multivariate linear regression analyses. We used the interaction term of residential area and distrust in the government to explore the difference in the association between the respondents in Fukushima prefecture and those in the Kanto area. Results: Valid responses were obtained from 976 (36.8%) residents. Distrust in the government was associated with depressive symptoms and the association was stronger in Fukushima prefecture than in the Kanto area. Conclusion: The deleterious effects of distrust in the government on mental health may become more serious after a nuclear power plant accident and require careful attention during support activities in an affected area.
Lived experiences in daily life with myalgic encephalomyelitis
Authors: Sandhu Reeti KK , Sundby Maj , Ørneborg Sidsel , Nielsen Svetlana Solgaard , Christensen Jeanette Reffstrup , Larsen Anette Enemark 
Published: November 2020

Introduction Myalgic encephalomyelitis is a complex systemic condition, causing severe symptoms that limit the quality of life of the people living with it. This study examined changes in life, coping strategies, and the ability to obtain a successful occupational adaptation in people with myalgic encephalomyelitis in Denmark, viewed from the perspective of the model of human occupation. Method In-depth qualitative interviews with seven persons with myalgic encephalomyelitis aged 31–61 years were analysed with qualitative content analysis. Results The participants experienced severe changes in their lives leading to impaired occupational competences which affected their occupational identity and made them lonely. Pacing and environmental changes were the preferred coping strategies in their attempt to adapt to the new circumstances. Conclusion The participants experienced major changes in everyday life with the onset of myalgic encephalomyelitis. Pacing and environmental changes were not sufficient strategies to secure a successful occupational adaptation. Thus, people living with myalgic encephalomyelitis need assistance to enable a successful occupational adaptation and preserve hope. Access to occupational therapy within the Danish programme for people living with myalgic encephalomyelitis may support more effective occupational adaptation in the population.
Validation of Prognostic Radiomic Features From Resectable Pancreatic Ductal Adenocarcinoma in Patients With Advanced Disease Undergoing Chemotherapy
Authors: Salinas-Miranda Emmanuel , Khalvati Farzad , Namdar Kashayar , Deniffel Dominik , Dong Xin , Abbas Engy , Wilson Julie M. , O’Kane Grainne M. , Knox Jennifer , Gallinger Steven , Haider Masoom A. 
Published: November 2020

Background: Radiomic features in pancreatic ductal adenocarcinoma (PDAC) often lack validation in independent test sets or are limited to early or late stage disease. Given the lethal nature of PDAC it is possible that there are similarities in radiomic features of both early and advanced disease reflective of aggressive biology. Purpose: To assess the performance of prognostic radiomic features previously published in patients with resectable PDAC in a test set of patients with unresectable PDAC undergoing chemotherapy. Methods: The pre-treatment CT of 108 patients enrolled in a prospective chemotherapy trial were used as a test cohort for 2 previously published prognostic radiomic features in resectable PDAC (Sum Entropy and Cluster Tendency with square-root filter[Sqrt]). We assessed the performance of these 2 radiomic features for the prediction of overall survival (OS) and time to progression (TTP) using Cox proportional-hazard models. Results: Sqrt Cluster Tendency was significantly associated with outcome with a hazard ratio (HR) of 1.27(for primary pancreatic tumor plus local nodes), (Confidence Interval(CI):1.01 -1.6, P-value = 0.039) for OS and a HR of 1.25(CI:1.00 -1.55, P-value = 0.047) for TTP. Sum entropy was not associated with outcomes. Sqrt Cluster Tendency remained significant in multivariate analysis. Conclusion: The CT radiomic feature Sqrt Cluster Tendency, previously demonstrated to be prognostic in resectable PDAC, remained a significant prognostic factor for OS and TTP in a test set of unresectable PDAC patients. This radiomic feature warrants further investigation to understand its biologic correlates and CT applicability in PDAC patients.
Clinical Outcomes and Complications Following Limited Open Achilles Repair Without an Instrumented Guide
Authors: Akoh Craig C. , Fletcher Amanda , Sharma Akhil , Parekh Selene G. 
Published: November 2020

Background: We report the clinical outcomes and complications following our limited open incision Achilles tendon repair technique without instrument guides. Methods: A total of 33 patients were included in this study. We recorded pre- and postoperative scores on the Foot and Ankle Disability Index (FADI), visual analog scale (VAS), and the Foot and Ankle Outcome Score (FAOS). Subgroup analyses were performed for acute (<2 weeks) and subacute (2-6 weeks) Achilles tendon repairs. A P value <.05 was considered significant for all statistical analyses. Results: The median time from injury to surgery was 10.0 days (range, 1-45 days). At a median follow-up of 3.7 years (range, 1.0-9.8 years), the average pre- and postoperative outcome scores improved significantly for the following: FADI index (49.1-98.4, P < .001), VAS (4.8-0.2, P < .001), FAOS Pain (54.8-99.2, P < .001), FAOS Symptoms (84.6-97.0, P < .001), FAOS activities of daily living (61.4-97.2, P < .001), FAOS Sports and Recreational Activity (39.5-98.5, P < .001), and FAOS quality of life (39.7-88.7, P < .001). There were no significant differences between pre- and postoperative outcome scores between the acute and subacute Achilles repair groups. There were no wound complication, reruptures, or reoperations in the entire cohort. Conclusion: Patients showed improvements in postoperative patient-reported outcome scores with minimal complications. There was no significant difference in outcomes for acute vs subacute repairs. Our limited open incision Achilles tendon repair, which required no additional targeting instrumentation, had favorable midterm results. Level of Evidence: Level IV, retrospective case series.