bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sekentei and objectively-measured physical activity among older Japanese people: a cross-sectional analysis from the NEIGE study
Authors: Murayama Hiroshi , Amagasa Shiho , Inoue Shigeru , Fujiwara Takeo , Shobugawa Yugo 
Published: October 2019

Abstract

Background
The concept of sekentei (social appearance), defined as sensitivity about one’s reputation, reflects Japanese behavioral principles and involves pressure to conform to social norms, particularly among people living in rural areas. However, data regarding the relationship between sekentei and health behaviors are sparse. In this study, we examined the relationship between sekentei and objectively-measured physical activity among community-dwelling older people in Japan.

Methods
We used data from the Neuron to Environmental Impact across Generations Study (NEIGE Study), which is a prospective cohort study of randomly-sampled community-dwelling individuals aged 65–84 years living in Tokamachi City, Niigata Prefecture, Japan. The baseline survey was conducted in 2017 and included 527 independent older people. We analyzed the baseline data cross-sectionally. To measure activity behaviors, participants wore a tri-axial accelerometer for seven consecutive days. Physically active individuals were defined based on the World Health Organization recommendation guidelines on physical activity. Sekentei was measured using the 12-item Sekentei Scale (score range: 12–60).

Results
After excluding 15 people for whom we had three or fewer days of valid accelerometer-assessed activity data, we used data from 512 participants in our analysis (average 73.4 years old; 46.9% men). Physically active individuals made up 22.3% of the sample, and the proportion of physically active men was higher than that of women. A logistic regression analysis showed that higher levels of sekentei were inversely associated with physical activity after adjusting for demographic factors, socioeconomic status, and health conditions (odds ratio [95% confidence interval]: 0.58 [0.36–0.91] for every 10-point increase in the Sekentei Scale score). This association was stronger in women than in men (0.66 [0.34–1.26] for men and 0.51 [0.26–1.00] for women).

Conclusions
Our findings indicate that an individual’s sense of sekentei may be an important socio-cultural factor affecting their level of physical activity. Culturally appropriate approaches may be beneficial in addressing insufficient physical activity in older adults.
Incidence and etiology of infectious diarrhea from a facility-based surveillance system in Guatemala, 2008–2012
Authors: Arvelo Wences , Hall Aron J. , Henao Olga , Lopez Beatriz , Bernart Chris , Moir Juan C. , Reyes Lissette , Montgomery Susan P. , Morgan Oliver , Estevez Alejandra , Parsons Michele B. , Lopez Maria R. , Gomez Gerry , Vinje Jan , Gregoricus Nicole , Parashar Umesh , Mintz Eric D. , McCracken John , Bryan Joe P. , Lindblade Kim A. 
Published: October 2019

Abstract

Background
Diarrhea is a major cause of morbidity and mortality, yet incidence and etiology data are limited. We conducted laboratory-based diarrhea surveillance in Guatemala.

Methods
A diarrhea case was defined as ≥3 loose stools in a 24-h period in a person presenting to the surveillance facilities. Epidemiologic data and stool specimens were collected. Specimens were tested for bacterial, parasitic, and viral pathogens. Yearly incidence was adjusted for healthcare seeking behaviors determined from a household survey conducted in the surveillance catchment area.

Results
From November 2008 to December 2012, the surveillance system captured 5331 diarrhea cases; among these 1381 (26%) had specimens tested for all enteric pathogens of interest. The adjusted incidence averaged 659 diarrhea cases per 10,000 persons per year, and was highest among children aged < 5 years, averaging 1584 cases per 10,000 children per year. Among 1381 (26%) specimens tested for all the pathogens of interest, 235 (17%) had a viral etiology, 275 (20%) had a bacterial, 50 (4%) had parasites, and 86 (6%) had co-infections. Among 827 (60%) specimens from children aged < 5 years, a virus was identified in 196 (23%) patients; 165 (20%) had norovirus and 99 (12%) rotavirus, including co-infections. Among 554 patients aged ≥5 years, 103 (19%) had a bacterial etiology, including diarrheagenic Escherichia coli in 94 (17%) cases, Shigella spp. in 31 (6%), Campylobacter spp. in 5 (1%), and Salmonella spp. in 4 (1%) cases. Detection of Giardia and Cryptosporidium was infrequent (73 cases; 5%).

Conclusions
There was a substantial burden of viral and bacterial diarrheal diseases in Guatemala, highlighting the importance of strengthening laboratory capacity for rapid detection and control and for evaluation of public health interventions.
Management and outcome of pelvic fracture associated with vaginal injuries: a retrospective study of 25 cases
Authors: Li Pengyu , Zhou Dongsheng , Fu Baisheng , Song Wenhao , Dong Jinlei 
Published: October 2019

AbstractBackgroundPelvic ring fractures associated with vaginal injuries were rarely reported due to low incidence. The displaced segments of pelvic ring may increase the risk of vaginal injury. The aim of this retrospective study was to evaluate the correlation between pelvic fracture and vaginal injury.MethodsWe conducted a retrospective review of 25 patients with pelvic fractures associated with vaginal injury treated at our institution. The medical records of these patients were collected and 24 patients were followed-up for 10–36 months.ResultsAll patients suffered anterior pelvic ring fracture. Young-Burgess fracture classification and compromised pubic symphysis were related to severity of vaginal injury. Gauze packing was done in 6 patients and 18 patients received surgical repair. Infection occurred in 6 patients, among them 4 were due to delayed diagnosis. Factors associated with pelvic outcome were age, urethral injury, and infection. Four patients suffered pain in sexual intercourse but no influence factor found correlated to sexual function.ConclusionVS type pelvic fracture and compromised pubic symphysis were related to higher severity of vaginal injury. Disruption of anterior ring and an unstable pelvic ring caused by forces on coronary and axial plane may increase the risk of vaginal injury.Trial registrationChiCTR1900020540. Registered 28 January 2019. Retrospectively registered. Trial registry: Chinese Clinical Trial Registry.
Dual graft living donor liver transplantation – a case report
Authors: Vinayak Nikam , Ravi Mohanka , Ankush Golhar , Rashmi Bhade , Prashantha Rao , Parul Gadre , Anurag Shrimal 
Published: October 2019

Abstract

Background
Living donor liver transplantation (LDLT) has emerged as an equally viable option to deceased donor liver transplant for treating end stage liver disease patients. Optimising the recipient outcome without compromising donor safety is the primary goal of LDLT. Achieving the adequate graft to recipient weight ratio (GRWR) is important to prevent small for size syndrome which is an uncommon but potentially lethal complication of LDLT.

Case presentation
Here we describe a case of successful dual lobe liver transplant for a 32 years old patient with ethanol related end stage liver disease. A right lobe graft without middle hepatic vein and another left lateral sector graft were transplanted successfully. Recipient and both donors recovered uneventfully.

Conclusion
Dual lobe liver transplant is a feasible strategy to achieve adequate GRWR without compromising donor safety.
Surgical management of pyelo-ureteral junction syndrome in a resource-limited setting: case of Zinder National Hospital, Niger
Authors: Adamou Harissou , Amadou Magagi Ibrahim , Halidou Maazou , Diongolé Hassane , Doutchi Mahamadou , Habou Oumarou , Ganiou Kabirou , Soumana Amadou , Sani Rachid 
Published: October 2019

Abstract

Background
Pyelo-ureteral junction syndrome (PUJS) is a frequent congenital malformation. We report the surgical management of PUJS by pyeloplasty according to Anderson-Hyne-Kuss’s procedure at the Zinder National Hospital..

Methods
This was a retrospective study from January 2013 to December 2016 (4 years), including patients who have undergone surgery for PUJS.

Results
Twelve (12) cases of PUJS had a surgery among which 66.7% were men with an average age of 32.5 ± 7.6 years. The clinical symptomatology was lumbar pain or renal colic in 92.3% of cases. This pain had evolved for more than 2 years for 58.3% of the cases. Ultrasound coupled with intravenous urography or CT-scan was performed to confirm the diagnosis of PUJS in 58.3 and 41.7% of cases. The average serum creatinine level at admission was 181.25 ± 67.3 μmol/L [Lab reference range: 53–97 μmol/L]. The Anderson-Hynes non dismembered pyeloplasty is used for all the patients. The release of a crossing lower pole vessel was performed in 25%, pyelolithotomy in 16.7%. The average surgery time was 118.3 ± 20.7 min. The average hospital length of stay was 10.8 ± 3 days. Immediate postoperative complications were recorded in 33.3% (n = 4). Postoperative outcomes were considered good by disappearance of clinical, biological and radiological signs.

Conclusion
The Anderson-Hynes non dismembered pyeloplasty gives good results and provides a successful alternative in an environment where laparoscopy and robotic surgery are not developed.
Laparoscopically excised retroperitoneal presacral Schwannoma: atypical pre and postoperative manifestations – case report
Authors: Carvalho Bárbara Justo , de Almeida Medeiros Kayo Augusto , Martines Diego Ramos , Nii Fernanda , Pipek Leonardo Zumerkorn , de Mesquita Gustavo Heluani Antunes , D’Albuquerque Luiz Augusto Carneiro , Meyer Alberto , Andraus Wellington 
Published: October 2019

Abstract

Background
We are a reporting a rare case of retroperitoneal schwanomma with atypical pre and postoperative manifestations. Retroperitoneal schwannomas are rare tumors that are difficult to preoperatively diagnose.

Case presentation
This is a case report of a male patient, 41 years old, with symptoms of hipogastric and lower right member pain, as well as a history of a papilliferous thyroid tumor. Computerized tomography exams were inconclusive, showing a mass in the presacral region with dimensions of 4.4 × 3.9 × 3.4 cm. Removal was carried out by laparoscopic surgery, with self-limited postoperative complications. Diagnosis was carried out by anatomopathological examination, and syndromic hypotheses were discarded.

Conclusions
The postoperative complications of schwanomma are little reported in the literature. In the simultaneous occurrence of schwanomma and other endocrine tumors, further studies are warranted to better differentiate the cases that need investigation of syndromic causes.
Safety and efficacy of Holmium laser enucleation of the prostate (HoLEP) in patients with previous transperineal biopsy (TPB): outcomes from a dual-centre case-control study
Authors: Bell Chris , Moore Sacha L. , Gill Amarit , Obi-Njoku Obinna , Hughes Stephen F. , Saleemi Asad , Ellis Gidon , Khan Farooq , Shergill Iqbal S. 
Published: October 2019

Abstract

Background
We investigated the surgical feasibility, safety and effectiveness of 50 W (low power) Holmium Laser enucleation of the prostate (HoLEP) in patients who have undergone previous template biopsy of the prostate (TPB).

Methods
Data encompassing pre-operative baseline characteristics, intra-operative measures and post-operative outcomes was collected for 109 patients undergoing HoLEP across two UK centres. Patients were stratified into two groups; group 1 (n = 24) had undergone previous TPB were compared with ‘controls’ (no previous TPB) in group 2 (n = 85). The primary outcome was successful HoLEP.

Results
There were no statistically significant differences in either key baseline characteristics or mass of prostate enucleated between groups 1 and 2. There was no statistically significant difference in enucleation or morcellation times parameters between the two groups other than enucleation efficiency in favour of group 1 (p = 0.024). Functional outcomes improved, without any statistically significant difference, in both groups.

Conclusions
In patients with a previous TPB, HoLEP is surgically feasible, safe and effective. TPB should not be considered a contraindication to HoLEP. Our work provides a strong foundation for further research in this area.
Barriers and facilitators to weight management in overweight and obese women living in Australia with PCOS: a qualitative study
Authors: Lim Siew , Smith Caroline A. , Costello Michael F. , MacMillan Freya , Moran Lisa , Ee Carolyn 
Published: October 2019

Abstract

Background
Lifestyle modification targeting weight management is the first-line treatment for women with Polycystic Ovary Syndrome (PCOS) regardless of presenting symptoms. Women with PCOS are more likely to gain more weight compared with women without PCOS, which may be related to barriers in engaging in lifestyle modification. The aim of this study is to explore the experience of women with PCOS in weight management and to determine the facilitators and barriers to lifestyle modifications in women with PCOS.

Methods
Ten women with PCOS participated in focus groups and semi-structured telephone interviews on lifestyle and weight management in PCOS. Discussions were audio-recorded and transcribed verbatim. Thematic analysis of the transcripts was conducted. Thematic analysis of the transcripts were conducted using the method of constant comparison.

Results
Women in the current study attempted a wide range of weight loss interventions, but had difficulties losing weight and preventing weight regain. Women felt that having PCOS affected their ability to lose weight and to keep it off. Facilitators to lifestyle modification for weight management were reported as structured approaches such as having balanced meals and support by health professionals, peers, friends or family. Barriers to lifestyle changes in women with PCOS included logistical barriers such as time and cost, motivational barriers including tiredness or feeling unrewarded, environmental barriers such as not having access to safe places to exercise, emotional barriers such as having depressive and defeating thoughts, and relational barriers such as having unsupportive partner or prioritising children’s meal preferences.

Conclusions
Women with PCOS face a number of personal, environmental and social facilitators and barriers to lifestyle modification for weight loss. While many of these are also experienced by women without PCOS, women with PCOS face additional barriers in having low sense of self-confidence and high prevalence of negative thoughts which may impair their ability to maintain efforts in lifestyle modification over the long term. Future research should further explore the impact of the emotional and mental burden of PCOS on the management of weight and other aspects of PCOS. Future lifestyle intervention should also address the psychosocial aspect of PCOS.
Image quality to estimate ventricular ejection fraction by last year medical students improves after short courses of training
Authors: Hüppe Tobias , Groesdonk Heinrich Volker , Volk Thomas , Wagenpfeil Stefan , Wallrich Benedict 
Published: October 2019

Abstract

Background
Transthoracic echocardiography is the primary imaging modality for diagnosing cardiac conditions but medical education in this field is limited. We tested the hypothesis that a structured theoretical and supervised practical course of training in focused echocardiography in last year medical students results in a more accurate assessment and more precise calculation of left ventricular ejection fraction after ten patient examinations.

Methods
After a theoretical introduction course 25 last year medical students performed ten transthoracic echocardiographic examination blocks in postsurgical patients. Left ventricular function was evaluated both with an eye-balling method and with the calculated ejection fraction using diameter and area of left ventricles. Each examination block was controlled by a certified and blinded tutor. Bias and precision of measurements were assessed with Bland and Altman method.

Results
Using the eye-balling method students agreed with the tutor’s findings both at the beginning (88%) but more at the end of the course (95.7%). The variation between student and tutor for calculation of area, diameter and ejection fraction, respectively, was significantly lower in examination block 10 than in examination block 1 (each p < 0.001). Students underestimated both the length and the area of the left ventricle at the outset, as complete imaging of the left heart in the ultrasound sector was initially unsuccessful.

Conclusions
A structured theoretical and practical transthoracic echocardiography course of training for last year medical students provides a clear and measurable learning experience in assessing and measuring left ventricular function. At least 14 examination blocks are necessary to achieve 90% agreement of correct determination of the ejection fraction.
Systematic review of the costs and effectiveness of interventions to increase infant vaccination coverage in low- and middle-income countries
Authors: Munk Cristina , Portnoy Allison , Suharlim Christian , Clarke-Deelder Emma , Brenzel Logan , Resch Stephen C. , Menzies Nicolas A. 
Published: October 2019

AbstractBackgroundIn recent years, several large studies have assessed the costs of national infant immunization programs, and the results of these studies are used to support planning and budgeting in low- and middle-income countries. However, few studies have addressed the costs and cost-effectiveness of interventions to improve immunization coverage, despite this being a major focus of policy attention. Without this information, countries and international stakeholders have little objective evidence on the efficiency of competing interventions for improving coverage.MethodsWe conducted a systematic literature review on the costs and cost-effectiveness of interventions to improve immunization coverage in low- and middle-income countries, including both published and unpublished reports. We evaluated the quality of included studies and extracted data on costs and incremental coverage. Where possible, we calculated incremental cost-effectiveness ratios (ICERs) to describe the efficiency of each intervention in increasing coverage.ResultsA total of 14 out of 41 full text articles reviewed met criteria for inclusion in the final review. Interventions for increasing immunization coverage included demand generation, modified delivery approaches, cash transfer programs, health systems strengthening, and novel technology usage. We observed substantial heterogeneity in costing methods and incompleteness of cost and coverage reporting. Most studies reported increases in coverage following the interventions, with coverage increasing by an average of 23 percentage points post-intervention across studies. ICERs ranged from $0.66 to $161.95 per child vaccinated in 2017 USD. We did not conduct a meta-analysis given the small number of estimates and variety of interventions included.ConclusionsThere is little quantitative evidence on the costs and cost-effectiveness of interventions for improving immunization coverage, despite this being a major objective for national immunization programs. Efforts to improve the level of costing evidence—such as by integrating cost analysis within implementation studies and trials of immunization scale up—could allow programs to better allocate resources for coverage improvement. Greater adoption of standardized cost reporting methods would also enable the synthesis and use of cost data.
Hospital competition and the expenses for treatments of acute and non-acute common diseases: evidence from China
Authors: Deng Chenhui , Pan Jay 
Published: October 2019

Abstract

Background
Because there is heterogeneity in disease types, competition among hospitals could be influenced in various ways by service provision for diseases with different characteristics. Limited studies have focused on this matter. This study aims to evaluate and compare the relationships between hospital competition and the expenses of prostatectomies (elective surgery, representing treatments of non-acute common diseases) and appendectomies (emergency surgery, representing treatments of acute common diseases).

Methods
Multivariable log-linear models were constructed to determine the association between hospital competition and the expenses of prostatectomies and appendectomies. The fixed-radius Herfindahl-Hirschman Index was employed to measure hospital competition.

Results
We collected data on 13,958 inpatients from the hospital discharge data of Sichuan Province in China from September to December 2016. The data included 3578 prostatectomy patients and 10,380 appendectomy patients. The results showed that greater competition was associated with a lower total hospital charge for prostatectomy (p = 0.006) but a higher charge for appendectomy (p <  0.001). The subcategory analysis showed that greater competition was consistently associated with lower out-of-pocket (OOP) and higher reimbursement for both surgeries.

Conclusions
Greater competition was significantly associated with lower total hospital charges for prostatectomies, while the opposite was true for appendectomies. Furthermore, greater competition was consistently associated with lower OOP but higher reimbursement for both surgeries. This study provides new evidence concerning the heterogeneous roles of competition in service provision for non-acute and acute common diseases. The findings of this study indicate that the pro-competition policy is a viable option for the Chinese government to relieve patients’ financial burden (OOP). Our findings also provide references and insights for other countries facing similar challenges.