bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bidirectional Irrigation System to Treat a Difficult Wound: A Case Series
Authors: Chen Li-Yung , Hou Jin-De , Peng Chian-Ze 
Published: December 2020

Aims To date, there is no distinct principle determining whether to use irrigation under negative-pressure wound therapy (NPWT). We developed a new economical device to manage difficult wounds, employing 1 of 2 techniques depending on the wound condition. Methods This case series study was conducted in 12 patients with difficult wound, from 2017 to 2018. Four patients were treated with Type A bidirectional irrigation system (wound irrigation), while 8 patients were treated with Type B bidirectional irrigation system (wound irrigation combined with NPWT). Results In the Type A device group, inflammatory profiles in case I, case IV, and case VIII were not monitored due to the stability of their wound. The mean recovery period was 3.75 weeks (2-8 weeks), with decreases in 100% healing rate. In the Type B device group, we noted an average of 71% reduction in inflammatory profiles. All patients’ infections were resolved or were healing, and 7 patients recovered satisfactorily. The recovery period ranged from 4 to 17 weeks, with a median value of 7 weeks. Conclusion Bidirectional irrigation system decreases secondary infections and complications, and increases the healing rate in patients with difficult wound.
Changing Perspectives: Offloading a Patient With a Diabetic Foot Ulcer as Opposed to Offloading a Diabetic Foot Ulcer
Authors: Samuelson Katherine L. , Kiefer Chase T. , Wu Stephanie C. , Crews Ryan T. 
Published: December 2020

Diabetic foot ulcers (DFUs) represent a tremendous burden to health care systems. Offloading is one of the key tenants to healing DFU and knee-high irremovable offloading devices are considered the gold standard for offloading DFU. However, the gold standard is rarely utilized in clinical practice. Patients’ limited tolerance for such devices is one of a number of reasons that have been attributed to the lack of use of these devices. The practice of evidence-based medicine relies on shared decision making by pairing patients’ values and preferences with the best available evidence. The present case report reviews the process of a patient-centered approach to identify the best offloading option for a patient with DFU. In consultation with the patient, a series of modalities were evaluated for offloading 2 unilateral forefoot DFUs. It is suggested that optimizing DFU offloading outcomes at the population level will require concerted efforts to employ the best offloading solution at the individual patient level. Offloading modalities are necessitated to mitigate the physical stress imparted on DFU during the weightbearing activity that patients engage in. Success is likely to be maximized by maintaining a mind-set of treating individual patients with DFUs as opposed to simply treating DFUs. Levels of Evidence: Level V: Case report
Vitrectomy for Tractional Retinal Detachment Due to Combined Hamartoma of the Retina and Retinal Pigment Epithelium
Authors: Holekamp Katherine E. , Holekamp Nancy M. 
Published: December 2020

Purpose: We discuss a peripheral combined hamartoma of the retina and retinal pigment epithelium (CHRRPE) with a macula-involving TRD that was repaired by vitrectomy surgery. Methods: A case report is presented. Results: A 15-year-old white girl with no significant medical or ocular history presented to the retina clinic with a 1-month history of progressive loss of inferior visual field in the right eye. A large, elevated CHRRPE was found in the superior midperipheral retina. On involvement of the macula, urgent vitrectomy surgery with peeling of the cortical vitreous membrane to the margins of the hamartoma was performed. Eighteen months later, vision had returned to 20/16 and the retina, relieved of traction, continued to reattach with trace remaining cystic changes at the fovea on optical coherence tomography. Conclusions: Physicians should consider vitrectomy surgery with membrane peeling of the cortical vitreous for TRD due to CHRRPE.
Cerebral artery dilation during transient ischemia is impaired by amyloid β deposition around the cerebral artery in Alzheimer’s disease model mice
Authors: Watanabe Nobuhiro , Noda Yoshihiro , Nemoto Taeko , Iimura Kaori , Shimizu Takahiko , Hotta Harumi 
Published: December 2020

AbstractTransient ischemia is an exacerbation factor of Alzheimer’s disease (AD). We aimed to examine the influence of amyloid β (Aβ) deposition around the cerebral (pial) artery in terms of diameter changes in the cerebral artery during transient ischemia in AD model mice (APPNL-G-F) under urethane anesthesia. Cerebral vasculature and Aβ deposition were examined using two-photon microscopy. Cerebral ischemia was induced by transient occlusion of the unilateral common carotid artery. The diameter of the pial artery was quantitatively measured. In wild-type mice, the diameter of arteries increased during occlusion and returned to their basal diameter after re-opening. In AD model mice, the artery response during occlusion differed depending on Aβ deposition sites. Arterial diameter changes at non-Aβ deposition site were similar to those in wild-type mice, whereas they were significantly smaller at Aβ deposition site. The results suggest that cerebral artery changes during ischemia are impaired by Aβ deposition.
Socio-demographic and clinical characteristics of diabetes mellitus in rural Rwanda: time to contextualize the interventions? A cross-sectional study
Authors: Bavuma Charlotte M. , Musafiri Sanctus , Rutayisire Pierre-Claver , Ng’ang’a Loise M. , McQuillan Ruth , Wild Sarah H. 
Published: December 2020

Abstract
Background
Existing prevention and treatment strategies target the classic types of diabetes yet this approach might not always be appropriate in some settings where atypical phenotypes exist. This study aims to assess the socio-demographic and clinical characteristics of people with diabetes in rural Rwanda compared to those of urban dwellers.

Methods
A cross-sectional, clinic-based study was conducted in which individuals with diabetes mellitus were consecutively recruited from April 2015 to April 2016. Demographic and clinical data were collected from patient interviews, medical files and physical examinations. Chi-square tests and T-tests were used to compare proportions and means between rural and urban residents.

Results
A total of 472 participants were recruited (mean age 40.2 ± 19.1 years), including 295 women and 315 rural residents. Compared to urban residents, rural residents had lower levels of education, were more likely to be employed in low-income work and to have limited access to running water and electricity. Diabetes was diagnosed at a younger age in rural residents (mean ± SD 32 ± 18 vs 41 ± 17 years; p < 0.001). Physical inactivity, family history of diabetes and obesity were significantly less prevalent in rural than in urban individuals (44% vs 66, 14.9% vs 28.7 and 27.6% vs 54.1%, respectively; p < 0.001). The frequency of fruit and vegetable consumption was lower in rural than in urban participants. High waist circumference was more prevalent in urban than in rural women and men (75.3% vs 45.5 and 30% vs 6%, respectively; p < 0.001). History of childhood under-nutrition was more frequent in rural than in urban individuals (22.5% vs 6.4%; p < 0.001).

Conclusions
Characteristics of people with diabetes in rural Rwanda appear to differ from those of individuals with diabetes in urban settings, suggesting that sub-types of diabetes exist in Rwanda. Generic guidelines for diabetes prevention and management may not be appropriate in different populations.
Communication patterns in the doctor–patient relationship: evaluating determinants associated with low paternalism in Mexico
Authors: Lazcano-Ponce Eduardo , Angeles-Llerenas Angelica , Rodríguez-Valentín Rocío , Salvador-Carulla Luis , Domínguez-Esponda Rosalinda , Astudillo-García Claudia Iveth , Madrigal-de León Eduardo , Katz Gregorio 
Published: December 2020

AbstractBackgroundPaternalism/overprotection limits communication between healthcare professionals and patients and does not promote shared therapeutic decision-making. In the global north, communication patterns have been regulated to promote autonomy, whereas in the global south, they reflect the physician’s personal choices. The goal of this study was to contribute to knowledge on the communication patterns used in clinical practice in Mexico and to identify the determinants that favour a doctor–patient relationship characterized by low paternalism/autonomy.MethodsA self-report study on communication patterns in a sample of 761 mental healthcare professionals in Central and Western Mexico was conducted. Multiple ordinal logistic regression models were used to analyse paternalism and associated factors.ResultsA high prevalence (68.7% [95% CI 60.0–70.5]) of paternalism was observed among mental health professionals in Mexico. The main determinants of low paternalism/autonomy were medical specialty (OR 1.67 [95% CI 1.16–2.40]) and gender, with female physicians being more likely to explicitly share diagnoses and therapeutic strategies with patients and their families (OR 1.57 [95% CI 1.11–2.22]). A pattern of highly explicit communication was strongly associated with low paternalism/autonomy (OR 12.13 [95% CI 7.71–19.05]). Finally, a modifying effect of age strata on the association between communication pattern or specialty and low paternalism/autonomy was observed.ConclusionsAmong mental health professionals in Mexico, high paternalism prevailed. Gender, specialty, and a pattern of open communication were closely associated with low paternalism/autonomy. Strengthening health professionals’ competencies and promoting explicit communication could contribute to the transition towards more autonomist communication in clinical practice in Mexico. The ethical implications will need to be resolved in the near future.
Demography and determinants of dog and cat ownership in three towns of West Shoa zone, Oromia Region, Ethiopia
Authors: Gebremedhin Endrias Zewdu , Sarba Edilu Jorga , Getaneh Abraham Mekebib , Tola Getachew Kebebew , Endale Solomon Shiferaw , Marami Lencho Megersa 
Published: December 2020

Abstract
Background
The dog and cat population data is generally scarce in developing countries due to absence of surveys. The demography of owned dogs and cats, and the associated ownership characteristics, are essential for the control of pet population and zoonosis. This study was conducted in three towns of West Shoa Zone of Ethiopia with the objectives of assessing demographic characteristics of owned dogs and cats and determinants of ownership.

Results
About 65.1% (95% CI: 62.1–69.8%) of the householders own dogs, 39.2% (95% CI: 35.8–43.8%) own cats, and 30.6% (95% CI: 27.4–35.0%) own both. The majority of the dog-owning households own a single dog (74.8%) and cat (74.9%). There were significantly higher proportion of dog and cat-owning households in Bako than Ambo and Gojo towns. The human to owned-dog ratio was 6:1, and that of cat ratio was 10:1. There were more male dogs (72.1%) and more female cats (59.7%). The male to female sex ratio was estimated at 3:1 for the dog while nearly 1:1 for cats. About 37.5% of the owned dogs were indoor, and 62.5% have free access to outside. Dogs and cats were acquired as a gift from families, neighbors, and friends. The identified reason for not owning dogs/cats were fear of zoonosis, dislike, no time to devote, benefit not realized, and shortage of finance. Logistic regression analysis identified study town, community type, gender of head of household, ownership of other animals as determinants for dog/cat ownership. Besides, possessing dogs was significantly associated with cat ownership.

Conclusion
The current study provide insights into the determinants of dogs/cats ownership and their demographic characteristics in Ethiopia. Dogs are more commonly owned, but the household determinants for dog and cat ownership were comparable. Means of obtaining and reason of owning or abandoning dogs/cats is partly different from those reported in the developed countries. The results of this study could be used for the provision of veterinary services, quantifying health risks and benefits associated with dog/cat ownership, and control of pet population and related zoonosis.
Active surveillance for antibodies confirms circulation of lyssaviruses in Palearctic bats
Authors: Seidlova Veronika , Zukal Jan , Brichta Jiri , Anisimov Nikolay , Apoznański Grzegorz , Bandouchova Hana , Bartonička Tomáš , Berková Hana , Botvinkin Alexander D. , Heger Tomas , Dundarova Heliana , Kokurewicz Tomasz , Linhart Petr , Orlov Oleg L. , Piacek Vladimir , Presetnik Primož , Shumkina Alexandra P. , Tiunov Mikhail P. , Treml Frantisek , Pikula Jiri 
Published: December 2020

Abstract
Background
Palearctic bats host a diversity of lyssaviruses, though not the classical rabies virus (RABV). As surveillance for bat rabies over the Palearctic area covering Central and Eastern Europe and Siberian regions of Russia has been irregular, we lack data on geographic and seasonal patterns of the infection.

Results
To address this, we undertook serological testing, using non-lethally sampled blood, on 1027 bats of 25 species in Bulgaria, the Czech Republic, Poland, Russia and Slovenia between 2014 and 2018. The indirect enzyme-linked immunosorbent assay (ELISA) detected rabies virus anti-glycoprotein antibodies in 33 bats, giving an overall seroprevalence of 3.2%. Bat species exceeding the seroconversion threshold included Myotis blythii, Myotis gracilis, Myotis petax, Myotis myotis, Murina hilgendorfi, Rhinolophus ferrumequinum and Vespertilio murinus. While Myotis species (84.8%) and adult females (48.5%) dominated in seropositive bats, juveniles of both sexes showed no difference in seroprevalence. Higher numbers tested positive when sampled during the active season (10.5%), as compared with the hibernation period (0.9%). Bat rabies seroprevalence was significantly higher in natural habitats (4.0%) compared with synanthropic roosts (1.2%). Importantly, in 2018, we recorded 73.1% seroprevalence in a cave containing a M. blythii maternity colony in the Altai Krai of Russia.

Conclusions
Identification of such “hotspots” of non-RABV lyssavirus circulation not only provides important information for public health protection, it can also guide research activities aimed at more in-depth bat rabies studies.
The triglyceride-glucose index predicts ischemic heart disease risk in Koreans: a prospective study using National Health Insurance Service data
Authors: Park Byoungjin , Lee Yong-Jae , Lee Hye Sun , Jung Dong-Hyuk 
Published: December 2020

Abstract
Background
Ischemic heart disease (IHD) without diabetes is considered an important challenge to human health and is associated with a poor prognosis, as well as a lack of health awareness. We prospectively investigated the relationship between the triglyceride-glucose (TyG) index, a surrogate marker of early insulin resistance, and incident IHD risk in a large cohort of nondiabetic Korean adults using National Health Insurance Service data.

Methods

We assessed 16,455 participants (8426 men and 8029 women) without diabetes using data from a health risk assessment study (HERAS) and Korea Health Insurance Review and Assessment (HIRA) data. The participants were divided into four groups according to TyG index quartiles, calculated as ln [fasting triglycerides (mg/dL) × fasting plasma glucose (mg/dL)/2]. We prospectively assessed hazard ratios (HRs) with 95% confidence intervals (CIs) for IHD using multivariate Cox proportional-hazards regression models over a 50-month period that followed the baseline survey.

Results
During the follow-up period, 322 (2.0%) participants developed IHD. HRs of IHD for TyG index quartiles 2–4 were 1.61 (95% CI 1.05–2.48), 1.85 (95% CI 1.21–2.81), and 2.29 (95% CI 1.50–3.51), respectively, after adjusting for age, sex, body mass index, smoking status, alcohol intake, and physical activity.

Conclusions
A higher TyG index precedes and significantly predicts future IHD among nondiabetic Koreans. Accordingly, the TyG index may be a useful measure in assessing cardiovascular risk for nondiabetic adults in the preclinical stage.
No Coil® placement in patients undergoing left hemicolectomy and low anterior resection for colorectal cancer
Authors: Ammendola Michele , Ruggiero Michele , Talarico Carlo , Memeo Riccardo , Ammerata Giorgio , Capomolla Antonella , Filippo Rosalinda , Romano Roberto , Pallio Socrate , Navarra Giuseppe , Montemurro Severino , Currò Giuseppe 
Published: December 2020

AbstractBackgroundColorectal cancer (CRC) is the most common tumor of the gastrointestinal tract. Anastomotic leak (AL) and prolonged postoperative ileus (PPOI) are two important complications of colorectal surgery. In this observational retrospective study, we evaluated the positive effects of transanal tube No Coil®in patients with CRC undergoing low anterior resection (LAR) and left hemicolectomy (LC).MethodsThirty-eight cases and forty controls resulted eligible for the final sample. No Coil®placement (SapiMed Spa, Alessandria, Italy) was considered an inclusion criteria for the case group. No Coil®was placed immediately after the end of surgical treatment.ResultsPPOI was significantly more frequent in the control group. AL was evident in 1 patient (2.6%) of cases and 3 patients (7.5%) of controls. No statistical difference was found in AL occurrence between groups. POI days and AL resulted associated with hospital stay. POI days were negatively associated with No Coil placement and positively with AL.ConclusionWith our preliminary data, we suggest that No Coil®placement can be considered as a valuable procedure assisting colorectal surgery, but further studies are required to confirm and enlarge actual evidence.
Predicting functional performance via classification of lower extremity strength in older adults with exergame-collected data
Authors: Becker Hagen , Garcia-Agundez Augusto , Müller Philipp Niklas , Tregel Thomas , Miede André , Göbel Stefan 
Published: December 2020

Abstract
Objective
The goal of this article is to present and to evaluate a sensor-based functional performance monitoring system. The system consists of an array of Wii Balance Boards (WBB) and an exergame that estimates whether the player can maintain physical independence, comparing the results with the 30 s Chair-Stand Test (30CST).

Methods
Sixteen participants recruited at a nursing home performed the 30CST and then played the exergame described here as often as desired during a period of 2 weeks. For each session, features related to walking and standing on the WBBs while playing the exergame were collected. Different classifier algorithms were used to predict the result of the 30CST on a binary basis as able or unable to maintain physical independence.

Results
By using a Logistic Model Tree, we achieved a maximum accuracy of 91% when estimating whether player’s 30CST scores were over or under a threshold of 12 points, our findings suggest that predicting age- and sex-adjusted cutoff scores is feasible.

Conclusion
An array of WBBs seems to be a viable solution to estimate lower extremity strength and thereby functional performance in a non-invasive and continuous manner. This study provides proof of concept supporting the use of exergames to identify and monitor elderly subjects at risk of losing physical independence.
Industry strategies in the parliamentary process of adopting a sugar-sweetened beverage tax in South Africa: a systematic mapping
Authors: Abdool Karim Safura , Kruger Petronell , Hofman Karen 
Published: December 2020

Abstract
Background
In 2016, the South African government became the first in the African region to announce the introduction of an SSB tax based on sugar content as a public health measure to reduce obesity. This tax was introduced against the backdrop of South Africa having a large sugar production and SSB manufacturing industry, as well as very high unemployment rates. The introduction of fiscal measures, such as a SSB tax, has been met with well-coordinated and funded opposition in other countries.

Methods
The aim of this study is to describe and analyse the arguments and strategies utilised by industry during policymaking processes to oppose regulatory actions in LMIC. This study analyses arguments and strategies used by the beverage and related industries during the public consultation phase of the process to adopt the South African SSB tax.

Results
Industry opposition to the SSB tax was comprehensive and employed several tactics. First, industry underscored its economic importance and the potential job losses and other economic harms that may arise from the tax. This argument was well-received by policymakers, and similar to industry tactics employed in other middle income countries like Mexico. Second, industry discussed self-regulation and voluntary measures as a form of policy substitution, which mirrors industry responses in the US, the Caribbean and Latin America. Third, industry misused or disputed evidence to undermine the perceived efficacy of the tax. Finally, considerations for small business and their ability to compete with multi-national corporations were a unique feature of industry response.

Conclusions
Industry opposition followed both general trends, and also introduced nuanced and context-specific arguments. The industry response experienced in South Africa can be instructive for other countries contemplating the introduction of similar measures.