bluuebunny/crossref_metadata_2025_split huggingface dataset:
Associations between maternal characteristics and pharmaceutical treatment of gestational diabetes: an analysis of the UK Born in Bradford (BiB) cohort study
Authors: Martine-Edith Gilberte , Johnson William , Hunsicker Eugenie , Hamer Mark , Petherick Emily S 
Published: November 2021

ObjectivesTo identify the maternal characteristics associated with pharmaceutical treatment of gestational diabetes mellitus (GDM).DesignProspective birth cohort study.SettingBradford, UK.Participants762 women from the Born in Bradford (BiB) cohort who were treated for GDM in a singleton pregnancy. BiB cohort participants were recruited from 2007 to 2010. All women booked for delivery were screened for GDM between 26 and 28 weeks of gestation using a 75 g 2-hour oral glucose tolerance test (OGTT).Outcome measureGDM treatment type: lifestyle changes advice (lifestyle changes), lifestyle changes advice with supplementary insulin (insulin) and lifestyle changes advice with supplementary metformin (metformin).Results244 (32%) women were prescribed lifestyle changes advice alone while 518 (68%) were offered supplemental pharmaceutical treatment. The odds of receiving pharmaceutical treatment relative to lifestyle changes advice alone were increased for mothers who were obese (OR 4.6, 95% CI 2.8 to 7.5), those who smoked (OR 2.6, 95% CI 1.2 to 5.5) and had higher fasting glucose levels at OGTT (OR 2.1, 95% CI 1.6 to 2.7). The odds of being prescribed pharmaceutical treatment rather than lifestyle changes advice were lower for Pakistani women (OR 0.7, 95% CI 0.4 to 1.0)) than White British women. Relative to insulin treatment, metformin was more likely to be offered to obese women than normal weight women (relative risk ratio, RRR 3.2, 95% CI 1.3 to 7.8) and less likely to be prescribed to women with higher fasting glucose concentrations at OGTT (RRR 0.3, 95% CI 0.2 to 0.6).ConclusionsIn the BiB cohort, GDM pharmaceutical treatment tended to be prescribed to women who were obese, White British, who smoked and had more severe hyperglycaemia. The characteristics of metformin-treated mothers differed from those of insulin-treated mothers as they were more likely to be obese but had lower glucose concentrations at diagnosis.
Impact of COVID-19 pandemic on sickness absence for mental ill health in National Health Service staff
Authors: van der Plaat Diana A , Edge Rhiannon , Coggon David , van Tongeren Martie , Muiry Rupert , Parsons Vaughan , Cullinan Paul , Madan Ira 
Published: November 2021

ObjectiveTo explore the patterns of sickness absence in National Health Service (NHS) staff attributable to mental ill health during the first wave of the COVID-19 epidemic in March–July 2020.DesignCase-referent analysis of a secondary dataset.SettingNHS Trusts in England.ParticipantsPseudonymised data on 959 356 employees who were continuously employed by NHS trusts during 1 January 2019 to 31 July 2020.Main outcome measuresTrends in the burden of sickness absence due to mental ill health from 2019 to 2020 according to demographic, regional and occupational characteristics.ResultsOver the study period, 164 202 new sickness absence episodes for mental ill health were recorded in 12.5% (119 525) of the study sample. There was a spike of sickness absence for mental ill health in March–April 2020 (899 730 days lost) compared with 519 807 days in March–April 2019; the surge was driven by an increase in new episodes of long-term absence and had diminished by May/June 2020. The increase was greatest in those aged >60 years (227%) and among employees of Asian and Black ethnic origin (109%–136%). Among doctors and dentists, the number of days absent declined by 12.7%. The biggest increase was in London (122%) and the smallest in the East Midlands (43.7%); the variation between regions reflected the rates of COVID-19 sickness absence during the same period.ConclusionAlthough the COVID-19 epidemic led to an increase in sickness absence attributed to mental ill health in NHS staff, this had substantially declined by May/June 2020, corresponding with the decrease in pressures at work as the first wave of the epidemic subsided.
Does knowledge of liver fibrosis affect high-risk drinking behaviour (KLIFAD)? protocol for a feasibility randomised controlled trial
Authors: Subhani Mohsan , Jones Katy A , Sprange Kirsty , Rennick-Egglestone Stefan , Knight Holly , Morling Joanne R , Enki Doyo G , Wragg Andrew , Ryder Stephen D 
Published: November 2021

IntroductionHeavy drinkers in contact with alcohol services do not routinely have access to testing to establish the severity of potential liver disease. Transient elastography by FibroScan can provide this information. A recent systematic review suggested providing feedback to patients based on markers of liver injury can be an effective way to reduce harmful alcohol intake. This randomised control trial (RCT) aims to establish the feasibility of conducting a larger national trial to test the effectiveness of FibroScan advice and Alcohol Recovery Video Stories (ARVS) in changing high-risk drinking behaviour in community alcohol services common to UK practice.Methods and analysisThis feasibility trial consists of three work packages (WP).WP1: To draft a standardised script for FibroScan operators to deliver liver disease-specific advice to eligible participants having FibroScan.WP2: To create a video library of ARVS for use in the feasibility RCT (WP3).WP3: To test the feasibility of the trial design, including the FibroScan script and video stories developed in WP1 and WP2 in a one-to-one individual randomised trial in community alcohol services. Semi-structured interviews will be conducted at 6 months follow-up for qualitative evaluation. Outcomes will be measures of the feasibility of conducting a larger RCT. These outcomes will relate to: participant recruitment and follow-up, intervention delivery, including the use of the Knowledge of LIver Fibrosis Affects Drinking trial FibroScan scripts and videos, clinical outcomes, and the acceptability and experience of the intervention and trial-related procedures. Data analysis will primarily be descriptive to address the feasibility aims of the trial. All proposed analyses will be documented in a Statistical Analysis Plan.Ethics and disseminationThis trial received favourable ethical approval from the West of Scotland Research Ethics Service (WoSRES) on 20 January 2021, REC reference: 20/WS/0179. Results will be submitted for publication to a peer-reviewed journal.Trial registration numberISRCTN16922410.
Effect of ERAS Combined with Comfortable Nursing on Quality of Life and Complications in Femoral Neck Fractures of the Aged People
Authors: Ping Hu , Ling Xu , Xue Yiwei , Dong Fanghui 
Published: November 2021

Objective. To explore the effect of enhanced recovery after surgery (ERAS) combined with comfortable nursing on the quality of life and complications of elderly patients with femoral neck fracture (FNF). Methods. From May 2019 to May 2020, 80 senile FNF patients who admitted to our hospital were treated by total hip arthroplasty (THA). All patients were randomly divided upon admission into a control group (CG) with usual care and a study group (RG) with ERAS combined with comfort care of 40 patients each. The postoperative efficacy was assessed by Harris score of hip joint function, and the psychology was evaluated by self-rating anxiety scale (SAS). The SF-36 score of quality of life, the time of catheter removal, the time of getting out of bed, the hospital stays, the satisfaction of nursing, and the Barthel score of self-care ability were compared between the two groups before and after nursing, and the incidence of postoperative complications was also evaluated. Results. Compared with the CG, the SF-36 score of quality of life and Barthel score of self-care ability in the RG were dramatically higher, while the SAS score of anxiety was dramatically lower. Besides, the time of catheter removal, the time of getting out of bed, and the hospital stays in the RG were dramatically lower (

P

< 0.05). Furthermore, the nursing satisfaction and postoperative efficacy of patients in the RG were obviously higher (both

P

< 0.05), while the incidence of complications in the RG was obviously lower (

P

< 0.05). Conclusion. ERAS combined with comfortable nursing can improve the hip joint function, quality of life, and self-care ability scores of senile FNF patients; relieve the anxiety in patients; and reduce the incidence of postoperative complications, which is valuable to be applied extensively.
Risk Stratifying and Prognostic Analysis of Subclinical Cardiac Implantable Electronic Devices Infection: Insight From Traditional Bacterial Culture
Authors: Lin Gaofeng , Zou Tong , Dong Min , Liu Junpeng , Cui Wen , Tong Jiabin , Shi Haifeng , Chen Hao , Chong Jia , Lyu You , Wu Sujuan , Wang Zhilei , Jin Xin , Gao Xu , Sun Lin , Qu Yimei , Yang Jiefu 
Published: November 2021

Background
Subclinical infection of cardiac implantable electronic devices (CIEDs) is a common condition and increases the risk of clinical infection. However, there are limited studies focused on risk stratifying and prognostic analysis of subclinical CIED infection.

Methods and Results

Data from 418 consecutive patients undergoing CIED replacement or upgrade between January 2011 and December 2019 were used in the analysis. Among the patients included, 50 (12.0%) were detected as positive by bacterial culture of pocket tissues. The most frequently isolated bacteria were coagulase‐negative staphylococci (76.9%). Compared with the noninfection group, more patients in the subclinical infection group were taking immunosuppressive agents, received electrode replacement, or received CIED upgrade and temporary pacing. Patients in the subclinical infection group had a higher PADIT (Prevention of Arrhythmia Device Infection Trial) score. Univariable and multivariable logistic regression analysis found that use of immunosuppressive agents (odds ratio [OR], 6.95 [95% CI, 1.44–33.51];
P
=0.02) and electrode replacement or CIED upgrade (OR, 6.73 [95% CI, 2.23–20.38];
P
=0.001) were significantly associated with subclinical CIED infection. Meanwhile, compared with the low‐risk group, patients in the intermediate/high‐risk group had a higher risk of subclinical CIED infection (OR, 3.43 [95% CI, 1.58–7.41];
P
=0.002). After a median follow‐up time of 36.5 months, the end points between the subclinical infection group and noninfection group were as follows: composite events (58.0% versus 41.8%,
P
=0.03), rehospitalization (54.0% versus 32.1%,
P
=0.002), cardiovascular rehospitalization (32.0% versus 13.9%,
P
=0.001), CIED infection (2.0% versus 0.5%,
P
=0.32), all‐cause mortality (28.0% versus 21.5%,
P
=0.30), and cardiovascular mortality (10.0% versus 7.6%,
P
=0.57).

Conclusions
Subclinical CIED infection was a common phenomenon. The PADIT score had significant value for stratifying patients at high risk of subclinical CIED infection. Subclinical CIED infection was associated with increased risks of composite events, rehospitalization, and cardiovascular rehospitalization.
Imprisoning “Enemies of the State” in a Communist Dictatorship
Authors: Nielsen Christian Axboe 
Published: November 2021

Abstract
Even though the Yugoslav Communists were expelled from the Soviet bloc in 1948, the Communist regime in Yugoslavia headed by Josip Broz Tito had embraced many of the repressive policies associated with Stalinist dictatorships. Based on newly available archival materials from Bosnia and Herzegovina, this article examines policies related to the incarceration of “enemies of the state” during the first several years of Tito's regime. By focusing on policy discussions and implementation, the article shows how government, state security, and prison officials dealt with questions relating to prison conditions, penal policy, and rehabilitation. These documents permit scholars to begin moving beyond the existing focus on well-documented events of mass killing and oppression during the early years of Communist rule—such as the Goli Otok prison camp for alleged Cominformists and mass executions in late 1944—to gain a better understanding of how Yugoslav officials viewed and debated penal policies.
Motivation Crowding in Peer Effects: The Effect of Solar Subsidies on Green Power Purchases
Authors: Nauze Andrea La 
Published: November 2021

Abstract
I test whether economic incentives impact peer effects in public-good settings. I study how a visible and subsidized contribution to a public good (installing solar panels) affects peer contributions to the same good that are neither subsidized nor visible (electing green power). Exploiting spatial variation in the feasibility of installing solar panels, I find that on average panels increase voluntary purchases of green power by neighbors. However, when subsidies to solar are high, solar panels reduce peer contributions. The results support the hypothesis that signals drive peer responses to visible public-good contributions and that economic incentives alter those signals.
Markups and Fixed Costs in Generic and Off-Patent Pharmaceutical Markets
Authors: Ganapati Sharat , McKibbin Rebecca 
Published: November 2021

Abstract
Wide dispersion is seen in pharmaceutical prices across countries with comparable quality standards. Under monopoly, off-patent and generic drug prices are at least four times higher in the United States than in comparable English-speaking high-income countries. With five or more competitors, off-patent drug prices are similar or lower. Our analysis shows that differential U.S. markups are largely driven by the market power of drug suppliers and are not due to wholesale intermediaries or pharmacies. Furthermore, we show that the traditional mechanism of reducing market power—free entry—is limited because implied entry costs are substantially higher in the United States.
Exploring the Engagement of Pacific Island Judges with the Convention on the Rights of the Child
Authors: Farran Sue 
Published: November 2021

Abstract
This article considers the extent to which judges in cases involving children in the island states of the Pacific, act consistently with, or are influenced by, the United Nations Convention on the Rights of the Child (uncrc). All Pacific island states have ratified the uncrc but giving effect to children’s rights faces challenges not least for judges. Drawing on the case-law of the region this article presents a quantitative and qualitative review of judicial engagement with the Convention, revealing that there are examples of good practice which could be shared, but also continuing difficulties which need to be met.
Perforated Peptic Ulcer of the Duodenum After the Laparoscopic Roux-en-Y Gastric Bypass
Authors: Laverty Robert B. , Yoon Brian S. , Sokol Kyle K. , Sparkman Brian K. 
Published: November 2021

Perforated ulcers of the gastric remnant and duodenum seem to be a rare complication after a Roux-en-Y gastric bypass. Diagnosis of this complication can be difficult given a vague presentation, however, early intervention is critical to prevent further morbidity. We present the case of a 38-year-old male with a perforated duodenal ulcer nearly a year after Roux-en-Y gastric bypass. Upon presentation, he complained of 8 hours of epigastric pain. His medical history was significant for chronic peptic ulcer disease and a negative history of H. pylori. Recently, he had been prescribed naproxen by his primary care physician for knee pain. His vital signs were normal with the exception of his systolic blood pressure which was 190 mmHg. He was diaphoretic and peritonitic on exam. He was taken emergently for a diagnostic laparoscopy and found to have a perforation of ∼5 mm of the anterior portion of his duodenum. This was repaired laparoscopically with an omental patch and the patient recovered without any further intervention required. While this is a rare complication reported in the literature, this or similar complications of the remnant stomach may be underrepresented in publications. The surgical intervention of this disease will either be resection of the remnant or an omental patch. However, controversy remains as to the proper post-operative medical treatment. For our patient, the inciting agent was likely the naproxen he was given and this was stopped immediately. Patient education and ownership should remain a cornerstone for patients that have undergone a Roux-en-y gastric bypass.
Acute Kidney Injury After Large Ventral Hernia Repair Requiring Transversus Abdominis Release
Authors: Schaeffer H. David , Sharp Nicole E. , Jaap Kathryn , Semian John , Alaparthi Mohanbabu , Sun Haiyan , Young Amanda , Factor Matthew 
Published: November 2021

Background Acute kidney injury (AKI) is a known postoperative complication of open ventral hernia repair contributing to increased costs, hospital length of stay, and mortality. The aim of this study was to identify whether the muscle injury that occurs in a posterior separation of components via transversus abdominis release (TAR) contributes to a higher incidence of postoperative AKI. Methods A retrospective cohort study of patients who underwent open retrorectus ventral hernia repair with and without TAR at a single institution between 2012 and 2019 was performed. Patients who underwent a separation of components via either unilateral or bilateral transversus abdominis release were compared to those who did not undergo TAR as part of their hernia repair (non-TAR). The outcome of interest was the development of postoperative AKI. Acute kidney injury was defined as an increase in creatinine of greater than 50% of the preoperative baseline. Univariate and multivariate analyses were performed to determine the influence of TAR on the development of AKI. Results There were 523 patients who met inclusion criteria, of which 159 (30.4%) had a TAR as part of their retrorectus hernia repair. No differences were found in preoperative characteristics between the TAR and non-TAR group including age, gender, history of kidney disease, or history of diabetes. By contrast, the TAR group had significantly greater median estimated blood loss (100 mL vs 75 mL, P < .01), mean positive intraoperative fluid balance (2255 mL vs 1887 mL, P < .01), and operative duration (321 min vs 269 min, P < .001). The rate of AKI in the TAR group was 11% (n = 18) vs 6% (n = 23, P = .0503) in the non-TAR group. On multivariate analysis controlling for patient characteristics and intraoperative factors, TAR was the only factor with a significantly increased odds of AKI (OR 1.97, 95% CI 0.994-3.905, P = .0521). Conclusions In patients with large ventral hernias requiring retrorectus repair, performing a TAR is associated with a nearly 2-fold increase in the development of postoperative AKI. These findings suggest that these patients should be optimized perioperatively with emphasis on fluid resuscitation, limiting nephrotoxic medications and monitoring urine output.
Do collaterals visualized on coronary angiography impact left ventricle ejection fraction among Asian Indians presenting with acute coronary syndrome? The Deucalion Study
Authors: Sharma Kamal , Champaneri Bhavik , Patel Iva , Thangasami Senthilraj , Tated Suyash , Jha Shobha Nand 
Published: November 2021

Background The coronary collaterals have been ascribed as a potential alternative source of myocardial perfusion to the extent that some suggest it as a “natural bypass”! We proposed to evaluate the impact of the extent of collaterals on left ventricle ejection fraction among Asian Indians presenting with acute coronary syndrome. Methods This was a retrospective, all-comers study performed on consecutive 3614 patients presenting with the acute coronary syndrome. Angiograms were evaluated for collaterals graded according to Rentrop’s classification among group A (grades 0 and 1) and group B (grades 2 and 3) collaterals. Results Patients were matched for traditional cardiovascular risk factors in groups A and B as well as for ST elevation myocardial infarction and non-ST elevation myocardial infarction subgroups in both the groups. Grades 2 and 3 collaterals were significantly ( P = 0.04) higher in patients with non-ST elevation myocardial infarction—266/1319 (20.17%), as compared to ST elevation myocardial infarction—group 400/2295 (17.43%). Left ventricle ejection fraction on presentation was better preserved in group A as compared to group B in those with double-vessel disease and triple-vessel disease patients with non-ST elevation myocardial infarction, whereas it was better in single-vessel disease and triple-vessel disease patients with ST elevation myocardial infarction. The inverse correlation ( r = −0.111, P = 0.000) existed between left ventricle ejection fraction and grades of collaterals. Conclusion Patients with the single-vessel disease were more likely to have poor coronary collateral as compared to double-vessel disease/triple-vessel disease. Despite higher grade coronary collateral among Asian Indians presenting with acute coronary syndrome, both non-ST elevation myocardial infarction and ST elevation myocardial infarction patients with triple-vessel disease had significantly lower left ventricle ejection fraction. This paradoxically brings out worse left ventricle ejection fraction on presentation in those with double-vessel disease and triple-vessel disease with ST elevation myocardial infarction and single-vessel disease and triple-vessel disease with ST elevation myocardial infarction despite higher grade of coronary collateral representing as “Asian Indian Paradox” in our cohort.
Carcinomatosis under control by osimertinib in EGFR and TP53 mutated lung adenocarcinoma
Authors: Provenzano Leonardo , Cuccarini Valeria , Platania Marco , Canziani Luca , Spagnoletti Andrea , Doniselli Fabio M. , Eoli Marica , Prelaj Arsela , Anghileri Elena 
Published: November 2021

Introduction: Approximately 25%–30% of patients with non-small cell lung cancer (NSCLC) develop central nervous system (CNS) metastases during the course of the disease; this percentage is higher in patients with epidermal growth factor receptor (EGFR) mutations. Leptomeningeal metastases, infrequent in the advanced setting, have a particularly dismal prognosis. Osimertinib, a third-generation EGFR inhibitor, can provide effective and durable response in this setting. Case Description: We present a 62-year-old man with progressive vomiting, headache, short-term memory impairment, and left lower limb hyposthenia. Computed tomography (CT) showed bilateral lung nodules, multiple lymphadenopathies, liver and bone metastases, and CNS and leptomeningeal dissemination, including multiple parenchymal nodules located at supra- and infratentorial brain. Bone needle biopsy documented TTF1+ lung adenocarcinoma. Whole brain radiotherapy (WBRT) and symptomatic treatments were started. Next-generation sequencing reported deletion of exon 19 of EGFR and mutation 8 of TP53. Osimertinib 80 mg was promptly started and WBRT interrupted. Some days after the patient experienced repetitive seizures and neurologic worsening, antiepileptic drugs and dexamethasone were implemented, with gradual improvement. Radiologic evaluation, including brain MRI and thorax–abdominal CT, showed partial response on CNS as well as extracranial sites, which was sustained. Conclusions: First-line treatment with osimertinib can be safe and effective in EGFR-mutated NSCLC even in presence of multiple negative predictive factors (poor Performance Status, diffuse leptomeningeal involvement, TP53 comutation), suggesting that deferring local treatments can be feasible in this setting, allowing the patient to maintain a good quality of life.