bluuebunny/crossref_metadata_2025_split huggingface dataset:
Waist-Height Ratio and the Risk of Severe Diabetic Eye Disease in Type 1 Diabetes: A 15-Year Cohort Study
Authors: Parente Erika B , Harjutsalo Valma , Forsblom Carol , Groop Per-Henrik 
Published: September 2021

Abstract

Context
Obesity prevalence has increased in type 1 diabetes (T1D). However, the relationship between body composition and severe diabetic eye disease (SDED) is unknown.

Objective
To investigate the associations between body composition and SDED in adults with T1D.

Methods
From 5401 adults with T1D in the Finnish Diabetic Nephropathy Study, we assessed 3468, and 437 underwent dual-energy X-ray absorptiometry for body composition analysis. The composite outcome was SDED, defined as proliferative retinopathy, laser treatment, antivascular endothelial growth factor treatment, diabetic maculopathy, vitreous hemorrhage, and vitrectomy. Logistic regression analysis evaluated the associations between body composition and SDED. Multivariable Cox regression analysis assessed the associations between the anthropometric measures and SDED. Subgroup analysis was performed by stages of albuminuria. The relevance ranking of each variable was based on the z statistic.

Results
During a median follow-up of 14.5 (interquartile range 7.8-17.5) years, 886 SDED events occurred. Visceral/android fat ratio was associated with SDED [odds ratio (OR) 1.40, z = 3.13], as well as the percentages of visceral (OR 1.80, z = 2.45) and android fat (OR 1.28, z = 2.08) but not the total body fat percentage. Waist-height ratio (WHtR) showed the strongest association with the SDED risk [hazard ratio (HR) = 1.28, z = 3.73], followed by the waist (HR 1.01, z = 3.03), body mass index (HR 1.03, z = 2.33), and waist-hip ratio (HR 1.15, z = 2.22). The results were similar in normo- and microalbuminuria but not significant in macroalbuminuria. A WHtR ≥ 0.5 increased the SDED risk by 28% at the normo- and microalbuminuria stages.

Conclusions
WHtR, a hallmark of central obesity, is associated with SDED in individuals with T1D.
Serum Phosphate: A Neglected Test in the Clinical Management of Primary Hyperparathyroidism
Authors: Castellano Elena , Attanasio Roberto , Boriano Alberto , Pellegrino Micaela , Borretta Giorgio 
Published: September 2021

Abstract

Background
Although the inverse correlation between serum PTH and phosphate (P) levels in patients with primary hyperparathyroidism (PHPT) is well known, the relationship between P levels and the clinical picture of the disease has not been well investigated. This was thus the aim of this paper.

Patients
A total of 472 consecutive patients with PHPT attending our center were retrospectively evaluated at diagnosis.

Results
P levels lower than 2.5 mg/dL (HypoP) were found in 198/472 patients (41.9%). HypoP was mild (2-2.5 mg/dL), moderate (1-1.9 mg/dL), and severe (&lt;1 mg/dL) in 168 (84.9%), 30 (15.1%), and 0 cases, respectively. P levels were lower in males than females. Patients with more severe bone density impairment at the radial (but not the vertebral or femoral) site had P levels significantly lower than other patients. PHPT severity was worse in HypoP patients, both clinically (higher prevalence of renal stones, but not of osteoporosis) and biochemically (higher serum calcium and PTH levels). All patients in the moderate HypoP group were either symptomatic or asymptomatic reaching surgical indication according to the latest guidelines.

Conclusions
We observed a relationship between P levels and biochemical and clinical features of PHPT severity. In asymptomatic PHPT patients, even moderate HypoP is predictive of surgical indication, regardless of age and hypercalcemia severity.
Achievement of another landmark during 2020 by Pakistan Journal of Medical Sciences
Authors: Jawaid Shaukat Ali , Jawaid Masood 
Published: September 2021

doi: https://doi.org/10.12669/pjms.37.7.5208
How to cite this:Jawaid SA, Jawaid M. Achievement of another landmark during 2020 by Pakistan Journal of Medical Sciences. Pak J Med Sci. 2021;37(7):1715-1718. doi: https://doi.org/10.12669/pjms.37.7.5208
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Getting our act together: a qualitative evaluation of the impact of a play on issues relating to women, sex work and substance use
Authors: Campbell Anne , Egan Jo , Murphy Paul , Blair Carolyn 
Published: September 2021

Background: The arts have always sought to explore significant social issues through literature, performing arts and visual art. However, more recently there has been an increase in the use of theatre as a means of gauging audiences’ perception and understanding of key social issues. The primary aim of the current evaluation was to seek the views of audience members, service users of addiction services and expert commentators as regards their perception of a number of key issues related to the content of a play entitled Madame Geneva. Methods: The evaluation used an exploratory qualitative design incorporating a dualistic approach to the research process: including post show discussion with panellists and members of the audience and a focus group comprising service users who had also viewed a live performance of the play. Results: The topics elucidated by the performance of the play included women and sex work, women and substance use, and impact on policy and practice. The discussion of the issues raised reiterated that women still experience high levels of oppression and discrimination in areas of substance use, sex work and welfare ‘reform’ which are often couched within male dominated political discourses and structures in contemporary society. Conclusions: The arts and specifically dramaturgical representations of substance use and related issues is an effective method of initiating important pragmatic and policy discussion of issues, which affect women
Long-term neurological and healthcare burden of adults with Japanese encephalitis: A nationwide study 2000-2015
Authors: Chen Hsuan-Ying , Yang Chen-Yi , Hsieh Cheng-Yang , Yeh Chun-Yin , Chen Chang-Chun , Chen Yen-Chin , Lai Chung-Chih , Harris Rebecca Claire , Ou Huang-Tz , Ko Nai-Ying , Ko Wen-Chien 
Published: September 2021

Objective
To assess the healthcare utilization, economic burden, and long-term neurological complications and mortality of an adult population with Japanese encephalitis (JE).

Methods
This study utilized two nationwide datasets in Taiwan: the Notifiable Disease Dataset of confirmed cases from the Centers for Disease Control to identify JE patients, and the National Health Insurance Research Database to obtain patients’ healthcare utilization. Survival analyses were performed to identify prognostic factors associated with the all-cause mortality of patients.

Results
This study included 352 adult cases with JE (aged≥20 years). The mean age of JE patients was 45 years. Stroke (event rate: 3.49/100 person-years) was the most common neurological complication, followed by epilepsy/convulsions (3.13/100 person-years), encephalopathy/delirium (2.20/100 person-years), and parkinsonism (1.97/100 person-years). Among the 336 hospitalized patients at JE diagnosis, 58.33% required intensive care. Among 79 patients who died following JE diagnosis, 48.84% of death events occurred within the year of diagnosis. The medical costs increased considerably at JE diagnosis and subsequent-year costs remained significantly higher than the costs before diagnosis (p<0.05). Having a four-dose JE vaccination (i.e., born after 1976) versus no JE vaccination history (i.e., born before 1963) was significantly associated with lower all-cause mortality (hazard ratio: 0.221 [95% confidence interval: 0.067, 0.725]). Comorbid diabetes and incident epilepsy/convulsion events significantly increased the mortality risk by 2.47- and 1.85-fold, respectively (p<0.05).

Conclusion
A considerable medical burden associated with JE was observed in affected adults, even in the years following JE diagnosis. Vaccination should be considered to prevent this sporadic, but lethal, viral infection.
Factors affecting the recovery of Kurdistan province COVID-19 patients: a cross-sectional study from March to June 2020
Authors: Zandkarimi Eghbal 
Published: September 2021

Abstract

Objectives
The Coronavirus disease 2019 (COVID-19) is a new viral disease of the coronavirus family that has a close relationship with SARS species. This study aims to identify factors affecting the recovery of COVID-19 patients in a population with a majority of Kurdish residents.

Methods
For this purpose, all clinical and demographic parameters were collected from patients with COVID-19 who were outpatients or hospitalized in Kurdistan province (located in western Iran) from March to June 2020. We used the binary logistic regression model to recognition affecting factors to recovery in the COVID-19.

Results
According to the results of this study, age, sex, coronary heart disease (CHD), cancer, and using antiviral drugs were associated with the chance of recovery.

Conclusions
Based on the findings of this study, it can be concluded that the chances of recovery of COVID-19 patients who are elderly or have underlying diseases such as CHD or cancer are low. On the other hand, viral drugs are effective in increasing the chances of recovery.
The Politics of Civil Procedure: The Curious Story of the Process for the Eviction of Tenants
Authors: Rosen-Zvi Issi , Rosenberg Israel 
Published: September 2021

Abstract
This article examines the process for the eviction of tenants (PET), which offers landlords a swift path for obtaining an eviction order against their tenants, as a case study exposing the politics of procedure. It shows that the PET is but one stage in a longstanding battle waged between two interest groups—landlords and tenants—involving both substantive law and procedural law. But while the story of their conflict over substantive law, fought in the parliament through the regular legislative process, is well-known, the story of the procedural amendments, despite their immense impact, remains shrouded in mystery and is told here for the first time. The reason for that, we argue, is that despite the vast impact of procedure on substantive right, many in the Israeli legal system mistakenly view civil procedure rules as highly technical and neutral directives for the day-to-day operation of the litigation process. The conclusion from such a view is that rulemaking should be left to expert legal technicians and court administrators and that transparency mechanisms or public participation are to be avoided as unnecessary due to the costs and burdens they impose on the rulemaking process. The article concludes with a call for overhauling the rulemaking process in Israel. We argue that the secretive and opaque process is anathema to democracy. Bearing in mind that procedural rules are inevitably imbued with substantive values and have an enormous effect on the substantive rights of the citizenry, the rulemaking process should be radically altered to enable all interested parties to take part in the process, making it far more transparent and subject to public scrutiny in all its stages.
Physicochemical stability of human insulin 1 I.U./mL infusion solution in 50 mL polypropylene syringes
Authors: Mohr André , Erdnüß Frank , Krämer Irene 
Published: September 2021

Abstract

Objectives
The objective of this study was to investigate the physicochemical stability of human insulin 1 I.U./mL injection solutions (Insuman® Rapid) diluted with 0.9% NaCl solution in 50 mL disposable three-piece polypropylene syringes and stored refrigerated or at room temperature.

Methods
1 I.U./mL test solutions were prepared with Insuman® Rapid and 0.9% sodium chloride infusion solution in 50 mL Original-Perfusor® syringes and BD® Perfusion syringes. Test solutions were stored for 90 days at 2–8 °C/dark or 48 h at 20–25 °C/diffuse room light in order to determine chemical stability. Additional test solutions were stored 28 days at 2–8 °C/dark followed by 24 h at 20–25 °C/diffuse room light to measure pH and particle counts. Human insulin concentrations were analysed by reversed-phase high-performance liquid chromatography at predefined time points. Test solutions were regularly inspected; subvisible particles and pH values were measured.

Results
Insuman® Rapid 1 I.U./mL injection solutions, stored at 2–8 °C/dark for 90 days showed a decrease of insulin content over time, regardless of the syringe type used. When kept at 20–25 °C/diffuse room light for 48 h, a slight decrease of the HI concentration was observed in both syringe types. No evidence of colour change, relevant particle formation or major pH-change was observed throughout the observation period in any test solution.

Conclusions
Insuman® Rapid 1 I.U./mL injection solutions can be prepared by dilution with 0.9% NaCl infusion solution in disposable 50 mL three-piece polypropylene syringes as suitable primary containers. Physicochemical stability has been demonstrated for at least 21 days stored at 2–8 °C/dark followed by 48 h at 20–25 °C/diffuse room light.
Ischemic stroke as a presenting manifestation of polycythemia vera: a narrative review
Authors: Burattini Marco , Falsetti Lorenzo , Potente Eleonora , Rinaldi Claudia , Bartolini Marco , Buratti Laura , Silvestrini Mauro , Viticchi Giovanna 
Published: September 2021

Abstract
Polycythemia vera (PV) is a myeloproliferative disorder associated with an increased risk of cerebrovascular diseases. In this narrative review, we aimed to analyze the relationships between acute ischemic stroke and PV. We conducted a PubMed/Medline and Web of Sciences Database search using MeSH major terms. We found 75 articles and finally considered 12 case reports and 11 cohort studies. The ischemic stroke resulted as the first manifestation of PV in up to 16.2% of cases; the cumulative rate of cerebrovascular events was up to 5.5 per 100 persons per year and stroke accounted for 8.8% of all PV-related deaths; age, mutations, and a previous history of thrombosis were the main risk factors. The best approach to reduce stroke recurrence risk is unclear, even if some evidence suggests a potential role of lowering hematocrit below 45%. Ischemic stroke represents one of the most common PV manifestations but, despite their relationship, patients with both diseases have a very heterogeneous clinical course and management. PV-related strokes often remain underdiagnosed, especially for the low prevalence of PV. An early diagnosis could lead to prompt treatment with phlebotomy, cytoreduction, and low-dose aspirin to decrease the risk of recurrences. Clinicians should be aware of PV as a risk factor for stroke when approaching the differential diagnosis of cryptogenic strokes. An early diagnosis could positively influence patients’ management and clinical outcomes. Further studies are required to evaluate the role of PV treatments in the prevention of cerebrovascular disease.
Aggiornamenti su Bartolomeo Varnucci
Authors: Guernelli Daniele 
Published: September 2021

Abstract
This article outlines the figure of the Florentine Bartolomeo Varnucci, an illuminator who for decades had his workshop in the Badia Fiorentina, where he was assisted by his brothers Giovanni and Chimenti. They where all cartolai, craftsmen able to take care of the production of manuscripts as a whole, from the preparation of the parchment to the binding. Active from the third to the eighth decade of the fifteenth century, Bartolomeo was able to interpret the rise of humanistic book production, with its typical decoration of white vine stems, but also to move through the vast requests of the devotional world, more inclined to conservative artistic solutions. This contribution gives a complete survey of the artist’s milieu and work, adding several new works to his catalogue.
“Malerische Dichtungen”: Two Landscape Paintings of 1916 by Ernst Ludwig Kirchner
Authors: Simmons Sherwin 
Published: September 2021

Abstract
During 1916 Ernst Ludwig Kirchner created a group of landscape paintings, based on his experiences at the Kohnstamm Sanatorium in Königstein, which were more symbolic in character than his previous landscapes. This essay shows that contact with Carl and Thea Sternheim, who encouraged a reengagement with Vincent van Gogh’s paintings and letters, played a role in this change. Kirchner’s recognition of how Van Gogh could express an affect through his painting was reinforced by Dr. Kohnstamm’s writings about empathy’s role in artistic expression. Artistic practice and aesthetic theory were joined in representations of Jena done during Fall 1916 in which Kirchner transformed the landscape through formal means into symbols of his emotional relationship to that space.
The Anachronic Madonna Lactans: Impersonations of the Nursing Virgin by Cindy Sherman, Catherine Opie, and Vanessa Beecroft
Authors: Sperling Jutta 
Published: September 2021

Abstract
This article examines Cindy Sherman’s Untitled #216 (1989), Catherine Opie’s Self-Portrait/ Nursing (2004), and Vanessa Beecroft’s White Madonna or VBSS.002 (2006) in relation to the medieval and Renaissance artworks these photos quote and re-instantiate: Jean Fouquet’s Virgin of Melun (1452–1455); Ambrogio Lorenzetti’s Madonna del Latte (1325–1335) and Leonardo da Vinci’s Litta Madonna (1490s); and Tino di Camaino’s Charity (1321) and Jan van Eyck’s Lucca Madonna (1436), respectively. This juxtaposition — framed by reference to Alexander Nagel’s and Christopher Wood’s concept of “anachronism” and to Aby Warburg’s notion of the Pathosformel — helps us ask new questions and gain new insights about the “old masters” under discussion.
Metabolic surgery improves the unbalanced proportion of peripheral blood myeloid dendritic cells and T lymphocytes in obese patients
Authors: Zhang Jingjing , Chen Xi , Liu Wei , Zhang Chunlan , Xiang Yufei , Liu Shiping , Zhou Zhiguang 
Published: September 2021

Background
Obesity is associated with impaired immune function and chronic low-grade inflammation. Metabolic surgery is one of the most effective therapies for treating obesity and related metabolic disorders. We aimed to explore the pathophysiological roles of peripheral dendritic cells (DCs) and T lymphocytes in metabolic surgery.

Method
In this observational cohort study, a total of 106 individuals, including obese participants with or without T2DM, overweight subjects and normal controls, were recruited. All obese participants underwent laparoscopic sleeve gastrectomy surgery and returned for the evaluation of the clinical indicators after surgery. We evaluated the frequencies of circulating DCs subsets (myeloid (mDCs) and plasmacytoid (pDCs)), the pro-inflammatory (Th1 and Th17) and anti-inflammatory (Th2 and Treg) T cell subsets by flow cytometry.

Results
Compared with normal controls, the frequencies of mDCs, Th1 and Th17 cells increased, while Treg and Th2 cells decreased in the obese participants. The frequency of mDCs and Th1 cells consistently declined after surgery compared with baseline in the obese patients and were restored to the levels observed in the normal controls after surgery. Moreover, the frequency of Treg cells was increased at 6 months after surgery in the obese patients with T2DM, and Th17 cells declined at 6 months after surgery in the severely obese patients without T2DM.

Conclusion
This study indicates that metabolic surgery can effectively improve imbalanced immune cells in peripheral blood and restore the proportion of immune cells to a normal range during a 12-month follow-up.
Physical properties of raspberry and orange flavoured fruit syrups
Authors: Lambert-Meretei Anikó , Vozary Eszter , Kaszab Timea 
Published: September 2021

AbstractIn the case of fruit syrups, consumers prefer thicker, deep-coloured ones because they remind them of good old homemade ones. Physical properties – as viscosity, colour, refractive index, soluble solid content (SSC), and electrical impedance - of fruit syrups flavoured with raspberry or orange juice were determined. The change of the measured physical properties was determined in three different experiments: 1. evaluating the effect of sugar and sweetener content 2. evaluating the effect of fruit juice composition and 3. evaluating the effect of sugar content on syrups containing raspberry or orange juice only. Variations in fruit and sugar content had a definite effect on the physical properties of squashes. Viscosity, SSC value, refractive index, and impedance magnitude increased with increasing sugar content and decreased with replacement of sugar with sweeteners although colour characteristics were defined mostly by the colorant added to the squash. Changes in the fruit composition of syrups could influence viscosity, refractive index, and SSC values but the magnitude of impedance showed little changes for all samples. The characteristics of squashes containing only raspberry or orange juice and different sugar content did not follow any trends, which emphasized that additives had a significant effect on the physical properties.
Entre la calle y el cementerio : prácticas, rituales y religiosidad de las trabajadoras sexuales transgénero, de Bastidas, Díaz y Villamarín.
Authors: Chaustre Fandiño Laura Viviana 
Published: September 2021

El Cementerio Central de Bogotá y su vecindad con el barrio Santa Fe son el núcleo articulador de un libro que cuenta encuentros diversos: entre vivos y ánimas benditas, entre mitos y biografías, entre vendedores y altares, entre ofrendas y milagros, entre trabajadoras sexuales y un espacio sagrado, entre mujeres trans, ángeles y santos.
La primera parte del libro da cuenta de la milagrosa facultad de los difuntos, las ánimas benditas, para intervenir en situaciones terrenales. Dicha facultad permite una serie de intercambios en los cuales, mediante ofrendas, las personas vivas solicitan favores y crean un compromiso ritual. Flores, agua, arroz, susurros, placas, oraciones, fuego en velas, caramelos, maíz y hasta cerveza son parte de los regalos que se entregan para pedir amparo, fortuna, amor, dinero, salud o, a la vuelta, agradecer losfavores recibidos.
Entre el cristianismo y la política : la incidencia política para la paz en la ideología de la iglesia cristiana menonita en Colombia.
Authors: Ramírez Bravo Yenny Natalia 
Published: September 2021

El presente artículo presenta los resultados de una investigación sobre la postura ideológica de la Iglesia Cristiana Menonita frente al proceso de paz en Colombia. Mediante un análisis de los discursos orales de sus integrantes y sus publicaciones, abordo su fundamentación doctrinal, su propuesta de participación política y sus estrategias de formación para la paz. Se trata de un estudio de caso que acude a las entrevistas semiestructuradas y al análisis de textos. Concluyo que los menonitas, desde una postura no partidista, quieren incidir políticamente en la construcción de paz en Colombia.