bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adult residual rectourethral fistula and diverticulum presenting decades after imperforate anus repair: a case report
Authors: McShane Erin K. , Gurland Brooke , Sheth Vipul R. , Bruzoni Matias , Enemchukwu Ekene 
Published: July 2021

Abstract
Background
This report describes a rare surgical case of an intraabdominal mass in a middle-aged patient 40 years after imperforate anus repair.

Case presentation
A 44-year-old Latino male with history of repaired anorectal malformation presented with recurrent urinary tract infections and rectal prolapse with bothersome bleeding and fecal incontinence. During his preoperative evaluation, he was initially diagnosed with a prostatic utricle cyst on the basis of magnetic resonance imaging findings, which demonstrated a cystic, thick-walled mass with low signal contents that extended inferiorly to insert into the distal prostatic urethra. However, at the time of surgical resection, the thick-walled structure contained an old, firm fecaloma. The final pathology report described findings consistent with colonic tissue, suggesting a retained remnant of the original fistula and diverticulum.

Conclusions
Although rare, persistent rectourethral fistula tracts and rectal diverticula after imperforate anus repair can cause symptoms decades later, requiring surgical intervention. This is an important diagnostic consideration for any adult patient with history of imperforate anus.
Knowledge of the community regarding mental health problems: a cross-sectional study
Authors: Tesfaye Yonas , Agenagnew Liyew , Anand Susan , Tucho Gudina Terefe , Birhanu Zewdie , Ahmed Gutema , Getnet Masrie , Yitbarek Kiddus 
Published: July 2021

AbstractBackgroundKnowledge of the community regarding mental health problems has a remarkable impact on the attitude, the help-seeking path, and prevention of stigma and discrimination against patients with mental health problems. It is also the cornerstone for designing evidence-based community mental health interventions. However, the evidence is scarce in developing countries like Ethiopia. This study aimed to assess the knowledge regarding mental health problems and associated factors among communities of Jimma Zone, Oromia, Ethiopia.MethodsA community-based cross-sectional study was conducted in the Jimma zone from March 1 to 22, 2020. A structured, pretested, and interviewer-administered questionnaire was used to collect data from 420 study participants selected through a systematic sampling technique. The knowledge about mental health was measured by the adapted version of the Mental Health Knowledge Schedule tool. Data were entered into Epi-data version 3.1 and exported to SPSS version 23.0 for analysis. Multivariate logistic regression analysis was done, andp-value < 0.05 and 95% CI were used to determine the predictors of the outcome variable.ResultsThe overall knowledge score showed (188, 44.8%) of the respondents had inadequate knowledge. Moreover, (75, 17.9%) of the respondents reported psychiatric disorders are contagious, and (138, 32.9%) mentioned leaving alone is the treatment for mental illness. Talking or laughing alone and showing strange or unusual behaviors were described as symptoms of mental illness by the majority (407, 96.9%) and (403, 96.0%) of respondents, respectively. Brain dysfunction was attributed to the cause of mental illness by most (390, 92.9%) of the study participants. Similarly, the percentage of responses that attributed the causes of mental illness to possession by an evil spirit, God’s punishment, and witchcraft were significantly high (368, 87.6%), (321, 76.4%) and (259, 67.1%), respectively. Furthermore, regression analysis showed that respondents who were able to read and write were 64% less likely to have adequate knowledge than those in secondary school and above educational status (AOR = 0.34, 95% CI (0.16–0.69)).ConclusionKnowledge of mental illness among the general public was relatively poor and higher levels of education were associated with good knowledge of mental health problems; this suggests the need for due emphasis on public education to improve the mental health literacy status of the community.
The costs of standardized apprenticeship curricula for training firms
Authors: Schweri Jürg , Aepli Manuel , Kuhn Andreas 
Published: July 2021

AbstractStandardized curricula define the set of skills that must be trained within a training occupation and thus are a key regulatory element of apprenticeship systems. Although clear economic rationales support the usage of such curricula, they necessarily impose costs, especially on firms that train apprentices, but do not use the full set of skills in their productive process and/or train other skills that are not covered by the curriculum. In this paper, we identify the trade-offs involved in setting up training curricula and use data from the most recent survey on the costs and benefits of apprenticeship training among Swiss firms to quantify the associated costs to training firms. On average, training firms state that they do not use 17% of the training content prescribed by the relevant curriculum, and 11% of the companies train additional skills not covered by the curriculum. We show that both kinds of misfit are associated with higher training costs and lower productive output from apprentices. This shows that the regulator imposes costs on firms in order to guarantee broad skills development for apprentices. It also cautions against overly broad curricula that may impose disproportionate costs on firms.
The safety and efficacy of fecal microbiota transplantation in a population with bipolar disorder during depressive episodes: study protocol for a pilot randomized controlled trial
Authors: Cooke Noah C. A. , Bala Asem , Allard Johane P. , Hota Susy , Poutanen Susan , Taylor Valerie H. 
Published: July 2021

AbstractBackgroundBipolar disorder (BD) is a chronic, debilitating illness with significant medical morbidity, often secondary to current treatments, and a high recurrence rate. This burden of disease reflects limitations in the tolerability and efficacy of current treatments. There is a compelling body of evidence linking the gut microbiota to mental illness, and while microbial manipulation via probiotic use has been studied as a therapeutic in BD, targeted trials of fecal microbiota transplantation (FMT) have not been conducted in this population.Methods and designWe describe a pilot randomized controlled trial of FMT in participants with BD depression to assess the feasibility, efficacy, safety, and tolerability of this intervention. Individuals between 18 and 65 years of age will be enrolled in the study if they meet diagnostic criteria for a major depressive episode of at least moderate severity in the context of a BD diagnosis and have not responded to treatment for BD. Participants will be randomized 1:1 to receive either screened and processed donor stool (allogenic FMT) or their own stool (autologous FMT) via colonoscopy and monitored for 24 weeks post intervention. Depressive and manic symptoms, treatment acceptability, and gastrointestinal and other side effects are assessed at baseline (prior to randomization) and weekly. Stool samples to assess microbiome composition are obtained at baseline and 3 and 6 months.DiscussionCurrently, FMT represents a novel therapeutic option for treating BD depression. This protocol allows for the assessment of the feasibility, efficacy, acceptability, and safety of an intervention aimed at changing the microbiome in those with BD. Results from this pilot study will guide the development of larger trials of FMT for BD depression and may give more insight into how the gut microbiome are altered in those with BD depression.Trial registrationClinical Trials GovNCT03279224
Cure and prevention of cardiovascular diseases: herbs for heart
Authors: Ray Suman , Saini Mahesh Kumar 
Published: July 2021

AbstractHerbs contribute to more than 60-70% in development of modern medicines in the world market either directly or indirectly. The herbal treatments for congestive heart failure, systolic hypertension, angina, atherosclerosis, cerebral insufficiency and venous insufficiency etc. has been known since ancient times. Unlike allopathic medicines, Ayurveda medicines are considered safe, however, the adverse reactions of herbal drugs is also reported. In this paper, we have compiled 128 herbs and their parts that have medicinal value to prevent, alleviate or cure heart disease related disorders. Jaccard Neighbour-joining cluster analysis using Free Tree software was used to assess the relative importance of plants in context with its healing potential for heart related disease. Based on the medicinal value in context with the heart, five major clusters of the selected 128 herbs were made. Correlation of the distance between herbs revealed that most of these herbs were found to have more than one medicinal property. The distance in dendogram depicted closeness of properties curing heart disease; as less the distance between two medicinal plants or two groups they will more close to cure particular heart disease. During drug development, a medicinal plant can be replaced by another plant of same group or by another plant of its neighbour group but from same pedigree. Thus, in case of non-availability of herbs or if it belongs to the category of rare, threatened, and endangered species, such method may add to new ways of drug development.
Alertness in patients with treatment-resistant depression: interface between sleep medicine and psychiatry—review article
Authors: Kolar Dusan , Kolar Michael V. 
Published: July 2021

Abstract
Background
Treatment-resistant depression (TRD) is a significant problem in clinical practice and reason for the lack of functional recovery among depressed patients. Sleep disturbances and poor alertness are common residual symptoms.

Main body of the abstract
Many patients with refractory depression experience residual symptoms, such as insomnia, daytime sleepiness, and poor alertness. This is a literature review and we searched the electronic databases, including PubMed, the Cochrane database, Ovid MEDLINE, PsycINFO, and Google Scholar of all studies published between 2000 and 2020.
The literature on the relationship between sleep quality and alertness in a patient with depression is very sparse. One possible reason could be the difficulty in defining alertness as a mental function. Alertness itself has been described as a state of responsivity to both interoceptive and external stimuli. Subjective and objective measures of alertness, daytime somnolence, and quality of sleep are presented. Adjunctive treatment with stimulant medications (methylphenidate, amphetamine, modafinil) to the standard antidepressant medications might be warranted in patients in patients with daytime sleepiness, decreased alertness, fatigue, and poor work performance.

Short conclusion
Patients with treatment-resistant depression usually suffer from poor quality of sleep and decreased alertness. Stimulant medications may help with alertness, daily functioning, and work performance.
Approach to the Patient With Adrenal Incidentaloma
Authors: Bancos Irina , Prete Alessandro 
Published: July 2021

Abstract
Adrenal tumors are commonly discovered incidentally on cross-sectional abdominal imaging performed for reasons other than adrenal mass. Incidence of adrenal tumors increased 10-fold in the past 2 decades, with most diagnosed in older adults. In any patient with a newly discovered adrenal mass, determining whether the adrenal mass is malignant and whether it is hormonally active is equally important to guide the best management. Malignancy is diagnosed in 5% to 8% of patients with adrenal tumors, with a higher risk in young patients, if history of extra-adrenal malignancy, in those with large adrenal tumors with indeterminate imaging characteristics, and in bilateral adrenal tumors. Although overt hormone excess is uncommon in adrenal incidentalomas, mild autonomous cortisol secretion can be diagnosed in up to 30% to 50% of patients. Because autonomous cortisol secretion is associated with increased cardiovascular morbidity and metabolic abnormalities, all patients with adrenal incidentalomas require work up with dexamethasone suppression test. Management of adrenal tumors varies based on etiology, associated comorbidities, and patient’s preference. This article reviews the current evidence on the diagnosis and evaluation of patients with adrenal mass and focuses on management of the most common etiologies of adrenal incidentalomas.
The 2014 New York State Medicaid Expansion and Severe Maternal Morbidity During Delivery Hospitalizations
Authors: Guglielminotti Jean , Landau Ruth , Li Guohua 
Published: July 2021

BACKGROUND:
Medicaid expansions under the Affordable Care Act have increased insurance coverage and prenatal care utilization in low-income women. However, it is not clear whether they are associated with any measurable improvement in maternal health outcomes. In this study, we compared the changes in the incidence of severe maternal morbidity (SMM) during delivery hospitalizations between low- and high-income women associated with the 2014 Medicaid expansion in New York State.

METHODS:
Data for this retrospective cohort study came from the 2006–2016 New York State Inpatient Database, a census of discharge records from community hospitals. The outcome was SMM during delivery hospitalizations, as defined by the Centers for Disease Control and Prevention. We used regression coefficients (β) from multivariable logistic models: (1) to compare independently in low-income women and in high-income women the changes in slopes in the incidence of SMM before (2006–2013) and after (2014–2016) the expansion, and (2) to compare low- and high-income women for the changes in slopes in the incidence of SMM before and after the expansion.

RESULTS:
A total of 2,286,975 delivery hospitalizations were analyzed. The proportion of Medicaid beneficiaries in parturients increased a relative 12.1% (95% confidence interval [CI], 11.8-12.4), from 42.9% in the preexpansion period to 48.1% in the postexpansion period, whereas the proportion of the uninsured decreased a relative 4.8% (95% CI, 2.8-6.8). Multivariable logistic modeling revealed that implementation of the 2014 Medicaid expansion was associated with a decreased slope during the postexpansion period both in low-income women (β = –0.0161 or 1.6% decrease; 95% CI, –0.0190 to –0.0132) and in high-income women (β = –0.0111 or 1.1% decrease; 95% CI, –0.0130 to –0.0091). The decrease in slope during the postexpansion period was greater in low- than in high-income women (β = –0.0042 or 0.42% difference; 95% CI, –0.0076 to –0.0007).

CONCLUSIONS:
Implementation of the Medicaid expansion in 2014 in New York State is associated with a small but statistically significant reduction in the incidence of SMM in low-income women compared with high-income women.
Beta-Blocker Therapy Is Associated With Increased 1-Year Survival After Hip Fracture Surgery: A Retrospective Cohort Study
Authors: Mohammad Ismail Ahmad , Ahl Rebecka , Forssten Maximilian Peter , Cao Yang , Wretenberg Per , Borg Tomas , Mohseni Shahin 
Published: July 2021

BACKGROUND:
The high mortality rates seen within the first postoperative year after hip fracture surgery have remained relatively unchanged in many countries for the past 15 years. Recent investigations have shown an association between beta-blocker (BB) therapy and a reduction in risk-adjusted mortality within the first 90 days after hip fracture surgery. We hypothesized that preoperative, and continuous postoperative, BB therapy may also be associated with a decrease in mortality within the first year after hip fracture surgery.

METHODS:
In this retrospective cohort study, all adults who underwent primary emergency hip fracture surgery in Sweden, between January 1, 2008 and December 31, 2017, were included. Patients with pathological fractures and conservatively managed hip fractures were excluded. Patients who filled a prescription within the year before and after surgery were defined as having ongoing BB therapy. The primary outcome of interest was postoperative mortality within the first year. To reduce the effects of confounding from covariates due to nonrandomization in the current study, the inverse probability of treatment weighting (IPTW) method was used. Subsequently, Cox proportional hazards models were fitted to the weighted cohorts. These analyses were repeated while excluding patients who died within the first 30 days postoperatively. This reduces the effect of early deaths due to surgical and anesthesiologic complications as well as the higher degree of advanced directives present in the study population compared to the general population, which allowed for the evaluation of the long-term association between BB therapy and mortality in isolation. Results are reported as hazard ratios (HR) with 95% confidence intervals (CI). Statistical significance was defined as a 2-sided P value <.05.

RESULTS:
A total of 134,915 cases were included in the study. After IPTW, BB therapy was associated with a 42% reduction the risk of mortality within the first postoperative year (adjusted HR = 0.58, 95% CI, 0.57–0.60; P < .001). After excluding patients who died within the first 30 days postoperatively, BB therapy was associated with a 27% reduction in the risk of mortality (adjusted HR = 0.73, 95% CI, 0.71–0.75; P < .001).

CONCLUSIONS:
A significant reduction in the risk of mortality in the first year following hip fracture surgery was observed in patients with ongoing BB therapy. Further investigations into this finding are warranted.
Solid Oxide Fuel Cell Using Plastic Waste Directly as Fuel
Authors: Hibino Takashi , Kobayashi Kazuyo , Hitomi Takuma 
Published: July 2021

Abstract
Direct utilization of combustible waste as an energy resource is very attractive for improving waste-to-energy conversion efficiency. Herein, we report a high-performance solid oxide fuel cell (SOFC) that can be supplied continuously with plastic waste as a fuel. Iron(III) oxide powder functioned as a pseudofuel in the ion transfer process and as a catalyst for gasification of the plastic. The resultant SOFC provided peak power densities of 0.71, 0.68, and 0.57 W cm−2 for nylon 66, polyethylene, and polystyrene, respectively.
Characterizing Behavior of Fatty Acids in Natural Organic Samples during Loss on Ignition (LOI) at Each Temperature
Authors: Satoh Yuhi , Wada Shigeki 
Published: July 2021

Abstract
The loss on ignition (LOI) of fatty acids (FAs; including carbon numbers of C8–C24) in vegetal and animal organic reference samples at 200–500 °C was examined. The total FAs in the samples preferentially disappeared through LOI operation compared to the other compounds. The average carbon numbers in total FAs did not change substantially from their original values due to LOI, regardless of the temperature. However, the unsaturation ratios in each FA species fluctuated throughout the operation.
The eyes see what the mind seeks: a systematic review of abdominal imaging findings in patients with COVID-19
Authors: Agarwal Lokesh , Agarwal Ayushi , Advani Shailesh , Katiyar Varidh , Chaturvedi Aprajita , Madhusudhan Kumble Seetharama 
Published: July 2021

Objectives: With the increasing recognition of gastrointestinal (GI) manifestation of coronavirus disease-19 (COVID-19), various abdominal imaging findings are increasingly being noted. We scoped the existing literature on the abdominal imaging findings in COVID-19. Methods: A systematic literature search was performed on PubMed, Embase, Google scholar and World Health Organization COVID-19 database. Results: 35 studies were included in the final descriptive synthesis. Among the studies reporting positive abdominal imaging findings in patients with COVID-19, majority described imaging abnormalities of the GI tract (16 studies), of which bowel wall thickening was most frequently reported. Other findings noted were abdominal imaging manifestations of bowel ischemia with thrombosis of the splanchnic vasculature, and imaging features suggestive of pancreatitis. Imaging findings suggestive of solid organ infarction were reported in nine studies. An association between imaging evidence of hepatic steatosis and COVID-19 was noted in three studies. Incidental lung base findings on abdominal imaging were noted in 18 studies, where patients presented with predominant GI symptoms. The most common finding was bilateral ground glass opacities (90.7%) with predominant multilobar (91.1%) and peripheral (64.4%) distribution. Conclusion: This systematic review provides insight into the abdominal imaging findings in patients with COVID-19. Knowledge of these imaging manifestations will not only help in further research but also will aid in curtailing transmission of the SARS-CoV-2. Further prospective studies are needed to gain better insight into the pathophysiology of these imaging manifestations. Advances in knowledge: This review highlights the abdominal imaging findings in patients with COVID-19, to gain insight into the disease pathophysiology and gear the abdominal radiologist through the pandemic.
Aerobic, resistance, and mind-body exercise are equivalent to mitigate symptoms of depression in older adults: A systematic review and network meta-analysis of randomised controlled trials
Authors: Miller Kyle J. , Areerob Pinyadapat , Hennessy Declan , Gonçalves-Bradley Daniela C. , Mesagno Christopher , Grace Fergal 
Published: July 2021

Background: Exercise has been identified as an allied health strategy that can support the management of depression in older adults, yet the relative effectiveness for different exercise modalities is unknown. To meet this gap in knowledge, we present a systematic review and network meta-analysis of randomised controlled trials (RCTs) to examine the head-to-head effectiveness of aerobic, resistance, and mind-body exercise to mitigate depressive symptoms in adults aged ≥ 65 years. Methods: A PRISMA-NMA compliant review was undertaken on RCTs from inception to September 12th, 2019. PubMed, Web of Science, CINAHL, Health Source: Nursing/Academic Edition, PsycARTICLES, PsycINFO, and SPORTDiscus were systematically searched for eligible RCTs enrolling adults with a mean age ≥ 65 years, comparing one or more exercise intervention arms, and which used valid measures of depressive symptomology. Comparative effectiveness was evaluated using network meta-analysis to combine direct and indirect evidence, controlling for inherent variation in trial control groups. Results: The systematic review included 82 RCTs, with 69 meeting eligibility for the network meta-analysis (n = 5,379 participants). Pooled analysis found each exercise type to be effective compared with controls (Hedges’ g = -0.27 to -0.51). Relative head-to-head comparisons were statistically comparable between exercise types: resistance versus aerobic (Hedges’ g = -0.06, PrI = -0.91, 0.79), mind-body versus aerobic (Hedges’ g = -0.12, PrI = -0.95, 0.72), mind-body versus resistance (Hedges’ g = -0.06, PrI = -0.90, 0.79). High levels of compliance were demonstrated for each exercise treatment. Conclusions: Aerobic, resistance, and mind-body exercise demonstrate equivalence to mitigate symptoms of depression in older adults aged ≥ 65 years, with comparably encouraging levels of compliance to exercise treatment. These findings coalesce with previous findings in clinically depressed older adults to encourage personal preference when prescribing exercise for depressive symptoms in older adults. Registration: PROSPERO CRD42018115866 (23/11/2018).