bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gender stereotypes and biases in early childhood: A systematic review
Authors: King Tania L , Scovelle Anna J , Meehl Anneke , Milner Allison J , Priest Naomi 
Published: April 2021

This review aimed to synthesise studies examining the presence of gender stereotypes and biases expressed by young children aged 3–5 years, with a focus on informing early childhood settings. Our review located only 21 separate studies in 16 articles, highlighting a dearth of research in this area. There was substantial heterogeneity in the operationalisation of gender stereotypes and biases. There was evidence that children in early childhood are aware of, and can apply, gender stereotypes. There was also evidence of the malleability of these biases and stereotypes. The social and cultural environment plays a large role in defining the cues by which young children classify on the basis of gender. Research is needed to understand ways to support the establishment of equitable gender attitudes amongst children in early childhood, as this could deliver important benefits to individuals across their lifetime, as well as society more broadly.
Abnormal levels of apolipoprotein A‐I in chronic thromboembolic pulmonary hypertension
Authors: Khirfan Ghaleb , Li Manshi , Wang Xiaofeng , DiDonato Joseph A. , Dweik Raed A. , Heresi Gustavo A. 
Published: April 2021

Recent studies have shown low high‐density lipoprotein cholesterol (HDL‐C) and dysregulated lipid metabolism in chronic thromboembolic pulmonary hypertension (CTEPH). Apolipoprotein A‐I (ApoA‐I) is the major protein component of HDL‐C and mediates most of its functions. We hypothesize that ApoA‐1 and its oxidative state might be more sensitive biomarkers in CTEPH. Plasma levels of HDL‐C, ApoA‐I, paraoxonase‐1 enzyme activity (PON1), and the oxidized dysfunctional ApoA‐I (oxTrp72‐ApoA‐I) were measured in patients with CTEPH and compared to those in healthy controls. Association with markers of disease severity in CTEPH was assessed. We included a total of 61 patients with CTEPH (age: 61.2 ± 15 years; male 52.5%) and 28 control subjects (age: 60.1 ± 8 years; male 59.3%). When adjusting for age, sex, body mass index, and statin use, ApoA‐I was lower in CTEPH compared to controls (CTEPH:125.2 ± 27 mg/dl; control:158.3 ± 29.4 mg/dl; p < 0.001), but HDL‐C levels were not statistically different. There were no significant differences in PON and oxTrp72‐ApoA‐I/ApoA‐I ratio. In exploratory analyses, ApoA‐I was associated with mean right atrial pressure (rs = −0.32, p = 0.013) and N‐terminal pro B‐type natriuretic peptide (rs = −0.31, p = 0.038). There were no significant associations between HDL‐C, PON1, or oxTrp72‐ApoA‐I/ApoA‐I ratio and markers of disease severity. We conclude that ApoA‐I is a more sensitive biomarker than HDL‐C in CTEPH, and may be associated with right heart dysfunction.
Ovarian reserve may influence the outcome of bone mineral density in patients with long-term use of dienogest
Authors: Yamamoto N , Wada-Hiraike O , Hirano M , Hirata T , Harada M , Hirota Y , Koga K , Fujii T , Osuga Y 
Published: April 2021

Objective: Long-term administration of dienogest, which is known to have effect on bone mineral density, is frequently done in patients with endometriosis and adenomyosis, but a few studies focused on the bone mineral density changes after finishing the long-term therapy. This study aimed to reveal the factors that adversely affect lumbar bone mineral density. Method: Fifty-seven premenopausal women who visited our hospital were diagnosed as either endometriosis or adenomyosis, and they were treated by dienogest for more than 115 weeks (26.5 months). Based on a previous report, bone mineral density changes less than 2% was categorized as the osteopenic group ( n = 30), and the others were assigned to the unchanged group ( n = 27). Bone mineral density was measured at the lumbar spine using dual-energy X-ray absorptiometry. A representative ovarian reserve marker, endogenous estradiol levels, and follicle-stimulating hormone levels were measured over time and were compared between the osteopenic and unchanged groups. Result: Duration of dienogest intake was 59.5 months (osteopenic group) versus 57.5 months (unchanged group). These patients experienced ovarian surgeries in a similar frequency, but the ovarian reserve in osteopenic group was impaired as suggested by the decline of endogenous estradiol level during intake of dienogest compared to that of unchanged group ( p = 0.0146). Endogenous follicle-stimulating hormone level between osteopenic group and unchanged group did not reach statistically significant difference, although the osteopenic group showed relatively higher level. Conclusion: This study might suggest that decreased ovarian reserve as judged by endogenous estradiol level is a factor that negatively affect bone mineral density, and measurement of endogenous estradiol level during intake of dienogest could have a predictive meaning of future decreased bone mineral density level.
Rate of blood pressure control and its determinants among adult hypertensive patients at Jimma University Medical Center, Ethiopia: Prospective cohort study
Authors: Kebede Bekalu , Chelkeba Legese , Dessie Bekalu 
Published: April 2021

Introduction: Despite the fact that the goals for the management of hypertension are well-defined and effective therapies are available, control of hypertension remains poor in countries with low resources including Ethiopia. This study aimed to determine blood pressure control rate and its determinants among ambulatory adult hypertensive patients at Jimma University Medical Center. Methods: A general prospective cohort study was conducted among adult hypertensive patients who had regular follow-up at Jimma University Cardiac Clinic from 20 March to 20 June 2018. Hypertensive patients who fulfilled the inclusion criteria were selected in the first month of the data collection period. Then, only those patients who visited the clinic at the first month were consequently followed-up for the next 3 months. The Eighth Joint National Committee guideline was used to categorize controlled and uncontrolled blood pressures. Patients’ specific data were collected using a structured data collection tool. Data were analyzed using the statistical software package SPSS version 21.0. Bivariate and multivariable logistic regression analysis was used to identify independent variables influencing blood pressure control. p-values of less than 0.05 were considered statistically significant. Results: From a total of 416 patients, 237 (57.0%) were male with a mean age of 56.50 ± 11.96 years. Two hundred and fifty eight (62.0%) participants had comorbid conditions and 275 (66.1%) were on combination therapy. The rate of blood pressure control was 42.8%. Age ⩾60 years was negatively associated with uncontrolled blood pressure (adjusted odd ratio = 0.52, confidence interval = 0.31–0.88, p = 0.015). Medication non-adherence (adjusted odd ratio = 1.64, confidence interval = 1.04–2.58, p = 0.034) and non-adherence to international guidelines (adjusted odd ratio = 2.33, confidence interval = 1.49–3.64, p < 0001) were positively associated with uncontrolled blood pressure. Conclusion: The rate of blood pressure control among hypertensive patients was suboptimal. Age, clinicians’ non-adherence to international guidelines, and patients’ non-adherence to medications were independent predictors of blood pressure control. Physicians and clinical pharmacists should adhere to guidelines for better treatment and care of hypertensive patients.
Association between adenoid bacteriology and clinical characteristics of adenoid-related diseases in children
Authors: Ungkanont Kitirat , Jootakarn Sujeenun , Leelaporn Amornrut , Kijsinthopchai Usa , Tanphaichitr Archwin , Vathanophas Vannipa , Komoltri Chulaluk 
Published: April 2021

Introduction: The aim of this research is to find the association between the pathogenic bacteria obtained from the adenoid culture and clinical characteristics of adenoid-related diseases in children. Methods: In this retrospective study, we reviewed the medical records of children who had adenoidectomy for adenoid-related diseases. Demographic data, diagnoses, indications for adenoidectomy and bacterial culture results were collected. The adenoid size was measured in the lateral skull X-ray as adenoid–nasopharyngeal ratio. Associations between the culture results and the demographic data, adenoid size, and the diagnoses were analyzed. Results: There were 407 children who had adenoidectomy for obstructive sleep-disordered breathing (75.2%), otitis media with effusion (19.2%), and chronic sinusitis (5.6%). Median age was 5.9 years. Common pathogenic bacteria in the adenoid were Haemophilus influenzae (26.2%), Staphylococcus aureus (23.5%), Streptococcus pneumoniae (18.2%), and Moraxella catarrhalis (12%). The patient’s age had significant association with the prevalence of pathogenic bacteria. S. pneumoniae was most prevalent in young children up to 7 years. S. aureus was more common in children over 7 years. H. influenzae had similar prevalence in all age groups. Size of the adenoid and type of adenoid-related diseases had no association with the outcome of bacterial culture. Conclusion: Age of the patients was the significant factor associated with the bacteriological findings of the adenoid while size and types of adenoid-related diseases were not associated with the outcome of bacterial culture.
Informed consent: What risks are material to patients consenting for urological procedures?
Authors: McCauley Nadine , Lodhia Siya , Ong Andrea , Clark Calum , Lane Tim 
Published: April 2021

Objective: This study aimed to assess patient recall of the consent discussion for urological procedures and to identify which risks were material to urology patients. Methods: A total of 102 patients undergoing urological procedures were interviewed in the 24-hour period surrounding the procedure. A self-designed, piloted questionnaire recorded information from the patient’s signed consent form and patient-reported data of the consent discussion. Results: The mean patient recall was 2.06 risks, whereas the average number of risks listed by the operating surgeon on the consent form was 5.69 risks. The most frequently recalled risk was impotence (91%), followed by urinary incontinence (63%) and haematuria (61%). The risks associated with poorest patient recall were stent symptoms (0%), urethral catheter insertion (5%) and recurrence (8%). Conclusions: Poor patient recall of the consent discussion has again been demonstrated in this study. However, certain urological procedure risks are better recalled by patients, with impotence, urinary incontinence and haematuria being most frequently recalled. Medical terminology such as stent or catheter may be poorly recalled due to a disparity in understanding between patient and clinician. Clinicians should be aware of poor patient recall when consenting for urology procedures and should ensure precise documentation. Level of evidence: Level 2b.
Association between vitamin D deficiency and prostate cancer: Prospective case-control study
Authors: Kumawat Ghanshyam , Chaudhary Vijay , Garg Anurag , Mehta Nishkarsh , Talwar Gagan , Yadav SS , Tomar Vinay 
Published: April 2021

Objective: We aimed to find out the association of low serum vitamin D levels with the incidence of prostate cancer through a prospective case-control study. Material and methods: This study was carried out in the tertiary care hospital (India). All newly diagnosed patients of prostate cancer and age-matched controls were included. Serum vitamin D levels were measured in all of them. Vitamin D status (ng/mL) was classified as severe deficiency <10, moderate deficiency 10–<30, normal 30–100, and toxicity >100. Normality of the data was tested by the Kolmogorov–Smirnov test, s﻿tatistical analysis was done with Statistical Package for the Social Sciences version 26.0, p-value of <0.05 was considered significant. Results: In our study, 320 cases and 320 controls were included. The mean vitamin D levels in cases and controls were 15.71 ± 6.5 (ng/mL) and 17.63 ± 4.54 (ng/mL), respectively, ( p-Value <0.01). Patients with severe vitamin D deficiency (73.58%) had a Gleason score ⩾8 on biopsy and 79.24% of them had a serum prostate specific antigen (PSA) level >20 ng/mL. Conclusion: We had concluded that there was no significant association between vitamin D deficiency and increased risk of prostate cancer, although patients with higher-grade prostate cancer and with higher PSA level had severe vitamin D deficiency. Level of evidence: Not applicable for this multicentre audit.
Loss of Ambulatory Level and Activities of Daily Living at 1 Year Following Hip Fracture: Can We Identify Patients at Risk?
Authors: Konda Sanjit R. , Dedhia Nicket , Ranson Rachel A. , Tong Yixuan , Ganta Abhishek , Egol Kenneth A. 
Published: April 2021

Introduction: Operative hip fractures are known to cause a loss in functional status in the elderly. While several studies exist demonstrating the association between age, pre-injury functioning, and comorbidities related to this loss of function, no studies have predicted this using a validated risk stratification tool. We attempt to use the Score for Trauma Triage for Geriatric and Middle-Aged (STTGMA) tool to predict loss of ambulatory function and need for assistive device use. Materials and Methods: Five hundred and fifty-six patients ≥55 years of age who underwent operative hip fracture fixation were enrolled in a trauma registry. Demographics, functional status, injury severity, and hospital course were used to determine a STTGMA score and patients were stratified into risk quartiles. At least 1 year after hospitalization, patients completed the EQ-5D questionnaire for functional outcomes. Results: Two hundred and sixty-eight (48.2%) patients or their family members responded to the questionnaire. Of the 184 patients alive, 65 (35.3%) reported a return to baseline function. Eighty-nine (48.4%) patients reported a loss in ambulatory status. Patients with higher STTGMA scores were older, had more comorbidities, reported greater need for help with daily activities, increased difficulty with self-care, and a reduction in return to activities of daily living (all p ≤ 0.001). Patients with lower STTGMA scores were more likely to never require an assistive device while those with higher scores were more likely to continue needing one (p = 0.004 and p < 0.001). Patients in the highest STTGMA risk groups were 1.5x more likely to have an impairment in ambulatory status (need for ambulatory assistive device or decreased ambulatory capacity) (p = 0.004). Discussion: Patients in higher STTGMA risk quartiles were more likely to experience impairment after hip fracture surgery. The STTGMA tool can predict loss of ambulatory independence following hip fracture. At-risk populations can be targeted for enhanced physiotherapy and rehabilitation services for optimal return to prior functioning.
Design and Evaluation of a Hospital-Based Educational Event on Fracture Care for Older Adult
Authors: Gosch Markus , Kammerlander Christian , Fantin Emilio , Jensen Thomas Giver , Salazar Ana Milena López , Olarte Carlos , Bavatonavarech Suthorn , Medina Claudia , Link Bjoern-Christian , Cunningham Michael 
Published: April 2021

Introduction: Surgeons, internal medicine physicians, nurses, and other members of the healthcare team managing older adults with a fracture all have barriers to attending educational courses, including time away from practice and cost. Our planning group decided to create and evaluate a hospital-based educational event to address, meet, and improve the care of older adults with a fracture. Materials and Methods: A committee of surgeons and geriatricians defined 3 learning objectives to improve knowledge and attitudes in co-managed care. They designed a 1-day educational event consisting of a departmental visit, a review of cases, a planning session to identify gaps and plan changes, and presentations on selected topics. Thirteen hospitals worldwide completed an 8-question online application form, and 7 sites were selected for delivery over 3 years in Denmark, Colombia, Thailand, Paraguay, Switzerland, and the Dominican Republic. Results: Each event was conducted by 1 or more visiting surgeons and geriatricians, and the local team leaders. The most common challenges reported in the applications were preoperative assessment or optimization, delayed surgery, lack of protocols, access to a geriatrician, teamwork, and specific aspects of perioperative and postoperative care. In each department, 4 or 5 goals and targets for implementation were agreed. The presentations section was customized and attended by 20 to 50 team members. Discussion: Topics selected by a majority of departments were principles of co-managed care (7), preoperative optimization (7), and management of delirium (4). Follow up was conducted after 3 and 12 months to review the degree of achievement of each planned change and to identify any barriers to complete implementation. Conclusions: Hospital-based events with visiting and local faculty were effective to engage a broader audience that might not attend external courses. A performance improvement component with goal setting and follow up was acceptable to all host departments.
Outcomes of COVID-19 Negative Hip Fracture Patients During the Acute and Subacute Pandemic
Authors: Onizuka Naoko , Topor Lauren N. , Schroder Lisa K. , Switzer Julie A. 
Published: April 2021

Objectives: To better elucidate how the COVID-19 pandemic has affected the operatively treated geriatric hip fracture population and how the health care system adapted to pandemic dictated procedures. Design: Retrospective cohort study. Setting: A community hospital. Participants: Individuals ≥65 years of age presented with a proximal femoral fracture from a low-energy mechanism undergoing operative treatment from January 17, 2020 to July 2, 2020 (N = 125). Measurements: We defined 3 phases of healthcare system response: pre-COVID-19, acute phase, and subacute phase. Thirty-day mortality, time to operating room (OR), length of stay, time to start physical therapy, perioperative complications, delirium rate, hospice admission rate, discharge dispositions, readmission rate, and the reason of surgery delay were assessed. Results: The number of hip fractures has remained constant during the pandemic. The 30-day mortality rate, time to OR, and length of stay were higher in the pandemic compared to the pre-pandemic. Those who had a longer wait time to OR (≥ 24 hours) had more complications and increased 30-day mortality rates. Some of the surgery delays were related to OR unavailability as a consequence of the COVID-19 pandemic. Surgery was delayed in 3 patients who were on direct oral anticoagulants (DOACs) in pandemic but none for pre-pandemic period. Conclusion: This is the first study to compare the effect of the acute and subacute phases of the pandemic on uninfected hip fracture patients. In the age of COVID-19, to provide the best care for the vulnerable geriatric orthopedic populations, the healthcare system must adopt new protocols. We should still aim to promote prompt surgical care when indicated. It is important to ensure adequate resource availability, such as OR time and staff so that hip fracture patients may continue to receive rapid access to surgery. A multidisciplinary approach remains the key to the management of fragility hip fracture patients during the pandemic.
Incentives, Status and Thereafter: A Critical Survey
Authors: Dey Oindrila , Banerjee Swapnendu 
Published: April 2021

This article provides a critical discussion on the working of status as an instrument to elicit desirable effort within an organization. It postulates a comprehensive survey of the studies on incentive, especially non-monetary incentives like status. Different studies are summarized concisely and elaborate comments on the divergent views on valuation for status, the relationship between monetary and status incentives, the technique of modelling status and the cost of introducing status have been illustrated. The article underlines some probable adverse consequences associated with the use of the status incentive. Status works by creating inequality and has strong unwarranted influence even beyond organizational purview. It emphasizes the need for profound research to account for the optimal and prudent use of status as incentives. JEL Classification: L2, D21, D86
Were Foreign Exchange Markets Reacting Negatively to Political Events? The Case of Malaysia
Authors: Hui Hon Chung 
Published: April 2021

This article explores the effects of political events on foreign exchange returns in Malaysia. We identify five political events in recent history, namely the 13th General Election (GE13), the imprisonment of a key opposition politician, the scandal from the 1MDB exposé, the appointment of a new Central Bank Governor and the 14th General Election (GE14). Using event studies, our findings show that the imprisonment of the opposition party leader triggered a favourable response from the foreign exchange market. However, market reactions to the 1MDB scandal were largely unfavourable. The GE13 triggered unfavourable market response, while the reverse is true for market reactions to GE14. Market response to the appointment of the new Central Bank Governor was rather positive. The Event Study is the first of its kind that examines the foreign exchange market implications of key political events in Malaysia. There are practical considerations that emanate from these findings. JEL Classification: F31, D72, D73, O38
Agreement in Medications Reported in Medical and Dental Electronic Health Records
Authors: Tenuta L.M.A. , Canady C. , Eber R.M. , Johnson L. 
Published: April 2021

Introduction: The historical separation between medicine and dentistry has resulted in the creation of separate health records, which have the potential to negatively impact patient care and safety. Of particular importance, errors or omissions in medication lists in separate electronic health records (EHRs) may lead to medical errors and serious adverse outcomes. Objective: This study aimed to compare medication lists reported in the EHRs of active patients treated by both the University of Michigan School of Dentistry and Michigan Medicine to determine if differences exist. Methods: In this cohort study, EHRs of a population of 159,733 patients that the University of Michigan medical and dental clinics share in common were investigated for agreement in the reporting of 16 medications. After exclusion of minors and patients not seen in the last 5 y, records of 27,277 patients were examined. Results: The maximum percentage of agreement in medications reported in both records was 52% for levothyroxine, and the minimum was 7% for sildenafil. The medical record had a significantly higher number of unique medications than the dental record, suggesting higher underreporting in the dental setting. Conclusion: The lack of agreement in the report of medications with serious dental and medical implications argues in favor of unification of records and use of available technology to increase accurate medication reporting. Knowledge Transfer Statement: The results demonstrate a lack of agreement between medications reported in medical and dental records, which can have serious implications to patients’ health. A unified health record, employing available technology to increase accurate medication reporting, would mitigate this problem.