bluuebunny/crossref_metadata_2025_split huggingface dataset:
Normative values of handgrip and pinch strengths in healthy female college students in Riyadh, Saudi Arabia: a cross-sectional study
Authors: Shaheen Afaf Ahmed Mohamed , Omar Mohammed Taher Ahmed , Ali Olfat Ibrahim 
Published: February 2021

Abstract
Background
Handgrip strength (HGS) and pinch strengths (PS) are the common measures to evaluate hand function and predict general health. Normative values of HGS, PS, and prediction equations of HGS for healthy young adult women have not been reported yet in Saudi Arabia. The aims of the study were to determine the HGS and PS normative values and develop the prediction equations for the established HGS in a sample of healthy female college students, aged 19–25 years. In this descriptive cross-sectional study, 139 healthy female college students were recruited randomly from King Saud University (KSU). Both HGS and PS in kilograms were measured using a Jamar hand dynamometer and pinch gauge respectively with standard testing protocol and instructions.

Results
HGS significantly increased with progress in age, while there was no significant effect of age on PS. HGS and PS of the dominant hand were statistically greater than those of the nondominant hand (P < 0.05) in most ages. There were significant correlations between dominant HGS, age (r = 0.7, P < 0.001), palmar width (r = 0.74, P < 0.001), and level of physical activity (r = 0.60, P < 0.001). Regression analysis revealed that palmar width and age were the predictors of dominant HGS and accounted for 55% and 14% of the variation, respectively.

Conclusions
Normative values can be used as a clinical reference in the evaluation of hand function in the rehabilitation process with consideration of age and palmar width for a particular population.
Metabolic Signatures of Genetically Elevated Vitamin D Among Chinese: Observational and Mendelian Randomization Study
Authors: Zhuang Zhenhuang , Yu Canqing , Guo Yu , Bian Zheng , Yang Ling , Millwood Iona Y , Walters Robin G , Chen Yiping , Xu Qinai , Zou Mingyuan , Chen Junshi , Chen Zhengming , Lv Jun , Huang Tao , Li Liming 
Published: February 2021

Abstract

Context
Observational studies have suggested that higher circulating 25-hydroxyvitamin D [25(OH)D] levels are associated with favorable serum lipids and related metabolites. However, whether such observations reflect causality remains unclear.

Objective
We aimed to investigate the causal effect of elevated 25(OH)D with a detailed systemic metabolite profile in Chinese adults.

Methods
A total of 225 lipid and other metabolites were quantiﬁed in 4662 individuals in the China Kadoorie Biobank. Instrumental variable analyses were performed to test the causal associations of plasma 25(OH)D with lipids and metabolites.

Results
Higher plasma 25(OH)D was related to favorable lipid profiles in observational analyses. The genetic risk score was robustly correlated with observed 25(OH)D (beta[SE] = 3.54 [0.32]; P &lt; 1 × 10−5, F-statistic = 122.3) and explained 8.4% of the variation in 25(OH)D in the Chinese population. For all individual metabolites, the causal estimates were not significant at the threshold P &lt; 5 × 10−4 (multiple testing corrected). However, a Mendelian randomization (MR) estimate showed that per 1-SD increase in genetically determined 25(OH)D was suggestive of association with decreased levels of cholesterol, lipoprotein particles, and phospholipids within very small very low-density lipoprotein (VLDL) and intermediate-density lipoprotein (IDL) (P ≤ 0.05, nominal significance). For amino acids, fatty acids, ketone bodies, glycoprotein acetyls, fatty acids, and other traits, we did not observe any significant causal association.

Conclusions
The MR analysis of metabolic data based a population-based cohort suggested a potential causal association of plasma 25(OH)D with cholesterol, lipoprotein particle, phospholipid concentrations, and total lipids within very small VLDL and IDL. Our findings highlight a long-term effect of 25(OH)D levels in maintaining healthy lipid metabolism.
IGSF1 Does Not Regulate Spermatogenesis or Modify FSH Synthesis in Response to Inhibins or Activins
Authors: Brûlé Emilie , Heinen Charlotte A , Smith Courtney L , Schang Gauthier , Li Yining , Zhou Xiang , Wang Ying , Joustra Sjoerd D , Wit Jan M , Fliers Eric , Repping Sjoerd , van Trotsenburg A S Paul , Bernard Daniel J 
Published: February 2021

AbstractLoss-of-function mutations in the X-linked immunoglobulin superfamily, member 1 (IGSF1) gene result in central hypothyroidism, often associated with macroorchidism. Testicular enlargement in these patients might be caused by increases in follicle-stimulating hormone (FSH) levels, as IGSF1 has been proposed to function as an inhibin B receptor or as an inhibitor of activin type I receptor (ALK4) activity in pituitary gonadotrope cells. If true, loss of IGSF1 should lead to reduced inhibin B action or disinhibition of activin signaling, thereby increasing FSH synthesis. Here, we show that FSH levels and sperm counts are normal in male Igsf1 knockout mice, although testis size is mildly increased. Sperm parameters are also normal in men with IGSF1 deficiency, although their FSH levels may trend higher and their testes are enlarged. Inhibin B retains the ability to suppress FSH synthesis in pituitaries of Igsf1-knockout mice and IGSF1 does not interact with ALK4 or alter activin A/ALK4 stimulation of FSHβ (Fshb/FSHB) subunit transcription or expression. In light of these results, it is unlikely that macroorchidism in IGSF1 deficiency derives from alterations in spermatogenesis or inhibin/activin regulation of FSH.
Removal of Epididymal Visceral Adipose Tissue Prevents Obesity-Induced Multi-organ Insulin Resistance in Male Mice
Authors: Franczyk Michael P , He Mai , Yoshino Jun 
Published: February 2021

Abstract
Obesity is associated with insulin resistance, an important risk factor of type 2 diabetes, atherogenic dyslipidemia, and nonalcoholic fatty liver disease. The major purpose of this study was to test hypothesize that prophylactic removal of epididymal visceral adipose tissue (VAT) prevents obesity-induced multi-organ (liver, skeletal muscle, adipose tissue) insulin resistance. Accordingly, we surgically removed epididymal VAT pads from adult C57BL/6J mice and evaluated in vivo and cellular metabolic pathways involved in glucose and lipid metabolism following chronic high-fat diet (HFD) feeding. We found that VAT removal decreases HFD-induced body weight gain while increasing subcutaneous adipose tissue (SAT) mass. Strikingly, VAT removal prevents obesity-induced insulin resistance and hyperinsulinemia and markedly enhances insulin-stimulated AKT-phosphorylation at serine-473 (Ser473) and threonine-308 (Thr308) sites in SAT, liver, and skeletal muscle. VAT removal leads to decreases in plasma lipid concentrations and hepatic triglyceride (TG) content. In addition, VAT removal increases circulating adiponectin, a key insulin-sensitizing adipokine, whereas it decreases circulating interleukin 6, a pro-inflammatory adipokine. Consistent with these findings, VAT removal increases adenosine monophosphate–activated protein kinase C phosphorylation, a major downstream target of adiponectin signaling. Data obtained from RNA sequencing suggest that VAT removal prevents obesity-induced oxidative stress and inflammation in liver and SAT, respectively. Taken together, these findings highlight the metabolic benefits and possible action mechanisms of prophylactic VAT removal on obesity-induced insulin resistance and hepatosteatosis. Our results also provide important insight into understanding the extraordinary capability of adipose tissue to influence whole-body glucose and lipid metabolism as an active endocrine organ.
Moral trauma caused by COVID-19 - An ethical debate
Authors: Zaidi Shabih H , Jawaid Shaukat Ali 
Published: February 2021

doi: https://doi.org/10.12669/pjms.37.3.4295
How to cite this:Zaidi SH, Jawaid SA. Moral trauma caused by COVID-19 - An ethical debate. Pak J Med Sci. 2021;37(3):613-615. doi: https://doi.org/10.12669/pjms.37.3.4295
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.
Effects of steroid therapy in patients with severe fever with Thrombocytopenia syndrome: A multicenter clinical cohort study
Authors: Jung Sook In , Kim Ye Eun , Yun Na Ra , Kim Choon-Mee , Kim Dong-Min , Han Mi Ah , Kim Uh Jin , Kim Seong Eun , Kim Jieun , Ryu Seong Yeol , Kim Hyun ah , Hur Jian , Kim Young Keun , Jeong Hye Won , Heo Jung Yeon , Jung Dong Sik , Lee Hyungdon , Huh Kyungmin , Kwak Yee Gyung , Lee Sujin , Lim Seungjin , Lee Sun Hee , Park Sun Hee , Yeom Joon-Sup , Kim Shin-Woo , Bae In-Gyu , Lee Juhyung , Kim Eu Suk , Seo Jun-Won 
Published: February 2021

Background
Severe fever with thrombocytopenia syndrome (SFTS) is an acute, febrile, and potentially fatal tick-borne disease caused by the SFTS Phlebovirus. Here, we evaluated the effects of steroid therapy in Korean patients with SFTS.

Methods
A retrospective study was performed in a multicenter SFTS clinical cohort from 13 Korean university hospitals between 2013 and 2017. We performed survival analysis using propensity score matching of 142 patients with SFTS diagnosed by genetic or antibody tests.

Results
Overall fatality rate was 23.2%, with 39.7% among 58 patients who underwent steroid therapy. Complications were observed in 37/58 (63.8%) and 25/83 (30.1%) patients in the steroid and non-steroid groups, respectively (P < .001). Survival analysis after propensity score matching showed a significant difference in mean 30-day survival time between the non-steroid and steroid groups in patients with a mild condition [Acute Physiology and Chronic Health Evaluation II (APACHE II) score <14; 29.2 (95% CI 27.70–30.73] vs. 24.9 (95% CI 21.21–28.53], P = .022]. Survival times for the early steroid (≤5 days from the start of therapy after symptom onset), late steroid (>5 days), and non-steroid groups, were 18.4, 22.4, and 27.3 days, respectively (P = .005).

Conclusions
After steroid therapy, an increase in complications was observed among patients with SFTS. Steroid therapy should be used with caution, considering the possible negative effects of steroid therapy within 5 days of symptom onset or in patients with mild disease (APACHE II score <14).
Knowledge, attitude, practice towards COVID-19 pandemic and its prevalence among hospital visitors at Ataye district hospital, Northeast Ethiopia
Authors: Gebretsadik Daniel , Ahmed Nuru , Kebede Edosa , Gebremicheal Saba , Belete Melaku Ashagrie , Adane Metadel 
Published: February 2021

Background
Coronavirus disease 19 (COVID-19) is currently a global health threat and public health emergency of international concern. Africa is the last continent to be hit by this pandemic and the population is still prone to misconceptions and may not take it seriously. In developing countries including Ethiopia, where trained human resources and equipment for the treatment of COVID-19 are scarce, working on prevention of the viral spread should be a priority as a feasible intervention strategy. The aim of this study was to determine the level of knowledge, attitude, practice (KAP) towards COVID-19 and its prevalence among hospital visitors.

Methods
Health institution based cross sectional study was conducted among 513 hospital visitors who are recruited by using simple random sampling technique at Ataye district hospital, Northeast Ethiopia from June 3, 2020 to August 10, 2020. A pre-tested structured questionnaire was used to obtain information related to socio-demographic characteristics, knowledge (11 questions), attitude (9 questions) and practice (9 questions). Oro-pharyngeal specimen was collected by trained healthcare provider and processed in a molecular laboratory. After extraction of viral nucleic acid, the Real-time fluorescent polymerase chain reaction (RT-PCR) kit was used for detecting novel coronavirus (2019-nCoV). Data was analyzed using bi-variable and multivariable logistic regression model with 95% CI (confidence interval). From the bi-variable analysis, variables having a P-value <0.25 were retained into multivariable analysis. From the multivariable analysis, variables with a P-value <0.05 was declared as associated factors.

Results
Majority (72.9%) of the study participants were male; and most were urban dwellers. From the total study participants, 17 (3.3%) were found to be infected with the virus. The magnitude of low-level of knowledge was 4.9%; and of the analyzed risk factors, female gender, age (category less than 16 years and category between 16 and 65 years), and usual alcohol drinking habit had statistically significant association with low level knowledge. The proportion of study participants who had low level of practice was 75/513 (14.62%). Family size, age category between 16 and 65 years, and low-level knowledge were associated with low-level practice.

Conclusion
Limited number of study participants had high-level knowledge and practice towards COVID-19; while majority of the study candidates demonstrated moderate level of knowledge and practice. Good knowledge, positive attitude and good practice can be a guarantee for the prevention and control of COVID-19. Hence, various measurements to combat the pandemic should be taken by different stakeholders including the community members, religious leader, health professionals and others.
Life chances after surgery of congenital heart disease: A case-control-study of inter- and intragenerational social mobility over 15 years
Authors: Geyer Siegfried , Fleig Katharina , Norozi Kambiz , Röbbel Lena , Paul Thomas , Müller Matthias , Dellas Claudia 
Published: February 2021

BackgroundPatients of congenital heart disease surgery have good prospects for reaching old age. Against the backdrop of increasing life expectancies, the question of how well such patients are mastering daily routines and their working life emerges. In our study, the educational and occupational performance of patients over 15 years was examined.MethodsIntergenerational social mobility (changes in social positions from the parental generation to the generation of children) was examined in terms of education, and intragenerational social mobility (changes in positions within the same generation, i.e., in individuals over their life courses) was examined in terms of occupational positions. Comparisons were made between patients and a control group drawn from the German Socio-Economic Panel (SOEP). Controls were drawn from respondents who participated in the 2004 and 2018 SOEP surveys.ResultsThe data were from 244 out of 360 patients (68%) with complete social data from the first survey (2003–2004) and who were included in the follow-up (2017–2019), and 238 controls were drawn from the SOEP. At the time of the second survey, subjects’ ages ranged from 28 to 59 years of age (M = 40.1 years). Intergenerational educational mobility did not differ between cases and controls. For intragenerational social mobility, downward changes were more frequent among controls. This latter finding may be explained by patients retiring earlier than the general population. Retirement rates increased over time, particularly among patients with severe congenital malformations. Unemployment rates were also higher among patients.ConclusionsTaken together, although a considerable proportion of patients with congenital heart disease retired prematurely or never entered the labour force, their educational and occupational careers proceeded more favourably than expected.
Characterizing tramadol users with potentially inappropriate co-medications: A latent class analysis among older adults
Authors: Yang Bo Ram , Um Hye-Yeon , Lee Min Taek , Kim Myo Song , Jung Sun-Young 
Published: February 2021

Background
Although tramadol is an effective weak opioid analgesic, careful monitoring of potential central nervous system adverse reactions in older adults is needed, especially when used with concomitant medications which may trigger the adverse effects. We aimed to characterize tramadol users with potentially inappropriate co-medications in older adults using a latent class analysis (LCA).

Method
Patients aged 65 years or older using tramadol and receiving potentially inappropriate co-medications were included from a nationwide healthcare claims database. We defined antidepressants, first-generation antihistamines, and anxiolytics as potentially inappropriate co-medications. We applied an LCA for grouping tramadol users based on the common characteristics of medication use and healthcare utilization, and each patient was probabilistically assigned to a class. Patients’ characteristics in different latent classes were compared. Potential adverse drug reactions (ADRs) was defined as the any visits for emergency department after the occurrence of potentially inappropriate co-medications. Logistic regression analysis was used to examine the association between latent classes and potential ADRs.

Results
We identified four distinct latent classes of tramadol users representing different patterns of co-medications: multiple potential drug-drug interaction (pDDI) combination users, antihistamines-tramadol users, antidepressants-tramadol users, and anxiolytics-tramadol users. Multiple pDDI combination users showed high proportion of regular tramadol use, tended to visit more medical institutions, and had a high Charlson comorbidity score. The duration of use of potentially inappropriate co-medications with tramadol was the longest in multiple pDDI combination users and the shortest in antihistamines-tramadol users.
When compared with antihistamines-tramadol users, increased potential ADR risk was observed in multiple pDDI combination users (adjusted odds ratio (OR), 1.81; 95% confidence interval (CI), 1.75–1.88), antidepressants-tramadol users (1.24; 1.19–1.29), and anxiolytics-tramadol users (1.04; 1.00–1.08).

Conclusions
Four distinct classes were identified among older adults using tramadol and potentially inappropriate co-medications. Differences in potential ADR risk were observed between these classes. These findings may help to identify patients at a high risk for ADRs owing to potentially inappropriate co-medications with tramadol.
Vitamin D supplementation among Bangladeshi children under-five years of age hospitalised for severe pneumonia: A randomised placebo controlled trial
Authors: Chowdhury Fahmida , Shahid Abu Sadat Mohammad Sayeem Bin , Tabassum Mosharrat , Parvin Irin , Ghosh Probir Kumar , Hossain Mohammad Iqbal , Alam Nur Haque , Faruque A. S. G. , Huq Sayeeda , Shahrin Lubaba , Homaira Nusrat , Hassan Zakiul , Akhtar Zubair , Mah-E-Muneer S. , Fuchs George J. , Ahmed Tahmeed , Chisti Mohammod Jobayer 
Published: February 2021

Introduction
Vitamin D is important for its immunomodulatory role and there is an independent association between vitamin D deficiency and pneumonia. We assessed the effect of vitamin D supplementation on the outcome in children hospitalized for severe pneumonia.

Methods
This was a randomised, double blinded, placebo-controlled clinical trial in children aged >2–59 months with severe pneumonia attending Dhaka Hospital, icddr,b. Children received age-specific megadose of vitamin D3 (20,000IU: <6 months, 50,000 IU: 6–12 months, 100,000 IU:13–59 months) or placebo on first day and 10,000 IU as maintenance dose for next 4 days or until discharge (if discharged earlier) along with standard therapy. This trial is registered at ClinicalTrials.gov, number NCT02185196.

Findings
We enrolled 100 children in placebo group and 97 in vitamin D group. On admission, 50 (52%) and 49 (49%) of children in vitamin D and placebo groups, respectively were vitamin D deficient. Among children with a sufficient serum vitamin D level on admission, a lower trend for duration of resolution of severe pneumonia in hours [72(IQR:44–96)vs. 88(IQR:48–132);p = 0.07] and duration of hospital stay in days [4(IQR:3–5)vs.5(IQR:4–7);P = 0.09] was observed in vitamin D group compared to placebo. No beneficial effect was observed in vitamin D deficient group or irrespective of vitamin D status.

Conclusion
Age-specific mega dose of vitamin D followed by a maintenance dose shown to have no statistical difference between the two intervention groups, however there was a trend of reduction of time to recovery from pneumonia and overall duration of hospital stay in under-five children with a sufficient serum vitamin D level on hospital admission.
The syndemic effects of mental ill health, household hunger, and intimate partner violence on adherence to antiretroviral therapy among pregnant women living with HIV in Yaoundé, Cameroon
Authors: Cordoba Evette , Parcesepe Angela M. , Gallis John A. , Headley Jennifer , Soffo Claudian , Tchatchou Berenger , Hembling John , Baumgartner Joy Noel 
Published: February 2021

BackgroundThis research advances understanding of interrelationships among three barriers to adherence to antiretroviral therapy (ART) among pregnant women living with HIV (WLWH) in Cameroon: probable common mental disorders (CMD), intimate partner violence (IPV), and hunger.MethodsThe sample included 220 pregnant WLWH in Cameroon. Multivariable modified Poisson regression was conducted to assess the relationship between IPV, hunger, and CMD on ART adherence.ResultsAlmost half (44%) of participants recently missed/mistimed an ART dose. Probable CMD was associated with greater risk of missed/mistimed ART dose (aRR 1.5 [95% CI 1.1, 1.9]). Hunger was associated with greater risk of missed/mistimed ART dose among those who reported IPV (aRR 1.9 [95% CI 1.2, 2.8]), but not among those who did not (aRR 0.8 [95% CI 0.2, 2.3]).ConclusionSuboptimal ART adherence, CMD, and IPV were common among pregnant WLWH in Cameroon. Pregnant WLWH experiencing IPV and hunger may be especially vulnerable to suboptimal ART adherence.
Prevalence and associated factors of post-partum depression in Ethiopia. A systematic review and meta-analysis
Authors: Zeleke Tadele Amare , Getinet Wondale , Tadesse Tessema Zemenu , Gebeyehu Kassahun 
Published: February 2021

Background
Globally, post-partum depression is a major public health problem and is associated with a harmful effect on the infant, child, and mothers’ mental, physical, and social health. Although a few post-partum depression studies have been published, we still lack an accurate estimated pooled prevalence of national PPD and associated factors.

Objectives
This study aims to show the estimated pooled prevalence of PPD and associated factors in Ethiopia.

Methods
We conduct the extensive search of articles as indicated in the guideline (PRISMA), reporting systematic review and meta-analysis. Databases like MEDLINE, PubMed, psych INFO, Web of Science, EMBASE, CINAHL, Scopus, and The Cochrane Library. All publications and grey literature were addressed by using MeSH terms and keywords. The pooled estimated effect of post-partum depression and associated factors was analyzed using the random effect model meta-analysis, and 95% CI was also considered.

Protocol and registration
PROSPERO 2020 CRD42020176769 Available from https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020176769.

Result
A total of 11 studies with 7,582 participants were included in this meta-analysis. The estimated pooled prevalence of post-partum depression (PPD) was 22.08%, with a 95% CI (17.66%, 26.49). For factors associated with post-partum depression, a random effect size model was used during meta-analysis; unplanned pregnancy [(OR = 2.84; 95% CI (2.04, 3.97)], domestic violence [OR = 3.14; 95% CI (2.59, 3.80)], and poor social support [OR = 3.57;95% CI (2.29,5.54) were positively associated factors with post-partum depression.

Conclusion and recommendation
The estimated pooled prevalence of post-partum depression was high in Ethiopia. Unplanned pregnancy, poor social support, and domestic violence were factors affecting PPD. Therefore, the Ethiopian policymakers and health personnel better give more emphasis to mothers who had a history of unplanned pregnancy, domestic violence, and poor social support