bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Sacred and the Profane: Menstrual Flow and Religious Values
Authors: Kamat Shefali , Tharakan Koshy 
Published: April 2021

Most religious texts and practices warrant the exclusion of women from religious rituals and public spheres during the menstrual flow. This is seemingly at odds with the very idea of ‘Religion’ which binds the human beings with God without any gender and sexual discrimination. The present article attempts to problematize the ascription of negative values on menstruating women prevalent in both Hinduism and Christianity, two major world religions of the East and the West. After briefly stating the patriarchal values that restrict women from participating in religious rituals and shaming them during menstruation as seen from both these religions, the article highlights the alternate feminist perspectives in beliefs that positively value the menstruating bodies. Thus, the notion of profanity is revalued as sacred in these alternate religious perspectives. Drawing from the writings of Mary Douglas, we then examine the connection between the notion of purity/impurity and menstruation and argue that what makes something pure or impure depends upon the archetype the society chooses to represent itself. In itself, nothing is either pure or impure in the sense of having a value or disvalue. This argument is exemplified through a feministic-hermeneutic approach to the religious practices in two major world religions. The article concludes by uncovering the patriarchal values held by religions as the cause of menstrual taboos in religious practices and argues that the notions of purity/impurity and sacred/profane are the results of the valuations made—from a patriarchal or feministic perspective.
Toward a More Comprehensive Assessment of School Age Children with Hemiplegic Cerebral Palsy
Authors: Hoyt Catherine R , Sherman Sarah K , Brown Shelby K , Newbold Dillan J , Miller Ryland L , Van Andrew N , Shimony Joshua S , Ortega Mario , Nguyen Annie L , Schlaggar Bradley L , Dosenbach Nico UF 
Published: April 2021

Background: Cerebral palsy (CP) is the leading cause of disability in children. While motor deficits define CP, many patients experience behavioral and cognitive deficits which limit participation. The purpose of this study was to contribute to our understanding of developmental delay and how to measure these deficits among children with CP. Methods: Children 5 to 15 years with hemiplegic CP were recruited. Cognition and motor ability were assessed. The brain injury associated with observed motor deficits was identified. Accelerometers measured real-world bilateral upper extremity movement and caregivers completed behavioral assessments. Results: Eleven children participated, 6 with presumed perinatal stroke. Four children scored below average intelligence quotient while other measures of cognition were within normal limits (except processing speed). Motor scores confirmed asymmetrical deficits. Approximately one third of scores indicated deficits in attention, behavior, or depression. Conclusions: Our findings corroborate that children with CP experience challenges that are broader than motor impairment alone. Despite the variation in brain injury, all participants completed study procedures. Implications: Our findings suggest that measuring behavior in children with CP may require a more comprehensive approach and that caregivers are amenable to using online collection tools which may assist in addressing the therapeutic needs of children with CP.
Direct oral anticoagulants and the risk of osteoporotic fractures in patients with non-valvular atrial fibrillation
Authors: Kuo Liang-Tseng , Lin Su-Ju , Wu Victor Chien-Chia , Chang Jung-Jung , Chu Pao-Hsien , Lin Yu-Sheng 
Published: April 2021

Background: The incidence of osteoporotic fracture increases with age, particularly in elderly populations with atrial fibrillation (AF). However, direct oral anticoagulants (DOACs) have less effect on osteoporotic fracture than vitamin K antagonists, it is unclear whether the risk of osteoporotic fracture is affected by different types and doses of DOACs in AF patients. Methods: This nationwide population-based cohort study included AF patients prescribed DOACs between 2011 and 2016 taken from the Taiwan National Health Insurance database. Adjusted hazard ratios (aHRs) for the risk of osteoporotic, hip, and spine fractures between DOAC users were compared using the Fine and Gray subdistribution hazard model to adjust for possible confounders. Results: A total of 56,795 patients who were prescribed DOACs were included in the present study. Among them, 24,597 patients received dabigatran, 26,968 received rivaroxaban, and 5230 received apixaban. After 2 years’ follow up, there was no significant difference in the incidence of osteoporotic, spine, or hip fracture among those receiving dabigatran, rivaroxaban, or apixaban. Subgroup analysis showed that patients taking dabigatran had a higher incidence of osteoporotic and hip fracture than those taking rivaroxaban and apixaban in cases with concomitant peripheral artery disease (PAD) or a history of hip fracture ( p for interaction: 0.004 and 0.030, respectively). However, dabigatran users had a lower incidence of osteoporotic fracture and spine fracture in those receiving standard-dose DOACs compared with rivaroxaban and apixaban; whereas, they had a higher incidence of hip fractures when administered at low dose. Conclusion: AF patients with different DOACs did not have different risks of osteoporotic fracture overall. However, additional concomitant morbidities, such as PAD or a history of hip fracture, and standard/low doses might be associated with different risks for different DOACs. These findings should be taken into consideration in the clinic when the DOAC is being chosen. Plain language summary Different direct oral anticoagulants had different impact on osteoporotic fracture Anticoagulation therapy is an essential therapy in atrial fibrillation (AF) patients, but osteoporotic fracture is another important issue in these patients prescribed with anticoagulants. However, no study has been conducted to evaluate the impact of different DOACs on different types of osteoporotic fractures. In our findings, although different DOACs had no significantly different impact on osteoporotic fractures, dabigatran users had a slightly higher incidence of osteoporotic and hip fractures among different DOACs, particularly in those have simultaneously had peripheral artery disease, a history of hip fracture. In addition, when AF patients taking low-dose DOACs, dabigatran users also have higher incidence of hip fracture than those taking other DOACs.
Knowledge, attitude, and practice of health professionals in Ethiopia toward COVID-19 prevention at early phase
Authors: Fetansa Getahun , Etana Belachew , Tolossa Tadesse , Garuma Melkamu , Tesfaye Bekuma Tariku , Wakuma Bizuneh , Etafa Werku , Fekadu Ginenus , Mosisa Alemnesh 
Published: April 2021

Introduction: Coronavirus disease (COVID-19) is a potentially lethal disease having significant public health concerns. As the disease is new, nothing has been intervened yet. Therefore, here we show the health worker’s knowledge, attitude, and practice toward COVID-19. Methods: The online cross-sectional study design was conducted from April to May 2020, among Ethiopia health workers. The data were collected online, downloaded by an Excel sheet, and transferred to IBM SPSS version 24. Using questionnaire containing four parts sociodemographic, knowledge, attitude, and practice assessing. Linear logistic regression and binary logistic regression were performed to test the association between the dependent and the independent variables. We reported the 95% confidence intervals of adjusted odds ratios with a statistical significance level at less than 0.05 p-values. Results and conclusion: A total of 441 health workers were included in this study. The majority of participants were from urban (88.7%), nurses (53.1%), male (88.4%), and have a degree educational level (66.7%). The mean knowledge level of respondents was 10.13 ± 0.057 standard deviation. The majority of respondents had a positive attitude toward control of COVID-19, 88%, and 77% of respondents had confidence that Ethiopia will control COVID-19. Similarly, male (2.746, 95% confidence interval (1.23, 6.02)) and good knowledge level (1.98, 95% confidence interval (1.01, 3.09)) were found to be a determinant for attitude regarding control of COVID-19. Good knowledge level 1.6 (1.02, 2.6), male sex 2.2 (1.07, 4.6), masters 2.33 (1.06, 5.08), and medical doctors 5.99 (1.76, 20.4) to practice wearing a mask when going out of the home. Knowledge, attitude, and practice of the participant health workers are considerable, but may not be enough to control the disease. Sex, age, and profession of the health workers were determinant factors for knowledge about COVID-19. Therefore, training has to be considered for updating health care workers on COVID-19 prevention and controlled at the national level.
Job Satisfaction Among Plastic Surgery Residents in Canada
Authors: Copeland Andrea E. , Mackinnon Victoria , Axelrod Daniel E. , Farrokhyar Forough , Avram Ronen , Coroneos Christopher J. 
Published: April 2021

Objective: Resident wellness is a focus of medical training and is prioritized in both Canadian and American accreditation processes. Job satisfaction is an important component of wellness that is not examined in the literature. The purpose of this study was to analyze job satisfaction in a national sample of plastic surgery residents, and identify factors that influence satisfaction. Methods: We designed a cross-sectional survey adapted from existing instruments, with attention to thorough item generation and reduction as well as pilot and clinical sensibility testing. All plastic surgery residents at Canadian institutions were surveyed regarding overall job satisfaction as well as personal- and program-specific factors that may affect satisfaction. Predictors of satisfaction were identified using multivariable regression models. Results: The response rate was 40%. Median overall job satisfaction was 4.0 on a 5-point Likert scale. Operative experience was considered both the most important element of a training program, and the area in most need of improvement. Senior training year ( P < .01), shorter commute time ( P = .04), fewer duty hours ( P = .02), fewer residents ( P < .01), and more fellows ( P < .01) were associated with significantly greater job satisfaction. Conclusions: This is the first study to gather cross-sectional data on job satisfaction from a national sample of plastic surgery residents. The results from this study can inform programs in making tangible changes tailored to their trainees’ needs. Moreover, our findings may be used to inform a prospectively studied targeted intervention to increase job satisfaction and resident wellness to address North American accreditation standards.
Meditation Monologue can Reduce Clinical Injection-Related Anxiety: Randomized Controlled Trial
Authors: Sugimoto Dai , Slick Nathalie R. , Mendel David L. , Stein Cynthia J. , Pluhar Emily , Fraser Joana L. , Meehan William P. , Corrado Gianmichel D. 
Published: April 2021

Background. Strategies to reduce anxiety prior to injection procedures are not well understood. The purpose is to determine the effect of a meditation monologue intervention delivered via phone/mobile application on pre-injection anxiety levels among patients undergoing a clinical injection. The following hypothesis was tested: patients who listened to a meditation monologue via phone/mobile application prior to clinical injection would experience less anxiety compared to those who did not. Methods. A prospective, randomized controlled trial was performed at an orthopedics and sports medicine clinic of a tertiary level medical center in the New England region, USA. Thirty patients scheduled for intra- or peri-articular injections were randomly allocated to intervention (meditation monologue) or placebo (nature sounds) group. Main outcome variables were state and trait anxiety inventory (STAI) scores and blood pressure (BP), heart rate, and respiratory rate. Results. There were 16 participants who were allocated to intervention (meditation monologue) while 14 participants were assigned to placebo (nature sounds). There was no interaction effect. However, a main time effect was found. Both state anxiety (STAI-S) and trait anxiety (STAI-T) scores were significantly reduced post-intervention compared to pre-intervention (STAI-S: p = 0.04, STAI-T: p = 0.04). Also, a statistically significant main group effect was detected. The pre- and post- STAI-S score reduction was greater in the intervention group (p = 0.028). Also, a significant diastolic BP increase between pre- and post-intervention was recorded in the intervention group (p = 0.028), but not in the placebo group (p = 0.999). Conclusion. Listening to a meditation monologue via phone/mobile application prior to clinical injection can reduce anxiety in adult patients receiving intra- and peri-articular injections. Registration: ClinicalTrials.gov NCT02690194
Prioritizing social identities: Patients’ perspective on living with multimorbidity
Authors: Sand Camilla Drivsholm , Rahbek Keren , Willadsen Tora G , Jønsson Alexandra R 
Published: April 2021

Objective: This article explores experiences of people with multimorbidity, and attempts to advance understandings of the complexity of living with multimorbidity outside the medical encounter in a social identity theoretical framework. Method: This is a qualitative study using individual semi-structured interviews among nine persons living with multimorbidity. The interviews are analysed inductively according to thematic content analysis. Results: The emerging themes are: 1) Impact on daily life, 2) Professional life and 3) Capacity for handling multimorbidity. People with multimorbidity experience physical limitations and psychological distress, which limits their ability to maintain social relations and affiliation to the labour market. Accordingly, they are challenged in their ability to retain a sense of normal everyday life, which is mediated by their capacity for handling multimorbidity. Discussion: Multimorbidity may compromise various social identities. The complexity of living with multimorbidity is increased by an aspiration to maintain valued social identities in order to preserve a coherent sense of self and a normal everyday life. This study suggests an increased focus on individual priorities and values outside the medical encounter, and argues in favour of recognizing the conflicts that people experience as they try to balance multimorbidity with other important aspects of their daily lives.
Differences in the “egumi” taste of moso-bamboo shoots: research using chemical analysis and two types of taste sensors
Authors: Furusawa Yuka , Nakamura Hitoshi , Ashitani Tatsuya 
Published: April 2021

AbstractWe conducted our research with the aim of determining whether the “egumi” taste of moso-bamboo shoots differs depending on the production area and how the “egumi” taste of bamboo shoots from Yamagata Prefecture, which is near the northern limit of cultivation, differs. The investigation was conducted using conventional chemical analysis methods to quantitatively evaluate the presence and content of homogentisic acid and oxalic acid in bamboo shoots from different regions. In addition, qualitative evaluation, for which chemical analysis alone is insufficient, was conducted using taste sensors, which have rarely been used. As a result, chemical analysis showed that homogentisic acid was not identified among the two substances considered to be major components of egumi taste, while oxalic acid was identified in all samples. Therefore, it is highly likely that oxalic acid is responsible for the “egumi” taste in this study. In addition, qualitative analysis using taste sensors revealed that there is a difference in “egumi” taste depending on the origin of the bamboo shoot. It was suggested that bamboo shoots from Yamagata Prefecture, near the northern limit of cultivation, had a stronger “egumi” taste than those from Kyoto and Fukuoka Prefectures.
Transcriptome dynamic landscape underlying the improvement of maize lodging resistance under coronatine treatment
Authors: Ren Zhaobin , Wang Xing , Tao Qun , Guo Qing , Zhou Yuyi , Yi Fei , Huang Guanmin , Li Yanxia , Zhang Mingcai , Li Zhaohu , Duan Liusheng 
Published: April 2021

Abstract
Background
Lodging is one of the important factors causing maize yield. Plant height is an important factor in determining plant architecture in maize (Zea mays L.), which is closely related to lodging resistance under high planting density. Coronatine (COR), which is a phytotoxin and produced by the pathogen Pseudomonas syringae, is a functional and structural analogue of jasmonic acid (JA).

Results
In this study, we found COR, as a new plant growth regulator, could effectively reduce plant height and ear height of both hybrids (ZD958 and XY335) and inbred (B73) maize by inhibiting internode growth during elongation, thus improve maize lodging resistance. To study gene expression changes in internode after COR treatment, we collected spatio-temporal transcriptome of inbred B73 internode under normal condition and COR treatment, including the three different regions of internode (fixed, meristem and elongation regions) at three different developmental stages. The gene expression levels of the three regions at normal condition were described and then compared with that upon COR treatment. In total, 8605 COR-responsive genes (COR-RGs) were found, consist of 802 genes specifically expressed in internode. For these COR-RGs, 614, 870, 2123 of which showed expression changes in only fixed, meristem and elongation region, respectively. Both the number and function were significantly changed for COR-RGs identified in different regions, indicating genes with different functions were regulated at the three regions. Besides, we found more than 80% genes of gibberellin and jasmonic acid were changed under COR treatment.

Conclusions
These data provide a gene expression profiling in different regions of internode development and molecular mechanism of COR affecting internode elongation. A putative schematic of the internode response to COR treatment is proposed which shows the basic process of COR affecting internode elongation. This research provides a useful resource for studying maize internode development and improves our understanding of the COR regulation mechanism based on plant height.
Infliximab‐induced seizures in a patient with Crohn’s disease: a case report
Authors: Lv Zhijie , Zhang Xiaoqi , Wu Li 
Published: April 2021

Abstract
Background
Infliximab-induced seizures in patients with Crohn’s disease are extremely rare and the mechanism of infliximab-induced seizures is unclear.

Case presentation
A 60-year-old woman with Crohn’s disease experienced infliximab-induced seizures, diagnosed on normal magnetic resonance imaging of the brain. Moreover, the rechallenge with infliximab was positive.

Conclusions
Neurological assessment and tight clinical monitoring before and during therapy with infliximab should be performed in patients with pre-existing seizure disorders.
Investigating the utility of COVID-19 antibody testing in end-stage renal disease patients receiving haemodialysis: a cohort study in the United Kingdom
Authors: Wickens Olivia , Chinnadurai Rajkumar , Mannan Fahmida , Svendsen Frida , Baig Mirza Yasar , Chukwu Chukwuma , Ali Ibrahim , Summersgill Christina , Evans Dawn , Antoine Berckley V. , Oxton Julie , Mairs Nathan , Flanagan Emma , Oliver Robert , Kalra Philip A. , Poulikakos Dimitrios 
Published: April 2021

Abstract
Background
End-stage renal disease (ESRD) patients receiving haemodialysis (HD) are a vulnerable group of patients with increased mortality from COVID-19. Despite improved understanding, the duration of host immunity following COVID-19 infection and role of serological testing alone or in addition to real-time reverse transcription polymerase chain reaction (rRT-PCR) testing in the HD population is not fully understood, which this study aimed to investigate.

Methods
There were two parts to this study. Between 15th March 2020 to 15th July 2020, patients receiving HD who tested positive on rRT-PCR for SARS-CoV-2 were recruited into the COVID-19 arm, whilst asymptomatic patients without a previous diagnosis of COVID-19 were recruited to the epidemiological arm of the Salford Kidney Study (SKS). All patients underwent monthly testing for anti-SARS-CoV-2 antibodies as per routine clinical practice since August 2020. The aims were twofold: firstly, to determine seroprevalence and COVID-19 exposure in the epidemiological arm; secondly, to assess duration of the antibody response in the COVID-19 arm. Baseline characteristics were reviewed between groups. Statistical analysis was performed using SPSS. Mann-Whitney U and Chi-squared tests were used for testing significance of difference between groups.

Results
In our total HD population of 411 patients, 32 were PCR-positive for COVID-19. Of the remaining patients, 237 were recruited into the SKS study, of whom 12 (5.1%) had detectable anti-SARS-CoV-2 antibodies. Of the 32 PCR-positive patients, 27 (84.4%) were symptomatic and 25 patients admitted to hospital due to their symptoms. Of the 22 patients in COVID-19 arm that underwent testing for anti-SARS-CoV-2 IgG antibodies beyond 7 months, all had detectable antibodies.
A higher proportion of the patients with COVID-19 were frail compared to patients without a diagnosis of COVID-19 (64.3% vs 34.1%, p = 0.003). Other characteristics were similar between the groups. Over a median follow up of 7 months, a higher number of deaths were recorded in patients with a diagnosis of COVID-19 compared to those without (18.7% vs 5.9%, p = 0.003).

Conclusions
Serological testing in the HD population is a valuable tool to determine seroprevalence, monitor exposure, and guide improvements for infection prevention and control (IPC) measures to help prevent local outbreaks. This study revealed HD patients mount a humoral response detectable until at least 7 months after COVID-19 infection and provides hope of similar protection with the vaccines recently approved.
Hemisensory syndrome: Hyperacute symptom onset and age differentiates ischemic stroke from other aetiologies
Authors: Koh Pei Xuan , Ti Joanna , Saffari Seyed Ehsan , Lim Zhen Yu Isis Claire , Tu Tianming 
Published: April 2021

Abstract
Background
An important cause of hemisensory syndrome is ischemic stroke. However, the diagnostic yield of neuroradiological imaging on hemisensory syndrome is low. Therefore, we aim to describe patients hospitalized with isolated hemisensory syndrome, and to identify clinical features associated with an aetiology of ischemic stroke.

Methods
We performed a single centre retrospective observation study, identifying patients who were hospitalised with hemisensory syndrome from October 2015 to March 2016, and whom underwent a magnetic resonance imaging (MRI) brain during the admission. Ischemic stroke was defined as the presence of restricted diffusion-weighted image on the MRI brain. Clinical information was analysed and compared between patients with and without stroke seen on MRI brain.

Results
79 patients, 36 (45.6%) males and 43 (54.4%) females, aged between 30 to 87 years (mean 54), were included in the final analysis. 18 (22.8%) patients were identified to have an acute ischemic stroke. Clinical features associated with ischemic stroke in hospitalised patients with hemisensory syndrome include symptom onset of ≤24 h at presentation (odds ratio 31.4, 95% CI 3.89–254.4), advanced age (odds ratio 1.14, CI 1.05–1.25) and smoking (odds ratio 7.35, 95% CI 1.20–45).

Conclusion
Older patients, with a history of smoking, and who present with an acute onset of symptoms, are more likely to have ischemic stroke as the cause of their hemisensory syndrome.