bluuebunny/crossref_metadata_2025 huggingface dataset:
CT- 3-DimenSional airway evaluation-guided intraluminal placement of endobronchial blocker in pediatric patients: a randomized controlled study
Authors: Xu Yingyi , Zhang Na , Wei Wei , Tan Yonghong , Zeng Minting , Hou Jianning , Liu Wei
Published: November 2020

Background: One-lung ventilation (OLV) with endobronchial blocking is commonly used in anesthesia for pediatric thoracic surgery. Bronchoscopy is commonly used to guide the endobronchial blocker placement. However, when bronchoscopy is not applicable, the proper placement of endobronchial blocker is challenging. Computed tomography (CT)-3-DimenSional evaluation may be used to accurately measure the airway of pediatric patients. The present study was aimed to propose a new approach of CT-3-DimenSional airway evaluation-guided endobronchial blocker placement in pediatric patients and to determine its efficiency in clinical application. Methods: A total of 127 pediatric patients of 0.5-3 years old scheduled for elective thoracic surgery under OLV were randomized into the bronchoscopy group and the CT group. The degree of lung collapse, postoperative airway mucosal injury, pulmonary infection within 72 hour after surgery, hoarseness after tracheal extubation, Durations of postoperative mechanical ventilation, intensive care unit (ICU) stay, and hospitalization, the successful rate of the first blocker positioning, and the required time and repositionings for successful blocker placement were compared between the two groups. Results: The degree of lung collapse, postoperative airway mucosal injury, pulmonary infection within 72 hour after surgery, hoarseness after tracheal extubation, durations of postoperative mechanical ventilation, ICU stay, and hospitalization were similar between the two groups (all P > 0.05). Conclusions: For pediatric patients who would undergo surgery with OLV, preoperative CT 3-DimenSional airway evaluation could be used to guide endobronchial blocker placement, with a blocking efficiency similar to that of bronchoscopy-guided blocker placement.
Comparison of bispectral index and patient state index during sevoflurane anesthesia in children: a prospective observational study
Authors: Ji Sang-Hwan , Jang Young-Eun , Kim Eun-Hee , Lee Ji-Hyun , Kim Jin-Tae , Kim Hee-Soo
Published: November 2020

Background: Cortical electroencephalography (EEG)-based devices are used to monitor the depth of anesthesia. In this study, we compared the values of bispectral index (BIS) and patient state index (PSI) during sevoflurane anesthesia in children. The ability/accuracy of BIS and PSI to predict the maintenance and recovery state of anesthesia was evaluated based on prediction probability (Pk) values and the secondary outcomes were agreement and correlation of two monitors.Methods: Fifty children (3-12 years old) were enrolled and the patients received sevoflurane anesthesia with remifentanil. Before the induction of anesthesia, BIS and PSI sensors were simultaneously placed on the forehead, and data were collected until the end of anesthesia. Maintenance state was defined as the period following intubation until the cessation of sevoflurane, while recovery state was defined as the period following the cessation of sevoflurane until awake. The prediction probability (Pk), agreement or correlation of BIS and PSI in different anesthesia state were calculated.Results: Anesthesia reduced mean BIS and PSI values. Pk of BIS (95% Confidential Interval (CI) [0.78-0.91])) and PSI (95% CI [0.82-0.91]) for anesthesia were 0.85 and 0.87, respectively. Agreement was 0.79 for recovery state and 0.73 for maintenance state.Conclusions: Pk values were comparable for BIS and PSI. Agreement between BIS and PSI measurements in the same state was relatively good. Therefore, these monitors are appropriate for monitoring for different state of anesthesia in pediatric population.Trial Registry Number: Clinical Trials.gov NCT03792334.
Incidence, characteristics, and outcomes of delirium in patients with noninvasive ventilation: A prospective observational study
Authors: Zhang Rui , Bai Linfu , Han Xiaoli , Huang Shicong , Zhou Lintong , Duan Jun
Published: November 2020

Background: Knowledge of delirium in noninvasive ventilation (NIV) patients is lacking. We investigated the incidence, characteristics, and outcomes of delirium in NIV patients. Methods: A prospective observational study was performed in an intensive care unit (ICU) of a teaching hospital. Patients in whom NIV was used as a first-line intervention were enrolled. During NIV intervention, delirium was screened using the Confusion Assessment Method for the ICU each day. The association between delirium and poor outcomes (e.g., NIV failure, ICU and hospital mortality) was investigated using forward stepwise multivariate logistic regression analyses.Results: We enrolled 1083 patients. Of these, 196 patients (18.1%) experienced delirium during NIV intervention. Patients with delirium had higher NIV failure rates (37.8% vs. 21.0%, p < 0.01), higher ICU mortality (33.2% vs. 14.3%, p < 0.01), and higher hospital mortality (37.2% vs. 17.0%, p < 0.01) than subjects without delirium. They also had a longer duration of NIV (median 6.3 vs. 3.7 days, p < 0.01), and stayed longer in the ICU (median 9.0 vs. 6.0 days, p < 0.01) and the hospital (median 14.5 vs. 11.0 days, p < 0.01). Furthermore, delirium was independently associated with NIV failure, ICU mortality, and hospital mortality (OR = 1.97, 2.58, and 2.55, respectively; all p values < 0.01). These results were confirmed in COPD and non-COPD cohorts. According to subtype, compared to hyperactive delirium patients, hypoactive and mixed delirium patients spent more days and many more days on NIV (median 3.4 vs. 6.5 vs. 10.1 days, p < 0.01). Similar outcomes were found for length of stay in the ICU and hospital. However, NIV failure, ICU mortality, and hospital mortality did not differ among the three subtypes.Conclusions: Delirium is associated with increases in poor outcomes (NIV failure, ICU mortality, and hospital mortality) and the use of medical resources (duration of NIV, and lengths of stay in the ICU and hospital). Regarding subtype, hypoactive and mixed delirium are associated with higher, and much higher, consumption of medical resources, respectively, compared to hyperactive delirium.
Crowded Household, Subdivided Flats, and Dilapidated Housing Are Risk Factors of Bedbug (Cimex Lectularius and Cimex Hemipterus) Infestation: a Cross-sectional Study of Hong Kong Households
Authors: Fung Eddy Hin Chung , Wong Hung , Chiu Siu Wai , Hui Jerome Ho Lam , Lam Hon Ming , Chung Roger Yat-nork , Wong Samuel Yeung-shan , Chan Siu Ming
Published: November 2020

Background: Bedbugs have been a neglected issue globally, disproportionately affecting low-income households. The features of many deprived housing units in Hong Kong provide suitable habitats for bedbug infestations. This study aims to identify the housing risk factors for bedbug infestations in Hong Kong.Methods: Using a cross-sectional study design, online self-reported questionnaires in Chinese were distributed between June 2019 to July 2020. Data collected were socio-demographics, crowded household condition, housing type, dilapidated housing features, and frequency of noticing bedbugs in the participant’s place of residence in the past year. The latter was transformed into a dichotomous dependent variable, “bedbug infestation”. Weighted bivariate and multivariate analysis using binary logistic regression were performed on SPSS 24.Results: The study sampled N=696 participants, 63.7% have had bedbug infestations. Bivariate analysis shows a positive correlation between the number of dilapidated housing features and bedbug infestation (OR=1.28, 95% CI 1.18-1.39, p<0.001). N=663 were included in the multivariate analysis. Those aged 45-64 (OR=2.53, 95% CI 1.30-4.91, p=0.006) and have primary education or below (OR=9.43, 95% CI 3.12-28.44, p<0.001) have significantly greater odds of bedbug infestation compared to their respective reference groups, ≥65 and tertiary education. Having monthly household income ≤HKD30,000 (OR=1.69, 95% CI 1.15-2.5, p=0.008) and living in subdivided flats (OR=16.53, 95% CI 1.01-269.72, p=0.049) and crowded household (OR=1.55, 95% CI 1.06-2.28, p=0.024) increases the odds of bedbug infestation. Dilapidated housing features that significantly increase the odds of bedbug infestation are having second-hand furniture (OR=2.97, 95% CI 1.16-7.58, p=0.023), housing cleanliness issues (OR=2.66, 95% CI 1.13-6.25, p=0.024), presence of bedbugs in neighbouring residential units (OR=3.32, 95% CI 1.57-7.04, p=0.002), and presence of bedbugs on the streets (OR=1.9, 95% CI 1.12-3.23, p=0.018).Conclusions: Crowded household, subdivided flats, and dilapidated housing are risk factors for bedbug infestations. To better control bedbug infestations, there needs to be a shift from viewing infestations as a personal hygiene to a public health issue. Efforts and policies should focus on addressing the housing risk factors identified in this study and prioritise vulnerable groups such as the elderly, low education level, low-income groups, and occupants of subdivided flats.
Dating the emergence of the first case of COVID-19 with flights: a retrospective modelling study 
Authors: Yang Liwei , Zhu Jing Yan , Zhang Yihe , Zhou Wenjie , Si Yicheng
Published: November 2020

Commercial flights contributed to the early-stage international transmission of SARS-CoV-2. Understanding the effect of international and inter-state flights on virus transmission is important to evaluate the initial response of the outbreak. This study investigated the likely date of the emergence of the first COVID-19 case. We constructed a geographical-structured epidemiology model, integrating 2541 province-level units, 250 country-level units, and 26,094,036 flight plans to evaluate the possible date of the emergence of the first case. Using the model, we estimated the number of cumulative deaths and the date of first death caused by COVID-19 in different countries. The pattern of the three parameters we evaluated suggests a high likelihood of the emergence of the first case of COVID-19 be around September 15 and September 22, 2019.
Erasable superconductivity in topological insulator Bi2Se3 induced by voltage pulse
Authors: Le Tian , Ye Qikai , Chen Chufan , Yin Lichang , Zhang Dongting , Wang Xiaozhi , Lu Xin
Published: November 2020

Three-dimensional topological insulators (TIs) attract much attention due to its topologically protected Dirac surface states. Doping into TIs or their proximity with normal superconductors can promote the realization of topological superconductivity (SC) and Majorana fermions with potential applications in quantum computations. Here, we observed an emergent superconductivity in local mesoscopic point-contacts on the topological insulator Bi2Se3 by applying a voltage pulse through the contacts, evidenced by the Andreev reflection peak in the point-contact spectra and a visible resistance drop in the four-probe electrical resistance measurements. More intriguingly, the superconductivity can be erased with thermal cycles by warming up to high temperatures (300 K) and induced again by the voltage pulse at the base temperature (1.9 K), suggesting a signicance for designing new types of quantum devices. Nematic behaviouris also observed in the superconducting state, similar to the case of CuxBi2Se3 as topological superconductor candidates.
Crossed Cerebellar Diaschisis: Risk Factors and Prognostic Value in Medically Intractable Epilepsy by 18F-FDG PET/CT
Authors: Hou Yaqin , Guo Kun , Fan Xiaotong , Shang Kun , Wang Jingjuan , Wang Zhenming , Shan Yongzhi , Zhao Guoguang , Lu Jie
Published: November 2020

Purpose Crossed cerebellar diaschisis (CCD) has been widely studied in hemispheric stroke but is less characterized in epilepsy. In this study, we used 18F-FDG positron emission tomography (PET)/computed tomography (CT) to investigate the risk factors for CCD and its prognostic value for intractable epilepsy. Methods One hundred medically intractable epilepsy patients pathologically diagnosed with focal cortical dysplasia (FCD) postoperatively were included and classified into two groups: CCD+ and CCD-. All patients underwent 18F-FDG PET/CT preoperatively. PET/CT images were analysed qualitatively by visual assessment and semi-quantitatively using the absolute asymmetry index (|AI|). Clinical factors, including age, sex, body mass index (BMI), age at seizure onset, epilepsy duration, seizure type, epilepsy severity, electroencephalography(EEG) and brain magnetic resonance imaging (MRI), were retrospectively assessed from medical records. Follow-up outcomes were evaluated according to the Engel classification at 3, 6, 12, 24 and 36 months postoperatively.Results Of the 100 patients, 77 (77%) were classified as CCD-, and 23 (23%) were classified as CCD+. CCD+ patients had a higher number of lobes involved on PET (3.61±2.16 vs 2.26±1.01, P<0.001) and more cases of occipital hypometabolism (21.74% vs 5.19%, P=0.03) than CCD- patients. CCD- patients showed more negative MRI results than CCD+ patients (P=0.02). Patients with a poor prognosis had more cases of parietal hypometabolism on PET (P=0.02). At 12 months postoperatively, 71%(29/41) of CCD- patients and 31%(4/13) of CCD+ patients presented a favourable prognosis (P=0.02). Significant differences in the average |AI| values in the posterior frontal and anterior temporal lobes were found between CCD+ and CCD- patients (P<0.05), but no significant correlation of the |AI| between supratentorial regions and the contralateral cerebellum was identified in CCD+ patients. Conclusion The number of lobes involved on PET, structural anomalies on MRI, the lesion location on PET, the |AI| values in the posterior frontal and anterior temporal lobes may be predisposing factors for CCD. CCD occurrence may help predict the prognosis of FCD patients at 12 months postoperatively, and parietal hypometabolism on PET may indicate a poor prognosis.
One-Hour Plasma Glucose as a Long-Term Predictor of Cardiovascular Events and All-Cause Mortality in a Chinese Older Male Population Without Diabetes: A 20-year Retrospective and Prospective Study
Authors: Rong Lingjun , Miao Xinyu , Gong Yanping , Li Chunlin , Sun Banruo
Published: November 2020

BackgroundThe association between one-hour plasma glucose (1h-PG) and the incidence of type 2 diabetes has been investigated in previous studies. However, the predictive value of 1h-PG for the risk of cardiovascular disease (CVD) and all-cause mortality, especially in older Asians, has been investigated in only a few studies. Therefore, the influence of 1h-PG on the incidence of CVD and mortality was evaluated in the present study. MethodsThe participants were recruited from the Chinese People’s Liberation Army General Hospital, and were categorized into 1h-PG tertiles. The primary outcomes were all-cause mortality, myocardial infarction, unstable angina, and stroke. Multivariate adjusted Cox proportional hazard regression models were performed to examine the association between risk factors and outcomes and to estimate the risk of CVD and all-cause mortality based on 1h-PG.ResultsThe study included 862 male participants. Median age was 74.0 (25th–75th percentile: 68.0–79.0) years. There were 480 CVD events and 191 deaths during 15,527 person-years of follow-up. The adjusted hazard ratio (HR) of 1h-PG as a continuous variable was 1.097 (95% CI 1.027–1.172; P = 0.006) for CVD events and 1.196 (95% CI 1.115-1.281; P < 0.001) for higher risk of mortality. When compared with the lowest 1h-PG tertile, the other tertiles were associated with CVD events (HR 1.464, 95% CI 1.031–2.080; P = 0.033 and HR 1.538, 95% CI 1.092–2.166; P = 0.014, for tertile 2 and tertile 3 compared with tertile 1, respectively), and the highest 1h-PG tertile had a significantly higher risk of mortality (HR 2.384, 95% CI 1.631-3.485; P < 0.001) after full adjustment.ConclusionHigher 1h-PG is associated with an increased risk of all-cause mortality and CVD. 1h-PG might be a better predictor of CVD than 2h-PG in older adults.
Effect of Intensive Lifestyle Intervention on the Association between Weight Variability and Mortality and Cardiovascular Events in Overweight or Obese Adults with Type 2 Diabetes Mellitus
Authors: Liu Menghui , Chen Xiaohong , Zhang Shaozhao , Yang Daya , Lin Yifen , Xiong Zhenyu , Huang Yiquan , Zhong Xiangbin , Wang Lichun , Zhuang Xiaodong , Liao Xinxue
Published: November 2020

Background: The association among intensive lifestyle intervention (ILI), weight variability and the risks of death and cardiovascular events have limited data. We aimed to examine whether the weight variability is associated with all-cause mortality and cardiovascular events, and whether the intensive lifestyle intervention (ILI) will affect these associations in overweight or obese individuals with type 2 diabetes mellitus (T2DM).Methods: Individuals from the Action for Health in Diabetes (Look AHEAD) trial who measured the weight variability based on 5 equally spaced medical measurements of within 4 years were enrolled. A multivariate-adjusted Cox regression models were used to evaluate the associations between weight variability and adverse outcomes including the all-cause mortality and primary cardiovascular disease (CVD) outcome, and the effects of ILI on these associations.Results: Among the 3,859 participants with a median follow-up of 9.6 years, those with the highest quartile of weight variability experienced a double higher risk of death compared with those the lowest quartile (HR 2.25; 95% CI 1.44-3.52), but no difference was found in primary CVD outcome (HR 1.02; 95% CI 0.78-1.33). Moreover, the restricted cubic splines revealed that the risk of death grew with the increased weight variability. Of note, the association between weight variability and all-cause mortality was not observed in ILI arm (the highest vs. lowest quartile group, [HR 1.30; 95% CI 0.67-2.50]) and was just found in diabetes support and education (DSE) arm (the highest vs. lowest quartile group, [HR 3.31; 95% CI 1.84-5.95]).Conclusions: Among the overweight or obese individuals with T2DM, the weight variability was independently associated with increased risks of all-cause mortality, but this association might be removed by ILI.Trial registrations ClinicalTrials.gov identifiers: NCT00017953.
Incorporating Local Adaptation Into the Forecasts of Paeonia Veitchii Distribution
Authors: Tian Lixia , Sun Xiao , Ahmad Bashir , Jiang Yuanyuan , Zhang Li , Huang Linfang
Published: November 2020

BackgroundSpecies distribution models(SDMs) have been widely used to forecast the distribution of medicinal plants under climate change at the species level. However, most predictions of this distribution have ignored local adaptation.MethodsHere, we used Paeonia veitchii, a Daodi herb from Sichuan Province, China, as an example. The 226 occurrence sites of P. veitchii and 31 bioclimatic variables were used to delineate different climatic populations based on principal component analysis and hierarchical cluster analysis. Maximum entropy algorithm was developed to project the distribution of the diverse population under Last Glacial Maximum community climate (ca. 22 ka), the Mid-Holocene (ca. 6 ka), and current and various future climate scenarios (representative concentration pathways [RCPs] 2.6, 6.0, and 8.5). Critical environmental variables that shape separate population distributions and distribution shifts under multiple climate change scenarios were also identified. ResultsThe results showed that local adaptation exists within the distribution range of P. veitchii and all presence sites were clustered into P. veitchii from Daodi (PV_Daodi) and non-Daodi (PV_non-Daodi). Precipitation of the wettest month, mean global UV radiation in January (UV_JAN), and mean global UV radiation in July are essential when shaping the distribution of PV_Daodi, and UV_JAN, annual mean air temperature, and isothermality are vital for PV_non-Daodi. The PV_Daodi population was predicted to have an expansion in potential distribution in 2050 and a slight contraction in 2070 under RCP 2.6 and 6.0 scenarios. The PV_non-Daodi population will have a consistent expansion under RCP 6.0 and 8.5 scenarios. Both populations tend to shift northward under climate change. Conclusion﻿The results of our study could be a useful reference to implement the long-term conservation of high-quality P. veitchii.
Chemotherapeutic Drugs in Lebanese Surface Waters: Estimation of Population Exposure and Identification of High-Risk Drugs
Authors: Saab Yolande , Nakad Zahi , Rahme Rita
Published: November 2020

Environmental risk assessment of anti-cancer drugs and their transformation products is a major concern worldwide due to two main factors: the consumption of chemotherapeutic agents is increasing throughout the years and conventional water treatment processes seem to be ineffective. The aim of the study is to investigate the consumption of anticancer drugs and assess their potential health hazard as contaminants of the Lebanese surface waters. Data on yearly consumption of 259 anti-neoplastic drugs over the years 2013 to 2018 were collected and the following parameters were calculated: yearly consumption of single active ingredients, yearly consumption of drug equivalents (for drugs belonging to the same pharmacologic class/ having the same active ingredient) and Predicted Environmental Concentrations. The classification of compounds into risk categories was based on exposure using Predicted Environmental Concentrations (PECs). The top five most commonly consumed drugs are Mycophenolate mofetil, Hydroxycarbamide, Capecitibine, Mycophenolic acid and Azathioprine. Based on the calculated PEC values of single active ingredients as well as their equivalents, six high risk priority compounds were identified: Mycophenolate mofetil, Hydroxycarbamide, Capecitibine, Mycophenolic acid and Azathioprine and 5-Fluorouracil. The impact of these micropollutants on animals as well as humans was analyzed. This research paper stresses the importance of further analysis of chemotherapy micropollutants with major focus on high risk drugs. Additionally, regulations should be set in place to ensure proper management of waste water and the development of efficient waste water treatment plants.
Preparation and Characterization of Magnesia-based Powder Added With Transition Metal
Authors: Kim Bong-Gu , Choi Hyun-Hee , Son Jung-Hun , Yang SeungCheol , Kwon Min-Seok , Tiamiyu Asimiyu A. , Zhang Jing , Jung Yeon-Gil
Published: November 2020

The solid-phase reaction method for preparing forsterite (Mg2SiO4) using MgO and SiO2 powders has the disadvantages of high reaction temperature, long reaction time, and inhomogeneous reaction depending on the particle size of MgO. Therefore, MgO-based powders with a high reactivity were synthesized using a coprecipitation method with substitutional elements (Mn or Ni), and the effects of processing parameters on synthesizing MgO-based binary composition powders were investigated through the particle characteristics. The crystal structure continuously changed with the contents of the substitutional element, showing the same trend as the atomistic simulation results. The MgO-based powders showed higher reactivity than the conventional MgO powder, which could be confirmed in the particle characteristics, such as particle size and crystallinity, obtained in a short reaction time, and at a relatively low temperature. The optimum composition ratio in the binary composition powder for forming the Mg2SiO4 depended on the type of substitutional element, and the reaction mechanism was identified based on the particle characteristics.
Wide-Frequency-Range Dielectric Tuning of BaTiO3 by Embedding Metal Nanocrystals
Authors: SHI Deli , FANG Leiming , Zhang Xiaoqiang , TANG Jinlong , LI Jun , FU Yajun , WANG Jin , GAO Zhipeng , XIONG Zhengwei
Published: November 2020

The Fe nanocrystals (NCs) were embedded into the epitaxial BaTiO 3 (BTO) matrix. According to optimize growth processes, a novel nanocomposite system was constructed, which consist of well epitaxial BTO layer and three-dimensional Fe NCs. Based on this, the different dielectric response in the regions of low temperature-high frequency and low frequency-high temperature were revealed by the contribution of hopping and interfacial polarizations, respectively. With the increased amount of Fe NCs, the obvious enhancement of low-frequency conductivity, middle frequency capacitance and high-frequency inductive effect was found. The metal NC embedding plays an important role in tuning the dielectric behaviors and ac conductivity of oxide dielectrics. This significant rectification effect in the wide-frequency ranges opens up a new direction for the designing of embedded nano-capacitors.
A New Pathological Classification of Intrahepatic Cholangiocarcinoma from an Embryological Viewpoint
Authors: Yamashita Shoko , Morine Yuji , Imura Satoru , Ikemoto Tetsuya , Saito Yu , Takasu Chie , Yamada Shinichiro , Tokuda Kazunori , Okikawa Shohei , Miyazaki Katsuki , Oya Takeshi , Tsuneyama Koichi , Shimada Mitsuo
Published: November 2020

Background: No universal classification method for intrahepatic cholangiocarcinoma (IHCC) has been reported based on the embryological origin of biliary epithelial cells. The aim of this study was to classify IHCC according to protein expression levels of somatostatin receptor 2 (SSTR2) and b-cell leukemia/lymphoma 2 (Bcl2) and to elucidate the clinicopathological features of each group.Methods: Fifty-two IHCC patients who underwent hepatic resection were enrolled in this study. Protein expression levels of SSTR2 and Bcl2 were examined using immunohistochemistry. Clinicopathological factors were compared between the three groups and prognostic factors were investigated. Results: The patients were divided into three groups: SSTR2 positive and Bcl2 negative (Group H, n=21), SSTR2 negative and Bcl2 positive (Group P, n=14), and the indeterminate group (Group U, n=17) for cases where SSTR2 and Bcl2 were both positive or both negative. All Group P cases displayed curability A or B. The 5-year survival rates of Group H and U patients were worse than those in Group P. Group H had higher T-factor, clinical stage, and incidence of periductal infiltration than Group P.Conclusions:This method could be used to classify IHCC into peripheral and perihilar type by embryological expression patterns of SSTR2 and Bcl2.
An Analysis of the Quality of New-Born Health Services in Nampula, Mozambique.
Authors: Pires Paulo Das Das Neves , Mupueleque Martins , Mucufo Jaibo , Siemens Ronald , Belo Celso
Published: November 2020

BackgroundNew-born morbidity and mortality are high in Africa, including Mozambique. One important factor to reduce this public health burden is ensuring the frequency and quality of new-born visits, with the availability of efficient, timely, patient centred care. To contribute to the reduction of new-born mortality rate in Nampula, the Lúrio University and the University of Saskatchewan, carried out an implementation research project which included training activities for health professionals in maternal and child health care. We planned a mid-project evaluation, to assess the impact of health professionals training on the quality of services at Marrere Health Centre.MethodsQuantitative study, applying two cross-sectional surveys about new-born visits service quality. The first surveys were conducted after two health professionals’ training sessions and the other after five more sessions. The samples of carers of infants up to 28 days of age in Marrere Health Centre, were calculated considering the average number of post-partum visits per month (47 in 2018, with a margin of error of 10% and a confidence interval of 90 %, 134 in 2019, with a margin of error of 5% and a confidence interval of 95%). The individual surveys used a five-point Likert scale and were entered into REDCap, and analysed to assess frequency, percentage, mean and standard deviation. This research was approved by the bioethics committees at Lúrio University and at the University of Saskatchewan.Results188 child carers were surveyed at Marrere Health Centre, about new-born services quality. Most areas showed no improvement. Positive improvements were a 48% increase in health professionals encouraging mothers to share any difficulties during the patient encounter, a 31% increase in encouraging mothers to have a person of their choice to accompany them during labour, suggesting a traditional birth attendant (97%). Many shortcomings persisted in practices of introducing themselves, communication with patients, privacy, and confidentiality.ConclusionThe quality of care at Marrere Health Centre did not improve and health professionals are not practising according to the protocol. Reviewing health professionals learning approach, developing continuous capacity building, would be the next best steps to improve quality of new-born centred care.Trial registrationThis study was not registered in any data base.
Assessement of myocardial contractile function in fetuses with obstructive
aortic lesions
Authors: S.I. Buryakova , M.V. Medvedev , U.A. Strupeneva et all
Published: November 2020

The potential possibilities to assess the contractile function of the myocardium in fetuses with obstructive
aortic lesions using speckle tracking are presented.
Ethical boundaries of the legal regulation of conditions of carrying out
genetic screening in prenatal diagnosis in Russia and abroad
Authors: M.V. Medvedev , G.N. Suvorov , S.S. Zenin et all
Published: November 2020

Objectives. The purpose of this study is to study the essence of ethical problems that arise in the field of
genetic screening for prenatal diagnosis (PND) and determine possible ways to overcome them by legal means,
taking into account the existing foreign experience.
Materials and methods. Normative legal acts and doctrinal sources of Great Britain, Germany, Ireland,
France and Switzerland are studied. Methods used: General philosophical, General scientific, private scientific,
special (structural-legal, comparative-legal, formal-legal).
Results. Ways to resolve ethical problems that arise or may arise in the future as a result of genetic screening
for PND, which can be applied within the Russian legal system, are proposed.
Conclusions. It is stated that most of the identified ethical problems are related to the lack of normative
consolidation of the legal status of the fetus. It is presumed that the beginning of ethics should serve as the guide
for legislation in this area. At the same time, it is emphasized that the legal regulation of genetic screening in
PND should be flexible enough to optimally ensure the interests of all participants in these relationships. In
addition, in this direction, it seems appropriate to refer to the experience of a number of foreign countries, whose
legislation provides for fairly strict requirements in the field of PND.
‘Solar septic tank’: evaluation of innovative decentralized treatment of blackwater in developing countries
Authors: Koottatep Thammarat , Connelly Stephanie , Pussayanavin Tatchai , Khamyai Sopida , Sangchun Wattanapong , Sloan William , Polprasert Chongrak
Published: November 2020

An innovative decentralized wastewater treatment system, namely the ‘Solar Septic Tank (SST)’, was constructed and tested at the household scale in a community in central Thailand. This study aimed to investigate the long-term performance of the SST in treating blackwater subject to year-round variation. Results of the 3-year continuous operation and monitoring showed significant improvement in the SST effluent quality with the potential to minimize environmental problems and public health risks. The SST achieved significantly higher total chemical oxygen demand, soluble chemical oxygen demand, total biochemical oxygen demand (TBOD), soluble biochemical oxygen demand, total kjeldahl nitrogen, total solid and total volatile solid removal efficiencies than a conventional septic tank (CST). The average TBOD concentration of the SST effluent was 150 ± 75 mg/L, meeting the Thai discharge standard (less than 200 mg/L of TBOD), while the average TBOD concentration of the CST was 240 ± 140 mg/L, higher than the Thai discharge standard. The Escherichia coli inactivation in the SST was 1–2 log reduction more than that in the CST. The removal efficiencies of TBOD and pathogens exhibited positive correlation with the ratios of the SST temperature.
Besinleri Ve Ağız Ortamını Taklit Eden Sıvıların Restoratif Materyallerin Yüzey Pürüzlülüğüne Etkisi
Authors: BİLGİLİ Dilber , BARUTÇUGİL Çağatay , DÜNDAR Ayşe
Published: November 2020

Amaç: Bu çalışmanın amacı, 5 farklı restoratif materyalin ağız ortamını taklit eden sıvılarda bekletil¬mesinin yüzey pürüzlülüğü (SR) üzerine etkilerini değerlendirmektir. Gereç ve Yöntemler: Çalışmada kullanılan materyaller Admira Fusion X-tra (AFX), Ceram X One (CRX), Gradia İndirekt (GRA), Filtek P60 (P60) ve Lava Ultimate’tir (LAV). Her materyalden 30 adet örnek hazırlandı ve örnekler 24 saat distile suda bekletildi. Tüm örneklere Sof-Lex seti kul¬lanılarak bitim ve cila işlemi uygulandı. Ardından tüm örneklerin başlangıç yüzey pürüzlülüğü bir profilometre cihazı (Surftest SJ-201, Mitutoyo) ile ölçüldü. Her materyal grubuna ait örnekler farklı solüsyonlarda bekletilmek üzere 4 alt gruba ayrıldı (n=6): Distile su, sitrik asit (0,02 N), etanol (%75) ve hidroklorik asit (HCl) (pH 1,2). Örnekler karanlık ortamda oda sıcaklığında 30 gün boyunca so¬lüsyonlarda bekletildi. Solüsyonlar haftalık olarak yenilendi. Otuz gün sonunda pürüzlülük ölçümleri tekrar yapıldı. Son ölçümden ilk ölçüm çıkarılarak ΔRa değerleri elde edildi. Veriler tek yönlü ANOVA ve ardından Tukey HSD testi ile analiz edildi (p=0,05).

Bulgular: Etanol-su çözeltisinde bekletilen materyaller arasında, GRA grubundaki ΔRa değerinin, CRX ve P60 grubuna kıyasla istatistiksel olarak anlamlı bir farklılık gösterdiği (p<0,05) bulundu. Sit¬rik asitte bekletilen örneklerin ΔRa değerleri incelendiğinde ise sadece AFX grubunda diğer grup¬lara göre istatistiksel olarak anlamlı artış gözlendi (p<0,05). Distile su ve hidroklorik asitte bekletilen bütün materyal grupları arasında ΔRa değerlerinde istatistiksel olarak anlamlı bir farklılık bulunmadı.

Sonuç: Değerlendirilen kompozit rezinlerin yüzey pürüzlülüğü, ağız ortamını taklit eden sıvılarda bekletilmelerinden farklı şekilde etkilendi.
Radial Artery Pseudoaneurysm as a Rare Complication after Transradial Coronary Angiography
Authors: KIŞ Mehmet , SOYDAN Elton
Published: November 2020

Compared to transfemoral coronary angiography (CAG), transradial CAG has been associ¬ated with less access site complications, shorter hospitalization, better patient comfort, and early mobilization. However, the use of radial access in CAG may also cause entry site compli¬cations. Radial pseudoaneurysm after transradial CAG is a rare complication reported in less than 0.1% of the procedures. In this report, we present a 78-year-old patient who was diag¬nosed with right radial artery pseudoaneurysm by Doppler ultrasonography after transradial CAG and treated nonsurgically
Obezite Polikliniğine Başvuran Hastaların Metabolik Fenotiplerine Göre Kardiyovasküler Riskleri
Authors: GÜVEN KACIROĞLU Burcu , MUTLU Hacer Hicran
Published: November 2020

Amaç: Obezite, hem artan yağ dokusunun pro-inflamatuar etkisi, hem de sıklıkla birliktelik gösteren hastalıklar nedeniyle kardiyovasküler riski arttıran bir durumdur. Son zamanlarda metabolik sağlıklı obezitenin kardiyovasküler risk üzerine olan etkisi tartışmalıdır. Çalışmamızda, plazma aterojenik indeksi (PAİ) kullanılarak obezite polikliniğimize başvuran hastaların metabolik fenotipine göre kardiyovasküler risk profilini saptamak amaçlanmıştır. Gereç ve Yöntemler: Katılımcıların kardiyovasküler riskini değerlendirmek için PAİ kullanıldı. Metabolik sendrom kriterlerinden bel çevresi artışı dışında herhangi bir metabolik sendrom kriterine sahip olmayanlar (kan basıncı≥130/85 mmHg, açlık kan şekeri≥100 mg/dl, trigliserit≥150 mg/dl, HDL-K erkeklerde<40 mg/dl, kadınlarda <50 mg/dl veya bu parametreleri düşürücü ilaç kullananlar) metabolik sağlıklı obez, bu kriterlerden herhangi birine sahip olanlar ise metabolik sağlıksız obez olarak tanımlandı. Bulgular: Tüm katılımcıların PAİ ile kardiyovasküler riski değerlendirildiğinde %76,9’unun (n=722) yüksek kardiyovasküler riskli grupta olduğu ve kardiyovasküler riski etkileyen sosyodemografik ve antropometrik faktörlerin cinsiyet, vücut kütle indeksi (VKİ), vücut yağ ve kas miktarı, sigara içme alışkanlığı, egzersiz alışkanlığı ve metabolik fenotip olduğu görülmektedir. Katılımcıların metabolik fenotipleri incelendiğinde %14,1’inin (n=137) metabolik sağlıklı, %85,9’unın (n=838) metabolik sağlıksız olduğu saptanmıştır. Kadınlar, erkeklere göre daha çok metabolik sağlıklı fenotipine sahiptir (p=0,009). Metabolik sağlıksız obezlerin yaşı daha ileridir (p=0,006). Metabolik sağlıklı obezlerin VKİ, vücut yağ ve kas kütleleri daha düşüktür (sırasıyla p<0,001; p<0,001; p<0,001). Metabolik sağlıksız obez bireylerin PAİ değerleri metabolik sağlıklı obez bireylerden anlamlı olarak daha yüksektir (p<0,001). Sonuç: Genel olarak değerlendirildiğinde obez bireylerin çoğunun yüksek kardiyovaküler riskli grupta olduğu, metabolik sağlıksız obez kişilerin kardiyovasküler riskinin metabolik sağlıklı obezlere göre anlamlı olarak daha yüksek olduğu sonucu çıkmıştır. Metabolik sağlıksız bireylerin VKI ve vücut yağ miktarlarının fazla olması, VKI ve yağ miktarı arttıkça metabolik sağlıklı bireylerin metabolik sağlıksızlığa doğru geçiş yapabileceği ve kardiyovasküler riskinin zamanla artabileceğini düşündürmüştür.
Synthesis and Biological Activities of Naturally Functionalized Polyamines: An Overview
Authors: Négrel Sophie , Brunel Jean Michel
Published: November 2020

Recently, extensive researches have emphasized the fact that polyamine conjugates
are becoming important in all biological and medicinal fields. In this review, we
will focus our attention on natural polyamines and highlight recent progress in both fundamental
mechanism studies and interests in the development and application for the therapeutic
use of polyamine derivatives.
Pain Biomarkers in Cancer: An Overview
Authors: Calapai Fabrizio , Mondello Epifanio , Mannucci Carmen , Sorbara Emanuela E. , Gangemi Sebastiano , Quattrone Domenico , Calapai Gioacchino , Cardia Luigi
Published: November 2020

Background:

Pain is a common symptom in oncologic patients and its management is generally guided with reference to pain individually perceived by patients and expressed through self-reported scales. However, the utility of these tools is limited as it strongly depends on patients’ opinions. For this reason, more objective instruments are desirable.

Objective:

In this overview, scientific articles indicating potential markers to be used for pain management in cancer were collected and discussed.

Methods:

Research was performed on principal electronic scientific databases by using the words “pain”, “cancer”, “markers” and “biomarkers” as the main keywords, and findings describing potential biomarkers for the management of cancer pain were reported.

Results:

Studies on pain markers not specific for cancer typology (inflammatory, genetic markers predicting response to analgesic drugs, neuroimaging markers) and pain markers for specific types of cancer (bone cancer, breast cancer, lung cancer, head and neck cancer, prostate cancer, cancer in pediatrics) have been presented and commented on.

Conclusion:

This overview supports the view of the involvement of inflammatory mediators in the mechanisms underlying cancer pain. Only a small amount of data from research up till today is available on markers that can help in the management of pain, except for pro-inflammatory cytokines and other inflammatory indexes such as C-reactive protein (CRP). However, biomarkers are a promising strategy useful to predict pain intensity and to objectively quantify analgesic response in guiding decisions regarding individual-tailored treatments for cancer patients.
Thiol/Disulfide Homeostasis as an Early Biomarker to Differentiate Sepsis from Pneumonia in Intensive Care Units
Authors: Cakir Esra , Gok Gamze , Erel Ozcan , Turan Isil Ozkocak
Published: November 2020

Background:

It is possible that patients with pneumonia also may have sepsis and the separation of these two
clinical entities may induce some trouble to clinicians

Objective:

In order to separate a patient with pneumonia and a patient with sepsis, we qualify thiol/disulfide homeostasis as
a potential biomarker.

Method:

This study designed between February 2018 – February 2019 prospectively. All patients in the intensive care unit
with pneumonia and sepsis were enrolled in the study. At the time of hospitalization, thiol/disulfide homeostasis was measured.
Patients diagnosed with sepsis and pneumonia were compared, in regards to thiol/disulfide homeostasis.

Conclusion:

In this study, we showed that thiol/disulfide homeostasis can be used as new markers in the early period in order
to separate patients with sepsis and patients with pneumonia.

Results:

During research period, 103 patients with sepsis and 120 patients with pneumonia were enrolled into the study.
When we compared native-thiol, total-thiol, and disulfide levels in both sepsis and pneumonia patients, we had similar results
(p>0.05). In sepsis group, index-1 (disulfide/native thiol ratio) and index-2 (disulfide/total thiol ratio) were found out to
be statistically higher than the pneumonia group, and index-3 (native thiol/total thiol ratio) was statistically lower than the
pneumonia group (p=0.020, p= 0.021, p=0.021, respectively).
Nanomedicinal Strategies as Emerging Therapeutic Avenues to Treat and Manage Cerebral Ischemia
Authors: Fatima Saman , Quadri Syed Naved , Parveen Shaheda , Beg Sarwar , Barkat Md Abul , Samim Mohamed , Abdin M.Z. , Ahmad Farhan Jalees
Published: November 2020

Amongst the various diseases on a global scale, the second leading cause of mortality
and morbidity is ischemic stroke due to the unavailability of an effective therapy. With the growing
occurrence and its related health risks along with the absence of effective therapeutics, ischemic
stroke demands the continued and intensive research to explore effective and safe therapeutics. These
therapies may positively affect the numerous pathways associated with neuroprotection, thus,
extending the advantages to a larger population of stroke patients. Several preclinical studies employing
neuroprotectants have shown promising outcomes, but failed in clinical trials either because
of the lack of safety or efficacy. The Blood-Brain Barrier (BBB) restricts the delivery of various
potent neuroprotectants to the specific areas of the brain. The application of nanovehicles for
the delivery of drugs in the brain, however, could revolutionize the treatment of ischemic stroke.
These nanovehicles loaded with the drug could readily traverse the BBB via carrier, receptor and
adsorptive-mediated endocytosis into the brain without compromising the integrity of the BBB. Recent
advances in neuronanotherapeutics have resulted in improved neuronal regeneration and recovery
after ischemic stroke. In this review, we have attempted to discuss unexploited neuronanotherapeutics
potentials to treat and manage ischemic stroke.
Neuroblastoma and Stem Cell Therapy: An Updated Review
Authors: Gupta Manoj Kumar , Mallepalli Suresh , Damu Amooru , Vadde Ramakrishna
Published: November 2020

Neuroblastoma (NBM) is the second leading pediatric cancer that develops from the precursors
of the sympathetic nervous system. To date, surgery, chemotherapy, and radiation serve as
the first-line treatment against NBM in high-risk patients. However, few of these approaches have
severe side effects. Recently, numerous studies have also reported that high chemotherapy doses,
along with stem cell rescue, improvise event-free survival in patients. In this review, the authors attempted
to discuss the pathogenesis associated with NBM and how stem cell therapy can be employed
for the treatment of NBM. Stem cells are a group of multipotent, undifferentiated cells that
are capable of producing all cells in a particular tissue, organ, or organism. They have an endogenous
self-renewal property. This property is tightly modulated for the normal homeostasis within
the body. However, the failure of this process leads to carcinogenesis, including NBM. As these
properties are modulated via various intrinsic as well as extrinsic pathways, the arrest of these pathways
via various drugs may help in controlling various carcinomas, including NBM. Recently,
stem cells were utilized for the diagnosis and treatment of NBM. Nevertheless, most of the studies
conducted to date are mainly designed on bulk-cell analysis, which in turn provides little information
about the population of cells. Thus, the authors believe that, by employing single-cell RNA sequencing
technologies and computational approaches, we can unmask the tumor heterogeneity in
NBM in a more comprehensive way. In the near future, this information will be highly useful for
the identification of biomarkers and treatment associated with NBM in humans.
An Affordable, Scalable, Open Architecture, IoT Eco-system for the Academic Community
Authors: Radhanand Anantha , Kumar K. Naga Balaji , Namburu Swetha
Published: November 2020

Aim:

Today, Internet of Things (IoT) applications are extended from smart homes to ehealth,
cyber security, data analytics, logistics and management of assets. There are many upcoming
IOT solutions and platforms like ThingWorx, Xively, and Yaler. However, the existing eco-systems
are not vibrant because of the high entry-level barrier and low potential for any stakeholder. Especially,
the academic community requires a comprehensible way to create IoT services, develop their skillsets
and build applications around them. In this regard, this work presents an affordable and scalable
IoT eco-system with an easily programmable hardware platform, a private web server on the cloud
and a user-friendly mobile application.

Background:

Home automation controls the devices and appliances in the home environment to increase
the comfort and convenience. To design a typical immune home automation system, we need to
incorporate different sensors, wireless networking and a central node that can collect data and act as a
gateway for the internet connection.

Objective:

Delivering an IoT solution involves the use of multiple technologies that cut across traditional
engineering stream boundaries - sensors, microcontrollers, wireless networking, network protocols,
web programming, and mobile app development. The open challenge is to put the entire ecosystem
together either through new development or through configuartion of existing components.

Methods:

In this work, we incorporated a suitable hardware platform that can be easily programmed.
The platform is open so that new sensors and actuators can be added as per requirement. The existing
web services are used to post and retrieve data from the cloud. In addition, mobile apps can be developed
to make data available to the user.

Results:

A custom-built GISMO based IoT cloud system is developed with sensors and nodes to form
an infrastructure. The framework will assure standard design that establishes a functional link between
hardware, software and web applications. A private web service using HTTP server and MQTT broker is
designed with access from anywhere with a public IP. The web services are coded in PHP and since it is
an in-house development, the addition of new services and maintenance of existing services are easy.

Conclusion:

The IoT eco-system developed provides a platform for a quick out-of-the-box implementation
of an IoT project. Other sensors such as a PIR sensor, an RTC module, an ultrasonic sensor, a
soil moisture sensor have been interfaced to the GISMO module using the IOs brought out onto the
expansion header. The GISMO thus can serve as a generic hardware platform for sensor/actuator interface
in the IoT scheme. The eco-system can be replicated in other institutes and can serve as a base
to implement applications like sensor-to-cloud interface, cloud-to-actuator interface, cloud-based
alerts and notifications, HTTP and MQTT protocols usage.