bluuebunny/crossref_metadata_2025 huggingface dataset:
Depression, resilience and post traumatic stress disorder (PTSD) in asylum-seeker war refugees
Authors: Malliarou Maria , Tsapakidi Dimitra , Gouva Mairi , Kotrotsiou Evaggelia , Nikolentzos Athanasios , Sarafis Pavlos
Published: March 2020

Background The number of refugees and displaced people who have been forced to migrate due to war, mass violence and political instability has reached unprecedented levels. The objective of this study was to assess the degree of depression, resilience and post-traumatic stress disorder (PTSD) in asylum-seeker war refugees, temporally stationed in Larisa, Central Greece, through self-administered questionnaire. Simple regression, Pearson’s correlation coefficient and one-way Anova was used.Methods A cross-sectional study carried out with asylum-seeker war refugees residing in Larisa at a number of apartments rented and ran by the UNHCR and the municipality of Larisa. For the data collection PHQ-9 questionnaire, CD-RISC questionnaire and Harvard Trauma questionnaire (HTQ) were used. Descriptive statistics were applied, as well as Cronbach’s alpha coefficient.Results A total of 64 immigrants (40 males and 23 females, 1-mssing value) agreed to participate in the research. The mean age was 35.72 (SD 7.45), 35 respondents were classified as increased PTSD (scores > 2.5). The results showed a physically and exhausted sample, with marginal mental strength (Mean = 59.38%), fluctuating between moderate (N% = 28.10%) and severe depression (N% = 28.10%). About one in two participants (N% = 54.70%) showed signs of post-traumatic stress disorder PTSD, reporting traumatic experiences that mainly involved immediate events of violence, i.e. beating, while there were very few cases of sexual abuse or violence. A key factor in the formulation of PTSD, depression and Mental Stress Indicators was found to be age but limited to 43 years.Conclusion This study revealed that the refugees of the sample are tired, after being absent and idle for about 2 years from their homeland, in a marginal state of collapse. The most important event-hope that sustains its moderate resilience is the grant of asylum and the hope of arrival in the country of destination.
Remotely monitoring ecosystem respiration from various grasslands along a large-scale east-west transect across northern China
Authors: Tang Xuguang , Zhou Yanlian , Li Hengpeng , Yao Li , Ding Zhi , Ma Mingguo , Yu Pujia
Published: March 2020

Background : Grassland ecosystems play an important role in the terrestrial carbon cycles through carbon emission by ecosystem respiration ( R e ) and carbon uptake by plant photosynthesis (GPP). Surprisingly, given R e occupies a large component of annual carbon balance, rather less attention has been paid to developing the estimates of R e compared to GPP. Results : Based on 11 flux sites over the diverse grassland ecosystems in northern China, this study examined the amounts of carbon released by R e as well as the dominant environmental controls across temperate meadow steppe, typical steppe, desert steppe and alpine meadow, respectively. Multi-year mean R e revealed relatively less CO 2 emitted by the desert steppe in comparison with other grassland ecosystems. Meanwhile, C emissions of all grasslands were mainly controlled by the growing period. Correlation analysis revealed that apart from air and soil temperature, soil water content exerted a strong effect on the variability in R e , which implied the great potential to derive R e using relevant remote sensing data. Then, these field-measured R e data were up-scaled to large areas using time-series MODIS information and remote sensing-based piecewise regression models. These semi-empirical models appeared to work well with a small margin of error ( R 2 and RMSE ranged from 0.45 to 0.88 and from 0.21 to 0.69 g C m -2 d -1 , respectively). Conclusions : Generally, the piecewise models from the growth period and dormant season performed better than model developed directly from the entire year. Moreover, the biases between annual mean R e observations and the remotely-derived products were usually within 20%. Finally, the regional R e emissions across northern China's grasslands was approximately 100.66 Tg C in 2010, about 1/3 of carbon fixed from the MODIS GPP product. Specially, the desert steppe exhibited the highest ratio, followed by the temperate meadow steppe, typical steppe and alpine meadow. Therefore, this work provides a novel framework to accurately predict the spatio-temporal patterns of R e over large areas, which can greatly reduce the uncertainties in global carbon estimates and climate projections.
Job Satisfaction and Associated Factors among Health Care Staff in Township Health Centers—— A Cross-Sectional Survey in Rural Central China
Authors: Chen Xuyu , Yao Hui , Ran Li , Wu Wenwen , Zhang Yupeng , Li Mengying , Duan Ruihua , Tan Xiaodong
Published: March 2020

Background:Township health centers play a cornerstone role in the work of primary health care in China while it’s development is largely limited by the brain drain. Job satisfaction is closely related to brain drain, investigating the relevant factors of job satisfaction can provide strategies to reduce brain drain. The aim of this study was to explore job satisfaction and associated factors among health-care staff in township health centers in Huangpi District. Methods: This research was conducted in Huangpi, China. Convenience sampling methods and self-administereded questionnaires were used. 1370 of valid samples were collected with 97.72% effective rate. Descriptive statistics are used to describe sociodemographic information. The Pearson Chi-square statistical was used to test the binary association between job satisfaction and another categorical variable. All the sociodemographic information was applied to the binary logistic regression model using the stepwise selection method. Results: The mean age was 36.98 (SD=9.84), Factors that affect job satisfaction include educational background (χ2= 7.99, p=0.046), monthly income (χ2= 51.43, p<0.001), hire form (χ2=7.64, p=0.049), hours worked per week (χ2=33.48, p<0.01), parent have had a stable job (χ2= 10.67, p<0.01). Conclusions: Government and management should consider the impact of current policies on job satisfaction to reduce staff’s personal job dissatisfaction, Reducing staff workload, increasing salary and overtime benefits, and promoting the fairness of wage distribution are potential strategies to ameliorate low levels of job satisfaction.
Security and efficiency of percutaneous microwave ablation by combining computer tomography- with ultrasound-guided in patients with BCLC-A1-3 hepatocellular carcinoma
Authors: Zhao Wenpeng , Guo Jiang , Li Honglu , Cai Liang , Duan Youjia , Hou Xiaopu , Du Hongliu , Shao Xihong , Diao Zhenying , Li Changqing
Published: March 2020

Background : To evaluate prospectively security and efficiency of percutaneous microwave ablation (MWA) by combining computer tomography (CT)- with ultrasound (US)-guided of in patients with BCLC-A1-3 hepatocellular carcinoma (HCC ). Methods : We studied 88 consecutive patients with single HCC who were treated with transcather hepatic arterial chemoembolization (TACE), patients were divided into 3 groups at random by using draw lots 1 week after TACE, combination group (34 cases) received MWA under the guidance of CT and US, while single group (CT group 30 cases, US group 24 cases) received MWA under the guidance of CT or US alone.1 month,3 months,6months and12 months after the procedure, contrast-enhanced MRI scan were performed in all cases. Study endpoints included treatment time, puncture time, local recurrence rate and adverse events. Results : A total of 88 lesions were radically treated with MWA after TACE. The median diameter of the lesion was 3.1(1.5-4.2) cm. The mean treatment time, puncture time were 38.6 (30-45) min, 36.7 (30-47) min, and 1.2 (1-2), 1.1 (1-2) in the combination group and US group, which were significantly inferior to CT group (45.8 minutes and 4.2); Local recurrence rate was 5.9% in the combination group, which was significantly inferior to US group (16.7%).Grade C complication rates occurred in the combination group was 5.9%, while it was 13.3% and 8.3% in CT group and US group, there was statistically significant between combination group and CT group ( P <0.05). Conclusions : Using CT- and US-guided microwave ablation in patients with BCLC-A1-3 hepatocellular carcinoma appeared to be much better in security and efficiency than that under the guidance of CT or US alone.
Determinants of Diabetic Retinopathy in Southwest Ethiopia: A facility-based case-control study
Authors: Garoma Dugasa , Merga Hailu , Hiko Desta
Published: March 2020

Background: Diabetic Retinopathy is one of the serious complications patients’ diabetic patients suffer from. Little is known about which risk factors are associated with this complication. The aim of this study was therefore to identify determinants of Diabetic Retinopathy in Jimma University Medical Center. Methods: A facility-based case-control study was conducted. Cases were Diabetic patients with diabetic retinopathy and who were on follow up at the Jimma University Medical Center while controls were Diabetic patients but free of diabetic retinopathy and who were on follow up at the Jimma University Medical Center. Cases and controls were identified and 311 of them were recruited using systematic random sampling. Data were entered into the Epi-Data version 4.1 and analyzed using SPSS Version 20. Binary Logistic regression analysis was conducted to identify determinants of diabetic retinopathy. Result: A total of 106 cases and 205 controls diabetic participated in the study. Being ≥60 years of age (AOR=5.04,95%CI: 1.83,13.87),being illiterate (AOR=7.17, 95% CI: 2.61,19.7), poor adherence to medication (AOR =3: 95% CI: 1.29,6.95),having high systolic blood pressure (AOR=3.38:95% CI: 1.26,9.05), having family history of Diabetes Mellitus (AOR=3.95: 95% CI: 1.64,9.54), having other micro vascular complications (AOR=3.76,95% CI: 1.33,10.66), poor glycemic control (AOR=9.08, 95%CI: 3.7,22.29), poor cholesterol control (AOR= 0.21, 95%CI: 0.08,0.51) and being anaemic (AOR= 2.8, 95%CI: 1.05,7.47) were the independent determinants of diabetic retinopathy. Conclusion: This study found that poor adherence to medication, being at the age of 60 years and above, being illiterate patients, having high systolic blood pressure, having a family history of Diabetes Mellitus, having other micro vascular complication, poor glycemic control, poor cholesterol control and being anemic patient were the independent determinants of diabetic retinopathy. Therefore, more attention should be given to older age and illiterate patients. Giving more emphasis for patients poorly adhered to anti-diabetic medications and giving advice for diabetic patients with high systolic blood pressure to follow their blood pressure regularly are also vital. Diabetic patients should also control their Blood sugar and blood cholesterol levels to prevent diabetic retinopathy or reduce its further complications.
Investigation into Erosion induced Highway Structural Failure along Ifon—Benin Highway, Southwestern Nigeria
Authors: Falowo Olumuyiwa Olusola
Published: March 2020

Geotechnical investigation was carried out at two failed segments along Ifon-Benin Highway, with the aim of determining cause, nature, and extent of the road failure. Eight in-situ cone penetration tests was carried out to a depth of about 20 m with a lateral spacing of 20 m. This was complemented by collection of eight soil samples at different depths within the failed segments and analyzed in the laboratory. The laboratory tests conducted were grain size analysis, Atterberg limit test, compaction test, California bearing ratio, undrained unconfined triaxial test. The failure that existed in both locations are around the embankment, shoulder/edge and wearing course of the highway, due to ingression of water into the subgrade since the earth (natural soil) embankment structure had been eroded by rain water. The laboratory geotechnical results revealed that all the parameters could not meet up with the federal ministry of works and housing specification of Nigeria, with plasticity index greater than 20 %, % fines greater than 35 %, CBR values less than 80 % minimum recommended, shear strength parameters; angle of friction and cohesion are less than minimum of 30° and 50 kPa respectively. The CPT revealed predominant sandy silt to clayey silt topsoil and clay substratum with an inferred compressive strength of 20 – 40 KN/m2. At both failed segments, the clayey substratum is seriously affected within the upper 6 m. The ingression of water into these foundation structures was due to compromise of the design/construction engineer, since a bridge was supposed to be erected across these two locations. Hence the stream channels across the highway were blocked by the earth-fill embankment. Therefore during wet season, pool of water that supposed to flow across the road through bridge system, continue to dissolve the embankment, and consequently infiltrate into the subgrade. This makes the highway to settle largely under traffic load. In addition, incessant heavy flooding around the embankment/shoulder of the highway might have induced the failure since a bridge was supposed to have been constructed across the two failed segments. This flooded water might have infiltrated into the pavement structural material leading to looseness, and less-cohesion of the layers which invariably reduces subgrade support and weakens various pavement layers.
A comparative Geological, Tectonic and Geomorphological assessment of the Charlotte, Regent and Madina Landslides, Western Areas, Sierra Leone
Authors: Lahai Yusuf Alhaji , Anderson Kelvin F. E. , Jalloh Yaguba , Rogers Ibrahim , Kamara Mohamed
Published: March 2020

This work focused on three landslide events that have attracted significant public concern due to the associated calamities. The slides have been analyzed for their geology, tectonics and geomorphological (GTG) characteristics. In addition, an understanding of the link between GTG characteristics and the landslide events was established.To achieve this, field surveys were conducted, particularly for the Charlotte landslide, where identification of geological structures was perturbed by the obliteration of vegetation and sediment accumulations on relatively planar sections of the landslide area. GIS and remote sensing techniques enhanced mapping and determination of landslide characteristics, and laboratory analyses on rock samples provided the petrological characterization of the landslides.Results indicated change in rock composition (gabbro), variable geomorphological characteristics and the nature/pattern and density of discontinuities; these factors, to a large extent, determined the nature and magnitude of the rainfall-triggered landslides. Charlotte lithology slightly differs from and recorded higher Silica (Si) and Aluminum (Al) and lower iron (Fe) than rocks of Regent and Madina landslides. Study also revealed only tenuous correlation between rock composition and weathering depth. The slope angles for the landslides’ main scarps (depletion zone) are steep (>45 degree) with altitudes ≈270m, 470m and 200m above sea level for Charlotte, Regent and Madina respectively. Additionally, the area and length of the landslides have relatively high variance (CV=1) and the variance of their run-outs as well is high (CV>1). Finally, information derived from this work can be useful to understand the spatial variation in landslide characteristics and the development of a susceptibility map.
Hop tests and psychological PROs provide a demanding and clinician-friendly RTS assessment of patients after ACL reconstruction, a registry study.
Authors: Piussi Ramana , Beischer Susanne , Thomeé Roland , Senorski Eric Hamrin
Published: March 2020

Background There is growing interest in assessing psychological well-being in patients after anterior cruciate ligament (ACL) reconstruction. It is unknown whether an assessment of psychological outcome in addition to tests of muscle function can facilitate decisions on return to sport. Therefore, the aim was to evaluate different return to sport (RTS) test batteries, comprising both muscle function and psychological outcomes 1 year after ACL. Method In this cross-sectional cohort study a total of 320 patients (51% men) aged 18-65 years were included 1 year after ACL reconstruction. Different muscle function (MF) test batteries consisting of knee extension and flexion strength tests, 3 hop tests, and 2 psychological patient-reported outcomes (PROs); Quality of Life subscale from the Knee injury and Osteoarthritis Outcome Score (KOOS QoL) and ACL Return to Sport after Injury (ACL-RSI), 1 year after ACL reconstruction. Results Passing rates in the different test batteries varied from 47% for 2 hop tests to 13% for 5 MF tests + 2 PROs. The use of psychological PROs together with tests of muscle function gave the lowest passing rates. There was a very strong correlation between passing 2 hop tests + 2 PROs and passing 5 MF tests as well as passing 5 MF tests + 2 PROs. Conclusion The use of hop tests together with psychological PROs provides a demanding and clinician-friendly RTS test battery for assessment 1 year after ACL reconstruction.
TREM2 knockout, but not the R47H Alzheimer’s variant, reduces neural phagocytosis and survival of human iPSC-derived macrophages
Authors: Hall-Roberts Hazel , Obst Juliane , Smith Thomas B. , Daniel Elena Di , Mead Emma , James William S. , Davis John B. , Cowley Sally A.
Published: March 2020

BACKGROUND: TREM2 is a microglial cell surface receptor, with risk mutations linked to Alzheimer’s disease (AD), including R47H. Binding of ligands to TREM2 triggers Syk-dependent signalling through the DAP12 co-receptor, leading to phagocytosis, survival, and changes to microglial activation state. In biochemical assays, R47H impairs TREM2 binding to phosphatidylserine, a lipid “eat-me” signal exposed by apoptotic neurons. The effect of R47H TREM2 upon phagocytosis of apoptotic neurons by human microglia has not yet been reported. METHODS: We generated human microglia-like iPSC-macrophages (pMac) from isogenic induced pluripotent stem cell (iPSC) lines with homozygous R47H mutation or TREM2 knockout (KO). To assess microglial phenotypic function in the mutants, we measured: (1) pro-inflammatory cytokine responses by ELISA; (2) survival after growth factor-withdrawal; (3) phagocytosis by novel high-content imaging assays, using two neuron-derived cargoes that expose phosphatidylserine (fixed SH-SY5Ys and synaptosomes). Downstream signalling resulting from TREM2 activation was additionally assessed by assaying Syk phosphorylation and calcium flux. RESULTS: We demonstrated that TREM2 KO strongly diminished both pMac survival and neural phagocytosis, while having little impact on inflammatory cytokine response. R47H TREM2 modified surface expression and shedding of TREM2, but did not impair TREM2-mediated signalling, survival, or phagocytosis. CONCLUSIONS: Under healthy conditions in culture, the R47H mutation is not sufficient to cause defects in phagocytosis or survival of human pMac, unlike more severe T66M or W50C TREM2 loss-of-function mutations. We hypothesise that R47H TREM2 affects other microglia phenotypes yet to be explored, and/or that pathogenic manifestation requires other stressors relating to neurodegenerative disease.
Towards a sustainable working life for registered nurses in a hospital setting: Factors explaining why they remain in work and profession – A salutogenic interview study
Authors: Nunstedt Håkan , Eriksson Monica , Obeid Ayman , Hillström Lisbeth , Truong Anh , Pennbrant Sandra
Published: March 2020

Background There is extensive research on how nurses experience their working conditions and environment; this research shows high job stress, job dissatisfaction and intention to leave the workplace. The aim was to describe and explore success factors explaining why hospital nurses remain in work and profession. Methods A qualitative, descriptive and explorative study based on a theory-driven (the salutogenic theory by Antonovsky) approach was conducted. Data collection took place from March to June 2018. Individual semi-structured interviews with twelve registered nurses working in a hospital in western Sweden were conducted. The sense of coherence and its three dimensions, comprehensibility, manageability and meaningfulness, were used as a tool to structure the analyses of the qualitative data. Hence, a deductive (theory-driven) and an inductive (data-driven) approach with qualitative content analysis of manifest and latent content were used. Results The results showed that a sense of meaningfulness, manageability and comprehensibility involved the factors having fun at work, being acknowledged, feeling togetherness in the team, having varying tasks with a manageable workload, good interaction between colleagues and patients, doing good work, feeling committed to and pride in the professional role, and having a balance between work and leisure time. Conclusions One precondition of improving registered nurses’ health and well-being was having clear leadership. Another precondition was having a sense of coherence in relation to both the working group and the organization. Experiencing job satisfaction and being acknowledged for one’s good work were important; acknowledgement was received not only from patients, but also from colleagues, other professionals and the nurse manager. In this way, the nurses felt acknowledged and could create a sense of meaningfulness, manageability and comprehensibility in their work.
The right internal mammary artery and the great saphenous vein used for left anterior descending artery revascularization in patients whose left internal mammal artery cannot be used: a study based on transit-time flow measurement.
Authors: Zhang Guodong , Chen Yu , Chen Shenglong , Liu Gang , Zhao Zhou
Published: March 2020

Background: Owing to the high patency, the use of the left internal mammary artery (LIMA) for left anterior descending artery (LAD) grafting has been a cornerstone of coronary artery bypass graft surgery (CABG). However, for some patients whose LIMA cannot be used, surgeons have to choose the other conduit materials to revascularize the LAD. The purpose of this study was to explore the difference of different conduit materials used for LAD in the parameters measured by transit-time flow measurement (TTFM) and the early graft patency detected by computed tomography angiography.Methods: We retrospectively collected the data of 410 patients who undergoing isolated primary OPCAB with intraoperative TTFM data. According to the strategy of the left descending artery (LAD) revascularization, 410 patients were assigned to three groups: a left internal mammal artery (LIMA)group(n=333), a right IMA group (n=34) and a great saphenous vein (SVG) group (n=43). The baseline and perioperative blood parameters were compared for the three groups, as well as the early graft patency rates. Results: Compared with the LIMA-LAD group, the SVG-LAD group had a significantly higher mean graft flow volume(37.15±23.29vs29.71±20.94ml/min, P=0.036),however, a lower pulsatility index (2.07±0.62vs 2.65±1.01,P＜0.001).There was no significant difference between the two groups in DF(P＞0.05).Compared with the RIMA-LAD group, the SVG-LAD group just had a lower pulsatility index(2.07±0.62vs 2.56±0.96,P=0.029).However, there was no significant difference between the two groups in MGF and DF(P＞0.05).Compared with the LIMA-LAD group, the RIMA-LAD group had a bit lower DF(70.76±11.87vs74.06±7.09,P=0.018),while there was no difference in MGF and PI between the two groups(P＞0.05). The patency rate of the LIMA-LAD group was 98.72% (309/313), the RIMA-LAD group was 97.06% (33/34), and the SVG-LAD group was 100%. There was no difference among the three groups in patency rate(P=0.405).Conclusions: We conclude that in patients whose LIMA cannot be used，the in-suit RIMA and the SVG are comparable and even better than the LIMA in the blood flow parameters measured by TTFM. In our study，the early patency before discharge of RIMA-LAD and SVG-LAD are comparable with the LIMA-LAD.
Efficacy of Attachment-Based Family Therapy compared to Treatment as Usual for Depressed Adolescents in Community Mental Health Clinics
Authors: Waraan Luxsiya , Rognli Erling W. , Czajkowski Nikolai Olavi , Aalberg Marianne , Mehlum Lars
Published: March 2020

Background: Major Depressive Disorder (MDD) is a disabling mood disorder, profoundly affecting a large number of adolescent’s quality of life. To date, no obvious treatment of choice for MDD in adolescents is available and progress in the treatment of depressed adolescents will have important public health implications. Attachment-Based Family Therapy (ABFT), as the only empirically supported family therapy model designed to treat adolescent depression, aims to repair interpersonal ruptures and rebuild an emotionally protective parent-child relationship. Objective: To study the efficacy of ABFT compared with Treatment as Usual (TAU) delivered within child- and adolescent mental health services (CAMHS) to adolescents with MDD. Method: Sixty adolescents, aged 13-18 years, with MDD referred to two CAMHS were randomized to receive 16 weeks of ABFT or TAU. ABFT consisted of weekly therapy sessions (family/individual or both) according to the treatment manual. TAU was not monitored. Primary outcomes were clinician-rated (Hamilton Depression Scale, HAMD) and self-reported (Beck Depression Inventory-II, BDI-II) depressive symptoms assessed at baseline and post-treatment by blinded evaluators for HAMD and at baseline, and after 4, 6, 8, 10,12, 14, and 16 weeks for BDI-II. Analyses were performed according to intent-to-treat principles. Results: At post-treatment, clinician-rated remission rates on the HAMD (5 % in ABFT and 3.33% in TAU, p =1, OR=1.54, Fisher’s exact test) and self-reported symptoms of depression on the BDI-II did not differ significantly between groups ( X 2 [2, N = 60] =0.06 , p = 0.97). In both treatment groups participants reported significantly reduced depressive symptoms, but the majority of adolescents were still in the clinical range after 16 weeks of treatment. Conclusion: In this sample of adolescents treated for MDD in community mental health clinics, ABFT was not associated with more favorable outcomes than TAU in terms of remission rates on clinician rated and self-reported depressive symptoms. Remission and response rates were low in both groups, suggesting a need for continued improvement of the treatment methods. Trial Registration: Clinicaltrials.gov identifier: NCT01830088 https://clinicaltrials.gov/ct2/show/NCT01830088?term=Villab%C3%B8&draw=2&rank=1 Date of registration: April 12, 2013 Keywords: Depression, Adolescents, Attachment Based Family Therapy, Efficacy trial
Effective Stereo Matching with Segment-based Cost Aggregation and Dual-path Refinement
Authors: Huang Chih-Shuan , Huang Ya-Han , Chan Din-Yuen , Yang Jar-Ferr
Published: March 2020

Stereo matching is one of the most important topics in computer vision and aims at generating precise depth maps for various applications. The main challenge of stereo matching is to suppress inevitable errors occurring in smooth, occluded and discontinuous regions. To solve the aforementioned problems, in this paper, the proposed robust stereo matching system by using segment-based superpixels and magapixels to design adaptive stereo matching computation and dual-path refinement. After determination for edge and smooth regions and selection of matching cost, we suggest the segment–based adaptive support weights in cost aggregation instead of color similarity and spatial proximity only. The proposed dual-path depth refinements utilize the cross-based support region by referring texture features to correct the inaccurate disparities with iterative procedures to improve the depth maps for shape reserving. Specially for left-most and right most regions, the segment-based refinement can greatly improve the mismatched disparity holes. The experimental results demonstrate that the proposed system can obtain higher accurate depth maps compared with the conventional methods.
The possible association of steroids with fluid accumulation in critically ill patients – a case of a potential bias
Authors: Frenkel Amit , Abuhasira Ran , Bichovsky Yoav , Bukhin Anton , Novack Victor , Brotfain Evgeni , Zlotnik Alexander , Klein Moti
Published: March 2020

Background: Glucocorticoids (GCS) are commonly administered to critically ill patients. Due to their mineralocorticoid effect, GCS might have a substantial influence on a positive fluid balance. We assessed the association between glucocorticoids (GCS) therapy and fluid balance in critically ill patients with sepsis.Methods: This is a retrospective study of patients with sepsis hospitalized during 2006-2018 in a general intensive care unit (ICU) at a 1100-bed tertiary medical center.Results – We considered two definitions of exposure: daily exposure to GCS and GCS treatment at any time in the ICU. Of 945 patients with a diagnosis of sepsis, 375 were treated with GCS at any time and 570 were not. We applied four regression models to assess the association between GCS treatment and fluid balance; in our first model, fluid balance did not differ during days with GCS treatment, between patients who were and were not treated with GCS in the ICU (coefficient estimate 79.5 (-55.4 to 214.4), p=0.25). In our second model, daily fluid balance was increased by 139.8 ml (10.8 to 268.9; p=0.03) in patients who were ever treated with GCS during their ICU stay compared to untreated patients. In the third model, which included only patients treated with GCS during their ICU stay, GCS treatment days were not associated with daily fluid balance (coefficient estimate -190.6 (-485.1 to 103.9), p-value=0.21). In the last model, on "steroid free days", patients who received GCS treatment during their ICU stay had a positive fluid balance compared to those who were never treated with steroids (coefficient estimate 157.7 (-24.6 to 340.1), p-value=0.09).Conclusions – Despite their known mineralocorticoid activity, GCS themselves appear not to contribute substantially to fluid retention. The findings highlight the importance of a clear definition of exposure.
High Hb F level is associated with the risk of cerebral vasculopathy in a cohort of sickle cell children in Mayotte.
Authors: Elenga Narcisse , CHAMOUINE Abdourahim , SAANDI Thoueiba , MUSZLAK Mathias , LARMARAUD Juliette , LAMBRECHT Laurent , POISSON Jean , BALICCHI Julien , PISSARD Serge
Published: March 2020

Background Understanding the genetics underlying the heritable subphenotypes of sickle cell anemia, specific to each population, would be prognostically useful and could inform personalized therapeutics. Methods This study aimed to describe the genetic modulators of sickle cell disease in a cohort of pediatric patients followed in Mayotte between 2007 and 2017. Results We included 190 children with 72% SS, 16% Sβ0-thalassemia and 12% Sβ+ thalassemia. The mean age was 9.5 (1.6-23.4) years; 10% of patients were lost to follow up. The Bantu haplotype was associated with an increase in hospitalizations and transfusions. The alpha-thalassemic mutation was associated with a decrease of hemolysis biological parameters (anemia, reticulocytes), and less cerebral vasculopathy. The SNPs BCL11A rs4671393, BCL11A rs11886868, BCL11A rs1427407 and HMIP rs9399137 were associated with the group of children with HbF> 10%. The survival analysis without occurrence of cerebral vasculopathy showed that the group of patients with HbF> 10% presented a significant risk of early onset of cerebral vasculopathy. Conclusions Although the sub-phenotypes were difficult to clearly distinguish in our study, a genotype-sub-phenotype link is emerging.
Gout treatment: problems, paradoxes, prospects
Authors: Eliseev M. S.
Published: March 2020

Interview with a leading expert in the treatment of gout, head of the laboratory of microcrystalline arthritis of the Federal State Budget Scientific Institution “Scientific Research Institute of Rheumatology named after V.A. Nasonova“ candidate of medical sciences Maxim Sergeevich Eliseev.
Insomnia in general practice: the role of doxylamine
Authors: Burchakov D. I. , Tardov M. V.
Published: March 2020

The general practitioner encounters all three forms of insomnia: idiopathic, chronic and acute. Idiopathic and chronic patients should receive specialized care by neurologist, psychiatrist or sleep disorders specialists because they require deep differential diagnosis and complex treatment. Acute insomnia patients need quick help to prevent the negative health impact and chronisation of sleep disruption. In theRussian Federation, the GP has access to three kinds of sleep drugs: benzodiazepines, melatonin receptor agonists, antihistamines. However, modern benzodiazepines are unavailable inRussiaand older benzodiazepines can lead to dependence. Melatonin receptor agonists are not effective enough for acute insomnia. Among available antihistamines, doxylamine is the most convenient option in clinical practice. Doxylamine has a good profile of safety and efficacy, it is included in the local clinical guidelines for insomnia. Also, doxylamine is the only sleep drug available for pregnant women. This paper presents a portrait of doxylamine and comments on its clinical niches and contraindications. We also discuss the pharmacology of doxylamine, drug interactions, and prescription modes. There are also three clinical case studies, presenting the typical acute insomnia patients and logic for their evaluation, underlining key clinical features of this disorder.
Use of monoclonal antibodies in patients with multiple sclerosis in the practice of a neurologist
Authors: Lashch N. Yu.
Published: March 2020

Multiple sclerosis (MS) ranks first for prevalence among diseases affecting the CNS white matter with 2.5 million cases estimated globally. InRussia, the number of cases is about 200 thousand. MS in most cases has a wavy course (periods of exacerbations and remissions), over time the progression of disease worses the quality of life of patients. The “gold standard” at the beginning of MS is first-line drugs disease-modifying therapies (DMT). If they are ineffective, it is necessary to strengthen the effect on the immune processes and the patient is prescribed second-line drugs (escalation of therapy). There is a method of induction therapy, when high activity of MS is recommended to start with drugs that have a strong immunosuppressive effect with a possible subsequent transition to soft supportive treatment. In patients with frequent exacerbations and signs of radiological activity of the disease, according to magnetic resonance imaging (MRI) of the brain and spinal cord, monoclonal antibody preparations are effectively used. Except of escalation and induction, it is also used the method of immune system reconstruction, which leads to a decrease in autoagression in MS. This article discusses a clinical case of using a drug of monoclonal antibodies that selectively bind to CD 52 on the surface of lymphocytes. The issues of efficacy and safety of alemtuzumab therapy in patients with MS are considered.
The experience of using ocrelizumab in routine practice
Authors: Popova E. V. , Ryabov S. A.
Published: March 2020

Introduction. The routine use of highly effective drugs that alter the course of multiple sclerosis requires careful patient selection in order to minimize the risks of possible adverse events. At present, drugs modifying the course of multiple sclerosis have been registered with different mechanisms of action. This makes it possible to implement individual selection of therapy taking into account the multifaceted pathogenesis of the disease. However, the presence of a burdened somatic anamnesis in the patient may significantly limit the choice of drugs by the attending physician. Aim: to gain experience in using ocrelizumab to treat patients with multiple sclerosis. 

Materials and methods. From 2018 ocrelizumab therapy was started in 52 MS patients: 32 patients with recurrent multiple sclerosis (MS) (23 with remitting multiple sclerosis (RMS) and 9 with secondary progressive MS with exacerbations) and 20 patients with primary progressive multiple sclerosis (PPMS). The drug was administered intravenously in drops with infusion in a dose of 600 mg every 6 months in a daytime regimen with an approved protocol of premedication and symptomatic therapy to prevent possible risks of adverse events. The initial dose was divided into 2 infusions of 300 mg at intervals of 2 weeks [5]. Before each infusion, detailed clinical blood analysis, biochemical blood tests, serological tests (HIV, hepatitis B and C, syphilis), and screening for tuberculosis (once a year) were necessarily repeated.

The results. The achieved results clearly demonstrate high efficacy of ocrelizumab in the form of reduction of exacerbations frequency, disease activity according to MRI data and slower progression, which is compared with the data from previous OPERA I, OPERA II and ORATORIO clinical trials. After analysis of the data of dynamics of disability index according to EDSS scale there was observed stabilization in PPMS patients and a slight decrease in RMS patients. No exacerbations were registered in patients with RMS during the period of treatment, as well as no objective data on progression in patients with PPMS were noted.

There is also good tolerance of therapy. However, the question remains as to how long the therapy should take into account the safety spectrum.
Enhancing stormwater sediment settling at detention pond inlets by a bottom grid structure (BGS)
Authors: Milovanović Ivan , Bareš Vojtěch , Hedström Annelie , Herrmann Inga , Picek Tomas , Marsalek Jiri , Viklander Maria
Published: March 2020

Stormwater sediments of various sizes and densities are recognised as one of the most important stormwater quality parameters that can be conventionally controlled by settling in detention ponds. The bottom grid structure (BGS) is an innovative concept proposed in this study to enhance removal of stormwater sediments entering ponds and reduce sediment resuspension. This concept was studied in a hydraulic scale model with the objective of elucidating the effects of the BGS geometry on stormwater sediment trapping. Towards this end, the BGS cell size and depth, and the cell cross-wall angle were varied for a range of flow rates, and the sediment trapping efficiency was measured in the model. The main value of the observed sediment trapping efficiencies, in the range from 13 to 55%, was a comparative assessment of various BGS designs. In general, larger cells (footprint 10 × 10 cm) were more effective than the smaller cells (5 × 5 cm), the cell depth exerted small influence on sediment trapping, and the cells with inclined cross-walls proved more effective in sediment trapping than the vertical cross-walls. However, the BGS with inclined cross-walls would be harder to maintain. Future studies should address an optimal cell design and testing in an actual stormwater pond.
O Déficit na Oferta de Serviços de Infraestrutura em Saneamento Básico: Um Recorte Histórico do Processo de Urbanização no Município de Belém - Pará
Authors: Silva Jaqueline Portal da , Pimentel Márcia Aparecida da Silva
Published: March 2020

O estudo visa mostrar evidências capazes de relacionar o déficit na oferta dos serviços de infraestrutura em saneamento básico à dinâmica econômica e ao processo histórico de urbanização do município de Belém, Pará, Amazônia brasileira. Trata-se de uma revisão sistemática, elaborada a partir da análise da literatura geográfica e urbanística, na qual os estudos foram selecionados em publicações indexadas nas bases de dados dos periódicos CAPES, Scielo e Google Acadêmico, através de palavras-chave. Ciclos econômicos, déficit habitacional foram alguns dos fatores determinantes do processo de urbanização desordenado que resultaram na ausência e/ou deficiências dos serviços de saneamento básico.
Mudanças Climáticas e Impactos da Elevação do Nível do Mar na Zona Costeira: Pesquisa Bibliográfica e Contribuição Conceitual
Authors: Braga Ronaldo da Cruz , Pimentel Márcia Aparecida da Silva , Rocha Edson José Paulino
Published: March 2020

Este artigo constitui esforço teórico sobre o tema relacionado ao aumento do Nível Médio do Mar e seus impactos nos sistemas ambientais naturais e antrópicos nas zonas costeiras, tema que está presente tanto no meio acadêmico, quanto fora dele, como uma reflexão cotidiana da sociedade contemporânea. Tal desafio empreendeu a construção de uma base teórica estruturada nos conceitos de Mudanças Climáticas, Zona Costeira, Nível Médio do Mar, Antropoceno e Meios Geográficos associados ao contexto das mudanças climáticas atuais. Para tanto, foi fundamental a pesquisa em periódicos indexados, internacionais e nacionais, livros, teses e sites, o que totalizou 125 referências sobre o tema. De forma procedimental houve, inicialmente, um breve resgate histórico dessas discussões desde a Antiguidade Clássica até a Primeira Revolução Industrial. Posteriormente, foram inseridas, as informações mais recentes baseadas na linha científica do Painel Intergovernamental sobre Mudanças Climáticas (IPCC). A correlação entre as projeções do Quinto Relatório do IPCC AR5/2013 e a base de dados de altimetria por satélites, demostrou que o nível do mar tem aumentado na maior parte do Globo, provocando diversos impactos socioambientais advindos da erosão e inundação, principalmente na chamada Zona Costeira de Baixa Elevação.
Dry Sand Quality: The Case Study of a Touristic Beach from Rio de Janeiro, Brazil
Authors: Krepsky Natascha , Nunes Karine Peixoto , Paula Junior Luiz Affonso de , Lino Viviane Almeida de Andrade , Naveira e Silva Clarissa Araujo Costa , Brandão Iracema Prestes , Santos Fernanda Silva dos
Published: March 2020

Coastal contamination became a growing public health concern. Enteric illness outbreaks, and the occurrence of dermatitis and mycoses during the summer season in leisure areas, were usually related to seawater pollution. Pathogenic microorganisms can reach coastal areas through sewage discharges, compromising marine water, and beach quality. Although sand transmission of enteric illness is still unclear, there is an expressed concern that sand may act as reservoirs or vectors for humans infection. In this context, the main hypotheses of this study were: (i) fecal coliforms density changes within beach compartments; (ii) dry sand is the most contaminated beach compartment; (ii) fecal coliforms densities are within international standard limits for sand. Therefore, this case study quantified and compared within three months total fecal bacteria (TC) and thermotolerant coliforms (TEC) densities in seawater, wet, and dry sand of a chosen touristic beach from Rio de Janeiro, Brazil. Furthermore, to contribute to coastal beach management, sand contamination data surveyed were compared with the standard limits ruling worldwide until April 2018 to check suitableness. Vermelha beach should be considered as a reference beach for sand monitoring in Brazil. Despite being a buffer zone from the MONA Pão Açucar conservation unit, it is subjected to intense touristic pressure. Even though, fecal bacteria densities quantified in Vermelha beach were within the standards of “excellent” quality sand and water according to current legislation/guidelines. However, dry sand was the most contaminated compartment, followed by seawater and wet sand. The bacterial density in dry sand was up to 4,600 times higher than wet sand. Except for Rio de Janeiro city, recreational guidelines for beach quality is exclusive for seawater contamination. There are no established parameters for recreational beach sand classification, only recommendations, including Portugal. Monitoring recreational beach dry sand is critical to reducing the risk of beachgoer exposure to pathogens.
Evaluation of in vitro Cytotoxic Effects of Especifico Pessoa Phytotherapic Tincture on Ehrlich Tumor Cells and Mice Spleen Cells
Authors: Castoldi Lindsey , Albiero Lucinéia Reuse , Nery Eduardo Figueredo , Kelly Taiany Oliveira , Dalazen Jeniffer Charlene Silva , Masochini Rosângela Guerino
Published: March 2020

Especifico Pessoa (EP) is traditionally used for the treatment of snakebite envenoming. The traditional use of EP and its properties have been reported. In this study, we evaluated the in vitro cytotoxic effects of EP on Ehrlich tumor and mice spleen cells. Cytotoxicity assay was carried out by using Trypan blue exclusion method. Spleen cell suspension was prepared (n=2) with RPMI medium and tumor cell suspension was prepared from ascitic fluid of Ehrlich tumor-bearing mice (n=1); both the suspensions contained 4 x 106 cells mL-1. Pure EP or EP diluted in RPMI (1:2; 1:4) was used. The results were expressed as percentage of cell viability and demonstrate that EP is toxic to Ehrlich cells at all concentrations (Control: 96.42 ± 3.40; Pure: 1.55 ± 2.91; 1:2: 4.85 ± 5.04; 1:4: 13.39 ± 5.08), but nontoxic to spleen cells in at the lowest dilution (Control: 72.86 ± 13.79; Pure: 13.52 ± 6,36; 1:2: 41.36 ± 13.51; 1:4: 56.59 ± 8.62). Therefore, the results demonstrate that EP has cytotoxic effects, depending on the dose and the cell line evaluated.
Síntese e Caracterização de Óxido de Zinco Nanoparticulado: Preparo Via Método Sol-Gel e Aplicação como Catalisador na Degradação de Cloridrato de Ciprofloxacino
Authors: Rosa Mauricio Ferreira da , Bortolini Bruna Loesch , Silva Alessandra Eugenio Carli da , Carvalho Vinicius Alexandre , Lobo Viviane da Silva
Published: March 2020

O presente trabalho reporta a síntese pelo método sol-gel de ZnO nanoparticulado (nZnO) e avalia sua atividade frente ao ZnO comercial (cZnO) como fotocatalisador na degradação do antibiótico cloridrato de ciprofloxacino (CIP) em solução aquosa. A caracterização do nZnO foi realizada por DRX, MEV, MET e infravermelho com transformada de Fourier. Os experimentos de fotodegradação foram organizados em um planejamento experimental 23 e a influência dos parâmetros [ZnO], [H2O2] e pH foram avaliados estatisticamente. Os resultados experimentais mostraram que as melhores condições para o processo de fotodegradação, [H2O2] = 500 mg L-1 e [ZnO] = 20 mg L-1 em pH 4, foram idênticas para ambos fotocatlisadores, e a atividade do nZnO foi 6% superior à atividade do cZnO. A pequena diferença observada na atividade do nZnO em relação ao cZnO pode ser atribuída à heterogeneidade morfológica do nZnO obtido sinteticamente.
Estudo Morfoanatômico e Atividade Antibacteriana do Óleo Essencial, Extrato Bruto e Frações das Folhas de Macairea radula (Bonpl.) Dc.
Authors: Tomé Luciana Uchôa , Ferreira Heleno Dias , Oliveira Larissa Gonçalves de , Alves Virgínia Farias , Paula José Realino de , Farias Wadson da Costa , Borges Leonardo Luiz , Fiuza Tatiana de Sousa
Published: March 2020

Macairea radula, “capuchinha”, é um arbusto popularmente usado para dermatoses e escabioses. Objetivou-se realizar o estudo morfoanatômico, a triagem fitoquímica, avaliar a atividade antibacteriana do óleo essencial, extrato bruto e frações das folhas. A caracterização macroscópica foi realizada na Serra dos Pireneus, Goiás. Os estudos anatômicos e a triagem fitoquímica foram realizados de acordo com as técnicas convencionais. A avaliação da atividade antibacteriana foi determinada através da Concentração Inibitória Mínima. O óleo essencial foi obtido por hidrodestilação em um aparelho de Clevenger. M. radula possui folhas simples, opostas. A lâmina foliar é hipoestomática, com tricomas em ambas as faces. Observou-se presença de cumarinas, esteroides, triterpenos, taninos, desoxiaçúcares, flavonoides e saponinas. Verificou-se atividade antimicrobiana do extrato bruto e da fração aquosa contra Pseudomonas aeruginosa, das frações diclorometano e acetato de etila contra Listeria innocua. Os resultados abrem perspectivas futuras para seu uso no desenvolvimento de produtos com potencial atividade antibacteriana.