bluuebunny/crossref_metadata_2025 huggingface dataset:
Self-Efficacy Parents in Undergoing Child Cancer Treatment at the Rumah Kanker Anak Cinta Bandung
Authors: Hendrawati Sri , Nurhidayah Ikeu , Mardhiyah Ai
Published: July 2019

The incidence of cancer in children is increasing and has entered into the top ten most prevalent diseases in children. Cancer in children have an impact both physical and psychosocial changes that can occur as a result of the disease and the side effects of treatment. The treatment for children with cancer should be done continuously and lasts a long time, so the role of parents in supporting the treatment is very important. Parents are the important factors to implementation of family centered care in the treatment and care for children with cancer. The implementation of family centered care is influenced by the self efficacy belief of parents. This study aimed to identify parental self efficacy in the treatment of children with cancer at the Rumah Kanker Anak Cinta Bandung. This study used a descriptive quantitative. The sample in this study was chosen by consecutive sampling, and found 40 samples within a month. Data collection using questionnaires developed based on Bandura theory (1997). Data was analyzed using descriptive analyzes by frequency and persentation. The results showed that the majority of parents who have children with cancer have a high self efficacy as many as 23 people (57.5%). Parents who have children with cancer in this study had a high ability or confidence (self efficacy) in treating children with cancer. So that it can be very supportive for the process of care, treatment, and cure of children, which expected to improve the quality of life for children with cancer.
Life Experience of Chronic Kidney Diseases Undergoing Hemodialysis Therapy
Authors: Wiliyanarti Pipit Festi , Muhith Abd
Published: July 2019

The incident of Kidney Disease increased year by years. Hemodialysis treatment is one of supportive therapies that can be maintained in health conditions of the chronocal kidney disease patient. This therapy can not replace the fuction of the kidney, however it could manage the quality of life of the kidney disease patients. The research descriptive qualitative approach was used in this study. The research results found 5 themes about chronic kidney disease patients with hemodyalisis. Those five themes were the knowledge of hemodynamic therapy, the impact of hemodynamic therapy, patients coping during the treatment process, family support and chronic kidney disease with hemodynamic therapy.
JENIS-JENIS IKAN LAYANG (Decapterus spp) BERDASARKAN HASIL TANGKAPAN NELAYAN BAGAN DI TELUK DORERI, KABUPATEN MANOKWARI, PROVINSI PAPUA BARAT
Authors: Suruan Sampari , Lahumeten Frankly , Bawole Roni , Sala Ridwan
Published: July 2019

Ikan layang (Decapterus spp) merupakan komponen utama dari sumberdaya ikan pelagis kecil yang sering tertangkap oleh nelayan bagan perahu di perairan Teluk Doreri, namun belum diketahui secara pasti jenis-jenis ikan layang (Decapterus spp) yang tertangkap oleh nelayan bagan perahu di perairan ini, sehingga dapat berakibat terhadap jenis-jenis ikan layang (Decapterus spp) secara spesies, jika tidak dapat dikelola secara berkelanjutan, sedangkan informasi ini sangat perlu diketahui untuk menunjang pengelolaan jenis-jenis ikan layang (Decapterus spp) perairan laut Teluk Doreri Kabupaten Manokwari dalam rangka pengelolaan perikanan tangkap secara berkelanjutan dan terpadu. Untuk itu, tujuan dari penelitian ini adalah mengetahui jenis-jenis ikan layang yang tertangkap oleh nelayan bagan di Teluk Doreri, Kabupaten Manokwari, Provinsi Papua Barat. Penelitian ini dilakukan selama 7 hari di bulan April 2019. Metode yang digunakan dalam penelitian ini adalah metode observasi langsung. Survei dilakukan pada 6 bagan nelayan yang melakukan operasi penangkapan di perairan Teluk Doreri. Analisis data yang digunakan dalam penelitian ini yaitu analisis deskriptif. Berdasarkan hasil yang didapatkan, nelayan biasanya melakukan operasi peangkapan pada 2 lokasi penangkapan, yaitu belakang Pulau Mansinam dan sekitar perairan Anday, dimana ke 2 lokasi ini merupakan target Fishing ground nelayan bagan. Hasil identifikasi jenis-jenis ikan layang menunjukan bahwa, dari 6 bagan nelayan yang melakukan penangkapan ikan layang, ditemukan 3 jenis ikan layang (Decapterus spp) yang sering tertangkap oleh bagan nelayan di sekitar perairan Teluk Doreri, yaitu jenis Decapterus macarellus, Decapterus akaadsi dan Decapterus macrosoma. Diperlukan kajian lebih lanjut dalam menunjang prospek perikanan ikan layang di Teluk Doreri, Kabupaten Manokwari, Provinsi Papua Barat, Indonesia.
Is Radial Extracorporeal Shock Wave Therapy Combined with a Specific Rehabilitation Program (rESWT + RP) More Effective than Sham-rESWT + RP for Acute Hamstring Muscle Complex Injury Type 3b in Athletes? Study Protocol for a Prospective, Randomized, Double-Blind, Sham-Controlled Single Centre Trial
Authors: Crupnik Javier , Silveti Santiago , Wajnstein Natalia , Rolon Alejandro , Vollhardt Alisa , Stiller Peter , Schmitz Christoph
Published: July 2019

Background: Acute injuries of the hamstring muscle complex (HMC) Type 3b (interfascicle / bundle-tear) are frequently observed in various sports disciplines both in elite and recreational sport. The treatment of choice of acute HMC injuries Type 3b is a progressive physiotherapeutic exercise program. Besides this, there is currently only insufficient scientific evidence to support other treatment methods, including local infiltrations and injections of platelet-rich-plasma. Very recently it was demonstrated that extracorporeal shock wave therapy (ESWT) may accelerate regeneration after acute skeletal muscle injury. The aim of the present study is to test the hypothesis that the combination of radial ESWT (rESWT) and a specific rehabilitation program (RP) is effective and safe in treatment of acute HMC injury Type 3b in athletes, and is statistically significantly more effective than the combination of sham-rESWT and RP. Methods/Design: We will perform a double blind, randomized, sham-controlled clinical trial at the clinic KinEf Kinesiología Deportiva, Ciudad Autónoma de Buenos Aires, Argentina. Fourty patients with acute HMC injury Type 3b will be randomly allocated to receive either rESWT (nine rESWT sessions; three sessions per week; 2500 radial extracorporeal shock waves (rESWs) per session; energy density depending on what the patient tolerates) or sham-rESWT. In addition, all patients will receive a specific rehabilitation program that will last for eight weeks. The primary outcome measure will be the individual time (days) necessary to return to play. Secondary outcomes will include the presence or absence of reinjury during a time period of six months after inclusion into the study. Discussion: Because of the lack of adequate treatment options for acute HMC injury Type 3b in athletes and particularly the high reinjury rate, we hypothesize that the results of this trial will be of importance and have impact on clinical practice. Trial registration: ClinicalTrials.gov ID NCT03473899. Registered March 22, 2018.
The College Park, Maryland Tornado of 24 September 2001
Authors: Pryor Kenneth , Wawrzyniak Tyler , Zhang Da-Lin
Published: July 2019

The 24 September 2001 College Park, Maryland, tornado was a long track and strong tornado that passed within a close range of two Doppler radars. It was the third in a series of three tornadoes associated with a supercell storm that developed in Stafford County, Virginia, and initiated 3 - 4 km southwest of College Park and dissipated near Columbia, Howard County. The supercell tracked approximately 120 km and lasted for about 126 minutes. This study presents a synoptic and mesoscale overview of favorable conditions and forcing mechanisms that resulted in the severe convective outbreak associated with the College Park tornado. Results show many critical elements of the tornadic event, including a negative-tilted upper-level trough over the Ohio Valley, a jet stream with moderate vertical shear, a warm, moist tongue of the air associated with strong southerly flow over south-central Maryland and Virginia, and significantly increased convective available potential energy during the late afternoon hours. Satellite imagery reveals banded convective morphology with high cloud tops associated with the supercell that produced the College Park tornado. Operational WSR-88D data exhibits a high reflectivity “debris ball” or tornadic debris signature (TDS) within the hook echo, the evolution of the parent storm from a supercell structure to a bow echo, and a tornado cyclone signature (TCS). Many of the mesoscale environmental features could be captured by contemporary numerical model analyses. This study concludes with a discussion of the effectiveness of the coordinated use of satellite and radar observations in the operational environment of nowcasting severe convection.
Developing an ANFIS-PSO Model to Estimate Mercury Emission in Combustion Flue Gases
Authors: Shamshirband Shahaboddin , Baghban Alireza , Hadipoor Masoud , Mosavi Amir
Published: July 2019

Accurate prediction of mercury content emitted from fossil-fueled power stations is of utmost important for environmental pollution assessment and hazard mitigation. In this paper, mercury content in the output gas of power stations’ boilers was predicted using adaptive neuro-fuzzy inference system (ANFIS) method integrated with particle swarm optimization (PSO). The input parameters of the model include coal characteristics and the operational parameters of the boilers. The dataset has been collected from 82 power plants and employed to educate and examine the proposed model. To evaluate the performance of the proposed ANFIS-PSO model the statistical meter of MARE% was implemented, which resulted 0.003266 and 0.013272 for training and testing respectively. Furthermore, relative errors between acquired data and predicted values were between -0.25% and 0.1%, which confirm the accuracy of the model to deal nonlinearity and representing the dependency of flue gas mercury content into the specifications of coal and the boiler type.
Genome Wide Association Studies for Four Physiological Traits in Groundnut (Arachis hypogaea L.) Minicore Collection
Authors: Shaibu Abdulwahab , Sneller Clay , Motagi Babu , Chepkoech Jackline , Chepngetich Mercy , Miko Zainab , Isa Adamu , Ajeigbe Hakeem , Mohammed Sanusi
Published: July 2019

In order to integrate genomics in breeding and development of drought tolerant groundnut genotypes, identification of genomic regions/genetic markers for drought surrogate traits is essential. We used SNP markers for a genetic analysis of the ICRISAT groundnut minicore collection for genome wide marker-trait association for some physiological traits and to determine the magnitude of linkage disequilibrium (LD) present in the genetic resources. The LD analysis showed that about 36% of loci pairs were in significant LD (P < 0.05 and r2 > 0.2) and 3.14% of the pairs were in complete LD. There was rapid decline in LD with distance and the LD was <0.2 at a distance of 41635 bp. The marker trait association (MTAs) studies revealed 20 significant MTAs (p <0.001) with 11 markers for leaf area index (4), canopy temperature (13), chlorophyll content (1) and NDVI (2). The markers explained 2 to 21% of the phenotypic variation observed. Most of the MTAs identified on the A subgenome were also identified on the respective homeologous chromosome on the B subgenome. The duplications of effect observed could be due to common ancestor of the A and B genome which explains the linkage detected between markers lying on different chromosomes seen in the current study. The present study identified a total of 20 highly significant marker trait associations with 11 markers for four physiological traits of importance in groundnut; LAI, CT, SCMR and NDVI. The markers identified in this study can serve as useful genomic resources to initiate marker-assisted selection and trait introgression of groundnut for drought tolerance. The identified markers in this study may be useful for marker assisted selection after further validation.
Innovative Processes and Technologies for Nutrients Recovery from Wastes: a Comprehensive Review
Authors: Ahmed Mukhtar , Ahmad Shakeel , Hassan Fayyaz , Qadir Ghulam , Hayat Rifat , Shaheen Farid , Raza Muhammad
Published: July 2019

Nutrients management is a mainspring in agricultural systems for sustained productivity, economy sustainability and environmental quality. Excessive and lesser nutrient application caused environmental pollution and reduced production, respectively impacting socio-economics of the entire ecosystems. Sustainable agricultural production thus demands supplementation of nutrients either through natural processes, application of animal by-products, and mineral fertilizers to crop fields. Technology application for treating useless agricultural wastes into useful source is a management strategy that prevents environment pollution. Crude animal manures triggered soil degradation, attenuation air and water quality, and resulted in higher concentrations of heavy metals. Primary nutrients, i.e., nitrogen, phosphorus and potassium are used globally and are non-renewable. Augmented upsurge in prices of inorganic fertilizers and required discharge restrictions on nutrient has stimulated the technological developments including biochar, composting, vermicomposting, composting with biochar, pyrolysis, forward osmosis, and electro-dialysis to recover nutrients. Therefore, outlining the research gaps considering the present and imminent potential of these technologies for adaptation of nutrient recycling is of great importance. Thus, it’s need of an hour to fix our environment and for that scientists are trying to introduce and renovate the technologies which have immense potential to mitigate the negative effects of technology adversities on our environment.
Updates on the Role of Molecular Alterations and NOTCH Signaling in the Development of Neuroendocrine Neoplasms
Authors: von Arx Claudia , Capozzi Monica , López-Jiménez Elena , Ottaiano Alessandro , Tatangelo Fabiana , Di Mauro Annabella , Nasti Guglielmo , Tornesello Maria Lina , Tafuto Salvatore
Published: July 2019

Neuroendocrine neoplasms (NENs) comprise a heterogeneous group of rare malignancies mainly originated from hormones secreting cells, which are widespread in human tissues. The identification of mutations in ATRX/DAXX genes in sporadic NENs, as well as the high burden of mutations scattered throughout MEN-1 gene in both sporadic and inherited syndromes, provided new insights into the molecular biology of tumour development. Other molecular mechanisms, such as the NOTCH signaling pathway, have shown to play an important role in the pathogenesis of NENs. NOTCH receptors are expressed on neuroendocrine cells and generally, act as tumour suppressor proteins, but in some contexts can function as oncogenes. The biological heterogeneity of NENs suggests that to fully understand the roles and the potential therapeutic implications of gene mutations and NOTCH signaling in NENs, a comprehensive analysis of genetic alterations, NOTCH expression patterns and their potential roles across all NEN subtypes is required.
Research of Influences of Bed Loints Reinforcements on Strength and Deformability of Masonry Shear Walls
Authors: Jasiński Radosław
Published: July 2019

The area of Central and Eastern Europe, and thus Poland, is not exposed to effects of seismic actions. Any possible tremors can be caused by coal or copper mining. Wind, rheological effects, the impact of other objects or a non-uniform substrate are the predominant types of loading included in calculations for stiffening walls. The majority of buildings in Poland, as in most other European countries, are low, medium-high brick buildings. Some traditional materials, like solid brick (>10% of construction materials market) are still used. But autoclaved aerated concrete (AAC) and cement-sand calcium-silicate (Ca-Si) elements with thin joints are prevailing (>70% of the market) on the Polish market. Adding reinforcement only to bed joints in a wall is a satisfactory solution (in addition to confining) for seismic actions occurring in Poland that improves ULS and SLS. This paper presents results from our own tests on testing horizontal shear walls without reinforcement and with different types of reinforcement. This discussion includes 51 walls made of solid brick (CB) reinforced with steel bars and steel trusses, results from tests on 15 walls made of calcium-silicate (Ca-Si) and AAC masonry units reinforced with steel trusses and plastic meshes. Taking into account our own tests and those conducted by other authors, empirical relationships were determined on the basis of more than 90 walls. They are applicable to design and construction phase to determine the likely effect of reinforcement on cracking stress that damage shear deformation and wall stiffness.
The Optimal Tuning, within Carbon Limits, of Thermal Mass in Naturally Ventilated Buildings
Authors: Craig Salmaan
Published: July 2019

What proportions should a thermally massive building have? How should the thermal mass be distributed? Should the "massing" change with the choice of material? This paper shows how to optimize the physical proportions of a building so that it synchronizes ambient heat exchanges in a natural feedback cycle. An internal mass is thermally coupled with buoyancy ventilation; the cycle is driven by the daily swing of outdoor temperature. Tripling up functions in this way—so that structural materials can reliably cool and power the ventilation for buildings—could help decarbonize the construction industry and provide an effective strategy for adapting to life-threatening heatwaves. Based on harmonic analysis, the method allows designers to thermally tune the form and mass of a building to meet chosen targets for temperature and ventilation in free-running mode. Once the optimal balance of exchange rates is known, design teams can proportionally vary the building height and ventilation openings against the surface area and thickness of an internal thermal mass. The possible permutations are infinite but parametrically constrained, allowing teams to fairly compare the functional and environmental credentials of different construction materials while they produce and evaluate preliminary options for organizing the exterior form and interior spaces of a building. An example study suggests that thin-shell structures of minimum weight, and even timber buildings, may be optimally tuned to produce ample ventilation and temperature attenuation.
Immobilized rGO/TiO2 Photocatalyst for Decontamination of Water
Authors: Zouzelka Radek , Remzova Monika , Plsek Jan , Brabec Libor , Rathousky Jiri
Published: July 2019

The preparation of immobilized graphene–based photocatalyst layers is highly desired for environmental applications. In this study, the preparation of an immobilized reduced graphene oxide (rGO)/TiO2 composite by electrophoretic deposition (EPD) was optimized. It enabled quantitative deposition without sintering and without the use of any dispersive additive. The presence of rGO had beneficial effects on the photocatalytic degradation of 4-chlorophenol in an aqueous solution. A marked increase in the photocatalytic degradation rate was observed, even at very low concentrations of rGO. Compared with the TiO2 and GO/TiO2 reference layers, use of the rGO/TiO2 composite (0.5 wt% of rGO) increased the first-order reaction rate constant by about 70%. This enhanced performance was due to the increased formation of hydroxyl radicals that attacked the 4-chlorophenol molecules. The direct charge transfer mechanism had only limited effect on the degradation. Thus, EPD-prepared rGO/TiO2 layers appear to be suitable for environmental application.
Crowding the library: How and why libraries are using crowdsourcing to engage the public
Authors: Severson Sarah , Sauve Jean-Sébastien
Published: July 2019

Over the past 10 years, there has been a noticeable increase of crowdsourcing projects in cultural heritage institutions, where digital technologies are being used to open up their collections and encourage the public to engage with them in a very direct way. Libraries, archives and museums have long had a history and mandate of outreach and public engagement but crowdsourcing marks a move towards a more participatory and inclusive model of engagement. If a library wants to start a crowdsourcing project, what do they need to know?

 This article is written from a Canadian University library perspective with the goal to help the reader engage with the current crowdsourcing landscape. This article’s contribution includes a literature review and a survey of popular projects and platforms; followed by a case study of a crowdsourcing pilot completed at the McGill Library. The article pulls these two threads of theory and practice together—with a discussion of some of the best practices learned through the literature and real-life experience, giving the reader practical tools to help a library evaluate if crowdsourcing is right for them, and how to get a desired project off the ground.
The Effect of Fines Migration During CO2 Injection Using Pore-Scale Characterization
Authors: Othman Faisal , Wang Yamin , Le-Hussain Furqan
Published: July 2019

Recent laboratory studies have shown that fines migration induces a decrease in rock permeability during CO2 injection. This study uses X–ray microcomputed tomography (micro–CT), nitrogen permeability, and Itrax X–ray fluorescence (Itrax–XRF) scanning to investigate the mechanism of fines migration during CO2 injection. We perform CO2–flooding experiments on two Berea core samples. The cores are characterized using nitrogen permeability, micro–CT, scanning electron microscopy with energy–dispersive X–ray spectroscopy (SEM–EDS), and Itrax–XRF scanning. The cores are flooded with fresh water, then CO2–saturated water, and finally water–saturated supercritical CO2 (scCO2). To calculate permeability, the pressure difference across the core samples is monitored during these fluid injections. The produced–water samples are analyzed using inductively coupled plasma–optical emission spectrometry (ICP–OES). After the flooding experiments, nitrogen permeability, micro–CT, SEM–EDS, and XRF scanning are repeated to characterize pore–scale damage. Micro–CT image–based computations are run to estimate permeability decrease along the core–sample length after injection.

Results show the dissolution of dolomite and other high–density minerals. Mineral dissolution dislodges fines particles, which migrate during water-saturated–scCO2 injection. During CO2–saturated–water injection, the permeability of Berea 1 and Berea 2 increase by 29 and 13%, respectively. After water–saturated–scCO2 injection, the permeability of Berea 1 and Berea 2 decrease by 60%. The permeability damage of the sample can be explained by fines migration and subsequent blockage. SEM–EDS images also show instances of pore blockage.
The characteristics of the frequent exacerbator with chronic bronchitis phenotype and non-exacerbator phenotype in patients with chronic obstructive pulmonary disease: a meta-analysis and system review
Authors: wu jianjun , Xu Hong-ri , Zhang Ying-xue , Li Yi-xuan , Yu Hui-yong , Jiang Liang-duo , Wang Cheng-xiang , Han Mei
Published: July 2019

Abstract
Objective: To investigate the clinical characteristics between the frequent exacerbator with chronic bronchitis (FE-CB) phenotype and the non-exacerbator (NE) phenotype among patients with chronic obstructive pulmonary disease (COPD).
Methods: We searched CNKI, Wan fang, Chongqing VIP, China Biology Medicine disc, PubMed, Cochrane Library, and EMBASE databases for relevant studies published as of April 30, 2019. All studies that investigated COPD patients with the FE-CB and NE phenotypes and which qualified the inclusion criteria were included. Cross-Sectional/Prevalence Study Quality recommendations were used to measure methodological quality. RevMan5.3 software was used for meta-analysis.
Results: Ten case-control studies (n=8848) were included. Compared with the NE phenotype, patients with the FE-CB phenotype showed significantly lower forced vital capacity percent predicted (FVC%pred) [mean difference (MD) -6.69, 95% confidence interval (CI) -7.73–-5.65, P<0.001, I2=5%], forced expiratory volume in one second percent predicted (FEV1%pred) (MD -8.50, 95% CI -11.36–-5.65, P<0.001, I2=91%), and forced expiratory volume in one second/forced vital capacity (FEV1/FVC) (MD -3.76, 95% CI -4.58–-2.95,P<0.001, I2=0%); in contrast, the quantity of cigarettes smoked (pack-years) (MD 3.09, 95% CI 1.60–4.58, P<0.001, I2=41%), COPD assessment test (CAT) score (MD 5.61, 95% CI 4.62–6.60, P<0.001, I2=80%), modified Medical British Research Council (mMRC) score (MD 0.72, 95% CI 0.63–0.82, P<0.001, I2=57%), exacerbations in previous year (2.65, 95% CI 2.32–2.97, P<0.001, I2=91%), body mass index (BMI), obstruction, dyspnea, exacerbations (BODEx) (MD 1.78, 95% CI 1.28–2.28, P<0.001, I2=91%), I2=34%), and Charlson comorbidity index (MD 0.47, 95% CI 0.37–0.58, P<0.001, I2=0] were significantly higher in patients with FE-CB phenotype. No significant between-group difference was observed with respect to BMI (MD-0.14, 95% CI -0.70–0.42, P=0.62, I2=75%).
Conclusion: COPD patients with the FE-CB phenotype had poorer pulmonary function and higher CAT score, the quantity of cigarettes smoked (pack-years), frequency of acute exacerbations, and mMRC scores than those with the NE phenotype.
Association between peripheral blood/bronchoalveolar lavage eosinophilia and significant oxygen requirements in patients with acute eosinophilic pneumonia
Authors: Choi Joon Young , Lim Jeong Uk , Jeong Ho Jung , Lee Ji Eun , Rhee Chin Kook
Published: July 2019

Background

We investigated the association between a combination of two markers, peripheral (PEC) and bronchoalveolar lavage (BAL) eosinophil percentage (BEP), and oxygen requirements in patients with acute eosinophilic pneumonia (AEP).

Methods

We retrospectively reviewed the medical records of patients with AEP treated at the Armed Forces Capital Hospital between May 2012 and May 2017. We used correlation analyses to assess the association between PEC/BEP and clinical outcomes in AEP patients. Receiver operating characteristic (ROC) curve analyses were used to calculate the cut-off value for BEP that categorised patients requiring a significant oxygen supply. The BAL/blood eosinophil (BBE) score was introduced to stratify patients with peripheral eosinophilia and elevated BEP. Clinical characteristics and outcomes were compared between the different groups. Multiple logistic regression was performed for significant oxygen requirements using two different models using age, C-reactive protein (CRP), smoking duration, and BBE score (model 1) and age, CRP, BEP, and PEC (model 2).

Results

Among the 338 patients, 99.7% were male, and their mean age was 20.4 ± 1.4 years. Only 0.6% of patients were never smokers and the mean number of smoking days was 26.2 ± 25.4. Correlation analyses revealed that both the PaO2/FiO2 ratio and duration of oxygen supply were associated with BEP. ROC curve analyses indicated a cut-off level of 41.5%. Patients with a high BBE score had favourable outcomes in terms of hypoxemia, hospital days, intensive care unit admission, oxygen supply days, and steroid treatment days. Multiple logistic regression revealed that BEP and BBE score tended to be associated with significant oxygen requirements.

Conclusions

In this study, we revealed that both peripheral and BAL eosinophilia is associated with favourable outcomes in AEP patients.
Complications and mortality of venovenous extracorporeal membrane oxygenation in the treatment of neonatal respiratory failure: a systematic review and meta-analysis
Authors: Xiong Jing , Zhang Li , Bao Lei
Published: July 2019

Background

Extracorporeal membrane oxygenation (ECMO) has been increasingly used for severe neonatal respiratory failure refractory to conventional treatments. To systematically evaluate the complications and mortality of venovenous ECMO in the treatment of neonatal respiratory failure.

Methods

PubMed, Embase, and Cochrane Library were searched. The retrieval period was from the establishment of the database to February 2019. Two investigators independently screened articles according to the inclusion and exclusion criteria. The quality of article was assessed by the Newcastle-Ottawa scale (NOS). The meta-analysis was performed by Stata 15.0 software.

Results

Four observational studies were included, with a total of 347 newborns. The overall mortality at hospital charge was 12% (5% - 18%) with a heterogeneity of I2 = 73.8% (p = 0.01). Two studies reported mortality during ECMO and after decannulation, with 10% (0.8% -19.2%) and 6.1% (2.6% - 9.6%) respectively. The most common complications associated with venovenous ECMO were: pneumothorax (20.6%), hypertension (20.4%), cannula dysfunction (20.2%), seizure (14.9%), renal failure requiring hemofiltration (14.7%), infectious complications (10.3%), thrombi (7.4%), intracranial hemorrhage or infarction (6.6%), hemolysis (5.3%), cannula site bleeding (4.4%), gastrointestinal bleeding (3.7%), oxygenator failure (2.8%), other bleeding events (2.8%), brain death (1.9%), and myocardial stun (0.9%).

Conclusion

The overall mortality at discharge of venovenous ECMO in the treatment of neonatal respiratory failure was 12%. Although complications are frequent, the survival rate during hospitalization is still high. Further larger samples, and higher quality of randomized controlled trials (RCT) are needed to clarify the efficacy and safety of this technique in the treatment of neonatal respiratory failure.
Diazepam and ethanol differently modulate neuronal activity in organotypic cortical cultures
Authors: Kreuzer Matthias , García Paul S , Brucklacher-Waldert Verena , Claasen Rebecca , Schneider Gerhard , Antkowiak Bernd , Drexler Berthold
Published: July 2019

Background: The pharmacodynamic results of diazepam and ethanol administration are similar, in that each can mediate amnestic, sedative-hypnotic effects. Although each of these molecules effectively reduces the activity of central neurons, diazepam does so through modulation of a more specific set of receptor targets (GABAA receptors containing a γ-subunit), while alcohol is less selective in its receptor bioactivity. Our investigation focuses on divergent actions of diazepam and ethanol on the firing patterns of cultured cortical neurons. Method: We used electrophysiological recordings from organotypic slice cultures derived from Sprague-Dawley rat neocortex. We exposed these cultures to either diazepam (15 and 30 µM) or ethanol (30 and 60 mM) and recorded the electrical activity at baseline and experimental conditions. For analysis, we extracted the episodes of spontaneous activity, i.e., cortical up-states. After separation of action potential and local field potential (LFP) activity, we looked at differences in the number of action potentials, in the spectral power of the LFP, as well as in the coupling between action potential and LFP phase. Results: While both substances seem to decrease neocortical action potential firing in a similar fashion, diazepam seems to increase the spectral power of the up-state without impacting the spectral composition, whereas ethanol does not change the spectral power but the oscillatory architecture of the up-state. Further, the action potential to LFP-phase coupling reveals a synchronizing effect of diazepam and a (rather weak) de-synchronizing effect for ethanol. Conclusion: Diazepam and ethanol, induce specific patterns of network depressant actions. Diazepam, via gamma subunit containing GABAA receptors, induces cortical network inhibition and increased synchronicity. Ethanol, via a wider span of molecular targets, also induces cortical network inhibition, but without an increase in synchronicity.
Microglia induce neurogenesis by stimulating PI3K/AKT intracellular signaling in vitro
Authors: Lorenzen Kristi , Mathy Nicholas W. , Whiteford Erin R. , Eischeid Alex , Chen Jing , Behrens Matthew , Chen Xian-Ming , Shibata Annemarie
Published: July 2019

Background

Emerging evidence suggests that microglia can support neuronal survival, synapse development, and neurogenesis in classic neurogenic niches. Little is known about the ability of microglia to regulate the cortical environment and stimulate cortical neurogenesis outside of the classic neurogenic niches. We used an in vitro co-culture model system to test the hypothesis that microglia respond to soluble signals from injured cortical cells to alter the cortical environment in order to promote cortical neurogenesis and maintain cell survival.

Results

Our model system allows for assessment of how microglial soluble signals influence mechanically injured cortical cells in vitro. These data demonstrate that microglia responding to soluble signals from uninjured and, to a greater extent, injured cortical cells enhanced cortical cell viability and proliferation. Co-culture of injured cortical cells with microglia significantly reduced apoptosis as shown by TUNEL immunocytochemistry. Microglial-derived soluble cues enhanced the proliferation of cells expressing neurogenic markers nestin, glial fibrillary acidic protein, and α-internexin as determined by western blot and immunocytochemistry. Significantly increased NeuN expression was observed in injured cortical cultures co-cultured with microglia. Multiplex ELISA assays and RT-PCR analysis revealed significant increase of MCP-1/CCL2 and downregulation of IFN-γ, MIP-1α, TNFα and RANTES in media from microglial and injured cortical co-cultures compared to uninjured controls. Microglia soluble cues increase AKT phosphorylation in cortical cells particularly following injury. Inhibition of AKT phosphorylation in cortical cells blocked the microglial-enhanced cortical cell viability and expression of neurogenic markers in vitro.

Conclusion

An in vitro model system allows for assessment of microglial-derived soluble signals, independent of cell-cell contact, on cortical cell viability, proliferation, and differentiation during homeostasis or following injury. While many intracellular signaling pathways may be activated in neurons by neurogenic microglial-derived soluble cues, these data suggest that microglial-derived soluble signals produced during homeostasis and following activation by acute cortical injury enhance neurogenesis by upregulating AKT signaling. Increasing our understanding of the mechanisms that drive cortical neurogenesis stimulated by microglia during homeostasis and following injury will provide insight into neuroprotective role of immune activity in the CNS.
Chondroitinase ABC reduces dopaminergic nigral cell death and striatal terminal loss in a 6-hydroxydopamine partial lesion mouse model of Parkinson’s disease
Authors: Fletc Edward JR , Moon Lawrence DF , Duty Susan
Published: July 2019

Background
Parkinson's disease (PD) is characterised by dopaminergic cell loss within the substantia nigra pars compacta (SNc) that leads to reduced striatal dopamine content and resulting motor deficits. Identifying new strategies to protect these cells from degeneration and retain striatal dopaminergic innervation is therefore of great importance. Chondroitin sulphate proteoglycans (CSPGs) are recognised contributors to the inhibitory extracellular milieu known to hinder tissue recovery following CNS damage. Digestion of these molecules by the bacterial lyase chondroitinase ABC (ChABC) has been shown to promote functional recovery in animal models of neurological injury. Although ChABC has been shown to promote sprouting of dopaminergic axons following transection of the nigrostriatal pathway, its ability to protect against nigrostriatal degeneration in a more clinically-relevant toxin model of PD has yet to be explored. Here we examined the neuroprotective efficacy of ChABC treatment in the full and partial 6-hydroxydopamine (6-OHDA) lesion mouse models of PD.
Results
In mice bearing a full 6-OHDA lesion, ChABC treatment failed to protect against the loss of either nigral cells or striatal terminals. In contrast, in mice bearing a partial 6-OHDA lesion, ChABC treatment significantly protected cells of the rostral SNc, which remained at more than double the numbers seen in vehicle-treated animals. In the partial lesion model, ChABC treatment also significantly preserved dopaminergic fibres of the rostral dorsal striatum which increased from 15.3 ± 3.5% of the intact hemisphere in saline-treated animals to 36.3 ± 6.5% in the ChABC-treated group. These protective effects of ChABC treatment were not accompanied by improvements in either the cylinder or amphetamine-induced rotations tests of motor function.
Conclusions
ChABC treatment provided significant protection against a partial 6-OHDA lesion of the nigrostriatal tract although the degree of protection was not sufficient to improve motor outcomes. These results support further investigations into the benefits of ChABC treatment for providing neuroprotection in PD.
Stakeholder views on the acceptability of Human Infection Studies in Malawi
Authors: Kapumba Blessings , Jambo Kondwani , Rylance Jamie , Gmeiner Markus , Sambakunsi Rodrick , Parker Michael , Gordon Stephen , Gooding Kate
Published: July 2019

Background

Human infection studies (HIS) are essential in vaccine development. Deliberate infection, however, creates challenging questions, particularly in low and middle-income countries (LMIC) where CHIM are new and ethical challenges may be heightened. Consultation with stakeholders is needed to support contextually appropriate and acceptable study design. We examined stakeholder perceptions about the acceptability and ethics of HIS in Malawi, to inform decisions about planned pneumococcal challenge research and wider understanding of HIS ethics in LMIC.

Methods

We conducted 6 deliberative focus groups and 15 follow-up interviews with research staff, medical students, and community representatives from rural and urban Blantyre. We also conducted 5 key informant interviews with clinicians, ethics committee members and district health government officials.

Findings

Stakeholders perceived HIS research to have potential population health benefits, but they also had concerns, particularly related to safety of volunteers and negative community reactions. Acceptability depended on a range of conditions related to procedures for voluntary and informed consent, inclusion criteria, medical support, compensation, regulation, and robust community engagement. These conditions largely mirror those in existing guidelines for HIS and biomedical research in LMICs. Stakeholder perceptions pointed to potential tensions, for example balancing equity, safety and relevance in inclusion criteria.

Conclusions

Our findings suggest HIS research can be acceptable in Malawi, provided certain conditions are in place. Ongoing assessment of participant experiences and stakeholder perceptions will be required as HIS are implemented.
A simple method for conservative treatment of urinary fistula following ileal conduit
Authors: Ye Yunlin , Liang Hai-tao , Tan Lei , Xiao Kang-hua , Qin Zike
Published: July 2019

Background
Urinary fistula after ileal conduit is challenging, and this study is to investigate the role of intra-conduit negative pressure system (NPS) in urinary fistula following ileal conduit (IC) as conservative treatment.

Methods
Using intra-conduit NPS, a minor drainage was set in the silicon tube to suck urine from the conduit with consistent negative pressure. Patients with urinary fistula following IC from August 2012 to July 2017 were recorded, the clinical characteristics and outcome were retrospectively analyzed.
Results
Intra-conduit NPS was set as a primarily conservative treatment for 13 patients, who suffered urinary fistula presenting as overdose of abdominal/pelvic drainage, without other significant morbidities. Median age was 60 years old (42-74 years), and 7 were male. The median duration between IC operation and urine fistula was 15 days (2-28 days) and the elevated creatinine was detected in abdominal/pelvic drainage with a median level of 2114µmol/L (636-3852µmol/L). Significant decrease of abdominal/pelvic drainage was identified in 12 patients. The median time of NPS is 9 days (7-11days). The other one failed after observing 2 days without any improvement and then underwent open surgery. With ureter stenting, 2 abdominal drainages and intra-conduit NPS set during operation, no urine leaked in the abdominal/pelvic field and the patient cured in 9 days. With median follow-up of 22 months, no fistula recurrence or hydronephrosis was detected.
Conclusion
Intra-conduit negative pressure system is a feasible and promising way to cure urinary fistula following ileal conduit. For it’s mini-invasive and simple, it might be an alteration for selected patients.
Flow-controlled ventilation (FCV) improves regional ventilation in obese patients – a randomized controlled crossover trial
Authors: Weber Jonas , Straka Leonie , Borgmann Silke , Schmidt Johannes , Wirth Steffen , Schumann Stefan
Published: July 2019

Background:
In obese patients, high closing capacity and low functional residual capacity increase the risk for expiratory alveolar collapse. Constant expiratory flow, as provided by the new flow-controlled ventilation (FCV) mode, was shown to improve lung recruitment. We hypothesized that lung aeration and respiratory mechanics improve in obese patients during FCV.
Methods:
We compared FCV and volume-controlled (VCV) ventilation in 23 obese patients in a randomized cross-over setting. Starting with baseline (BL) measurements, ventilation settings were kept identical except for the ventilation mode related differences (VCV: I:E ratio 1:2 with passive expiration, FCV I:E ratio 1:1 with active, linearized expiration). Primary endpoint of the study was the change of end-expiratory lung volume (EELV) compared to BL ventilation. Secondary endpoints were the change of mean lung volume (MLV), respiratory mechanics and hemodynamic variables and.
Results:
The loss of EELV and MLV compared to BL was lower during FCV compared to VCV (ΔEELV: FCV, -126 ±207 ml; VCV, -316 ±254 ml; p < 0.001, ΔMLV: FCV, -108.2 ±198.6 ml; VCV, -315.8 ±252.1 ml; p < 0.001) and at comparable plateau pressure (PPlat: BL, 19.6 ±3.7; VCV, 20.2 ±3.4; FCV, 20.2 ±3.8 cmH2O; p = 0.441), mean tracheal pressure was higher (Pmean: BL, 13.1 ±1.1; VCV, 12.9 ±1.2; FCV, 14.8 ±2.2 cmH2O; p < 0.001). All other respiratory and hemodynamic variables were comparable between the ventilation modes.
Conclusions:
This study clearly demonstrates that FCV in obese patients maintains lung aeration better than VCV at comparable PEEP, tidal volume, PPlat and ventilation frequency.
Stunting and its Determinant Factors among Early Adolescent School Girls of Gondar town, northwest Ethiopia: A school based cross -sectional study
Authors: Tamrat Azmera , Yeshaw Yigizie , Fekadu Abel
Published: July 2019

Introduction: Stunting in adolescent have an effect on physical growth, intellectual capacity, educational achievement, work capacity and more importantly it maintains an intergenerational malnutrition burden. Stunting has been considered as a problem of children’s at early age and adolescent girls of tomorrow mothers have been neglected and studies conducted on this area are very scarce.
Methods: we conducted a school based cross-sectional study to assess the prevalence and determinant factors of stunting among early adolescent school girls (age 10-14 years) of Gondar town. A multi stage sampling method was used to select a sample of 662 adolescent girls in selected primary schools in Gondar Town. Pre-tested structured interviewer administered questionnaire was used to collect the required data. We used SPSS Version 20.0 and WHO Anthro-plus software to analyze the data. Bi-variable and multivariable logistic regression analyses were run to identify factors associated with adolescent stunting. Adjusted odds ratio with its 95% confidence interval and a P- value ≤ 0.05 was used to declare a statistical significant.
Results: We estimated a prevalence of stunting to be 27.5% [95% CI: 25.5% - 29.5%]. The odds of stunting in adolescent girls was found to be higher among those in grade 5 [AOR; 95%CI: 1.90; 1.13 - 3.20], had a meal frequency of less than or equal to three times per day [AOR; 95%CI: 2.37; 1.60-3.50], and those who are from food insecure families [AOR; 95%CI: 2.52; 1.70 - 3.73]. On the other side, adolescent girls whose their mothers’ were government employees [AOR; 95%CI: 0.48; 0.26 – 0.89] and merchants [AOR; 95%CI: 0.43; 0.28 – 0.67] were less stunted as compared to adolescent girls who had a mother who were housewife’s.
Conclusion: we found that stunting in early adolescent school girls become a significant public health problem and much needs to be done to improve nutritional status of girls in the first 1000 days of perinatal period to reduce a burden of stunting during adolescent period.
Modeling the Predictors of Stunting in Ethiopia: Analysis of 2016 Ethiopian Demographic Health Survey Data (EDHS)
Authors: Mengesha Hayelom Gebrekirstos , Vatanparast Hassan , Feng Cindy , Petrucka Pammla
Published: July 2019

Background

Despite the continued effort to address malnutrition, there is a minimal reduction in the rate of stunting in developing countries including Ethiopia. Nutritional and socioeconomic factors have not been assed using a rigorous analysis so far. Therefore, this study aims to model the effect of nutritional and socioeconomic predictors using 2016 Ethiopian Demographic health survey.

Methods

This study is a secondary of data analysis of the 2016 EDHS survey. 7909 children of age 6-59 months were included. Descriptive statistics using frequency and percentage for categorical data and mean and standard deviation for metric data were conducted. Linearity, confounding and multicolinearity were checked. Bivariable and multivariable logistic regression were carried out. Odds ratio and 95% confidence interval were calculated. Receiver operative curve was built to estimate the sensitivity and specificity of the model.

Result

The study identified as 39.2% of children included to this analysis were stunted. 76.47%, 84.27%, 92.62% of the children did not consume fruits and vegetables, legumes and lentils, and meat and its products respectively. Children aged 24 month to 59 months were at 9.71 times higher risk of being stunted compared to younger children of age 6-24 months old (AOR: 9.71; CI: 8.07, 11.6 children) with weights below 9.1 kilogram were at 27.86 odds of being stunted compared to those weight of 23.3 kg and above. Moreover, mothers below 150 cm tall (AOR: 2.01; CI: 1.76, 2.5), living in a rural area (AOR: 1.3, CI: 1.09, 1.54) and being male (AOR: 1.4; CI: 1.26, 1.56) were associated with stunting. Predictive ability of the model was 77% correctly such pair of observation.

Conclusion

The model indicates that being born male, being from a mother of short stature, living in the rural area, small child size, mother with mild anemia, being from a husband with no education or primary education only, having low weight, and reaching age above 24 months increases the likelihood of stunting. On the other hand, being born of an overweight or obese mother decreases the likelihood of stunting.