bluuebunny/crossref_metadata_2025 huggingface dataset:
Low-Temperature Bitumen Recovery from Oil-Sand Reservoirs Using Ionic Liquids
Authors: Abdelfatah Elsayed , Berton Paula , Rogers Robin D. , Bryant Steven L.
Published: September 2019

Steam injection is widely used for bitumen recovery. However, steam is not efficient for shallow or thin reservoirs because of heat loss in the wellbore or to surrounding formations. Numerous alternatives have been proposed, including the addition of solvents and replacement of steam with volatile solvents. Here, we describe a new technology that combines nonvolatile ionic liquids (ILs) and waterflooding for bitumen recovery that can deliver high recovery at ambient temperature.

Different ILs were designed for complete dispersal/dissolution of bitumen at ambient temperature. The designed ILs were tested in coreflood experiments with high–grade oil–sand ore from Alberta. Two different scenarios were tested: continuous injection of ILs at different injection rates and injection of a slug of ILs followed by water injection. Different slug volumes were tested at a constant injection rate. After ILs injection, the oil sand was removed from the column, and the remaining bitumen was quantified using a modified Dean–Stark method. Viscosity and solid–content measurements of the recovered samples at breakthrough were conducted.

Bitumen recovery by the designed ILs can be thought of as a solution mining process. Tuning the physical and chemical properties of the ILs is the most important aspect of achieving the desired interaction with the oil–sand system. Properties of the designed IL depend on the selected cation and anion, and the strength of their intermolecular interaction. Primary amines mixed with the oleic acid chosen for IL1 form a viscous IL that can recover bitumen, leaving a slight amount of bitumen behind, but a large pressure gradient. Changing the cation to tertiary amines produces significantly less–viscous ILs, which completely recover the bitumen in the oil–sand column. Moreover, the cation can be tailored to significantly minimize the fines (clay) migration and viscosity of the recovered bitumen and to provide compatibility with an aqueous phase. In all cases, these recoveries are significant, compared with the currently used technologies.

This work proves that bitumen recovery from oil sand is possible at low temperatures by means of a process analogous to solution mining with the design of the proper ILs, in contrast to viscosity–reduction processes achieved by thermal methods. The properties of these ILs can be tuned for different recovery mechanisms. Thus, this work establishes the basis for developing a new class of in–situ recovery processes with high recovery efficiencies and low environmental impact.
Use of a New Analytical Model To Match Production Data and Identify Opportunities To Maximize Well Productivity in the Tuscaloosa Marine Shale Reservoir
Authors: Guo Boyun , Yang Xu
Published: September 2019

The low productivity of the oil wells in the Tuscaloosa Marine Shale (TMS) Trend, located in Louisiana and Mississippi, is a mystery. Production data from 55 wells in the TMS Trend were analyzed to identify possible means of enhancing well productivity. The −1/2 slope in a log–log plot for reservoir linear flow (RLF) was observed for some wells, but not all, and the −1 slope for boundary–dominated flow (BDF) has not been seen in the past 5 years of production. The behavior of the TMS wells is attributed to the ultralow permeability of the TMS matrix and the decline of fracture conductivity, both of which delay the BDF. On the basis of the concept of the distance of investigation, derived from the radius–of–investigation concept, the matrix permeability of the seven TMS wells was estimated to be between 34 and 65 nd, with an average of 51 nd. A new mathematical model for production decline of multifractured horizontal wells was developed taking into consideration the time–dependent fracture conductivity during the BDF period. This model fits TMS–well production data, with an average error of 6.12% and an R2 value of 0.96. Assuming constant matrix permeability, fitting the new model to the production data in the BDF period gives a rate of fracture–conductivity decline of between 0.20 and 0.74% per month. The new mathematical model reveals opportunities to optimize well completion to enhance well productivity in the TMS Trend. For a given amount of fracture proppant allocated to a well, the shortest possible fracture spacing should be used to maximize well productivity. If the number of fractures is fixed as a constraint of well completion design, well productivity is inversely proportional to the square root of fracture spacing (i.e., if the fracture spacing is shortened by fourfold, well productivity is expected to double). If the horizontal wellbore length is fixed as a constraint of well completion, well productivity is inversely proportional to fracture spacing (i.e., if the fracture spacing is shortened by 50%, well productivity is expected to double).
Epidemiological study of scarlet fever in Shenyang City, China
Authors: Chen Huijie , Chen Ye , Sun Baijun , Wen Lihai , An Xiangdong
Published: September 2019

Objectives: To depict the Spatiotemporal epidemiological characteristics of the incidence of scarlet fever in Shenyang, China, in 2018 so as to provide the scientific basis for effective strategies of scarlet control and prevention. Methods: Excel 2010 was used to demonstrate the temporal distribution at the month level and ArcGIS10.3 was used to demonstrate the spatial distribution at the district/county level. Moran’s autocorrelation coefficient was used to examine the spatial autocorrelation and the Getis-Ord statistic was used to determine the hot-spot areas of scarlet fever. Results: A total of 2,314 scarlet fever cases were reported in Shenyang in 2018 with an annual incidence of 31.24 per 100,000. The incidence among males was higher than that among females(X2=95.013, P≤0.001). A vast majority of the cases (96.89%) were among children aged 3 to 11 years. The highest incidence was 625.34/100,000 in children aged 5-9 years. There are two seasonal peaks occurred in June (Summer-peak) and in December (Winter-peak) in 2018. The incidence of scarlet fever in urban areas was significantly higher than that in rural areas(X2=514.115, P≤0.001).The incidence of scarlet fever was randomly distributed in Shenyang. There are hot-spots areas located in seven districts. Conclusions: Urban areas are the hot spots of scarlet fever and joint prevention and control measures between districts should be applied. Children in the kindergartens and the primary school students are the main population of scarlet fever and the time distribution of scarlet fever is highly consistent with their school and vacation time. It is suggested that measure for prevention and control of scarlet fever in kindergartens and primary schools is the key to control the epidemic of scarlet fever.
Modelling the effect of subcellular mutations on the migration of cells in the colorectal crypt
Authors: Romijn Lotte B , Almet Axel A , Tan Chin Wee , Osborne James
Published: September 2019

Background
Many cancers arise from mutations in cells in epithelial tissues.
Mutations manifesting at the subcellular level influence the structure and function of the tissue.
In this paper we present a framework that allows the investigation of the influence of mutations such as subcellular knockouts and knockdowns on migration of cells within epithelial tissues.

Results
In particular we investigate how specific mutations may lead to the increase in numbers of cells in the epithelial lining of the colorectal crypt, which may lead to the eventual destabilisation of the structure of the crypt and the onset of colorectal cancer.
Secondly, we present the computational tools that allow the straightforward integration, and simulation of, SBML representations of subcellular dynamics with multicellular representations of the colorectal crypt.

Conclusions
We see that mutations in APC can cause downward invasion of mutant cells in the crypt.
Intervention strategy of Traditional Chinese Medicine for prediabetes(the syndrome of spleen-deficiency phlegm-dampness ) based on the reversal of blood glucose and the improvement of fatigue
Authors: Sun Xiao , Guo Ping Li , Ren Ming , He Fei Su , Li Yan , Wang Na Mei , Zhai Bo Jing , Li Dan Meng , Hao Jing Zhi
Published: September 2019

Background:Prediabetes is a growing health concern,a large percentage of whom will develop full 2 type diabetes. The prominent symptom of patients with diabetes and prediabete is fatigue.The syndrome of spleen-deficiency phlegm-dampbess is the main syndrome of prediabetes.Effective intercentions on prediabetes will delay or prevent the occurrence or development of diabetes.
Methods:Randomized controlled trial is implemented in this study.The study term is 3 months.Participants are recruited from Binhai hospital of Tianjin of Traditional Chinese Medicine,Jinghai hospital of Tianjin of Traditional Chinese Medicine and affiliated Wuqing hospital of Tianjin university of Traditional Chinese Medicine.160 participants are randomized to treatment group(Liu Jun Zi granules) and control group(Liu Jun Zi granules emulsifier):80 participants each.Participants being included in this study must have been diagnosed as prediabetes via western medicine criteria and traditional Chinese Medicine criteria.The primary outcomes is the score of fatigue-scale 14 and the rate of blood glucose return to the normal.The secondary outcomes inludes fasting plasma glucose,2-hour post-meal blood glucose and blood lipid test.The indexes of safety include general medical examination;electrocardiogram(ECG),liver function(ALT) and renel function(BUN,Creatinine) test and record of adverse event.
Discussion:The aim of this study is to evaluate the effectiveness and safety of Liu Jun Zi granules for the treatment of patients with prediabetes.
Trial registration:Chinese clinical trials register ChiCTR1900022736.
Comparative analysis of basic helix–loop–helix gene family among Brassica oleracea, Brassica rapa, and Brassica napus
Authors: Miao Liming , Gao Yingying , Zhao Kun , Kong Lijun , Yu Shubo , Li Rongrong , Liu Kaiwen , Yu Xiaolin
Published: September 2019

Background: The basic helix–loop–helix (bHLH) transcription factors exist widely in eukaryotes and play important roles in development and stress response regulation in plants. The bHLH gene family has been identified in many species, except for Brassica oleracea and Brassica napus thus far. This study aims to identify the bHLH family members in B. oleracea, Brassica rapa, and B. napus and elucidate the expression, duplication, phylogeny and evolution characters of these genes.
Result: A total of 268 bHLH genes in B. oleracea, 440 genes in B. napus, and 251 genes in B. rapa, including 21 new bHLH members, have been identified. Subsequently, the analysis of the phylogenetic tree, conserved motifs and gene structures showed that the members in the same subfamily were highly conserved. Most Ka/Ks values of the homologous gene were <1, which indicated that the homologous genes suffered from strong purifying selection for retention. The Ks values of the three Brassica crops were concentrated in the range of 0.3–0.5. Hence, the divergence time of the bHLH gene family between Brassica crops and Arabidopsis thaliana is approximately 10–18 MYA. The retention rates of BrabHLH and BolbHLH genes were 51.6% and 55.1%, respectively. A total of 182 genes were lost in B. napus after tetraploid. GO annotations of BolbHLH genes showed that most genes focused on DNA-binding transcription factor, DNA-binding, and protein dimerization activities. The temporal and spatial expression patterns of 50 BolbHLH genes were diverse, some of which showing high expression in the reproduction tissue, while some had high expression in the root. The comparison of expression patterns between B. rapa and B. napus showed that they had similar expression patterns in the root and contrasting patterns in the stems, leaves, and reproduction tissues. However, the expression patterns of B. oleracea and B. napus were different.
Conclusion: This study is the first to report about the gene family analysis of the bHLH gene in B. oleracea and B. napus. Our results not only offer useful information on the functional analysis of the bHLH gene but also provide new insights into the evolution of Brassica spp.
Evaluating the impact of the weather conditions on the influenza propagation
Authors: Singh David E. , Marinescu Maria-cristina , Carretero Jesus , Delgado-Sanz Concepcion , Gomez-Barroso Diana , Larrauri Amparo
Published: September 2019

Background: Predicting the details of how an epidemic evolves is highly valuable as health institutions need to better plan towards limiting the infection propagation effects and optimizing their prediction and response capabilities. Simulation is a cost- and time-effective way of predicting the evolution of the infection as the joint influence of many different factors: interaction patterns, personal characteristics, travel patterns, meteorological conditions, previous vaccination, etc. The work presented in this paper extends EpiGraph, our influenza epidemic simulator, by introducing a meteorological model as a modular component that interacts with the rest of EpiGraph's modules to refine our previous simulation results. Our goal is to estimate the effects of changes in temperature and relative humidity on the patterns of epidemic influenza based on data provided by the Spanish Influenza Sentinel Surveillance System (SISSS) and the Spanish Meteorological Agency (AEMET).

Methods: Our meteorological model is based on the regression model developed by Barreca and Shimshack, and it is tuned with influenza surveillance data obtained from SISSS. After pre-processing this data to clean it and reconstruct missing samples, we obtain new values for the reproduction number of each urban region in Spain, every 10 minutes during 2011. We simulate the propagation of the influenza by setting the date of the epidemic onset and the initial influenza-illness rates for each urban region.

Results: We show that the simulation results have the same propagation shape as the weekly influenza rates as recorded by SISSS. We perform experiments for a realistic scenario based on actual meteorological data from 2010-2011, and for synthetic values assumed under simplified predicted climate change conditions. Results show that a diminishing relative humidity of 10\% produces an increment of about 1.6\% in the final infection rate. The effect of temperature changes on the infection spread is also noticeable, with a decrease of 1.1\% per extra degree.

Conclusions: Using a tool like ours could help predict the shape of developing epidemics and its peaks, and would permit to quickly run scenarios to determine the evolution of the epidemic under different conditions. We make EpiGraph source code and epidemic data publicly available.
Chronic Hypersensitivity Pneumonitis In The Southeastern United States: An Assessment Of How Clinicians Reached The Diagnosis
Authors: Gu Jessie , Tsai Chen-Liang , Wysham Nicholas , Huang Yuh-Chin Tony
Published: September 2019

Background: Chronic hypersensitivity pneumonitis (cHP) is a disease caused by exposure to inhaled environmental antigens. Diagnosis of cHP is influenced by the awareness of the disease prevalence, which varies significantly in different regions, and how clinicians utilize relevant clinical information. We conducted a retrospective study to evaluate how clinicians in the Southeast United States, where the climate is humid favoring mold growth, diagnosed cHP using items identified in the international modified Delphi survey of experts, i.e., environmental exposure, CT imaging and lung pathology,
Methods: We searched Duke University Medical Center database for patients over the age of 18 with a diagnosis of cHP (ICD-9 code: 495) between Jan. 1, 2008 to Dec. 31, 2013 using a query tool, Duke Enterprise Data Unified Content Explorer (DEDUCE).
Results: Five hundred patients were identified and 261 patients had cHP confirmed in clinic notes by a pulmonologist or an allergist. About half of the patients lived in the Research Triangle area where our medical center is located, giving an estimated prevalence rate of 6.5 per 100,000 persons. An exposure source was mentioned in 69.3% of the patient. The most common exposure sources were environmental molds (43.1%) and birds (26.0%). We used Venn diagram to evaluate how the patients met the three most common cHP diagnostic criteria: evidence of environmental exposures (history or precipitin) (E), chest CT imaging (C) and pathology from lung biopsies (P). Eighteen patients (6.9%) met none of three criteria. Of the remaining 243 patients, 135 patients (55.6%) had one (E 35.0%, C 3.3%, P 17.3%), 81 patients (33.3%) had two (E+C 12.3%, E+P 17.3%, C+P 4.9%), and 27 patients (11.1%) had all three criteria (E+C+P). Overall, 50.6% of patients had pathology from lung biopsy compared to 31.6% with CT scan.
Conclusions: Environmental mold was the most common exposure for cHP in the Southeast United States. Lung pathology was available in more than half of cHP cases in our tertiary care center, perhaps reflecting the complexity of referrals. Differences in exposure sources and referral patterns should be considered in devising future diagnostic pathways or guidelines for cHP.
Protocol of 4-plex N,N-Dimethyl Leucine Isobaric Labeling Based Proteome Quantitation by LC-MS/MS
Authors: Cui Yusi , Yu Qing , Li Lingjun
Published: September 2019

Isobaric labeling is one of the wide-spread high throughput proteome quantification strategies, where enzymatically digested protein extracts from different experimental groups are labeled with chemical tags and yield identical mass shift for individual peptides in MS precursor scan, whereas quantitation can be achieved by comparing reporter ion ratios upon fragmentation in tandem MS scan. In addition to commercial tags such as TMT and iTRAQ, we developed 4-plex and 12-plex N,N-dimethyl leucine (DiLeu) tags as cost-effective alternatives with comparable performance 1,2. DiLeu labeling methods allow multiplexing of samples and enable comparative analysis of acetyl-CoA flux regulated proteomes from different mouse models in the same LC-MS runs, providing statistically reliable data that avoids run-to-run variations. This protocol describes steps including 40 hrs of sample preparation of lysis, tryptic digestion, tag labeling, SCX purification and high pH fractionation, as well as details about LC-MS/MS analysis and data processing. The protocol can be applied to other proteome quantitation systems.
Construction of a novel quinoxaline as a new class of Nrf2 activator
Authors: Kandasamy Murugesh , Mak Kit-Kay , Devadoss Thangaraj , Thanikachalam Punniyakoti Veeraveedu , Sakirolla Raghavendra , Choudhury Hira , Pichika Malllikarjuna Rao
Published: September 2019

The transcription factor Nuclear factor erythroid-2-related factor 2 (NRF2) and its principal repressive regulator, the E3 ligase adaptor Kelch-like ECH-associated protein 1 (KEAP1), are critical in the regulation of inflammation, as well as maintenance of homeostasis. Thus, NRF2 activation provides cytoprotection against numerous inflammatory disorders. N-nicotinoylquinoxaline-2-carbohdyrazide (NQC) was designed by combining the important pharmacophoric features of bioactive compounds reported in the literature. NQC was synthesised and characterised using spectroscopic techniques. The compound was tested for its anti-inflammatory effect using LPSEc induced inflammation in mouse macrophages (RAW 264.7 cells). The effect of NQC on inflammatory cytokines was measured using ELISA. The Nrf2 activity of the compound NQC was determined using ‘Keap1:Nrf2 Inhibitor Screening Assay Kit’. To obtain the insights on NQC’s activity on Nrf2, molecular docking studies were performed using Schrodinger suite. The metabolic stability of NQC was determined using mouse, rat and human microsomes. NQC was found to be non-toxic until the dose of 50 µM on RAW 264.7 cells. The NQC showed potent anti-inflammatory effect in an in vitro model of Lipopolysaccharide (LPS) stimulated murine macrophages (RAW 264.7 cells) with an IC50 value 26.13 ± 1.17 µM. The NQC dose-dependently down regulated the pro-inflammatory cytokines (Interleukin (IL)-1β, IL-6 and tumor necrosis factor (TNF)-α) and inflammatory mediator, prostaglandin E2 (PGE2) with IC50 values 13.27 ± 2.37, 10.13 ± 0.58, 14.41 ± 1.83 and 15.23 ± 0.91 µM respectively. Molecular docking studies confirmed the favourable binding of NQC at Kelch domain of Keap-1. It disrupts the Nrf2 interaction with kelch domain of keap 1 and its IC50 value was 4.21 ± 0.89 µM. The metabolic stability studies of NQC in human, rat and mouse liver microsomes revealed that it is quite stable with half-life values; 59.78 ± 6.73, 52.93 ± 7.81, 28.43 ± 8.13 minutes; microsomal intrinsic clearance values; 22.1 ± 4.31, 26.0 ± 5.17 and 47.13 ± 6.34 µL/min/mg protein; respectively. So, rat has comparable metabolic profile with human, thus, rat could be used for predicting the pharmacokinetics and metabolism of NQC in human. NQC is a new class of NRF2 activator with potent in vitro anti-inflammatory activity and good metabolic stability.
Assessment of Drug Related Problems among Type 2 Diabetic Patients on Follow up at Hiwot Fana Specialized University Hospital, Harar, Eastern Ethiopia
Authors: Abdulmalik Haymen , Tadiwos Yohannes , Legesse Nanati
Published: September 2019

Objectives: To assess drug related problem among patients with type 2 diabetes at Hiwot Fana Specialized University HospitalResults: In this study, a total of 148 patient medication records were included. More than half, 83(57.4%) were males and the rest 65(42.6%) were females. The mean age of the study participant’s was 51.26 ± 7.08. Around one third (74.3%) of the participants had urban residency. A total of 127 drug related problems were identified, of which dosage too low was the most common type of DRP encountered, 47(37%), followed by unnecessary drug therapy, 25(19.7%) and ineffective drug therapy, 25(19.7%). 95(64.2%) of the patients had at least one drug related problem. Among patients with DRP, more than half of them, 59 (62.1%) had a single DRP. Out of the total participants, 85(57.4%) of them were taking one anti-diabetic medication and 63(42.6%) of them dual anti-diabetic medications. Only half of the patients have attained the desired FBG level. There was no patient who had experienced more than two types of drug related problems at a time. Less than 10% of patients were taking five or more drugs at a time. Key Words: Diabetes mellitus, Drug therapy problem, Hiwot fana specialized university hospital.
Associations of mental disorders and neurotropic parasitic diseases: a meta-analysis in developing and emerging countries.
Authors: Daré Labanté Outcha , Bruand Pierre-Emile , Gérard Daniel , Marin Benoît , Lameyre Valérie , Boumédiène Farid , Preux Pierre-Marie
Published: September 2019

Background Although they are declining worldwide, neurotropic parasitic diseases are still common in developing and emerging countries. The aim of this study was to estimate the pooled prevalence and pooled association measures of comorbidities between mental disorders (anxiety, depression, bipolar disorder, and schizophrenia) and neurotropic parasitic diseases (malaria, cysticercosis, toxoplasmosis, human African trypanosomiasis, Chagas disease, and human toxocariasis) in developing and emerging countries.Methods As the first meta-analysis on this topic, this study was performed in accordance with PRISMA guidelines. The protocol was registered in PROSPERO (N°CRD42017056521). The Medline, Embase, Lilacs, and Institute of Epidemiology and Tropical Neurology databases were used to search for articles without any restriction in language or date. We evaluated the quality of studies independently by two investigators using the Downs and Black assessment grid and pooled estimates using the random-effects method from CMA (Comprehensive Meta Analysis) Version 3.0.Results In total, 18 studies studies published between 1997 and 2016 met our inclusion criteria. We found that the prevalence of anxiety and depression in people suffering from Chagas disease and/or neurocysticercosis was 44.9% (95% CI, 34.4 – 55.9). In 16 pooled studies that included 1,782 people with mental disorders and 1,776 controls, mental disorders (schizophrenia and/or bipolar disorders) were associated with increased risk of toxoplasmosis and/or toxocariasis (odds ratio = 2.3; 95% CI, 1.7 – 3.2). Finally, schizophrenia was associated with an increased risk of the onset of toxocariasis and/or toxoplasmosis (odds ratio = 2.4 / 95% CI, 1.7 – 3.4).Conclusion Our pooled estimates show that the association between neurotropic parasitic diseases among people with related mental disorders, and mental disorders among people with neurotropic parasitic diseases are relatively high in developing and emerging countries even though most studies have been found in Asia. This meta-analysis could prove useful to researchers who want to further explore and understand the associations between mental disorders and neurotropic patristic diseases in developing and emerging countries.
Pregnancy outcomes of dichorionic triamniotic triplet pregnancies after in vitro fertilization-embryo transfer: multifoetal pregnancy reduction versus expectant management
Authors: Cai Pei , Ouyang Yan , Gong Fei , Li Xihong
Published: September 2019

Background: Trichorionic triplet pregnancy reduction to twin pregnancy is associated with a lower risk of preterm delivery but not of miscarriage. However, reports on dichorionic triamniotic (DCTA) triplet pregnancy outcomes are few. This study aimed to compare the pregnancy outcomes of reducing DCTA triplets achieved via in vitro fertilization-embryo transfer (IVF-ET) to monochorionic (MC) singleton or monochorionic diamniotic (MCDA) twin pregnancies at 11-13+6 gestational weeks to the pregnancy outcomes of expectant management.
Method: Two hundred and ninety-eight patients with DCTA triplets via IVF-ET from January 2012 to December 2016 were retrospectively analysed. All foetuses were alive until 11-13+6 gestational weeks. Eighty-four DCTA triplet pregnancies were reduced to MC singleton pregnancies (group A), 149 were reduced to MCDA pregnancies (group B), and 65 were managed expectantly (group C). Each multifoetal pregnancy reduction (MFPR) was performed at 11-13+6 gestational weeks. Pregnancy outcomes were compared among these 3 groups.
Result(s): There were no significant differences in the miscarriage rates (4.8 vs. 2.7 vs. 6.2%, respectively) or live birth rates (90.5 vs. 87.2 vs. 86.2%, respectively) among groups A, B and C (P > 0.05).
Group A had significantly lower preterm delivery (11.9 vs. 89.2%; odds ratio (OR) 0.016, 95% confidence interval (CI) 0.006-0.045) and low birth weight rates (LBW; 9.2 vs. 92.9%; OR 0.008, 95% CI 0.003-0.021) than group C (P < 0.001).
Group B had significantly lower preterm delivery (51.7 vs. 89.2%; OR 0.129, 95% CI 0.055-0.301) and LBW rates (59.0 vs. 92.9%; OR 0.111, 95% CI 0.057-0.214) than group C (P < 0.001).
Group A had significantly lower preterm delivery (11.9 vs. 51.7%; OR 0.126, 95% CI 0.061-0.263; P < 0.001), LBW (9.2 vs. 59.0%; OR 0.071, 95% CI 0.031-0.160; P < 0.001) and perinatal mortality rates (5.0 vs. 13.4%; OR 0.339, 95% CI 0.117-0.978; P = 0.037) than group B.
Conclusion: The MFPR of DCTA triplet pregnancies to singleton or MCDA pregnancies was associated with better pregnancy outcomes than DCTA triplets managed expectantly. The perinatal outcomes of DCTA triplets reduced to singleton pregnancies were better than those of DCTA triplets reduced to MCDA pregnancies.
Effect of maternal birth positions on duration of second stage of labor: Systematic review and meta-analysis
Authors: Badi Marta Berta , Lindgren Helena , Christensson Kyllike , Mekonnen Sollomon , Adefris Mulat
Published: September 2019

Background: it is believed that giving birth in an upright position is beneficial for both mother and the infant for several physiologic reasons. An upright positioning helps the uterus to contract more strongly and efficiently, the baby gets in a better position and thus can pass through the pelvis faster. Upright and lateral positions enables flexibility in the pelvis and facilitates the extension of the outlet. Before implementing a change in birthing positions in our clinics we need to review evidences available and context valid related to duration of second stage of labor and birthing positions. Objective: The aim of this review was to examine the effect of maternal flexible sacrum birth position on duration of second stage of labor. Method: The research searched articles using bibliographical Databases: Medline/PUBMED, SCOPUS, Google scholar and Google. All study designs were considered while investigating the impact of maternal flexible sacrum birthing positioning in relation duration of second stage of labor. Studies including laboring mothers with normal labor and delivery. A total of 1,985 women were included in the reviewed studies. We included both qualitative and quantitative analysis. Results: We identified 1,680 potential citations, of which 8 articles assessed the effect of maternal upright birth positioning on the reduction during the duration of second stage of labor. Two studies were excluded because of incomplete reports for meta analysis. The result suggested a reduction in duration of second stage of labor among women in a flexible sacrum birthing position, with a mean duration from 3.2-34.8. The pooled weighted mean difference with random effect model was 21.118(CI: 11.839-30.396) minutes, with the same significant heterogeneity between the studies (I2=96.8%, p<000). Conclusion: The second stage duration was reduced in cases of a flexible sacrum birthing position. Even though the reduction in duration varies across studies with considerable heterogeneity, laboring women should be encouraged to choose her comfortable birth position. Researchers who aim to compare different birthing positions should consider study designs which enable women to choose birthing position. Prospero registration number [CRD42019120618]
Lights and shadows on the last week of life of nursing home residents with advanced dementia: retrospective study
Authors: Toscani Franco , Finetti Silvia , Giunco Fabrizio , Basso Ines , Rosa Debora , Pettenati Francesca , Bussotti Alessandro , Villani Daniele , Gentile Simona , Boncinelli Lorenzo , Monti Massimo , Spinsanti Sandro , Piazza Massimo , Charrier Lorena , Giulio Paola Di
Published: September 2019

Background
Barriers to palliative care still exist in geriatric settings, thus persons with advanced dementia may not receive adequate palliative care in the last days of their life; instead, they may be exposed to aggressive and/or inappropriate treatments. The study aimed at evaluating the palliative appropriateness of clinical interventions and care at end of life in a cohort of NH residents with advanced dementia in a large Italian region (Lombardy Region).
Methods
Retrospective study in a convenience sample of 29 NHs. Data were collected from the clinical records of 482 residents with advanced dementia, who had resided in the NH for at least 6 months before death, mainly focusing on the last week of life.
Results
Most residents (97.1%) died in the NH. In the 7 days before death, 20% were fed and hydrated by mouth, and 13.4% were tube fed. A median of five, often inappropriate, drugs was prescribed. The acknowledgement of worsening condition in clinical records was recorded for 57% of residents, a median of 4 days before death.
Conclusions
A full implementation of palliative care is not yet achieved possibly due to the insufficient acknowledgement of the inappropriateness of some drugs and interventions, and health professionals’ fears and prejudices regarding critical end-of-life decisions. Further studies should focus on how to improve care for NH residents.
Temporal trends and geographic differences of insurance coverage for cancer drug trials in mainland China
Authors: Huang Huiyao , Wu Dawei , Fan Qi , Wang Jun , Wang Shuhang , Fang Hong , Yu Yue , Bai Ying , Fang Yuan , Sun Chao , Cui Dandan , Yan Zhao , Cao Ye , Jiang Min , Liu Yanfei , Li Kunyan , Li Ning
Published: September 2019

Background: To analyze the time trend and regional difference of insurance coverage of cancer drug trials in mainland China for the past decade, thus to provide data support for the improvement and implementation of related policies, such as clinical trial insurance and ethical review in China. Methods: Based on the national authoritative database, “Drug Clinical Trial Registration and Information Disclosure Platform”, the time trend analysis of insurance coverage of cancer drug trials was conducted, from both the perspectives of trials and participants. Meanwhile, the group comparisons between seven regions, as well as different drug types and study phases, were also performed. Data processing and analysis were carried out using SAS 9.4. Mann-Kendall test was used for trend analysis, and chi-square test was used to conduct group comparisons. Results: A total of 1433 clinical trials were finally included, with 1153 (80.5%) trials being international. In average, the insurance rate of trials was 75.9%, and it was steadily increased by 7.8% annually. While the insurance coverage of Chinese participants was 58.8%, and it showed a wavy upward trend. Compared with international trials (90.0%), insurance rate of domestic trials (72.4%)) was significantly lower ( P < 0.001), but the rate gap decreased gradually. The comparisons by region showed that, the insurance rate for clinical trials in Northeast China (83.3%) was the highest, followed by South area (80.7%), North area (78.1%), and that for Northwest China (37.5%) was lowest. Compared with chemicals (74.8%) and biological products (79.9%), trials on traditional Chinese medicine had significantly lower rate of insurance (30.4%). For different study phase, insurance coverage in BE studies was the lowest (57.1%), followed by phase II trials, while it achieved the highest in phase III trials (85.1%). Conclusions: The insurance coverage of cancer drug trials in mainland China has been increasing steadily over the past decade. However, the regional differences are significant. To promote insurance coverage emphatically in underdeveloped areas could be our work emphasis in the near future. Although this study specially included cancer drug trials, the results could also provide reference for trials in all other fields.
Barriers of effective health insurance coverage for rural-to-urban migrant workers in China: A systematic review and policy gap analysis
Authors: Chen Shanquan , Chen Yingyao , Feng Zhanchun , Chen Xi , Wang Zheng , Zhu Jianfeng , Jin Jun , Yao Qiang , Xiang Li , Yao Lan , Sun Ju , Zhao Lu , Fung Hung , Wong Laiyi , dong dong
Published: September 2019

Objective: To review China’s healthcare policies and their applications to rural-to-urban migrant workers (RUMWs) in China, to identify problems faced by RUMWs and the policy gaps that need to be addressed in future, and to facilitate better implementation of the UHC on RUMWs. Methods: A systematic review guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The searched databases included PubMed, Embase, Medline, Web of Science, PsycINFO, Maternity and Infant Care Database MIDIRS, the Cochrane Library, WHO Library Database (WHOLIS), WHO Global Health Library, World Bank eLibrary, OpenGrey, CNKI, and Wanfang. In total 71 articles were reviewed. Findings: (1) Chinese RUMWs have a high work mobility and low job stability; (2) Barriers faced by RUMWs to have effective health insurance coverage are mainly due to the reluctancy of employers to provide insurance for all employees and a disadvantaged position held by RUMWs when negotiating with their employers; (3) Fissures among existing health insurance schemes leaves no room for RUMWs to meet their primary needs; and (4) Recent efforts in improving the portability and transferability of insurance across borders and schemes are not enough to solve the barriers. Conclusion: It is argued that the Chinese central government must deal with the fragmentation of healthcare system in China and promote the effective coverage by: (1) playing a more active role in coordinating different healthcare and social welfare schemes across the country, (2) increasing the health insurance portability, (3) making the healthcare policies more compatible with RUMW’s characteristics to meet their primary health needs, (4) strengthening supervision over employers, and (5) providing more vocational trainings and other supports to increase RUMW’s job stability.
The social determinants of otitis media in Aboriginal children in Australia: are we addressing the primary causes? A systematic content review
Authors: DeLacy Jack , Dune Tinashe , Macdonald John
Published: September 2019

Background Aboriginal and Torres Strait Islander children experience some of the highest rates of otitis media in the world. Key risk factors for otitis media in Aboriginal children in Australia are largely social and environmental factors such as overcrowded housing, poverty and limited access to services. Despite this, little is known about how to address these risk factors. A scoping content review was performed to determine the relationship between social determinants of health and otitis media in Aboriginal and Torres Strait Islander children as described by peer-reviewed and grey literature.Method Search terms were established for location, population and health condition. The search terms were used to conduct a literature search using six health research databases. Following the exclusion process, articles were scoped, analysed and categorised using scoping parameters and a social determinants of health framework.Results Housing-related issues were the most frequently reported determinants for otitis media (56%). Two articles (4%) directly investigated the impact of social determinants of health on rates of otitis media within Aboriginal and Torres Strait Islander children. The majority of the literature (68%) highlight social determinants as playing a key role in the high rates of otitis media seen in Aboriginal populations. There were no intervention studies targeting social determinants as a means to reduce otitis media rates among Aboriginal and Torres Strait Islander children.Conclusions This review identifies a disconnect between otitis media drivers and the focus of public health interventions within Aboriginal and Torres Strait Islander populations. Despite consensus that social determinants play a key role in the high rates of otitis media in Aboriginal and Torres Strait Islander children, the majority of literature consists of intervention studies aimed at developing vaccines and antibiotics. This review highlights the need for otitis media intervention studies to shift away from a purely biomedical model and toward investigating the underlying social determinants of health. By shifting interventions upstream, otitis media rates may decrease within Aboriginal and Torres Strait Islander children, as focus is shifted away from a treatment-focussed model and toward a more preventative model.
The perceived oral health status, practices, knowledge and periodontal status of pregnant women in a maternity hospital in Trinidad
Authors: Rafeek Reisha , Ramroop Visha , Balkaran Ramaa , Kowlessar Anne , Bissoon Arlana , Royer Christina , Low Risa Yuk
Published: September 2019

Background The effects of physiological changes that occur during pregnancy on oral tissues have been well documented. The oral health status, practices, knowledge and periodontal status of pregnant women has not been studied before in Trinidad. The aim of this study is to report that of pregnant women in a maternity hospital in Trinidad.Methods A descriptive oral health survey involving a self-administered questionnaire was undertaken from a convenience sample of pregnant women who attended a maternity hospital in Trinidad. A simple oral health examination took place at the School of Dentistry clinic. Data included education and employment status, medical and dental history, frequency and reason for dental attendance, and the patients’ perceived oral health status, knowledge and practices. Examination included the Basic Periodontal Examination (BPE). Data were analyzed using SPSS version 24.0 and ethical approval was obtained by the University of the West Indies Campus Ethics Committee.Results One hundred and sixty one pregnant women participated and 79.5% were between the ages 26 to 45. Fifty seven per cent attended high school and 58.1% were employed. Nearly 60% rated their oral health as average or good. The majority of women (91.9%) did not attend the dentist routinely. Almost half (46.0%) of the participants said safety concerns with dental treatment during pregnancy would prevent them from seeking care. 54.7% said the cost of dental treatment would act as a barrier to care. The majority had good oral health knowledge for flossing (97.5%) however 37.3% thought that dental care should be avoided during pregnancy unless it was an emergency. Nearly 60% had some form of periodontitis mild (34.2%) or moderate to severe (25.2%). Significant associations found between level of education and brushing, and also between age and smoking, use of mouthwash and BPE.Conclusions Although oral health knowledge in areas of tooth brushing, flossing and need for attending the dentist was good, in other areas there were serious misconceptions such as dental care should be avoided during pregnancy. Understanding oral health needs of pregnant women can guide oral health promotion and delivery of preventive care and potentially improve pregnancy outcomes.
The Dimerization Interface in VraR is Essential for Induction of the Cell Wall Stress Response in Staphylococcus aureus: A Potential Druggable Target
Authors: Tajbakhsh Ghazal Ghazal , Golemi-Kotra Dasantila
Published: September 2019

Background
Staphylococcus aureus remains a medical challenge in the treatment of bacterial infections. It has acquired resistance to commonly used antibiotics, and to those considered to be the last weapons in treating staphylococcal infections, such as vancomycin. Studies have revealed that S. aureus is capable of mounting a rapid response to antibiotics that target cell wall peptidoglycan biosynthesis, such as β-lactams and vancomycin. The two-component system VraSR has been linked to the coordination of this response. VraS is a histidine kinase that undergoes autophosphorylation in the presence of signals elicited upon cell wall damage and it then transfers its phosphoryl group to VraR. VraR is a response regulator protein that functions as a transcription factor. Phosphorylation of VraR leads to its dimerization, which is required for optimum binding to its target promoters. Two-component systems have been targeted for the development of antibacterial agents. Deletion of the vraS or vraR gene has been shown to re-sensitize S. aureus to β-lactams and vancomycin.
Results
In this study, we explored perturbation of the VraR phosphorylation-induced activation as a means to inhibit the VraSR-mediated signal transduction pathway. We show that dimerization of VraR is essential for the phosphorylation-induced activation of VraR. A single point mutation in the dimerization interface of VraR, in which Met13 was replaced by Ala, led to the inability of VraR to dimerize and to bind optimally to the target promoter. The consequences of these in vitro molecular deficiencies are equally dramatic in vivo. Complementation of a vraR deletion S. aureus strain with the vraRM13Ala mutant gene failed to induce the cell wall stress response.
Conclusions
This study highlights the potential of targeting the phosphorylation-induced dimerization of VraR to disrupt the S. aureus cell wall stress response and in turn to re-sensitize S. aureus to β-lactams and vancomycin.
The impact of key audit matter (KAM) disclosure in audit reports on stakeholders’ reactions: a literature review
Authors: Velte Patrick , Issa Jakob
Published: September 2019

This article presents a literature review of 49 empirical studies on key audit matter (KAM) disclosure in audit reports. The study involves a structured literature review on KAM disclosure based on the reactions of stakeholders. The limitations of former studies and useful recommendations for research are stressed. Five major streams of empirical research that analyze the impact of KAM disclosure on stakeholders’ reactions are focused: (1) shareholders (e.g. investors’ perceptions of auditors’ responsibility and litigation, value relevance and investors’ decisions); (2) debtholders (e.g. loan contracting terms); (3) external auditors (e.g. audit processes and audit fees); (4) boards of directors (e.g. earnings management); and (5) other stakeholders (e.g. informational value for suppliers and customers). The authors stress that most of the included studies use experimental or archival data and analyze the impact of KAM disclosure on investor reactions in a US-American setting. As the international standard setters assume a positive impact of KAM on stakeholder reactions, mixed empirical results are found. Although there are some indications of decreased earnings management behavior, most studies find no significant changes in auditor behavior. Furthermore, there are many insignificant results with regard to shareholders’ reaction in line with our stakeholder and behavioral agency framework. The literature review is especially useful for management decisions, because firm reputation may be positively or negatively influenced by KAM regulations.
A Evolução da Geodésia: da observação às estrelas aos satélites
Authors: Costa Sonia Maria Alves , Fortes Luiz Paulo Souto
Published: September 2019

Da mesma forma que as demais áreas das geociências, a geodésia passou por grandes transformações devido à evolução tecnológica ocorrida nos últimos 50 anos. Voltando um pouco no tempo, o objetivo principal da geodésia consistia na determinação de uma posição na superfície terrestre, através das coordenadas - latitude, longitude e altitude. Estas coordenadas eram obtidas através técnicas e métodos que proporcionassem a melhor precisão possível. Entretanto, dada a grande evolução nas missões espaciais dedicadas ao melhor conhecimento do nosso planeta e as interações entre os seus diversos sistemas, é possível hoje monitorar também as variações que ocorrem nas coordenadas ao longo do tempo. Estas informações são de extrema importância para os sistemas de alerta de terremotos e erupções vulcânicas que estão sendo implantados em várias partes do mundo.Este trabalho tem por objetivo relatar as transformações que a geodésia do IBGE passou desde a sua primeira responsabilidade na campanha de determinação das coordenadas das sedes municipais, visando a atualização da Carta Geográfica do Brasil para o Censo de 1940, até os dias de hoje, com a adoção do Sistema de Referência Geocêntrico para as Américas SIRGAS 2000. São abordadas também as mudanças que ocorreram na forma de atuar como gestor Sistema Geodésico Brasileiro, através da disponibilização de serviços de posicionamento no portal do IBGE, os quais contam com um número expressivo de usuários, possibilitando inclusive o posicionamento em tempo real.
Tempo, Espaço e Geografia - um ensaio
Authors: Corrêa Roberto Lobato
Published: September 2019

Tempo e espaço são elementos para a existência de processos e formas tanto criados pela natureza como pela ação humana. Sem tempo e espaço nada existe ou se reproduz. Ambos, tempo e espaço, têm sido objetos da física, filosofia e de outros campos do conhecimento, tendo, no entanto, recebido uma relativamente pequena atenção entre os geógrafos, a despeito da superfície da Terra, morada do Homem, ser uma notável expressão da ação do tempo e do espaço. O presente ensaio procura ressaltar algumas conexões entre tempo, espaço e geografia, estando apoiado na literatura produzida muito particularmente pelos geógrafos. Trata-se, portanto, de um ensaio direcionado sobretudo aos geógrafos.