bluuebunny/crossref_metadata_2025 huggingface dataset:
Controls On Sedimentation and Cyclicity of the Boquillas and Equivalent Eagle Ford Formation from Detailed Outcrop Studies of Western and Central Texas, U.S.A.
Authors: Lehrmann Daniel J. , Yang Wan , Sickmann Zachary T. , Ferrill David A. , McGinnis Ronald N. , Morris Alan P. , Smart Kevin J. , Gulliver Kirk D.H.
Published: July 2019

Facies of the Boquillas and equivalent Eagle Ford Formation can be assigned to two associations: a hydrodynamically recycled association and a pelagic association. The hydrodynamically recycled association is composed of lenticular to continuous cross-laminated lime packstone–grainstone, heterolithic facies, and intraclastic grainstone conglomerate with intercalated calcareous mudrock. Sharp bedding contacts, abundant scours, ripple cross-lamination, oscillatory-current indicators, hummocky cross-bedding, and rounded clasts indicate recycling of the bottom sediments by storms and bottom currents above storm wave base (SWB). The pelagic association is composed of continuous lime packstone to grainstone and chalk beds with intercalated calcareous mudrock. Gradational contacts and planar lamination indicate dominant deposition by pelagic rain, but scour surfaces, coarse-fine alternations, and ripple cross-laminae indicate the influence of bottom currents below SWB.

Vertical shifts between the hydrodynamically recycled association, interpreted to represent storm agitation of the seafloor during falls in sea level, alternate with the pelagic association and define four sequence boundaries and three depositional sequences with a lower-order periodicity (third-order periodicity, ca. average 2.4 My). Sequence boundaries correspond approximately to member boundaries recognized by gamma-ray profiles. Spectral analysis reveals higher-frequency mudrock–carbonate cycles prominent in the pelagic association, likely resulting from Milankovitch climate forcing of planktonic carbonate productivity versus clay flux. Comparison of gamma-corrected spectra with absolute age constraints reveals that the Ernst Tinaja section (in Big Bend National Park) is less than 28% complete. This is interpreted to result from abundant depositional hiatuses and erosional gaps that occur at the bed scale and at member boundaries within and bounding the Eagle Ford Formation.

We demonstrate that deep-marine pelagic deposits in epicratonic settings may be subject to a complex interaction of depositional processes including pelagic rain and recycling by bottom currents and wave-generated currents modulated by low-frequency sea-level fluctuation and high-frequency fluctuations in sediment supply.
Innovación en salud en México: retos importantes y un largo camino que recorrer
Authors: Pérez-Orive Javier , Ibarra Ponce de León José Clemente
Published: July 2019

La transferencia de tecnología de instituciones de investiga­ción en salud a empresas que generen nuevos tratamientos médicos ha generado grandes beneficios para la salud pública a nivel mundial. Sin embargo, en México existen importantes rezagos en los indicadores de innovación. Hay barreras cultu­rales, regulatorias y financieras que obstaculizan la innovación en México. Al mismo tiempo, los últimos años han visto la aparición de varias iniciativas útiles que avanzan en la dirección correcta. El presente trabajo describe la situación actual y las principales barreras y oportunidades para promover la innovación en salud y la contribución de ésta a mejoras en salud pública.
Drug plasma trough concentrations during treatment with daclatasvir and sofosbuvir are associated respectively with liver impairment and with renal dysfunction in HIV/HCV co-infected patients
Authors: Mastrorosa Ilaria , Tempestilli Massimo , Notari Stefania , Lorenzini Patrizia , Fabbri Gabriele , Lupi Federico , Bellagamba Rita , Vergori Alessandra , Zaccarelli Mauro , Agrati Chiara , Antinori Andrea , Ammasari Adriana
Published: July 2019

Background

Sofosbuvir (SOF) plus daclatasvir (DCV) achieved high rates of sustained virologic response (SVR) with no difference according to HIV serostatus. Only limited information is available on the pharmacokinetics variability of SOF and DCV in HIV/HCV co-infected patients. Aim was to evaluate the association of plasma drug concentrations (Ctrough) of SOF and of DCV with patient-, treatment-, and disease-related factors in the real-world setting of HIV/HCV co-infected persons.

Methods

HIV/HCV co-infected patients, undergoing SOF plus DCV treatment, were prospectively enrolled. At baseline, week4 (W4), end of treatment (EOT), and after-EOT, biochemical and viro-immunological parameters were assessed. FIB-4 score and CKD-EPI equation were used for estimation of liver disease and glomerular filtration rate (eGFR), respectively. SOF, SOF metabolite (GS-331007), and DCV Ctrough were measured at W4 and week8 (W8), and the mean value (mean-Ctrough) was calculated

Results

Thirty-five patients were included (SVR 94%). Increasing GS-331007 mean-Ctrough significantly correlated with decreasing eGFR at W4 (rho=-0.36; p=0.037) and EOT (rho=-0.34; p=0.048). Between DCV mean-Ctrough and FIB-4, a significant correlation was observed at all time-points: baseline (rho=-0.35; p=0.037), W4 (rho=-0.44; p=0.008), EOT (rho=-0.40; p=0.023), after-EOT (rho=-0.39; p=0.028).

Conclusion

In HIV/HCV co-infected patients receiving SOF plus DCV, plasma drug concentrations are associated with renal dysfunction for GS-331007 and with liver impairment for DCV. Though clinical and therapeutically relevance of these findings may apparently be limited, growth of clinicians’ knowledge on DAA exposure in difficult-to-treat patients, as cirrhotic and renal impaired subjects, can be relevant in single cases.
Three-dimensional photographic analysis of the face in European adults from southern Spain with normal occlusion: reference anthropometric measurements
Authors: López-Mateos María Luisa Menendez , Carreño Javier Carreño , Palma Juan Carlos , ALARCON JOSE ANTONIO , López-Mateos Cristina Menendez , Menéndez-Núñez Mario
Published: July 2019

Background

Recent non-invasive 3D photography method has been applied to facial analysis, offering numerous advantages in orthodontic. The purpose of this study was to analyze the faces of a sample of healthy European adults from southern Spain with normal occlusion in order to establish reference facial soft tissue anthropometric parameters in this specific geographic-ethnic population, as well as to analyze sexual dimorphism.

Methods

A sample of 100 healthy adult volunteers consisting of 50 women (mean age, 22.92 ± 1.56 years) and 50 men (mean age, 22.37 ± 2.12 years) were enrolled in this study. All participants had normal occlusion, skeletal Class I, mesofacial pattern, and healthy body mass index. Three-dimensional photographs of the faces were captured non-invasively using Planmeca ProMax 3D ProFace®. Thirty landmarks related to the face, eyes, nose, and orolabial and chin areas were identified.

Results

Male displayed higher values in all vertical and transversal dimensions, with the exception of the lower lip height. Larger differences between sexes were observed in face, mandible, and nose. Male also had higher values in the angular measurements which referred to the nose. No sex differences were found in transverse upper lip prominence or transverse mandibular prominence. No differences were found in the ratio measurements, with the exception of intercantal width/nasal width, which was higher in women than in men.

Conclusions

Reference anthropometric measurements of facial soft tissues have been established in European adults from southern Spain with normal occlusion. Significant sexual dimorphism was found, with remarkable differences in size between sexes.
Identification, Characterization and Expression Analysis Reveal the Potential Function of Annexin Genes in Response to Abiotic stress, Calcium and Hormones in Cassava (Manihot esculeta Crantz)
Authors: Li Ruimei , Wang Yuqing , Zhou Yangjiao , Qiu Tingting , Song Yu , Yao Yuan , Liu Jiao , Fu Shaoping , Hu Xinwen , He Yingdui , Guo Jianchun
Published: July 2019

Background

The calcium (Ca2+)-dependent phospholipid binding protein annexin gene family, which is known to be related to membrane lipid and cytoskeletal components, is involved in a diverse range of biological functions. However, in cassava (Manihot esculenta Crantz), no studies focusing on the roles of annexin genes in response to abiotic stresses, calcium, and hormones have been informed.

Results

12 annexin genes were found and assigned to eight chromosomes in the cassava genome. All of the MeAnns contain a typical annexin domain with four 70-amino acid repeats. The MeAnns are classified into six groups in the phylogenetic tree. In their promoter regions, MeAnns possess at least 3 hormone response-related cis-elements and 1 abiotic stress response-related cis-acting element. MeAnn1, MeAnn2 and MeAnn5 exhibit very high levels of expression in each tested organs or tissues. By contrast, MeAnn12 exhibits very low levels in all the tested organs or tissues. qRT-PCR analysis indicates that both MeAnn5 and MeAnn9 have significantly high expression in leaves after cold, drought, and salt treatments and are highly responsive to CaCl2, GA and JA treatments. MeAnn2 and MeAnn10 are significantly downregulated in leaves by cold, drought and salt stress and negatively respond to CaCl2, GA and JA. The expression patterns of MeAnns under cold, drought, and salt stress are irregular in shoots. In roots, MeAnn1 and MeAnn9 are downregulated by cold, CaCl2 and JA treatments, while their other gene expression patterns are irregular.

Conclutions

In this study, we identified annexin genes in cassava and our expression profiling analysis demonstrated that cassava annexin genes responded to multiple stresses. Our results laid the foundation for further study of the function of cassava anesxin genes and provided an entry point for understanding the response mechanism of cassava to abiotic stress.
Brucella melitensis B115-based ELISA to Implement Diagnosis of Bovine Brucellosis: A Field Study
Authors: Trotta Adriana , Marinaro Mariarosaria , Cirilli Margie , Sposato Alessio , Adone Rosanna , Beverelli Matteo , Buonavoglia Domenico , Corrente Marialaura
Published: July 2019

Background: Brucellosis is a zoonosis whose incidence is not declining worldwide despite the global effort to control the disease. Accurate and precise diagnosis is a crucial step in any prophylaxis program but single tests to unequivocally detect animals infected with Brucella spp. are currently unavailable. In Italy, serological diagnosis of bovine brucellosis is performed with two official tests: a rapid agglutination test (i.e., Rose Bengal Plate test, RBPT) and a complement fixation test (CFT) that detect antibodies directed mainly to the smooth lipopolysaccharide (S-LPS). Neither of the two tests is able to avoid the detection of false positive serological reactions (FPSRs) caused by bacteria sharing S-LPS components with Brucella spp. and responsible for the single reactors (SR) phenomenon. An ELISA based on a R strain of Brucella, i.e., Brucella melitensis B115, was employed to measure specific IgG responses in a collection of bovine sera (n=648). Sera were obtained from 180 farms (either officially brucellosis-free or not brucellosis-free) recruited during an extended period of time (2014-2018) and were preliminarily assayed with the official tests by the Italian Reference Centers and then subjected to the ELISA.
Results: Negative sera, when subjected to the ELISA, gave an O.D. value below the cutoff (i.e., 0.143); SR sera, i.e. RBPT positive and CFT negative, as well as double positive sera, i.e. RBPT and CFT positive, gave O.D. values that were below the cutoff. All positive sera, i.e. from Brucella-infected animals, were RBPT positive and CFT positive (ICFTU ranging from 20 to 1280) and gave ELISA O.D. values above the cutoff.
Conclusions: Neither of the two official tests is able to avoid the detection of FPSRs caused by bacteria sharing S-LPS components with Brucella spp. The B. melitensis B115-based ELISA systematically unravelled all false positive (FP) sera while confirming the diagnosis, so the test employed in the present study may complement official tests to avoid the costly slaughter of FP animals and consequently the economic losses.
Treatment of simple bone cysts of humerus by intramedullary decompression and drainage with elastic stable intramedullary nailing combined with intralesional injections of steroids
Authors: Zhang Peng , Zhu Naiqiang , Du Lilong , Zheng Jihui , Hu Sibin , Xu Baoshan
Published: July 2019

Background: Simple bone cysts (SBCs) are common benign lytic bone lesions in children. This study focused on exploring a clinical treatment method, minimally invasive intramedullary decompression and drainage with elastic stable intramedullary nailing (ESIN) combined with intralesional injections of steroids, and evaluated its effectiveness, complications and morbidity through functional and radiographic outcomes.
Methods: The postoperative recovery of 18 children who suffered from SBCs of humerus was evaluated (mean follow-up, 40 months) from January 2009 to December 2016. These patients (11 males, 7 females; 8 in the left, 10 in the right; mean age, 10.9 years old) were treated with minimally invasive intramedullary decompression and drainage with ESIN combined with intralesional injections of steroids. The diagnosis was based on not only pre-operative typical medical images (X-rays/CT/MRI) but also surgical findings and pathological diagnosis. Radiological and functional outcomes were evaluated according to Capanna and Musculoskeletal Tumor Society (MSTS) score. The interclass differences were analyzed by t-test.
Results: According to Capanna and MSTS criteria, after treatment, 14 patients made full recoveries which was presented by all the cysts filled with bone tissue, and 4 patients made partially recoveries, which were presented by cystic spaces partially filled with low density bone. All the cysts responded to treatment method, and there was no cyst recurrence. All except 2 patients had good functional results. One of the two patients had irritation of the end of the nail and one patient had a valgus deformity.
Conclusions: Treatment for SBCs of humerus by minimally invasive intramedullary decompression and drainage with ESIN combined with intralesional injections of steroids is safe, effective and convenient. The clinical effect is satisfactory and worth popularizing.
Comparison of four pharmacological strategies aimed to prevent the lung inflammation and paraquat-induced alveolar damage
Authors: Buendia Jefferson A. , Castro José Armando Justinico , Vela Laura Tapia , Sinisterra Dennis , Villamil Juana Patricia Sanchez , Salazar Andres Felipe Zuluaga
Published: July 2019

Objective : The aim of this study was to compare in vivo effect of five pharmacological options on inflammation and pulmonary fibrosis induced by paraquat. Methods: 54 Wistar SPF rats were used. After 2 hours post-intoxication with paraquat ion, groups of 9 animals were randomly assigned to : (1) cyclophosphamide plus dexamethasone (2) low molecular weight heparin (3) unfractionated heparin (4) vitamin C every 24 h , (v) atorvastatin or (vi) placebo with intraperitoneal saline .Lung inflammation, alveolar injury, hepatocyte damage, hepatic regeneration, acute tubular necrosis and kidney congestion were evaluated.
Results: In the control group 100% of animals presented moderate and severe lung inflammation, while in the groups with atorvastatin and intratracheal heparin this proportion was lower (55.5% ; CI 26.6 – 81.3%) (p = 0.025). A lower degree of moderate or severe hepatic regeneration was evident in the treatment groups with atorvastatin (p = 0.009). In this study was demonstrated that statins and heparin may have a protective effect in the paraquat-induced destructive phase. More evidence are needed to evaluated of dose response effects of these drugs before to study in clinical trials.
Association about dietary vitamin C intake on the risk of ovarian cancer: A meta-analysis
Authors: Long Yuhang , Fei Hui , Xu Sumei , Wen Jianzhen , Ye Lihua , Su Zhaojuan
Published: July 2019

Background: Changes in dietary vitamin C intake have been related to the risks of various cancers. However, the association between dietary vitamin C intake and the risk of ovarian cancer has not been fully determined. A meta-analysis was performed to evaluate the relationship between vitamin C intake and ovarian cancer risk.
Methods: Observational studies that evaluated the association between vitamin C intake and ovarian cancer risk were identified via systematic search of PubMed and Embase databases. A random effect model was used to combine relative risk (RR) with corresponding 95% confidence intervals (CI).
Results: Sixteen studies (5 cohort studies and 11 case-control studies) with 4,553 cases and 439,741 participants were included. Pooled results showed that dietary vitamin C intake had non-significant association on the risk of ovarian cancer (RR=0.95, 95%CI= 0.81-1.11, I2= 52.1%, P for heterogeneity= 0.008). Subgroup analyses according to characteristics including geographic location and study design showed consistent results with the overall result.
Conclusions: In summary, findings from this study indicated that dietary vitamin C intake is not associated with the risk of ovarian cancer.
DEATHS FROM SURGICAL CONDITIONS IN MALAWI A Randomised Cross-sectional Nationwide Household Survey
Authors: Varela Carlos Gomes , Young Sven , Groen Reinou , Banza Leonard Ngoe , Mkandawire Nyengo , Elisabeth Moen Bente , Viste Asgaut
Published: July 2019

Back ground

The prevalence of untreated surgical conditions in Malawi has been estimated at 35% with 24% of the deaths associated with untreated surgical conditions. In SSA, the primary emphasis for health research has been on communicable diseases, and relatively little is known about deaths from surgical conditions in most middle- to low-, income African countries, including Malawi. This study aimed to address this knowledge gap by quantifying and describing the deaths from surgical conditions in Malawi.

Methods

To access the deaths associated with surgical conditions in Malawi, a randomised multi-stage cross-sectional national household survey was carried out using the Surgeons Overseas Assessment of Surgical Need (SOSAS) tool. Randomisation was done on 48 233 settlements, using 50 villages from each district as data collection sites. Two to four household were randomly selected from each village. Two members of each selected household were interviewed. 1487 households were involved in the survey. Data collection was done using an electronic questionnaire.

Results

The total number of reported deaths from all causes was 616 in the 1479 households, ranging from 0 to 9 dead household members. Further data related to the deaths were available for 558 persons, with 294 (52.7%) males and 259 (46.4%) females. A total of 13 women died during pregnancy (5% of deceased women).

Non-surgical conditions accounted for 408 (73.5%) of all the total deaths. Symptoms such as body swelling, abdominal distension and injuries were among the common associations of deaths: (6.0%, 5.3% and 4.6%).

Almost half of the deaths occurred at home (234 persons - 41.9%) while 288 (51.6%) died at a health facility. Thirty persons died on their way to a health facility. Seventy-two persons (12.9%) who died had sought care from a traditional herbalist prior to attending a health facility.

Conclusion

In Malawi, body swelling, abdominal distension and injuries were the main conditions reported to be related to surgical causes of death. These occurred while the patients were either waiting at home or at health centre. Some patients initially consult a traditional herbalist prior to seeking modern health care. This delayed the possibility of timely surgical intervention.
Methylation Analysis in Uygur and Kazak Patients with Hypertension Complicated with Left Ventricular Hypertrophy: Ethnic Difference Based On High-density Genomic DNA Methylation Chips
Authors: Chen Xi , Zhang Na , Xu Xinjuan , Liang Xiaohui , Hu Guangmei
Published: July 2019

Background:This study aimed to analyze the methylation level in Uygur and Kazak patientswith hypertension complicated with left ventricular hypertrophy using high-density DNA methylation chips.
Methods: Three Uygur and three Kazak patients with hypertension complicated with left ventricular hypertrophy were selected for DNA extraction and bisulfite conversion. Left ventricular hypertrophy was defined by echo Penn convention as left ventricular mass index≥115 g/m2 in men and ≥95 g/m2 in women. Illumina HD450K Infmium Methylation BeadChip was applied to detect 450,000 methylation sites of the whole human genome.The cluster analysis and significance test were carried out to analyze the different methylation levelsin Uygur and Kazak patients with left ventricular hypertrophy. The Delta Data were screened for statistics.Results: A total of 236genes (including 84 hypermethylated and 152 hypomethylated) showed significant differences in the degree of methylation between Uygur and Kazak patients.The average methylation level of significantly different genes was higher in the experimental group compared with the control group.The chromosome distribution of aberrant methylationgenes was quite even. The cluster analysis of the candidate genes showed thataberrant methylation genes in Uygur and Kazak patients with hypertension complicated with left ventricular hypertrophy mainly participated in cell adhesion,signal transduction, and cell cycle.Conclusions:Different methylation genes were found in Uygur and Kazak patients with hypertension complicated with myocardial hypertrophy, providing the basis for further studies on the molecular mechanism and prevention and treatment ofhypertension complicated with target organ damage among different nationalities in Xinjiang.
Willingness to adopt wearable devices with behavioral and economic incentives by health insurance wellness programs: results of a US cross-sectional survey with multiple consumer health vignettes
Authors: Soliño-Fermández Diego , Ding Alexander , Ding Eric L. , Bayro-Kaiser Esteban
Published: July 2019

Background: The number of health-related wearable devices is growing but it is not clear if Americans are willing to adopt health insurance wellness programs based on wearables and the incentives with which they would be more willing to adopt.

Methods: In this cross-sectional study we used a survey methodology, usage vignettes and a dichotomous scale to examine U.S. residents’ willingness to adopt wearables (WTAW) in six use-cases where it was mandatory to use a wearable device and share the resulting data with a health insurance company. Each use-case was tested also for the influence of additional economic incentives on WTAW.

Results: A total of 997 Americans across 46 states participated in the study. Most of them were 25 to 34 years old (40.22%), 57.27% were female, and 74.52% were white. On average, 69.5% of the respondents were willing to adopt health-insurance use-cases based on wearable devices, though 77.8% of them were concerned about issues related to economic benefits, data privacy and to a lesser extent, technological accuracy. WTAW was 11-18% higher among consumers in use-cases involving health promotion and disease prevention. Furthermore, additional economic incentives combined with wearables increased WTAW overall. Notably, financial incentives involving providing healthcare credits, insurance premium discount, and/or wellness product discounts had particularly greater effectiveness for increasing WTAW in the consumer use-cases involving participation: for health promotion (RR=1.06 for financial incentive, 95% CI: 1.01-1.11; P=0.018); for personalized products and services (RR=1.11 for financial incentive, 95% CI: 1.01-1.21; P=0.018); and for automated underwriting discount at annual renewal (RR=1.28 for financial incentive, 95% CI: 1.20-1.37; P<0.001).

Conclusions:
Under the adequate economic, data privacy and technical conditions, 2 out of 3 Americans would be willing to adopt health insurance wellness programs based on wearable devices, particularly if they have benefits related to health promotion and disease prevention, and particularly with financial incentives.
Equity in Distribution of Public Subsidy for Noncommunicable Diseases among the Elderly in India: An Application of Benefit Incidence Analysis
Authors: Bose Montu , Banerjee Somdutta
Published: July 2019

Background:

Rapid ageing of the population and increasing non-communicable diseases (NCDs) among the elderly is one of the major public health challenges in India. To achieve the Universal Health Coverage, ever-growing elderly population should have access to needed healthcare, and they should not face any affordability related challenge. As most of the elderly suffers from NCDs and achieving health-equity is a priority, this paper aims to:
-study the utilization pattern of healthcare services for treatment of NCDs among the elderly;
-estimate the burden of out-of-pocket expenditure for the treatment of NCDs among the elderly and
-analyze the extent of equity in distribution of public subsidy for the NCDs among the elderly.

Methods:

National Sample Survey data (71st round) has been used for the study. Exploratory data analysis and benefit incidence analysis have been applied to estimate the utilization, out-of-pocket expenditure and distribution of public subsidy among economic classes. Concentration curves and indices are also estimated.

Results:

Results show that public-sector hospitalization for NCDs among the elderly has a pro-rich trend in rural India. However, in urban sector, for both inpatient and outpatient care the poorest class has substantial share in utilization of public facilities. Same result is also observed for rural outpatient care. Analysis shows that out-of-pocket expenditure is very high for both medicine and medical care even in public facilities for all economic groups. It is also observed that medicine has the highest-share in total medical expenses during treatment of NCDs among the elderly in both the region. Benefit incidence analysis shows that the public subsidy has a pro-rich distribution for inpatient care treatment in both the sectors. In case of outpatient care, subsidy share is the maximum among the richest in the urban sector and in the rural region the poorest class enjoys the maximum subsidy benefit.

Conclusions:

It is evident that a substantial share of the public subsidies is still going to the richer sections for the treatment of NCDs among the elderly. Evidences also suggest that procuring medicines and targeted policies for the elderly are needed to improve utilization and equity in the public healthcare system.
Increasing uptake of maternal, newborn, and child health interventions through a group-based health education and microfinance program: a prospective matched cohort study in western Kenya
Authors: Maldonado Lauren Yu-Lien , Songok Julia J. , Snelgrove John W. , Ochieng Christian B. , Chelagat Sheilah , Ikemeri Justus E. , Okwanyi Monica A , Cole Donald C. , Ruhl Laura Jane , Christoffersen-Deb Astrid
Published: July 2019

Background

We launched Chamas for Change (Chamas), a group-based health education and microfinance program for pregnant women and their infants, to address inequities contributing to high rates of maternal and neonatal mortality in western Kenya. In this prospective matched cohort study, we evaluated Chamas’ impact on improving uptake of evidence-based maternal, newborn and child health (MNCH) interventions.

Methods

We prospectively compared MNCH intervention uptake between a cohort of Chamas participants and controls matched for age, parity, and prenatal care location. Between October-December 2012, government-sponsored community health volunteers (CHV) recruited pregnant women in Busia county attending their first antenatal care (ANC) visit to participate in Chamas and enroll in this study. Upon joining, women agreed to attend bi-monthly group health education and optional microfinance sessions for 12 months. We selected controls among non-Chamas participants who attended the same ANC clinics. We collected baseline sociodemographic and reproductive health data at study enrollment. We used descriptive analyses and adjusted multivariable logistic regression models to compare outcomes across cohorts at 6-12 months postpartum, with α set to 0.05.

Results

Compared to controls (n=115), a significantly higher proportion of Chamas participants (n=211) delivered in a facility with a skilled birth attendant (84.4% vs. 50.4%, p<0.001), attended at least four ANC visits (64.0% vs. 37.4%, p<0·001), exclusively breastfed to six months (82.0% vs. 47.0%, p<0·001), and received a CHV home visit within 48 hours postpartum (75.8% vs. 38.3%, p<0·001). In our adjusted models, Chamas participants were nearly five times as likely as controls to deliver in a health facility (OR 5.07, 95% CI 2.74-9.36, p<0.001). Though not statistically significant, Chamas participants experienced fewer stillbirths than non-participants (n=2 vs. n=6, p=0.083). Our sensitivity analyses revealed no significant difference in the odds of facility delivery based on microfinance participation.

Conclusions

Chamas participation was associated with increased uptake of MNCH interventions among pregnant women in western Kenya. Our findings demonstrate this program’s potential to achieve population-level maternal and infant health benefits; however, a larger study is needed to validate this observed effect.
Role of collateral embolization in addition to uterine artery embolization followed by hysteroscopic curettage for the management of cesarean scar pregnancy
Authors: Zhang Guodong , Li Jijun , Tang Jun , Zhang Lei , Wang Dechao , Sun zengtao
Published: July 2019

Purpose

The aim of this study was to assess the feasibility, safety and outcome of the embolization of non-gonadal collateral supplying gestational sac (GS) in addition to uterine artery embolization (UAE), followed by hysteroscopic curettage for the management of cesarean scar pregnancy (CSP).

Methods

A retrospective study was undertaken from January 2012 to September 2018 in 24 CSP patients in whom non-gonadal collaterals supplying GS were identified by arterial angiography performed immediately after UAE. These patients underwent attempt collateral embolization in addition to UAE, followed by hysteroscopic curettage for the management of CSP. The 24 patients were divided into two groups based on whether they underwent technically successful collateral embolization (UAE-SCE group) or failed collateral embolization (UAE-FCE group) in addition to UAE. The baseline characteristics and clinical outcomes including time for serum β-human chorionic gonadotropin (β-hCG) levels normalization, blood loss, secondary anemia, and pelvic pain were compared between the two groups.

Results

Collateral embolization was techinically successful in 16 (66.7%, 16/24) patients and failed in the other 8 (33.3%, 8/24) patients. There were no significant differences between the two groups in baseline characteristics. The mean blood loss and secondary anemia in the UAE-SCE group were significantly less than UAE-FCE group. No significant difference was found between the two groups in the mean time for β-hCG levels normalization and pelvic pain.

Conclusions

Embolization of non-gonadal collateral supplying GS in addition to UAE, followed by hysteroscopic curettage for the management of CSP may be a feasible, safe and effective treatment in patients with non-gonadal collateral supplying GS, and the additional embolization of the collateral may reduce blood bloss related to hysteroscopic curettage.
Determinants of Low Birth Weight in Rural Areas of North West in Iran: 2013-2017 (A Case-Control Study)
Authors: Rafiemanesh Hosein , Aghdam Seyed Rasoul Hashemi , Safarzadeh Avaz , Chapar Sanaz , Zemestani Alireza , Safarpour Hamid
Published: July 2019

Background

Low birth weight (LBW) is one of the main causes of death in children and is an important factor related to the growth and development of children. LBW is associated with causes but some of the risk factors may be due to the country or geographical region. Aim of this study was conducted to investigate the risk factors associated with LBW in the villages of Oskou county, northwest of Iran.

Methods

This study is a population-based case-control study and all the cases of LBW, that have occurred during the five years 2013-2017 in all villages of Oskou county, East Azerbaijan Province, Iran. Controls were selevted based on systematic random sampling in that same village and year. Chi-square and fisher's exact test analysed and then a univariate and multivariate logistic regression model was used to investigate possible factors.

Results

In this study 242 cases and 242 control groups were analyzed. Base on multivariate logistic regression important risk factors were LBW history (OR=25.87), mothers who used natural methods of contraception (OR=29.54), twin's birth (OR=24.04) and gestational age less than 37 weeks (OR=3.89).

Conclusion

According to the result of the present study the most important risk factors of LBW are as follows: Contraception method using, having a history of previous LBW newborn, twin's birth, gestational age, fathers’ occupation, mothers’ education, maternal weight, maternal weight gain during pregnancy and number of of caring during pregnancy.
Postoperative outcomes of lung separation with double-lumen tubes and bronchial blockers
Authors: Yu Chia-Hung , Chen Yi-Chen , Chang Ying-Jen , Liang Fu-Wen , Chen Jen-Yin , Ho Chung-Han , Chu Chin-Chen
Published: July 2019

Objectives

The choice between a double-lumen tube (DLT) and a bronchial blocker (BB) for lung isolation remains controversial. The aim of this study was to determine if the features of these lung isolation devices affect postoperative pulmonary outcomes.

Methods

We retrospectively identified claims by patients who underwent surgery under lung isolation in 2000–2012 in the Taiwan National Health Insurance Research Database. After matching for age, sex, and year of surgery, 1898 patients were enrolled in the BB group and 5694 in the DLT group. The risks of readmission in the first postoperative year with pulmonary complications, in-hospital death, and one-year mortality were estimated using conditional logistic regression analysis.

Results

Patients in the BB group had higher risks of readmission with pulmonary infection (adjusted odds ratio [aOR], 1.46; 95% confidence interval [CI], 1.22–1.74), respiratory failure (aOR, 1.38; 95% CI, 1.09–1.76), in-hospital deaths (aOR, 2.03; 95% CI, 1.40–2.94), and one-year mortality rate (aOR, 1.94; 95% CI, 1.60–2.35) in the first postoperative year than did those in the DLT group after adjusting for the type of surgery, difficult airway condition, hospital accreditation level, and underlying comorbidity. Patients in the BB group had longer median (interquartile range) stays in the intensive care unit (1 [0–4] versus 1 [0–3] days, P < 0.001) and in hospital (16 [10–26] versus 13 [8–22] days, respectively, P < 0.001).

Conclusions

Patients undergoing thoracic surgery are more likely to experience postoperative pulmonary complications related to BB than to DLT.
Effects of methanandamide on human periodontal ligament cells
Authors: Zhang Fengqiu , Özdemir Burcu , Nguyen Phuong Quynh , Andrukhov Oleh , Rausch-Fan Xiaohui
Published: July 2019

Background

Endocannabinoid system is involved in the regulation of periodontal tissue homeostasis. Synthetic cannabinoid methanandamide (Meth-AEA) has an improved stability and affinity to cannabinoid receptors compared to its endogenous analogue anandamide. In the present study, we investigated the effect of methanandamide on the production of pro-inflammatory mediators in primary human periodontal ligament cells (hPdLCs).

Methods

hPdLCs were treated with Meth-AEA for 24 h and resulting production of interleukin (IL)-6, IL-8, and monocyte chemotactic protein (MCP)-1 was measured under normal condition as well as under inflammatory conditions mimicked by the presence of Porphyromonas gingivalis lipopolysaccharide (LPS). Additionally, the effect of Meth-AEA on the proliferation/viability of hPdLCs was measured by MTT method.

Results

Methanandamide at concentration of 10 µM significantly inhibited P. gingivalis LPS induced production of IL-6, IL-8, and MCP-1. Basal production of IL-6 and IL-8 was slightly enhanced by 10 µM Meth-AEA. No effect of Meth-AEA on the basal production of MCP-1 was observed. Proliferation/viability of hPdLCs was not affected by Meth-AEA in concentrations up to 10 µM and was significantly inhibited by 30 µM Meth-AEA.

Conclusion

Our study supports the influence of cannabinoid system on the inflammatory processes in periodontal tissue and its potential involvement in the progression of periodontal disease.
Vitamin D recommendations in nutritional guidelines: A systematic quality evaluation using AGREE-2 and analysis of potential predictors
Authors: Navarro David Fraile , López-García-Franco Alberto , Niño-de-Guzmán Ena , Pardo-Hernandez Hector , Aybar Carlos Canelo , Kuindersma Jesse , Saladich Ignasi Gich , Alonso-Coello Pablo
Published: July 2019

Background

Vitamin D has been widely promoted for bone health through supplementation and fortification of the general population. However, there is growing evidence that does not support these strategies. Our aim is to review the quality and recommendations on vitamin D nutritional and clinical practice guidelines and explore predictive factors for their direction and strength.

Methods

We searched Medline, TRIP, G-I-N and guidelines.gov databases for guidelines from January 2010 to January 2018. We performed a descriptive analysis, a quality appraisal using AGREE II scores (Appraisal of Guidelines Research and Evaluation) and a bivariate analysis evaluating the association between direction and strength of recommendations, three AGREE II domains’ scores (Rigor of development, Applicability and Editorial Independence) and pre-specified characteristics.

Results

We included 24 guidelines in our review. Nine recommended supplementations, eight suggested its use, and seven did not recommended it. AGREE II mean scores were 40.1% for “Rigor of development”, 34.5% for “Applicability, and 39.6% for “Editorial independence”. Guidelines with higher scores in these domains were less likely to recommend or suggest vitamin D supplementation (64% recommending against vs 29% suggesting for, and 27% recommending for; p=0.002, 52% vs 26% and 25%; p=0.003, 61% vs 35% and 24%; p=0.001, respectively). Guidelines with potential conflicts of interest were more likely to recommend or suggest vitamin D supplementation (likelihood ratio: p=0.018).

Conclusions

Policy makers, clinicians and patients should be aware that lower quality guidelines, and those reporting conflicts of interest are more likely to promote vitamin D supplementation. Guideline organizations should improve the quality of their recommendations’ development, and the management of conflicts of interest. Users and editors should be aware of these findings when using and appraising guidelines.
Factors associated with malnutrition in children <5 years in Western Kenya. A hospital based unmatched case control study
Authors: Ransom James Anthony , Gudu Edwin , Obonyo Mark , Omballa Victor , Oyugi Elvis , Kiilu Cecilia , Githuku Jane , Gura Zeinab
Published: July 2019

Background

Globally, under-nutrition accounts for >3 million deaths annually among children <5 years, with Kenya having ~35,000 deaths. We sought to identify factors associated with malnutrition in children aged <5 years in Western Kenya.

Methods

We conducted a hospital-based unmatched case-control study carried out between December 2016 and March 2017. Cases were defined as children aged 6-59 months with either z-score for weight-for-height, ≤-2SD or ≥+2SD; weight-for-age, ≤-2SD or ≥+2SD; or height-for-age of ≤-2SD. Controls were children aged 6-59 months with age-appropriate anthropometric measurements. Cases were consecutively recruited while systematic random sampling was used to select three controls. Unconditional logistic regression using backward elimination was used to identify independent associative factors using Epi-Info.

Results

A total 94 cases and 281 controls were recruited. Of the cases, 86% (81/94) were under-nourished. Mother not having attended ante-natal clinic (OR=7.9; 95% CI: 1.5-41.2), deworming (OR=0.8; 95% CI: 0.4-1.2) and pre-lacteal feeding (OR=1.8; 95% CI: 1.1-3.0) were associated with under-nutrition. Delayed developmental milestones (AOR=13.9; 95% CI: 2.8-68.6); low birth weight (AOR=3.3; 95% CI: 1.4-7.6) and paternal lack of formal education (AOR=4.9; 95% CI: 1.3-18.9) were independently associated with under-nutrition. Urban residence (OR=5.4; 95% CI: 0.5-68.8) and male gender (OR=2.7; 95% CI: 0.7-11.8) were associated with over-nutrition with age <12 months (AOR=6.8; 95% CI: 1.6-29.7) and family income >5,000 Kenya shillings (AOR=4.6; 95% CI: 1.2-17.8) being independently associated.

Conclusion

Proper pre-natal care, child feeding practices and deworming programs should be enhanced to reduce pediatric malnutrition.
Measuring Governance: Developing a Novel Metric for Assessing the Translation of Policies into Action in Nepal
Authors: Namirembe Grace , Shrestha Robin , Houser Robert , Ghosh Shibani , Baral Kedar , Davis Dale , Webb Patrick
Published: July 2019

Background

The Nutrition Governance Indicator (NGI) defines a first standardized approach to quantifying the ‘quality of governance’ in relation to national plans of action to accelerate improvements in nutrition. It was created in response to growing demand for evidence-based measures that reveal opportunities and challenges as nutrition-related policies on paper are translated into outcomes on the ground. Past efforts to measure ‘governance’, most notably the WHO’s Nutrition Governance Indicator and Hunger and Nutrition Commitment Index (HANCI) lack granularity below the national level, and failure to capture pinch points relating to necessary cross-sectoral actions.

The NGI addresses these caveats. This paper introduces the approach that underpins the NGI, discusses its methodology and demonstrates its application in the context of Nepal.

Methods

The NGI was developed using principal components analysis techniques. The resulting score was standardized to a more intuitive scale ranging from 0 to 100, and categorized into quintiles. Cronbach’s alpha was used to test for reliability in addition to testing for goodness of fit using confirmatory factor analysis methods. The data used to derive the index were obtained from 520 participants in the Policy and Science for Health, Agriculture and Nutrition (PoSHAN) study, a prospective and nationally representative longitudinal survey conducted across 21 districts and three agro-ecological zones of Nepal.

Results

The NGI passed validity tests with the exception of two fit indices. Two of the six domains passed the reliability test (Understanding nutrition and Collaboration), the Financial resources domain marginally passed at 0.70 criteria of Nunally, while the remaining domains need re-assessment to improve their reliability. The Nepal Health sector showed the most improvement in mean NGI score over a two-year period followed by the Agricultural sector. About half of all health sector representatives were more likely to have a high score compared to other sectors (OR 0.52, 95% CI 0.36 – 0.74).

Conclusion

Using two panels of data collected in Nepal, this paper has shown that policy-to-action translation can be quantified and applied to sub-national institutions. These findings underscore the practical utility of the index and its importance to the nutrition policy realm.
Parenchymal central nervous system involvement in aggressive B-cell lymphoma: retrospective analysis of clinical and MRI features in a Chinese population
Authors: Wu Yuchen , Wang Yaming , Sun Xuefei , Bai Xueyan , Qian Jun , Zhu Hong , Cui Qu , Xing Ruixian , Chen Yuedan , Liu Qing , Guo Jiayuan , Ji Nan , Sun Shengjun , Liu Yuanbo
Published: July 2019

Introduction

Secondary central nervous system lymphoma (SCNSL) was defined as secondary central nervous system (CNS) involvement in patients with systemic lymphoma. Parenchymal involvement of the CNS in aggressive B-cell lymphoma was rare and remains a diagnostic dilemma.

Materials and Methods

In our study, we retrospectively analyzed the clinical and magnetic resonance imaging (MRI) features of 26 parenchymal SCNSL patients. In addition, we compared MRI features between SCNSL and primary CNS lymphoma (PCNSL) patients after 1:1 propensity score matching.

Results

Among SCNSL patients, the median CNS relapse time was 3 months, and multiple lesions were found in 76.9% of the cases. In PCNSL, this percentage was 34.8% (p=0.023). None of the SCNSL patients and 11.5% of the PCNSL patients had solitary infratentorial lesions (p=0.011).

Conclusions

the majority of parenchymal involvement occurred within the first year of systemic lymphoma, in which mostly cases presenting with multiple and supratentorial locations, unlike what was found in PCNSL.
Case Identification of Mental Health and Related Problems in Children and Young People using the New Zealand Integrated Data Infrastructure
Authors: Bowden Nicholas , Gibb Sheree , Thabrew Hiran , Kokaua Jesse , Audas Richard , Merry Sally , Taylor Barry , Hetrick Sarah
Published: July 2019

Background

In a novel endeavour we aim to develop a clinically relevant case identification method for research into the mental health of children and young people in New Zealand using the Integrated Data Infrastructure (IDI). The IDI is a linked individual-level database containing New Zealand government and survey microdata.

Methods

We draw on diagnostic and pharmaceutical information contained within five secondary care service use and medication dispensing datasets to identify cases of mental health and related problems. A systematic classification and refinement of codes, including restrictions by age, was undertaken to assign cases into 13 different mental health problem categories. This process was carried out by a group of seven professionals (a clinical psychologist, one child and adolescent psychiatrist, two child psychiatrists/paediatricians and two research fellows). The case identification algorithm was applied to the New Zealand youth estimated resident population for the 2014/15 fiscal year.

Results

Over 84,000 unique individuals aged 0-24 with at least one specified mental health or related problem were identified using the case identification algorithm for the 2014/15 fiscal year. The most prevalent mental health problem subgroups were emotional problems (31,299 individuals), substance problems with (16,545), and disruptive behaviours (14,091). Overall the pharmaceutical collection was the largest source of case identification data (59,862).

Conclusion

This study demonstrates the value of utilising IDI data for mental health research, taking us beyond relying solely on diagnostic based incidence, while providing directions for future use, including further linkage of data to the IDI.