bluuebunny/crossref_metadata_2025 huggingface dataset:
Екологічні детермінанти стану стоматологічного здоров’я дитячого населення Українського Придунав’я
Authors: Denga O. V. , Velikov M. I. , Svetlichna O. M.
Published: October 2020

Загальновідомо, що стоматологічне здоров'я дітей визначає здоров'я дорослих, і є інтегральним показником загального благополуччя суспільства. Світовий досвід свідчить, що за умов застосування сучасних технологій первинної та вторинної профілактики поширеність багатьох стоматологічних захворювань може бути суттєво зменшена.

Мета дослідження – визначити екологічні детермінанти стану стоматологічного здоров’я дитячого населення Українського Придунав’я (на прикладі Ізмаїльського району).

Матеріали і методи. Дослідження виконано на базі відділу дитячої стоматології ДУ «Інститут стоматології НАМН України» протягом 2017–2019 рр. Було обстежено 300 дітей обох статей у віці 7; 12 та 15 років, які проживали у населених пунктах Ізмаїльського району. Проведено аналіз рівня еколого-гігієнічної безпеки у місцях проживання обстежених.

Результати досліджень та їх обговорення. Показано, що упродовж останніх 10 років зберігається тенденція до зростання частоти карієсу та гінгівітів серед дітей препубертатного віку та підлітків. Серед 6-річних дітей відзначалися більш високі рівні поширеності карієсу та патології пародонта серед хлопців – КПВз – (0,23±0,1) бала, КПВп – (0,23±0,1), РМА – (87,4±4,9)  %. Більш яскравими виглядають ці відмінності щодо стану зубів змінного прикусу: в дівчаток КПз – (3,8±1,0), у хлопців – (4,8±0,3) бала, КПп – відповідно (2,8±0,2) й (5,7±0,3) бала. Подібна картина спостерігається й у підлітків 12 років. У хлопців цього віку показник КПВз склав (2,6±0,3), а у дівчат – (1,8±0,2) бала, КПВп – відповідно (3,2±0,3) та (2,1±0,2) бала. Щодо показника РМА, то він серед дівчат складав (98,9±1,0) %, а серед хлопців – (104,3±1,8) %. З віком гендерні відмінності нівелювалися. Потребує пояснення, чому у дівчат-підлітків рівень КПВз сягав (4,5±0,3) року, а у хлопців – лише (2,0±0,2) року. Щодо КПВп, то цей показник склав у 15-річних дівчат – (2,2±0,2) року, а в хлопців – (5,3±0,4) (p<0,01). Поширення гінгівіту було більшим серед хлопців – (103,0±2,7) % (проти (17,3±0,9) % у дівчат). Питні води неоптимального мінерального складу споживали 41,7 % осіб, високий вміст рафінованих вуглеводів був притаманний раціонам 63,0 % обстежених дітей.

Висновки. До екологічних детермінант стану стоматологічного здоров’я дитячого населення Українського Придунав’я належать вживання фізіологічно неоптимальних питних вод та переважання у раціоні харчування рафінованих вуглеводів. Несприятливий вплив екологічних чинників на стоматологічне здоров'я дитячого населення посилюється з віком.
ВИВЧЕННЯ АМІНОКИСЛОТНОГО СКЛАДУ ЛИСТЯ КАБАЧКІВ
Authors: Iosypenko O. O. , Кyslychenko V. S. , Omelchenko Z. І.
Published: October 2020

Вступ. Рослини є джерелом майже 30 % амінокислот, які перебувають у вільному або зв’язаному стані. Поширеність амінокислот у рослинах та їх висока біологічна активність сприяють ефективній дії на організм як лікарської сировини, так і препаратів з неї.

Мета дослідження – вивчити якісний склад та визначити кількісний вміст амінокислот у листі кабачків трьох сортів для раціонального використання при виробництві фітопрепаратів або дієтичних добавок, передусім оздоровчого призначення.

Методи дослідження. Загальний амінокислотний склад листя кабачків визначали методом іонообмінної рідинно-колонної хроматографії.

Результати й обговорення. В усіх досліджуваних зразках сировини було виявлено по 18 амінокислот. Їх амінокислотний профіль достатньо однорідний за складом: 7 незамінних амінокислот, 3 напівзамінних та 8 замінних. Найбільший вміст суми амінокислот визначено в листі кабачків жовтоплодних (16,103 мг/100 мг), а найменший – у листі кабачків білоплодних (10,782 мг/100 мг). В усіх зразках досліджуваної сировини домінували глутамінова й аспарагінова кислоти, в значній кількості містились лейцин, аланін, лізин, аргінін, гліцин, пролін. Вміст у досліджуваній сировині суми незамінних амінокислот становив майже 1/3 від їх загальної суми (в листі кабачків білоплодних – 32,38 %, жовтоплодних – 32,71 %, зеленоплодних – 32,56 %). Серед незамінних амінокислот переважали лейцин, лізин, фенілаланін і треонін. Встановлено, що листя кабачків має достатньо високий показник амінокислотного скору за всіма незамінними амінокислотами і наближається до “ідеального” білка за вмістом валіну, лізину, лейцину та фенілаланіну. З’ясовано, що білок листя кабачків усіх досліджуваних сортів характеризується високою біологічною цінністю (61,27, 54,38 та 80,60 % відповідно).

Висновки. Методом іонообмінної рідинно-колонної хроматографії вивчено амінокислотний профіль листя кабачків трьох сортів. Встановлено, що склад амінокислот достатньо однорідний, а загальний їх вміст коливається в межах 10,782–16,103 мг/100 мг. Домінують глутамінова й аспарагінова кислоти, в значній кількості містяться лейцин, аланін, лізин, аргінін, гліцин, пролін. Результати проведених досліджень свідчать про досить високий і різноманітний вміст у листі кабачків амінокислот, які можуть поліпшувати збалансованість лікарських фітопрепаратів, дієтичних добавок на їх основі та дозволяють припустити наявність широкого спектра фармакологічної активності.
Polygenic Score for β-Blocker Survival Benefit in European Ancestry Patients With Reduced Ejection Fraction Heart Failure
Authors: Lanfear David E. , Luzum Jasmine A. , She Ruicong , Gui Hongsheng , Donahue Mark P. , O’Connor Christopher M. , Adams Kirkwood F. , Sanders-van Wijk Sandra , Zeld Nicole , Maeder Micha T. , Sabbah Hani N. , Kraus William E. , Brunner-LaRocca Hans-Peter , Li Jia , Williams L. Keoki
Published: October 2020

Background:

β-Blockers (BBs) are mainstay therapy for heart failure with reduced ejection fraction. However, individual patient responses to BB vary, which may be partially due to genetic variation. The goal of this study was to derive and validate the first polygenic response predictor (PRP) for BB survival benefit in heart failure with reduced ejection fraction patients.

Methods:

Derivation and validation analyses were performed in n=1436 total HF patients of European descent and with ejection fraction <50%. The PRP was derived in a random subset of the Henry Ford Heart Failure Pharmacogenomic Registry (n=248) and then validated in a meta-analysis of the remaining patients from Henry Ford Heart Failure Pharmacogenomic Registry (n=247), the TIME-CHF (Trial of Intensified Versus Standard Medical Therapy in Elderly Patients With Congestive Heart Failure; n=431), and HF-ACTION trial (Heart Failure: a Controlled Trial Investigating Outcomes of Exercise Training; n=510). The PRP was constructed from a genome-wide analysis of BB×genotype interaction predicting time to all-cause mortality, adjusted for Meta-Analysis Global Group in Chronic Heart Failure score, genotype, level of BB exposure, and BB propensity score.

Results:

Five-fold cross-validation summaries out to 1000 single-nucleotide polymorphisms identified optimal prediction with a 44 single-nucleotide polymorphism score and cutoff at the 30th percentile. In validation testing (n=1188), greater BB exposure was associated with reduced all-cause mortality in patients with low PRP score (n=251; hazard ratio, 0.19 [95% CI, 0.04–0.51];
P
=0.0075) but not high PRP score (n=937; hazard ratio, 0.84 [95% CI, 0.53–1.3];
P
=0.448)—a difference that was statistically significant (
P
interaction, 0.0235). Results were consistent regardless of atrial fibrillation, ejection fraction (≤40% versus 41%–50%), or when examining cardiovascular death.

Conclusions:

Among patients of European ancestry with heart failure with reduced ejection fraction, a PRP distinguished patients who derived substantial survival benefit from BB exposure from a larger group that did not. Additional work is needed to prospectively test clinical utility and to develop PRPs for other population groups and other medications.
Studies on Apoptosis and Mechanism of Curcumin Chitosan Induced Human Colon Cancer Cells in Colorectal Cancer
Authors: Wang Quanlan , Liao Peng , Wu Yinglin , Huang Yuanhua , Wu Yan , Xu Xinqun
Published: October 2020

To explore the function of curcumin chitosan on the proliferation of human colorectal cancer HT29 cells and to explore its effect on apoptosis. We applied MTT assay to test the inhibitory effect of curcumin chitosan on the proliferation of HT29 cells. The alterations of colorectal cancer
cell morphology were observed by optical microscope and electron microscope. The change of early apoptosis rate was determined by flow cytometry using Annexin-V/PI double staining. By Comparison with the control group, curcumin chitosan significantly suppressed the cell proliferation and promoted
cell apoptosis of HT29 cells in not only dose- but also time-dependent manner; through light microscopy and electron microscopy, the cell volume was reduced, the cell membrane was shrunk, chromatin was significantly concentrated. Typical apoptotic features such as aggregation; flow cytometry
confirmed a significant increase in apoptotic rates (p < 0 05).
Mechanism of Tripchlorolide Inhibiting Hedgehog Signaling Pathway to Delay Lung Fibrosis
Authors: Tan Shirui , Li Qingrong , Duan Feifei , Yuan Qingqing , Deng Gang
Published: October 2020

Background: The paper aimed to determine whether Tripchlorolide can exert anti-fibrotic effects by up-regulating Sufu to influence the Hedgehog signaling pathway, and to promote the application of Tripchlorolide in diseases associated with the Hedgehog signaling pathway. Material
and Methods: In vivo experiment, bronchoalveolar lavage was performed on the 7th day after intratracheal instillation of bleomycin. The number of inflammatory cells and IL-6 levels were analyzed to observe the anti-inflammatory effect of Tripchlorolide. The lung tissues were obtained
on the 14th day. The lung tissue injury was observed, and the expressions of a-SMA, collagen I, TGF-β i, Gli 1 and Sufu were determined. In vitro experiments, mouse lung was transfected with lentivirus to make fibroblasts. The Sufii was overexpressed, the changes in Gli 1 and Gli 2 levels
were observed. The effects of the overexpressed Sufti of on the phenotype transformed a-SMA and collagen I levels in TGF-β 1 induced mouse lung fibroblasts were observed. Results: After administration with bleomycin, IL-6 level, total number of cells, neutrophils and macrophages
in BALF of the Tripchlorolide group mice were reduced. The lung injury score, the expressions of lung tissue TGF-βl, a-SMA and Collagen I were low. The expression of Sufu was high, while the expression of Gli 1 was low. Compared with the groups in which cells were not transfected with
lentivirus, the expression of Sufu in the transfected cells increased, and the expressions of Gli 1 and Gli 2 decreased. After stimulation with TGF-β Sufu decreased. Conclusion: Tripchlorolide can inhibit Hedgehog signaling pathway by up-regulating Sufu to exert an anti-fibrotic
effect.
The Function and Molecular Mechanism of MicroRNA-429 in Rheumatoid Arthritis
Authors: Zhang Pengdong , Yu Bailong , Lei Bin , Li Changlin , Yuan Xiaoqiang
Published: October 2020

Objective: To explain the function and molecular mechanism of miRNA-429 in Rheumatoid Arthritis development. Methods: Collecting synovial tissue of 36 RA patients and 36 traumatic amputation patients, the miRNA-429 and TLR4 gene expressions were measured by RT-PCR. The
SD rats were divided into NC, 14 d Model and 28 d Model groups. The IL-1β and TNF-α concentrations of serum were measured by Elisa assay in difference rats groups; The synovial tissue pathology was evaluated by HE staining; the miRNA-429 gene expression of rats groups were measured
by RT-PCR, the TLR4 and NF-κB proteins expressions of rats groups were evaluated by IHC staining; the correlation between miRNA-429 and TLR4 were evaluated by Double luciferase assay. Results: Compared with normal synovial tissues, the miRNA-429 and TLR4 gene expression of synovial
tissues were significantly difference in RA patients. In rats vivo study, we found that IL-1 and TNF-α concentrations were significantly up-regulation with time increasing (P < 0 05, respectively); inflammation degree was serious by HE staining and miRNA-429 gene expression was significantly
reduced (P < 0.05, respectively); TLR4 and NF-κB proteins expressions were significantly up-regulation (P < 0.05, respectively) with time increasing; TLR4 was the target gene of miRNA-429 by Double luciferase assay. Conclusion: miRNA-429 over-expression stimulated RA development.
Nonmarket Responses to Regulation: A Signaling Theory Approach
Authors: Brown Lee Warren , Goll Irene , Rasheed Abdul A. , Crawford Wayne S.
Published: October 2020

We examine how regulatory intensity and increases in regulation affect the nonmarket activities of firms. Using a signaling theory perspective, we seek to better understand how firms respond to regulation in terms of corporate social responsibility (CSR) and corporate political activity (CPA), the two main pillars of nonmarket activity. Examination of both CSR and CPA in concert rather than in isolation provides insights into whether they are complements or substitutes. We use textual analysis of the US Code of Federal Regulations to measure regulatory intensity and increases in regulation. Based on a sample of 331 S&P 500 firms for the period 1998–2014, our findings suggest that regulatory intensity leads to more nonmarket responses from firms. We also find support for nonlinear relationships between CSR and CPA.
Ionizable polyol from cottonseed oil for anionic waterborne polyurethane-silanol dispersions
Authors: Gaddam Sashivinay Kumar , Palanisamy Aruna
Published: October 2020

A novel cottonseed oil-based ionizable polyol was introduced as ionic soft segment in waterborne polyurethane dispersion (PUD) synthesis. The ionizable polyol was synthesized by ring opening of epoxidized cottonseed oil (ECSO) with 4-aminobenzoic acid (PABA) and blended with hydroxylated cottonseed oil polyol (HCSO) in different weight ratios to develop a series of mixed polyols having different hydroxyl numbers viz., 146, 130 and 114 mg KOH/g. Three different PUDs were synthesized using the mixed polyols, isophorone diisocyanate, and 3-aminopropyltriethoxysilane. The chemical structure, thermo-mechanical properties, and surface properties of cured PUD films were examined using Fourier-transform infrared spectroscopy (FTIR), Dynamic mechanical thermal analysis (DMTA), universal testing machine (UTM) and contact angle measurements respectively. The effect of Si–O–Si cross-linking network density, which increases with an increase in OH values of the mixed polyol was also investigated. All the PUDs prepared in this study exhibited good storage stability (>4 months), and the average particle sizes of PUDs ranged from 18 to 124 nm. The highest hydroxyl mixed polyol derived PUD film (PUD-35 film) exhibited high thermal stability, mechanical strength; Tg value, water contact angle value, chemical, and abrasion resistance properties due to the extended siloxane cross-link network structure. The introduction of ionizable polyol into the soft segment led to an improvement in hard and soft segment phase mixing of PUDs, and this strategy could enrich the exploration of new synthetic methodologies in the field of bio-based PUD manufacturing.
Infectious etiologies of genital elephantiasis outside of filariasis endemic regions: a case report
Authors: Kharbach Youssef , Bakali Issaoui Zakaria , Retal Youssef , Khallouk Abdelhak
Published: October 2020

Background

Isolated genital elephantiasis outside filariasis endemic tropical and subtropical regions is rare and presents a diagnostic and therapeutic challenge. Serologic and radiographic investigation must be undertaken to exclude reversible causes of genital elephantiasis.

Case presentation

Authors report herein the case of a 58-year-old patient with chronic penile and scrotal elephantiasis. He had a history of untreated urethritis and an endoscopic urethrotomy for urethra stricture three years ago. Serological test for chlamydiosis was positive. Retrograde urethrocystography demonstrated a bulbar urethra stricture. The patient spectacularly and completely improved after endoscopic urethrotomy and long-term doxycycline.

Conclusions

Early treatment of sexual transmitted infections such as chlamydiosis is important to prevent the evolution of penoscrotal elephantiasis and to avoid surgical procedures.
Non-target screening for detecting the occurrence of plant metabolites in river waters
Authors: Nanusha Mulatu Yohannes , Krauss Martin , Brack Werner
Published: October 2020

Background

In surface waters, using liquid chromatography coupled to high resolution mass spectrometry (LC-HRMS), typically large numbers of chemical signals often with high peak intensity remain unidentified. These chemical signals may represent natural compounds released from plants, animals and microorganisms, which may contribute to the cumulative toxic risk. Thus, attempts were made to identify natural compounds in significant concentrations in surface waters by identifying overlapping LC-HRMS peaks between extracts of plants abundant in the catchment and river waters using a non-target screening (NTS) work flow.

Results

The result revealed the presence of several thousands of overlapping peaks between water—and plants from local vegetation. Taking this overlap as a basis, 12 SPMs from different compound classes were identified to occur in river waters with flavonoids as a dominant group. The concentrations of the identified compounds ranged from 0.02 to 5 µg/L with apiin, hyperoside and guanosine with highest concentrations. Most of the identified compounds exceeded the threshold for toxicological concern (TTC) (0.1 µg/L) for non-genotoxic and non-endocrine disrupting chemicals in drinking water often by more than one order of magnitude.

Conclusion

Our results revealed the contribution of chemicals eluted from the vegetation in the catchment to the chemical load in surface waters and help to reduce the number of unknowns among NTS high-intensity peaks detected in rivers. Since secondary plant metabolites (SPMs) are often produced for defence against other organisms and since concentrations ranges are clearly above TTC a contribution to toxic risks on aquatic organisms and impacts on drinking water safety cannot be excluded. This demands for including these compounds into monitoring and assessment of water quality.
Emotional experiences and coping strategies of nursing and midwifery practitioners in Ghana: a qualitative study
Authors: Lartey Joshua King Safo , Osafo Joseph , Andoh-Arthur Johnny , Asante Kwaku Oppong
Published: October 2020

Background

Emotional regulation forms an integral part of healthcare delivery. In the performance of the core duties of nursing and midwifery, health professionals are expected to enhance occupationally/organisationally required emotions. The purpose of this study is to explore.

The meaning nurses and midwives give to emotional labour as well as the coping resources employed by these professionals in order to manage the emotional demands of their profession.

Method

A qualitative study was conducted using a semi-structured interview guide with fifteen (15) purposively selected nurses and midwives. Interviews were recorded and simultaneously translated and transcribed. Thematic analysis was used to analyse the data.

Results

Our findings showed that participants conceptualized emotional labour as display of rules. Sadness, abuse and bullying, poor incentivisation, emotional exhaustion and emotional mix bag were reported by the participants as emotional demands and deficits. Nurses and midwives coped with emotional labour through the use of five (5) main resources: psychological capital, routinisation of emotions, religious resources, social support and job security.

Conclusion

Nursing and midwifery professional duties are accompanied with emotional regulations which tend to have consequential effects on a myriad of work-related issues. Clinical healthcare training needs to intensify and equip professionals with the skills of regulating and managing their emotions since managing emotional demands are central to effective healthcare delivery.
Vitamin B6, vitamin B12 and methionine and risk of pancreatic cancer: a meta-analysis
Authors: Wei Dan-Hong , Mao Qi-Qi
Published: October 2020

Background

Nutrients involved in one-carbon metabolism may play a key role in pancreatic carcinogenesis. The aim of this study was to examine the association between pancreatic cancer risk and intake or blood levels of vitamins B6, B12 and methionine via meta-analysis.

Methods

A systematic search was performed in PubMed, Web of Knowledge and Chinese National Knowledge Infrastructure (CNKI) up to April 2020 to identify relevant studies. Risk estimates and their 95% confidence intervals (CIs) were retrieved from the studies and combined by a random-effect model.

Results

A total of 18 studies were included in this meta-analysis on the association of vitamin B6, B12 and methionine with pancreatic cancer risk. The combined risk estimate (95% CI) of pancreatic cancer for the highest vs lowest category of vitamin B6 intake and blood pyridoxal 5′-phosphate (PLP, active form of vitamin B6) levels was 0.63 (0.48–0.79) and 0.65 (0.52–0.79), respectively. The results indicated a non-linear dose-response relationship between vitamin B6 intake and pancreatic risk. Linear dose–response relationship was found, and the risk of pancreatic cancer decreased by 9% for every 10 nmol/L increment in blood PLP levels. No significant association were found between pancreatic cancer risk and vitamin B12 intake, blood vitamin B12 levels, methionine intake and blood methionine levels.

Conclusion

Our study suggests that high intake of vitamin B6 and high concentration of blood PLP levels may be protective against the development of pancreatic cancer. Further research are warranted to confirm the results.
Dietary approaches to stop hypertension (DASH) score and obesity phenotypes in children and adolescents
Authors: Rahimi Hamed , Yuzbashian Emad , Zareie Rahim , Asghari Golaleh , Djazayery Abolghassem , Movahedi Ariyo , Mirmiran Parvin
Published: October 2020

Background

The prevalence of obesity and its two important phenotypes, the metabolically healthy obese (MHO) and the metabolically unhealthy obese (MUO) are 10.9, 9.1, and 1.8%, respectively, among children and adolescents in Iran. Data on the link between diet quality indices and obesity phenotypes in children and adolescents is scarce. The present study aimed to assess the association of the Dietary Approaches to Stop Hypertension (DASH) score with MHO and MUO, as well as with cardiometabolic risk factors (RFs) in children and adolescents with excess weight.

Methods

This cross-sectional study was conducted on 341 children and adolescents with excess weight aged 6–13 years, selected from primary schools of Tehran. The DASH score was determined based on eight components using a valid and reliable food frequency questionnaire. Anthropometric measures, insulin, fasting plasma glucose, lipid profile, and physical activity levels were collected. MUO was classified based on two definitions: having 2 or more cardiometabolic RFs, or being insulin resistant determined by a homeostatic model assessment of insulin resistance (HOMA-IR) ≥ 3.16. Multivariable logistic regression models were used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for MUO phenotypes and cardiometabolic RFs in each tertile of the DASH score after adjustment for confounders.

Results

The mean ± SD for age and DASH score was 9.3 ± 1.7 years and 24.0 ± 4.9, respectively. The prevalence of MUO was 62.2% based on RFs, and 43.4% based on HOMA-IR. Participants in the highest tertile of the DASH score had significantly decreased odds for MUO based on HOMA-IR (OR = 0.49; 95% CI: 0.28–0.87) compared with those in the lowest tertile, after adjustment for confounders. However, there were no associations between the DASH score and any of cardiometabolic RFs, or MUO based on RFs (OR = 0.68; 95% CI: 0.38–1.20).

Conclusion

The DASH score was inversely associated with MUO based on HOMA-IR, but not associated with MUO based on cardiometabolic RFs in this sample of children and adolescents. A DASH-style diet may have favourable effects on insulin sensitivity among children and adolescents with excess weight. Universal definitions for MHO/MUO are required, and longitudinal studies recommended to shed light upon this subject.
Consequences of the COVID-19 pandemic on the continuum of care in a cohort of people living with HIV followed in a single center of Northern Italy
Authors: Quiros-Roldan Eugenia , Magro Paola , Carriero Canio , Chiesa Annacarla , El Hamad Issa , Tratta Elena , Fazio Raffaella , Formenti Beatrice , Castelli Francesco
Published: October 2020

Introduction

During the COVID-19 pandemic, hospitals faced increasing pressure, where people living with HIV risked to either acquire SARS-CoV-2 and to interrupt the HIV continuum of care.

Methods

This is a retrospective, observational study. We compared the numbers of medical visits performed, antiretroviral drugs dispensed and the number of new HIV diagnosis and of hospitalizations in a cohort of people living with HIV (PLWH) followed by the Spedali Civili of Brescia between the bimester of the COVID-19 pandemic peak and the bimester of October–November 2019. Data were retrieved from administrative files and from paper and electronic clinical charts. Categorical variables were described using frequencies and percentages, while continuous variables were described using mean, median, and interquartile range (IQR) values. Means for continuous variables were compared using Student’s t-tests and the Mann–Whitney test. Proportions for categorical variables were compared using the χ2 test.

Results

As of December 31st, 2019, a total of 3875 PLWH were followed in our clinic. Mean age was 51.4 ± 13 years old, where 28% were females and 18.8% non-Italian. Overall, 98.9% were on ART (n = 3834), 93% were viro-suppressed. A total of 1217 and 1162 patients had their visit scheduled at our out-patient HIV clinic during the two bimesters of 2019 and 2020, respectively. Comparing the two periods, we observed a raise of missed visits from 5 to 8% (p < 0.01), a reduction in the number of new HIV diagnosis from 6.4 in 2019 to 2.5 per month in 2020 (p = 0.01), a drop in ART dispensation and an increase of hospitalized HIV patients due to COVID-19. ART regimens including protease inhibitors (PIs) had a smaller average drop than ART not including PIs (16.6 vs 21.6%, p < 0.05). Whether this may be due to the perception of a possible efficacy of PIs on COVID19 is not known.

Conclusions

Our experience highlights the importance of a resilient healthcare system and the need to implement new strategies in order to guarantee the continuum of HIV care even in the context of emergency.
Controlled manual loading of body tissues: towards the next generation of pressure algometer
Authors: Evans Davidk W. , De Nunzio Alessandro Marco
Published: October 2020

Assessing the responses of body tissue subjected to mechanical load is a fundamental component of the clinical examination, psychophysical assessments and bioengineering research. The forces applied during such assessments are usually generated manually, via the hands of the tester, and aimed at discreet tissue sites. It is therefore desirable to objectively quantify and optimise the control of manually applied force. However, current laboratory-grade manual devices and commercial software packages, in particular pressure algometer systems, are generally inflexible and expensive. This paper introduces and discusses several principles that should be implemented as design goals within a flexible, generic software application, given currently available force measurement hardware. We also discuss pitfalls that clinicians and researchers might face when using current pressure algometer systems and provide examples of these. Finally, we present our implementation of a pressure algometer system that achieves these goals in an efficient and affordable way for researchers and clinicians. As part of this effort, we will be sharing our configurable software application via a software repository.
Epithelioid trophoblastic tumor coexisting with choriocarcinoma around an abdominal wall cesarean scar: a case report and review of the literature
Authors: Yang Chunfeng , Li Jianqi , Zhang Yuanyuan , Xiong Hanzhen , Sheng Xiujie
Published: October 2020

Background

Mixed gestational trophoblastic neoplasms are extremely rare and comprise a group of fetal trophoblastic tumors including choriocarcinomas, epithelioid trophoblastic tumors, and placental site trophoblastic tumors. We present a case of a patient with extrauterine mixed gestational trophoblastic neoplasm adjacent to the abdominal wall cesarean scar. On the basis of a literature review, this type of case has never been reported before due to the unique lesion location and low incidence.

Case presentation

Our patient was a 39-year-old Chinese woman who had a history of two cesarean sections and one miscarriage. She had a recurrent anterior abdominal wall mass around her cesarean scar, and the mass was initially suspected of being choriocarcinoma of unknown origin. The patient had concomitant negative or mildly increased serum β-human chorionic gonadotropin at follow-up and no abnormal vaginal bleeding or abdominal pain. However, she underwent local excision twice and had two courses of chemotherapy with an etoposide and cisplatin regimen. She finally opted for exploratory laparotomy with abdominal wall lesion removal, subtotal hysterectomy, bilateral salpingectomy, and left ovarian cyst resection, which showed the abdominal wall lesion, whose components were revealed by microscopy and immunohistochemical staining to be approximately 90% epithelioid trophoblastic tumors and 10% choriocarcinomas from a solely extrauterine mixed gestational trophoblastic neoplasm around an abdominal wall cesarean scar.

Conclusions

It is worth noting whether epithelioid trophoblastic tumor exists in the setting of persistent positive low-level β-human chorionic gonadotropin. More studies are required to provide mechanistic insights into these mixed gestational trophoblastic neoplasms.
Impact of early postoperative oral nutritional supplement utilization on clinical outcomes in colorectal surgery
Authors: Williams David G. A. , Ohnuma Tetsu , Krishnamoorthy Vijay , Raghunathan Karthik , Sulo Suela , Cassady Bridget A. , Hegazi Refaat , Wischmeyer Paul E.
Published: October 2020

Background

Small randomized trials of early postoperative oral nutritional supplementation (ONS) suggest various health benefits following colorectal surgery (CRS). However, real-world evidence of the impact of early ONS on clinical outcomes in CRS is lacking.

Methods

Using a nationwide administrative-financial database (Premier Healthcare Database), we examined the association between early ONS use and postoperative clinical outcomes in patients undergoing elective open or laparoscopic CRS between 2008 and 2014. Early ONS was defined as the presence of charges for ONS before postoperative day (POD) 3. The primary outcome was composite infectious complications. Key secondary efficacy (intensive care unit (ICU) admission and gastrointestinal complications) and falsification (blood transfusion and myocardial infarction) outcomes were also examined. Propensity score matching was used to assemble patient groups that were comparable at baseline, and differences in outcomes were examined.

Results

Overall, patients receiving early ONS were older with greater comorbidities and more likely to be Medicare beneficiaries with malnutrition. In a well-matched sample of early ONS recipients (n= 267) versus non-recipients (n= 534), infectious complications were significantly lower in early ONS recipients (6.7% vs. 11.8%,P< 0.03). Early ONS use was also associated with significantly reduced rates of pneumonia (P< 0.04), ICU admissions (P< 0.04), and gastrointestinal complications (P< 0.05). There were no significant differences in falsification outcomes.

Conclusions

Although early postoperative ONS after CRS was more likely to be utilized in elderly patients with greater comorbidities, the use of early ONS was associated with reduced infectious complications, pneumonia, ICU admission, and gastrointestinal complications. This propensity score-matched study using real-world data suggests that clinical outcomes are improved with early ONS use, a simple and inexpensive intervention in CRS patients.
Duration of orthodontic treatment with fixed appliances in adolescents and adults: a systematic review with meta-analysis
Authors: Abbing Allen , Koretsi Vasiliki , Eliades Theodore , Papageorgiou Spyridon N.
Published: October 2020

Objectives

Adults with fixed orthodontic appliances are increasing nowadays. Compared with adolescents, adults present biological differences that might influence treatment duration. Therefore, the aim of the study was to compare duration of treatment with fixed appliances between adults and adolescents.

Materials and methods

Eight databases were searched up to September 2019 for randomized and non-randomized clinical studies comparing treatment duration with fixed appliances in adolescents and adult patients. After duplicate study selection, data extraction, and risk of bias assessment with the Cochrane ROBINS-I tool, random effects meta-analyses of mean differences (MD) and their 95% confidence intervals (CIs) were performed, followed by assessment of the quality of evidence with GRADE.

Results

A total of 11 unique studies (one prospective and 10 retrospective non-randomized) with 2969 adolescents and 1380 adult patients were finally included. Meta-analysis of 7 studies found no significant difference in the duration of comprehensive treatment with fixed appliances (MD = − 0.8 month; 95% CI = − 4.2 to 2.6 months; P = 0.65; I2 = 92%) between adults and adolescents. Similarly, both distalization of upper first molars with skeletal anchorage for class II correction and the retraction of canines into the premolar extraction spaces lasted similarly long among adults and adolescents. On the other hand, alignment of palatally displaced canines lasted considerably longer in adults compared to adolescents (1 study; MD = 3.8 months; 95% CI = 1.4 to 6.2 months; P = 0.002). The quality of evidence for the meta-analysis was low due to the inclusion of non-randomized studies with considerable risk of bias.

Conclusions

While existing evidence does not indicate a difference in the overall duration of treatment with fixed appliances between adults and adolescents, the alignment of palatally displaced canines lasted significantly longer in adults. However, our confidence in these estimates is low due to the risk of bias in the included studies.

Trial registration

PROSPERO: (CRD42019148169)
Factors contributing to longer length of stay in Aboriginal and Torres Strait Islander children hospitalised for burn injury
Authors: Ryder Courtney , Mackean Tamara , Hunter Kate , Towers Kurt , Rogers Kris , Holland Andrew J. A. , Ivers Rebecca
Published: October 2020

Background

Aboriginal and Torres Strait Islander children have higher incidence, severity and hospital length of stay for their acute burn injuries than other Australian children. We examined factors contributing to longer length of stay for Aboriginal and Torres Strait Islander children with an acute burn injury.

Methods

Burns Registry of Australia and New Zealand admissions of children < 16 years of age between October 2009 and July 2018 were analysed. Descriptive statistics explored patient and injury characteristics; Cox-regression models estimated characteristics associated with longer length of stay. Knowledge Interface methodology and Indigenous research methods were used throughout.

Results

A total of 723 children were identified as Aboriginal and Torres Strait Islander and 6257 as other Australian. The median hospital length of stay for Aboriginal and Torres Strait Islander children (5 days [CI 5–6]) was 4 days longer than other Australian children (1 day [CI 1–2]). Remoteness, flame burns, high percentage total body surface area (%TBSA) and full thickness burns were factors associated with longer length of stay for Aboriginal and Torres Strait Islander children. Similar prognostic factors were identified for other Australian children along with Streptococcus sp. and Staphylococcus sp. infection.

Conclusion

Remoteness, flame burns, %TBSA, and full thickness burns are prognostic factors contributing to extended hospital length of stay for all Australian children. These factors are more prevalent in Aboriginal and Torres Strait Islander children, impacting length of stay. Treatment programs, clinical guidelines, and burns policies should engage with the unique circumstances of Aboriginal and Torres Strait Islander children to mitigate inequities in health.
Infant and child health status ahead of implementation of an integrated intervention to improve nutrition and survival: a cross-sectional baseline assessment
Authors: Odjidja Emmanuel Nene , Hakizimana Sonia , Gatasi Ghislaine , Masabo Jean-Berchmans , Irakoze Gildas , Muzungu Heritier , Murorunkwere Honorine , Ngabirano Leila Raissa , Elkasabi Mahmoud , De Courten Barbora
Published: October 2020

Background

Burundi has one of the poorest child health outcomes in the world. With an acute malnutrition rate of 5% and a chronic malnutrition rate of 56%, under five death is 78 per 1000 live births and 47 children for every 1000 children will live until their first birthday. In response to this grim statistics, Village Health Works, a Burundian-American organisation has invested in an integrated clinical and community intervention model to improve child health outcomes. The aim of this study is to measure and report on child health indicator ahead of implementing this model.

Methods

A cross sectional design was employed, adopting the Demographic Health Survey methodology. We reached out to a sample of 952 households comprising of 2675 birth, in our study area. Mortality data was analysed with R package for mortality computation and other outcomes using SPSS. Principal component analysis was used to classify households into wealth quintiles. Logistic regression was used to assess strength of associations and significance of association was considered at 95% confidence level.

Results

The incidence of low birth weight (LBW) was 6.4% at the study area compared to 10% at the national level with the strongest predictor being malnourished women (OR 1.4 95%CI 1.2–7.2 p = 0.043). Fever incidence was higher in the study area (50.5%) in comparison to 39.5% nationally. Consumption of minimum acceptable diet was showed a significant protection against fever (OR 0.64 95%CI 0.41–0.94 p = 0.042). Global Acute Malnutrition rate was 7.6% and this significantly reduced with increasing age of child. Under-five mortality rate was 32.1 per 1000 live births and infant mortality was 25.7 per 1000 in the catchment with most deaths happening within the first 28 days of life (57.3%).

Conclusion

Improving child health status is complex, therefore, investing into an integrated intervention for both mother and child could yield best results. Given that most under-five deaths occurred in the neonatal period, implementing integrated clinical and community newborn care interventions are critical.
Cost-benefit analysis of trading strategies in the stock index futures market
Authors: Xiong Xiong , Cui Yian , Yan Xiaocong , Liu Jun , He Shaoyi
Published: October 2020

With the introduction of many derivatives into the capital market, including stock index futures, the trading strategies in financial markets have been gradually enriched. However, there is still no theoretical model that can determine whether these strategies are effective, what the risks are, and how costly the strategies are. We built an agent-based cross-market platform that includes five stocks and one stock index future, and constructed an evaluation system for stock index futures trading strategies. The evaluation system includes four dimensions: effectiveness, risk, occupation of capital, and impact cost. The results show that the informed strategy performs well in all aspects. The risk of the technical strategy is relatively higher than that of the other strategies. Moreover, occupation of capital and impact cost are both higher for the arbitrage strategy. Finally, the wealth of noise traders is almost lost.
An experience of subglottic airway foreign body removal in a patient under tracheal intubation: a case report
Authors: Tanaka Shiori , Yoshida Keisuke , Muramatsu Kenichi , Yamagishi Shigeki , Obara Shinju , Watanabe Kazuhiro
Published: October 2020

Background

Removal of an airway foreign body is challenging to anesthesiologists. We report successful removal of an extremely rare foreign body between a tracheal tube and the trachea in patients under tracheal intubation.

Case presentation

A 57-year-old male received total aortic arch replacement and postoperative mechanical ventilation. An airway foreign body was detected just below the glottis, outside the tracheal tube during mechanical ventilation after surgery in the intensive care unit. Before the removal procedure, we planned multiple strategies to cope with unexpected airway and breathing troubles. As a result, the foreign body was successfully removed orally by using a bronchial fiber, without extubation of the tracheal tube, under general anesthesia with dexmedetomidine and ketamine.

Conclusions

We reported the successful removal of a foreign body in the subglottic airway of a patient under tracheal intubation.
Management of cesarean section in a patient with Fontan circulation: a case report of dramatic reduction of maternal oxygen consumption after delivery
Authors: Saito Kazutomo , Toyama Hiroaki , Okamoto Atsushi , Yamauchi Masanori
Published: October 2020

Background

The anesthetic management of cesarean sections in Fontan-palliated parturients requires strict hemodynamic control. However, patient management with central venous oxygen saturation (ScvO2) and oxygen consumption (VO2) has never been reported.

Case presentation

A 30-year-old woman, who had received a total cavopulmonary connection for tricuspid atresia, was planned to undergo cesarean section at 38 weeks’ gestation. During combined spinal-epidural anesthesia, ScvO2 in addition to arterial pressure-based cardiac output (APCO) and central venous pressure (CVP) was monitored, and the change of VO2 was evaluated. After delivery, her APCO was almost unchanged. However, her ScvO2 increased dramatically from 42.1 to 67.3% and her CVP increased from 9 to 11 mm Hg. The calculated mean maternal VO2 changed from 443 to 295 mL/min.

Conclusions

In a cesarean section for a Fontan-palliated parturient, ScvO2 dramatically increased and maternal VO2 decreased by more than 25% after delivery.
Etiology of community-acquired pneumonia in adults: a systematic review
Authors: Shoar Saeed , Musher Daniel M.
Published: October 2020

Background

The etiology of community-acquired pneumonia (CAP) has evolved since the beginning of the antibiotic era. Recent guidelines encourage immediate empiric antibiotic treatment once a diagnosis of CAP is made. Concerns about treatment recommendations, on the one hand, and antibiotic stewardship, on the other, motivated this review of the medical literature on the etiology of CAP.

Methods

We conducted a systematic review of English-language literature on the etiology of CAP using methods defined by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched PubMed using a combination of the keywords ‘pneumonia’, ‘CAP’, ‘etiology’, ‘microbiology’, ‘bacteriology’, and ‘pathogen’. We examined articles on antibiotics that were develop to treat pneumonia. We reviewed all ‘related articles’ as well as studies referenced by those that came up in the search. After we excluded articles that did not give sufficient microbiological data or failed to meet other predetermined criteria, 146 studies remained. Data were stratified into diagnostic categories according to the microbiologic studies that were done; results are presented as the percentage in each category of all cases in which an etiology was established.

Results

Streptococcus pneumoniae remains the most common cause of CAP although declining in incidence; this decline has been greater in the US than elsewhere. Haemophilus influenzae is the second most common cause of CAP, followed by Staphylococcus aureus and Gram negative bacilli. The incidence of all bacteria as causes of CAP has declined because, with routine use of PCR for viruses, the denominator, cases with an established etiology, has increased. Viruses were reported on average in about 10% of cases, but recent PCR-based studies identified a respiratory virus in about 30% of cases of CAP, with substantial rates of viral/bacterial coinfection.

Conclusion

The results of this study justify current guidelines for initial empiric treatment of CAP. With pneumococcus and Haemophilus continuing to predominate, efforts at antibiotic stewardship might be enhanced by greater attention to the routine use of sputum Gram stain and culture. Because viral/bacterial coinfection is relatively common, the identification of a virus by PCR does not, by itself, allow for discontinuation of the antibiotic therapy.
Quality control of the traditional herbs and herbal products: a review
Authors: Balekundri Amruta , Mannur Vinodhkumar
Published: October 2020

Background

Herbal medicinal material and product need is increasing, and with this increase in the need, it is very much an essential requirement to maintain the quality of them.

Main body

The quality of the herbals is altered by various physical, chemical, and geographical aspects which contribute to the quality of these materials. Apart from that, adulteration is also an increasing concern when it comes to herbal material quality. Various chemical and phytochemical test, analytical techniques, and hyphenated analytical techniques are used for determining the quality aspects of the herbal materials in the herbal pharmaceuticals.

Conclusion

These techniques can be used as quality control tool in assessing the quality of herbal materials and herbal pharmaceuticals.
Method for obtaining response functions from noisy magnetotelluric data using frequency-domain independent component analysis
Authors: Sato Shinya , Goto Tada-Nori , Kasaya Takafumi , Ichihara Hiroshi
Published: October 2020

The magnetotelluric (MT) method has been used for visualizing subsurface resistivity structures and more recently for monitoring resistivity changes. However, electromagnetic data often include cultural noise, which can cause errors in the estimation of MT response functions and subsurface resistivity structure analysis. Frequency-domain independent component analysis (FDICA) offers advantages for MT data processing particularly because this method can extract hidden components in the observed data. These components can be decomposed into natural MT signals and cultural noise so that the noise effect in the recovered MT data is reduced. FDICA is applied to MT data acquired at the Kakioka Magnetic Observatory in Japan. The apparent resistivity and phase curves are obtained with small estimated errors between periods of 7 and 12,000 s, although the length of the time-series data is limited. The curves are smoother than those obtained using a conventional method. Various types of synthetic noise are added to the time series at Kakioka to test the noise-reduction performance of FDICA for MT data with high noise contamination. The results demonstrate that FDICA can be used to estimate MT response functions with high accuracy even under conditions in which more than half of the time-series data are contaminated by noise.