bluuebunny/crossref_metadata_2025 huggingface dataset:
Availability and affordability of essential medicines and diagnostic tests for diabetes mellitus in sub-Saharan Africa: A systematic review.
Authors: KIBIRIGE Davis , Sanya Richard E , Sekitoleko Isaac , Katende David , Atuhe David , Milln Jack , Schwartz Jeremy I , Nyirenda Moffat J
Published: March 2020

Background Currently, sub-Saharan Africa (SSA) is experiencing a steady increase in the prevalence of diabetes mellitus (DM) coupled with a prevailing high burden of communicable diseases. To effectively address this burgeoning burden of DM, optimal access to affordable essential medicines and diagnostic tests for DM in healthcare systems should be prioritised. We conducted a systematic review of the evidence on the availability and affordability of essential medicines and diagnostic tests for DM in SSA as recommended by the World Health Organization Package of Essential Non-communicable Disease Interventions for Primary Health Care in Low-Resource Settings. Methods PubMed, Science Direct and African Journals Online databases were searched for original research articles conducted in sub-Saharan Africa and published between 2000 and 2018 reporting availability and affordability of essential medicines and diagnostic tests for diabetes mellitus. Results Twenty one original cross-sectional studies were included in the systematic review, with the majority conducted in Eastern Africa (n=11, 58%). The availability of essential medicines and diagnostic tests was largely sub-optimal. For oral hypoglycaemic agents and insulin, angiotensin-converting-enzyme inhibitors, statins and aspirin, availability ranged from 0-100%, 0-96.5%, 0-84% and 53%-100% respectively. Considering diagnostic tests, availability of blood glucose tests, urine protein and ketone tests, serum creatinine tests, lipid profile tests and electrocardiography ranged from 6-100%, 33.3-100%, 0-86.4%, 0-65.9% and 5.7-54.6% respectively. The lowest priced generic (LPG) glibenclamide, metformin and aspirin cost <1.2 days’ wages. However, the cost of LPG insulin (any type), captopril and simvastatin ranged from 3.85-18.7 days’ wages, 1.2-6.41 days’ wages and 6.5-30 days’ wages respectively. Blood glucose tests, urine protein and ketone tests and serum creatinine tests cost <3.3 days’ wages. Conclusions Optimal access to affordable essential medicines and diagnostic tests for DM remains a significant challenge in SSA. This represents a significant barrier towards the attainment of sustainable development goals and universal health coverage. Pragmatic region-specific solutions are urgently needed to address this challenge.
Comparison of the effectiveness of the piston-pump method versus the pressure-infusor method for rapid infusion of fluids
Authors: Hashimoto Wataru , Takenaka Ichiro , Yasunami Keisuke , Minami Tomoko
Published: March 2020

Background The piston-pump method is a simple method for rapid administration of fluids. However, some problems regarding effectiveness in increasing the flow rate of fluid administration, occurrence of excessive pressure in the infusion circuit and vessel, and bacterial contamination of fluids are unsolved. We compared the effectiveness of using the piston-pump method with that of the pressure-infusor method.Methods Twelve anesthesiologists were classified randomly into the piston-pump and pressure-infusor groups. They were asked to infuse 500 ml of 0.9% saline three times successively through a 16-G intravenous cannula as rapidly as possible using a pump with a 50-ml syringe or a pressure-infusor at 300 mmHg. The time taken for infusion, the pressure in the infusion circuit and substitute vessel, and bacterial contamination were examined. Results The infusion time (mean ± SD) in the pressure-infusor and piston-pump groups was 233 ± 19 s and 301 ± 48 s, respectively (P < 0.01). There was a significant difference in the infusion time at the first and third attempts of infusion only in the piston-pump group (P < 0.05). The pressure (in mmHg) in the circuit was 131 ± 9 and > 200 (P < 0.01) and in the substitute vessel was 5 ± 1 and 17 ± 7 (P < 0.01) in the pressure-infusor and piston-pump groups, respectively. A pressure of -200 mmHg or less occurred at all infusion attempts in the piston-pump group. Bacterial infection was not observed in either group. Conclusions If fluids must be administered rapidly, use of the pressure-infusor is more efficient than the piston-pump method because the latter is less effective in infusing fluids rapidly and associated with excessive positive and negative pressure in the infusion circuit. However, this method should be considered as first aid until a commercially available rapid transfusion and infusion system has been prepared.
Quantitative Assessment of Renal Function In Children with UPJO By Contrast-enhanced Ultrasound: A Pilot Study
Authors: Chen Shuofan , Lin Defu , Liu Pei , Sun Ning , Han Wenwen , Li Minglei , Zhang Weiping , Song Hongcheng , Li Zhenwu , Liu Qinglin , Wang Xiaoman
Published: March 2020

Background: Contrast-enhanced ultrasonography (CEUS) is a new potential modality for the quantitative evaluation of the microvascular perfusion of a parenchymal organ.Objective: To prospectively evaluate the diagnostic value of CEUS in assessing renal function in patients with ureteropelvic junction obstruction (UPJO).Methods: The study protocol was approved by the local ethics committee, and written informed consent was obtained from the patients’ parents or guardians.Ultrasonography (US), CEUS, and radioisotope renography were performed in 51 children (42 boys, 9 girls; mean age, 6.75 ± 4.14 years) with unilateral UPJO. The slope of the ascending curve (A), time to peak (TTP), peak intensity (PI), and area under the curve (AUC) were recorded during CEUS; the quantitative data were calculated by the QLAB system (semiautomated border tracking, Philips Healthcare) software. Sensitivity and specificity values were determined for CEUS and compared with radioisotope renography.Results: CEUS depicted 102 kidneys in 51 patients, in whom the perfusion time-intensity curve（TIC）was determined. The TIC of renal cortical perfusion in all groups showed an asymmetrical single-peak curve, which could be clearly distinguished between the experimental group and the control group. Compared to the control group, the TTP was markedly prolonged but A was significantly decreased in the experimental group (P < 0.05). The ROC curve drawn to differentiate the differential renal function (DRF) using the TTP value provided an area under the ROC curve (AUROC) of 0.86. The diagnostic performance of contrast-enhanced US was better than that of US, as the sensitivity and specificity values were 92.86% and 76.14%, respectively.Conclusions: This preliminary experience represents the first report of evaluating the diagnostic value of CEUS in assessing renal function in children with UPJO. CEUS is a highly sensitive, rapid, and cost-effective diagnostic imaging modality for detecting and monitoring renal function noninvasively.
Supplementation of c-type natriuretic peptide during the whole in vitro growth period benefits the development of murine secondary follicles
Authors: Li Ang , Cao Haixia , Li Hongxia , Li Ruijiao , Wang Huaixiu , Guo Xingping
Published: March 2020

Background Supplementation of c-type natriuretic peptide (CNP) in the culture medium shortly before in vitro maturation (IVM) has been reported to be effective in delaying meiotic resumption of murine oocyte. The present study investigated the effect of CNP supplementation during the whole period of in vitro growth (IVG) on the development of murine secondary ovarian follicles.Methods Late secondary ovarian follicles isolated from ovaries of Kunming mice were cultured in vitro with and without supplementation of CNP. In experiment 1, CNP was supplemented at the early stage and the follicle development was evaluated. In experiment 2 and 3, CNP was supplemented during the whole period of IVG. In experiment 2, follicle development and oocyte maturity were evaluated. In group 3, follicle development and rate of cleaved embryos after in vitro fertilization (IVF) was assessed.Results In control group in all 3 experiments, granulosa cells migrated from within follicle and adhered to the plate at different degrees. The follicles flattened and could not reach antral stage. About 39.8% (39/98) of the oocytes ovulated nakedly. As no antral follicle was obtained, IVF was not performed in control group in experiment 3. In experiment group in all 3 experiments, no migration of guanulosa cells was observed and the follicles grew three-dimensionally. Ovulation of naked oocyte decreased substantially. The rate of antral stage follicle were 45% (18/40) in experiment 1. This parameter was 75.9% (44/58) in experiment 2 and 3 combined. In experiment 2, in preovulatory follicles without ovulation induction, oocytes at germinal vesicle (GV) stage and germinal vesicle breakdown (GVBD) stage were 87.5% (14/16) and 12.5% (2/16), respectively. In preovulatory follicles with ovulation induction, no GV stage oocyte was retrieved, oocytes at GVBD and metaphase II (MII) stage were 50% (8/16), respectively. In experiment 3, among 18 follicles cultured, 12 cumulus-oocyte complexes (COC) ovulated automatically after ovulation induction. Eleven oocytes were fertilized and cleaved. Compared with control groups, the follicle development assessed by naked oocyte ovulation and follicle stage (preantral follicle and antral follicle) in experiment groups were significantly superior (p<0.0001). CNP effectively maintained oocytes’ meiotic arrest and enhanced fertilization competency.Conclusions The supplementation of CNP in culture system of murine late secondary follicle during the whole period of IVG could sustain the 3-dimensional structure of follicle, increase the antral formation rate. As a result, the oocyte’s competency to be fertilized was greatly improved.
Construction of a nomogram to predict overall survival for patients with lung large cell neuroendocrine carcinoma: analysis of the SEER database
Authors: Han Dong , Gao Fei , Li Nan , Wang Hao , Fu Qi
Published: March 2020

Background Lung large cell neuroendocrine carcinoma (L-LCNEC) has a poor prognosis with lower survival rate than other NSCLC patients. The estimation of an individual survival rate is puzzling. The main purpose of this study was to establish a more accurate model to predict the prognosis of L-LCNEC.Methods Patients aged 18 years or older with L-LCNEC were identified from the Surveillance, Epidemiology and End Results (SEER) database from 2004 to 2015. Cox regression analysis was used to identify factors associated with survival time. The results were used to construct a nomogram to predict 1-year, and 3-year survival probability in L-LCNEC patients. Overall survival (OS) were compared between low risk group and high risk group by the Kaplan–Meier analysis.Results A total of 3216 patients were included in the study. We randomly divided all included patients into 7:3 training and validating groups. In multivariable analysis of training cohort, age at diagnosis, sex, stage of tumor, surgical treatment, radiotherapy and chemotherapy were independent prognostic factors for OS. All these factors were incorporated to construct a nomogram, which was tested in the validating cohort.Conclusions we constructed a visual nomogram prognosis model, which had the potential to predict the 1-year and 3-year survival rate of L-LCNEC patients, and could be used as an assistant prediction tool in clinical practice.
Fairness evaluation for the elder population in China
Authors: Wang Guan , Shen Qing
Published: March 2020

Introduction: Population aging and the increasing burden of non-communicable diseases are increasingly a strain on health systems. The World Health Organization (WHO) uses fairness of health financing as one of the criteria for assessing health system performance. The Chinese government has undertaken taken a series of health reforms to reduce the pace of disease transition towards non-communicable diseases (NCDs), as well as protecting people from catastrophic health expenditures. The aim of this study was to assess the fairness of health financing among the elderly with different health conditions in China. Methods: Fairness of health financing analysis was used to evaluate how the burden of health financing is distributed according to the household ability to pay (ATP). The data source was the WHO Study on global AGEing and adult health (SAGE) Wave 1, a national weighted data collected from adults older than 50 years. Chi-square and partial proportional odds model test were applied to assess the distribution of socioeconomic and health behavior factors among different chronic conditions. Kakwani indexes and curves were obtained from concentration index/ curves and Gini coefficient/ATP for progressivity analysis in healthcare financing. Dominance tests were applied for comparing different ways of health financing among health conditions. Results: More than half of the elderly had at least one chronic condition, and around 20% people suffered from multi-morbidity. Several socioeconomic as well as health behavior factors were associated with developing NCDs. Out-of-pocket payment dominated other health finance sources in all three chronic conditions with a regressive pattern. Even though mandatory insurance had covered more than 70% of the elder population in China, due to the relative lower proportion reimbursement for chronic diseases, people still had to pay a lot for seeking healthcare. Conclusion: When reimbursement for chronic diseases is relatively low, high mandatory insurance coverage does not ensure fairness of health financing. The Chinese health system should be developed further in order to meet the needs of elderly with different chronic conditions. Key words : Non-communicable diseases, the elderly, socioeconomic status, health financing, kakwani index
Perceived Benefits, Challenges, and Recommendations for National HIV/AIDS Research Dissemination Efforts in Tanzania
Authors: Conserve Donaldson , Saini Subina , Issango Jumanne , Kamwela Jerome , Maboko Leonard , Kilale Andrew , Nhigula Patrick , Shirima Sylvia , Vargo Julianna , Rawson Ryleigh , Ondrus Abigail , Whembolua Guy-Lucien
Published: March 2020

Background Although a number of international and national HIV/AIDS conferences exist, there is not a national conference in Tanzania focusing on disseminating HIV/AIDS research conducted in the country. This creates a missed opportunity for researchers to share their research findings with local policy makers and HIV program implementers who can influence the adoption and implementation of locally promising research to public health and clinical practice settings. This paper reports on the findings from a brainstorming session conducted at the first HIV/AIDS Research Forum designed to enhance local dissemination efforts of HIV/AIDS research conducted in Tanzania. Method During the second day of the Forum, which was held in Morogoro, Tanzania, a 1-hour structured brainstorming session was conducted with the Forum participants. Participants included researchers, medical professionals, policymakers, representatives from different ministries. Transcription of the brainstorming session was analyzed to identify benefits of the Forum, perceived challenges for organizing similar HIV/AIDS research dissemination events, and recommendations for addressing the challenges. Results Overall, 50 participants attended the Forum and they perceived the forum to be beneficial because it brought together researchers, policymakers, and other stakeholders working in HIV/AIDS programs and implementers. Having policymakers and researchers in the same place enhance the likelihood of policymakers using research findings to inform policies and influence adoption and implementation of effective interventions. Forum participants identified several potential challenges of similar local HIV/AIDS research dissemination efforts including the costs and lack of funding for organizing and hosting such forums or having repetitive presentations. To address these concerns, they recommended a biennial national conference in order to allow more time to raise funds to cover the costs associated with organizing such a conference. Conclusion The benefits identified for the Forum highlight the importance of developing a national level HIV/AIDS conference in Tanzania. However, the potential challenges discussed need to be addressed in order to develop a sustainable national HIV/AIDS conference by incorporating the recommendations that forum attendees proposed.
Preserving left colic artery in anterior resection reduce the incidence of anastomotic leakage in rectal cancer patients: A prospective cohort study
Authors: Zheng Huichao , Ye Jingwang , Tian Yue , Zhang Yong , Shen Haode , Li Fan , Liu Baohua , Tong Wei-Dong
Published: March 2020

Background Whether or not to preserving left colic artery(LCA) in anterior resection for rectal cancer and its effect on anastomotic leakage are remains controversial. The aim of this study was to investigate the clinical outcomes of preserving the LCA during anterior resection for rectal cancer. We further explored branching types of the inferior mesenteric artery(IMA) based on the three-dimensional computed tomography reconstruction images. Methods Between January 2017 and October 2019, patients who underwent anterior resection for rectal cancer were allocated to preservation LCA or non-preservation LCA. Evaluation parameters including intraoperative conditions, pathological outcomes, postoperative complications, and short-term results. Furthermore, preoperative three-dimensional computer tomography reconstruction were performed to assess types of IMA. Results 160 patients with rectal cancer were enrolled in this study, 56 were arranged to preservation LCA and 104 to non-preservation LCA. The incidence of anastomotic leakage and overall early complications were significantly(P<0.05) decreased in the preservation LCA group. The reoperation rate of the preservation LCA group (1.8%) was lower than that of the non-preservation LCA group (10.6%), but the difference was not statistically significant (P>0.05). The two groups did not significantly(P>0.05) differ in blood loss, intraoperative complications, total number of harvested lymph nodes, and number of positive lymph nodes. The three-dimensional computer tomography reconstruction images of 108 patients with rectal cancer were evaluated, the IMA was divided into four types, of which 53(49.1%) were type I, 24 (22.2%) were type II, 18 (16.7%) were type III, and 13 (12%) were type IV. Conclusions The preservation of LCA in anterior resection for rectal cancer could help reducing the incidence of anastomotic leakage, overall early complications and without increasing other known risks. The three-dimensional computer tomography reconstruction technique was useful for evaluating the IMA types to facilitate make intraoperative surgical decisions and preservation of LCA during rectal cancer surgery.
Assessment of DLG Correction Factor in Mobius3D Commissioning Affected by Couch Top
Authors: Han Min Cheol , Kim Jihun , Hong Chae-Seon , Chang Kyung Hwan , Han Su Chul , Park Kwangwoo , Kim Dong Wook , Park Myoung Kyu , Noh Yu Yun , Kim Jin Sung
Published: March 2020

Purpose: This study assesses the dosimetric leaf gap (DLG) correction factor in Mobius3D commissioning affected by a couch top platform and calculates the optimal DLG value according to the point dose difference function. Methods: DLG optimizations were performed for 3 LINAC machines and a total of 30 patient VMAT plans (i.e., 10 plans per each LINAC). Point dose calculations were performed using an automatic dose calculation system in Mobius3D as well as Mobis3D calculation using an MVP-based QA plan with a carbon fiber couch top. Subsequently, the results were compared with measurement data. Results: The averaged point dose measured for the MVP with a couch top decreased by approximately 2% relative to that without the couch top. The average of the optimal DLG factors increased by 1.153 due to the couch top effect for a dose decrease of 2% at the measured point. Conclusions: Users should adjust the DLG correction factor using a specific phantom (including MVP) with a couch top. If the factor adjusted by using MVP automatic dose calculation system, the factor should be increased by approximately 1.153 per 2% dose difference considering user’s couch top effect.
Clinical Characteristics of 6 patients with SARS-Cov-2 infected severe pneumonia in Zunyi, China
Authors: Fu Bao , Qian Kun , Chen Tao , Fu Xiaoyun , Chen Miao
Published: March 2020

Purpose To study the clinical characteristics, laboratory examination, radiological changes and treatments of 6 patients with severe SARS-Cov-2 infected pneumonia in Zunyi City, China.MethodsThe clinical data, laboratory examination, radiological changes and clinical treatment process of 6 patients with severe SARS-Cov-2 infected pneumonia admitted to the Department of Critical Medicine of the Affiliated Hospital of Zunyi Medical University were retrospectively analyzed.Results Four of the six patients were older than 65 years. Two patients had a history of exposure to Wuhan, and four patients had family clustering infection. The most common symptoms at onset of illness were dry cough (4, 66%) and fever (4, 66%). Laboratory tests showed that white blood cell count, neutrophil count, C-reactive protein, IL-6, IL-10, and urea nitrogen elevated. The Total lymphocyte count and T lymphocyte count decreased. All patients received antiviral therapy, blood purification, immunomodulatory therapy, and Chinese herb treatments. One patient was discharged from the hospital, and 5 patients' condition improved significantly. ConclusionT lymphocyte decreased significantly, IL-6 and IL-10 elevated in severe SARS-Cov-2 infected pneumonia patients. Elderly patients with comorbidities appear to be more severe and to recover more slowly. Blood purification can be tried for severe and critically ill patients. Early identification and timely treatment of critical cases is of crucial importance.
A single-center analysis of clinical features of 145 tuberous sclerosis complex—associated renal angiomyolipoma cases in China
Authors: Wang Xu , Zhao Yang , Wang Wenda , Wang Zhan , Zhang Yushi
Published: March 2020

Background: Tuberous sclerosis complex (TSC) is a rare autosomal dominant genetic disease with multiple organ system involvement. Renal angiomyolipoma (RAML) is a leading cause of death in TSC-adult patients. The aim of the study was to investigate the clinical features of tuberous sclerosis-associated renal angiomyolipoma among Chinese population so that clinicians can make better clinical diagnosis.Methods: Retrospective review of clinical data of 145 patients with tuberous sclerosis-associated renal angiomyolipoma treated in the Department of Urology, Peking Union Medical College Hospital from January 2014 to January 2019. Analysis of age and gender distribution, tumor stage, and combined clinical manifestations. All analyses used a significance level of 0.05 and were presented in SPSS23.0 software.Results: A total of 145 patients were enrolled. There were 51 males and 94 females. The male to female ratio was 1:1.84, with mean age of 30.50±9.79 years (range 7-58 years). 92 cases were mainly distributed in 21-40 age group, accounting for 63.45%. Among all 6 age groups, 21-30 age group contained the largest number of patients(48 case，33.10%). 86 (59.31%) renal angiomyolipoma cases were classified stage 6; 19 cases had a history of tumor rupture and hemorrhage, including 7 selective arterial embolization, 8 partial nephrectomy and 4 nephrectomy. Subependymal nodules (104/122cases, 85.24%), angiofibromas /fibrous cephalic plaque (121 cases, 83.44%), hypomelanotic macules (89 cases, 61.39%), shagreen patch (65 cases, 44.83%) and ungual fibromas (62 cases, 42.07%) were the main combined clinical manifestation. 91.30% (42/46) lymphangioleiomyomatosis cases were female.Conclusion: Patients with TSC-RAML were mainly young and middle-aged females with giant Angiomyolipoma. Most tumor were ranged in stage 5 and 6. Nervous system characteristics (subependymal nodules), dermatological lesions (angiofibromas or fibrous cephalic plaque, hypomelanotic macules, shagreen patch and ungual fibromas) were common combined clinical manifestations. Lymphangioleiomyomatosis showed an obvious difference in gender distribution
A grape seed extract maternal dietary supplementation improves egg quality and reduces ovarian steroidogenesis without affecting fertility parameters in reproductive hens: a link with plasma and ovarian cell adipokines expression?
Authors: Barbe Alix , Mellouk Namya , Ramé Christelle , Grandhaye Jérémy , Anger Karine , Chahnamian Marine , Ganier Patrice , Brionne Aurélien , Riva Antonella , Froment Pascal , dupont joelle
Published: March 2020

Background: In mammals, oxidative stress (OS) induces negative effects on reproductive functions. In broiler hens, the genetic selection has increased susceptibility to OS. Grape seed extracts (GSE) are known as potent antioxidants. Here, we investigated the effects of time and level of GSE dietary supplementation on egg production and quality, fertility parameters, Reactive Oxygen Species (ROS) and steroid content in yolk egg associated to plasma adipokines in broiler hens. Methods: We designed an in vivo study using four groups of hens: A (control), B and C (supplemented with GSE at 0.5% and 1% of the total diet composition, respectively, starting at week 4) and D (supplemented with GSE at 1% of the total diet composition since hatching). We assessed the egg production from 23 th to 40 th weeks and quality at 33 th week. After artificial inseminations, the fertility parameters were calculated. In egg yolk, Reactive Oxygen Species (ROS) level and steroid production were evaluated by Ros-Glo H202 and ELISA assay, respectively. Expression of steroidogenic enzymes and adipokines and their receptors was determined by RT-qPCR in ovarian cells and plasma adipokines (RARRES2, ADIPOQ and NAMPT) were evaluated by specific ELISA assays. Results: The fertility parameters and egg production were unaffected by GSE supplementation. However, the rate of double-yolk eggs decreased for all GSE supplemented. Eggs from the C group were bigger and larger. The shell elasticity was higher for B and C groups. In the yolk egg, GSE supplementation reduced ROS content and steroidogenesis consistent with a decrease in P450 aromatase and StAR mRNA expression and basal in vitro progesterone secretion in granulosa cells. Interestingly, RARRES2 plasma levels were positively correlated while ADIPOQ and NAMPT plasma levels were negatively correlated, with steroids and ROS in yolk. Conclusions: Maternal dietary GSE supplementation did not affect egg production and fertility parameters whereas it reduced ROS content and steroidogenesis in yolk egg. Furthermore, it ameliorated egg quality by decreasing the number of double-yolk eggs and by improving the size of normal eggs and the elasticity of the shell. Taken together, our data suggest the possibility of using dietary maternal GSE to improve egg quality.
The serum levels of circulating matrix metalloproteinase MMP-9, MMP-2/TIMP-2 complex and TIMP-1 do not change significantly during normal pregnancy.
Authors: Nissi Ritva , Santala Markku , Talvensaari-Mattila Anne
Published: March 2020

Background Matrix metalloproteinases (MMPs) are important regulators of vascular and uterine remodeling. Normal pregnancy is associated with increased MMP activity. Measurements of the plasma levels on MMPs have not been consistent between studies in complicated pregnancies. Methods We have examined MMP-9, MMP-2 and their respective tissue inhibitors TIMP-1 and TIMP-2 in different time points in the sera of 13 women with normal pregnancy Results The serum levels of MMP-9 and TIMP-1 were stable throughout pregnancy. The level of MMP-2/TIMP-2 complex was slightly increased after week 15 without statistical significance.Conclusions The serum levels of MMP-9, MMP-2/TIMP-2 and TIMP-1 on different time points during normal pregnancy are poorly studied. Further measurements of the plasma levels of MMPs and the correlation with MMP levels in the placenta and other maternal tissues are needed.
Changes in physical activity across pregnancy among Chinese women: a longitudinal cohort study
Authors: Lü Yan , Feng Yahui , Ma Shuai , Jiang Yu , Ma Liangkun
Published: March 2020

Background Sufficient physical activity (PA) during pregnancy is beneficial for a woman’s health; however, the PA levels of Chinese women at different pregnancy stages are not clear. The aim of our study was to investigate PA changes during pregnancy and determinants of PA changes among Chinese women.Methods Data were obtained from 2485 participants who were enrolled in the multicentre prospective Chinese Pregnant Women Cohort Study. PA level was assessed in early pregnancy and again in mid-to-late pregnancy using the International Physical Activity Questionnaire short form (IPAQ-SF). Sufficient PA (≥600 MET min/week) in early pregnancy and insufficient PA in mid-to-late pregnancy indicated decreasing PA. Insufficient PA in early pregnancy and sufficient PA in mid-to-late pregnancy indicated increasing PA. The associations between demographic, pregnancy-related and health-related characteristics and PA changes were examined by logistic regression analysis.Results Energy expenditure on PA increased significantly from early to mid-to-late pregnancy ( P <0.001), and 55.25% of the participants eventually had sufficient PA. Walking was the dominant form of PA. Women with sufficient PA levels in early pregnancy were more likely to have sufficient PA in mid-to-late pregnancy (OR=1.897, 95% CI: 1.583-2.274; P <0.001). Women in West China and those in Central China were most and least likely, respectively, to have increasing PA (OR=1.387, 95% CI: 1.078-1.783; P =0.011 vs. OR=0.721, 95% CI: 0.562-0.925; P =0.010). Smoking was inversely associated with increasing PA (OR=0.480, 95% CI: 0.242-0.955; P =0.036). Women with higher educational levels were less likely to have decreasing PA (OR=0.662, 95% CI: 0.442-0.991; P =0.045).Conclusions PA increased as pregnancy progressed, and walking was the dominant form of PA among Chinese women. Avoiding smoking and maintaining sufficient PA in early pregnancy may help women achieve sufficient PA throughout the whole pregnancy. Interventions for PA should consider differences in regional distributions and educational levels.
AMH as an ovarian function predictor in premenopausal female breast cancer patients receiving chemotherapy is effective only for those over 35 years old
Authors: Li Xiaolin , Liu Sixuan , Ma Lisi , Chen Xuan , Weng Huaiyu , Huang Run , Yu Yang , ZONG XIANGYUN
Published: March 2020

Background The predicting value of AMH for ovarian dysfunction after chemotherapy is controversial. This study is designed to evaluate the value of serum AMH clinically and theoretically. Methods We detected the serum estradiol, FSH and AMH in 144 pre-menopausal women with breast cancer receiving cyclophosphamide-based chemotherapy. The differences of hormones before and after chemotherapy were compared; the correlations among the hormones and amenorrhea, menstrual recovery were analyzed. In addition, serum AMH was detected randomly in 177 normal healthy women and 36 normal female C57BL/6J mice of different ages, meanwhile the status of ovary follicles was observed. Furthermore, 72 Balb/c nude mice with breast cancer were randomly assigned to three groups with different dosage of CTX (control, 100mg/kg, 200mg/kg), the alterations of serum AMH and ovary follicles were recorded and analyzed. Results Chemotherapy induced amenorrhea was associated with pre-chemo AMH level, E2 level and FSH level (P <0.0001). Recovery of menstruation was associated with pre-chemo AMH level (P <0.0001) but not E2 and FSH level (P >0.05). In breast cancer patients received chemotherapy, the serum AMH did not differ significantly between pre- and post- chemotherapy in patients younger than 35 years old (P>0.05), while dramatic decline was detected in patients over 35 years old (P<0.0001). In healthy women, the AMH level sharply declined after 35 years old ( P <0.0001) and remained relatively stable in early age. Similar results were obtained in normal mice experiments. The cancer-bearing mice exposed to 200mg/kg CTX endured significant decline of AMH levels and remarkable decrease of primordial and growing follicles (P <0.0001). Conclusion Our results indicate that AMH is effective for predicting post-chemo ovarian function only in premenopausal female breast cancer patients over 35 years old.
Goal-directed hemodynamic therapy in patients with colorectal cancer undergoing laparoscopic surgery
Authors: Panaﬁdina V. A. , Shlyk I. V.
Published: March 2020

Introduction.The conductance of goal-directed hemodynamic therapy is controversial due to the difficulty in its implementation in routine practice despite the signiﬁcant number of studies and meta-analyses.

Objective.To estimate the efficacy of a modiﬁed algorithm of goal-directed hemodynamic management in patients with colorectal cancer who undergo laparoscopic surgery based on non-invasive monitoring of cardiac output.

Subjects and methods.A single-centered, randomized trial was conducted. The control group included 75 patients, while the goal-directed therapy (GDT) group included 72 patients. In the control group, hemodynamic management was based on mean arterial pressure and intraabdominal perfusion pressure. In addition, results of ﬂuid responsiveness tests were considered in the GDT group. The suggested protocol efficacy was evaluated on the basis of frequency of critical incidents, shifts in acid-base balance and lactate concentration, infusion volume, vasopressor doses, the incidence of acute kidney injury, and other complications.

Results.After anesthesia induction and according to the results of a modiﬁed, passive leg raising test, 67.1% of patients were considered responders and received 1250 (1000; 1500) ml of balanced crystalloids before carboxyperitoneum. The infusion differentiation test of hypotension cause was performed in 47 patients of the GDT group, 37% were considered responders, and others received vasopressors and/or inotropes. The use of the GDT protocol led to a decrease in total infusion volume and vasopressor doses. A lower frequency of critical incidents was recorded when the GDT protocol was used. In the GDT group, there were no signs of ischemia and increased frequency of complications (including acute kidney injury).

Conclusions.Testing of ﬂuid responsiveness and non-invasive cardiac output monitoring allows for the correction of hemodynamics during surgery. Goal-directed therapy in the intraoperative period allows different approaches to maintaining systemic and intraabdominal perfusion pressure, thus decreasing the total volume of infusion without increasing hypoperfusion risk.
Abiotic Synthesis of Methane and Organic Compounds in Earth’s Lithosphere
Authors: Reeves Eoghan P. , Fiebig Jens
Published: March 2020

Accumulation of molecular hydrogen in geologic systems can create conditions energetically favorable to transform inorganic carbon into methane and other organic compounds. Although hydrocarbons with a potentially abiotic origin have been proposed to form in a number of crustal settings, the ubiquitous presence of organic compounds derived from biological organic matter presents a challenge for unambiguously identifying abiotic organic molecules. In recent years, extensive analysis of methane and other organics in diverse geologic fluids, combined with novel isotope analyses and laboratory simulations, have, however, yielded insights into the distribution of specific abiotic organic molecules in Earth’s lithosphere and the likely conditions and pathways under which they form.
The Behavior of H2 in Aqueous Fluids under High Temperature and Pressure
Authors: Bazarkina Elena F. , Chou I-Ming , Goncharov Alexander F. , Akinfiev Nikolay N.
Published: March 2020

The presence of H2 and H2O in planetary interiors prompts the need for fundamental studies on these compounds under corresponding conditions. Here, we summarize data on H2 properties in aqueous systems under conditions of high temperature and pressure. We explain how to measure important H2 fugacities in hydrothermal systems. We present available experimental data and thermodynamic models for H2 solubility and vapor–liquid partitioning under hydrothermal conditions. In addition, we introduce the fascinating world of H2–H2O clathrate hydrates under extreme temperatures and pressures. The properties of the H2–H2O system are well established below the critical point of water (374 °C and 22.06 MPa), but far less is known under higher temperatures and pressures, or the effect of salt.
Hydrogen, Hydrocarbons, and Habitability Across the Solar System
Authors: Glein Christopher R. , Zolotov Mikhail Yu.
Published: March 2020

The ingredients to make an environment habitable (e.g., liquid water, chemical disequilibria, and organic molecules) are found throughout the solar system. Liquid water has existed transiently on some bodies and persistently as oceans on others. Molecular hydrogen occurs in a plume on Saturn’s moon Enceladus. It can drive the reduction of CO2 to release energy. Methane has been observed in many places: from the dusty plains of Mars, to the great lakes of the Saturnian moon Titan, to the glacial wonderland that is Pluto. Organic molecules are common where volatile elements and reducing conditions prevail: these organic molecules can have diverse origins. Future space missions will attempt to illuminate the “organic solar system” and the role played by possible extraterrestrial life.
Multi-objective Optimization to Increase Nusselt Number and Reduce Friction Coefficient of Water/Carbon Nanotubes via NSGA II using Response Surface Methodology
Authors: Moslemi Petrudi Amin , Fathi Pourya , Rahmani Masoud
Published: March 2020

Heat transfer science is one of the most important and most applied engineering sciences, with the importance of energy management and energy conservation being doubled. Because of their properties, nanofluids have been widely used in various industries, making them particularly important to study. In this paper, the Nusselt number and coefficient of friction with volume fraction ranging from 0 to 0.1 at approximately Reynolds numbers of 200 to 5000 are studied experimentally. Higher thermal conductivity, better stability, lower pressure drop was observed using nanoparticles of solid particles. NSGA II algorithm was used to maximize Nusselt number and minimum friction coefficient by changing temperature and volume fraction of nanoparticles. To obtain Nusselt number and friction coefficient based on the temperature and volume fraction of the nanoparticles, the experimental data response surface methodology was used and with increasing Reynolds number, the Nusselt number increased and the friction coefficient decreased. In order to evaluate the objective functions in the optimization, the response surface methodology is attached to the optimization algorithm. At the end, the Pareto Front and its corresponding optimal points are presented.
Ischemic stroke on the background of probable in situ thrombosis of atrial septal aneurysm in a patient taking hormonal contraceptives
Authors: Mekhryakov S. A. , Kulesh A. A. , Syromyatnikova L. I.
Published: March 2020

Introduction. The independent role of the atrial septal aneurysm in the occurrence of ischemic stroke remains controversial. In addition to the mechanism of paradoxical embolism against the background of a patent foramen ovale associated with an aneurysm, a number of studies have demonstrated that ischemic stroke can develop due to in situ thrombosis in the aneurysm region.

Materials and methods. Description of the clinical case of a patient with atrial septal aneurysm and ischemic stroke while taking hormonal contraceptives. Analyzed all available publications in PubMed on this topic.

Results and discussion. Among publications suitable for the criteria, in addition to direct visualization of a blood clot in the area of the atrial septal aneurysm, its independent effect on the occurrence of embolic events was demonstrated. In all analyzed cases, anticoagulants were prescribed for secondary prevention, which is justified on the basis of the hypothesis of in situ thrombosis in the aneurysm region.

Conclusion. The analysis of scientific publications showed that the knowledge of this problem is still extremely small. There are no clear criteria, in addition to direct visualization of a blood clot, allowing the atrial septal aneurysm to be considered as a direct cause of ischemic stroke. Nevertheless, the presence of this cardiac abnormality and in combination with risk factors or evidence of prothrombotic status make it possible to regard it as an independent cause of stroke, and qualify the stroke as cardioembolic, which justifies the advisability of prescribing anticoagulants for secondary prevention.
Heterogeneity of speech disorders in Parkinson’s disease: potential for classification, diagnostics and therapy
Authors: Vasenina E. E. , Levin O. S.
Published: March 2020

Introduction. Speech disorders in Parkinson’s disease are a very common clinical sign. The structure of speech disorders is at the moment not fully understood, there is no unified approach to classification, therapy effects have not been studied.

Materials and methods: 324 PD patients were primarily included in the study, and from those the patients showing clinically significant speech disorders (22,4%) were selected. All the patients were assessed for motor disorders (UPDRS part 3), cognitive disorders (Addenbrooke’s cognitive examination), as well as affective disorders.

Results: by means of cluster analysis we identified 4 subtypes of speech disorders as dysphasia (adynamic, disprosodic, constructive, and logopenic). None of the forms was associated with parkinsonism severity and general severity of cognitive impairment, which allowed to consider dysphasia as a separate clinical syndrome. Disprosodic dysphasia differentiated by severity of axial symptoms (F value = 3.279, p < 0,05), adynamic dysphasia was associated with more pronounced apathy (F value = 4,2, p < 0,01), constructive dysphasia – with impairment of visual-spatial functioning (F value 29,93, p<0,0001), while logopenic dysphasia was associated with more severe attention deficiency.

Conclusion: Speech disorders in PD are heterogeneous and can be regarded as manifestations of dysphasia. Identification of various subtypes will allow for optimizing the treatment of PD patients.
Transformation tools enabling the implementation of nature-based solutions for creating a resourceful circular city
Authors: Katsou Evina , Nika Chrysanthi-Elisabeth , Buehler Devi , Marić Bruno , Megyesi Boldizsár , Mino Eric , Babí Almenar Javier , Bas Bilge , Bećirović Dženan , Bokal Sabina , Đolić Maja , Elginöz Nilay , Kalnis Gregoris , Mateo Mari-Carmen Garcia , Milousi Maria , Mousavi Alireza , Rinčić Iva , Rizzo Agatino , Rodriguez-Roda Ignasi , Rugani Benedetto , Šalaševičienė Alvija , Sari Ramazan , Stanchev Peyo , Topuz Emel , Atanasova Natasa
Published: March 2020

The linear pattern of production-consumption-disposal of cities around the world will continue to increase the emission of pollutants and stocks of waste, as well as to impact on the irreversible deterioration of non-renewable stocks of raw materials. A transition towards a circular pattern proposed by the concept of ‘Circular Cities’ is gaining momentum. As part of this urban transition, the emergent use of Nature-based Solutions (NBS) intends to shift public opinion and utilize technology to mitigate the urban environmental impact. In this paper, an analysis of the current research and practical investments for implementing NBS under the umbrella of Circular Cities is conducted. A combined appraisal of the latest literature and a survey of ongoing and completed National-European research and development projects provides an overview of the current enabling tools, methodologies, and initiatives for public engagement. It also identifies and describes the links between facilitators and barriers with respect to existing policies and regulations, public awareness and engagement, and scientific and technological instruments. The paper concludes introducing the most promising methods, physical and digital technologies that may lead the way to Sustainable Circular Cities. The results of this research provide useful insight for citizens, scientists, practitioners, investors, policy makers, and strategists to channel efforts on switching from a linear to a circular thinking for the future of cities.
Modelling heat recovery potential from household wastewater
Authors: Wärff C. , Arnell M. , Sehlén R. , Jeppsson U.
Published: March 2020

There is a strongly growing interest for wastewater heat recovery (WWHR) in Sweden and elsewhere, but a lack of adequate tools to determine downstream impacts due to the associated temperature drop. The heat recovery potential and associated temperature drop after heat recovery on a building level is modelled for a case study in Linköping, Sweden. The maximum temperature drop reaches 4.2 °C, with an annual recovered heat of 0.65 kWh · person−1 · day−1. Wastewater temperature out from the heat exchanger was 18.0 °C in winter at the lowest. The drinking water source type can be an important factor when considering wastewater heat recovery.
Environmental and cost benefits of co-digesting food waste at wastewater treatment facilities
Authors: Morelli Ben , Cashman Sarah , Ma Xin (Cissy) , Turgeon Jason , Arden Sam , Garland Jay
Published: March 2020

The wastewater industry is undergoing a paradigm shift from focusing solely on treatment to incorporating concepts aimed at mitigating environmental impacts such as energy and nutrient recovery and water reuse. This study uses life cycle assessment and life cycle cost analysis to investigate the effect of expanding anaerobic digestion (AD) capacity and adding combined heat and power on environmental and cost indicators at a mid-sized wastewater treatment facility (WWTF) in Massachusetts, USA. Since 2014, Massachusetts has banned the disposal of organic waste from commercial organizations producing more than one ton of material per week. The WWTF's additional digester capacity allows the co-digestion of municipal solids with a food-based engineered bioslurry due to this ban. Study data were compiled for several AD feedstock quantity and performance scenarios, and compared to a baseline scenario representative of historic plant operations prior to co-digestion. Reductions in environmental impact are demonstrated for six of eight environmental impacts, including global climate change potential and cumulative energy demand. Eutrophication potential increases by 10 percent and 24 percent across assessed scenarios. Water use remains relatively constant across scenarios. Facility energy production increases dramatically with co-digestion, satisfying 100 percent of the WWTF's thermal energy requirement and producing surplus electricity assuming full AD capacity utilization.