bluuebunny/crossref_metadata_2025 huggingface dataset:
Qualitative Study of Socio-Cultural Challenges in the Nursing Profession in Pakistan
Authors: Abbas Sidra , Zakar Rubeena , Fischer Florian
Published: January 2020

Background In a patriarchal social system, a women-dominated profession like nursing is mostly seen as a disempowered group due to its stereotypical image and negative connotations. The low social prestige of this profession is based on the roles typically assigned to men and women to maintain gender identity according to their performance and embodiment. The aim of this study was to explore the social and cultural challenges faced by nurses while creating their professional image within the regional context of Lahore (Punjab) in Pakistan.Methods A qualitative research design was chosen to conduct one-to-one, in-depth interviews with twelve nurses. Recruitment was based on purposive sampling from three large public hospitals in Lahore to learn about nurses’ perceptions of social and cultural challenges in the nursing profession. A thematic analysis was conducted using the data analysis software package NVIVO 12 Plus.Results Certain social and cultural stigmas attached to the nursing profession affect its status and changing perceptions of nurses, who either do not choose to remain or do not recommend nursing as a career option. This is still a major barrier that perpetuates the shortage of nurses in the healthcare system. Four major themes relating to the social and cultural challenges facing the nursing profession were identified: 1) it is a gender-segregated profession with less acceptance of male nurses; 2) inappropriate portrayal as low-profile professionals having little visibility in the media; 3) issues around finding a marriage partner or being refused when introduced as a nursing professional; 4) nurses’ identity from a religious perspective with the label of being impure due to touching male patients during caring work.Conclusion The present study solely highlights nurses’ perspectives on redefining gender roles and gender integration within the nursing profession. It argues that there is a need for positive portrayals in the media for the removal of public misperceptions related to nursing. This would reduce the shortage of nurses along with increasing retention and improving the quality of healthcare delivered to the public.
Management Outcome, Mortality and Factors Associated with Mortality Amongst Hospitalized Patients with Stroke. A Cross Sectional Study.
Authors: Weldegebreal Solomon , Gidey Kiday , Gidey Kidu , Nirayo Yirga Legesse , Desta Desilu Mahari , Atey Tesfay Mehari
Published: January 2020

Background Outcomes, mortality due to stroke and factors related with mortality are not profoundly known in the northern Ethiopia. Hence, the main purpose of the study was to assess management outcome, mortality and factors associated with mortality amongst stroke patients.Methods A cross sectional study design was used to conduct the study. Patients medical chart were utilized to collect patient information. Patients medical registries who were diagnosed with stroke and treated in Ayder Comprehensive Specialized Hospital over the years were retrospectively seen. Sample size was estimated using single population formula. Medical charts have been assigned a number and patients were selected using systematic random sampling technique. The findings were analyzed using SPSS version 22. Using logistic regression analysis factors associated with mortality in hospital were identified. A P value less than 0.05 were deemed to be significant in all types of analyses.Results About 216 patients with the diagnosis of stroke were studied. Of the total patients studied, 126(58.3%) were females. From the total stroke patients analyzed, 102(47.2%) were discharged with improvement, 44(20.4%) left against medical advice, and 22(10.2%) patients discharged with no change. Moreover, about 48(22.2%) patients died in the hospital. The median time to death was 3 days ranging from 1 to 48 days and the average mean time to death was 6.2±8.7 days. One hundred thirty-six (62.9%) patients had affirmed to have at least one complication during their hospital stay. The total frequency of complication detected was 234 in number and aspiration pneumonia (n=92, 39.4%) was the frequently identified complication. Sever (3-8) record of Glasgow coma scale (GCS) at admission (Adjusted Odds Ratio=15.33, 95%CI:3.77-62.40, p=0.001) and being unconscious (AOR=2.61, 95%CI:1.06-6.40, p=0.037) during admission were positively associated with mortality.Conclusion Substantially higher number of patients died at the hospital. Majority of the patients admitted to the hospital developed complication, aspiration pneumonia being the most frequently affirmed complication during their stay in the wards. Patients with severe GCS and who were unconscious during admission were more likely to die at the hospital. Sketching out strategies to solve the problem will be conducive for the patients with stroke.
Effect of bridging with intravenous thrombolysis on cognitive function in stroke thrombectomy – An analysis of the German Stroke Registry
Authors: Ettelt Philipp , Maier Ilko , Schnieder Marlena , Bähr Mathias , Behme Daniel , Psychogios Marios-Nikos , Liman Jan
Published: January 2020

Background The targeted use of endovascular therapy (EVT), with or without intravenous thrombolysis (IVT) in acute large cerebral vessel occlusion stroke (LVOS) has been proven to be superior compared to IVT alone. Despite favorable functional outcome, many patients complain about cognitive decline after EVT. If IVT in addition to EVT has positive effects on cognitive function is unclear. Methods We analyzed data from the German Stroke Registry (GSR, an open, multicenter and prospective observational study) and compared cognitive function 90 days after index ischemic stroke using MoCA in patients with independent (mRS≤2 pts) and excellent (mRS=0 pts) functional outcome receiving combined EVT and IVT (EVT+IVT) vs. EVT alone (EVT-IVT). Results Of the 2636 GSR patients, we included 166 patients with mRS≤2 at 90 days in our analysis. Of these, 103 patients (62%) received EVT+IVT, 63 patients (38%) were treated with EVT alone. There was no difference in reperfusion status between groups (mTICI≥2b in both groups at 95%, p=0.65). Median MoCA score in the EVT+IVT group was 20 pts (18-25 IQR) vs. 18 pts (16-21 IQR) in the EVT-IVT group (p=0.014). There were more patients with cognitive impairment (defined as MoCA < 26 pts) in the EVT-IVT group (54 patients (86%)) compared to the EVT+IVT group (78 patients (76%)). EVT+IVT was associated with a higher MoCA score at 90 days (mRS≤2: p=0.033, B=2.39; mRS=0: p=0.021, B=4.38). Conclusions In Patients with good functional outcome after LVOS, rates of cognitive impairment are lower with combined EVT and IVT compared to EVT alone.
How is breastfeeding perceived in the informal work environment? A qualitative study among working mothers in India and South Africa
Authors: Horwood Christiane , Surie Aditi , Haskins Lyn , Luthuli Silondile , Hinton Rachael , Chowdhury Antara , Rollins Nigel
Published: January 2020

Background Worldwide, over 740 million women make their living in the informal economy. These women do not benefit from formal employment benefits, such as maternity leave, that can improve infant feeding practices. Returning to work is one of the biggest challenges women face to maintaining breastfeeding but little is known about how informal work impacts on infant feeding.Methods The study used a qualitative research design. Purposive and snowball sampling was employed. Focus group discussions (FGDs) were conducted among men and women working in the informal sector in India and South Africa. Data was analysed using a thematic approach and the framework method.Findings Between March and July 2017, 14 FGDs were conducted in South Africa and nine in India. Most women were knowledgeable about the benefits of breastfeeding and reported initiating breastfeeding. However, pressures of family responsibilities and household financial obligations often forced mothers to return to work soon after childbirth. Upon return to work many mothers changed their infant feeding practices, adding breastmilk substitutes like formula milk, buffalo milk, and non-nutritive fluids like Rooibos tea. Some mothers expressed breastmilk to feed the infant while working but many mothers raised concerns about breastmilk becoming ‘spoilt’. Breastfeeding in the workplace was challenging as the work environment was described as unsafe and unhygienic for breastfeeding and childcare. Mothers also described being unable to complete their work tasks while caring for an infant. In contrast, the flexibility of informal work allowed some mothers to successfully balance competing priorities of child care and work. Sociocultural challenges influenced breastfeeding practices. For example, men in both countries expressed mixed views about breastfeeding. Breastfeeding was perceived as good for both mother and child, however it was culturally unacceptable for women to breastfeed in public. This affected the ability of working mothers to breastfeed outside the home and contributed to a lack of respect for women who chose to breastfeed in the workplace.Conclusion Mothers working in the informal sector face multiple challenges to maintaining breastfeeding. Interventions are required to support optimal feeding and child care if global nutrition and development goals are to be met.
Harnessing mobile health technology to support long-term chronic illness management: Exploring family caregiver support needs in the outpatient setting
Authors: Shin Ji Youn , Chaar Dima , Kedroske Jacob , Vue Rebecca , Chappell Grant , Mazzoli Amanda , Hassett Afton L. , Hanauer David A. , Park Sun Young , Barton Deb , Choi Sung Won
Published: January 2020

BACKGROUND Family caregiving is an important public health issue, particularly with the aging population. In recent years, mobile health (mHealth) technology has emerged as a potential low-cost, scalable platform to address caregiver support needs, and thereby alleviate caregiver burden. This study sought to examine the support needs of family caregivers in their lived experiences of outpatient care in an effort to inform the development of a future mHealth intervention. METHODS The current study is a part of a larger study in a population of family caregivers to patients undergoing blood and marrow transplant (BMT), consisting of three phases: i) tablet-based caregiver-facing intervention design (Phase I); ii) usability testing in an inpatient healthcare setting (Phase II); and iii) randomized trial to expand the user group to an outpatient setting (Phase III). In an earlier pilot study (Phases I and II), a tablet-based caregiver-facing application was developed and tested for supporting inpatient care. As part of Phase III, we conducted 20 semi-structured interviews in two outpatient BMT clinics at a large academic medical center in the Midwestern United States. A thematic analysis was performed to define emerging themes. RESULTS Our data analysis identified five primary themes that BMT caregivers faced: I. lifestyle restrictions due to the patient’s immunocompromised state; II. unfamiliar medical tasks required on behalf of patients; III. unmet needs based on existing resources; IV. adopting strategies due to the new roles; and V. reformation of social relationships with family and friends. Based on these findings, we observed three design considerations to guide the development of a future mHealth intervention: i) connecting caregivers with other caregivers through Chat Forums; ii) enabling video conferencing with healthcare providers; and iii) using readily accessible activities (e.g., journaling) to help express emotions. CONCLUSION The findings herein captured the family caregiver’s lived experiences during outpatient care. There was broad agreement that caregiving was challenging and stressful. Thus, effective and scalable interventions to support caregivers are needed. This study provided data to guide the content and design of a future mHealth intervention in the outpatient setting.
Predictors of tuberculosis incidence and the effects of multiple deprivation indices on tuberculosis management in OR Tambo district over a 5-year period
Authors: Dlatu Ntandazo , Longo-Mbenza Benjamin , Apalata Teke
Published: January 2020

BackgroundThis study investigated the associations between socio-economic deprivation and tuberculosis (TB) treatment outcomes, alongside well-known TB risk factors. The effects of healthcare expenditures and their growth on trends in TB incidence from 2009 to 2013 were also assessed. MethodsSecondary data analysis was performed on data obtained from various sources including governmental, non-governmental and research institutions. Indicators for TB treatment outcomes included rates of TB deaths, TB case finding index, TB treatment failure, HIV associated TB deaths, TB defaulter rate, and new TB smear positive cases. Analysis of variance (ANOVA) and Post-Hoc Bonferroni pairwise tests were used to compare means of variables of interest considering a type I error rate of 0.05. Regression models and canonical discriminant analysis (CDA) were used to explore the associations between trends in TB incidence and independent TB predictors. During CDA, Fischer’s linear functions, Eigen values, and Mahalanobis distances were determined with values of Wilk’s Lambda closer to zero being the evidence for well discriminated patient groups. Data analysis was performed using SPSS® statistical software version 23.0 (Chicago, IL).ResultsIn total, 62 400 records of TB notification were analyzed for the period 2009-2013. The TB incidence rate reduced by 80% at the end of the evaluation. After adjusting for confounders, expenditure per patient day equivalent (PDE) and PHC expenditure per capita were significantly and independently associated with the decline of incident TB cases (adjusted R2 = 60%; ρ = 0.002) following the equation: Y= (- 209× Expenditure per PDE) + (- 0.191 × PHC expenditure per capita). CDA showed that TB cases in the most socio-economically deprived communities (quintile 1) were significantly more likely to have high HIV and TB co-infection death rates as compared to the least socio-economically deprived group (quintile 5) [Eigen value (12.95), function coefficient (1.49) > (.77); Wilk’s Lambda = .019, p < .0001]. ConclusionsAlthough TB control programs in OR Tambo district have averted thousands of TB incident cases, their effects on HIV associated TB deaths among the most deprived communities remain insignificant. There is an urgent need for strengthening integration of TB/HIV services in most deprived settings.
Population Attributable fraction Estimation of the Cardiovascular Diseases–related factors: An Evidence from western part of Iran
Authors: Javani Zhila , Salimi Yahya , Moradinazar Mahdi , Najafi Farid
Published: January 2020

Background: Cardiovascular diseases are the first cause of deaths and years of lost life due to disability, worldwide. The population attributable fraction has been widely used in literature to quantify an impact of removing risk factors in occurrence of diseases. This study was designed to estimate the population attributable fraction of prevalent cases of cardiovascular diseases associated with different risk factors, using data from people aged 35-65 years old in Ravansar County.Methods: Data of this study came from 9825 adults aged 35-65 years that were included in the study of Ravansar Non-Communicable disease (RaNCD). First, to identify the confounding variables, we did a comprehensive review of the available resources and then presented the relationship between different risk factors with directed acyclic graphs and for any risk factor. Sequential and average adjusted attributable fractions were used. To calculate 95% confidence intervals, the Monte Carlo simulation was conducted. All statistical analyses were performed using the ’averisk’ package in R version 3.4.4.Results: The age adjusted prevalence for cardiovascular diseases was 12.6% (95% CI: 11.9, 13.2%). Among the modifiable predictors of cardiovascular diseases, the highest amount of population attributable fraction after adjusting for age, sex, and other factors associated with cardiovascular diseases, in men were for hypertension 35.7% (95% CI: 30.2, 40.6%), dyslipidemia 12.2% (95% CI: 7.5, 17.6%), general obesity 5.7% (95% CI: -0.7, 11.9%) and for cigarette smoking 4.0% (95% CI: -6.3, 14.6%), and in women were hypertension 42.8% (95% CI: 36.5, 47.3%), general obesity 10.7% (95% CI: 6.2, 15.3%), central obesity 10.1% (95% CI: -7.0, 23.8%) and for dyslipidemia 9.7% (95% CI: 5.1, 14.5%).Conclusion: Due to the difference in the population attributable fraction of cardiovascular diseases- related factors in men and women, it is advisable to prioritize preventive cardiovascular diseases interventions by sex segregation. Special attention should be paid to control hypertension, dyslipidemia in men, and hypertension, general obesity and dyslipidemia in women, and priority should be given to strategies for preventing cardiovascular diseases.
Magnitude of Home Delivery and Associated Factors Among Child Bearing Age Mothers in Sherkole District, Benishangul Gumuz Regional State-Western-Ethiopia
Authors: Gebremariam Resom Berhe , Nigusie Adane
Published: January 2020

Background Globally, more than 536,000 maternal and 8 million perinatal deaths occur every year. Ethiopian Demographic and Health Survey stated that maternal death was 412 per 100,000 in 2016.This still indicate that maternal health remains a major public health problem in Ethiopia irrespective of the government’s measure to institutional delivery.MethodsCommunity based cross sectional study was conducted among women aged 15-49 years in Sherkole district, Benishangul Gumuz region from January to Jun 2018. A total of 451 randomly selected women were included in the study. Stratified sampling followed by simple random sampling technique was used to select the study participants. Data were collected using pretested and structured questionnaire. Bivariate and multivariate logistic regression model was fitted to identify factors associated with home delivery among women’s in the child bearing age. An adjusted odds ratio with 95% confidence interval was computed to determine the level of significance.Results The magnitude of home delivery was 353 (80%) and were assisted by non-skilled birth attendants. Mothers whose husband choose the place of delivery [AOR: 5.6, 95% CI (2.1-15.2), Mothers’ occupation ([AOR: 0.21 95% C I (0.08-0.57), ANC visit [AOR: 95 CI: 5.1(1.6-15.8), decision making [AOR: 95 CI: 0.3(0.01-0.7)] and traditional remedies [AOR: 95%CI: 0.03(0.01-0.09)] were significantly associated with home delivery.Conclusions Based on the findings of the survey, it was concluded that the overall magnitude of home delivery was found to be high. ANC visit, mother’s occupation, traditional remedies and decision making were significantly associated with home delivery.
Predicting Non-elective hospital readmission or Death using a Composite Assessment of Cognitive Impairment and Frailty in Elderly Inpatients With Cardiovascular Diseases
Authors: Yao Simin , Zheng Peipei , Liang Yaodan , Wan Yuhao , Sun Ning , Luo Yao , Yang Jiefu , Wang Hua
Published: January 2020

Background: No prior studies have assessed the role of cognitive impairment and physical frailty in elderly inpatients with cardiovascular disease (CVD). We aimed to assess the utility of a combination developed using the mini-mental state examination (MMSE) + clock drawing test (CDT) and the Fried phenotype for predicting non-elective hospital readmission or death within 6-month in elderly inpatients with CVD. Methods : A single center prospective cohort was conducted between September 2018 and February 2019. Inpatients aged 65 years or older were recruited. All enrolled patients received a comprehensive geriatric assessment during hospitalization. The Kaplan-Meier curves were used to estimate the cumulative incidence of events. The multivariate Cox regression model was used to analyze the association between frailty and cognitive status and the non-elective hospital readmission or death. Results : A total of 542 patients were included; and a total of 113 patients (20.9%) died or were readmitted at 6-month. Overall 20% screened positive for cognitive impairment, including 8% were cognitive impairment combined with physical frailty, which were more older, more common in women and non-married group, had a lower education and a higher risk of malnutrition. Frail participants with normal (hazard ratio [HR]:1.73, 95% confidence intervals [CI]:1.06-2.82, P=0.028) and impaired cognition (HR:2.50, 95% CI:1.27-4.91, P=0.008) had a higher risk of non-elective hospital readmission or death than robust patients, after adjustment for age, sex, education level, marital status, the presence of diabetes mellitus, heart failure, and previous stroke. Conclusions : The presence of physical frailty and cognitive frailty were powerful predictors of non-elective hospital readmission or death in elderly inpatients with CVD, and taking cognitive impairment into account in the frailty model may allow better prediction of adverse outcomes of frailty in the short time. Trial registration: ChiCTR1800017204; date of registration: 07/18/2018.
Early detection of postpartum depression (PPD) for women suffering high-risk pregnancy: An explorative study on self-perceived burden and other prenatal risk factors of immediate PPD among women hospitalized with threatened preterm labour1
Authors: Ni Qianqian , Cheng GuiZhi , Chen An , Heinonen Seppo
Published: January 2020

Background: The mental health of pregnant women, particularly those with elevated risks, has been an issue of global concern. Thus far, few studies have addressed mental health of pregnant women with threatened preterm labour (TPL). In the present study, we investigated self-perceived burden (SPB) and postpartum depression (PPD) among hospitalized pregnant women with TPL, exploring the association of SPB with PPD, and identifying other potential risk factors of early PPD. Methods: A self- reported survey conducted in the Obstetrics Department of Anhui Provincial Hospital, People’s Republic of China. Women hospitalized with TPL were approached one week after delivery. One hundred fifty women were recruited from January 2017 to December 2017. Self-Perceived Burden Scale (SPBS), Edinburgh Postnatal Depression Scale (EPDS), and Multidimensional Scale of Perceived Social Support (MSPSS) were the main measures. Descriptive statistics, Spearman's correlation, and multiple logistic regression were employed for data analysis.Results: SPB and PPD were commonly experienced by women hospitalized with TPL, and SPB was positively and significantly correlated with PPD. A multiple logistic regression analysis revealed that, for the women hospitalized with TPL during pregnancy, the emotional aspect of SPB (OR = 1.473, 95% CI = 1.141–1.903, p = 0.003), age (OR = 1.178, 95%CI = 1.056–1.314, p = 0.003), occupation (OR = 0.282, 95%CI = 0.095–0.023, p = 0.023), history of scarred uterus (OR = 0.163, 95%CI = 0.034–0.769, p = 0.022), delivery mode (OR = 5.974, 95%CI = 1.750–20.396, p = 0.004), and family support to women hospitalized with TPL during pregnancy (OR = 0.665, 95% CI = 0.498–0.887, p = 0.006) were the significant factors predicting early signs of PPD. Conclusion: This study indicated that SPB and PPD were prevalent mental issues among hospitalized women with TPL, and SPB, especially perceived emotional burden, is a strong predictor of PPD. Our study suggests the necessity of paying attention to mental health issues—especially SPB and PPD—among hospitalized women with TPL, as well as providing appropriate interventions at the prenatal stage to prevent adverse consequences. Perceiving support from family during pregnancy with high risk can help women in reducing the risk of PPD.
BAMscale: quantification of next-generation sequencing peaks and generation of scaled coverage tracks
Authors: Pongor Lorinc , Gross Jacob M , Alvarez Roberto Vera , Murai Junko , Jang Sang-Min , Zhang Hongliang , Redon Christophe , Fu Haiqing , Huang Shar-Yin , Thakur Bhushan , Baris Adrian , Marino-Ramirez Leonardo , Landsman David , Aladjem Mirit I , Pommier Yves
Published: January 2020

Background: Next-generation sequencing allows genome-wide analysis of changes in chromatin states and gene expression. Data analysis of these increasingly used methods either requires multiple analysis steps, or extensive computational time. We sought to develop a tool for rapid quantification of sequencing peaks, and an efficient method to produce coverage tracks for accurate visualization that can be intuitively interpreted by experimentalists with minimal bioinformatics background. We demonstrate its strength by integrating data from several types of sequencing approaches. Results: We have developed BAMscale, a one-step tool that processes a wide set of sequencing datasets. To demonstrate the usefulness of BAMscale, we analyzed multiple sequencing datasets from chromatin immunoprecipitation sequencing (ChIP-seq) data, chromatin state change data (Assay for Transposase-Accessible Chromatin using sequencing: ATAC-seq, DNA double strand break mapping sequencing: END-seq), DNA replication data (Okazaki fragments sequencing: OK-seq, Nascent-strand sequencing: NS-seq, single-cell replication timing sequencing: scRepli-seq) and RNA-seq data. The outputs consist of raw and normalized peak scores (multiple normalizations) in text format and scaled bigWig coverage tracks that are directly accessible to data visualization programs. Our tool can effectively analyze large sequencing datasets (~100Gb size) in minutes, outperforming currently available tools.Conclusions: BAMscale is a tool that can be used to accurately quantify and normalize identified peaks directly from BAM files, as well as create coverage tracks for visualization in genome browsers. BAMScale can be implemented for a wide set of methods for calculating coverage tracks such as ChIP-seq / ATAC-seq, as well as splice aware RNA-seq, END-seq and OK-seq for which no dedicated software is available. BAMscale is freely available on github (https://github.com/ncbi/BAMscale).
Porous gold nanoparticles for attenuating infectivity of influenza A virus
Authors: Kim Jinyoung , Yeom Minjoo , Lee Taeksu , Kim Hyun-Ouk , Na Woonsung , Kang Aram , Lim Jong-Woo , Park Geunseon , Park Chaewon , Song Daesub , Haam Seungjoo
Published: January 2020

Background: Influenza viruses (IVs) have become increasingly resistant to antiviral drugs that target neuraminidase and matrix protein 2 due to gene mutations that alter their drug-binding target protein regions. Consequently, almost all recent IV pandemics have exhibited resistance to commercial antiviral vaccines. To overcome this challenge, an antiviral target is needed that is effective regardless of genetic mutations.Main body: In particular, hemagglutinin (HA), a highly conserved surface protein across many IV strains, could be an effective antiviral target as it mediates binding of IVs with host cell receptors, which is crucial for membrane fusion. HA has 6 disulfide bonds that can easily bind with the surfaces of gold nanoparticles. Herein, we fabricated porous gold nanoparticles (PoGNPs) via a surfactant-free emulsion method that exhibited strong affinity for disulfide bonds due to gold-thiol interactions, and provided extensive surface area for these interactions. A remarkable decrease in viral infectivity was demonstrated by increased cell viability results after exposing MDCK cells to various IV strains (H1N1, H3N2, and H9N2) treated with PoGNP. Most of all, the viability of MDCK cells infected with all IV strains increased to 96.8% after PoGNP treatment of the viruses compared to 33.9% cell viability with non-treated viruses. Intracellular viral RNA quantification by real-time RT-PCR also confirmed that PoGNP successfully inhibited viral membrane fusion by blocking the viral entry process through conformational deformation of HA. Conclusion: We believe that the technique described herein can be further developed for PoGNP-utilized antiviral protection as well as metal nanoparticle-based therapy to treat viral infection. Additionally, facile detection of IAV can be achieved by developing PoGNP as a multiplatform for detection of the virus.KEYWORDS: Virus inactivation, Influenza A virus, Porous gold nanoparticle, Membrane fusion, disulfide bond
WITHDRAWN: High Failure Rate after Beta-tricalcium Phosphate Grafting for the Treatment of Femoral Head Osteonecrosis: a Retrospective Analysis
Authors: Liu Pei , Mu Xiao-hong , Yu Hua-chen , Jian-lei Guan , Liu Zhao-hui , Wang Wei-guo , Zhang Qi-dong , Guo Wanshou
Published: January 2020

Background: Non-vascularized bone grafting is a promising head-preserving technique for younger patients diagnosed as non-traumatic osteonecrosis of the femoral head (NONFH). Among the various types of bone grafting techniques, “light-bulb” procedure grafting with synthetic bone substitute is an attractive option. We aimed to assess the effectiveness of using beta-tricalcium phosphate (β-TCP) for the treatment of pre-collapse and early post-collapse lesions NONFH. Methods: From April 2010 to June 2014, 33 patients (47 hips) with NONFH were treated using the afore-mentioned technique. The clinical and radiological outcomes were compared between pre- and post-operation. Harris hip score (HHS) was used to evaluate the clinical results, and Association Research Circulation Osseous (ARCO) stage was applied to assess the radiological outcomes. Results: After 5 years’ follow-up, the failure rate of using β-TCP grafting was accounting for 74.5%. 2 hips collapsed more than 2 mm were awaiting for THA, and 33 of the 47 hips had converted to THAs in an average time to failure of 24.1±14.6 months postoperatively. Meanwhile, only 4 hips survived without collapse, and 8 hips collapsed less than 2 mm. After surgery, the time onset of head collapse was 3.6±1.4 months on average, and the first conversion to THA was performed at 5 months postoperative. Conclusions: Our results suggest that “light-bulb” procedure grafting with β-TCP sticks presented with a high failure rate in the early postoperative period. It is not proposed for the treatment of pre-collapse and early post-collapse lesions NONFH.
Calcium Application Method Impacts Botrytis Blight Severity on Petunia Flowers
Authors: Bennett Katherine , Vargo Mary , Schnabel Guido , Faust James E.
Published: January 2020

Two application methods of calcium (Ca), fertigation and spray, were investigated regarding their effects on Botrytis blight on petunia (Petunia ×hybrida) flowers. Plants were grown for 6 weeks with three nutrient solutions consisting of 0, 100, or 200 mg·L−1 Ca and weekly calcium chloride (CaCl2) sprays of 0, 750, or 1500 mg·L−1 Ca for a total of nine treatment combinations. Flowers were harvested, inoculated with Botrytis spores, placed in humidity chambers, and evaluated for Botrytis blight severity. Disease severity decreased by 57% and 70% when flowers were treated with Ca spray applications of 750 and 1500 mg·L−1 Ca, respectively; however, no change in disease severity occurred across the Ca fertigation applications. Ca concentration in the flower petal tissue increased with the Ca spray applications: the flower petal Ca concentration increased from 0.26% to 0.65% of tissue dry mass (DM) as the Ca spray application rate increased from 0 to 1500 mg·L−1. However, no change was observed across the Ca fertigation treatments. Leaf tissue Ca concentration increased from 2.1% to 3.2% DM as the fertigation solution increased from 0 to 200 mg·L−1 Ca, whereas spray application had no significant effects of leaf tissue Ca concentration. The results demonstrate that spray application is a more effective technique than fertigation application to provide higher Ca tissue concentrations in flowers, and that the Ca concentration in flower petal tissue is an important consideration when evaluating tissue susceptibility to Botrytis blight. Because of the high rate of fungicide resistance to Botrytis cinerea found in commercial greenhouses, spray applications of CaCl2 are an important disease management tool for commercial growers.
Efficacy of In-field Thermotherapy in Comparison and Combination of Defoliation for Mitigating Huanglongbing in Sweet Orange
Authors: Vashisth Tripti , Livingston Taylor
Published: January 2020

Huanglongbing (HLB), a bacterial disease, is one of the most destructive citrus diseases. For many decades, it has been known that using heat/high temperatures (thermotherapy) is effective in suppressing plant diseases, particularly the suppression of Candidatus Liberibacter (CLas, casual agent for HLB) when the treated plants are grown in pots (allowing treatment of roots) under controlled conditions. However, in-field thermotherapy has yielded inconsistent results: the tree shows vigorous and symptomless growth for a brief period and then relapses with HLB symptoms. To understand why, this 2-year study was conducted to evaluate the efficacy of in-field thermotherapy and its comparison with defoliation. A significant reduction in visible tree health, foliage, and yield was observed over time in all the treatments. The quantitative real-time polymerase chain reaction (qRT-PCR) results showed that in-field thermotherapy and other treatments were not effective in reducing CLas titer. Interestingly, the performance of thermotherapy and partial defoliated trees were comparable throughout the course of the experiment, indicating that the short-term effects and vigorous growth after thermotherapy are likely an artifact of defoliation and should not be confused with or considered recovery from disease. In an in-depth molecular and biochemical analysis, we found a few subtle transient (up to 15 days) differences occurring in the in-field thermotherapy trees. Genes associated with stress and plant defense response were observed to be altered by in-field thermotherapy. Overall, our results indicate that in-field thermotherapy is not an effective and reliable strategy for mitigating HLB in commercial citrus production and that its efficacy within in-field conditions is similar to manual defoliation. It is critical that any strategy aimed at mitigating HLB should target the whole plant, including the roots, as the CLas colonizes in shoots and the root system; therefore, it can possibly translocate within the entire plant with the bulk phloem flow.
Granular computing–neural network model for prediction of longitudinal dispersion coefficients in rivers
Authors: Ghiasi Behzad , Sheikhian Hossein , Zeynolabedin Amin , Niksokhan Mohammad Hossein
Published: January 2020

Successful application of one-dimensional advection–dispersion models in rivers depends on the accuracy of the longitudinal dispersion coefﬁcient (LDC). In this regards, this study aims to introduce an appropriate approach to estimate LDC in natural rivers that is based on a hybrid method of granular computing (GRC) and an artificial neural network (ANN) model (GRC-ANN). Also, adaptive neuro-fuzzy inference system (ANFIS) and ANN models were developed to investigate the accuracy of three credible artificial intelligence (AI) models and the performance of these models in different LDC values. By comparing with empirical models developed in other studies, the results revealed the superior performance of GRC-ANN for LDC estimation. The sensitivity analysis of the three intelligent models developed in this study was done to determine the sensitivity of each model to its input parameters, especially the most important ones. The sensitivity analysis results showed that the W/H parameter (W: channel width; H: flow depth) has the most significant impact on the output of all three models in this research.
Research on the coagulant aid effects of modified diatomite on coal microbial flocculation
Authors: Jingshen Dong , Quanjun Liu
Published: January 2020

Diatomite was modified by chitosan to prepare modified diatomite, and the modified diatomite in an optimized ratio was utilized in coal bio-flocculation. The interaction behavior and flocculation mechanism of modified diatomite on coal slurry water were investigated by single factor experiments, infrared spectroscopy, Brunauer-Emmett-Teller (BET) measurements, and zeta potential measurements. The single factor experiments showed that when the amount of microbial flocculant added was 1.5 ml, the temperature of coal slurry water was 39 °C, the pH was 5, and the amount of modified diatomite was 0.2 g, after 30 min of sedimentation, the flocculation transmittance of the coal slurry water reached 84.3%. The infrared spectra showed that the -NH2 and -OH of the chitosan molecule had a polar interaction with the Si-OH bond in diatomite. The BET measurements showed that the specific surface area of diatomite was not a decisive factor affecting the flocculation effect. Zeta potential measurements indicated that the amino protonation of chitosan increased the isoelectric point (IEP) of modified diatomite. These results showed that modified diatomite has a good effect on coal bio-flocculation.
Aptamers Which Target Proteins: What Proteotronics Suggests to Pharmaceutics
Authors: Cataldo Rosella , De Nunzio Giorgio , Millithaler Jean-Francois , Alfinito Eleonora
Published: January 2020

Aptamers represent a challenging field of research, relevant for diagnosis in macular degeneration, cancer, thrombosis and many inflammatory diseases, and promising in drug discovery and development. Their selection is currently performed by a stable in vitro technology, namely, SELEX. Furthermore, computationalstatistical tools have been developed to complement the SELEX selection; they work both in the preliminary stage of selection, by designing high affinity aptamers for the assigned target, and also in the final stage, analyzing the features of the best performers to implement the selection technique further. A massive use of the in silico approach is, at present, only restricted by the limited knowledge of the specific aptamer-target topology. Actually, only about fifty X-ray structures of aptamer-protein complexes have been experimentally resolved, highlighting how this knowledge has to be improved. The structure of biomolecules like aptamer-protein complexes can be represented by networks, from which several parameters can be extracted. This work briefly reviews the literature, discussing if and how general network parameters in the framework of Proteotronics and graph theory (such as electrical features, link number, free energy change, and assortativity), are important in characterizing the complexes, anticipating some features of the biomolecules.

To better explain this topic, a case-study is proposed, constituted by a set of anti-angiopoietin (Ang2) aptamers, whose performances are known from the experiments, and for which two different types of conformers were predicted. A topological indicator is proposed, named Möbius (M), which combines local and global information, and seems able to discriminate between the two possible types of conformers, so that it can be considered as a useful complement to the in vitro screening for pharmaceutical aims.
Burden and Prevention of HPV. Knowledge, Practices and Attitude Assessment Among Pre-Adolescents and their Parents in Italy
Authors: Icardi Giancarlo , Costantino Claudio , Guido Marcello , Zizza Antonella , Restivo Vincenzo , Amicizia Daniela , Tassinari Federico , Piazza Maria Francesca , Paganino Chiara , Casuccio Alessandra , Vitale Francesco , Ansaldi Filippo , Trucchi Cecilia
Published: January 2020

Despite infections due to HPV nowadays represent the most common sexually transmitted diseases
worldwide with recognized effective and safe preventive strategies, knowledge, attitudes; however, awareness on
HPV is considerably low. The present study has two main objectives: 1. To conduct a literature review to analyze
the evolution of preventive tools, the complexity of the vaccine choice process, and the challenges posed by HPV
vaccine hesitancy and refusal among pre-adolescents and their parents; 2. To assess knowledge, practices and
attitudes toward HPV infection and vaccination in a sample of Italian pre-adolescents and their parents. The observational
study was carried out through the use of two anonymous and self-administered pre- and postintervention
questionnaires dedicated to the target populations. Between the administrations of the pre- and postintervention
questionnaires, an educational intervention on HPV infection and related diseases, and prevention
strategies was conducted. All participants demonstrated suboptimal knowledge and positive attitudes in the preintervention
questionnaire. Higher levels of knowledge and attitudes were observed among pre-adolescents
thatused social networks and had heard of sexually transmitted diseases at home/school/physician and from parents
and also who had heard of HPV from General Practitioners, Gynecologists, family members and newspapers.
A significant increase in HPV vaccination awareness was observed among pre-adolescents after the educational
sessions. Health education programs aimed at increasing knowledge, attitudes and awareness on HPV are needed
to implement the outcomes of HPV immunization programs, especially if supported by the physicians involved in
counselling and recommendation processes.
Pathophysiological Features of Obesity and its Impact on Cognition: Exercise Training as a Non-Pharmacological Approach
Authors: Inoue Daniela S. , Antunes Bárbara M. , Maideen Mohammad F.B. , Lira Fábio S.
Published: January 2020

Background:

The number of individuals with obesity is growing worldwide and this is a worrying
trend, as obesity has shown to cause pathophysiological changes, which result in the emergence of comorbidities
such as cardiovascular disease, diabetes mellitus type 2 and cancer. In addition, cognitive performance may be
compromised by immunometabolic deregulation of obesity. Although in more critical cases, the use of medications
is recommended, a physically active lifestyle is one of the main foundations for health maintenance, making
physical training an important tool to reduce the harmful effects of excessive fat accumulation.

Aim:

The purpose of this review of the literature is to present the impact of immunometabolic alterations on cognitive
function in individuals with obesity, and the role of exercise training as a non-pharmacological approach to
improve the inflammatory profile, energy metabolism and neuroplasticity in obesity.

Method:

An overview of the etiology and pathophysiology of obesity to establish a possible link with cognitive
performance in obese individuals, with the executive function being one of the most affected cognitive components.
In addition, the brain-derived neurotrophic factor (BDNF) profile and its impact on cognition in obese
individuals are discussed. Lastly, studies showing regular resistance and/or aerobic training, which may be able to
improve the pathophysiological condition and cognitive performance through the improvement of the inflammatory
profile, decreased insulin resistance and higher BDNF production are discussed.

Conclusion:

Exercise training is essential for reestablishment and maintenance of health by increasing energy
expenditure, insulin resistance reduction, anti-inflammatory proteins and neurotrophin production corroborating
to upregulation of body function.
Effect of Environmental Exposure and Pharmacogenomics on Drug Metabolism
Authors: Banerjee Basu Dev , Kumar Ranjeet , Thamineni Krishna Latha , Shah Harendra , Thakur Gaurav Kumar , Sharma Tusha
Published: January 2020

Background:

Pesticides are major xenobiotic compounds and environmental pollutants, which are able to alter drug-metabolizing enzyme as well as pharmacokinetics of drugs. Subsequent to the release of the human genome project, genetic variations (polymorphism) become an integral part of drug development due to their influence on disease susceptibility/ progression of the disease and their impact on drug absorption, distribution, metabolism of active metabolites and finally excretion of the drug. Genetic polymorphisms crucially regulate pharmacokinetics and pharmacodynamics of drugs under the influence of physiological condition, lifestyle, as well as pathological conditions collectively.

Objective:

To review all the evidence concerning the effect of environmental exposure on drug metabolism with reference to pharmacogenomics.

Method:

Scientific data search and review of basic, epidemiological, pharmacogenomics and pharmacokinetics studies were undertaken to evaluate the influence of environmental contaminants on drug metabolism.

Result:

Various environmental contaminants like pesticides effectively alter drug metabolism at various levels under the influence of pharmacogenomics, which interferes with pharmacokinetics of drug metabolism. Genetic polymorphism of phase I and phase II xenobiotic-metabolizing enzymes remarkably alters disease susceptibility as well as the progression of disease under the influence of various environmental contaminants at various levels.

Conclusion:

Individual specific drug response may be attributed to a large variety of factors alone or in combination ranging from genetic variations (SNP, insertion, deletion, duplication etc.) to physiological setting (gender, age, body size, and ethnicity), environmental or lifestyle factors (radiation exposure, smoking, alcohol, nutrition, exposure to toxins, etc.); and pathological conditions (obesity, diabetes, liver and renal function).
‘New/Designer Benzodiazepines’: An Analysis of the Literature and Psychonauts’ Trip Reports
Authors: Orsolini Laura , Corkery John M. , Chiappini Stefania , Guirguis Amira , Vento Alessandro , De Berardis Domenico , Papanti Duccio , Schifano Fabrizio
Published: January 2020

Background:

NPS belonging to the benzodiazepine (BZD) class, e.g., ‘legal/designer
BZDs’/‘research chemicals’, have recently emerged in the drug (mainly online/virtual) market.

Objective:

While certain NPS belonging to the BZD class possess pharmacological profiles similar
to controlled pharmaceutical BZDs, clinical and pharmacological profiles of current emerging
BZDs are still not well-described. Therefore, there is a need to increase clinicians’/public health
knowledge/awareness, to incentive harm reduction strategies.

Methods:

A comprehensive overview was carried out by using the EMCDDA/EDND database regularly
monitored by our research team, by specifically looking at the ‘new BZDs’ so far notified.
Furthermore, given the limitation of peer-reviewed data published so far, a nonparticipant multilingual
qualitative netnographic study was conducted to obtain further clinical/pharmacological/
toxicological data, including psychonauts’ online trip reports.

Results:

First designer BZDs appeared as NPS around 2007. So far, 29 designer BZDs have been
notified to the EMCDDA, being some of them extremely powerful, also at lower dosages. They are
sold as tablets/powder/pellets/capsules/blotters/liquids, at very affordable prices, and variably administered.
Some are also sold on the illicit drugmarket as counterfeit forms of traditional BZDs or
as either adulterants or diluents in heroin or other synthetic opioids/cannabinoids. Nowadays, there
is no guarantee of the quality of designer BZDs composition/purification and, hence, most NPS
consumers may be inadvertently exposed to unsafe and harmful compounds.

Conclusions:

Given the limited information on their pharmacology/toxicity, variations in dosage,
onset of effects, combination of substances, potency, and general patient or individual variability,
the concomitant use of these substances with other drugs entails several and unpredictable risks.