bluuebunny/crossref_metadata_2025 huggingface dataset:
3D Printing of a Bio-Based Ink Made of Cross-Linked Cellulose Nanoﬁbrils With Various Metal Cations
Authors: Mietner Jakob , Jiang Xuehe , Edlund Ulrica , Saake Bodo , Navarro Julien
Published: December 2020

In this work, we present an approach to cross-link cellulose nanofibrils (CNFs) with various metallic cations (Fe3+, Al3+, Ca2+, and Mg2+) to produce inks suitable for three-dimensional (3D) printing application. The printability of each hydrogel ink was evaluated, and several parameters such as the optimal ratio of Mn+:TOCNF:H2O were discussed. CNF suspensions were produced by mechanical disintegration of cellulose pulp with a microfluidizer and then oxidized with 2,2,6,6-tetramethylpiperidine-1-oxyl (TEMPO). Finally, metal cations were introduced to the deprotonated TEMPO-oxidized CNF (TOCNF) suspension to cross-link the nanofibrils and form the corresponding hydrogels. The performances of each gel-ink were evaluated by rheological measurements and 3D printing. Only the gels incorporated with divalent cations Ca2+ and Mg2+ were suitable for 3D printing. The 3D printed structures were freeze-dried and characterized with Fourier transform infrared spectroscopy (FT-IR) and Scanning Electron Microscopy (SEM). The better interaction of the TOCNFs with the divalent metallic cations in terms of printability, the viscoelastic properties of the inks, and the variation trends owing to various metal cations and ratios are discussed.
GMP-compliant Manufacturing Process of an Advanced Therapy Medicinal Product Based on Conjunctival Epithelial Cells
Authors: Bertolin Marina , Ferrari Stefano , Breda Claudia , Ferrari Barbara , Ponzin Diego , Barbaro Vanessa
Published: December 2020

Background. Conjunctival epithelial stem cell therapy represents a potential and valuable therapeutic option for people suffering from conjunctival disorders. We recently developed a research protocol for the ex vivo cultivation of conjunctival epithelial cells. However, manufacturing and release of any Advanced Therapy Medicinal Product (ATMP) must be designed and planned according to the Good Manufacturing Practices (GMPs) guidelines. GMPs require the development and validation of properly defined manufacturing processes, analysis methods and process validations. Our previous experience with GMP-cultured corneal epithelial stem cells for clinical application on patients with limbal stem cell deficiency led us to set up a protocol for cultivation of conjunctival cells with standards complying with the requests for clinical studies. The major challenge for cell-based products is to develop manufacturing processes while maintaining the critical quality parameters in terms of safety, identity, purity and potency.Results. The manufacturing process was re-designed in order to include all the quality control assays needed for the release of any ATMP, i.e., sterility, morphology, cell viability, dose, cell identity and impurities, potency, lack of pyrogens, mycoplasma and viral detection. Methods and acceptance values were set for all the assays. Quality control assays to evaluate safety and efficacy were also investigated.Conclusion. Here, we describe the main phases of the manufacturing process of a conjunctival stem cell-based product to use in clinical applications. Such characterization is crucial for the preparation of documents and dossiers needed by the competent authorities to start a phase I clinical study on patients with conjunctival disorders. The procedure necessary to reach the marketing authorization of such a new cell-based product is still long, but, if reliable and validated, we believe that, in the near future, patients with conjunctival disorders might have a new treatment based on transplantation of autologous cultured conjunctival epithelial stem cells.
Organophosphorus Pesticide Malathion and Immunotoxicity: A More Sensitive Toxicological Target and Current Recommendations
Authors: Lou Minhan , Yong Ling , Mao Weifeng , Xiao Xiao , Liang Chunlai , Wang Wei , Yang Hui , Jia Xudong , Liu Zhaoping , Wang Yin , Li Ning , Song Yan
Published: December 2020

Background Malathion has been wildly used in agriculture and household pest control for years and can affect human health through drinking water and dietary exposure. This study was to investigate the immunotoxicity of malathion (MLT）on BALA/c mice for the purpose of providing a scientific basis for pesticides registration management of MLT and other pesticides. Methods Female mice were randomly divided into five groups. Both the negative control and the positive control groups of mice were daily gavage with corn oil, and those in the positive control group were intraperitoneal injected with 200 mg/kg bw of cyclophosphamide (CY) 24 h before the end of the study. In the dosage groups, MLT were daily gavage at doses of 16, 65 and 258 mg/kg bw for 30 days, respectively. After exposure, the body weight, the absolute and relative weight of organs, the hematology and clinical chemistry parameters, the splenocyte number, the bone marrow cell classification, histopathology, as well as the cellular immunity, humoral immunity, and non-specific immunity functions of mice were studied. Comparisons between multiple groups were carried out by using one-way ANOVA followed by Bonferroni post hoc comparisons tests when equal variances assumed and Dunnett’s T3 post hoc tests when equal variances assumption was not met.ResultsCompared with the negative control group, the low dose of MLT significantly reduced the levels of IL-10, neutrophil, polychromatic erythroblast and monocyte series (P<0.05)，induced atrophy in white pulp of spleen (1/10), which showed an immunosuppression in mice，and increased the absolute and relative weight of thymus (P<0.05). Inhibition of the PFC response, liver injury and thymus atrophy were observed in the high-dose group. What’s more, the IgG level was abnormally elevated with the increase of dose and presented a dose-response relation (P<0.05). ConclusionsThe immunotoxicity of low-dose of MLT is clear from the evidence and the LOAEL of MLT is preliminarily considered to be 16 mg/kg bw. It is much lower than that of the NOAEL (29 mg/kg bw) based on a 2-year chronic toxicity test and carcinogenicity test in rats, which was used to derive the ADI by Joint WHO/FAO Meeting on Pesticide Residues (0.3 mg/kg bw). It indicates that the immune system is a more sensitive target of MLT toxicity.
Using a Screening Toolkit to Determine the Prevalence of Non-Communicable Diseases in an Urban Slum of Mumbai, India: A Cross-Sectional Study
Authors: Rungta Ria , DeWan Andrew T. , Gawali Vijaykumar , Witte Luc de , Hassan Saria
Published: December 2020

Background: Higher than national rates of non-communicable diseases have been found in some urban slums of India. This has been attributed to potentially lower levels of education and decreased access to preventative care. We sought to assess the prevalence of NCDs in a Mumbai slum compared to national averages and understand the association with social determinants of health.Methods: We used a screening toolkit called THULSI (Toolkit for Healthy Urban Life in Slums Initiative) in a community health-camp setting to screen 266 slum dwellers for obesity (BMI above 25 kg/m2), elevated blood pressure (SBP > 120 mm of Hg and DBP > 80 mm of Hg), and elevated blood glucose (RPG > 200 mg/dL). A health survey was administered to understand the demographic data and information about health-seeking behavior of the slum dwellers. The collected data was analyzed to determine the prevalence of each condition and associations with different social determinants of health such as literacy and education level, diagnosis and marital status, age, gender, place of care, employment, availability of toilet, and languages spoken. Results: Of the screened population, 72.6% had elevated blood pressure, 9.0% had elevated blood glucose, 63.2% were obese, and 12.4% were overweight. These rates were 2.81, 1.04, and 3.84 times higher than the national averages, respectively. Of the study population, 26.7% had one condition, 53.4% had two conditions, and 7.9% had all the three conditions we screened for. Male gender (OR: 3.33, 95% CI: 1.37, 8.07) and older age (35-49 years OR: 3.03, 95% CI: 1.52, 6.05, 49-63 years OR: 7.22, 95% CI: 3.06, 17.05, >= 63 years OR: 6.82, 95% CI: 2.12, 22.00) were associated with increased odds of elevated blood pressure, not being previous diagnosed (OR: 0.04, 95% CI: 0.01, 0.13) was associated with lower odds of elevated blood glucose, and older age (35-49 years OR: 2.51, 95% CI: 1.21, 5.21, 49-63 years OR: 4.95, 95% CI: 2.06, 11.92) was associated with increased odds of obesity.Conclusion: We found higher than national rates of the NCDs and high comorbidity in the screened slum population of Mumbai. This signifies the need for screening services and the importance of awareness and education in this population.
Association Between Happiness and Objective/Subjective Economic Status Among Older Adults in Myanmar
Authors: Sasaki Yuri , Shobugawa Yugo , Nozaki Ikuma , Takagi Daisuke , Nagamine Yuiko , Funato Masafumi , Chihara Yuki , Shirakura Yuki , Lwin Kay Thi , Zin Poe Ei , Bo Thae Zarchi , Sone Tomofumi , Win Hla Hla
Published: December 2020

BackgroundFew studies have examined whether objective or subjective economic status (ES) has a greater effect on the happiness of older adults in developing countries with ageing populations. This study examined whether objective/subjective economic status (ES) is associated with happiness in older adults in Myanmar.MethodA multistage, random sampling procedure and face-to-face interviews were conducted in urban and rural areas in Myanmar. The happiness of 1,200 participants aged 60+ was evaluated using a single happiness score of 0 (very unhappy) to 10 (very happy). The wealth index, used as an objective economic indicator, was calculated from household asset items. Subjective economic status was assessed by asking “Which of the following best describes your current financial situation in light of general economic conditions?” The possible responses ranged from (1) very difficult to (5) very comfortable. ResultsThe mean happiness score was lower among participants with low objective and subjective ES than among those with medium or high objective ES (6.24 versus 6.80 points, p < 0.001) and average or higher subjective ES (5.62 versus 6.83 points, p < 0.001), respectively. Both low objective and subjective ES were negatively associated with happiness after adjusting for confounding variables (B: -0.41, 95% confidence interval [CI]: -0.69, -0.13 and B: -0.71, 95% CI: -1.00, -0.42, respectively) and stratification by region (low objective ES, urban: B: -0.52, 95% CI: -1.03, -0.02; low subjective ES, urban: B: -0.50, 95% CI: -0.96, -0.03; low objective ES, rural: B: -0.37, 95% CI: -0.73, -0.02; and low subjective ES, rural: B: -0.80, 95% CI: -1.18, -0.41). ConclusionsIn Myanmar, both objective and subjective ES might influence happiness among older adults. Although they had a similar impact on happiness in urban areas, subjective ES had a stronger impact in rural areas. Interventions for promoting happiness in older adults should consider differences in how objective/subjective ES impacts happiness in different regions, and focus should be placed not only on improving objective ES but also subjective ES in society.
Exploring the Benefits of Participation in Community-Based Running and Walking Events: A Cross-Sectional Survey of Parkrun Participants
Authors: Quirk Helen , Bullas Alice , Haake Steve , Goyder Elizabeth , Graney Mike , Wellington Chrissie , Copeland Robert , Reece Lindsey , Stevinson Clare
Published: December 2020

Background: Whilst the benefits of physical activity for health and wellbeing are recognised, population levels of activity remain low. Significant inequalities exist, with socioeconomically disadvantaged populations being less physically active and less likely to participate in community events. We investigated the perceived benefits from participation in a weekly running/walking event by those living in the most socioeconomically deprived areas and doing the least physical activity.Methods: A cross-sectional online survey was emailed to 2,318,135 parkrun participants in the UK. Demographic and self-reported data was collected on life satisfaction, happiness, health status, physical activity, motives, and the perceived benefits of parkrun. Motivation, health status and benefits were compared for groups defined by level of physical activity at parkrun registration and residential Index of Multiple Deprivation.Results: 60,000 completed surveys were received (2.7% of those contacted). Respondents were more recently registered with parkrun (3.1 v. 3.5 years) and had a higher frequency of participation than non-respondents (14.5 v. 3.7 parkruns per year). Those who were inactive at registration and from socioeconomically deprived areas reported lower happiness, lower life satisfaction and poorer health than the full sample. They were more likely to want to improve their physical health, rather than get fit or lose weight. Of those reporting less than one bout of activity a week at registration, 88% (87% in the most socioeconomically deprived areas) increased their physical activity level and 52% (65% in the most socioeconomically deprived areas) reported improvements to overall health behaviours. Previously inactive respondents from the most socioeconomically deprived areas reported greater improvements to fitness (93% v. 89%), physical health (90% v. 85%), happiness (83% v. 79%) and mental health (76% v. 69%).Conclusion: The least active respondents from the most socioeconomically deprived areas reported changes to their activity levels and benefits to their health and wellbeing since participating in parkrun. Whilst the challenge of identifying how community initiatives like parkrun can better engage with the least active and most socioeconomically deprived remains, if this can be achieved, then such interventions can have a critical public health role in addressing inequalities in benefits associated with recreational physical activity.
Interaction Effects of Diabetes and Hypertension on Cardio-Cerebrovascular Diseases: A Cross-Sectional Study
Authors: Wang Zhehui , Yang Tubao , Fu Hanlin
Published: December 2020

Background It is still not clear whether there exsist interaction effects of diabetes and hypertension on cardio-cerebrovascular diseases. We can not ignore it in order to prevent the incidence and progress of cardio-cerebrovascular diseases considering the high prevalence of diabetes and hypertension in the world.Methods A cross-sectional study with a multistage stratified random sampling method was conducted among people aged 18 years or older in Changsha City, Hunan Province. A multivariate logistic regression model was performed to analyze the association between diabetes complicated with hypertension and cardio-cerebrovascular diseases. The multiplicative interaction effect was evaluated by including the product term of hypertension and diabetes in the model after adjusting for age, sex, smoking, drinking, physical exercise, and body mass index. The relative excess risk ratio (RERI), attribution percentage (AP), synergy index (SI) and 95% confidence interval (CI) were calculated by the Excel calculation table compiled by Andersson to evaluate the additive interaction effects between hypertension and diabetes on cardio-cerebrovascular diseases.Results A total of 14422 participants were recruited. The prevalence of cardio-cerebrovascular diseases in the non-diabetes and non-hypertension, diabetes, hypertension, and diabetes and hypertension combination groups was 3.7%, 12.1%, 21.2% and 31.4%, respectively. The RERI, AP and SI of diabetes combined with hypertension on cardiovascular diseases were 1.92 (95% CI: -2.67 - 6.50), 0.23 (95% CI: -0.22 - 0.68) and 1.34 (95% CI: 0.69 - 2.62), respectively.Conclusions The prevalence of cardio-cerebrovascular diseases in diabetes complicated with hypertension was higher than that in any single condition. However, no interaction effects between diabetes and hypertension were found on the prevalence of cardio-cerebrovascular diseases, indicating that the high prevalence may be due to the simple superposition of the two variables.
Community Based Case Control Study on Effect of Nutrition Education Intervention on Nutritional Status and Contributing Factors Among Under Five Children In Pastoralist And Agro-Pastoralist Community of Somali Region, Eastern Ethiopia.
Authors: Guled Rashid Abdi , Mamat Nik Mazlan , Belachew Tefera , Bakar Wan Azdie Mohd Abu , Assefa Nega
Published: December 2020

Background: Undernutrition is most common public health problem in developing world. It is responsible for more than three million global deaths of under five children every year. Severe wasting and stunting are the major contributors of this problems. Hence, this study was designed to document the effect of nutrition education intervention (NEI) on nutritional status of the children in pastoralist and agro-pastoralist community of Somali regional state, Eastern Ethiopia.Methods: A group randomized controlled trial was carried out among 404 paired child to mothers/caregivers in two phases. A chi-square for categorical variables, t-test and for continuous variables were used. In addition, World Health Organization (WHO) AnthroPlus software were also used.Results: After NEI this has shown statistically significant improvement, in all three types of malnutrition compared to control. The malnutrition prevalence has been significantly decreased within the group from baseline to post intervention; wasting (19% to 9.4%, p = 0.005), underweight (18.5% to 7.4%, p= 0.029), and stunting (31.2% to 21.7%, p= 0.001). Whereas, the control group showed no significant difference (p >0.05) in all three types. The overall mean Z-score difference of the difference (DOD) of wasting and underweight between groups from pre and post intervention were shown better off, compared to control group, with mean DOD wasting of (-0.738, p <0.001) and underweight of (-0.615, p <0.001). But, this was not seen in stunting (-0.239, p >0.05).Conclusion: The NEI using behaviour change communication (BCC) showed promising outcome, and need to be further scaled up and adapted to other districts in the zone or other areas in the region.
Modeling the Effect of Age on Quantiles of the Incubation Period Distribution of COVID-19
Authors: Liu Xiaohui , Wang Lei , Ma Xiansi , Wang Jiewen , Wu Liwen
Published: December 2020

Background: Since the ﬁrst case of pneumonia with unknown etiology was identiﬁed in Wuhan, Hubei province in China in December 2019, the novel coronavirus pneumonia has placed a serious impact on many aspects of the world. Note that the incubation period distribution plays important roles in prevention and control eﬀorts of COVID-19. This study aimed to investigate the conditional distribution of the incubation period of COVID-19 on the age of infected cases, and estimate its corresponding quantiles from information of 2172 conﬁrmed cases from 29 provinces outside Hubei in China.Methods: We collected data including the infection dates, onset dates, and ages of the conﬁrmed cases from the websites of the centres of disease control, or the daily public reports through February 16th, 2020. A maximum likelihood method was developed to account for the biased sampling issue of the data as the epidemic was still ongoing at the time of collecting data. Results: Based on the collected data, we found that the conditional quantiles of the incubation period distribution of COVID-19 varies over ages. In detail, the high conditional quantiles of people in the middle age group are shorter than those of others. We estimated that the 0.95-th quantile related to people in the age group 23∼55 is less than 15 days. Conclusions: Observing that the conditional quantiles vary over ages, we may take more precise measures for people of diﬀerent ages. For example, we may consider carrying out an age-dependent quarantine duration, rather than a uniform 14-days quarantine, in practice. Remarkably, we may need to extend the current quarantine duration for people aged 0 ∼ 22 and over 55 because the related 0.95-th quantiles are much greater than 14 days.
Spatial Analysis of the Tuberculosis Cure in Primary Care in Rio de Janeiro, Brazil
Authors: Junior José Carlos Prado , Medronho Roberto de Andrade
Published: December 2020

Background: Tuberculosis (TB) presents a high burden of disease and is considered a global emergency by the World Health Organization (WHO), consisting of the most important cause of death from infectious disease in adults. It is related directly to access to health services and socioeconomic factors. Primary health care provides greater linking people to health services and greater medication adherence in some chronic diseases. Also, it provides supervised treatment and the search for more effective contacts. Objective: This paper aims to compare the tuberculosis cure among the areas covered and not covered by the family health teams from 2012 to 2014. Methods: A cross-sectional study was carried out in Rio de Janeiro. The variables were obtained from the Notifiable Diseases Information System for Tuberculosis (SINAN-TB) and the socioeconomic variables from the 2010 national census. The socioeconomic variables were selected from the multivariate analysis using principal factors analysis techniques. For the spatial analysis was used a generalized additive model (GAM). Results: Association was found between TB cure and education, alcoholism, contacts search, serology for HIV and the elderly. People with family health coverage between 35 and 41 months had 1,64 more chance of cure when compared to people without coverage (95% CI 1.07 to 2.51). Conclusion: From the spatial analysis, it was possible to identify areas with less chance of cure for tuberculosis in the municipality.
An Assessment of Provisions of Noncommunicable Disease Services on Health Promotion, Prevention and Control at Primary Health Care: A Case Study from Two Divisions of Bangladesh
Authors: Pinki Sadia Sobhan , Noor Irfan Nowroze , Amin Bayzid , Islam Md. Ziaul , Riaz Baizid Khoorshid
Published: December 2020

BackgroundAlthough evidence suggests that cardiorespiratory fitness is the most important component associated with future health, little is known of how it is associated with multiple other physical fitness components. Since various physical fitness aspects do not change the same as cardiorespiratory fitness during childhood, it is necessary to establish possible associations between cardiorespiratory fitness and other physical fitness components in children. Therefore, the main purpose of the study was to test the associations between cardiorespiratory fitness with motor performance and body size in 7-14-year-old children.MethodsIn this cross-sectional study, we recruited 1612 children (52.5% girls). Health-related physical fitness components included: 1) body-mass index (kg/m2) calculated from height and weight (measure of body size), 2) sit-and-reach test (measure of flexibility), 3) standing long jump (measure of explosive strength), 4) sit-ups in 30 sec (measure of repetitive strength), 5) 10x5 shuttle run test (measure of agility) and 6) 20-m shuttle run test (measure of aerobic capacity). The associations were performed using generalized estimating equations with β coefficients.ResultsAfter adjusting for age, cardiorespiratory fitness was associated with sit-and-reach test (β=0.13, p<0.001), standing long jump (β=0.59, p<0.001), sit-ups in 30 sec (β=0.53, p<0.001) and 10x5 shuttle run test (β=-0.56, p<0.001) in boys. In girls, cardiorespiratory fitness was associated with body-mass index (β=-0.12, p<0.001), sit-and-reach test (β=0.21, p<0.001), standing long jump (β=0.25, p<0.001), sit-ups in 30 sec (β=0.36, p<0.001) and 10x5 shuttle run test (β=-0.40, p<0.001). No significant associations between cardiorespiratory fitness and body-mass index in boys were observed.ConclusionsAlthough significant, cardiorespiratory fitness is weakly to moderately associated with other physical fitness components, pointing out that such measure should be tested separately from other aspects of physical fitness in school-aged children.
Effects of Family Intervention on Physical Activity and Sedentary Behavior in Children Aged 2.5-12 Years: A Meta-Analysis
Authors: Huang Ting , Zhao Guanggao , Guo Zhiqiang , Wu Hua , Fu Jinmei , Sun Shunli , Lv Wendi , He Zihao , Hu Qiming , Quan Minghui
Published: December 2020

Background: To use a quantitative approach to examine the effects of family interventions on physical activity (PA) and sedentary behavior (SB) in children aged 2.5-12 years. Methods: PubMed, OVID, Web of Science, and others were searched from their inception to May 2020. Intervention studies that examined the effects of family interventions on PA among children aged 2.5-12 years were included in this meta-analysis. Lastly, subgroup analyses were conducted to examine the potential modifying effects of family intervention’s characteristics and study quality. Results: Eleven articles met the inclusion criteria for this review. Studies investigated a range of PA outcomes, including moderate-to-vigorous PA (MVPA), total PA (TPA), daily steps, and SB levels. Meta-analysis showed that family intervention had a significant effect on PA [standardized mean difference (SMD)=0.10; 95%CI=0.01, 0.19], especially for daily steps [weight means difference (WMD)=1,006; 95%CI=209, 1,803], but not for SB (WMD=-0.38; 95%CI=-7.21, 6.46). Subgroup analyses indicated the improvements in PA occurred when children were 6-12 years old, intervention focused on PA only, intervention duration ≤ 10 weeks, and “low risk of bias” study performed. Conclusions: Family intervention may be a promising way to promote children’s PA levels, especially for daily steps. Trial registration: Meta-analysis protocol was registered on PROSPERO: CRD42020193667.
Relationship Between Multimorbidity, Combination and All-Cause Mortality Among Older Adults: A Retrospective Cohort Analysis
Authors: He Kun , Zhang Wenli , Hu Xueqi , Zhao Hao , Guo Bingxin , Shi Zhan , Zhao Xiaoyan , Yin Chunyu , Shi Songhe
Published: December 2020

Background: Previous studies have evaluated the association of multimorbidity with higher mortality, but epidemiologic data on the association between the combination of multimorbidity and all-cause mortality risk are rare. We aimed to examine the relationship between multimorbidity (number/combination) and all-cause mortality in Chinese older adults. Methods: We conducted a population-based study of 50,100 Chinese participants. Cox regression models were used to estimate the impact of long-term conditions (LTCs) on all-cause mortality. Results: The prevalence of multimorbidity was 31.35% and all-cause mortality was 8.01% (50,100 participants). In adjusted Cox models, the hazard rations (HRs) and 95% confidence intervals (CIs) of all-cause mortality risk for those with 1, 2, and ≥ 3 LTCs compared with those with no LTCs was 1.10 (1.01-1.20), 1.21 (1.10-1.33), and 1.46 (1.27-1.67), respectively (Ptrend <0.001). In the LTCs ≥ 2 category, the combination of chronic diseases that included hypertension, diabetes, CHD, COPD, and stroke had the greatest impact on mortality. In the stratified model by age and sex, absolute all-cause mortality was higher among the ≥ 75 age group with an increasing number of LTCs. However, the relative effect size of the increasing number of LTCs on higher mortality risk was larger among those < 75 years.Conclusions: The risk of all-cause mortality is increased with the number of multimorbidity among Chinese older adults, particularly combinations.
Prevalence, Associated Factors and Awareness of Hypertensive Retinopathy Among an Elderly Population with Hypertension in Nepal: The Bhaktapur Retina Study
Authors: Thapa Raba , Khanal Shankar , Tan Hendra , Thapa Suman , Rens Gerardus Hermanus Maria Bartholomeus van Rens van
Published: December 2020

Background: This study aimed to assess the prevalence, associated factors and awareness of hypertensive retinopathy among an elderly population with hypertension in Nepal Methods: A population-based, cross-sectional study was conducted from 2013 to 2015 in Bhaktapur district, Nepal. The sample size was 2100 subjects age 60 years and above. From this sample, all diagnosed patients with hypertension were analyzed. A detailed history was obtained, and an ocular examination was performed. Blood sugar and blood pressure were measured. Result: Information was complete for 1860 (88.57%) subjects. The age ranged from 60 to 95 years with the mean ± SD age of 69.64±7.31 years. Hypertension was found in 643 subjects (34.61%), of which 224 (12.04%) were newly diagnosed cases. Hypertensive retinopathy was found in 81 cases (12.6%). Grade 1, grade 2, and grade 3 hypertensive retinopathy comprised 53 (65.43%), 19 (23.46%), and 9 (11.11%) cases, respectively. Hypertensive retinopathy was more frequent in the age group 70-79 years (15.23%) compared to other age groups, among males (13.25%), illiterates (13.56%), diabetics (16.49%), and those with body mass index (BMI) ≥25 kg/m2 (14%). However, none of the factors was found to be statistically significant. Among the subjects with hypertension, awareness of hypertension’s effects on the eyes, retina and vision was found in 13.84%, 8.4%, and 11.98% respectively. Conclusion: Prevalence of hypertension, hypertensive retinopathy and associated factors among an elderly population were similar to other countries. Awareness of hypertensive retinopathy was found in only 8.4%. Increased emphasis should be directed toward improving awareness campaigns. Key words: Hypertension, hypertensive retinopathy, elderly, awareness, Nepal
Hybrid Imaging Reveals Improved Absorbed Dose from Selective Internal Radiation Treatment by Using an Anti-Reflux Catheter
Authors: Rangraz Esmaeel Jafargholi , Tang Xikai , Maleux Geert , Dekervel Jeroen , Cutsem Eric Van , Verslype Chris , Baete Kristof , Nuyts Johan , Deroose Christophe M
Published: December 2020

Selective internal radiation therapy (SIRT) is a promising technique for patients with hepatic malignancies. Several image-based investigations, e.g. volumetric and absorbed dose assessment, are mandatory for SIRT planning and treatment verification based on national and international regulations.General treatment workflows are described in guidelines, recommendations, and the package inserts of the manufactures. But, guidance to tackle particular clinical conditions can be ill-defined and different centers practice their own workflow to analyze the treatment process. This case report includes an example of inconsistency between treatment simulation and observed treatment result, revealed by hybrid imaging. There is no universally accepted standard procedure defined in the literature for detecting and evaluating a possible mismatch between [99mTc]Tc-MAA-based simulation and distribution of the therapeutic microspheres. In this setting, more advanced multi-modal image-based analysis may be beneficial.A 78 year old patient with hepatocellular carcinoma underwent liver radioembolization with resin 90Y-microspheres. Tumoral and non-tumoral dose–volume histograms were evaluated for simulated activity distribution using [99mTc]Tc-MAA-SPECT and post-treatment activity measurement using 90Y-PET. During simulation workup, [99mTc]Tc-MAA particles were administered using a regular catheter. On the other hand, for the treatment session an anti-reflux catheter was used. Our result, suggests that the use of an anti-reflux catheter might improve tumor coverage, and as a result decrease non-tumoral liver uptake deposition.
Clinical outcome of the Intrathecal administration of the allogeneic side population Adipose Derived Mesenchymal Stem Cells in Werdnig Hoffman patients: An open-label Phase I clinical trial
Authors: Mohseni Rashin , Hamidieh Amir Ali , Shoae-Hassani Alireza , Ghahvechi-Akbari Masood , Majma Anahita , Mohammadi Mahmoud , Nikougoftar Mahin , Shervin-Badv Reza , Ai Jafar , Montazerlotfelahi Hadi , Ashrafi Mahmoud Reza
Published: December 2020

Background

Werdnig Hoffman (WH), a hereditary neurodegenerative disorder of lower motoneurons associated with progressive muscle weakness is the most common genetic cause of infant mortality. There is no effective treatment for WH exists. The field of translational research is active now, and clinical trials or case studies are ongoing. We present a phase 1 clinical trial in patients with WH who received side population adipose-derived mesenchymal stem cells (SPADMSCs).
Methods

The intervention group administered with three intrathecal administrations of escalating doses of SPADMSCs. The safety analysis was assessed by controlling the vital signs and efficacy analysis performed by the Ballard score and EMG test. These tests were performed previous to treatment and at the end of the follow-up.
Results

The treatment well-tolerated, without any adverse event related to the stem cell administration. Patients showed significant improvement in the amplitude response of motor in the tibial nerve (0.56 mV; p: 0.029). The weight of patients, ventilation days, and number of hospitalizations were not meaningful parameters in the response of patients in the intervention and control groups. One patient in the intervention group is still alive after 36 months. He gained a normal weight and has a normal growth rate. The patient can breathe without ventilator aid.
Conclusion

The present study for stem cell therapy shows safety and efficacy in WH patients, mainly in the recovery of the tibial nerve, respiratory system, and length of life.
Perceptions of important outcomes of moral case deliberations: a qualitative study among healthcare professionals in childhood cancer care
Authors: Weiner Charlotte , Pergert Pernilla , Molewijk Bert , Castor Anders , Bartholdson Cecilia
Published: December 2020

BACKGROUND: In childhood cancer care, healthcare professionals must deal with several difficult moral situations in clinical practice. Previous studies show that morally difficult challenges are related to decisions on treatment limitations, infringing on the child's integrity and growing autonomy, and interprofessional conflicts. Research also shows that healthcare professionals have expressed a need for ethics support to help them deal with morally difficult situations. Moral case deliberations (MCDs) are one example of ethics support. The aim of this study was to describe the MCD-related outcomes that HCPs in childhood cancer care considered important, before MCDs were implemented, in order to facilitate the implementation of MCDs in childhood cancer care in Sweden.METHODS: This study is based on qualitative data. Healthcare professionals, mostly representing registered nurses, nursing assistants and physicians, working at childhood cancer care centres in Sweden, were invited to respond to the translated and content-validated European Moral Case Deliberation Outcomes Instrument, before participating in regular MCDs. The main open-ended question included in the questionnaire was analysed according to systematic text condensation. RESULTS: Data was collected from 161 responses from the healthcare professionals who were invited to participate. The responses included healthcare professionals’ perceptions of which MCD-related outcomes they found important for handling moral challenges. Three different themes of important outcomes from the analysis of the data are presented as follows: Interprofessional well-being in team interactions on a team level; Professional comfort when dealing with moral challenges on a personal level; and Improved quality of care on a care level. CONCLUSIONS: Healthcare professionals in childhood cancer care considered it important that ethics support could enhance the well-being of interprofessional teams, support healthcare professionals on an individual level and improve quality of care. The results of this study can be used in current and future training for MCD-facilitators. When knowing the context specific important MCD-outcomes, the sessions could be adapted. Managers in childhood cancer care would benefit from knowing about the specific important outcomes for their target group because they could then tailor the conditions.
Characterization of bacterial community in the rumen of bovine with laminitis using high-throughput sequencing
Authors: Guo Jian , Liu Bo , Maimai Tuniyazi. , Zhao Caijun , Cao Yongguo , Zhang Naisheng , Hu Xiaoyu , Fu Yunhe
Published: December 2020

Background: Laminitis- an inflammation of lamella, could cause great economic loss to dairy industry, which has attracted wide attention around the world. Although previous researches explored risk factors of laminitis, the exact pathological mechanism of laminitis is still remaining unclear. In recent years, microbiota is considered as one of the vital parts that played significant role in various diseases processes. However, current studies are far from sufficient. Aim of this study is to explore the characteristics of ruminal microbiota in laminitis cows.Results: The serum of bovines with or without laminitis from farms was collected to detect concentrations of LPS, lactic acid, and histamine, and the ruminal fluid was collected for 16S rRNA sequence analysis. The results showed that there was a significant increase in LPS and lactic acid levels in laminitis group comparing to control group cows. In addition, the higher abundance of bacteria that -riches acid-enhancing metabolites, namely, Candidatus Saccharimonas, Saccharofermentans, Erysipelotrichaceae UCG-009, Erysipelotrichaceae UCG-008, Clostridium papyrosolvens and Ruminococcaceae bacterium AE2021 were detected in the rumen fluid from laminitis bovines.Conclusions: This article confirmed that difference of rumen microbiota were occurred in rumen between health and laminitis bovines. The elevated abundance of bacteria that riches acid- enhancing metabolites, as well as increased the concentration of lactic acid and LPS could be harmful factors to bovines and increase risks of laminitis.
What is the role of locoregional anesthesia in breast surgery? A systematic literature review focused on pain intensity, opioid consumption, adverse events, and patient satisfaction
Authors: Sansone Pasquale , Giaccari Luca Gregorio , Faenza Mario , Costanzo Pasquale Di , Izzo Sara , Aurilio Caterina , Coppolino Francesco , Passavanti Maria Beatrice , Pota Vincenzo , Pace Maria Caterina
Published: December 2020

Background: Breast surgery in the United States is common. Pain affects up to 50% of women undergoing breast surgery and can interfere with postoperative outcomes. General anesthesia is the conventional, most frequently used anaesthetic technique. Various locoregional anesthetic techniques are also used for breast surgeries. A systematic review of the use of locoregional anesthesia for postoperative pain in breast surgery is needed to clarify its role in pain management.Objectives: To systematically review literature to establish the efficacy and the safety of locoregional anesthesia used in the treatment of pain after breast surgery.Methods: Embase, MEDLINE, Google Scholar and Cochrane Central Trials Register were systematically searched in Mars 2020 for studies examining locoregional anesthesia for management of pain in adults after breast surgery. The methodological quality of the studies and their results were appraised using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist and specific measurement properties criteria, respectively.Results: Nineteen studies evaluating locoregional anesthesia were included: 1058 patients underwent lumpectomy/mastectomy, 142 breast augmentation and 79 breast reduction. Locoregional anesthesia provides effective anesthesia and analgesia in the perioperative setting, however no statistically significant difference emerged if compared to other techniques. For mastectomy only, the use of locoregional techniques reduces pain in the first hour after the end of the surgery if compared to other procedures (p = 0.02). Other potentially beneficial effects of locoregional anesthesia include decreased need for opioids, decreased postoperative nausea and vomiting, fewer complications and increased patient satisfaction. All this improves postoperative recovery and shortens hospitalization stay. In none of these cases, locoregional anesthesia was statistically superior to other techniques.Conclusion: The results of our review showed no differences between locoregional anesthesia and other techniques in the management of breast surgery. Locoregional techniques are superior in reducing pain in the first hour after mastectomy.
Selected ions and major- and trace elements as contaminants in coal-waste dump water from the Lower- and Upper Silesian Coal Basins (Poland)
Authors: Lewińska-Preis Lucyna , Szram Ewa , Fabiańska Monika , Nádudvari Ádám , Misz-Kennan Magdalena , Abramowicz Anna , Kruszewski Łukasz , Kita Andrzej
Published: December 2020

Many temporary- and permanent reservoirs of water occur on or near coal-waste dumps in the Lower- and Upper Silesian Coal Basins (Poland). Little or nothing is known of the degree to which their water chemistry might reflect (a) reservoir type, i.e., whether permanent or temporary, (b) level of coal-waste thermal activity, i.e., whether inactive or self-heating or burnt-out or (c) region, i.e., whether the dumps are in Upper- or Lower Silesia. To provide some answers, concentrations of selected ions (NH4+, HCO3-, F-, Cl-, Br-, NO2-, NO3-, PO43-,SO42-) were determined by ion chromatography and of nineteen elements (Al, B, Ba, Ca, Cd, Cr, Cu, Fe, K, Li, Mg, Mn, Na, P, Pb, S, Si, Sr, Zn) by inductively coupled plasma mass spectrometry (ICP-MS). The data allow a number of the following observations. When permanent reservoirs are considered, there is a clear relationship between concentrations of ions and major- and trace elements and dump thermal activity. The highest concentrations occur where the thermal activity is high as inorganic components are transformed into more water-soluble forms. As dump thermal activity shows a regional pattern, it follows also that elemental- and ion concentrations in the dump waters show significant regional differences. In temporary reservoirs, concentrations of ions and major- and trace elements are much lower and any correlations between components less significant than in the permanent reservoirs; these reservoirs exist for too short a time for any balance between coal waste- and water components to be established.
Associations between metabolic syndrome and type of dementia: Analysis based on the National Health Insurance Service database of Gangwon province in South Korea
Authors: KIM YEO JIN , Kim Sang Mi , Jeong Dae Hyun , Lee Sang-Kyu , Ahn Moo-Eob , Ryu Ohk-Hyun
Published: December 2020

BackgroundMetabolic syndrome is a cluster of conditions that occur together, increasing the risk of cardiovascular disease. However, the relationship between metabolic syndrome and dementia has remained controversial. Using nationwide population cohort data, we investigated the association between metabolic syndrome and dementia, according to the dementia type.MethodsWe analyzed data of 84,144 individuals, in the aged group of more than 60 years, between January 1, 2009, to December 31, 2009, at Gangwon province by using the information of the (Korean) National Health Insurance Service. After eight years of gap, in 2017, we investigated the relationship between metabolic syndrome and dementia. We classified Dementia either as dementia of the Alzheimer type (AD) or vascular dementia (VD). AD and VD were defined as per the criteria of International Classification of Disease, Tenth Revision, Clinical Modification codes. Multiple logistic regression analyses examined the associations between metabolic syndrome or five metabolic syndrome components and dementia. Analyses included factors like age, sex, smoking, alcohol, physical inactivity, previous stroke, and previous cardiac disease.ResultsMetabolic syndrome was associated with AD (OR= 11.48, 95% CI 9.03-14.59), not with VD. All five components of metabolic syndrome were associated with AD, independently. (high serum triglycerides: OR= 1.87, 95% CI 1.60-2.19; high blood pressure: OR =1.85, 95% CI 1.55-2.21; high glucose: OR= 1.77, 95% CI 1.52-2.06; abdominal obesity: OR= 1.88, 95% CI 1.57-2.25; low serum high-density lipoprotein cholesterol: OR= 1.91, 95% CI 1.63-2.24) However, among components of metabolic syndrome, only the high glucose level was associated with VD. (OR= 1.26, 95% CI= 1.01-1.56) Body Mass Index (BMI), fasting glucose, and smoking were also associated with AD. A history of the previous stroke was associated with both AD and VD.ConclusionsMetabolic syndrome was found associated with AD but not with VD. Patients with metabolic syndrome had an 11.48 times more likeliness to develop AD compared to those without metabolic syndrome. VD was associated only with several risk factors that could affect the vascular state rather than a metabolic syndrome. We suggested that the effect of metabolic syndrome on dementia would vary depending on the type of dementia.
Carbon Neutral Bhutan: sustaining carbon neutral status under growth pressures.
Authors: Yangka Dorji , Rauland Vanessa , Newman Peter
Published: December 2020

Background: Bhutan has pledged to remain carbon neutral (CN) in perpetuity. Whether they can sustain this is questionable due to the country’s increasing economic growth (GDP) and commitment to gross national happiness (GNH) outcomes, both of which can lead to a rise in greenhouse gas (GHG) emissions. The nexus between GHG, GNH and GDP is the essence of the Paris Agreement and Sustainable Development Goals global project.Results: Through scenario modelling using the Long-range Energy Alternative Planning (LEAP) model, the study finds that the carbon neutral declaration will derail between 2037 and 2050 without mitigation measures. By putting in place mitigation measures especially in the industry and transport sectors, CN can be retained even under high growth pressure, which may cost just 2% of GDP. CN can be easily retained under low economic growth, but this could undermine GNH. High growth will require immediate interventions to enable electrification of industry and transport.Conclusions: The options to remain CN will require Bhutan to adopt more efficient technologies and electrify industry and transport under both low and high growth scenarios. The additional cost to the Bhutanese economy is feasible through low and high growth opportunities. The options are similar to those confronting emerging nations struggling with issues of climate commitments under economic growth pressures. All will need to adapt their specific economic contexts to achieve the simultaneous objectives of the Sustainable Development Goals whilst addressing the net zero Paris agenda. Bhutan shows it is possible.
Alterations in MicroRNA Gene Expression Profile in Liver Transplant Patients with Hepatocellular Carcinoma
Authors: Afshari Afsoon , Yaghobi Ramin , Karimi Mohammad hossin , Mowla Jvad
Published: December 2020

Background: HCC can lead to liver failure, rendering liver transplant. Since miRNAs can receive early evaluation before clinical symptoms are manifested, they might be detected as biomarkers of several disorders. Therefore, in the present study, alterations in miRNAs as biomarkers were detected in LT patients with HCC.Methods: Fourteen tissue samples composed of 5 rejected and 9 non-rejected ones were used for studying the microRNAs expression pattern by LNA-array probe. The result was evaluated by qRT-PCR on 30 other tissue samples composed of 10 rejected and 20 non-rejected ones for the selected miRNAs. All samples were collected from liver transplanted patients with HCC. Results: The study results revealed that in rejected patients compared to non-rejected ones, hsa-miR-3158-5p, -4449, -4511, and -4633-5p were up-regulated and hsa-miR-122-3p, -194-5p, 548as-3p, and -4284 were down-regulated. Conclusion: It was concluded that the tissue levels of specific miRNAs (especially hsa-miR-3158-5p, -4449, -194-5p and -548as-3p) correlated well with the development of HCC, which could be further studied as biomarkers.