bluuebunny/crossref_metadata_2025 huggingface dataset:
I linfomi nei pazienti con infezione da HIV: uno studio retrospettivo.
Authors: Vito A De , al. et
Published: June 2020

Le persone con infezione da HIV (PLWH) hanno un rischio maggiore di sviluppare tumori rispetto alla popolazione HIV-negativa. Dal 2005 al 2018, nel nostro centro 82 pazienti hanno sviluppato una neoplasia, 25 (30,1%) di questi un linfoma. È stato eseguito uno studio retrospettivo che includeva i PLWH con una diagnosi di linfoma, visti nel centro negli ultimi 15 anni. Sono state registrate le informazioni sulla diagnosi, il tipo di tumore, la stadiazione, il trattamento e le cause di morte. Dei 25 pazienti arruolati 20 (80%) erano maschi. L’età media era di 47,6 ± 9,4 anni. I pazienti con linfoma non-Hodgkin (LNH) erano 17 (68%) mentre quelli con linfoma di Hodgkin (LH) erano 8 (32%). Per quanto riguarda i LNH, la forma più frequente è stata quella a grandi cellule B, diagnosticata in 10 (58,8%) pazienti. A 18 (72%) pazienti è stato diagnosticato un linfoma in stadio IV. Venti (80%) pazienti hanno iniziato un trattamento chemioterapico, e 3 (12%) hanno anche effettuato dei cicli di radioterapia. Sono state osservate 11 (44%) morti, 9 (82%) delle quali in pazienti con LNH. In conclusione, la mortalità nei PLWH con linfoma è ancora molto elevata (44%). Appare cruciale implementare strategie di diagnosi precoce e perseguire la completa soppressione virale per ridurre l’incidenza dei LNH.
Delayed Replantation of an Avulsed Permanent Incisor Tooth
Authors: Wahluyo Soegeng , Anggraini Ratri , Anggarani Welly , Ramadhaniati Dwi Mulia , Tedjosasongko Udijanto
Published: June 2020

Background: Incidence of dental avulsion is 1-11% of all dental injuries to the permanent dentition, with the maxillary central incisor being the most frequently involved tooth. The age group of 7-10 years appears to be most affected. If the avulsed teeth are not treated immediately, they can have a significant negative impact on the child such as functional, aesthetic and psychological disorder. Purpose: The aims of this case reports was to discuss the important role of storage medium that can influence the success of replantation treatments of avulsion teeth. Case Management: The first phase of treatment was an extra oral root canal treatment and were repositioned into the socket. Clinical and radiographic control was carried out periodically for 2 months. Discussion: Delayed replantation has a poor long-term prognosis. The periodontal ligament will be necrotic and not expected to heal. The goal in delayed replantation is to restore the tooth to the dentition for esthetic, functional, and psychological reasons and to maintain alveolar contour. Conclusion: This case reports showed the important role of storage medium that can influence the success of replantation treatments of avulsion teeth.
Posterior Maxillary Prosthetic Treatment with Molar Hemisection – A case report
Authors: Kurdi Abil , Hidayati Hanoem Eka
Published: June 2020

Background: Hemisection is an alternative treatment option for maintaining tooth with multiple root that indicated for extraction. Purpose: To reported tooth with multiple root indicated by extraction to be used as a fixed-fixed bridge abutment by extracting the infected root and maintain the healthy one. Case: A 53-year-old woman with caries in upper 1st molar teeth in mesiobuccally root that can’t be maintained. Patients refuse the teeth to be extracted. Case Management: Hemisection treatment was performed on 26 mesiobuccal root, with the addition of bone graft. After the healing process, fixed-fixed bridges were made on 25, 26, 27, 28, with PFM on 25, 26, 27 and full cast crowns on 28 as the material. Discussion: Hemisection as a conservative treatment, can be an option for multiple  root teeth that has been indicated for extraction but still have root that can be maintained. Conclusion: Teeth performed by hemisection treatments can be used as abutments with attention to the selection of patients to achieve long-term success.
Complete Denture Treatment With a Flat Ridge Using Semi-adjustable Articulator
Authors: Herdianti Nur Cecilia , Soekobagiono Soekobagiono , Dahlan Agus
Published: June 2020

Background: Complete denture is a removable denture replacing all the missing teeth and tissue in the upper jaw and lower jaw. The purpose of making complete denture is to improve the function of chewing, aesthetic functions and maintaining patient's oral health. Complete edentulous ridge will causes resorption, until it become flat. A flat ridge is associated with difficulties in providing successful dentures. Purpose: This case report aims to reported the treatment of complete edentulous maxillary and mandibular with a flat ridge using semi-adjustable articulator. Case(s): A 63-year-old male patient visited the Prosthodontic Clinic of Dentistry Faculty, Airlangga University with complete edentulous maxillary and mandibular, also flat ridge in his mandibular.  Case Management: This case is using semi-adjustable articulator (Stratos 300). Some accessories in Stratos 300 were used in this case, such as centric tray to help determine the height of bite, gnathometer M to help the process of functional impression and bite block, also tooth arrangement with 2D templates. Conclusion: The use of semi-adjustable articulator (Stratos 300) could restore stomatognathic function in accordance with patient’s condition.
Pre-surgical Orthopedic (PSO) Pre-maxilla Appliance for Children with Cleft Lip and Palate: A Case Series
Authors: Saskianti Tania , Amalia Rizki , Limbri Stephanie Clara , Dewi Ardianti Maartrina , Tedjosasongko Udijanto
Published: June 2020

Background: Cleft lip and palate is one of most common craniofacial anomalies. It is a congenital defect and can be resulted from genetic mutation, environment and multifactor causes. The problems of cleft lip and palate on baby complicate as poor feeding ability can lead to growth and development disturbances. Purpose: This article described the use of PSO in a 4-day old male neonate with unilateral cleft lip and palate and a 3- year old male child with soft and hard palate cleft, both with chief complaint of feeding difficulty. Case Management: Custom tray was used to deliver the alginate impression. The appliance was both fabricated using self-cured acrylic and with / without lip strapping. Discussion: Pre-surgical orthopedic appliances are most frequently provided by the pediatric dentist on cleft palate teams at most hospital-based programs. Conclusion: The PSO appliance could approximate the segments of the cleft maxilla by allowing spontaneous growth of palatal shelves prior to the reconstructive and definitive surgery.
Comparison of Tungsten Carbide and Arkansas Stone For Adhesive Removal On Enamel Surface After Debonding Procedure
Authors: Noviyanti Putri Aditya Kartika , Hamid Thalca , Triwardhani Ari
Published: June 2020

Background: Debonding aims to remove orthodontic appliances from the patient's teeth and cleanse all residual adhesive material on the surface of the tooth to restore surface conditions such as before orthodontic treatment. Damage may occur after debonding process. Removal of the remaining adhesive material has a major effect on the enamel surface conditions, the researcher wants to know the effect of cleaning adhesive material using Tungsten carbide 12 flute burs, Arkansas stone bur on the enamel surface Purpose: To determine the effect of cleaning the remaining adhesive material using Tungsten carbide 12 flute burs and Arkansas stone bur Against the Surface of the Enamel. Method: This study was experimental laboratory (in vitro study) with 4 groups division, first control group was tooth before bracket was installed, group 2 was done debonding without cleaning of residual adhesive, group 3 was done adhesive cleansing with Arkansas stone and group 4 was done adhesive cleaning with tungsten carbide 12-flutted Result: Showing that the use of 12-flutted tungsten carbide was able to clean enamel surfaces with the most delicate results and did not cause cracks or cracks on enamel surface Conclusions: The best method to clean the remaining adhesive is using 12-flutted tungsten carbide bur using contra angle high speed and with adequate water flow and sprays to prevent increasing of temperature that damage dental pup.
Increasing Denture Retention using Compound Denture Technique – A Case Report
Authors: Wirayudha Agam , Kamadjaja Michael Josef Kridanto , Agustono Bambang
Published: June 2020

Background: Treating missing tooth with denture, in some cases, still leave the patient unfulfilled. Good mastication and retention are the main considerations especially for those who require more retentions. In some cases, combination of partial and fixed denture the best approach to achieve better functional and retention results. Purpose: To report compound denture procedures with good mastication and retention as the main considerations. Case: A 43-year-old male patient reported a complaint of chewing difficulty due to missing right upper front teeth caused by work accident and extracted posterior. Patient wanted to wear partial denture to regain good mastication. Case management: Compound denture was chosen to optimize the remaining teeth for better functional and aesthetic. Zirconia all ceramic fixed dentures were fabricated on 13, 14, 15 with an occlusal rest on 13 and 15. Pontic on the 14 used ridge lap design. Discussion: Compound denture is a combination of removable and fixed denture where a minor connector of a removable denture should involve a fixed denture. Fixed denture shall be fabricated first and then removable denture. Conclusion: The definitive restoration of this case was compound denture, which is a combination of partial denture metal frame and fixed denture to restore the good mastication and retention.
Değişik Katlarda Çıkan Yangın Sonucunda Çelik Yapıların Dayanımlarının Araştırılması
Authors: YAZGAN Mehmet Toyanç
Published: June 2020

Yangın olaylarının yol açtığı can ve mal kayıplarını önleyebilmek
için, öncelikle tehlikeye neden olabilecek etkenleri ortadan kaldırmak,
yapıların yangına dayanım gücünü artırmak ve kolay müdahale olanağı sağlamak
gerekmektedir. Bu nedenle yapıların tasarım aşamasında, estetiğe, işleve,
konfora ve ekonomiye dayalı kaygıların arasında, yapılardaki yangına karşı can
güvenliğinin sağlanması da olmak zorundadır. Yangına dayanıklı yapı tasarımında, yangının meydana getirdiği
olumsuz etkilerinin bilinmesi ve taşıyıcı sistemi oluşturan yapı elemanlarının
bu deformasyonlara karşı dayanımlı olmalarının yanında, mimari tasarımdan
başlayarak yapının taşıyıcı sisteminin oluşturulmasında, yangın dayanımını
arttıracak birçok ayrıntının göz önüne alınması gerekmektedir. Yangın geçirmiş çelik binalarda çelik elemanların mekanik
özelliklerinde yangının derecesine göre büyük değişiklikler meydana
gelmektedir.
Asal Katsayılarla Düzenlenmiş Doğrusal Üreteç
Authors: GENÇOĞLU Hakan
Published: June 2020

Karıştırma algoritmaları, bir veri bütünün parça parça düşünüp bu parçaların yerlerini rastgele seçilen parçalarla değiştirmesi şeklinde işlem yapar. Yani rastgele üretilen bir değere ait konumda bulunan bir veriyi, sıradaki konumdaki veri ile yer değiştirerek karıştırma işlemi sağlanmış olur. Burada karıştırma işleminin gerçekleşmesini sağlayan rastgele üretilen değerlerdir. Karıştırma algoritmalarının temel amacı veriyi karıştırmak olduğundan karıştırılmış veri bloklarının eski haline getirilmesi ile ilgilenmezler. Dolayısıyla ihtiyaç halinde eski veriye ulaşmak gerekirse karıştırma algoritmaları tek başlarına yeterli olmaz. Bu çalışmada geri dönüşsüz karıştırma algoritmaları ile yapılan veri bloklarının geri getirilmesi incelenmiş ve farklı bir algoritma önerilmiştir.
A Higher-Order Sensitive Finite Differences Scheme Of The Cauchy Problem For 2D Linear Hyperbolic Equations With Constant Coefficients In A Class Of Discontinuous Functions
Authors: YENER Öykü , SİNSOYSAL Bahaddin , RESULOV Mahir
Published: June 2020

In this study we develop a finite difference schema for practical calculation of the Cauchy problem for the 2D scalar advection equation with a higher accuracy oder constant coefficient, encountered in different areas of hydrodynamics. For this aim to develop an auxiliary problem having some advantages over the main problem is introduced. The proposed auxiliary problem permits us construct a higher order sensitive finite differences schema.
Spectral Analysis Of Elastic Waveguides
Authors: HASANSOY Mahir
Published: June 2020

Elastik Dalga klavuzlarının operatör modelleri oluşturulmuş ve spektral yapısı araştırmıştır.
Dalga klavuzlarının kesitlerinin sonlu ve sonsuz olduğu durumlar ele alınmıştır
ELECTROMAGNETIC SHIELDING PERFORMANCES OF COLEMANITE / PANI / SIO2 COMPOSITES IN RADAR AND WIDER FREQUENCY RANGES
Authors: ŞAHİN Ethem İlhan , EMEK Mehriban , ERTUG Burcu , KARTAL Mesut
Published: June 2020

In this study, colemanite-SiO2 were produced by using mixed oxide technique. The composition was formed with various proportions for the structural analysis. The results of the structural analysis indicated that second phase did not form in colemanite and SiO2. Addionality, the colemanite/polyaniline/SiO2 composites were produced by hot pressing using the compositions of colemanite-SiO2 in different proportions and aniline. The weight ratios of colemanite-SiO2 and aniline were 1:1 respectively and epoxy resin was used to produce microwave shielding composites. The microwave shielding performances of colemanite/polyaniline/SiO2 composites were investigated by shielding effectiveness in 8 –18 GHz using two–port vector network analyzer. A minimum of – 41.1 dB shielding effectiveness performance was obtained in 16.09 GHz at the thickness of 1.5 mm. This shielding performance can be modulated simply by controlling the content of polyaniline and content of colemanite-SiO2 in the samples for the required frequency bands.
The Impact of COVID-19 Pandemic on the Academic Performance of Veterinary Medical Students
Authors: Mahdy Mohamed
Published: June 2020

The current cross-sectional study was carried out to analyze the impact of COVID-19 lockdown on the academic performance of veterinary medical students and researchers. An online google form questionnaire was used to invite veterinary students and researchers to answer the questionnaire. A total of 807 participants were from 86 different countries answered the questionnaire with an overall response rate of 94.1%. The participants were 50.1% males and 49.9% females. The age of participants ranged from 17 to 51 years, and the majority of them (85.0%) were undergraduate students while postgraduate students comprised 15.0%. The data showed that the COVID-19 pandemic lockdown affected the academic performance of most participants (96.5%) with varying degrees. The mean evaluation scores for the online education, in general, was 4.9 ± 2.4 while that for the practical parts was 3.7± 2.6. About 60.7% of participants evaluated the online learning in general with 1-5 of 10 points, while 77.9% of participants evaluated the online learning in practical lessons with 1-5 of 10 points. Although online education provides an opportunity for self-study. The main challenge online education faces in veterinary medical science is how to give practical lessons. Since most of the subjects are practical; therefore, it is not easy to learn it online. Students think that it is difficult to fulfill the veterinary competencies only with the online education system. Online education can be improved by making it more interactive, showing medical procedures in real situations, giving concise information, and providing 3D virtual tools to mimic the real situation.
A Comprehensive Review of the Cross-Disciplinary Impact of COVID-19 in India
Authors: Dhawal Pranjali , Kakodkar Shruti , Pawar Rasika , Bhome Shraddha , Barve Siddhivinayak
Published: June 2020

A novel coronavirus (2019-nCoV) responsible for a severe acute respiratory disorder (SARS-CoV-2) in humans, with its epicentre in Wuhan, China emerged in December 2019. This coronavirus, by far, has hit >200 countries, affecting 7 million worldwide accounting 11% death of the affected population. The transmission is majorly caused by human-to-human contact and, through fomite. In view of the increasing number of COVID-19 cases and the absence of definitive treatment or vaccinations, WHO has deemed the viral infection a pandemic of international concern. In such grave situations, there is a need for expanding the health sector workforce, government and police workforce, sanitation and prevention strategies. The current article describes the virology aspect, control of COVID-19 and revisits the various treatment options available at present this deadly infection. Epidemiology of COVID-19 is also discussed to further understand the pandemic status of India. The article also discusses implicating quarantine or social distancing, and in extreme cases, lockdown or alternative approaches such as herd or indirect immunity, as a measure to control the pandemic. Lockdown or social distancing will give rise to economic, emotional, political and social downfall in the country. It is estimated that a lockdown period will set back the country, possibly, by $240 billion, yet it stands unavoidable in the spread of control of infection. Thus, policymakers should strategize economic revival depending upon the best possible data and critical understanding.
A ocorrência da espécie exótica Litopenaeus vannamei (Boone, 1931) no complexo estuarino-lagunar de Cananéia, Iguape e Ilha Comprida
Authors: BARBIERI Edison , COA Francine , REZENDE Karina Fernades Oliveira
Published: June 2020

As espécies exóticas constituem hoje em um problema exponencial de escala global e um dos principais fatores de modificações do meio ambiente e da biodiversidade de uma região. A introdução de espécies exóticas encontra-se tipicamente vinculada í­Â s atividades de interesse sócio-econômico. As invasões têm consequências ecológicas, econômicas e sanitárias, atuando, í­Â s vezes, de modo sinergético. O presente trabalho registra a ocorrência de Litopenaeus vannamei em várias áreas do estuário de Cananeia, Iguape e Ilha Comprida. Para avaliar a ocorrência do L. vannamei junto í­Â  pesca de Farfantepenaeus paulensis, F. brasiliensis e Litopenaeus schmitti foram realizadas 109 amostragens com rede gerival, de março de 2005 adezembro de 2013. Foram capturados 64 exemplares de L. vannamei com tamanhos e pesos médios da menor para maior espécime capturada de 1,68 para 6,30 cm e 26,70 para 31,78 g, respectivamente. Os dados não indicam que L. vannamei está proliferando na região, a ponto de ser considerado uma espécie invasora e causando problemas econômicos.
Caracterização sazonal das águas do sistema estuarino do Caeté (Bragança-PA)
Authors: MOURA Hanna Tereza Garcia de Sousa , NUNES Zélia Maria Pimentel
Published: June 2020

Investigou-se o efeito das marés de sizígia na qualidade física, química e biológica da água de canais-de-maré, considerando a sazonalidade regional e a distribuição espacial do furo do Taici e do furo da Estiva no estuário do Caeté. As variáveis abióticas foram determinadas in situ durante o ciclo diurno da maré. Os nutrientes e a clorofila–a foram determinados por espectrofotometria. Em Taici houve aumento significativo da salinidade (18,57±2,78) e do nitrito (12,93±7,92 µM) no período seco, enquanto que no chuvoso foram registradas elevadas turbidez (>900UNT) e clorofila-a (12,09±5,72 µg.L-1). Em Estiva, a salinidade apresentou valores distintos no período seco (36,84±1,37) e no chuvoso (21,56±5,54). Na enchente foram registrados valores de pH (7,72±0,18) e oxigênio dissolvido (6,62±0,54 mg.L-1) superiores aos da vazante. Os valores da temperatura (29,26±1,08 °C), fosfato (1,73±1,43 µM) e clorofila-a (33,6±14,74 µg.L-1) foram mais elevados na vazante. O furo da Estiva sofreu influência de águas costeiras, e o do Taici, influência da drenagem do manguezal.
A pesca de pequena escala na bacia Amazônica: padrões gerais e diversidade pelos desembarques de cinco sub-bacias
Authors: LOPES Giulia Cristina dos Santos , CATARINO Michel Fabiano , LIMA Álvaro Carvalho de , FREITAS Carlos Edwar de Carvalho
Published: June 2020

A pesca comercial das sub-bacias dos rios Madeira, Purus, Juruá, Alto Solimões e Baixo-Amazonas foi estudada com o objetivo de traçar o perfil integrado da atividade pesqueira na Bacia Amazônica. Os dados foram coletados em 2012,nos principais portos de desembarque das cidades de Humaitá, Boca do Acre, Juruá, Tabatinga e Parintins. O nome comum das espécies foi registrado, assim como a captura (kg), os apetrechos, os pesqueiros e esforço de pesca. Em geral, o desembarque foi dominado por Characiformes migradores. Em Boca do Acre, no rio Purus, os Siluriformes foram mais importantes, com destaque ao surubim, (Pseudoplatystoma spp.). Os desembarques foram maiores nos períodos de vazante. Redes de emalhar e um tipo de rede de cerco (chamado localmente de “redinha”) concentraram as capturas. Rio e Lagos foram os pesqueiros mais explorados. A CPUE variou de 12 a 216.5 kg/homem.dia, com maiores valores médios nos municípios de Parintins e Juruá.
Digital Divide: Marked Disparities in Computer and Broadband Internet Use and Associated Health Inequalities in the United States
Authors: Singh Gopal K. , Girmay Mehrete , Allender Michelle , Ramey Christine T.
Published: June 2020

Background:

Despite the considerable increase in computer and internet use over the past two decades, few studies have examined socioeconomic, demographic, and health characteristics associated with computer and internet use in the United States. Community-level differences in computer and internet use and associated disparities in health and mortality indicators have not been analyzed. This study examines these associations at the individual and community level using national census, health, and mortality data.

Methods:

We analyzed data from the 2017 American Community Survey (ACS) Micro-data Sample, the 2013-2017 ACS Summary File, National Vital Statistics System, and 2019 County Health Rankings and Roadmaps. Health and socioeconomic characteristics associated with broadband internet and computer use among adults aged ≥18 were modeled by logistic regression (N=2,385,595).

Results:

In 2017, 89.7% of Asian/Pacific Islanders (APIs) had broadband internet service, compared with 66.0% of American Indians/Alaska Natives (AIANs), 77.2% of Blacks/African-Americans, 78.8% of Hispanics, and 83.5% of non-Hispanic Whites. APIs (97.4%) were more likely than other racial/ethnic groups to own or use a computer (including smartphones), while AIANs (80.3%) were less likely. Socioeconomic gradients in internet and computer use were marked. Those below the poverty level and with less than a high school education reported 18 and 15 percentage points lower rates of internet and computer use respectively. Compared to metropolitan areas, nonmetropolitan areas had lower internet access (80.3% vs. 69.7%) and computer use (88.4% vs. 80.5%). Rural areas and small urban towns had the lowest level of internet and computer use. Risks of disabilities and lack of health insurance were greater among persons with lower broadband internet and computer access. Communities with low internet and computer use had seven years shorter life expectancy than communities with high use and were at increased risks of mortality from various chronic conditions, poor health, mental distress, hospitalization, smoking, obesity, and physical inactivity.

Conclusions and Implications for Translation:

Significant socioeconomic and racial/ethnic disparities in internet and computer use and associated health inequalities exist in the US. Closing the social divide in internet and computer use can positively impact individual empowerment, educational attainment, economic growth, community development, access to health care and health-related information, and health promotions efforts.
Successful Rigless Subsea Stimulation in Asia Using Novel Well-Access Technology and a Fully Integrated Service Model
Authors: Avery Mike , Large Robert , Azhar Herman , Wong Kai San , Yusoff Mohd Faizal Bin
Published: June 2020

A successful rigless subsea stimulation was executed during 2018, with the intervention performed on three target wells offshore of Sabah Malaysia, at a water depth of approximately 1400 m (4,593 ft). Significant changes in reservoir performance prompted an acid-stimulation and scale-squeeze treatment, designed to remedy fines migration and scaling issues within the well and production system. Treatment fluids were delivered subsea by an open-water hydraulic access system, using a hybrid coiled tubing downline (HCTD). Access to the subsea trees was enabled by a novel choke-access technology, allowing for a flexible, cost-efficient, and low-risk intervention. The intervention system was installed on a multiservice vessel, with the downline deployed via the vessel moonpool. A second support vessel was used as required to provide additional fluid capacity without disturbing primary intervention operations. This enhanced the flexibility of the operation, accommodating potential changes in the treatment plan without impact to critical path-stimulation activities.

The full intervention was delivered as an integrated service, with all elements supplied by a single provider, via one contract. An established network of in-house equipment, expertise, test laboratories, and operational bases supported the planning and execution of the project. This was complemented by select external providers for vessels, remotely operated vehicle services, and other specialist contractors.

The challenges faced during execution included completion of a comprehensive treatment fluid test program, importation and logistics of equipment from around the globe, and managing operational risks, all within a condensed timeline to satisfy a brief intervention window. A collaborative solution was developed that combined the resources of the service provider, inclusion of performance-based elements within the contract, and delivery of an efficient and flexible well-access technology that supported rapid mobilization and alleviated operational risk.

Post-stimulation well testing confirmed an average increase in oil productivity of 86%, with a corresponding productivity-index factor gain of 3.4. These results confirm the appropriateness of open-water hydraulic access using coiled tubing (CT) for performing cost-effective stimulations on complex subsea wells.
The effect of milrinone on mortality in adult patients who underwent CABG surgery: A systematic review of randomized clinical trials with a meta-analysis and trial sequential analysis
Authors: Ren Yu-shan , Li Lan-fang , Peng Tao , Tan Yu-jun , Sun Ying , Cheng Guo-liang , Zhang Gui-min , Li Jie
Published: June 2020

Background: As an inodilator, milrinone is commonly used for patients who undergo coronary artery bypass graft (CABG) surgery because of its effectiveness in decreasing the cardiac index and mitral regurgitation. The aim of this study was to perform a systematic review and meta-analysis of existing studies from the past 20 years to evaluate the impact of milrinone on mortality in patients who undergo CABG surgery.Methods: We performed a systematic literature search on the application of milrinone in patients who underwent CABG surgery in studies published between 1997 and 2017 in BioMed Central, PubMed, EMBASE, and the Cochrane Central Register. The included studies evaluated milrinone groups compared to groups receiving either placebo or standard treatment and further compared the systemic administration.Results: The network meta-analysis included 723 patients from 16 randomized clinical trials. Overall, there was no significant difference in mortality between the milrinone group and the placebo/standard care group when patients underwent CABG surgery. In addition, 9 trials (with 440 randomized patients), 4 trials (with 212 randomized patients), and 10 trials (with 470 randomized patients) reported that the occurrence of myocardial infarction (MI), myocardial ischemia, and arrhythmia was lower in the milrinone group than in the placebo/standard care group. Between the milrinone treatment and placebo/standard care groups, the occurrence of myocardial infarction, myocardial ischemia, and arrhythmia was significantly different. However, the occurrence of stroke and renal failure, the duration of inotropic support (h), the need for an intra-aortic balloon pump (IABP), and mechanical ventilation (h) between these two groups showed no differences.Conclusions: Based on the current results, compared with placebo, milrinone might be unable to decrease mortality in adult CABG surgical patients but can significantly ameliorate the occurrence of MI, myocardial ischemia, and arrhythmia. These results provide evidence for the further clinical application of milrinone and of therapeutic strategies for CABG surgery. However, along with milrinone application in clinical use, sufficient data from randomized clinical trials need to be collected, and the potential benefits and adverse effects should be analyzed and reevaluated.
Changing Clinical Characteristics Of Non-Cystic Fibrosis Bronchiectasis In Children
Authors: Erdem Ela , Gokdemir Yasemin , Atag Emine , Ikizoglu Nilay Bas , Ergenekon Pinar , Yilmaz Cansu Yegit , Kut Arif , Ersu Refika , Karakoc Fazilet , Karadag Bulent
Published: June 2020

Background: The prevalence of non-cystic fibrosis (CF) bronchiectasis is increasing in both developed and developing countries in recent years. Although the main features remain similar, etiologies seem to change. Our aim was to evaluate the clinical and laboratory characteristics of our recent non-CF bronchiectasis patients and to compare these with our historical cohort in 2001. Methods: 104 children with non-CF bronchiectasis followed between 2002 and 2019 were enrolled. Age of diagnosis, underlying etiology and microorganisms in sputum culture were recorded. Clinical outcomes were evaluated in terms of lung function tests and annual pulmonary exacerbation rates at presentation and within the last 12 months. Results: Mean FEV1 and FVC %predicted at presentation improved compared to historical cohort (76.6±17.1 vs. 63.3±22.1 and 76.6±15.1 vs. 67.3±23.1, respectively; p<0.001). There was a significant decrease in pulmonary exacerbation rate from 6.05±2.88 at presentation to 3.23±2.08 during follow-up (p<0.0001). In 80.8% of patients, an underlying etiology was identified. There was an increase in primary ciliary dyskinesia (PCD) (32.7% vs. 6.3%;p=0.001), decrease in idiopathic cases (19.2% vs. 37.8%;p=0.03) with no change in postinfectious and immunodeficiencies as underlying etiology. Sputum cultures were positive in 77.9% of patients which was 46.9% in the historical cohort (p=0.001). Conclusion: Baseline pulmonary function tests were better and distribution of underlying etiology had changed with a remarkable increase in diagnosis of PCD in the recent cohort.
Evaluating the Care Provision of a Community-Based Serious-Illness Care Program Via Chart Measures
Authors: Kistler Christine , Dongen Matthew Van , Ernecoff Natalie , Daaleman Timothy , Hanson Laura
Published: June 2020

Background: Although quality-of-care domains for home-based primary and palliative programs have been proposed, they have had limited testing in practice. Our aim was to evaluate the care provision in a community-based serious-illness care program, a combined home-based primary and palliative care model.Methods: Retrospective chart review of patients in an academic community-based serious-illness care program in central North Carolina from August 2014 to March 2016 (n=159). Chart review included demographics, health status, and operationalized measures of seven quality-of-care domains: medical assessment, care coordination, safety, quality of life, provider competency, goal attainment, and access.Results: Patients were mostly women (56%) with an average age of 70 years. Patients were multi-morbid (53% ≥3 comorbidities), functionally impaired (45% had impairment in ≥2 activities of daily living) and 32% had dementia. During the study period, 31% of patients died. Chart review found high rates assessment of functional status (97%), falls (98%), and medication safety (96%). Rates of pain assessment (70%), advance directive discussions (65%), influenza vaccination (59%), and depression assessment (54% of those with a diagnosis of depression) were lower. Cognitive barriers, spiritual needs, and behavioral issues were assessed infrequently (35%, 22%, 21%, respectively). Conclusion: This study is one of the first to operationalize and examine quality-of-care measures for a community-based serious-illness care program, an emerging model for vulnerable adults. Our operationalization should not constitute validation of these measures and revealed areas for improvement; however, the community-based serious-illness care program performed well in several key quality-of-care domains. Future work is needed to validate these measures.
Improved ascertainment of modes of HIV transmission in Ukraine indicates importance of drug injecting and homosexual risk
Authors: Dumchev Kostyantyn , Kornilova Marina , Kulchynska Roksolana , Azarskova Marianna , Vitek Charles
Published: June 2020

Background: It is important to understand how HIV infection is transmitted in the population in order to guide prevention activities and properly allocate limited resources. In Ukraine and other countries where injecting drug use and homosexuality are stigmatized, the information about mode of transmission in case registration systems is often biased.Methods: We conducted a cross-sectional survey in a random sample of patients registered at HIV clinics in seven regions of Ukraine in 2013-2015. The survey assessed behavioral risk factors and serological markers of viral hepatitis B and C. We analyzed the discrepancies between the registered mode of transmission and the survey data, and evaluated trends over three years.Results: Of 2,285 participants, 1,032 (45.2%) were females. The proportion of new HIV cases likely caused by injecting drug use based on the survey data was 59.7% compared to 33.2% in official reporting, and proportion of cases likely acquired through homosexual transmission was 3.8% compared to 2.8%. We found a significant decrease from 63.2% to 57.5% in the proportion of injecting drug use-related cases and a steep increase from 2.5 to 5.2% in homosexual transmission over three years. Conclusions: The study confirmed the significant degree of misclassification of HIV mode of transmission among registered cases. The role of injecting drug use in HIV transmission is gradually decreasing, but remains high. The proportion of cases related to homosexual transmission is relatively modest, but is rapidly increasing, especially in younger men. Improvements in ascertaining the risk factor information are essential to monitor the epidemic and to guide programmatic response.
Healthy Weight Services in England before, during and after pregnancy: a mixed methods approach
Authors: Fair Frankie , Marvin-Dowle Katie , Arden Madelynne , Soltani Hora
Published: June 2020

Background: Maternal overweight and obesity are associated with numerous adverse outcomes including higher rates of maternal and infant mortality and morbidity. Overweight and obesity before, during and after pregnancy are therefore a significant public health priority in England. This project explored and mapped healthy weight service availability at different stages of the childbearing cycle.Methods: A mixed methods approach included a questionnaire-based survey disseminated through Local Maternity Systems and semi-structured interviews or focus groups with providers and commissioners. Current maternal weight service provision was explored along with some of the barriers and facilitators for providing, delivering and accessing healthy weight services. Descriptive statistics were reported for quantitative data and content analysis was used for thematic reporting of qualitative data. Results: A total of 88 participants responded to the survey. All services were offered most frequently during pregnancy; with healthy eating and/or weight management services offered more often than physical activity services. Few services were targeted specifically at women with a raised body mass index. There was a high degree of inconsistency of service provision in different geographical areas. Several themes were identified from qualitative data including "equity and variation in service provision", "need for rigorous evaluation", "facilitators” to encourage better access or more effective service provision, including prioritisation, a change in focus and co-design of services, "barriers" encountered including financial and time obstacles, poor communication and insufficiently clear strategic national guidance and "the need for additional support”.Conclusions: There is a need to reduce geographical variation in services and the potential health inequalities that this may cause. Improving services for women with a raised body mass index as well as services which encourage physical activity require additional emphasis. There is a need for more robust evaluation of services to ensure they are fit for purpose. An urgent need for clear national guidance so that healthcare providers can more effectively assist mothers achieve a healthy weight gain was identified. Commissioners should consider implementing strategies to reduce the barriers of access identified such as childcare, transport, location and making services free at the point of use.
Effect of pericardial incision on left ventricular morphology and systolic function in patients during coronary artery bypass grafting
Authors: Zhao Lan-Ting , Liu Lu , Meng Ping-Ping , Wang Yong-Huai , Li Meng , Yang Jun , Gu Tian-Xiang , Ma Chun-Yan
Published: June 2020

Background: Accurate assessment of left ventricular (LV) systolic function is important after coronary artery bypass grafting (CABG). LV ejection fraction (LVEF) is conventionally used to evaluate LV systolic function; deformation parameters can be used to detect subtle LV systolic dysfunction. It is unclear whether an incised pericardium without sutures during CABG could affect LV morphology and function. We investigated the effect of pericardial incision on LV morphology and systolic function during CABG. Methods: Intraoperative transesophageal echocardiography was performed in 27 patients during elective off-pump beating heart CABG 5 minutes before and after pericardial incision. LV longitudinal and mid-cavity transversal diameters, sphericity index, volumes, and LVEF were measured. LV global longitudinal strain (GLS), global circumferential strain (GCS), global radial strain (GRS), and twist obtained by two-dimensional speckle tracking echocardiography were measured simultaneously. Results: LV mid-cavity transversal diameter increased, while the LV sphericity index decreased (P<0.001) immediately after pericardial incision. The GLS, GCS, and twist significantly decreased, while the GRS notably increased (P<0.001). The LV volumes and LVEF remained unchanged. Conclusions: Pericardial incision immediately transformed LV morphology from an ellipsoid to sphere, with decreased longitudinal and circumferential strain and twist, and increased radial strain, while LVEF remained unchanged. This should be considered when evaluating LV systolic function in patients after CABG.
Trends of Mycobacterium Tuberculosis and rifampicin resistance in Adigrat General Hospital, Eastern Zone of Tigrai, North Ethiopia
Authors: Abay Getachew Kahsu , Hailay Bahlibi
Published: June 2020

Background: Tuberculosis is an infectious disease usually caused by Mycobacterium tuberculosis bacteria. The global emergence of mono- or multidrug-resistant tuberculosis and extensively drug-resistant forms of tuberculosis pose a considerable challenge to tuberculosis control programs. There has been no reliable and organized data on trends and drug resistance of Mycobacterium tuberculosis in the study area. Therefore, this study aimed to determine the trends of Mycobacterium tuberculosis and rifampicin resistance in the Adigrat General Hospital, eastern Zone of Tigrai, North Ethiopia.Methods: A hospital-based retrospective cross-sectional study was conducted at Adigrat General Hospital from January 2015 to 2018.Data was collected retrospectively from the GeneXpertTM TB registration book using a data extraction format. Data was entered into Epi-Info 3.1 and subsequently exported and analyzed using SPSS Version 20.The results were summarized using descriptive statistics, tables, and figures. Bivariate and multi-variant regression analysis was employed to measure the association between dependent and independent variables. P values < 0.05 were considered statistically significant.Result: A total of 5,944 Mycobacterium tuberculosis presumptive patients were included in the study. The majority of the study participants were male (58.1%) with participants’ median age of 40.0 (IQR 26-57) years, the majority were 30-44 years. The overall positive cases of Mycobacterium tuberculosis was 24.3% (1446) with a total of 132 (9.1%) found to be resistant to rifampicin. Of the total confirmed positive cases 8.7 % (103/1188) and 11.2 % (29/258) were rifampicin resistance of presumptive tuberculosis and presumptive drug resistance tuberculosis patients respectively. Age, the reason for diagnosis, site of presumptive tuberculosis, and/or being HIV infected showed significant association with our dependent variable; however, only age and being HIV infected were associated with rifampicin resistance.Conclusion: In our study, the overall trends of Mycobacterium tuberculosis and rifampicin resistance were found to be high. Rifampicin resistance is more common in patients with HIV and presumptive drug resistance tuberculosis individuals. Therefore, maximizing early detection of drug-resistant and strengthening tuberculosis infection control activities are recommended to reduce the burden of this contagious and potentially deadly disease.
Impact of pre-transplant dialysis modality on the outcome and health-related quality of life of patients after simultaneous pancreas-kidney transplantation
Authors: Scheuermann Uwe , Rademacher Sebastian , Jahn Nora , Sucher Elisabeth , Seehofer Daniel , Sucher Robert , Hau Hans-Michael
Published: June 2020

Background: Simultaneous pancreas-kidney transplantation (SPKT) profoundly improves the health-related quality of life (HRQoL) of recipients. However, the influence of the pre-transplant dialysis modality on the success of the SPKT and post-transplant HRQoL remains unknown. Methods: We analyzed the surgical outcome, long-term survival, as well as HRQoL of 83 SPKTs that were performed in our hospital between 2000 and 2016. Prior to transplant, 64 patients received hemodialysis (HD) and nineteen patients received peritoneal dialysis (PD). Physical and mental quality of life results from eight basic scales and the physical and mental component summaries (PCS and MCS) were measured using the Short Form 36 (SF-36) survey.Results: Peri- and postoperative complications, as well as patient and graft survival were similar between the two groups. Both groups showed an improvement of HRQoL in all SF-36 domains after transplantation. Compared with patients who received HD before transplantation, PD patients showed significantly better results in four of the eight SF-36 domains: physical functioning (mean difference HD - PD: -12.4 ± 4.9, P = < 0.01), bodily pain (-14.2 ± 6.3, P < 0.01), general health (-6.3 ± 2.8, P = 0.04), vitality (-6.8 ± 2.6, P = 0.04), and PCS (-5.2 ± 1.5, P < 0.01) after SPKT. In the overall study population, graft loss was associated with significant worsening of the HRQoL in all physical components (each P < 0.01).Conclusions: The results of this analysis show that pre-transplant dialysis modality has no influence on the outcome and survival rate after SPKT. Regarding HRQoL, patients receiving PD prior to SPKT seem to have a slight advantage compared with patients with HD before transplantation.
Generating Human Gastruloids from Human Embryonic Stem Cells
Authors: Moris Naomi , Anlas Kerim , Schroeder Julia , Ghimire Sabitri , Balayo Tina , Brink Susanne C. van den , Alemany Anna , Oudenaarden Alexander van , Arias Alfonso Martinez
Published: June 2020

Gastruloids are aggregates of Pluripotent Stem Cells (PSCs) which, when exposed to differentiation medium and plated within defined conditions, undergo trilineage differentiation to all three germ layers (mesoderm, ectoderm and endoderm) with constitutive cell types organised spatiotemporally along 3 axes (Becarri et. al. 2018). They also undergo morphological shape changes including axial elongation through convergent extension cell movements. The gastruloid method has been well-established using mouse Embryonic Stem Cells (mESCs) and mouse induced PSCs (iPSCs) (van den Brink et. al., 2014; Turner et. al. 2016a; Turner et. al. 2016b; Bailie-Johnson et. al. 2015; Turner et. al. 2017a; Turner et. al. 2017b, Beccari et. al., 2018, See method in Girgin et. al., 2018). Here, we describe a new method to generate equivalent gastruloids from human pluripotent stem cells (hPSCs). hPSCs are able to generate axially elongated human gastruloids with evidence of spatially organised germ layers and comparable features to their mouse counterparts (Moris et. al., 2020).
Determinants and risk factors of gastroenteritis in the general population, a web-based cohort between 2014 and 2017 in France
Authors: Ecollan Marie , Guerrisi Caroline , Souty Cécile , Rossignol Louise , Turbelin Clément , Hanslik Thomas , Colizza Vittoria , Blanchon Thierry
Published: June 2020

Background: Although it is rarely fatal in developed countries, acute gastroenteritis (AGE) still induces significant morbidity and economic costs. The objective of this study was to identify factors associated with AGE in winter in the general population.Methods: A prospective study was performed during winter seasons from 2014-2015 to 2016-2017. Participants filled an inclusion survey and reported weekly data on acute symptoms. Factors associated with having at least one AGE episode per winter season were analyzed using the generalized estimating equations (GEE) approach. Results: They were 13,974 participants included in the study over the three seasons. On average, 8.1% of participants declared at least one AGE episode during a winter season. People over 60 declared fewer AGE episodes (adjusted OR (aOR)=0.76, 95% CI [0.64; 0.89]) compared to individuals between 15 and 60 years old, as well as children between 10 and 15 (aOR=0.60 [0.37; 0.98]). Overweight (aOR=1.25 [1.07; 1.45]) and obese (aOR=1.47 [1.19; 1.81]) individuals, those having frequent cold (aOR=1.63 [1.37; 1.94]) and those with at least one chronic condition (aOR=1.35 [1.16; 1.58]) had more AGE episodes. Living alone was associated with a higher AGE episode rate (aOR=1.31 [1.09; 1.59]), as well as having pets at home (aOR=1.23 [1.08; 1.41]). Conclusions: Having a better knowledge of AGE determinants will be useful to adapt public health prevention messages.