bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy of Parent-Infant-Psychotherapy with mothers with postpartum mental disorder: study protocol of the randomized controlled trial as part of the SKKIPPI project.
Authors: Mattheß Janna , Eckert Melanie , Richter Katharina , Koch Gabriele , Reinhold Thomas , Vienhues Petra , Berghöfer Anne , Roll Stephanie , Keil Thomas , Schlensog-Schuster Franziska , von Klitzing Kai , Ludwig-Körner Christiane , Kuchinke Lars
Published: May 2020

Background: After the birth of a child, many mothers and fathers experience postpartum mental disorders like depression, anxiety, obsessive-compulsive disorder, stress or other illnesses. This endangers the establishment of a secure attachment between the children and their primary caregivers. Early problems in parent-child interaction can have adverse long-term effects on the family and the child’s well-being. In order to prevent a transgenerational transmission of mental disorders, it is necessary to evaluate psychotherapeutic interventions that target psychologically burdened parents of infants or toddlers. The aim of this trial is to investigate the efficacy of Parent-Infant-Psychotherapy (PIP) for mothers with postpartum mental disorder and their infants (0-12 month).Methods: In this open randomized controlled intervention trial 180 mother-infant dyads will be included and randomly allocated to 12 sessions of PIP or care as usual. The interventions take place either in inpatient adult psychiatric departments or in outpatient settings with home visits. The primary outcome is the change in maternal sensitivity assessed by the Sensitivity subscale of the Emotional Availability Scale (EAS) through videotaped dyadic play-interactions after 6 weeks. Secondary outcomes are maternal psychopathology, stress, parental reflective functioning, infant development and attachment after 6 weeks and 12 months. In addition, maternal attachment (AAI) and reflective functioning (AAI) will be analyzed as potential moderators, and resource usage in the German health system as well as associated costs will be evaluated. Discussion: There is increasing demand for well-controlled studies on psychotherapeutic interventions in the postpartum period that do not only focus on particular risk groups. This RCT represents one of the first studies to investigate the efficacy of PIP in inpatient psychiatric departments and outpatient care centres in Germany. The results will fill knowledge gaps on the factors contributing to symptom reduction in postpartum mental disorders and improvements in mother-child relationships and help developing preventive and therapeutic strategies for the fragmented German health care system.Trial registration: German Register for Clinical Trials: DRKS00016353.
Utilization pattern of kangaroo mother care after introduction in eight selected neonatal intensive care units in China
Authors: Liu Xin , Li Zhankui , Chen Xiaohui , Cao Bei , Yue Shaojie , Yang Changyi , Liu QiongYu , Yang Chuanzhong , Zhao Gengli , Feng Qi
Published: May 2020

Background: Kangaroo mother care (KMC) is an evidence-based and cost-effective intervention that could prevent severe complications for preterm babies, however it has not been widely adopted in China. In this study, we aim to investigate the feasibility and parental experience of adopting KMC in a Chinese context by studying the implementation of a KMC program in eight self-selected neonatal intensive care units (NICUs).Methods: A cross-sectional study of 135 preterm infants discharged from eight NICUs in April 2018. For infants information was collected on postnatal day and corrected gestational age (GA) at KMC initiation, frequency and duration of KMC provision and whether the infant was receiving respiratory support. A nurse-administered questionnaire on parents’ knowledge and experience of KMC provision was administered to parents providing KMC.Results: 135 preterm infants received KMC, 21.2% of all preterm infants discharged. 91.1% of those who received KMC were below 34 weeks GA, 91.1% had a birth weight below 2000g, and 20.7% needed respiratory support at KMC initiation. Average KMC exposure was greater in infants born at GA <28 weeks that babies born at greater GA. 94.8% of parents that participated in the parental survey indicated that KMC was positively accepted by their family members; 60.4% of the parents claimed that KMC could relieve anxiety, 57.3% claimed it prompted more interactions with medical staff and 69.8% suggested it increased parental confidence in care for their infants.Conclusions: After advocacy, training and promotion, intermittent KMC was initiated on more immature and high-risk infants, and well-accepted by parents. We suggest continuing to promote KMC education to parents and enhancing preterm infant health.
Randomized trial: inflammatory response to corticoids versus placebo in moderate and severe bronchiolitis. COTHEBstudy.
Authors: Felipe Aida , Balaguer Mònica , Alejandre Carme , Esteban Elisabeth , Alsina Laia , Muñoz-Almagro Carmen , Esteban Maria Esther , Cambra Francisco José , Jordan Iolanda
Published: May 2020

Background: The use of corticosteroids has been shown not to improve the prognosis of patients with bronchiolitis, but it could be assumed that steroids will reduce inflammation. This study aimed to assess whether corticoid therapy influenced the inflammatory and clinical response of critically ill infants. Methods: Prospective, randomized, double blind placebo-controlled trial of glucocorticoids (GCT) in infants of less than 12 monthswith severe or moderate bronchiolitis. Patients were randomized to receive systemic corticoid therapy or placebo. The main outcomes were: a) levels of lymphocyte subsets; b) levels of IL-2, IL-12, and IFNγ as pro-inflammatory factors,and c) levels of IL-4 and IL-10 as anti-inflammatory response. Secondary outcomes related with the clinical response were also analyzed. Results: 97 patients were randomized. Evolution of lymphocyte subsets was similar in both groups. Pro-inflammatory interleukins and interferon decreased, but without differences. Anti-inflammatory interleukins showed a significant decrease from baseline to the end of the study, and IL-10 values were significantly lower (p = 0.046) in the GCT group [1.82 pg/ml (1.2-3.5)] vs non-GCT [4 pg/ml (1.5-6.3)]. GCT group showed a lower time of mechanical ventilation and of hospitalization, but without statistically significant differences. No cases of severe adverse reaction to steroids were detected. Conclusions: administration of systemic GCT did not modify the inflammatory nor the clinical response of patients with severe bronchiolitis, except for IL-10 levels that were significantly lower in the GCT group. This can open a line of investigation about the relation of IL-10 and response to bronchiolitis.Trial registration: Glucocorticoid Therapy Impact on the Inflammatory Response and Clinical Evolution in Patients With Severe Bronchiolitis, Clinical Trials.gov registration number: NCT02571517.Study start date: Nov 2011.
Percutaneous stent placement for malignant hilar biliary obstruction: side-by-side versus stent-in-stent technique
Authors: Zhou Wei-zhong , Liu Sheng , Yang Zheng-Qiang , Xian Yu-Tao , Xu Hong-Dou , Wu Jun-Zheng , Shi Hai-bin
Published: May 2020

Background: Currently, side-by-side (SBS) and stent-in-stent (SIS) are the two main techniques for stent deployment to treat hilar biliary obstructions. Previous studies comparing these two techniques are very limited, and thus, no consensus has been reached on which technique is better. The purpose of this study is to compare the clinical efficacy and safety of SBS and SIS deployment via a percutaneous approach for malignant hilar biliary obstruction.Methods: From July 2012 to April 2019, 65 patients with malignant hilar biliary obstruction who underwent bilateral stenting using either the SBS or SIS techniques were included in this study. Among them, 27 patients underwent SIS stent insertion (SIS group), and the remaining 38 patients underwent SBS stent insertion (SBS group). Technical success, improvement of jaundice, complications, duration of stent patency, and overall survival were evaluated.Results: Technical success was achieved in all patients in the two groups. The serum bilirubin level decreased more rapidly 1 week after the procedures in the SBS group than in the SIS group (P=0.02). Although the total complication rate did not differ between the two groups, cholangitis was found to be more frequent in the SIS group (P=0.04). The median stent patency was significantly longer in the SBS group (149 days) than in the SIS group (75 days; P=0.02). The median overall survival did not significantly differ between the two groups (SBS vs. SIS, 155 days vs. 143 days; P>0.05).Conclusions: Percutaneous transhepatic bilateral stenting using either the SBS or SIS technique is safe and effective in the management of malignant hilar biliary obstruction. However, SBS offers a quicker improvement of jaundice, a lower incidence of cholangitis after the procedure, and a longer stent patency period than SIS.
Maximum emergency department overcrowding is correlated with occurrence of unexpected cardiac arrest
Authors: Kim June-sung , Bae Hyun-Jin , Sohn Chang Hwan , Cho Sung-Eun , Hwang Jeongeun , Kim Won Young , Kim Namkug , Seo Dong-Woo
Published: May 2020

Background Emergency department overcrowding negatively impacts critically ill patients and could lead to the occurrence of cardiac arrest. However, association between emergency department crowding and occurrence of in-hospital cardiac arrest has not been thoroughly investigated. This study aimed to evaluate the correlation between emergency department occupancy rates and incidence of in-hospital cardiac arrest. Methods A single-center, observational, registry-based cohort study was performed including all consecutive adult, non-traumatic in-hospital cardiac arrest patients between January 2014 and June 2017. We used emergency department occupancy rates as a crowding index at time of presentation time of cardiac arrest and at the time of maximum crowding, and the average crowding rate for the duration of emergency department stay for each patient. To calculate incidence rate, we divided the number of arrest cases for each emergency department occupancy period by accumulated time. The primary outcome is association between the incidence of in-hospital cardiac arrest and emergency department occupancy rates. Results During the study period, 629 adult, non-traumatic cardiac arrest patients were enrolled in our registry. Among these, 187 patients experienced in-hospital cardiac arrest. Overall survival discharge rate was 24.6%, and 20.3% of patients showed favorable neurologic outcomes at discharge. Emergency department occupancy rates were positively correlated with in-hospital cardiac arrest occurrence. Moreover, maximum emergency department occupancy in the critical zone had the strongest positive correlation with in-hospital cardiac arrest occurrence (Spearman rank correlation ρ = 1.0, P < .01). Meanwhile, occupancy rates were not associated with the ED mortality. Conclusion Maximum emergency department occupancy was strongly associated with in-hospital cardiac arrest occurrence. Adequate monitoring and managing the maximum occupancy rate would be important to reduce unexpected cardiac arrest.
Predictors of infant-survival practices among mothers attending paediatric clinics in Ijebu-Ode, Ogun State, Nigeria
Authors: Sokefun Eniolufolake Elizabeth , Atulomah Nnodimele Onuigbo
Published: May 2020

Background: Despite concerted global efforts towards achieving infant-survival, infant mortality lingers as a problem in developing countries. Environmental and personal-level factors are assumed to account for this situation. This study was undertaken to provide better understanding of the dynamics of predictors of infant-survival practices among mothers with infants attending paediatric clinics.Methods: A cross-sectional survey design was adopted. Data was collected from 386 nursing mothers selected by convenience sampling. Interviewer-administered questionnaires were used for data collection. The questionnaire consisted of 38-items including demographic information of respondents, health-literacy counsels received during antenatal care, social-support from significant others, and self-efficacy to carry-out infant-survival instructions. Responses were transformed into rating scales for each variable and data analysis was conducted by linear regression analysis with test of hypotheses at 5% level of significance.Results: The mean age of respondents was 29.8 ± 5.8 years. Majority (81.6%) were married. Yorubas (83.90%) were predominant. Participants had mean scores of 10.50±3.83, 10.56±3.70 and 16.61±4.56 respectively computed for levels of health-literacy, social-support, and self-efficacy. The dependent variable measured level of infant-survival practices and respondents scored 16.53±4.71. The study found a significant association among variables. Self-efficacy was the major predictor variable of self-reported infant-survival practices (R=0.466; R2=0.217; P˂0.05).Conclusion: We conclude that participants had average levels of health-literacy, social-support, self-efficacy, and infant-survival practices. Healthcare providers should make efforts to empower pregnant women on activities essential for infant-survival. Family members of nursing mothers should as well be knowledgeable about the advantages of supporting them.
40 years after Alma Ata: How people trust in primary health care?
Authors: Bazargani Homayoun Sadeghi , Saadati Mohammad , Tabrizi Jafar Sadegh , Farahbakhsh Mostafa , Golestani Mina
Published: May 2020

Background: Primary Health Care (PHC) was introduced as the first level of health services delivery after Alma Ata declaration. It needs to be more trustful to achieve its defined goals. Public trust in PHC is one of the ignored issues in the context. The aim of this study was to explore public trust in PHC in Iran.Methods: This was a household survey study conducted in East Azerbaijan Province, Iran. Two-stage cluster sampling method with probability proportional to size (PPS) approach was used. Totally 1178 households were enrolled in the study. PHC trust questionnaire and Ultra-short version of socio-economic status assessment questionnaire (SES-Iran) was used for data collection. Data were analyzed using STATA 15 through descriptive statistics and linear regression. Results: The mean age of the participants was 41.2, (SD: 15.1) and most of them (53.7%) were female. Mean score of PHC trust was 56.9±24.7 (out of 100). It was significantly different between inhabitants of Tabriz (the province capital city) and other cities in the province (p<0.001). Linear regression showed that younger age, gender, insurance type, being married and households higher socio-economic situation had a significant positive influence on PHC trust level with R2 = 0.14383 .Conclusions: Public trust in PHC system in Iran needs to be improved. Individual variables had a small but significant share in trust level. PHC trust not only influenced by individual variables and experience but also by health system and health providers characteristics and public sphere about PHC system. PHC trust level could be used as a public indicator in health systems especially in Low and Middle income countries to lead system strengthening policies in national and international levels.
Association of anthropomorphic measures across the life-course with refractive error and ocular biometry at age 15 years.
Authors: Bruce Alison , Mojarrad Neema , Santorelli Gillian
Published: May 2020

Background: A recent Genome-wide association meta-analysis (GWAS) of refractive error reported shared genetics with anthropometric traits such as height, BMI and obesity. To explore a potential relationship with refractive error and ocular structure we performed a life-course analysis including both maternal and child characteristics using data from the Avon Longitudinal Study of Parents and Children cohort.Methods: Measures collected across the life-course were analysed to explore the association of height, weight, and BMI with refractive error and ocular biometric measures at age 15 years from 1613children. The outcome measures were the mean spherical equivalent (MSE) of refractive error (dioptres), axial length (AXL; mm), and radius of corneal curvature (RCC; mm). Potential confounding variables; maternal age at conception, maternal education level, parental socio-economic status, gestational age, breast-feeding, and gender were adjusted for within each multi-variable model.Results: Maternal height was positively associated with teenage AXL (0.010 mm; 95% CI: 0.003, 0.017) and RCC (0.005 mm; 95% CI: 0.003, 0.007), increased maternal weight was positively associated with AXL (0.004 mm; 95% CI: 0.0001, 0.008). Birth length was associated with an increase in teenage AXL (0.067 mm; 95% CI: 0.032, 0.10) and flatter RCC (0.023 mm; 95% CI: 0.013, 0.034) and increasing birth weight was associated with flatter RCC (0.005 mm; 95% CI: 0.0003, 0.009). An increase in teenage height was associated with a lower MSE (-0.007 D; 95% CI: -0.013, -0.001), an increase in AXL (0.021 mm; 95% CI: 0.015, 0.028) and flatter RCC (0.008 mm; 95% CI: 0.006, 0.010). Weight at 15 years was associated with an increase in AXL (0.005 mm; 95% CI: 0.001, 0.009).Conclusions: At each life stage (pre-natal, birth, and teenage) height and weight, but not BMI, demonstrate an association with AXL and RCC measured at age 15 years. However, the negative association between refractive error and an increase in height was only present at the teenage life stage. Further research into the growth pattern of ocular structures and the development of refractive error over the life-course is required, particularly at the time of puberty.
Quantitative CT-based Structural Alterations of Segmental Airways in Cement Dust-Exposed Subjects
Authors: Kim Taewoo , Cho Hyun Bin , Kim Woo Jin , Lee Chang Hyun , Chae Kum Ju , Choi So-Hyun , Lee Kyeong Eun , Bak So Hyeon , Kwon Sung Ok , Jin Gong Yong , Choi Jiwoong , Park Eun-Kee , Lin Ching-Long , Hoffman Eric A , Choi Sanghun
Published: May 2020

Background: Dust exposure has been reported as a risk factor of pulmonary disease, leading to alterations of segmental airways and parenchymal lungs. This study aims to investigate alterations of quantitative computed tomography (QCT)-based airway structural and functional metrics due to cement-dust exposure. Methods: To reduce confounding factors, subjects with normal spirometry without fibrosis, asthma and pneumonia histories were only selected, and a propensity score matching was applied to match age, sex, height, smoking status, and pack-years. Thus, from a larger data set (N=609), only 41 cement dust-exposed subjects were compared with 164 non-cement dust-exposed subjects. QCT imaging metrics of airway hydraulic diameter (Dh), wall thickness (WT), and bifurcation angle (θ) were extracted at total lung capacity (TLC) and functional residual capacity (FRC), along with their deformation ratios between TLC and FRC. Results: In TLC scan, dust-exposed subjects showed a decrease of Dh (airway narrowing) especially at lower-lobes (p<0.05), an increase of WT (wall thickening) at all segmental airways (p<0.05), and an alteration of θ at most of the central airways (p<0.001) compared with non-dust-exposed subjects. Furthermore, dust-exposed subjects had smaller deformation ratios of WT at the segmental airways (p<0.05) and θ at the right main bronchi and left main bronchi (p<0.01), indicating airway stiffness.Conclusions: Dust-exposed subjects with normal spirometry demonstrated airway narrowing at lower-lobes, wall thickening at all segmental airways, a different bifurcation angle at central airways, and a loss of airway wall elasticity at lower-lobes. The airway structural alterations may indicate different airway pathophysiology due to cement dusts.
Tuberculosis registration rates analysis and prediction based on Exponential Smoothing model: could tuberculosis control milestones be achieved in 2020, 2025 in Henan Province, China?
Authors: Zhang Yanqiu , Li Xinxu , Li Weibin , Jiang Jianguo , Zhang Guolong , Zhuang Yan , Xu Jiying , Shi Jie , Sun Dingyong
Published: May 2020

Background: The World Health Organization (WHO) End TB Strategy meant that compared with 2015 baseline, the reduction in pulmonary tuberculosis (PTB) incidence should be 20% and 50% in 2020 and 2025, respectively. The case number of PTB in China accounted for 9% of the global total in 2018, which ranked the second high in the world. From 2007 to 2019, 854,672 active PTB cases were registered and treated in Henan Province, China. We need to assess whether the WHO milestones could be achieved in Henan Province.Methods: The active PTB numbers in Henan Province from 2007 to 2019, registered in Chinese Tuberculosis Information Management System (CTIMS) were analyzed to predict the active PTB registration rates in 2020 and 2025, which is conductive to early response measures to ensure the achievement of the WHO milestones. The time series model was created by monthly active PTB registration rates from 2007 to 2016, and the optimal model was verified by data from 2017 to 2019. Monthly and annual active PTB registration rates and 95% confidence interval (CI) from 2020 to 2025 were predicted.Results: High active PTB registration rates in March, April, May and June showed the seasonal variations. The exponential smoothing winter’s multiplication model was selected as the best-fitting model. The predicted values were approximately consistent with the observed ones from 2017 to 2019. The annual active PTB registration rates were predicted as 49.2 (95% CI: 36.0-62.5) and 34.3 (95% CI: 17.7-50.8) per 100,000 population in 2020 and 2025, respectively. Compared with the active PTB registration rate in 2015, the reduction will reach 23.7% (95% CI: 3.1%-44.2%) and 46.9% (95% CI: 21.3%-72.5%) in 2020 and 2025, respectively.Conclusions: The high active PTB registration rates in spring and early summer indicates that high risk of tuberculosis infection in late autumn and winter in Henan Province. Without regard to the confidence interval, the first milestone of WHO End TB Strategy in 2020 will be achieved. However, the second milestone in 2025 will not be easily achieved unless there are early response measures in Henan Province, China.Trial registration: Not applicable
Patient satisfaction with malaria care among pregnant women and mothers of under 5 children in Ibadan, Southwest Nigeria
Authors: Oladimeji Kelechi Elizabeth , Tsoka-Gwegweni Joyce Mahlako , Yaya Sanni , Nutor Jerry John , Adeola Abiodun M , Cumber Samuel Nambile , Hyera Francis Leonard Mpotte , Goon Ter Daniel
Published: May 2020

Background Patient satisfaction is as an important measure of program assessment and health system performance. In our study, we assessed patient’s satisfaction with malaria care among pregnant women (PW) and mothers of children less than five years of age (MU5) in Ibadan, Nigeria. Methods A cross-sectional design, patient satisfaction with malaria care was assessed among 1,373 participants (818 PW and 555 MU5) with the anti-malarial care they received in a comprehensive hospital in Ibadan, Nigeria. Data on patient satisfaction was obtained using a validated eighteen-item questionnaire (PSQ-18) and analyzed using the standard satisfaction scales and quantitative scores. Results Overall, more than half of the participants (79.5% of PW and 78.8% MU5) were well satisfied with malaria care. The least satisfaction i.e., 41.4% among PW (mean satisfaction score = 3.06±1.2) and 45.1% (mean 3.16±1.3) among MU5 was reported on the clinical technical quality of (Sometimes doctors make me wonder if their diagnosis is correct). Furthermore, general satisfaction (based on satisfactions with technical quality, inter-personal attitude, communication, cost, accessibility or convenience and time spent with the doctor) was inversely associated with parity of PW (OR for PW with one child = 0.51, 95% CI: 0.34-0.75 with reference to pregnant women who have had more than one child) in multivariate analyses. Among MU5, general satisfaction was associated with extreme poverty (OR = for the poorest = 0.30, 95% CI: 0.10-0.90, with reference to the richest). Conclusion Socio economic status plays significant roles in mothers’ satisfaction with health care access, level of care received and most importantly their prospective health seeking behaviour. Important aspect, such as patient’s perception of being well treated by the health care provider should be a key consideration for formulate a patients’ centred strategy to improve malaria cares in Oyo state and Nigeria at large.
Inference about Time-dependent Prognostic Accuracy Measures in the Presence of Competing Risks
Authors: Dey Rajib , Sebastiani Giada , Saha-Chaudhuri Paramita
Published: May 2020

Background: Evaluating a candidate marker or developing a model for predicting risk of future conditions is one of the major goals in medicine. However, model development and assessment for a time-to-event outcome may be complicated in the presence of competing risks. In this manuscript, we propose local and global estimators of cause-specific AUC for right-censored survival times in the presence of competing risks. Methods: The local estimator - cause-specific weighted mean rank (cWMR) - is a local average of time-specific observed cause-specific AUCs within a neighborhood of given time t. The global estimator - cause-specific fractional polynomials (cFPL) - is based on modelling the cause-specific AUC as a function of t through fractional polynomials. Results: We investigated the performance of the proposed cWMR and cFPL estimators through simulation studies and real-life data analysis. The estimators perform well in small samples, have minimal bias and appropriate coverage. Conclusions: The local estimator cWMR and the global estimator cFPL will provide computationally efficient options for assessing the prognostic accuracy of markers for time-to-event outcome in the presence of competing risks in many practical settings.
Three-dimensional random walk models of individual animal movement and their application to trap counts modelling
Authors: Ahmed Danish Ali , Benhamou Simon , Bonsall Michael , Petrovskii Sergei
Published: May 2020

Background:
Random walks (RWs) have proved to be a powerful modelling tool in ecology, particularly in the study of animal movement. An application of RW concerns trapping which is the predominant sampling method to date in insect ecology, invasive species, and agricultural pest management. A lot of research effort has been directed towards modelling ground-dwelling insects by simulating their movement in 2D, and computing pitfall trap counts, but comparatively very little for flying insects with 3D elevated traps.
Methods:
We introduce the mathematics behind 3D RWs and present key metrics such as the mean squared displacement (MSD) and path sinuosity, which are already well known in 2D. We develop the mathematical theory behind the 3D correlated random walk (CRW) which involves short-term directional persistence and the 3D Biased random walk (BRW) which introduces a long-term directional bias in the movement so that there is an overall preferred movement direction. In this study, we consider three types of shape of 3D traps, which are commonly used in ecological field studies; a spheroidal trap, a cylindrical trap and a rectangular cuboidal trap. By simulating movement in 3D space, we investigated the effect of 3D trap shapes and sizes and of movement diffusion on trapping efficiency.
Results:
We found that there is a non-linear dependence of trap counts on the trap surface area or volume, but the effect of volume appeared to be a simple consequence of changes in area. Nevertheless, there is a slight but clear hierarchy of trap shapes in terms of capture efficiency, with the spheroidal trap retaining more counts than a cylinder, followed by the cuboidal type for a given area. We also showed that there is no effect of short-term persistence when diffusion is kept constant, but trap counts significantly decrease with increasing diffusion .
Conclusion:
Our results provide a better understanding of the interplay between the movement pattern, trap geometry and impacts on trapping efficiency, which leads to improved trap count interpretations, and more broadly, has implications for spatial ecology and population dynamics.
Air Gasification of Banana (Musa spp.) Residues to Produce Biofuels
Authors: Adeniyi Adewale George , Ighalo Joshua O.
Published: May 2020

Thermochemical conversion of biomass is a technique used in recovering its energetic content and for the production useful biofuels. A lot of wastes/residues are generated from the harvesting and consumption of banana fruits. This study developed an ASPEN Plus model for the gasification of banana (Musa Spp.) residues pseudo-stem, the peels and the leaves. The model will be used to study the effect of gasification temperature, gasification pressure and air-fuel ratio (AFR) on the selectivity of the chemical species in the product stream. For all three residues, the selectivity of hydrogen increases with temperature with temperature. At the optimum temperature, the hydrogen molar selectivity in the product stream is 56% (900oC), 55% (900oC) and 53% (700oC) for pseudo-stem, peels and leaves respectively. At the optimum atmospheric pressure, the hydrogen molar percentage in the product stream was 48%, 49% and 50% for pseudo-stem, peels and leaves respectively. At the optimum AFR, the hydrogen selectivity in the product stream is 55%, 52% and 46% for pseudo-stem, peels and leaves respectively. All three residues are reasonably good feedstock for the gasification process but the pseudo-stem possesses a marginal advantage over the others.
Association between renal hyperfiltration, arterial stiffness and subendocardial viability ratio in prediabetic subjects: a cross-sectional study.
Authors: Pino Antonino Di , Marchisello Simona , Scicali Roberto , Zanoli Luca , Ferrara Viviana , Urbano Francesca , Filippello Agnese , Mauro Stefania Di , Scamporrino Alessandra , Piro Salvatore , Castellino Pietro , Purrello F , Rabuazzo Agata Maria
Published: May 2020

Background: Glomerular hyperfiltration is a well-recognized early renal alteration in subjects with diabetes mellitus and a strong and independent predictor of cardiovascular events in these patients. Prediabetes has been associated with increased glomerular filtration rate (GFR), however, the association between prediabetes, glomerular hyperfiltration and early markers of cardiovascular damage has not been investigated. The aim of this study was to investigate the association between renal hyperfiltration (RHF) and early markers of cardiovascular disease in subjects with prediabetes.Methods: Arterial stiffness [Augmentation Pressure (Aug), Augmentation Index (AugI)], subendocardial viability ratio (SEVR), pulse wave velocity (PWV), intima-media thickness (IMT), glycated hemoglobin (HbA1c), oral glucose tolerance test and estimated GFR (eGFR) were evaluated in 230 subjects with prediabetes. The eGFR was assessed using the Chronic Kidney Disease Epidemiology Collaboration formula (CKD-EPI). Hyperfiltration was defined as an eGFR above the 75th percentile.The subjects were divided into two groups according to the presence or absence of RHF: 169 subjects with prediabetes without RHF and 61 subjects with prediabetes with RHF.Results: Subjects with RHF showed higher Aug, AugI and lower SEVR compared with prediabetic subjects with lower eGFR (14.1±7.2 vs 10.8±6.2, 32.9±12.7 vs 27.6±11.7, 153.5±27.8 vs 162±30.2, P<0.05). No differences were found in PWV and IMT values between the two groups. We then performed multiple regression analysis to test the relationship between Aug, SEVR and several cardiovascular risk factors. In multiple regression analysis Aug was associated with age, systolic blood pressure (SBP), homeostatic model assessment for insulin resistance (HOMA-IR) and eGFR; the major determinants of SEVR were eGFR, HOMA-IR and SBP.Conclusions: Our data show that subjects with prediabetes and RHF exhibited an increased Aug, AugI and a reduced SEVR. Longitudinal studies are needed to explore whether hyperfiltration increases the possibility of diabetic nephropathy and cardiovascular disease in individuals with prediabetes.
Circulating Receptor Activator of Nuclear factor kB Ligand and triglycerides are associated with progression of lower limb arterial calcification in Type 2 Diabetes: a prospective, observational cohort study
Authors: Bourron Olivier , Phan Franck , Diallo Mamadou Hassimiou , Hajage David , Aubert Carole-Elodie , Carlier Aurélie , Salem Joe-Elie , Funck-Brentano Christian , Kemel Salim , Cluzel Philippe , Redheuil Alban , Davaine Jean-Michel , Massy Ziad , Mentaverri romuald , Bonnefont-Rousselot Dominique , Gillery Philippe , Jaisson Stéphane , Vermeer Cees , Lacorte Jean-Marc , Bouziri Nesrine , Laroche Suzanne , Amouyal Chloé , Hartemann Agnès
Published: May 2020

Background:Lower limb arterial calcification is a frequent, underestimated but serious diabetic complication. The DIACART study is a prospective cohort study designed to evaluate the determinants of lower limb arterial calcification progression in 198 patients with Type 2 Diabetes.Methods:Lower limb arterial calcification score was determined by computed tomography at baseline and after a mean follow up of 31+/-4 months. Serum RANKL (Receptor Activator of Nuclear factor kB Ligand) and bone remodeling, inflammatory and glycation markers were measured at baseline. The predictive effect of these markers on calcification progression was analyzed by a multivariate linear regression model.Results:At baseline, mean+/-SD and median lower limb arterial calcification scores were, 2364+/- 5613 and 527 respectively and at the end of the study, 3739 +/- 6886 and 1355 respectively. In multivariate analysis, progression of lower limb arterial log calcification score was associated with (β coefficient [slope], 95%CI, p-value) baseline log(calcification score) (1.02, 1.00–1.04, p < 0.001), triglycerides (0.11, 0.03–0.2, p = 0.007), log(RANKL) (0.07, 0.02–0.11, p = 0.016), previous ischemic cardiomyopathy (0.36, 0.15–0.57, p = 0.001) and duration of follow up (0.04, 0.01–0.06, 0.004).Conclusion:In patients with Type 2 Diabetes, lower limb arterial calcification is a frequent and major pathological process which can progress rapidly. Circulating RANKL and triglycerides are independently associated with the progression of lower limb arterial calcification. These results open new therapeutic perspectives in peripheral diabetic calcifying arteriopathy.Trial registration: NCT02431234
Factors Influencing Cancer Genetic Somatic Mutation Test Ordering By Cancer Physicians
Authors: Demeshko Anastassia , Pennisi David J. , Narayan Sushil , Gray Stacy W. , Brown Matthew A. , McInerney-Leo Aideen M.
Published: May 2020

Background: Clinical whole exome sequencing was introduced in an Australian centre in 2017, as an alternative to Sanger sequencing. We aimed to identify predictors of cancer physicians’ somatic mutation test ordering behaviour.Methods: A validated instrument assessed somatic mutation test ordering, genomic confidence, perceived utility of tumour molecular profiling, and percent of patients eligible for targeted therapy. A cash incentive was included in 189/244 questionnaires which were mailed to all Queensland cancer specialists in November 2018.Results: 110 participated (response rate 45%); 54.7% oncologists, and the remainder were surgeons, haematologists and pulmonologists. Oncologists were more likely to respond (p = 0.008), and cash incentive improved the response rate (p < 0.001). 67/102 (65.7%) of physicians ordered ≥ 5 somatic mutation tests annually. Oncologists saw 86.75 unique patients monthly and ordered 2.33 somatic mutation tests (2.2%). An average of 51/110 (46.1%) reported having little/no genomic confidence. Logistic regression identified two significant predictors of somatic mutation test ordering: being an oncologist (OR 3.557, CI 1.338–9.456; p = 0.011) and having greater confidence in interpreting somatic results (OR 5.926, CI 2.230–15.74; p < 0.0001).Conclusions: Consistent with previous studies, the majority of cancer physicians ordered somatic mutation tests. However, the percentage of patients on whom tests were ordered was low. Almost half respondents reported low genomic confidence. Somatic mutation test ordering was higher amongst oncologists and those with increased confidence in interpreting somatic variants. It is unclear whether genomically confident individuals ordered more tests or whether ordering more tests increased genomic confidence. Educational interventions could improve confidence and enhance test ordering behaviour.
Comprehensive Comparison between Empty-nesters and Non-empty-nesters in Anhui, China: Subjective Well-being and Depression
Authors: Su Dan
Published: May 2020

BACKGROUND: China is one of the countries facing the most serious population aging. Empty-nesters accounted half of the total old adults in China, improving mental health status of old people is necessary. This cross-sectional study aimed to compare the subjective well-being and depression comprehensively between empty-nesters and non-empty-nesters in Anhui, China.METHODS: 1452 participants were surveyed by using the demographic characteristics questionnaire, the subjective well-being (SWB) single-choice facial expression questionnaire and the 30-item Geriatric Depression Scale (GDS-30).RESULTS: Education level and depression were risk factors for both groups ( P <0.05), but age, marital status, living mode, and religious belief were main risk factors for empty-nesters ( P <0.05). Monthly individual income and SWB were risk factors for both groups( P <0.05), but living mode, religious belief and physical exercise were main risk factors for elderly empty-nesters, whereas economy situation was the main risk factor for non-empty-nesters( P <0.05).CONCLUTION: The influencing factors of two groups had similarities and differences. With the aging population of China, improving mental health status of old people was necessary. We should implement targeted interventions addressing mental health influencing factors of older adults.
Reference values of the central corneal thickness with different refractive errors for the adult Egyptian population
Authors: Gab-Alla Amr A.
Published: May 2020

Background: To generate reference values of the central corneal thickness (CCT) with different refractive errors for the adult Egyptian population. Methods: A retrospective, observational, and cross-sectional study of 2200 eyes in 1166 subjects scheduled for LASIK, who came to private refractive eye center, Ismailia, Egypt. The study period was from January 2018 to January 2020. The subjects were divided into a broad range of myopia with spherical equivalent (SE) <-0.5D and hyperopia SE> +0.5D. Then, the myopic eyes divided into low (SE>-3.0D), moderate (SE-3.0D to >-6.0D), and high (SE<-6.0D). Similarly, the hyperopic eyes were divided into low (SE<+3.0 D) and moderate (SE+3.0D to <+6.0D) and high >+6.0D. The refractive error was measured by an auto-refractometer (Topcon, Tokyo Optical Co., Ltd., Japan), and CCT was measured using Sirius (CSO, Florence, Italy). Results: The data of 1100 myopic eyes in 556 subjects (30.5% males and 69.5% females) and 1100 hyperopic eyes in 610 subjects (33.6% males and 66.4% females). The mean+SD of CCT for the total myopic subjects was 531.98+32.92μm, range (406 to 636μm). The mean+SD of SE was -4.1±2.5D, range (-0.5 to -12.0D). The mean+SD of CCT for the total hyperopic subjects was 529±38.8μm, range (448 to 619 μm). The mean+SD of SE was +3.65+1.97D, range (+0.5 to +8.5D).Conclusion: In this study, the mean of CCT of the Egyptian population was 531.9 μm for myopic and 529μm for hyperopic subjects respectively. The myopic and hyperopic subjects show a reduction in CCT with age. Females have a thinner cornea than males, 23.6% of the myopic eyes, and 16.5% of the hyperopic eyes have CCT less than 500μm.
Irreversibility of Nerve Root Sedimentation Sign in Lumbar Spinal Stenosis After Decompression Surgery: Incidence and Risk Factors
Authors: Zhang Jinhong , Zhang Qunhu , Xia Shaoxiang , Xu Yunshan , Ni Jinrong , Yin Guoyong , Cao Xiaojian
Published: May 2020

Background. The nerve root sedimentation sign (Sed-sign) is a new diagnostic test for lumbar spinal stenosis. However, few studies have evaluated radiographical outcomes of positive Sed-sign after decompression surgery. The current study aims to evaluate the radiographicaland clinical outcomes of Sed-signafter decompression surgery among a relatively large sample sizeMethods. Patients with positive Sed-sign who underwent transforaminal lumbar interbody fusion (TLIF) surgery were reviewed. Based on postoperative MRI scans, patients with negative or irreversible Sed-sign were assigned to the reversible (R) or irreversible (Ir) groups, respectively. Demographics, radiographic parameters, and health-related quality of life (HRQOL) were evaluated.Results. The R and Ir groups were comprised of 67 and 15 patients, respectively. There were no significant differences between two groups in terms of mean age, sex, postoperative complications as well as mean follow-up time (all P>0.05). After surgery, disc height (DH), foramina height (FH), and segmental lordosis (SL) in both groups were restored. At the latest follow-up, the smallest cross-sectional area (CSA) was significantly increased when compared with preoperatively (P<0.05). The CSA value and correction rate in the R-group was considerably higher than in the Ir-group (P=0.002 and P=0.007). Both groups had improved HRQOL after TLIF surgery; however, the Oswestry disability index, Zürich Claudication Questionnaire, and visual analog scale for back and leg pain were higher in the Ir vs. R groups (P<0.05). Multiple logistic regression analysis revealed that a postoperative CSA less than 131.4 mm2 was a risk factor for the irreversibility of Sed-sign.Conclusion.TLIF surgery resulted in reversibility of positive Sed-sign for most patients. The irreversibility of Sed-sign was associated with poor clinical outcomes. Independent risk factor for the irreversibility of Sed-sign was CSA less than 131.4 mm2.
Distribution of Genes Encoding Virulence Factors of Shigella Strains Isolated from Children with Diarrhea in Southwest Iran.
Authors: Afzali maryam , jomehzadeh nabi , ahmadi khadijeh
Published: May 2020

Background: This study aimed to investigate the distribution of virulence factor genes in Shigella strains isolated from children with diarrhea in the southwest, Iran.Methods: In this cross-sectional study, a total of 91 Shigella spp. were isolated from diarrhea specimens of 1 530 children aged under 15 years in Ahvaz and Abadan, southwest Iran. The Shigella strains were identified by biochemical methods. Subsequently, Shigella spp. were identified by polymerase chain reaction (PCR).All Shigella spp evaluated by PCR for the presence of 9 virulence genes (ipaH, ial, virF, invE, sat, sigA, pic, pet, and sepA).Results: A total of 91 isolates including 47 S. flexneri, 36 S. sonnei, and 8 S. boydii were identified. All isolates were positive for the ipaH gene. The other genes include ial, virF, invE, sigA, sat, sepA, pic and pet found in 84.6%, 72.5%,68.1%, 62.6%, 51.6%, 39.5%, 37.3% and 28.5% of the isolates, respectively.Conclusion: Our results showed a high distribution of virulence genes among Shigella strains in our region. It seems that for different Shigella spp. different virulence factors contribute to pathogenesis. The current study provided insights into some baseline information about the distribution of some virulence genes of Shigella isolates in Southwest Iran.
High Rates of Malaria Microscopy but Low Turnaround of Test-results Among Inpatients in Tertiary Care: With Delayed Initiation, Monotherapy and Incomplete Dosing of Antimalarials
Authors: Kiguba Ronald , Karamagi Charles , Bird Sheila M.
Published: May 2020

Objectives:To describe the patterns of malaria diagnosis and antimalarial use: monotherapy, missed Day 1 dosing and risk-factors. Methods: Prospective cohort of consented adult inpatients on the medical and gynaecological wards of Uganda’s 1790-bed Mulago National Referral Hospital.Results: One in five (19%, 146/762; 95% confidence interval (CI): 16% to 22%) inpatients had an admitting or discharge malaria diagnosis or both. Microscopy was requested in 77% (108/141; 95% CI: 69% to 83%) of inpatients with an admitting malaria diagnosis; results were available for 46% (50/108; 95% CI: 37% to 56%), of whom 42% (21/50; 95% CI: 28% to 57%) were positive. Artesunate (AS) only (47%, 47/100; 95% CI: 37% to 57%) was the most frequently hospital-administered antimalarial followed by quinine (Q) only (23%, 95% CI: 15% to 32%). A quarter (25%, 25/100; 95% CI: 17% to 35%) of the inpatients missed their Day 1 dose of hospital-initiated antimalarials. Nearly half (47%, 95% CI: 34% to 61%) of 57 inpatients on AS and 18%(95% CI: 4% to 32%) of 28inpatients on Q missed at least one day of dosing in Days 1-3. Number of admitting diagnoses was a significant risk-factor for missed Day 1 dosing of hospital-initiated antimalarials (OR = 2.7, 95% CI: 1.53-4.54; P-value < 0.001).Conclusions: Half the malaria microscopy results were not available; yet, the rate of testing was high. Improvement in laboratory services, procurement, prescription, dispensing and administration of antimalarials could curb missed treatment for confirmed malaria cases, monotherapy and delayed doses.
The decrease of CD4 T cell is associated with mortality in critical inpatients with COVID-19
Authors: Xiong Jun , Yang Mei , Yang Weize , Luo Xiaomin , Hu Ke , zhao qingyan
Published: May 2020

Background The 2019 novel coronavirus (SARS-CoV-2) has caused an outbreak in the world. The critically ill patients had a high mortality. However, the possible risk factors of critical patients with coronavirus disease 2019 (COVID-19) are not fully known. We aim to investigate the risk factors in critical patients with COVID-19 and to address their role in predicting disease progression.Methods In this single-centered, retrospective, observational study, we enrolled 91 critically ill adult patients with COVID-19 in Renmin Hospital of Wuhan University between Jan 20, 2020 and Feb 28, 2020. Data were collected using a standard method including clinical records and laboratory findings.Results 39 patients (42.9%) were dead and 52 patients (57.1%) were cured and discharged before Mar 22, 2020. CD4 T cell count, CD8 T cell count and glomerular filtration rate were significantly lower in non-survivors than in survivors. However, the non-survivors presented a higher proportion of D-dimer, Cardiac troponin and immunoglobulin G than in survivors. Intravenous immunoglobulin was more common in survivors than in non-survivors. On multivariate analysis, D-dimer (༞1 µg/mL, OR = 9.53, 95% CI, 2.53–35.88), CD4 + T count (༜200/µl, OR = 9.68, 95%CI, 2.76-40.00 ) and cardiac troponin (༞0.04 ng/mL, OR = 5.73, 95% CI, 1.86–17.66) were independent risk factors for mortality.Conclusion The decrease of CD4 T cell is associated with higher risk mortality in critical inpatients with COVID-19. Intravenous immunoglobulin was more common in survivors than in non-survivors.