bluuebunny/crossref_metadata_2025 huggingface dataset:
Lingual Frenectomy as Treatment of Ankyloglossia in Children: A case report
Authors: Saskianti Tania , Aprillia Zita , Puteri Mega Moeharyono , Az Zahra Alivy Aulia , Tedjosasongko Udijanto
Published: June 2020

Background: Ankyloglossia or tongue tie is a congenital condition that results when the inferior lingual fraenulum is too short and attached to the tip of the tongue, limiting its normal movements.  It causes restricted tongue mobility which in turn causes feeding difficulties and speech problems. Purpose : The article was aimed to report the treatment of an  eight years old boy  who came with the chief complaint of difficulty in moving his tongue freely which causes speech difficulties. Case Management : The patient was treated for a lingual frenectomy procedure under local anaesthesia using one haemostat method. The haemostats were used to delimit the area to be excised as well as to guide the incisions. One haemostat used to clamp the upper aspect of the fraenulum may be helpful to guide the incision close to the ventral surface of the tongue. After the release of the tongue, care must be taken not to injury the submandibular ducts when making the second incision at the lower aspect of the fraenulum. After 1 to 2 weeks the incision was completely healed. Discussion: Ankyloglossia occurs due to failure in cellular degeneration leading to longer anchorage between tongue and floor of the mouth. Surgical intervention for treating ankyloglossia includes conventional technique with hemostats, electrocautery and laser. In this case, patient was undertaken surgical intervention using one hemostat method. Conclusion: The ankyloglossia case showed that the frenectomy gave good healing with no post operative complications in 8 years old boy.
Telescopic Overdenture as An Aesthetic Treatment for Partially Dentate Patients – A case report
Authors: M Satrio Krestiono , Laksono Harry
Published: June 2020

Background: Metal frame denture design is common used for partially dentate patient, one of the problem was a metal appearance from wrought wire or a metal casting clasp as retainer, which is not really aesthetic. Telescopic overdenture with its double crown will be the best solution for those cases. Purpose: The purpose of this case report was to reported telescopic overdenture design and fabrication where the aesthetic was the main consideration. Case: Sixty years old female patient, a businesswoman, came to Dental Hospital of Universitas Airlangga, complained about her upper partially dentate and 6 years lower fixed partial denture, which is not comfortable to wear and her upper anterior teeth doesn’t look quite good. She wanted to make crowns and removable denture. Case management: After the diagnosis were made, the pretreatment plan were remove crown for the upper jaw, remove the bridges on lower jaw, and transitional dentures were made to maintain the VDO. The crowns and veneer were fabricated and inserted while the inner copings were tried up on prepared teeth. After the the dentures were produced, the inner copings were luted to the abutment teeth, and then the dentures were inserted using FGP (Friction GriP) cement for the friction effect. Discussion: Telescopic overdenture is consists of a double crown system known as “the telescopic”, the procedure involves fitting the remaining natural teeth with inner metal crowns, followed by outer crowns as part of an over denture that can be removed by the patient. Conclusion: This technique ensures that telescopic overdentures give natural aesthetic result.
Immediate Complete Overdenture – A case report
Authors: Fatahillah Ali Surahman , Kridanto Kamadjaja Michael Josef , Laksono Harry
Published: June 2020

Background: Edentulousness resulting from extraction of teeth often leads to psychological problem and social isolation of the patient. The patient has to adapt to the situation with respect to speech, chewing, swallowing, and so forth. A smooth transition from dentulousness to edentulousness is the result of immediate over denture with a few retained teeth. Purpose: to report overdenture prevents alveolar ridge bone absorption, stabilizes a denture, and makes the typical sensory function to be looked closer to natural teeth. Case: A 79-year-old female complaint of missing multiple teeth and desire to replace them. Extraoral examination and temporomandibular joint movement were normal. Five teeth (12,11,21,22,34) exhibited grade II mobility with diagnosis apical chronic periodontitis. Radiographic examination is an overview of diffuse radiolucent on the apical on the teeth 17,13,12,11,21,22,34. Case Management: First, make a diagnostic impressions of the maxillary and mandibular with irreversible hydrocolloid then poured in dental stone. After that, the final impressions were taken and poured in dental stone, casts mounted on articulators. Bite registration was done after using bite rim and bite registration material. The next step is setting up the artificial teeth then tried to the patient. Five teeth (12,11,21,22,34) were trimmed from the casts on the functional model. The patients tooth 12, 11, 21,22 and 34 were reduced to a dome shape only 2 mm above gingival margin then restored with GIC on the surface. The denture was then placed immediately after reduced. Discussion: The selected abutments teeth were reduced to a dome shape only 2 mm above gingival margin. This will create adequate space for the overlying artificial denture tooth and denture base. Also, it reduces the lateral stresses and lever action of the tooth. The retained tooth roots, used for overdenture, transfers occlusal forces to the alveolar bone through the periodontal ligament and maintain alveolar ridge morphology. Conclusion: Overdenture can be used to prevents alveolar ridge bone absorption, stabilizes a denture, and makes the typical sensory function to be looked closer to natural teeth.
Toxicity Test on Taro Leaf Extract (Colocasia Esculenta L. Schoot) as Mouthwash to BHK-21 Fibroblast Cell Culture in Denture Users
Authors: Meilena Tiara , Fabiansyah Januar Cidie , Djulaeha Eha , Hidayati Hanoem Eka
Published: June 2020

Background: One of requirements for a material to be used in dentistry is that the material must be non toxic and non irritant, as well as have biocompatibility properties, not triggering a detrimental effect on the biological environment, both locally and systemically. The first-line tests that must be conducted is in vitro tests, one of which is MTT Assay. Samples used in this research were fibroblast cells (cultured BHK-21 cells) since fibroblasts are the most important and largest components in pulp, periodontal ligament, and gingiva. Purpose: This research aimed to determine toxicity effect of taro leaf extracts (Colocasia esculenta L. Schoot) on BHK-21 fibroblast cells. Methods: This research is an experimental laboratory research using Post Test Only Control Group design.  The research treatment are the administration of Taro leaf extract (Colocasia esculenta L. Schoot)  with 100%, 80%, 60%, and 40% concentration on BHK-21 fibroblast cell. Results: The fibroblast cell life percentage in 100%, 80%, 60%, and 40% concentration respectively are 106,3%, 50,9%, 36,2%, and 30,1%. The toxicity results are obtained using MTT assay technique after 24 hours. The optical density absorbency values are read by ELISA reader and represent life cell viability. Conclusion: Taro leaf extract (Colocasia esculenta L. Schoot) at a concentration above 80% is considered as non-toxic material to BHK-21 fibroblast cells
Perfil socioeconômico e laboral dos pescadores artesanais de camarão-rosa no complexo estuarino de Tramandaí­­ (RS), Brasil
Authors: SILVA-GONÇALVES Raoní , D'INCAO Fernando
Published: June 2020

A pesca artesanal no Brasil possui importí­¢ncia social e econômica. O presente estudo tem como objetivo caracterizar o perfil dos pescadores artesanais de camarão-rosa, Farfantepenaeus paulensis, em Tramandaí­­, RS, Brasil. Os pescadores foram entrevistados nos anos de 2012 e 2013. A faixa etária deles foi de 45 a 58 anos, com média de 30 anos de profissão. A maioria tem filhos, possui baixa escolaridade e pretende continuar na profissão. No entanto, 92,3% dos pescadores não gostariam que seus filhos os seguissem neste ofí­­cio. Eles trabalham em média seis horas diárias, sete dias por semana. Em 2012, capturaram, por semana, cerca de 104 kg de camarão e, em 2013, 61,2 kg. Embora consigam manter suas famí­­lias com a pesca, mostram-se insatisfeitos com a profissão. A pouca escolaridade e a falta de oportunidades em outras ocupações fazem com que não pretendam abandonar a atividade pesqueira.
Fração solúvel de hidrolisado proteico de sardinha na alimentação do jundiá
Authors: VENTURIN André , GONÇALVES André Fernando Nascimento , OLIVEIRA Nandara Soares de , SKORONSKI Everton , PESSATTI Marcos Luiz , FABREGAT Thiago El Hadi Perez
Published: June 2020

O objetivo deste trabalho foi avaliar o efeito da inclusão da fração solúvel do hidrolisado proteico de sardinha sobre a estabilidade das dietas e a excreção de amônia de juvenis de jundiá. Foram elaboradas sete dietas experimentais com as frações solúveis dos hidrolisados de músculo e vísceras de sardinha. A determinação da estabilidade do pellet na água foi medida em intervalos de tempo diferentes (5 min, 10 min, 20 min, 30 min, 1 h e 1,5 h). A determinação de amônia total foi realizada a cada cinco horas. Como resultado do teste de estabilidade foi detectado diferença significativa somente no período de 5 minutos, onde a dieta contendo 20% de hidrolisado solúvel de musculo teve maior taxa de lixiviação em comparação com a dieta controle. A partir de 10 horas de observação, a concentração de amônia foi maior no controle em relação aos outros tratamentos. O hidrolisado proteico de resíduo de sardinha tem grande potencial para ser utilizado nas rações do jundiá, melhorando a eficiência ambiental das dietas. A inclusão de até 10% da fração solúvel de hidrolisados de músculo e de vísceras de sardinha não afeta a estabilidade das dietas, além de diminuir a excreção de amônia.
EFEITO DA ALCALINIDADE NO CONSUMO ALIMENTAR DE JUVENIS DE CAMARÃO BRANCO DO PACÍFICO CULTIVADOS EM SISTEMA DE ÁGUA CLARA E BIOFLOCOS
Authors: MAICÁ Paula Fraga , FURTADO Plínio Schmidt , MARTINS Átila Clívea da Silva , Filho Kleber Campos MIRANDA , WASIELESKY Jr. Wilson
Published: June 2020

Esse estudo objetivou avaliar o efeito da alcalinidade no consumo alimentar e demais parí­¢metros de desempenho de juvenis de Litopenaeus vannamei cultivados em água contendo bioflocos e água clara. Para tanto, durante 3 dias, camarões de 4,06 Â± 0,34 g foram mantidos em recipientes de 3 L, sob as concentrações Controle, 50, 100 e 200 mg L-1 de alcalinidade, com 5 repetições cada, em bioflocos e água clara. O consumo alimentar foi verificado uma vez ao dia e os demais parí­¢metros de desempenho foram avaliados ao final do experimento. Nesse estudo, verifica-se que o consumo alimentar dos camarões não é afetado entre os ní­­veis de alcalinidade e nos sistemas de água clara e bioflocos. Já o ganho em peso e a taxa de crescimento especí­­fico são afetados positivamente nas maiores concentrações de alcalinidade, no sistema de bioflocos, onde demonstram os melhores resultados. E a sobrevivência, assim como o consumo alimentar, não é afetada entre os ní­­veis de alcalinidade e nos sistemas de água clara e bioflocos. Contudo, a possibilidade de exposição í­Â  concentrações de alcalinidade inapropriadas, durante longos perí­­odos de tempo, pode afetar negativamente os animais, assim, ressaltando a importí­¢ncia da manutenção da alcalinidade em ní­­veis adequados í­Â  espécie cultivada.
RESPOSTA FITOPLANCTÔNICA í­â‚¬ DIFERENTES FONTES DE CARBONO E RELAÇÃ­-ES C:N NA ALEVINAGEM DE TILÁPIA CULTIVADA COM BIOFLOCOS
Authors: SILVA Ugo Lima , VIEIRA Lucas Conceição , MELLO Marcus Vinicius Lourenço de , FRANÇA Elton José de , FALCON Dario Rocha , CORREIA Eudes de Souza
Published: June 2020

O objetivo deste trabalho foi avaliar a diní­¢mica da comunidade fitoplanctônica durante a alevinagem de tilápia do Nilo, Oreochromis niloticus, com tecnologia de bioflocos. Adotou-se um delineamento experimental inteiramente casualizado com 6 tratamentos e 4 repetições, sendo testadas três fontes de carbono: melaço (ME), açúcar (AC) e fécula de mandioca (FE), nas relações carbono/nitrogênio (C:N) 10:1 e 20:1. As coletas de fitoplí­¢ncton foram realizadas semanalmente durante 63 dias, em amostras de 5 L de água filtradas numa rede de plí­¢ncton com malha de 25 Î¼m. A comunidade fitoplanctônica do ambiente de cultivo esteve representada por 17 gêneros, distribuí­­dos entre as classes Bacillariophyceae, Chlorophyceae, Cyanophyceae, Euglenophyceae e Fragilariophyceae. Em termos de gênero, pode-se concluir que a Pseudanabaena e Synechococcus foram os principais integrantes responsáveis pela dominí­¢ncia da Cyanophyceae em todos os tratamentos. A Chlorophyceae foi a segunda classe mais diversificada, tendo como principais gêneros Chlorella e Scenedesmus. A fonte de carbono que mais influenciou no desenvolvimento do fitoplí­¢ncton foi o melaço, na relação carbono:nitrogênio 20:1.
TOXICIDADE DO ÓLEO ESSENCIAL DE Lippia origanoides EM TAMBAQUI (Colossoma macropomum) E SEU EFEITO FRENTE í­â‚¬ Aeromonas hydrophila
Authors: OLIVEIRA Susanne Regina Nazaré de , OLIVEIRA Marjorie Aymê Souza de , BRANDÃO Franmir Rodrigues , MAJOLO Cláudia , CHAVES Francisco Célio Maia , CHAGAS Edsandra Campos
Published: June 2020

O presente estudo avaliou a toxicidade do óleo essencial de Lippia origanoides em tambaqui (Colossoma macropomum) e sua atividade in vivo frente í­Â  Aeromonas hydrophila. Para os testes de toxicidade, tambaquis foram expostos a 0, 5, 10, 12,5, 15, 17,5 e 20 mg L-1 do óleo essencial de L. origanoides por 96 horas. A concentração média letal (CL50) foi estimada em 15,2 mg L-1. Após exposição dos tambaquis í­Â s concentrações subletais de L. origanoides (7,6 e 11,4 mg L-1) por 96 horas, poucas alterações hematológicas e bioquí­­micas como aumento no volume corpuscular médio e decréscimo nos valores de proteí­­nas totais foram observadas na concentração de 7,6 mg L-1, o que não compromete a homeostase orgí­¢nica dos peixes. Tambaquis experimentalmente infectados com A. hydrophila alcançaram maior taxa de sobrevivência (79,2%) após banho terapêutico com 10 mg L-1 do óleo essencial de L. origanoides. Portanto, o tambaqui exibe moderada tolerí­¢ncia ao óleo essencial de L. origanoides e este óleo tem potencial para uso no tratamento de tambaqui (C. macropomum) infectado com A. hydrophila.
Abundance tracking by long-read nanopore sequencing of complex microbial communities in samples from 20 different biogas/wastewater plants
Authors: Brandt Christian , Bongcam-Rudloff Erik , Müller Bettina
Published: June 2020

Background: Anaerobic digestion (AD) has long been critical technology for green energy, but the majority of the microorganisms involved are unknown and are currently not cultivable, which makes abundance tracking difficult. Developments in nanopore long-read sequencing make it a promising approach for monitoring microbial communities via metagenomic sequencing. For reliable monitoring of AD via long reads, a robust protocol for obtaining less fragmented, high-quality DNA, while preserving bacteria and archaea composition, was established. Results: Samples from 20 different biogas/wastewater reactors were investigated, and a median of 20.5 Gb sequencing data per nanopore flow cell was retrieved for each reactor using the developed DNA isolation protocol. The nanopore sequencing data was compared against Illumina sequencing data while using different taxonomic indices for read classifications. The Genome Taxonomy Database (GTDB) index allowed sufficient characterisation of the abundance of bacteria and archaea in biogas reactors with a dramatic improvement (1.8- to 13-fold increase) in taxonomic classification compared to the RefSeq index. Both technologies performed similarly in taxonomic read classification with a slight advantage for Illumina in regards to the total proportion of classified reads. However, nanopore sequencing data revealed a higher genus richness after classification. Conclusion: Metagenomic read classification via nanopore provides a promising approach to monitor the abundance of taxa present in a microbial AD community, as an alternative to 16S rRNA studies or Illumina Sequencing.
Retrospective investigation of Echinococcus canadensis emergence in translocated elk (Cervus canadensis) in Tennessee, USA, and examination of canid definitive hosts
Authors: Dell BreeAnna Mary , Newman Shelley J. , Purple Kathryn , Miller Brad , Ramsay Edward , Donnell Robert , Gerhold Richard W.
Published: June 2020

Background: Few reports of Echinococcus granulosus have been described in the Unites States; however, the geographical distribution of Echinococcus spp. in wild hosts is increasing consequent to human activities. Methods:We investigated the prevalence of Echinococcus spp. in re-established elk ( Cervus canadensis ) populations in the North Cumberland Wildlife Management Area and the Great Smoky Mountains National Park via a retrospective analysis of banked elk tissues and an examination of intestinal contents from 11 coyotes ( Canis latrans ) from the North Cumberland Wildlife Management Area. Results: Four elk were PCR and sequence positive for E. canadensis . Each sequence had 98% or greater coverage and identity to multiple E. canadensis genotypes in Genbank. Adult Echinococcus spp. were not detected in any of the coyotes examined in this study. Conclusions: Continued surveillance of this disease in susceptible species in these areas is warranted, and these data further underscore the risk of zoonotic pathogen introduction secondary to wildlife translocation.
Initiation into street, challenges, means of survival and perceived strategies to alleviate its plights among street children in Addis Ababa, Ethiopia 2019 A phenomenological study design
Authors: Chimdessa Ayana Fite
Published: June 2020

Background: There has been a major discrepancy in defining the term street children-where various stakeholders define in different ways. In spite of increasing in number, the life and health of street children is becoming a global concern. Even though a wide range of policies and strategies are available, they are poorly designed with helpless implementation. This made street children defenseless to harassments and denial of social protection services.Methodology: A phenomenological study design was employed to explore difficulties of the street children and perceived strategies to prevent and alleviate plights. The study was conducted from January to March 2019. A Time-Space Sampling (TSS) was used to recruit participants. Pre-tested interview guide was used for data collection. Data was analyzed by using framework analysis software. Results: A total of 103 street children took part in the study. Complexity of push and pull factors pose to risk of flee into the street. Street children are facing widespread challenges i.e. social network fragmentation, child trafficking, harassments and shortage of coverage of basic needs. Furthermore, absences of comprehensive and contextualized strategies and less political value for this group worsening it. Thus, street children have been considered as felon, out laws and having a mentality of committing crime by both law keeping bodies and society. This in turn, affecting street children’s’ acceptance by their community and get legal protection under the law and made them more risk to denial of social protection services. To win street life struggles, they use different survival mechanisms by forming small group. Income Generating Activities (IGAs), shelter, community support, child protection, access to health education, health services, life coaching and by less extent reintegration are positively perceived strategies to address their problems. Conclusion: Lack/poorly designed policies and strategies targeting street children has made them prone to health and social problems. Furthermore, stigma by community, limited resources, lack of comprehensive standards and absence of political value of interventions exacerbating it. Therefore, call for different stakeholders in supporting to design and implement clear, case based and contextualized strategic policies to address and prevent plights; by considering positively perceived street children’s proposed strategies.
Prognostic factors for the short-term mortality of patients with rheumatoid arthritis admitted to intensive care units
Authors: Fujiwara Toshifumi , Tokuda Kentaro , Momii Kenta , Shiomoto Kyohei , Tsushima Hidetoshi , Akasaki Yukio , Ikemura Satoshi , Fukushi Jun-ichi , Maki Jun , Kaku Noriyuki , Akahoshi Tomohiko , Taguchi Tomoaki , Nakashima Yasuharu
Published: June 2020

Background: Patients with rheumatoid arthritis (RA) have high mortality risk and are frequently treated in intensive care units (ICUs). Methods: This was a retrospective observational study. This study included 67 patients (20 males, 47 females) with RA who were admitted at the ICU of our institution for ≥48 h between January 2008 and December 2017. We analyzed the 30-day mortality of these patients and the investigated prognostic factors in RA patients admitted to our ICU.Results: Upon admission, the median age was 70 (range, 33–96) years, and RA duration was 10 (range, 0–61) years. The 5-year survival after ICU admission was 47%, and 30-day, 90-day, and 1-year mortality rates were 22%, 27%, and 37%, respectively. The major reasons for ICU admission were cardiovascular complications (24%) and infection (40%) and the most common ICU treatments were mechanical ventilation (69%), renal replacement (25%), and vasopressor (78%). In the 30-day mortality group, infection led to a fatal outcome in most cases (67%), and nonsurvival was associated with a significantly higher glucocorticoid dose, updated Charlson’s comorbidity index (CCI), and acute physiology and chronic health evaluation (APACHE) II score. Laboratory data obtained at ICU admission showed that lower platelet number and total protein and higher creatinine and prothrombin time international normalized ratio (PT-INR) indicated significantly poorer prognosis. The multivariate Cox proportional hazard model revealed that nonuse of csDMARDs, high updated CCI, increased APACHE II score, and prolonged PT-INR were associated with a higher risk of mortality after ICU admission.Conclusion: Our study demonstrated that the nonuse of csDMARDs, high updated CCI, elevated APACHE II score, and coagulation abnormalities predicted poorer prognosis in RA patients admitted to the ICU.
Inferring the votes in a new political landscape. The case of the 2019 Spanish Presidential elections.
Authors: Grimaldi Didier , Diaz Javier , Arboleda Hugo
Published: June 2020

The avalanche of personal and social data circulating in Online Social Networks over the past 10 years has attracted a great deal of interest from Scholars and Practitioners who seek to analyse not only their value, but also their limits. Predicting election results using Twitter data is an example of how data can directly influence the politic domain and it also serves an appealing research topic. This article aims to predict the results of the 2019 Spanish Presidential election and the voting share of each candidate, using Tweeter. The method combines sentiment analysis and volume information and compares the performance of five Machine Learning algorithms. Several data scrutiny uncertainties arose that hindered the prediction of the outcome. Consequently, the method develops a political lexicon-based framework to measure the sentiments of online users. Indeed, an accurate understanding of the contextual content of the tweets posted was vital in this work. Our results correctly ranked the candidates and determined the winner by means of a better prediction of votes than official research institutes.
Development and validation of a scoring system for predicting cancer patients at risk of extended-spectrum b-lactamase-producing Enterobacteriaceae infections.
Authors: Martinez-Valencia Alvaro Jose , Martínez Brian J Gómez , Ayala Anita M Montañez , Garcia Katherin , Pedraza Ricardo Sánchez , Cetina Leydy Jiménez , Rincón Julio Cesar Gómez , Maldonado Sonia Isabel Cuervo
Published: June 2020

Background: Extended-spectrum beta-lactamase producing Enterobacteriaceae (ESBL-PE) infections are frequent and highly impact cancer patients. We developed and validated a scoring system to identify cancer patients harboring ESBL-PE at the National Institute of Cancer of Colombia. Methods: We retrospectively analyzed medical records of 1695 cancer patients. Derivation phase included 710 patients admitted between 2013 to 2015, ESBL-PE positive culture (n = 265) paired by month and hospitalization room with Non-ESBL-PE (n = 445). A crude and weighted score was developed by conditional logistic regression. The model was evaluated in a Validation cohort (n = 985) with the same eligibility criteria between 2016 to 2017. Results: The score was based on eight variables (reported with Odds Ratio and 95% confidence interval): Hospitalization ≥7 days (5.39 [2.46 - 11.80]), Hospitalization during the previous year (4 , 87 [2.99 - 7.93]), immunosuppressive therapy during the previous 3 months (2.97 [1.44-6.08]), Neutropenia (1.90 [1.12 - 3.24]), Exposure to Betalactams during previous month (1.61 [1.06 - 2.42]), Invasive devices (1.51 [1.012 - 2.25]), Neoplasia in remission (2.78 [1.25 - 1.17]), No chemotherapy during the previous 3 months (1.90 [1.22 - 2.97]). The model demonstrated an acceptable discriminatory capacity in the Derivation phase, but poor in the Validation phase (Recipient Operating Characteristic Curve: 0.68 and 0.55 respectively). Conclusions: Cancer patients have a high prevalence of risk factors for ESBL-PE infection. The scoring system did not adequately discriminate patients with ESBL-PE. In a high-risk population, other strategies should be sought to identify patients at risk of resistant ESBL-PE infection.
Global Incidence of Necrotizing Enterocolitis: a Systematic Review and Meta-Analysis
Authors: Alsaied Amer , Islam Nazmul , Thalib Lukman
Published: June 2020

Background: Necrotizing Enterocolitis (NEC) is a major cause of morbidity and mortality in the Neonatal Intensive Care Unit (NICU), yet the global incidence of NEC has not been systematically evaluated. We conducted a systematic review and meta-analysis of cohort studies reporting the incidence of NEC in infants with Very Low Birth Weight (VLBW).Methods: The databases searched included PubMed, MEDLINE, the Cochrane Library, EMBASE and grey literature. Eligible studies were cohort or population-based studies of newborns including registry data reporting incidence of NEC. Data were extracted from the selected papers included incidence of NEC cases and size of population at risk, author and publication details, follow up period covered by the study, location and setting of the study and whether it was VLBW infants or preterm infants. Additionally, risk of bias assessment of the included studies were carried out using a validated tool. Bias adjusted Quality Effect Model (QEM) were used to pool the estimates. In the presence of substantial heterogeneity, Random Effect Models (REM) were used as an additionally sensitivity analyses. The heterogeneity between studies were evaluated using the Cochrane Q statistics and Higgin’s I2 value. Subgroup analysis and meta-regression were used to explore the sources of heterogeneity. Funnel plots as appropriate for ratio measures were used to assess publication bias. Results: A systematic and comprehensive search of databases identified 27 cohort studies reporting the incidence of NEC. The pooled estimate of the global incidence of NEC was 6.0% (95% CI: 4.0%-9.0%). There were substantial heterogeneity (I2 = 100%) between studies. Funnel plots showed no evidence of publication bias.Conclusion: Seven out of 100 of all VLBW infants in NICU are likely to develop NEC. However, there were considerable heterogeneity between studies. High quality studies assessing incidence of NEC along with associated risk factors are warranted.
Echography analysis altered in musculoskeletal, heart and liver associated with endothelial dysfunction of obese rat
Authors: Coria Alejandra Martínez , Estrada-Cruz Norma Angélica , Ordoñez María Inés Pérez , Montes-Cortes Daniel H. , Manuel-Apolinar Leticia
Published: June 2020

Background: Modern imaging plays a central role in the care of obese patients, with an integral focus on its use and accessibility in individuals into this condition with alterations of various organs. Objective. To perform an echographical analysis of musculoskeletal system disorders, endothelial dysfunction and the left ventricle in obese rats. Methods. Sprague Dawley rats (250±5 g) were used and divided in two groups: control group (C) fed with a standard diet, and the obese group (Ob) fed with a hyper caloric diet of high fructose-fat for 4 months. Body weight, cholesterol, triglycerides, glucose, inflammatory cytokines and adhesion molecules (ICAM-1, VCAM-1) were measured. Additionally, two-dimensional echocardiography, abdominal ultrasound and musculoskeletal system studies were performed in the lower extremities.Results. Body weight in the Ob group was increased compared to the control group, (p <0.001); in addition, increased glucose, cholesterol and triglycerides were found in the Ob group vs the C group, (p<0.05), and as well as increased adhesion molecules ICAM-1 and, VCAM-1 (p<0.01). On ultrasound, 75% of the Ob group presented, showed 75% fatty liver and distal joint abnormalities. Conclusion. Endothelial dysfunction and changes at the level of the musculoskeletal system with the presence of joint cysts in the posterior region of the distal joint of the lower extremities and fat liver were observed in obese rodents.
Household Expenditures And Direct Medical Costs Among Older Adults In Ghana: Evidence From WHO-SAGE Wave 2
Authors: Blankson Paa-Kwesi , Hewlett Sandra Ama , Ndanu Thomas Akuetteh , Amoah Gyaami , Boamah Matthew Owusu , Tormeti Daniel , Ampofo Patrick , Mensah George , Minicuci Nadia , Kowal Paul , Lartey Margaret , Biritwum Richard , YAWSON ALFRED
Published: June 2020

Background: The Ghanaian population aged 60 years and older will almost double to reach 14% of the total population by 2050. Ascertaining the pattern of health expenditures among this growing population group is important to inform policy makers about the targets for financial risk protection as part of achieving Universal Health Coverage (UHC) by 2030. This study aimed to estimate household expenditures among older adults and determine their direct medical costs.Methods: The World Health Organization's Study on global AGEing and adult health (SAGE) Wave 2 was conducted in China, Ghana, India, Mexico, Russian Federation, and South Africa between 2014 and 2015, as a follow-up to Wave 0 in 2003 to 2004 and Wave 1 in 2007 to 2010. Survey questions explored sources of income and total directhousehold expenditures in the year preceding the interview. SAGE Ghana was implemented using face-to-face interviews in a nationally representative sample of persons aged 50+ years with a comparison sample of younger adults aged 18–49 years. Findings: Analyses included a total of 4,735 participants, with 1,948 (43.8%) males and 2,787 (56.2%) females, with a mean age of 57.6 (±16.7). The average annual household expenditure was US$ 2,458 (±7,374). Older adults had higher expenditure levels at US$ 2,501 (±8,307), as compared to younger adults, US$ 2,309 (±3,056). Direct health-related and food costs accounted for 10% and 35% respectively of the total household expenditure. The prevalence of catastrophic health expenditure in households of older adults in Ghana was 7.5% (95% CI 6.0% - 9.3%).Conclusion: These updated estimates on household expenditure among older adults provide needed evidence to support the inclusion of social protection mechanisms in the national ageing agenda. The National Health Insurance reduced the burden of direct health expenditure for households with older adults.
Effects of β-carotene intake on the risk of fracture: A Bayesian meta-analysis
Authors: Charkos Tesfaye Getachew , Liu Yawen , Oumer Kemal Sherefa , Vuong Ann M , Yang Shuman
Published: June 2020

Background: Epidemiological studies examining the association between β-carotene intake and risk of fracture has reported inconsistent findings. We conducted a meta-analysis to investigate the association between β-carotene intake and risk of fracture using a Bayesian approach. Methods: We systematically searched PubMed, EMBASE and Cochrane library databases for relevant articles that were published until December 2019. We also identified studies from reference lists of articles identified from the clinical databases. The Bayesian random-effects model was used to synthesize data from individual studies. Results: Nine studies with a total of 190,545 men and women, with an average age of 59.8 years, were included in this meta-analysis. For β-carotene intake, the pooled risk ratio (RR) of any fracture was 0.67 (95% Credible Interval (CrI): 0.51-0.82; heterogeneity: P = 0.66, I2 =0.00 %) and 0.63 (95%CrI: 0.44-0. 82) for hip fracture. By study design, the pooled RRs were 0.55 (95% CrI: 0.14-0.96) for case-control studies and 0.82 (95% CrI: 0.58-0.99) for cohort studies. By geographic region, the pooled RRs were 0.58 (95% CrI: 0.28-0.89) for studies conducted in China, and 0.86 (95% CrI: 0.35-0.1.37) 0.91(95% CrI: 0.75-1.00) for studies conducted in the United States and Europe, respectively. By gender, the pooled RRs were 0.88 (95% CrI: 0.73-0.99) for males and 0.76 (95% CrI: 0.44-1.07) for females. There was a 95% probability that β-carotene intake reduces risk of hip fracture and any type of fracture by more than 20%. Conclusions: The present meta-analysis suggests that β-carotene intake was inversely associated with fracture risk, which was consistently observed for case-control and cohort studies. Randomized controlled trials are warranted to confirm this relationship.
Prognostic Value of Circulating Tumour Cells detected with the CellSearch System in Esophageal Cancer Patients: A Systematic Review and Meta-Analysis
Authors: Li Yiding , Wu Guiling , Yang Wanli , Wang Xiaoqian , Duan Lili , Niu Liaoran , Zhang Yujie , Liu Jinqiang , Hong Liu , Fan Daiming
Published: June 2020

Background: Esophageal carcinoma (EC) is the seventh-most prevalent tumor in the world, which is still one of the primary causes of tumor-related death. Identifying noteworthy biomarkers for EC is particularly significant in guiding effective treatment. Recently, circulating tumor cells (CTCs) in peripheral blood (PB) were intensively discussed as prognostic markers in patients with EC. However, an ongoing controversy still exists regarding the prognostic significance of CTCs determined by the CellSearch system in EC sufferers. This meta-analysis was designed to approach this topic. Methods: We systematically conducted searches using PubMed, Medline, Web of Science and the Cochrane Library for relevant studies, which were published through February 20, 2020. Using the random-effects model, our study was performed in Review Manager software, with odds ratios (ORs), risk ratios (RRs), hazard ratios (HRs) and 95% confidence intervals (CIs) as the effect values. Results: Totally 7 articles were finally included in this study. For clinicopathological characteristics, the pooled results on TNM stage indicated that the III/IV group had higher rate of CTCs compared with the I/II group (OR=1.36, 95% CI: 0.68-2.71, I2=0%). Incidence of CTCs was higher in patients with T3/T4 stage (OR=2.92, 95% CI: 1.31-6.51, I2=0%) and distant metastasis group (OR=5.18, 95% CI: 2.38-11.25, I2=0%) compared to patients with T1/T2 stage or non-metastatic group. The pooled analysis revealed that CTC positivity detected in EC patients was correlated with poor overall survival (OS) (HR=2.83, 95% CI:1.99-4.03, I2=0%) and relapse-free survival (RFS) (HR=4.71, 95% CI:2.73-8.13, I2=0%). When pooling the estimated RR, a poor therapeutic response to chemoradiotherapy was discovered in patients with CTC positivity (RR=1.99, 95% CI:1.73-2.29, I2=60%). Conclusions: In summary, our meta-analysis demonstrated that CTCs positivity determined by the CellSearch system are correlated with the prognosis of EC patients and might indicate a poor therapeutic response to chemotherapy in EC patients.
Identifying Integration and Differentiation in a Hospital’s Logistical System: A social network analysis of a case study
Authors: Ham Annelies van der , Merode Frits Van , Ruwaard Dirk , Raak Arno Van
Published: June 2020

Background Integration, the coordination and alignment of tasks, has been promoted widely in order to improve the performance of hospitals. Both organization theory and social network analysis offer perspectives on integration. This exploratory study research aims to understand how a hospital’s logistical system works, and in particular to what extent there is integration and differentiation. More specifically, it first describes how a hospital organizes logistical processes; second, it identifies the agents and the interactions for organizing logistical processes, and, third, it establishes the extent to which tasks are segmented into subsystems, which is referred to as differentiation, and whether these tasks are coordinated and aligned, thus achieving integration.Methods The study is based on case study research carried out in a hospital in the Netherlands. All logistical tasks that are executed for surgery patients were studied. Using a mixed method, data were collected from the Hospital Information System (HIS), documentation, observations and interviews. These data were used to perform a social network analysis and calculate the network metrics of the hospital network.Results This paper shows that 23 tasks are executed by 635 different agents who interact through 31,499 interaction links. The social network of the hospital demonstrates both integration and differentiation. The network appears to function differently from what is assumed in literature, as the network does not reflect the formal organizational structure of the hospital, and tasks are mainly executed across functional silos. Nurses and physicians perform integrative tasks and two agents who mainly coordinate the tasks in the network, have no hierarchical position towards other agents. The HIS does not seem to fulfill the interactional needs of agents. Conclusions This exploratory study reveals the network structure of a hospital. The cross-functional collaboration, the integration found, and position of managers, coordinators, nurses and doctors suggests a possible gap between organizational perspectives on hospitals and reality. This research sets a basis for further research that should focus on the relation between network structure and performance, on how integration is achieved and in what way organization theory concepts and social network analysis could be used in conjunction with one another.
GHG displacement factors of harvested wood products: the myth of substitution
Authors: LETURCQ Philippe
Published: June 2020

Abstract

Background: A currently held idea is that substituting wood for fossil fuels and energy intensive materials reduces greenhouse gas emissions. This is supported by the values usually attributed to the displacement factors that normalise the emission reduction to the wood carbon mass (typically, 0.5 tC/tC for fossil fuel substitution, 2 tC/tC for building material substitution). These values are based on the “carbon neutrality” assumption of harvested wood, which is claimed valid as long as forests are sustainably managed, but holds true in static conditions only. Harvesting disturbs forest growth and wood carbon storage for a long term. Therefore, the carbon footprint of harvested wood and related displacement factors must be assessed as time-dependant quantities, and the effect of substitutions should be appreciated relatively to specific time horizons. In this study, the meaning, values and use of the displacement factors are reconsidered according to this new line of thinking.

Results: When taking into account the forest carbon dynamics, the presumed values of the displacement factors under the carbon neutrality assumption are achieved only in steady-state conditions, a very long time after harvest. Shortly after harvest, and even for time horizons comparable with climatic deadlines, the transient values of these factors appear much less than the steady-state values, and may even be negative. This is especially the case for the substitution of wood for fossil fuels which first increases the carbon emission for the same energy released. An additional weakness of the ordinary concept of displacement lies in possible misevaluations of carbon benefits from substitution, especially when large sectors of wood products are concerned or when the market conditions are disregarded. Corrective measures are proposed for this.

Conclusions: The use of inadequate constant values of displacement factors under the carbon neutrality assumption and the supposition that wood substitution for other fuels or materials is always possible and effective leads to overestimations of carbon benefits. These overestimations erroneously incite the increase in harvesting and wood utilisation, which may be counter-productive for climate change mitigation objectives, especially when wood is used as a fuel.

Keywords: Forest carbon, Harvested wood products, Carbon accounting, Carbon neutrality, Sequestration parity, Energy and material substitution, Displacement factors, Climate change mitigation.
Spatial distribution and determinants of iron supplementation among reproductive age women in Ethiopia: a spatial and multilevel analysis
Authors: Agegnehu Chilot Desta , Tesema Getayeneh Antehunegn , Teshale Achamyeleh Birhanu , Alem Adugnaw Zeleke , Yeshaw Yigizie , Kebede Sewnet Adem , Liyew Alemneh Mekuriaw
Published: June 2020

Background: Anemia remains a global public health problem. Despite WHO recommended all pregnant women to have iron supplementation, nearly 50% of maternal anemia in SSA was occurred due to lack of iron supplementation during pregnancy. Maternal anemia is associated with an increased risk of maternal death, obstetric complications, preterm birth, and low birth weight. There is limited evidence on the spatial pattern and determinants of iron supplementation using spatial and multilevel analysis methods. Therefore, this study aimed to investigate the spatial pattern, and determinants of iron supplementation in Ethiopia. Methods: We used Ethiopian Demographic Health Survey in 2016 data explore the spatial distribution and associated factors of iron supplementation among women in Ethiopia. A weighted sample of 7589 women were included in the analysis. Bernoulli model was used to explore the purely spatial clusters of pregnant women using SaTScan version 9.6 and ArcGIS version10.3. Multilevel logistic regression analysis was fitted to identify significant individual and community level determinants of iron supplementation. Results: Spatial analysis revealed that there was significant spatial variation of iron supplementation among reproductive age women in Ethiopia with Global Moran’s index value of 0.3 (p <0.001). The primary cluster was in Southwest Somali and Central part of the Oromia region ((LLR=66.69, P<0.001, RR=1.35). ANC visit (AOR= 3.66, 95%CI: 3.21, 417), community education [AOR= 1.31, 95%CI, 1.07, 1.59), media exposure (AOR=1.33, 95%CI: 1.15, 1.53), distance to health facility (AOR=1.32, 95%CI: 1.16, 1.50), region and household wealth index were significantly associated with iron supplementation among women in Ethiopia. Conclusion: The spatial distribution of iron supplementation among reproductive age women were significantly varied across the country with significant hotspot areas located in the Southwest Somali and Central Oromia regions. Besides, ANC visit, region, household wealth index, media exposure, distance to the health facility, and community education were significant determinants of iron supplementation among reproductive age women. Therefore, the finding of this study could help to design effective public health interventions targeting areas low iron supplementation and maternal health services should be delivered in all areas of our country. Keywords : Iron supplementation, spatial analysis, women, Ethiopia
Relationship between Maternal Meat Consumption during Pregnancy and Umbilical Cord Ferritin Concentration
Authors: Castro Mario Moraes , Camacho Fabiola Ruth Castedo , Ceriani Florencia , Fares Nelson , Herrera Tamara Isabel , Ferreira Catalina Vaz , Arocena Elsa , Girona Alejandra , Cavalleri Fiorella , Colistro Valentina , Borbonet Daniel
Published: June 2020

Background Nutrition during pregnancy impacts the health of the fetus and the newborn, with effects at the epigenetic level determining long-term neurological consequences. Iron requirements in pregnancy are estimated at 27 mg/day. The best absorbed heme iron is found in meat: beef, pork, poultry, and fish. The determination of ferritin in umbilical cord blood can be used to assess iron deposits reached during the fetal stage. Ferritin levels were associated with long-term effects on child development. Methods A descriptive, observational study with prospectively collected data was carried out during one-year period at the Department of Neonatology of the Pereira Rossell Hospital Center (CHPR) in Montevideo, Uruguay. A total of 188 patients met the inclusion criteria. Umbilical cord blood was drawn following a strict cord clamping after one minute of life. Ferritin was measured using the chemoimmunofluorescence method. A maternal nutritional survey was applied, using a qualitative-quantitative form measuring the frequency of consumption of iron source foods and approximated quantities consumed during the last trimester of pregnancy. This survey was focused on maternal consumption of beef as the major heminic iron source in Uruguay. The relationship between these variables was analysed. Results Latent iron deficiency (ferritin in the umbilical cord <100 ng / ml) was associated with less consumption of beef during pregnancy. Fisher p-value: 0.0133, OR: 3.71, 95% CI [1.25 - 11.05]. Conclusions This study considers adequate evidence that low levels of total iron and meat consumption during pregnancy will determine an increased risk of latent iron deficiency and lower levels of ferritin in newborns, and therefore, greater risk of long-term adverse effects on myelination and neurocognitive development.