bluuebunny/crossref_metadata_2025 huggingface dataset:
Study protocol of a randomised controlled feasibility study of food related computerised attention training versus mindfulness-training and waiting list control for adults with overweight or obesity
Authors: Beivide Daniela Mercado , Werthmann Jessica , Campbell Iain C , Schmidt Ulrike
Published: November 2019

Background: Obesity is a highly prevalent condition with multiple adverse health consequences. Widely available first-line treatments for obesity, such as dietary and other lifestyle interventions, typically have only short-term effects. Thus, new treatment approaches are needed. Novel interventions such as Attention Bias Modification Training (ABMT) and Mindfulness Based Interventions focus on modifying different maladaptive cognitive patterns typically present in people with obesity (e.g. attention bias to food cues), however, their mechanisms of action remain largely unknown. We describe the theoretical basis and the rationale for a study protocol of a feasibility randomised controlled trial (RCT) comparing two attention trainings (ABMT vs Mindfulness Training [MT]) in people with overweight or obesity. The aim of this study is to inform the development of a large scale RCT in relation to acceptability and attendance rates and to identify preliminary evidence for the interventions’ clinical efficacy and potential underlying mechanisms.
Design: Forty-five adults who are either overweight or obese (minimum body mass index of 25 kg/m2) will be randomly allocated to receive eight sessions over eight weeks of either computerised ABMT or MT or be on a waiting list. Clinical and cognitive outcomes will be assessed at baseline, post-treatment (8 weeks) and follow-up (12 weeks post-randomisation). These include mood, body composition and attention biases. Credibility and acceptability of the trainings will be assessed using questionnaires, and recruitment and retention rates will be recorded.
Discussion: Findings will inform the feasibility of developing a large scale RCT that takes into consideration effect sizes for primary outcome measures and the acceptability of the design. The study will also provide preliminary evidence on the clinical efficacy of two different attention trainings for people with obesity and their underlying mechanisms.
Effectiveness of the Healthy Start-Départ Santé approach on physical activity, healthy eating and fundamental movement skills of preschoolers attending childcare centres: A randomized controlled trial
Authors: Leis Anne , Ward Stéphanie , Vatanparast Hassan , Humbert Louise , Chow Amanda Froehlich , Muhajarine Nazeem , Engler-Stringer Rachel , Bélanger Mathieu
Published: November 2019

Background: Since young children spend approximately 30 hours per week in early childcare centres (ECC), this setting is ideal to foster healthy behaviors. This study aimed to asses the effectiveness of the Healthy Start-Départ Santé (HSDS) randomized controlled trial in increasing physical activity (PA) levels and improving healthy eating and fundamental movement skills in preschoolers attending ECC. Methods: Sixty-one ECC were randomly selected and allocated to either the usual practice (n=30; n=433 children) or intervention group (n=31; n=464 children). The HSDS intervention group was provided a 3-hour on-site training for childcare educators which aimed to increase their knowledge and self-efficacy in promoting healthy eating, PA and development of fundamental movement skills in preschoolers. PA was measured during childcare hours for five consecutive days using the Actical accelerometer. Preschoolers’ fundamental movement skills were assessed using the standard TGMD-II protocol and POMP scores. Food intake was evaluated using digital photography-assisted weighted plate waste at lunch, over two consecutive days. All data were collected prior to the HSDS intervention and again 9 months later. Mixed-effect models were used to analyse the effectiveness of the HSDS intervention on all outcome measures. Results: Total number of children who provided valid data at baseline and endpoint for PA, food intake and fundamental movement skills were 259, 670 and 492, respectively. Children in the HSDS intervention group had, on average, a 3.33 greater point increase in their locomotor motor skills scores than children in the control group (β=3.33, p=0.009). No significant differences in effects were observed for object control, PA and food intake. However, results demonstrated a marginal increase in portions of fruits and vegetables served in the intervention group compared to control group (β=0.06, p=0.05). Conclusion: Locomotor skills showed a significant improvement in the intervention group compared to the control one. Although modest beneficial effects of HSDS were found, most outcome indicators progressed in a direction favouring the HSDS intervention compared to the usual practice group.
Full-length transcriptome sequencing reveals the low-temperature-tolerance mechanism of Medicago falcata roots
Authors: Cui Guowen , Chai Hua , Yin Hang , Yang Mei , Hu Guofu , Guo Mingying , Yi Rugeletu , Zhang Pan
Published: November 2019

Background: Low temperature is one of the main environmental factors that limits crop growth, development, and production. Medicago falcata is an important leguminous herb that is widely distributed worldwide. M. falcata is related to alfalfa but is more tolerant to low temperature than alfalfa. Understanding the low temperature tolerance mechanism of M. falcata is important for the genetic improvement of alfalfa. Results: In this study, we explored the transcriptomic changes in the roots of low-temperature-treated M. falcata plants by combining SMRT sequencing and NGS technologies. A total of 115,153 nonredundant sequences were obtained, and 8,849 AS events, 73,149 SSRs, and 4,189 lncRNAs were predicted. A total of 111,587 genes from SMRT sequencing were annotated, and 11,369 DEGs involved in plant hormone signal transduction, protein processing in endoplasmic reticulum, carbon metabolism, glycolysis/gluconeogenesis, starch and sucrose metabolism, and endocytosis pathways were identified. We characterized 1,538 TF genes into 45 TF gene families, and the most abundant TF family was the WRKY family, followed by the ERF, MYB, bHLH and NAC families. A total of 134 genes, including 101 whose expression was upregulated and 33 whose expression was downregulated, were differentially coexpressed at all five temperature points. PB40804, PB75011, PB110405 and PB108808 were found to play crucial roles in the tolerance of M. falcata to low temperature. WGCNA revealed that the MEbrown module was significantly correlated with low-temperature stress in M. falcata. Electrolyte leakage was correlated with most genetic modules and verified that electrolyte leakage can be used as a direct stress marker in physiological assays to indicate cell membrane damage from low-temperature stress. The consistency between the qRT-PCR results and RNA-seq analyses confirmed the validity of the RNA-seq data and the analysis of the regulatory mechanism of low-temperature stress on the basis of the transcriptome. Conclusions: The full-length transcripts generated in this study provide a full characterization of the transcriptome of M. falcata and may be useful for mining new low-temperature stress-related genes specific to M. falcata. These new findings could facilitate the understanding of the low-temperature-tolerance mechanism of M. falcata.
Associations between echocardiographic manifestations and bacterial species in patients with infective endocarditis: a cohort study
Authors: Damlin Anna , Westling Katarina , Maret Eva , Lundborg Cecilia Stålsby , Caidahl Kenneth , Eriksson Maria J
Published: November 2019

Background The diagnosis of infective endocarditis (IE) is based on microbiological analyses and diagnostic imaging of cardiac manifestations. Echocardiography (ECHO) is preferred for visualization of IE-induced cardiac manifestations. We investigated associations between bacterial infections and IE manifestations diagnosed by ECHO. Methods In this cohort study, data from patients aged 18 years or above, with definite IE admitted at the Karolinska University Hospital between 2008 and 2017 were obtained from Swedish National Registry of Endocarditis. Bacteria registered as pathogen were primarily selected from positive blood culture and for patients with negative blood culture, bacteria found in culture or PCR from postoperative material was registered as pathogen. Patients with negative results from culture or PCR, and patients who did not undergo ECHO during hospital stay, were excluded. IE manifestations diagnosed by ECHO were obtained from the registry. Chi-squared test and two-sided Fisher’s exact test was used for comparisons between categorical variables, and student’s t test was used for continuous numerical variables. Multivariable analyses were performed using logistic regression. Secular trend analyses were performed using linear regression. Associations and the strength between the variables were estimated using odds ratios (ORs) with 95% confidence intervals (CIs). P < 0.05 was considered significant. Results The most common bacteria were Staphylococcus aureus (n = 239, 49%) and viridans group streptococci (n = 102, 21%). The most common manifestations were vegetation in the mitral (n = 195, 40%), aortic (n = 190, 39%), and tricuspid valves (n = 108, 22%). Associations were seen between aortic valve vegetations and Enterococcus faecalis among patients with native aortic valves, between mitral valve vegetations and streptococci of group B or viridans group, between tricuspid valve vegetations and S.aureus among patients with intravenous drug abuse, and between perivalvular abscesses as well as cardiovascular implantable electronic device (CIED)-associated IE and coagulase negative staphylococci (all P < 0.05). Conclusions Associations were found between certain bacterial species and specific ECHO manifestations. Our study contributes to a better understanding of IE manifestations and their underlying bacterial etiology, which pathogens can cause severe infections and might require close follow-up and surgical treatment.
Pregnancy options counselling in Ghana: A case study of women with unintended pregnancies in Kumasi metropolis, Ghana
Authors: Agbeno Evans Kofi , Gbagbo Fred Yao , Morhe ESK , Maltima Soale Issah , Sarbeng Kwadwo
Published: November 2019

Background
Pregnancy crisis mismanagement has contributed to maternal deaths and illnesses globally and in Ghana due to absence/inadequate pregnancy options counselling for clients to make informed decisions. This study examines options counselling for abortion seekers in health facilities in Ghana.

Methods
Analytical cross-sectional study design was done in selected specialised public and NGO health facilities within Kumasi Metropolis of Ghana, using self-administered structured questionnaires for data collection from 1st January to 30th April, 2014. Participants were 442 women with unintended pregnancies seeking abortion services. Data was analysed using Epi-Info (7.1.1.14) and STATA 12 to generate descriptive statistics, Pearson chi-square and multivariable logistic regressions. The Kwame Nkrumah University of Science and Technology approved the study.

Results
Respondents had divergent reproductive and socio-demographic profiles. Majority (about 58%) of them had been pregnant more than twice, but about 53% of this population had no biological children. (Although about 90% of respondents held perceptions that the index and previous pregnancies were mistimed/unintended, the majority (72%) had no induced abortion history. Induced abortion (208, 49%) and parenting (216, 51%) were mentioned as the only available options to unintended pregnancy in hospitals. Exposure to options counselling was observed to be significantly associated with parity (P= <0.001), gestational age (P= <0.001), previous induced abortions (P= <0.001), perception of pregnancy at conception (P= <0.001) and level of education (P= 0.002). The logistic regression analysis also shows that higher education has statistically significant effect on being exposed to options counselling (P= <0.001). Majority of respondents (95%) were not aware that giving a child up for adoption is an option to abortion in Ghana.

Conclusions
Pregnancy options counselling remains a major challenge in comprehensive abortion care in Ghana. Although higher educational attainments significantly exposes women to options counselling for informed decisions, the less educated are disadvantaged in this regard. Further research on type and depth of counselling services provided to pregnant women in health facilities is required to inform health policy and program decisions.
Acceptability of Internet-based interventions for problem gambling: a qualitative study of focus groups with clients and clinicians
Authors: Sanchez Sherald , Jindani Farah , Shi Jing , Maas Mark van der , Hagopian Sylvia , Murray Robert , Turner Nigel
Published: November 2019

Although Internet-based interventions (IBIs) have been around for two decades, uptake has been slow. Increasing the acceptability of IBIs among end users may increase uptake. In this study, we explored the factors that shape acceptability of IBIs for problem gambling from the perspective of clients and clinicians. Findings from this qualitative study of focus groups informed the design and implementation of an IBI for problem gambling.Methods Using a semi-structured interview guide, we conducted three focus groups with clients experiencing gambling problems (total n = 13) and two with clinicians providing problem gambling treatment (total n = 21). Focus groups were audio recorded, transcribed verbatim, and analyzed using a two-part inductive-deductive approach to thematic analysis.Results Although both user groups reported similar experiences, each group also had unique concerns. Clinician perspectives were more homogeneous reflective of healthcare professionals sharing the same practice and values. Clinicians were more concerned about issues relating to the dissemination of IBIs into clinical settings, including the development of policies and protocols and the implications of IBIs on the therapeutic relationship. In comparison, client narratives were more heterogeneous descriptive of diverse experiences and individual preferences, such as the availability of services on a 24-hour basis. There was consensus among clients and clinicians on common factors influencing acceptability: access, usability, high quality technology, privacy and security, and the value of professional guidance.Conclusions Acceptability is an important factor in the overall effectiveness of IBIs. Gaining an understanding of how end users perceive IBIs and why they choose to use IBIs can be instrumental in the successful and meaningful design, implementation, and evaluation of IBIs.
A retrospective genomic analysis of drug-resistant strains of M. tuberculosis in a high-burden setting, with an emphasis on comparative diagnostics and reactivation and reinfection status.
Authors: Wollenberg Kurt , Harris Michael , Gabrielian Andrei , Ciobanu Nelly , Chesov Dumitru , Long Alyssa , Taaffe Jessica , Hurt Darrell , Rosenthal Alex , Tartakovsky Michael , Crudu Valeriu
Published: November 2019

Background Recurrence of drug-resistant tuberculosis (DR-TB) after treatment occurs through relapse of the initial infection or reinfection by a new drug-resistant strain. Outbreaks of DR-TB in high burden regions present unique challenges in determining recurrence status for effective disease management and treatment. In the Republic of Moldova the burden of DR-TB is exceptionally high, with many cases presenting as recurrent.Methods We performed a retrospective analysis of Mycobacterium tuberculosis from Moldova to better understand the genomic basis of drug resistance and its effect on the determination of recurrence status in a high DR-burden environment. To do this we analyzed genomes from 278 isolates collected from 189 patients, including 87 patients with longitudinal samples. These pathogen genomes were sequenced using Illumina technology, and SNP panels were generated for each sample for use in phylogenetic and network analysis. Discordance between genomic resistance profiles and clinical drug-resistance test results was examined in detail to assess the possibility of mixed infection.Results There were clusters of multiple patients with 10 or fewer differences among DR-TB samples, which is evidence of person-to-person transmission of DR-TB. Analysis of longitudinally collected isolates revealed that many infections exhibited little change over time, though 35 patients demonstrated reinfection by divergent (number of differences > 10) lineages. Additionally, several same-lineage sample pairs were found to be more divergent than expected for a relapsed infection. Network analysis of the H3/4.2.1 clade found very close relationships among 61 of these samples, making differentiation of reactivation and reinfection difficult. There was discordance between genomic profile and clinical drug sensitivity test results in twelve samples, and four of these had low level (but not statistically significant) variation at DR SNPs suggesting low-level mixed infections.Conclusions Whole-genome sequencing provided a detailed view of the genealogical structure of the DR-TB epidemic in Moldova, showing that reinfection may be more prevalent than currently recognized. We also found increased evidence of mixed infection, which could be more robustly characterized with deeper levels of genomic sequencing.
A systematic review of the overlap of fluid biomarkers in delirium and advanced cancer-related syndromes.
Authors: Amgarth-Duff Ingrid , Hosie Annmarie , Caplan Gideon , Agar Meera
Published: November 2019

Delirium is a serious and distressing neurocognitive disorder of physiological aetiology that is common in advanced cancer. Understanding of delirium pathophysiology is largely hypothetical, with some evidence for involvement of inflammatory systems, neurotransmitter alterations and glucose metabolism. To date, there has been limited empirical consideration of the distinction between delirium pathophysiology and that of the underlying disease, for example, cancer where these mechanisms are also common in advanced cancer syndromes such as pain and fatigue. This systematic review explores biomarker overlap in delirium, specific advanced cancer-related syndromes and prediction of cancer prognosis.Methods A systematic literature search was conducted, using MEDLINE, PubMed, Embase, CINAHL, CENTRAL and Web of Science, to identify body fluid biomarkers in delirium, cancer prognosis and advanced cancer-related syndromes of interest. Studies were excluded if they reported delirium tremens only; did not measure delirium using a validated tool; the sample had less than 75% of participants with advanced cancer; measured tissue, genetic or animal biomarkers, or were conducted post-mortem. Articles were screened for inclusion independently by two authors, and data extraction and an in-depth quality assessment conducted by one author, and checked by two others.Results The 151 included studies were conducted in diverse settings in 32 countries between 1985 and 2017, involving 28130 participants with a mean age of 69.3 years. Seventy-one studies investigated delirium biomarkers, and 80 studies investigated biomarkers of an advanced cancer-related syndrome or cancer prognosis. Overall, 41 biomarkers were studied in relation to both delirium and either an advanced cancer-related syndrome or prognosis; and of these, 24 biomarkers were positively associated with either delirium or advanced cancer syndromes/prognosis in at least one study. The quality assessment showed large inconsistency in reporting.Conclusion There is considerable overlap in the biomarkers in delirium and advanced cancer-related syndromes. Improving the design of delirium biomarker studies and considering appropriate comparator/controls will help to better understanding the discrete pathophysiology of delirium in the context of co-existing illness.
Building research capacity in musculoskeletal health: qualitative evaluation of a graduate Nurse and Allied Health Professional internship programme
Authors: Wright David , Fry Mary , Adams Jo , Bowen Catherine
Published: November 2019

Background: Evidence based practice enhances service planning and delivery, clinical decision making and patient care. However, health professionals often lack the time and opportunity to access or generate evidence. Research capacity building is thus an important mechanism for improving health service delivery. This study evaluates the effectiveness of a Nurse and Allied Health Professional musculoskeletal research internship programme and explores the experiences of interns and their mentors.
Methods: Sixteen new graduates completed the internship programme (September 2015 – August 2018). Twelve interns and thirteen mentors participated in the evaluation. The evaluation used qualitative asynchronous email-based interviews to explore the experiences of interns and mentors. Interpretive phenomenological analysis of coded transcripts identified principal themes.
Results: Early research outputs from the interns include three peer reviewed publications and 21 conference abstract presentations. Two interns were in full time research at the time of interview or had a research component in their clinical role. Nine interns in clinical posts disclosed plans to return to research in the near future. Seven themes were identified: the impact on interns’ careers; personal impact (for example, influence on self-confidence); impact on clinical practice; drivers for applying; intervention design (for example, attitudes concerning the timing and duration of the intervention); mentorship and networking (including general support provided and quality of career advice); challenges.
Conclusion: The internship programme is an effective model in building research capacity in musculoskeletal research for Nurses and Allied Health Professionals, influencing careers, building confidence and improving clinical practice. The internship programme has the potential to be replicable to other clinical contexts nationally and internationally.
Evaluating of the predictors of high blood pressure in children and adolescence: Findings from Iranian health care system reform plan
Authors: Taghizadeh Shahnaz , Farhangi Mahdieh Abbasalizad , Pourali Fathollah Pourali , jafarabadi mohammad asghari
Published: November 2019

Background: to evaluate the role of dietary pattern and life style associated factors in predicting hypertension among overweight and obese pediatrics. Methods : In the current cross-sectional study, 425 overweight and obese children and adolescents aged 6 to 18 years were enrolled. The predictors of blood pressure considering patterns of fruits, vegetables, dairy products, fast food or junk food intake and meal consumption and also life style habits including hours of watching TV and physical activity, anthropometric indices were included in the scoring algorithm. Results : The results of final model of hierarchical linear regression showed that SBP and DBP had directly significant correlation with age (p<0.001, p<0.001) and BMI (p<0.005, p<0.007) respectively. Moreover, DBP was in significant correlation with fruit consumption of less than 2 serving per day versus never consumption (p=0.014, B= 0.444), fruit consumption of more than 2 serving per day versus never consumption (p=0.014, B= 0.480), and vegetable consumption less than 3 serving per day versus never consumption (p=0.045, B= -0.374). Also, results showed that DBP had significant correlation with fast foods /junk foods consumption of 1-2 items per week versus almost every day consumption (p= 0.047, B=-0.177). This final model could predict 32.1% of hypertension by SBP and DBP (R2 =0.321). Conclusion : According to our findings, consumption of lower vegetables and fruits, higher amounts of fast foods, higher age and BMI could be potent predictors of high blood pressure among Iranian children and adolescents. Key words: hypertension, children, adolescents, Iranian health care reform system
Economic burden and mental health of primary caregivers of perinatally HIV infected adolescents from Kilifi, Kenya
Authors: Katana Patrick V , Abubakar Amina , Nyongesa Moses K. , Ssewanyana Derrick , Mwangi Paul , Newton Charles R , Jemutai Julie
Published: November 2019

Background: Eighty per cent of perinatally HIV infected (PHI) adolescents live in sub-Saharan Africa (SSA), a setting also characterized by huge economic disparities. Caregiving is crucial to the management of chronic illness such as HIV/AIDS, but the economic costs and mental disorders borne by caregivers of PHI adolescents often go unnoticed. In this study, we evaluated economic costs, coping strategies and association between economic cost and mental health functioning of caregivers of perinatally HIV infected adolescents in Kilifi, Kenya. Methods: We used a cost of illness descriptive analysis approach and mental health was assessed using the Patient Health Questionnaire (PHQ-9). Cross-sectional data were collected from 121 primary caregivers of PHI adolescents in Kilifi using a structured cost questionnaire. Economic costs (direct costs and indirect costs) were measured from primary caregivers’ perspective. We used descriptive statistics in reporting the results of this study. Results: Average monthly direct and indirect costs per primary caregiver was Ksh 2,784.51 (USD 27.85). Key drivers of direct costs were transportation (66.5%) and medications (13.8%). Total monthly costs represented 28.8% of the reported caregiver monthly earnings. Majority of the caregivers borrowed resources to cope with high economic burden. About 10.7% of primary caregivers reported depressive symptoms. Caregivers with positive depression screen (PHQ-9 score ≥10) had high average monthly direct and indirect costs. However, this was not statistically different compared to costs incurred by caregivers who screened negative for depressive symptoms. Conclusion: Our study indicates that HIV/AIDS is associated with a significant economic burden for caregivers of adolescents living with HIV. These high economic burdens seem to negatively influence the mental health of caregivers of adolescents living with HIV. Results underscore the need for developing economic empowerment and social support programmes that reduce the economic burden of caring for perinatally infected adolescent. These efforts may improve the mental health and quality of life of caregivers of adolescents living with HIV.
Characterization of lumbar lymph node, a CNS-specific draining lymph node, after spinal cord injury in rats
Authors: Askarifirouzjaei Hadi , Khajoueinejad Leila , Fazeli Mehdi , Tiraihi Taki , Pourfathollah Ali Akbar
Published: November 2019

Regional tissue-draining lymph nodes are the major active site after inflammation that generate primary immune responses according to lymphatic system pathways. However, CNS specific draining lymph nodes have not characterized individually after spinal cord injury (SCI). Therefore, we examined the morphofunctional state of the Lumbar lymph node, the closest CNS-draining lymph node adjacent to the lesion site in thoracic spinal cord injury. Findings: Lumbar lymph nodes isolated 7 days after low thoracic spinal cord injury were compared with sham control and intact control rats. The significant enlargement was observed in lumbar lymph nodes in SCI group accompanied by increased total cell number, while there was a significantly higher cell death rate. Besides, the proliferation test performed on lymphocytes lumbar lymph nodes one week after SCI revealed accelerated proliferation rate compared to sham and intact control groups, which was associated with significant elevation of IFN-γ/IL4 ratio, which confirms adaptive immunity is biased towards the Th1 pro-inflammatory responses. Conclusions: Accordingly, we conclude that the lumbar lymph node is an important CNS-draining lymph node for understanding the immunopathology of SCI, which needs to be considered as a major active lymphoid organ adjacent to the lesion site.
Differential Activation of Neuroinflammatory Pathways in Children with Seizures: A Cross-Sectional Study
Authors: Bartolini Luca , Moran Michael P. , Norato Gina , Thomas Bobbe , Dick Alexander D. , Wells Elizabeth , Suslovic William , Bumbut Adrian , Chamberlain James M. , Theodore William H. , Gaillard William D. , Jacobson Steven
Published: November 2019

Background: Experimental and clinical findings suggest a crucial role of inflammation in epileptogenesis. We aimed to analyze levels of inflammatory cytokines in plasma and saliva from children with acute seizures and healthy controls and measure their associations with HHV6 and EBV infection.
Methods: We analyzed plasma from 36 children within 24 hours of acute seizures (cases) and 43 healthy controls and saliva from 44 cases and 44 controls with a multiplex immunoassay. Saliva from all controls and 65 cases and blood from 26 controls and 35 cases were also analyzed by ddPCR for viral DNA. Statistical analysis included Wilcoxon Rank Sum test, Fisher’s exact test, ANOVA and Spearman correlation.
Results: Compared to controls, children with breakthrough seizures (n=18) had higher levels of CCL11 (p<0.001), CCL26 (p<0.001), IL-8 (p=0.03), CCL4 (p=0.02) in plasma. Children with new onset seizures (n=13) showed higher levels of CCL11 (p=0.05) and IL-6 (p=0.01). Patients with febrile seizures (n=5) had higher levels of IFNg (p<0.001), IL-6 (p<0.001), IL-10 (p<0.001), CXCL10 (p=0.001). CCL11 was higher with 3 or more seizures (p=0.01), seizures longer than 10 minutes (p=0.001) and when EEG showed focal slowing (p=0.02).
In saliva, febrile seizures had higher levels of IL-1β (n=7, p=0.04) and new onset seizures had higher IL-6 (n=15, p=0.02). Plasma and saliva cytokine levels did not show correlation.
Frequency of HHV-6 and EBV detection was similar across seizure types and not different than controls. We found no correlation between viral load and cytokine levels
Conclusions: We showed differential activation of neuroinflammatory pathways in plasma from different seizure etiologies compared to controls, unrelated to HHV-6 infection.
Monitoring of selected parasites and other foodborne microorganisms in vegetable products at point of sale
Authors: Moravkova Monika , Vasickova Petra , Mikel Pavel , Slany Michal , Kolackova Ivana , Karpiskova Renata , Kralik Petr
Published: November 2019

It is supposed that epidemiological data linked to cases of alimentary infection from fresh produce are scarce and usually underestimated. The present study reveals data concerning the occurrence of less studied foodborne pathogens such as parasites ( Giardia intestinalis , Cryptosporidium parvum/hominis ) and viruses (norovirus, hepatitis A virus) in 175 samples of fresh-cut vegetables, frozen vegetables and sprouts. In addition, samples were also analyzed for the presence of bacterial indicators of production hygiene such as Escherichia coli and Staphylococcus aureus . Our results revealed that DNA of G. intestinalis was found in two samples (1.1%) of mixed fresh vegetable salads and mixed frozen vegetables at a level of 100 CFU/g. Norovirus was detected in two samples (1.1%) of rucola and frozen mixed vegetables. No sample was positive for C. parvum/hominis or hepatitis A virus. Our results highlight the need for microbial analysis of food of non-animal origin for specific parasitic and viral agents not generally monitored in these food category types, but their presence poses risks for alimentary infection.
Effects of Acute Peritoneal Dialysis in Extremely-Low-Birth-Weight Infants: A Retrospective Cohort Study
Authors: Noh Jihyun , Kim Chae Young , Jung Euiseok , Lee Joo Hoon , Park Young-Seo , Lee Byong Sop , Kim Ellen Ai-Rhan , Kim Ki-Soo
Published: November 2019

Background :Acute peritoneal dialysis (APD) is a first-line rescue therapy for neonatal acute kidney injury (AKI) refractory to conservative management, but its efficacy in preterm infants remains unclear. This study aimed to investigate the clinical outcomes of APD and APD efficiency in extremely-low-birth-weight (ELBW) infants. Methods : We reviewed the medical records of inborn ELBW infants who underwent APD in a tertiary center. We recorded perinatal characteristics, including the causes of AKI and clinical outcomes. Serial input and output data and laboratory parameters to assess ultrafiltration/dialysis efficiency were also obtained. Results : A total of 12 ELBW infants were included in the study. Mean gestational age and birth weight were 27.2 weeks and 706.5 g, respectively. Leading cause of AKI was sepsis (50%) followed by perinatal asphyxia. Mean age at the start of PD was 16.3 days. Mean ultrafiltration (UF) rate was 2.73 mL/kg/h. After a mean duration of 9.4 days, the mean reduction in serum BUN and Cr levels was 42.5% and 20.1%, respectively. Mean sodium level increased from 135.8 to 144.7 mg/mL, and mean potassium level decreased from 6.8 to 5.0 mg/mL. The most common complication was mechanical dysfunction of the catheter, including dialysate leakage via the insertion site (75%). Only two patients were successfully weaned off APD. The overall mortality rate was 92%. Conclusions : In ELBW infants with AKI, APD was an effective rescue therapy in terms of its ultrafiltration and dialysis efficiency, but not with respect to neonatal mortality. Indications for APD in ELBW infants should be individualized depending on the etiology of AKI.
IDentification of patients in need of general and specialised PALLiative care (ID-PALL©): item generation and content validity of a new interprofessional screening instrument.
Authors: Lüthi Fabienne Teike , Bernard Mathieu , Beauverd Michel , Gamondi Claudia , Ramelet Anne-Sylvie , Borasio Gian Domenico
Published: November 2019

Background Early identification of patients requiring palliative care is a major public health concern. A growing number of instruments exist to help professionals in identifying these patients, but thus far, none have been thoroughly assessed for criterion validity. In addition, no currently available instruments differentiate between patients in need of general vs. specialized palliative care, and most are primarily intended for physicians’ use. This study aims to develop a new interprofessional instrument allowing identification of patients in need of general vs specialized palliative care.Methods The instrument development consisted of four steps: i) literature review to determine the concept to measure; ii) generation of a set of items; iii) review of the initial set of items by experts to establish the content validity; iv) administration of the items to a sample of the target population to establish face validity. We conducted a Delphi process with experts in palliative care to accomplish step 3 and sent a questionnaire to nurses and physicians non-specialised in palliative care to achieve step 4. A committee of interdisciplinary clinical experts supervised all steps.Results The study was conducted in the French - and Italian-speaking regions of Switzerland. The literature review confirmed the necessity of distinguishing between general and specialised palliative care needs and of adapting clinical recommendations to these different needs. Thirty-six nurses and physicians participated in the Delphi process and 28 were involved in the face validity assessment. The Delphi process resulted in two item lists: a 7-items list to identify patients in need of general PC and an 8-items list for specialised PC needs. The content and face validity were deemed to be acceptable by both the expert and the target populations.Conclusion This instrument considers a new perspective in the identification of patients requiring palliative care as it has been designed to differentiate between general and specialised palliative care needs. Moreover, diagnostic data is not fundamental to the use of the instrument, thus facilitating its use by healthcare professionals other than physicians, in particular nurses. Internal and criterion validity assessments are ongoing and essential before further dissemination of the instrument.
Oral health status and associated lifestyle behaviors among Iranian adults: a population based household survey
Authors: Jahangiry Leila , Bagheri Raziollah , Darabi Fatemeh , Sarbakhsh Parvin , Sistani Mohammad Mehdi Naghibi , Ponnet Koen
Published: November 2019

Background: Poor oral hygiene can lead to serious diseases, like periodontitis, tooth decay, pain and discomfort in teeth or gums, infection, and loss of teeth. In Iran, particularly adults between 50 years and older experience oral health problems, and this age group will grow the next decades. Despite increasing attention into healthy aging, there is less emphasis on oral hygiene. This survey aimed to investigate oral health status among Iranian adults. This knowledge may provide vital information to those who are planning strategies of oral health care.
Method: A population-based household survey was conducted to recruit a representative sample of adults. This study was carried out among adults aged 18-65 years between May and October 2016 in Tabriz, Iran. The study population was sampled using a multi-stage cluster sampling design. The WHO’s oral health questionnaire (WHO’s OHQ) was used for measuring oral health status and oral health behavior.
Results: In total, 2310 respondents completed the survey. The mean age (SD) of the participants was 41.6(23.4) years. About 48.8% of participants were male and 51.2% were female. 187(8.1%) were edentulous, and 152 (20.7%) of those participants were aged 50 to 65 years. 72.3% of the sample were dentate in that they had 20 or more teeth. Half of adults aged 50-65 years said they had 20 or more teeth. In general, about one-third of the participants reported that they don’t brush their teeth daily (23% for 18-35-year-old adults, 35.9% for 36-50-year-old adults, and 44.6% for 51- to 65-year-old adults).
In our sample, 39.4% of 18-35-year-olds, 34.1% of 36-50-year-olds, and 26.6% of 51-65-year-olds had visited a dentist less than six months ago. One-third of participants eat sweets every day and frequently consume tea with sugar.
Conclusion: The oral health status indicates that even though the majority of Iranian people assess their dental health positively, only a minority of participants have regular dental visits. Visits to the dentist decline by increasing age, and oral health problems increase. The study findings underline the importance of dental visits and that poor oral health may increase the risk of adverse health outcomes, particularly as age increases.
Engaging perceived value towards political marketing mix for head of region voting decision
Authors: Ferry Bastian Asep , Setiawan Margono , Armanu  , Rohman Fatchur
Published: November 2019

This study aims to determine and analyze the role of perceived value in influencing political marketing mix on voting decision for Head of Region in the Election of Governor and Deputy Governor of Banten in 2017. The population of this study involves people who have the rights to vote in Banten and are kept on the permanent voter list. Sample of this study consists of 664 respondents, in which most of the respondents include casual workers, outsourcing, casual daily laborers, housewives, and workers who do not need special skills. The proportional random sampling technique was utilized in determining the number of respondents. SEM (Structural Equation Modeling) was conducted by applying WarpPLS 6.0. The results of the study indicated that there is a positive and significant relationship between political marketing mix and perceived value concerning the voting decision, as demonstrated by positive and significant effect on perceived value. The findings confirmed that political marketing mix influenced the decision to elect a Head of Region mediated by perceived value. To improve the decision to vote, the researchers believe/suggest that providing attention to political products such as branding of political candidates, is thus deemed necessary.
Novel complete ensemble EMD with adaptive noise-based hybrid filtering for rolling bearing fault diagnosis
Authors: Song Xiaojun , Sun Hongwei , Zhan Liwei
Published: November 2019

A feature extraction of fault bearing has attracted considerable attention in recent years. However, weak fault feature is difficult to extract under heavy background noise. To solve this problem, a novel multi-layer filtering method is proposed to filter out noise and extract weak fault feature. The first layer introduces a metric based on de-trended fluctuation analysis (DFA) to identify intrinsic mode function (IMF) that reflect period impulsive information for vibration signal adaptively. The second layer uses non-local mean (NLM) method as a pre-filter of the third layer to realize extraction of singular value decomposition (SVD) which reflect the most information of IMFs. The last layer introduces a relative energy difference criterion of a singular value to extract important feature of Hankel matrix of IMFs. The filtered signal is obtained by re-constructed signal from identified singular value of SVD. Experiment results on simulation and real vibration signals indicate that the hybrid filtering method removes heavy noise successfully and extract weak fault feature of rolling bearing effectively.
An explicit closed-form solution for transverse and longitudinal vibration of beam with multi-directional elastic constraints under an arbitrary moving load
Authors: Ding Yong , Han Lingxia , You Jiuang
Published: November 2019

Beams with elastic constraints are widely used in dynamic systems in engineering. A general explicit solution is presented here for the vibration of simple span beam with transverse, rotational and axial elastic boundary constraints due to an arbitrary moving load. The Euler-Bernoulli beam theory is adopted, in which the boundary constraints are treated as multi-directional boundary springs. After the modal analyses, the explicit closed-form solutions of transverse and axial vibration of the beam under a constant, sinusoidal and cosinoidal moving loads are obtained, respectively. And the vibration of a beam subjected to an arbitrary moving load is derived by the superposition of Fourier series. The current analytical solution is exact and can be applied in multiple engineering fields to obtain accurate structural vibrations. In numerical examples, the effects of the boundary springs on the natural frequencies, modes, deflection, bending moment and boundary reaction of the beam are studied in details. The effects of the number of terms in Fourier series of arbitrary moving load are also discussed.
Numerical simulation and experimental analysis of magneto-mechanical behavior of anti-seismic active sandwich structure
Authors: Zerrouni Nassim , Aguib Salah , Grine Ali , Chikh Noureddine
Published: November 2019

This work focuses on the quasi-static behavior study for simply supported sandwich beams with aluminum faces and magnetorheological elastomer core subjected to three points bending subjected to a magneto-mechanical loading by numerical and experimental investigations. The mechanical properties of the magnetorheological elastomer core are measured experimentally and the mechanical behavior of the MRE was identified by the generalized Maxwell rheological model. Depending upon the adjustable properties of the beam, energy dissipation is by core shear. A systematic series of experiments and finite elements simulations have been performed in order to assess the static behavior of the beam. The results obtained show a significant influence of the magnetic field intensity on the flexural displacement of the beam.
Erzurum İlinde İçme Suyu İçin Ödeme İstekliliği Üzerine Etkili Olan Faktörlerin Belirlenmesi
Authors: Uzundumlu Ahmet Semih , Fakıoğlu Özden , Köktürk Mine
Published: November 2019

Belediyelerin
topluma daha hijyenik, daha güvenilir içme sularını ulaştırmaları yıllar
geçtikçe daha fazla önem arz etmektedir. Ancak bu amacı gerçekleştirmek
belediyelerin çok büyük yatırımlar yapmasını gerektirmektedir. Bu yatırımları
yerine getirmesinde toplumun katkısı da önemli bir yere sahiptir. Bu
çalışmadaki amaç içme suyunda toplumun belediye hizmetlerinin iyileştirmesine
yönelik katkıda bulunup bulunmayacağını araştırmaktır. Çalışmada hanelerin %65.7’sinin
belediye suyunun 1 litresine 50-80 kuruş ödemeye istekli olduğu tespit edilmiştir.
Ayrıca hanelerde meyve suyu tüketimi arttıkça içme suyu için ödeme istekliliği
artmaktadır. Bunun dışında hanelerdeki birey sayısı arttıkça, hane reisinin
eğitim yılı azaldıkça, hane reisinin mesleği esnaflık olunca, çeşme suyunun
maliyeti arttıkça ve tüketicilere sunulan ödeme istekliliği fiyatı arttıkça
tüketicilerin içme suyu için ödeme istekliliği azalmaktadır. Tüketiciler
güvenilir içme sularına ödedikleri su faturasına yaklaşık 3.2 katı kadar
ödemeye razıdırlar. Bu nedenle belediyeler tüketicilere daha hijyenik ve tadı daha
güzel suları ulaştırmak için altyapı hizmetlerini iyileştirmesinde toplumun
desteğini alabilir.
Gel-based Microemulsion Design and Evaluation for Topical Application of Rivastigmine
Authors: Fang Chih-Wen , Tsai Ling-Chun , Fu Yaw-Syan , Cheng Ting-Yu , Wu Pao-Chu
Published: November 2019

Objective:

The aim of the present study was to design nanocarriers for the topical application
of rivastigmine.

Methods:

The effect of cosurfactants, hydrophilic gel and loading amount on the permeability of rivastigmine
through rat skin was evaluated. Skin irritation tests and stability tests were performed to
evaluate the utility of tested formulations.

Results:

The results showed that the microemulsion formation and characteristics of drug-loaded formulations
were related to many parameters of the components. When using microemulsion systems as
a vehicle, the permeation rate remarkably increased about 13.2~24.3-fold and the lag time was significantly
shortened from 24 h to 4.7 h. Formulations containing a cosurfactant of Diethylene Glycol
Monobutyl Ether (DEGBE) showed higher enhancement effect, while increasing the loading dose from
0.5% to 5% further increased the flux about 2.1-fold and shortened the lag time.

Conclusion:

The drug-loaded experimental formulation did not cause skin irritation and had good stability
at 20ºC and 40ºC storage for at least 3 months. The result showed that gel-based microemulsion
formulation could be a promising approach for topical administration.
Household Food Insecurity and Health-related Quality of Life in an Urban Adult Population in Iran
Authors: Gholami Ali , Jahromi Leila M. , Shams-Beyranvand Mehran , Khazaee-Pool Maryam , Naderimagham Shohreh , Mehrizi Ali A.H. , Amirkalali Bahareh , Asadi-lari Mohsen
Published: November 2019

Background:

The relationship between food insecurity and mental and physical components of health-related quality of life (HRQOL) has been less addressed by healthcare professionals.

Objective:

We aimed to investigate the relationship between household food insecurity and mental
and physical components of HRQOL in a large sample of urban people and to determine whether
household food insecurity has a negative effect on mental and physical components of HRQOL.

Methods:

This cross-sectional study was conducted across twenty-two districts of Tehran (capital of
Iran) during 2011. The participants were selected through multistage cluster random sampling. Two
questionnaires were used to measure household food insecurity and HRQOL in the study population,
while descriptive and inferential statistics were applied to test the relationships between these two parameters.

Results:

The mean age of the study population was 44.5 ± 15.5 years and most were female (64.8%).
The results of this study indicated an independent relationship between household food insecurity
and different subscales of HRQOL (P<0.001). Household food insecurity had a significant negative
relationship with physical (β= -5.93; P<0.001) and mental (β= -6.54; P<0.001) summary scores of
HRQOL. Likewise, average scores on all subscales of HRQOL according to household food security
status were significantly different (P<0.001).

Conclusion:

Food insecurity was associated with mental and physical components of HRQOL
among urban participants and can be considered as a part of comprehensive interventions that target
to improve general health.