bluuebunny/crossref_metadata_2025 huggingface dataset:
The trinity of ecological contrasts: a case study on rich insect assemblages by means of species, functional and phylogenetic diversity measures
Authors: Guariento Elia , Strutzenberger Patrick , Truxa Christine , Fiedler Konrad
Published: May 2020

Background

The ‘classical’ concept of species diversity was extended in the last decades into other dimensions focusing on the functional and phylogenetic diversity of communities. These measures are often argued to allow a deeper understanding of the mechanisms shaping community assembly along environmental gradients. Because of practical impediments, thus far only very few studies evaluated the performance of these diversity measures on large empirical data sets. Here, data on species-rich riparian moth communities under different flood regimes and from three different rivers has been used to compare the power of various diversity measures to uncover ecological contrasts.

Results

Contrary to the expectation, classical metrics of species diversity (Hill numbers N1, N2 and Ninf) and evenness (Buzas-Gibson’s E and Pielous’s J) turned out to be the most powerful measures in unravelling the two gradients investigated in this study (e.g. flood regime and region). Several measures of functional and phylogenetic diversity tended to depict either only one or none of these contrasts. Rao’s Q behaved similarly as species diversity and evenness. NTI and NRI showed a similar pattern among each other but, were different to all the other measures. Functional Divergence also behaved idiosyncratically across the 28 moth communities. The community weighted means of nearly all individual functional traits showed significant ecological patterns, supporting the relevance of the selected traits in shaping assemblage compositions.

Conclusions

Species diversity and evenness measures turned out to be the most powerful metrics and clearly reflected both investigated environmental contrasts. This poses the question when it is useful to compile the additional data necessary for the calculation of additional diversity measures, since assembling trait bases and community phylogenies often requires a high work load. Apart from these methodological issues, most of the diversity measures related to communities of terrestrial insects like moths increased in forests that still are subject to flooding dynamics. This emphasizes the high conservation value of riparian forests and the importance of keeping and restoring river dynamics as a means of fostering also terrestrial biodiversity in floodplain areas.
The role of text messaging intervention in Inner Mongolia among patients with type 2 diabetes mellitus: a randomized controlled trial
Authors: Wang Xuemei , Liu Dan , Du Maolin , Hao Ruiqi , Zheng Huiqiu , Yan Chaoli
Published: May 2020

Background

Short messages service (SMS) provides a practical medium for delivering content to address patients to adherence to self-management. The aim of study was to design some patient-centered health education messages, evaluate the feasibility of messages, and explore the effect of this model.

Methods

The messages were designed by a panel of experts, and SMS Quality Evaluation Questionnaire was used to evaluate their quality. A two-arm randomized controlled trial was conducted to evaluate the effectiveness of this management model. Participants were randomly divided into an intervention group (IG) who received evaluated messages and a control group (CG) who received regular education. The primary outcomes were changes in plasma glucose and control rates, and the secondary outcomes were improvements in diet control, physical activities, weight control, etc.

Results

A total of 42 messages covering five main domains: health awareness, diet control, physical activities, living habits and weight control were designed, and the average scores of the messages were 8.0 (SD 0.7), 8.5 (SD 0.6), 7.9 (SD 1.0), 8.0 (SD 0.7), and 8.4 (SD 0.9), respectively. In the SMS intervention, 171 patients with an average age of 55.1 years were involved, including 86 in the CG and 85 in the IG. At 12 months, compared with the control group (CG), the decrease of fasting plasma glucose (FPG) (1.5 vs. 0.4, P = 0.011) and control rate (49.4% vs. 33.3%, P = 0.034), the postprandial glucose (PPG) (5.8 vs. 4.2, P = 0.009) and control rate (57.8% vs. 33.7%, P = 0.002) were better in the intervention group (IG). In terms of self-management, improvements in weight control (49.3% vs. 28.2%, P = 0.031), vegetables consumption (87.3% vs. 29.0%, P < 0.001), fruits consumption (27.5% vs. 7.4%, P = 0.022), and physical activities (84.7% vs. 70.0%, P = 0.036) were better in the IG than in the CG.

Conclusions

The overall quality of the messages was high. It was effective and feasible to carry out an SMS intervention to improve the behavioral habits of patients with chronic diseases in remote and undeveloped areas.

Trial registration

Clinicaltrials.gov, ChiCTR1900023445. Registered May 28, 2019--Retrospectively registered.
Clinicopathological and prognostic significance of nestin expression in patients with breast cancer: a systematic review and meta-analysis
Authors: Zhang Xinyi , Xing Changsheng , Guan Wenting , Chen Lang , Guo Kai , Yu Anze , Xie Kai
Published: May 2020

Background

Nestin has been revealed to promote tumorigenesis, progression, metastasis, and angiogenesis of breast cancer. Although the prognostic and clinicopathological impact of nestin expression on breast cancer patients has been assessed in several independent studies, their results remained conflicting. Therefore, we performed this meta-analysis to elucidate the prognostic and clinicopathological association of nestin expression with breast cancer.

Methods

A comprehensive literature search was performed in the electronic databases PubMed, EMBASE, Web of Science, the Cochrane Library, China National Knowledge Infrastructure (CNKI), and the Wangfang Data. The statistical analysis was conducted using Stata 15.0 and Review Manager 5.3.

Results

A total of 15 studies with 6066 breast cancer patients were included in this meta-analysis. Pooled results indicated that positive expression of nestin was significantly associated with reduced breast cancer-specific survival (BCSS, univariate analysis, HR = 2.11, 95% CI [1.79, 2.49], P < 0.00001; multivariate analysis, HR = 1.30, 95% CI [1.06, 1.60], P = 0.01), worse overall survival (OS, univariate analysis, HR = 1.88, 95% CI [1.31, 2.71], P = 0.0007; multivariate analysis, HR = 1.89, 95% CI [1.34, 2.67], P = 0.0003) and poorer recurrence-free survival (univariate analysis, HR = 2.60, 95% CI [1.52, 4.46], P = 0.0005), but not with distant metastasis-free survival in univariate analysis (P > 0.05). In addition, increased nestin expression was correlated with younger age, higher tumor grade, larger tumor size, positive blood vessel invasion and high vascular proliferation index, but not with lymph node metastasis or lymph vessel invasion. Nestin was preferentially expressed in invasive ductal carcinoma, triple-negative breast cancer and basal-like subtypes. Nestin expression was inversely associated with the expression of ER and PR, but not with HER-2. Conversely, nestin expression was positively correlated with the expression of basal-like markers CK5, P-cadherin and EGFR. Moreover, nestin expression was strongly associated with the presence of five basal-like profiles (BLP1-5).

Conclusions

This meta-analysis revealed the prognostic value and clinicopathological significance of nestin expression in breast cancer. Nestin is an independent prognostic factor for worse BCSS and OS of breast cancer patients. Nestin is also a valuable biomarker for unfavorable clinicopathological features and tumor angiogenesis of breast cancer. Therefore, nestin is a promising therapeutic target for malignant breast cancer, especially for TNBC and basal-like phenotype.
Using pulse oximetry waveforms to detect coarctation of the aorta
Authors: Sorensen Matthew W. , Sadiq Ismail , Clifford Gari D. , Maher Kevin O. , Oster Matthew E.
Published: May 2020

Background

Coarctation of the aorta is a common form of critical congenital heart disease that remains challenging to diagnose prior to clinical deterioration. Despite current screening methods, infants with coarctation may present with life-threatening cardiogenic shock requiring urgent hospitalization and intervention. We sought to improve critical congenital heart disease screening by using a novel pulse oximetry waveform analysis, specifically focused on detection of coarctation of the aorta.

Methods and results

Over a 2-year period, we obtained pulse oximetry waveform data on 18 neonates with coarctation of the aorta and 18 age-matched controls hospitalized in the cardiac intensive care unit at Children’s Healthcare of Atlanta. Patients with coarctation were receiving prostaglandin E1 and had a patent ductus arteriosus. By analyzing discrete features in the waveforms, we identified statistically significant differences in the maximum rate of fall between patients with and without coarctation. This was accentuated when comparing the difference between the upper and lower extremities, with the lower extremities having a shallow slope angle when a coarctation was present (p-value 0.001). Postoperatively, there were still differences in the maximum rate of fall between the repaired coarctation patients and controls; however, these differences normalized when compared with the same individual’s upper vs. lower extremities. Coarctation patients compared to themselves (preoperatively and postoperatively), demonstrated waveform differences between upper and lower extremities that were significantly reduced after successful surgery (p-value 0.028). This screening algorithm had an accuracy of detection of 72% with 0.61 sensitivity and 0.94 specificity.

Conclusions

We were able to identify specific features in pulse oximetry waveforms that were able to accurately identify patients with coarctation and further demonstrated that these changes normalized after surgical repair. Pulse oximetry screening for congenital heart disease in neonates may thus be improved by including waveform analysis, aiming to identify coarctation of the aorta prior to critical illness. Further large-scale testing is required to validate this screening model among patients in a newborn nursery setting who are low risk for having coarctation.
Hepatic steatosis induced in C57BL/6 mice by a non-ß oxidizable fatty acid analogue is associated with reduced plasma kynurenine metabolites and a modified hepatic NAD+/NADH ratio
Authors: Berge Rolf K. , Cacabelos Daniel , Señarís Rosa , Nordrehaug Jan Erik , Nygård Ottar , Skorve Jon , Bjørndal Bodil
Published: May 2020

Background

Non-alcoholic fatty liver disease is often associated with obesity, insulin resistance, dyslipidemia, and the metabolic syndrome in addition to mitochondrial dysfunction and nicotinamide adenine dinucleotide (NAD+) deficiency. The aim of this study was to investigate how inhibition of mitochondrial fatty acid oxidation using the compound tetradecylthiopropionic acid (TTP) would affect hepatic triacylglycerol level and plasma levels of kynurenine (Kyn) metabolites and nicotinamide.

Methods

12 C57BL/6 mice were fed a control diet, or an intervention diet supplemented with 0.9% (w/w) tetradecylthiopropionic acid for 14 days. Blood and liver samples were collected, enzyme activities and gene expression were analyzed in liver, in addition to fatty acid composition. Metabolites in the tryptophan/kynurenine pathway and total antioxidant status were measured in plasma.

Results

Dietary treatment with tetradecylthiopropionic acid for 2 weeks induced fatty liver accompanied by decreased mitochondrial fatty acid oxidation. The liver content of the oxidized form of NAD+ was increased, as well as the ratio of NAD+/NADH, and these changes were associated by increased hepatic mRNA levels of NAD synthetase and nicotinamide mononucleotide adenyltransferase-3. The downstream metabolites of kynurenine were reduced in plasma whereas the plasma nicotinamide content was increased. Some effects on inflammation and oxidative stress was observed in the liver, while the plasma antioxidant capacity was increased. This was accompanied by a reduced plasma ratio of kynurenine/tryptophan. In addition, a significant decrease in the inflammation-related arachidonic fatty acid in liver was observed.

Conclusion

Fatty liver induced by short-time treatment with tetradecylthiopropionic acid decreased the levels of kynurenine metabolites but increased the plasma levels of NAD+ and nicotinamide. These changes are most likely not associated with increased inflammation and oxidative stress. Most probably the increase of NAD+ and nicotinamide are generated through the Preiss Handler pathway and/or salvage pathway and not through the de novo pathway.

The take home message is that non-alcoholic fatty liver disease is associated with the metabolic syndrome in addition to mitochondrial dysfunction and nicotinamide adenine dinucleotide (NAD+) deficiency. Inducing fatty liver in mice by inhibition of fatty acid oxidation resulted in a concomitant change in kynurenine metabolites increasing the plasma levels of nicotinamides and the hepatic NAD+/NADH ratio, probably without affecting the de novo pathway of kynurenines.
Associations of 2D speckle tracking echocardiography-based right heart deformation parameters and invasively assessed hemodynamic measurements in patients with pulmonary hypertension
Authors: Theres Lena , Hübscher Anne , Stangl Karl , Dreger Henryk , Knebel Fabian , Brand Anna , Hewing Bernd
Published: May 2020

Background

We aimed to evaluate associations of right atrial (RA) and right ventricular (RV) strain parameters assessed by 2D speckle tracking echocardiography (2D STE) with invasively measured hemodynamic parameters in patients with and without pulmonary hypertension (PH).

Methods

In this study, we analyzed 78 all-comer patients undergoing invasive hemodynamic assessment by left and right heart catheterization. Standard transthoracic echocardiographic assessment was performed under the same hemodynamic conditions. RA and RV longitudinal strain parameters were analyzed using 2D STE. PH was defined as invasively obtained mean pulmonary arterial pressure (mPAP) ≥25 mmHg at rest and was further divided into pre-capillary PH (pulmonary capillary wedge pressure [PCWP] ≤ 15 mmHg), post-capillary PH (PCWP > 15 mmHg) and combined PH (PCWP > 15 mmHg and difference between diastolic PAP and PCWP of ≥7 mmHg). Correlation analyses between variables were calculated with Pearson’s or Spearman’s correlation coefficient as applicable.

Results

Out of 78 patients, 45 presented with PH. Within the PH group, 39 had post-capillary, five had combined pre- and post-capillary PH, and one had pre-capillary PH. Patients with PH had a significantly increased RA area (PH 22.0 ± 9.2 cm2, non-PH 17.3 ± 10.7 cm2;p = 0.003) and end-systolic RV area (PH 14.7 ± 6.1, non-PH 11.9 ± 4.8 cm2;p = 0.022). RV mid strain was significantly reduced in PH (PH -17.4 ± 7.8, non-PH: − 21.6 ± 5.5;p = 0.019). Average peak systolic RA strain (RAS) and average peak systolic RV strain (RVS) showed a significant association with mPAP (r = − 0.470,p = 0.001 and r = 0.490, p = 0.001, respectively) and with PCWP (r = − 0.296,p = 0.048 and r = 0.365,p = 0.015, respectively) in patients with PH. Furthermore, RV apical, mid and basal strain as well as RV free wall strain showed moderate associations with mPAP. In patients without PH, there were no associations detectable between RA or RV strain parameters and mPAP and PCWP.

Conclusion

In an all-comer cohort, RA and RV strain parameters showed significant associations with invasively assessed mPAP and PCWP in patients with predominantly post-capillary PH. These associations may be useful in clinical practice to assess the impact of post-capillary PH on myocardial right heart function.
Carbon monoxide increases utero-placental angiogenesis without impacting pregnancy specific adaptations in mice
Authors: Dickson Megan A. , Peterson Nichole , McRae Karalyn E. , Pudwell Jessica , Tayade Chandrakant , Smith Graeme N.
Published: May 2020

Background

Cigarette smokers have a reduced risk of developing preeclampsia, possibly attributed to an increase in carbon monoxide (CO) levels. Carbon monoxide is a gasotransmitter that has been implicated in maintaining vascular tone, increasing angiogenesis, and reducing inflammation and apoptosis at physiological concentrations. Moderately increasing CO concentrations may have therapeutic potential to prevent or treat preeclampsia; however, the effects of CO on pregnancy are under studied. Our objective was to investigate the effect of CO on major angiogenic and inflammatory markers in pregnancy, and to evaluate the effect of CO on indicators of placental health.

Findings

Pregnant CD-1 mice were constantly exposed to either ambient air or 250 ppm CO from conception until gestation day (GD)10.5 or GD16.5. Using a qRT-PCR array, we identified that CO increased expression of major angiogenic genes at the implantation site on GD10.5, but not GD16.5. Pro-inflammatory cytokines in the plasma and tissue lysates from implantation sites in treated mice were not significantly different compared to controls. Additionally, CO did not alter the implantation site phenotype, in terms of proliferative capacity, invasiveness of trophoblasts, or abundance of uterine natural killer cells.

Conclusions

This study suggests that CO exposure is pro-angiogenic at the maternal-fetal interface, and is not associated with demonstrable concerns during murine pregnancy. Future studies are required to validate safety and efficacy of CO as a potential therapeutic for vascular insufficiency diseases such as preeclampsia and intrauterine growth restriction.
Developing metrics for nursing quality of care for low- and middle-income countries: a scoping review linked to stakeholder engagement
Authors: Gathara David , Zosi Mathias , Serem George , Nzinga Jacinta , Murphy Georgina A. V. , Jackson Debra , Brownie Sharon , English Mike
Published: May 2020

Background

The use of appropriate and relevant nurse-sensitive indicators provides an opportunity to demonstrate the unique contributions of nurses to patient outcomes. The aim of this work was to develop relevant metrics to assess the quality of nursing care in low- and middle-income countries (LMICs) where they are scarce.

Main body

We conducted a scoping review using EMBASE, CINAHL and MEDLINE databases of studies published in English focused on quality nursing care and with identified measurement methods. Indicators identified were reviewed by a diverse panel of nursing stakeholders in Kenya to develop a contextually appropriate set of nurse-sensitive indicators for Kenyan hospitals specific to the five major inpatient disciplines. We extracted data on study characteristics, nursing indicators reported, location and the tools used. A total of 23 articles quantifying the quality of nursing care services met the inclusion criteria. All studies identified were from high-income countries. Pooled together, 159 indicators were reported in the reviewed studies with 25 identified as the most commonly reported. Through the stakeholder consultative process, 52 nurse-sensitive indicators were recommended for Kenyan hospitals.

Conclusions

Although nurse-sensitive indicators are increasingly used in high-income countries to improve quality of care, there is a wide heterogeneity in the way indicators are defined and interpreted. Whilst some indicators were regarded as useful by a Kenyan expert panel, contextual differences prompted them to recommend additional new indicators to improve the evaluations of nursing care provision in Kenyan hospitals and potentially similar LMIC settings. Taken forward through implementation, refinement and adaptation, the proposed indicators could be more standardised and may provide a common base to establish national or regional professional learning networks with the common goal of achieving high-quality care through quality improvement and learning.
48,XXYY syndrome presenting with long-term infertility and newly observed neck deformities: a case report
Authors: Alhalabi Mohammad Marwan , Alhalabi Marwan
Published: May 2020

Background

Long-term infertility can be attributed to many factors, with the genetic factor being the most overlooked due to its many nonspecific morphological or endocrine signs. We present a rare case of a patient with progressive testicular failure associated with 48,XXYY syndrome.

Case presentation

A 39-year-old Arab man presented to our fertility clinic for fertility treatment. He was diagnosed with primary infertility, which had been present for 20 years at the time of presentation. Our patient had nonspecific morphological features of an abnormally wide neck with front slouching neck posture, clinodactyly of the third finger, and had moderate hypoandrogenemic features. A semen analysis revealed azoospermia. Genetic tests for azoospermia, including sex-determining region Y (SRY) detection and chromosome Y microdeletion, revealed no deletion present on the Y chromosome. Karyotyping was used and our patient was diagnosed with 48,XXYY syndrome.

Conclusion

Genetic testing (karyotyping and so on) played a key role in the diagnosis of our patient with long-term primary infertility secondary to 48,XXYY syndrome, and should play a vital role in all cases of long-term infertility, especially when presentation is accompanied by endocrine, skeletal, or morphological symptoms, signifying an underlying genetic factor.
Implementation of the WHO hand hygiene strategy in Faranah regional hospital, Guinea
Authors: Müller S. A. , Diallo A. O. K. , Wood R. , Bayo M. , Eckmanns T. , Tounkara O. , Arvand M. , Diallo M. , Borchert M.
Published: May 2020

Background

Healthcare-associated infections are the most frequent adverse events in healthcare worldwide, with limited available evidence suggesting highest burden in resource-limited settings. Recent Ebola epidemics emphasize the disastrous impact that spread of infectious agents within healthcare facilities can have, accentuating the need for improvement of infection control practices. Hand hygiene (HH) measures are considered to be the most effective tool to prevent healthcare-associated infections. However, HH knowledge and compliance are low, especially in vulnerable settings such as Guinea.

The aim of PASQUALE (Partnership to Improve Patient Safety and Quality of Care) was to assess knowledge and compliance with HH and improve HH by incorporating the WHO HH Strategy within the Faranah Regional Hospital (FRH), Guinea.

Methods

In a participatory approach, a team of FRH staff and leadership was invited to identify priorities of the hospital prior to the start of PASQUALE. The local hygiene committee was empowered to increase its activities and take ownership of the HH improvement strategy. A baseline assessment of knowledge, perception and compliance was performed months before the intervention. The main intervention consisted of local alcohol-based-hand-rub (ABHR) production, with final product efficacy testing, in conjunction with a training adapted to the needs identified in the baseline assessment. A follow-up assessment was conducted directly after the training. Effectiveness of the intervention was assessed via uncontrolled before-and-after comparison.

Results

Baseline knowledge score (13.0/25) showed a significant increase to 19.0/25 in follow-up. Baseline-Compliance was 23.7% and increased significantly to 71.5% in follow-up. Compliance rose significantly across all professional groups except for midwifes and in all indications for HH, with the largest in the indication “Before aseptic tasks”. The increase in compliance was associated with the intervention and remained significant after adjusting for confounders. The local pharmacy successfully supplies the entire hospital. The local supply resulted in a ten-fold increase of monthly hospital disinfectant consumption.

Conclusion

The WHO HH strategy is an adaptable and effective method to improve HH knowledge and compliance in a resource-limited setting. Local production is a feasible method for providing self-sufficient supply of ABHR to regional hospitals like the FRH. Participatory approaches like hygiene committee ownership builds confidence of sustainability.
Re-inhabiting one’s body: A pilot study on the effects of dance movement therapy on body image and alexithymia in eating disorders
Authors: Savidaki Maria , Demirtoka Sezin , Rodríguez-Jiménez Rosa-María
Published: May 2020

Background

Body image disturbance and alexithymia are two core aspects of Eating Disorders (EDs). However, standard treatments for EDs do not include specific techniques to approach these issues on a bodily level. This pilot study evaluated the effects of a Dance Movement Therapy (DMT) intervention on body image and alexithymia in patients with EDs, and also explored their experience of the therapeutic process.

Method

14 patients with EDs were recruited from a private clinic. Seven were assigned via quasi-randomization to the DMT group and the others (n= 5) continued their treatment as usual. The length of the intervention was 14 weeks. All participants completed the Multidimensional Body Self Relations Questionnaire (MBSRQ) and the Toronto Alexithymia Scale (TAS-20) at the beginning and at the end of the intervention. Additionally, the DMT group wrote reflective diaries about their experience at the end of each session, which were analyzed using qualitative methods.

Results

Between the pre- and post-intervention, the participants of the DMT group significantly improved in Body Areas Satisfaction (effect size: 0.95) and Appearance Evaluation (effect size: 1.10), and they decreased significantly in Appearance Orientation (effect size: 1.30). A decrease in Overweight Preoccupation was observed (effect size: 0.75), however this was not statistically significant. The control group did not show significant changes in any of the MBSRQ subscales. Neither the DMT group nor the control group improved significantly in the alexithymia scores. The qualitative analysis revealed valuable insights into the participants’ processes throughout the sessions. In general, participants received the DMT intervention positively. They reported improvements in their mood states and an increase in their self-awareness. They also appreciated the relationship with the group and the therapist.

Conclusion

These results indicate that DMT might be a complementary treatment option for EDs, as it may be able to address body image issues more effectively than verbal therapies. More studies with larger samples are needed to confirm these promising preliminary results.
Parenting stress and competence in borderline personality disorder is associated with mental health, trauma history, attachment and reflective capacity
Authors: Steele Kayla R. , Townsend Michelle L. , Grenyer Brin F. S.
Published: May 2020

Background

Individuals with borderline personality disorder (BPD) may experience additional challenges in their parenting role, including increased stress and lower self-efficacy and satisfaction. These difficulties have been shown to impact their children, and may be implicated in the potential intergenerational transmission of personality vulnerabilities.

Methods

Parental stress and competence variables were examined in a cross-sectional study of 284 parents (94.72% female, M = 37.37, SD = 8.04 years), of which 69 (24.30%) met caseness for BPD criteria. We completed a multivariate analysis of variance to test how parents with ‘high BPD features’ (meeting caseness for BPD) compared to those with ‘low BPD features’ on a range of parenting and mental health variables. Multivariate linear regression modelling was then utilised to explore whether these parenting variables were associated with personality and psychological wellbeing, recalled trauma history, orientation to attachment relationships and reflective capacity.

Results

Individuals high in BPD features experienced more stress and lower competence in their parenting role than those low in BPD features. These parents also reported more personality vulnerabilities, poorer psychological wellbeing, recalled more traumatic experiences in their childhood, were more likely to endorse insecure attachment styles and had poorer reflective capacity. In the regression model, parenting stress and competence was associated with personality traits, general psychological wellbeing, recalled trauma history, attachment style and reflective capacity variables. Parental reflective capacity had the strongest association with parenting stress, satisfaction, efficacy, the perception of having a difficult child and a difficult parent-child relationship, and psychological wellbeing had the greatest association with parenting distress.

Conclusions

Parents who were able to imaginatively enter the subjective world of the child and hold the child’s mind in mind with less certainty, reported reduced parenting stress and greater parenting satisfaction and efficacy. Helping to improve personality and mental health functioning, increasing parental reflective capacity and strengthening parent-child attachment relationships, may reduce parenting stress and increase parenting competence in individuals with BPD.
Chemical-technological research and radiocarbon AMS dating of wall painting fragments from the ruins of the XIIth-XIIIth centuries AD church from archaeological excavations in the city of Smolensk, Russia
Authors: Voronin Konstantin , Kabanova Mariya
Published: May 2020

In 2012, the ruins of a temple of the old Russian period were found during archaeological research in the medieval historical territory of Smolensk. The archaeological complex consists of the ruins of an ancient temple, built in the middle of the XIIth century AD, and adjacent to it from the South-West of the territory, which housed the remains of the market XI-turn XIII-XIV centuries AD and necropolis XIII–XVI centuries AD. Chronologically diverse use of the investigated territory up to the XVIth century AD was determined by the nearby Church. Approximately 1000 fragments of wall paintings, 5 fragments window glass and 4 glazed floor tiles were found near the ruins of the Church building. For the first time fragments of wall paintings medieval of Old Russian temple were dated by the AMS radiocarbon dating and went through chemical-technological research (analysis of the plaster foundation, the definition of used pigments) by X-RAY diffractometry (XRD) and scanning electron microscopy (SEM/EDS). Optical microscopy also was used for visual observations of the samples of the wall painting. According to the results of the radiocarbon analysis, the fragments of the wall paintings were divided into two chronological groups. The earlier belongs to the last quarter of the XIIth–the first quarter of the XIIIth century AD. Samples of the wall paintings from the second group are dated back to the third quarter of the XIIIth century AD. A narrow range of Accelerator Mass Spectrometry (AMS) radiocarbon dating of fragments of the murals, obtained from carbonates due to the presence of high content of C14 isotope in carbon of the plaster, is simultaneous in age to the moment of creation of the plaster base. As a result of chemical and technological researches of the fragments of the wall paintings it was established that the plaster basis of the fragments of the wall painting consists of two layers. The plaster base contains organic binders. Chemical and technological analysis of pigments presents the following results: (1) the basis of the blue paint layer is ultramarine (mineral) and anatase (mineral); (2) the basis of the green paint layer is celadonite (mineral); (3) the basis of the brown paint layer is ochre (clay); (4) black particles in the colorful mixture of brown is an organic wood coal pigment.
Sociological factors influencing the performance of organic activities in Iran
Authors: Fatemi Mahsa , Rezaei-Moghaddam Kurosh
Published: May 2020

The conventional production model based on extensive use of chemical inputs such as pesticides is increasingly challenged. Organic agriculture is considered as one of the most important alternative agricultural systems to produce healthy food without any chemicals. Current models are not suitable for prediction of environmental behaviors. The current study aims to analyze the diffusion of organic agriculture to produce healthy food with the environmental sociology approach among farmers. The study was conducted using the survey research and multi-stage random sampling in Fars province, in the south of Iran. The samples included 215 farmers. The reliability of the questionnaire was confirmed by conducting a pilot study out of the main sample. The results showed that the farmers have strong attitude to the environment and are for the most part, highly intentioned to perform organic activities. Based on the results, the farmers’ intention toward adoption of organic agriculture, environmental identity, and responsibility of pro-environmental behavior, and their moral norms play an important role to accept organic agricultural activities. There are also some effective factors in implementation of organic agriculture including farmers` increasing awareness about the principles of organic farming, controllability of environmental behaviors as well as their accessibility to the resources and facilities for organic farming. The study emphasized that the attitude and enhancing the knowledge do not lead to pro-environmental behaviors and organic activities directly. Using the models and environmental sociology theories is more efficient to explain pro-environmental behaviors. To this aim, some suggestions were presented to increase the adoption of organic activities and persuade the Iranian farmers to select this kind of cultivation.
MicroCT X-ray comparison of aligner gap and thickness of six brands of aligners: an in-vitro study
Authors: Lombardo Luca , Palone Mario , Longo Mattia , Arveda Niki , Nacucchi Michele , De Pascalis Fabio , Spedicato Giorgio Alfredo , Siciliani Giuseppe
Published: May 2020

Background

To investigate and compare the gap (i.e. fit) and thickness of six aligner systems (Airnivol, ALL IN, Arc Angel, F22, Invisalign and Nuvola) using industrial computed tomography (CT). The null hypothesis was that there would be no detectable differences in either measurement between the aligners investigated.

Materials and methods

Passive aligners of each brand were fitted to one single resin cast prototyped from an STL file from a single patient. The samples obtained were examined under high-resolution micro-CT, and the resulting tomographic microphotographs and volumetric data were compared. 3D analysis investigated the gap volume, the mean gap width and the maximum gap width of each sample. A total of 204 linear 2D measurements were made on 18 microtomographic images to investigate the aligner gap and thickness among different systems. Investigated regions were the central incisor, canine and first molar. The resulting measurements were analysed by ANOVA and compared using Tukey’s post hoc analysis (P < 0.05).

Results

3D analysis revealed that the F22 displayed lower gap volume and mean gap width, followed by Airnivol and Invisalign, whereas Airnivol the lowest maximum gap width. 2D analysis showed that F22 had the lowest mean gap and aligner thickness at all teeth investigated. Comparison of the 2D point values revealed statistically significant differences between brands in terms of both measurements (P < 0.05), with the exception of six points in the gap analysis and one in the thickness analysis.

Conclusions

There are differences between the six aligner systems examined in terms of 2D and 3D measurements of aligner thickness and gap.
Large-scale evaluation of interventions designed to reduce childhood Drownings in rural Bangladesh: a before and after cohort study
Authors: Alonge Olakunle , Bishai David , Wadhwaniya Shirin , Agrawal Priyanka , Rahman Aminur , Dewan Hoque Emdad Md. , Baset Kamran Ul , Salam Shumona Sharmin , Bhuiyan Al-Amin , Islam Md Irteja , Talab Abu , Rahman Qazi Sadeq-ur , Rahman Fazlur , El-Arifeen Shams , Hyder Adnan A.
Published: May 2020

Background

This paper estimates the impact on childhood drowning rates of community-based introduction of crèches or playpens or both in rural Bangladesh for children aged 0–47 months.

Methods

A baseline census of the whole population of 270,387 households in 51 unions, 451 villages from 7 rural sub-districts in Bangladesh was conducted in 2013. The baseline census determined retrospective, age-specific, and cumulative drowning incidence rates (IR) experienced in the target households in the 12 months prior to the intervention. Beginning in late 2013, creches for drowning prevention were established across the study area. Acceptance into creches was provided and written assent to attend a creche was obtained for all children aged 9–47 months in all participating unions. Playpens were provided to 45,460 of these children, of which 5981 children received only the playpens. All children were followed-up until their 48-month birthday or administrative censoring (fixed timepoint to stop observing the drowning deaths), after a two-year implementation period (2014–2016). Drowning IR were estimated for children and compared to corresponding baseline rates from 2012. Age-specific drowning IR under different “as treated” categories (playpen-only, creche-only, and playpen-plus-creche) were compared to the baseline rates experienced by the categorized households prior to intervention.

Results

A total of 3205 creches (average of 7 creches per village) were established, and 116,054 children aged 9–47 months were exposed to the intervention packages. Aggregated drowning IRs between age 0 and 47 were estimated per 100,000 population per year at 86.73 (95% CI: 69.67–107.97) and 43.03 (95% CI: 35.55–52.10) in the baseline and post implementation period, respectively. Risk ratios were 0.40 (95% CI: 0.28–0.57) overall, and 0.34 (95% CI: 0.13–0.90), 0.09 (95% CI: 0.02–0.36), and 0.04 (95% CI: 0.002–0.60) in children under the creche-only, aged, 1, 2, and 3 years old respectively. Inexplicably, drowning rates were statistically significantly higher post-intervention in children 0-11 months. There was no mortality reduction with playpen use (alone or in combination), and this group may actually have had a higher risk of drowning.

Conclusions

Creches are effective for preventing childhood drowning in rural Bangladesh for children above age 1-year, and should be considered for further scale-up.
Sequential intraventricular injection of tigecycline and polymyxin B in the treatment of intracranial Acinetobacter baumannii infection after trauma: a case report and review of the literature
Authors: Zhong Li , Shi Xue-Zhi , Su Lei , Liu Zhi-Feng
Published: May 2020

Background

Intracranial infection after craniotomy is one of the most serious postoperative complications, especially multidrug-resistant (MDR) or extensively drug-resistant (XDR) bacterial meningitis, and strongly affects the prognosis of patients. Current treatment experience regarding these infections is scarce.

Case presentation

We report a case of severe intracranial infection of XDR Acinetobacter baumannii (A. baumannii) that was treated by intravenous (IV) injection, sequential intraventricular (IVT) injection of tigecycline and polymyxin B, and other anti-infective drugs. Good results were obtained, and the patient was eventually discharged from the hospital. This case is characterized by intracranial infection.

Conclusions

The polymyxin B IV + IVT pathway is an ideal treatment strategy for XDR A. baumannii. The tigecycline IVT pathway is also a safe treatment option.
Utilization of risk-based predictive stability within regulatory submissions; industry’s experience
Authors: McMahon Megan , Williams Helen , Debie Elke , Fu Mingkun , Bujalski Robert , Qiu Fenghe , Wu Yan , Li Hanlin , Wang Jin , Hoaglund-Hyzer Cherokee , Pulliam Donnie
Published: May 2020

Risk-Based Predictive Stability (RBPS) tools, such as the Accelerated Stability Assessment Program (ASAP) and other models, are used routinely within pharmaceutical development to quickly assess stability characteristics, especially to understand mechanisms of degradation. These modeling tools provide stability insights within weeks that could take months or years to understand using long-term stability conditions only. Despite their usefulness, the knowledge gained through these tools are not as broadly used to support regulatory filing strategies. This paper aims to communicate how industry has used RBPS data to support regulatory submissions and discuss the regulatory feedback that was received.
Balloon-oriented puncture for creating an access for endovascular aortic aneurysm repair in a case of iliac and femoral artery occlusion
Authors: Ichihashi Shigeo , Nagatomi Satoru , Iwakoshi Shinichi , Inagaki Masahiro , Bolstad Francesco , Kichikawa Kimihiko
Published: May 2020

Background

Abdominal aortic aneurysms (AAA) with iliac artery occlusive diseases are not uncommon. When an occlusion extends from iliac artery to common femoral artery (CFA), adjunctive procedures such as endareterectomy of CFA and angioplasty of iliac artery are performed prior to endovascular aneurysm repair (EVAR). Alternatively, aorto-uni-iliac stentgrafting with femoro-femoro bypass surgery could be performed. If run off vessels such as superficial femoral artery (SFA) and profunda femoris artery (PFA) are both occluded in addition to the CFA, surgical procedures may become extremely complex, with much longer procedure time. We present an unusual case of AAA with arterial occlusion ranging from external iliac artery (EIA) to superficial and profunda femoris arteries, which was fully managed with endovascular means.

Case presentation

The patient was a 76 year old male who was found incidentally to have a fusiform infrarenal AAA, the size of which was 55 mm in maximal transverse diameter. Despite the occlusions of left EIA, CFA and proximal parts of SFA and PFA, he did not have ischemic symptoms in his left leg due to the development of abundant collateral networks from left internal iliac artery. The patient had a past history of endarterectomy of left CFA. Since a repeated endarterectomy or interposition grafting of the CFA were deemed extremely difficult, without any patent runoff vessel, EVAR was performed using the occluded vessel simply as a conduit for the delivery of the endograft, without revascularizing the vessel. An angioplasty balloon was delivered from right CFA to the occluded left CFA through a subintimal space. A percutaneous puncture of the expanded balloon was done at the occluded left CFA under fluoroscopy, inserting the guidewire into the punctured balloon, finally establishing the through and through wire. EVAR was successfully performed using AFX unibody stentgraft without any complication.

Conclusion

AAA with access vessel occlusions from EIA to SFA was successfully treated with EVAR with the aid of the balloon oriented percutaneous puncture technique. Having the technique as an armamentarium can broaden the application of EVAR for AAA with the complicated access.
Machine learning based LOS/NLOS classifier and robust estimator for GNSS shadow matching
Authors: Xu Haosheng , Angrisano Antonio , Gaglione Salvatore , Hsu Li-Ta
Published: May 2020

Global Navigation Satellites Systems (GNSS) is frequently used for positioning services in various applications, e.g., pedestrian and vehicular navigation. However, it is well-known that GNSS positioning performs unreliably in urban environments. GNSS shadow matching is a method of improving accuracy in the cross-street direction. Initial position and classification of observed satellite visibility between line-of-sight (LOS) and non-line-of-sight (NLOS) are essential for its performance. For the conventional LOS/NLOS classification, the classifiers are based on a single feature, extracted from raw GNSS measurements, such as signal noise ratio, pseudorange, elevation angle, etc. Especially in urban canyons, these measurements are unstable and unreliable due to the signal reflection and refraction from the surrounding buildings. Besides, the conventional least square approach for positioning is insufficient to provide accurate initialization for shadow matching in urban areas. In our study, shadow matching is improved using the initial position from robust estimator and the satellite visibility determined by support vector machine (SVM). The robust estimator has an improved positioning accuracy and the classification rate of SVM classification can reach 91.5% in urban scenarios. An important issue is related to satellites with ultra-high or low elevation angles and satellites near the building boundary that are very likely to be misclassified. By solving this problem, the SVM classification shows the potential of about 90% classification accuracy for various urban cases. With the help of these approaches, the shadow matching has a mean error of 10.27 m with 1.44 m in the cross-street direction; these performances are suitable for urban positioning.
Angiotensin-converting enzyme insertion/deletion (I/D) gene polymorphism in Iraqi type 2 diabetic patients: association with the risk of cardiac autonomic neuropathy
Authors: Dhumad Muhanad M. , Hamdan Farqad B. , Al-Mayah Qasim S.
Published: May 2020

Background

Studies have shown a direct association between angiotensin-converting enzyme (ACE) and diabetic neuropathies. As such,ACEgene polymorphisms could be a risk factor for cardiac autonomic neuropathy (CAN) in patients with diabetes. The objective of our study was to investigate the association of theACEI/D gene polymorphism with the development of CAN in Iraqi patients with type 2 diabetes mellitus (T2DM).

Results

This is a cross-sectional study that included 142 patients with T2DM comprising 62 males and 80 females, and 100 volunteers served as a healthy control group. Cardiac autonomic functions were tested using four standard Ewing’s noninvasive tests. Blood samples were taken for genetic evaluation of anACEgene I/D polymorphism.

AnalyzingACEgene polymorphism revealed that the D allele was far more frequent among patients with diabetes than healthy control subjects (76.07% vs. 62.67%). The frequency of I/I, I/D, and D/D genotypes in patients with diabetes was 8.55%, 30.77%, and 60.68%, respectively, compared with 18.67%, 37.33%, and 44%, respectively, in controls with a significant difference in mutant homozygous genotype. However, there were no significant differences in these genotypes between patients with and without CAN. Although patients with CAN showed a much higher frequency of D allele than those without CAN, the difference did not reach significance (p= 0.054).

Conclusion

The DD genotype and D allele of theACEI/D gene polymorphism can be a risk factor for T2DM, and the D allele of this polymorphism can even be associated with the development of CAN in these patients.