bluuebunny/crossref_metadata_2025 huggingface dataset:
Solidarity, vulnerability and mistrust: how context, information and government affect the lives of women in times of Zika
Authors: Linde-Arias Ana Rosa , Roura Maria , Siqueira Eduardo
Published: April 2020

Background

The public health response to Zika outbreak has mostly focused on epidemiological surveillance, vector control, and individual level preventative measures. This qualitative study employs a social-ecological framework to examine how macro (historical, legislative, political, socio-economic factors), meso (sources of information, social support, social mobilization) and micro level factors (individual actions, behavioral changes) interacted to influence the response and behavior of women with respect to Zika in different contexts.

Methods

A qualitative study was carried out. Women were recruited through the snowball sampling technique from various locations in Brazil, Puerto Rico, and the United States. They were of different nationalities and ethnicities. Data were collected through semi-structured interviews. The data transcripts were analyzed using thematic analysis.

Results

Women in this study deemed the information provided as insufficient, which led them to actively reach out and access a variety of media sources. Social networks played a vital role in sharing information but also resulted in the spread of hoaxes or rumors. Participants in our research perceived socio-economic inequities but focused on how to remedy their microenvironments. They did not engage in major social activities. Lack of trust in governments placed women in vulnerable situations by preventing them to follow the guidance of health authorities. These impacts were also a result of the response tactics of health and government administrations in their failed attempts to ensure the well-being of their countries’ populations.

Conclusions

Our findings call for public health interventions that go beyond individual level behavioral change campaigns, to more comprehensively address the broader meso and macro level factors that influence women’ willingness and possibility to protect themselves.
Novel foetal echocardiographic image processing software (5D Heart) improves the display of key diagnostic elements in foetal echocardiography
Authors: Hu Wan-Yu , Zhou Jin-Hong , Tao Xiao-Ying , Li Shi-Yan , Wang Bei , Zhao Bo-Wen
Published: April 2020

Background

To evaluate the clinical value of foetal intelligent navigation echocardiography (5D Heart) for the display of key diagnostic elements in basic sections.

Methods

3D volume datasets of 182 normal singleton foetuses were acquired with a four chamber view by using a volume probe. After processing the datasets by using 5D Heart, eight cardiac diagnostic planes were demonstrated, and the image qualities of the key diagnostic elements were graded by 3 doctors with different experiences in performing foetal echocardiography.

Results

A total of 231 volume datasets acquired from the 182 normal foetuses were used for 5D Heart analysis and display. The success rate of 8 standard diagnostic views was 88.2%, and the success rate of each diagnostic view was 55.8–99.2% and 70.7–99.0% for the random four chamber view as the initial section and for the apical four chamber view as the initial section, respectively. The success rate of each diagnostic element in the 8 diagnostic sections obtained by 5D Heart was 58.9%~ 100%. Excellent agreement was found between experienced sonographers and less-experienced sonographers (kappa> 0.769). Inter- and intra-observer agreement were substantial to near-perfect, kappa values ranging from 0.612 to 1.000 (Cohen’s kappa).

Conclusions

5D Heart can significantly improve the image quality of key diagnostic elements in foetal echocardiography with low operator dependency and good reproducibility.
Association of acute kidney injury with readmissions after hospitalization for acute exacerbation of chronic obstructive pulmonary disease: a population-based study
Authors: Hirayama Atsushi , Goto Tadahiro , Hasegawa Kohei
Published: April 2020

Background

Little is known about the relationship between acute kidney injury (AKI) and outcomes after acute exacerbation of chronic obstructive pulmonary disease (AECOPD). We aimed to investigate associations between AKI and readmission risks after hospitalization for AECOPD.

Methods

A retrospective, population-based cohort study using State Inpatient Databases from seven U.S. states (Arkansas, California, Florida, Iowa, Nebraska, New York, and Utah) from 2010 through 2013. We identified all adults (aged ≥40 years) hospitalized for AECOPD during the study period. Among them, we further identified patients with a concurrent diagnosis of new AKI. The outcome measures were any-cause readmissions within 30 days and 90 days after hospitalization for AECOPD. To determine associations between AKI and readmission risk, we constructed Cox proportional hazards models examining the time-to-readmission. We also identified the primary reason of readmission.

Results

We identified 356,990 patients hospitalized for AECOPD. The median age was 71 years and 41.9% were male. Of these, 24,833 (7.0%) had a concurrent diagnosis of AKI. Overall, patients with AKI had significantly higher risk of 30-day all-cause readmission compared to those without AKI (hazard ratio 1.47; 95% CI 1.43–1.51; P < 0.001). Likewise, patients with AKI had significantly higher risk of 90-day all-cause readmission (hazard ratio 1.35; 95% CI 1.32–1.38; P < 0.001). These associations remained significant after adjustment for confounders (both P < 0.05). Additionally, patients with AKI were likely to be readmitted for non-respiratory reasons including sepsis, acute renal failure, and congestive heart failure.

Conclusions

Among patients hospitalized for AECOPD, patients with AKI were at higher risk of 30-day and 90-day readmission, particularly with non-respiratory reasons.
Stem/progenitor cell marker expression in clear cell renal cell carcinoma: a potential relationship with the immune microenvironment to be explored
Authors: Yoon Ju-Yoon , Gedye Craig , Paterson Joshua , Ailles Laurie
Published: April 2020

Background

Clear cell renal cell carcinoma (ccRCC) is a markedly heterogeneous disease in many aspects, including the tumour microenvironment. Our previous study showed the importance of the tumour microenvironment in ccRCC xeno-transplant success rates. In order to better understand the potential relationship between TICs and the immune microenvironment, we employed a multi-modal approach, examining RNA and protein expression (flow cytometry, immunohistochemistry).

Methods

We first examined the gene expression pattern of 18 stem/progenitor marker genes in the cancer genome atlas (TCGA) ccRCC cohort. Flow cytometry was next employed to examine lineage-specific expression levels of stem/progenitor markers and immune population makeup in six, disaggregated, primary ccRCC specimens. Immunohistochemistry was performed on a commercial ccRCC tissue microarray (TMA).

Results

The 18 genes differed with respect to their correlation patterns with one another and to their prognostic significance. By flow cytometry, correlating expression frequency of 12 stem/progenitor markers and CD10 resulted in two clusters—one with CD10 (marker of proximal tubular differentiation), and second cluster containing mostly mesenchymal stem cell (MSC) markers, including CD146. In turn, these clusters differed with respect to their correlation with different CD45+ lineage markers and their expression of immune checkpoint pathway proteins. To confirm these findings, four stem/progenitor marker expression patterns were compared with CD4, CD8 and CD20 in a ccRCC TMA which showed a number of similar trends with respect to frequency of the different tumour-infiltrating leukocytes.

Conclusion

Taken together, we observed heterogeneous but patterned expression levels of different stem/progenitor markers. Our results suggest a non-random relationship between their expression patterns with the immune microenvironment populations in ccRCC.
Internet addiction mediates the association between cyber victimization and psychological and physical symptoms:moderation by physical exercise
Authors: Lin Ling , Liu Jianbo , Cao Xiaolan , Wen Siying , Xu Jianchang , Xue Zhenpeng , Lu Jianping
Published: April 2020

Background

The potential mechanisms underlying cyber victimization and the resulting psychological and physical symptoms remain unclear. Thus, the present study investigated whether Internet addiction mediates the association between peer victimization (e.g., cyberbullying) and psychological and physical symptoms. Furthermore, it was assessed whether physical exercise moderates the hypothetical mediation.

Methods

1854 students from 11 middle and high schools in Shenzhen, Guangdong Province, China, were sampled for this study. Psychological and physical symptoms were assessed using the World Health Organization Quality of Life-BREF, while Internet addiction was evaluated using the Internet addiction test by Young. Cyber victimization was measured using a single question. In addition, this study examined whether Internet addiction mediated the association between cyber victimization and both psychological and physical symptoms. Additional work was conducted to test if physical exercise played a moderating role in the mediation hypothesized above. Mediation and moderation were analyzed using PROCESS macro for SPSS.

Results

Regression analysis showed that both cyber victimization (β = − 0.102, p < 0.05) and Internet addiction (β = − 0.278, p < 0.05) significantly predicted psychological and physical symptoms and demographic variables were controlled. Further mediation analysis suggested that Internet addiction mediated the relationship between cyber victimization and psychological and physical symptoms. The 95% CI (confidence interval) of the direct effect was (− 4.283, − 1.696) and the indirect effect (− 1.904, − 0.820), respectively, excluding zero. Finally, moderation analysis indicated that physical exercise moderated the relationship between Internet addiction and psychological and physical symptoms (p = 0.047).

Conclusions

Internet addiction plays a mediating role in the association between cyber victimization and both psychological and physical symptoms, Thus, addressing Internet addiction among cyberbullying victims is worthwhile. Furthermore, physical exercise alleviates negative impacts on health and should thus be promoted.
What are the drivers of recurrent cholera transmission in Nigeria? Evidence from a scoping review
Authors: Elimian Kelly Osezele , Mezue Somto , Musah Anwar , Oyebanji Oyeronke , Fall Ibrahima Soce , Yennan Sebastian , Yao Michel , Abok Patrick Okumu , Williams Nanpring , Omar Lynda Haj , Balde Thieno , Ampah Kobina , Okudo Ifeanyi , Ibrahim Luka , Jinadu Arisekola , Alemu Wondimagegnehu , Peter Clement , Ihekweazu Chikwe
Published: April 2020

Background

The 2018 cholera outbreak in Nigeria affected over half of the states in the country, and was characterised by high attack and case fatality rates. The country continues to record cholera cases and related deaths to date. However, there is a dearth of evidence on context-specific drivers and their operational mechanisms in mediating recurrent cholera transmission in Nigeria. This study therefore aimed to fill this important research gap, with a view to informing the design and implementation of appropriate preventive and control measures.

Methods

Four bibliographic literature sources (CINAHL (Plus with full text), Web of Science, Google Scholar and PubMed), and one journal (African Journals Online) were searched to retrieve documents relating to cholera transmission in Nigeria. Titles and abstracts of the identified documents were screened according to a predefined study protocol. Data extraction and bibliometric analysis of all eligible documents were conducted, which was followed by thematic and systematic analyses.

Results

Forty-five documents met the inclusion criteria and were included in the final analysis. The majority of the documents were peer-reviewed journal articles (89%) and conducted predominantly in the context of cholera epidemics (64%). The narrative analysis indicates that social, biological, environmental and climatic, health systems, and a combination of two or more factors appear to drive cholera transmission in Nigeria. Regarding operational dynamics, a substantial number of the identified drivers appear to be functionally interdependent of each other.

Conclusion

The drivers of recurring cholera transmission in Nigeria are diverse but functionally interdependent; thus, underlining the importance of adopting a multi-sectoral approach for cholera prevention and control.
The analysis of groundwater nitrate pollution and health risk assessment in rural areas of Yantai, China
Authors: Yu Guimei , Wang Jiu , Liu Lei , Li Yun , Zhang Yi , Wang Songsong
Published: April 2020

Background

Nitrate is one of the most common chemical contaminants of groundwater, and it is an important unqualified factor of rural groundwater in Yantai. In order to assess the risk of exposure to drinking water nitrate for adults and juveniles, in recent years, we monitored the nitrate concentrations in rural drinking water,a model was also used to assess the human health risk of nitrate pollution in groundwater.

Methods

From the year 2015 to 2018, the drinking water in rural areas of Yantai was tested according to the “Sanitary Standard for Drinking Water” (GB5749–2006). The principal component analysis was used to analyze the relationship between groundwater chemicals and nitrate. The model was used to assess human health risks of groundwater nitrate through the drinking water and skin contact.

Results

A total of 2348 samples were tested during the year 2015–2018.Nitrate and total dissolved solids, total hardness, chloride are all relevant, the above indicators may come from the same source of pollution; The median nitrate content (CEXP50) was 17.8 mg / L; the risk of exposure in each group was ranked as: Juveniles > Adult female > Adult male;the median health risk (HQ50) for minors and adults exceed 1.

Conclusions

The concentrations of nitrate is stable and does not change over time. The high concentration of nitrate in rural areas of Yantai may be the result of the interaction of fertilizers and geological factors. The risk of exposure to nitrate in juveniles and adults is above the limit, so it is necessary to be on the alert for the high levels of nitrate.
Sexually transmitted disease among street dwellers in southern Ethiopia: a mixed methods study design
Authors: Wakgari Negash , Woyo Terefe , Kebede Emnet , Gemeda Hirut , Gebremedhin Samson
Published: April 2020

Background

Lack of knowledge about sexual violence, its consequences, substance use and homelessness are major problems that make street dwellers susceptible to sexually transmitted diseases. Hence, this study assessed knowledge, attitudes and treatment-seeking behaviors related to sexually transmitted diseases among street dwellers in southern Ethiopia.

Methods

An explanatory sequential mixed-methods study design was conducted among 842 respondents. A simple random sampling technique was used to select seven cities among fourteen major cities of the region. The sample was allocated proportionally to each selected city. In order to identify and fill in the required sample size, a snowball sampling technique was used. A pre-tested and structured interviewer-administered questionnaire was used to collect quantitative data. The collected data were entered using Epidata and exported to SPSS version 23.0 for further analysis. Unstructured questionnaires were also used to collect 21 in-depth interviews and 10 key informants’ interviews. Respondents for in-depth interviews were selected purposively during quantitative data collection.

Results

Most street dwellers were aware of (86.7%) and had a favourable attitude towards (84.4%) prevention and management of sexually transmitted diseases. A portion of respondents experienced bad-smelling genital discharge (13.8%), genital ulcers (11.2%) and a burning sensation (14.5%) during urination, in the previous year. Among those who experienced symptoms of sexually transmitted disease, only 15.3% of them received treatment from a health care provider. Fear of questions raised by providers was one of the reasons for not seeking care according to our qualitative findings.

Conclusions

In this study, a significant number of street dwellers reported experiencing symptoms of a sexually transmitted disease. Despite having awareness about sexually transmitted diseases, seeking treatment from a health center was found to be low based on both quantitative and qualitative findings. We recommend that health care providers should undergo special training to address the sexual and reproductive health problems of street dwellers.
How do combinations of unhealthy behaviors relate to attitudinal factors and subjective health among the adult population in the Netherlands?
Authors: Dieteren Charlotte M. , Brouwer Werner B. F. , van Exel Job
Published: April 2020

Background

Health behaviours like smoking, nutrition, alcohol consumption and physical activity (SNAP) are often studied separately, while combinations can be particularly harmful. This study aims to contribute to a better understanding of lifestyle choices by studying the prevalence of (combinations of) unhealthy SNAP behaviours in relation to attitudinal factors (time orientation, risk attitude) and subjective health (self-rated health, life expectancy) among the adult Dutch population.

Methods

In total 1006 respondents, representative of the Dutch adult population (18–75 years) in terms of sex, age, and education, were drawn from a panel in 2016. They completed an online questionnaire. Groups comparisons and logistic regression analyses (crude and adjusted) were applied to analyse (combinations of) SNAP behaviours in relation to time orientation (using the Consideration of Future Consequences scale comprising Immediate (CFC-I) and Future (CFC-F) scales) and risk attitude (Health-Risk Attitude Scale; HRAS-6), as well as subjective health (visual analogue scale and subjective life expectancy).

Results

In the analyses, 989 respondents (51% men, average 52 years, 22% low, 48% middle, and 30% high educated) were included. About 8% of respondents engaged in four unhealthy SNAP behaviours and 18% in none. Self-rated health varied from 5.5 to 7.6 in these groups, whilst subjective life expectancy ranged between 73.7 and 85.5 years. Logistic regression analyses, adjusted for socio-demographic variables, showed that smoking, excessive drinking and combining two or more unhealthy SNAP behaviours were significantly associated with CFC-I scores, which increased the odds by 30%, 18% and 19%, respectively. Only physical inactivity was significantly associated with CFC-F scores, which increased the odds by 20%. Three out of the four SNAP behaviours were significantly associated with HRAS-6, which increased the odds between 6% and 12%. An unhealthy diet, excessive drinking, and physical inactivity were significantly associated with SRH, which decreased the odds by 11%. Only smoking was significantly associated with subjective life expectancy, which decreased the odds by 3%.

Conclusion

Our findings suggest that attitudinal factors and subjective health are relevant in the context of understanding unhealthy SNAP behaviours and their clustering. This emphasizes the relevance of a holistic approach to health prevention rather than focusing on a single unhealthy SNAP behaviour.
Measuring character strengths as possible protective factors against suicidal ideation in older Chinese adults: a cross-sectional study
Authors: Cheng Xinfeng , Bu He , Duan Wenjie , He Along , Zhang Yaping
Published: April 2020

Background

Suicide is a global issue among the elderly. The number of older people committing suicide is proliferating, and the elderly suicide rate is the highest among all age groups in China. A better understanding of the possible protective factors against suicidal ideation is necessary to facilitate prevention and intervention efforts. The objectives of the present study are threefold. First, this study aims to examine the psychometric properties of the three-dimensional inventory of character strengths (TICS) with a sample of older adults. Second, this study intends to investigate correlations among suicide ideation, wellbeing, and character strengths. Third, the study seeks to explore the possible protective roles of the three character strengths and wellbeing in explaining suicidal ideation among older adults.

Methods

A cross-sectional study comprising 308 older adults aged at least 50 years old from nursing homes was conducted. Four questionnaires, namely, the TICS, the Geriatric Suicide Ideation Scale—10 items, the Brief Inventory of Thriving, and the Satisfaction with Life Scale, were used. Exploratory structural equation modeling, intraclass correlation coefficients, partial correlations, and sets of hierarchical regressions were adopted to estimate and report the results.

Results

TICS could be used to assess the character strengths (i.e., caring, inquisitiveness, and self-control) among older adults with an acceptable goodness-of-fit (chi square = 157.30, df = 63, p < 0.001, CFI = 0.94, TLI = 0.90, RMSEA = 0.07, 90% CI = [0.06, 0.08]). Wellbeing and character strengths exhibited a negative association with suicidal ideation among older adults. Moreover, character strengths showed an independently cross-sectional relationship with suicidal ideation, explaining 65.1% of the variance of suicidal ideation after controlling for the wellbeing and demographics.

Conclusion

This study indicated that character strengths were associated with low levels of suicidal ideation. Therefore, the protective factors against suicidal ideation among older adults should be given additional attention.
The effect of a centralization procedure for extruded lateral meniscus on load distribution in porcine knee joints at different flexion angles
Authors: Kubota Rei , Koga Hideyuki , Ozeki Nobutake , Matsuda Junpei , Kohno Yuji , Mizuno Mitsuru , Katano Hisako , Sekiya Ichiro
Published: April 2020

Background

Meniscal extrusion results in loss of the ability to resist hoop strain and biomechanical overload on the joint articular surface. A centralization technique has been developed to overcome these problems. In this study, we analyzed the biomechanics of the extruded and centralized lateral meniscus (LM) in porcine knee joints at different flexion angles.

Methods

Porcine knee joints (n = 8) were set in the universal tester and each knee was tested under the following states: 1) intact; 2) extrusion—meniscal extrusion was created by resecting the posterior root of the LM and posterior synovial capsule; and 3) centralization—centralization was performed by two anchors inserted in the lateral tibial plateau. Deviation distance of the meniscus, contact pressure, and contact area in the anterior LM, middle LM, posterior LM, and the contact pressure of the tibial cartilage were evaluated with an axial compressive force of 200 N at knee flexion angles of 30°, 45°, 60°, and 90°.

Results

The deviation distance of LM significantly increased in extrusion but was restored to the intact status after centralization at all angles. Both the contact pressure and area significantly decreased in extrusion and were restored after centralization close to the intact status in the anterior and middle LM; in the posterior LM, however, decreased contact pressure and area were not restored after centralization. The contact pressure of the tibial cartilage increased significantly in extrusion but decreased close to the intact status after centralization.

Conclusions

This centralization procedure could reduce extrusion of the LM and restore the load-distributing function of the anterior-middle LM. However, the procedure itself could not restore hoop function in cases where the defect lies in the posterior LM.
Radiographic performance depends on the radial glenohumeral mismatch in total shoulder arthroplasty
Authors: Hasler Anita , Meyer Dominik C. , Tondelli Timo , Dietrich Tobias , Gerber Christian
Published: April 2020

Background

Optimal radii of curvature of the articulating surfaces of the prosthetic components are factors associated with the longevity of cemented glenoid components in anatomical total shoulder arthroplasty. It was the purpose of this study, to evaluate the radiographic and clinical performance of an anatomical glenoid component of a total shoulder arthroplasty (TSA) with respect to radial mismatch of the glenoid and humeral component.

Methods

In a retrospective study 75 TSA were analyzed for their clinical and radiographic performance with computed tomography by independent examiners using an established methodology. The study group was divided in two groups, one with mismatch < 4.5 mm (n:52) the others with mismatch ≥4.5 mm (n:23) and analyzed for confounding variables as indication, primary or revision surgery, age, gender, glenoid morphology and implant characteristics.

Results

The mean glenohumeral radial mismatch was 3.4 mm (range 0.5–6.9). At median follow-up of 41 months (range 19–113) radiographic loosening (defined as modified Molé scores ≥6) was present in 7 cases (9.3%). Lucencies around the glenoid pegs (defined as modified Molé score ≥ 1) were present in 34 cases (45%). Radiolucencies were significantly associated with a radial mismatch < 4.5 mm (p = 0.000). The pre- to postoperative improvements in Subjective Shoulder Value and absolute Constant Score were significantly better in the group with a mismatch ≥4.5 mm (p = 0.018,p = 0.014).

Conclusion

A lower conformity of the radii of humerus and glenoid seems to improve the loosening performance in TSA. Perhaps cut-off values regarding the recommended mismatch need to be revalued in the future.
Correlation between chemical composition and antibacterial activity of some Lamiaceae species essential oils from Tunisia
Authors: Moumni Sarra , Elaissi Ameur , Trabelsi Amine , Merghni Abderrahmen , Chraief Imed , Jelassi Brahim , Chemli Rachid , Ferchichi Salima
Published: April 2020

Background

Lamiaceae family is one of the most diverse and common plant families in terms of ethnomedicine due to their potential therapeutic effects. The aim of this study is to investigate the correlation between the chemical composition and the antibacterial effect of five essential oils from this family against five reference bacterial strains responsible of nosocomial diseases and foodborne illnesses.

Methods

The commercial essential oils of Tunisian Rosmarinus officinalis, Thymus capitatus, Origanum majorana and Salvia officinalis were analyzed by GC/FID and GC-MS. Essential oils were evaluated for their antibacterial activities by disc diffusion and microbroth dilution methods against five reference bacterial strains: Pseudomonas aeruginosa, Escherichia coli, Salmonella enterica, Bacillus subtilis and Staphylococcus aureus. The inhibition zone diameter values and the twenty major compounds of the selected essential oils were subjected to PCA and HCA analysis.

Results

Analysis by GC/FID and GC/MS allowed the identification of ninety-one components representing 96.0 to 98.2% of the total oils. The different component contents varied according to the species. The main components were carvacrol, 1,8-cineole, α-thujone, α-terpineol and α-pinene. The PCA and the HCA of the selected essential oil components and the inhibition zone diameter (IZD) values identified four species groups and subgroups. Each essential oils group constituted a chemotype responsible for their bacterial inhibition ability. Thymus capitatus essential oil showed the strongest antibacterial activity with MBC ranging from 0.73 to 2.94 mg mL− 1.

Conclusion

Rosmarinus officinalis, Thymus capitatus, Origanum majorana and Salvia officinalis essential oils have shown promising antibacterial activities against reference bacterial strains responsible for nosocomial diseases and foodborne illnesses.
Depletion of β-sitosterol and enrichment of quercetin and rutin in Cissus quadrangularis Linn fraction enhanced osteogenic but reduced osteoclastogenic marker expression
Authors: Ruangsuriya Jetsada , Charumanee Suporn , Jiranusornkul Supat , Sirisa-ard Panee , Sirithunyalug Busaban , Sirithunyalug Jakkapan , Pattananandecha Thanawat , Saenjum Chalermpong
Published: April 2020

Background

Cissus quadrangularisLinn. (CQ) has been used in Indian and Thai traditional medicine for healing bone fractures because of numerous active ingredients in CQ. It is still unclear which compounds are the active ingredients for bone formation.

Methods

The molecular docking technique, the ethanolic extraction along with hexane fractionation, and an in vitro experiment with a human osteoblast cell line (MG-63) were used to narrow down the active compounds, to prepare the CQ extract, and to test biological activities, respectively.

Results

The molecular docking technique revealed that quercetin and β-sitosterol had highest and lowest potential to bind to estrogen receptors, respectively. Compared to the crude ethanol extract (P1), the ethanolic fraction (P2) was enriched with rutin and quercetin at 65.36 ± 0.75 and 1.06 ± 0.12 mg/g, respectively. Alkaline phosphatase (ALP) activity was significantly enhanced in osteoblasts exposed to the P2 in both tested concentrations. The amount of hydroxyproline was slightly increased in the P1 treatment, while osteocalcin was inhibited. Moreover, the P2 significantly activated osteoprotegerin (OPG) and inhibited receptor activator of nuclear factor κ ligand (RANKL) expression.

Conclusions

Taken together, the enriched rutin and quercetin fraction of CQ triggered the molecules involved in bone formation and the molecules inhibiting bone resorption.
A scoping review on family medicine in sub-Saharan Africa: practice, positioning and impact in African health care systems
Authors: Flinkenflögel Maaike , Sethlare Vincent , Cubaka Vincent Kalumire , Makasa Mpundu , Guyse Abraham , De Maeseneer Jan
Published: April 2020

Background

Family medicine (FM) is a relatively new discipline in sub-Saharan Africa (SSA), still struggling to find its place in the African health systems. The aim of this review was to describe the current status of FM in SSA and to map existing evidence of its strengths, weaknesses, effectiveness and impact, and to identify knowledge gaps.

Methods

A scoping review was conducted by systematically searching a wide variety of databases to map the existing evidence. Articles exploring FM as a concept/philosophy, a discipline, and clinical practice in SSA, published in peer-reviewed journals from 2000 onwards and in English language, were included. Included articles were entered in a matrix and then analysed for themes. Findings were presented and validated at a Primafamed network meeting, Gauteng 2018.

Results

A total of 73 articles matching the criteria were included. FM was first established in South Africa and Nigeria, followed by Ghana, several East African countries and more recently additional Southern African countries. In 2009, the Rustenburg statement of consensus described FM in SSA. Implementation of the discipline and the roles and responsibilities of family physicians (FPs) varied between and within countries depending on the needs in the health system structure and the local situation. Most FPs were deployed in district hospitals and levels of the health system, other than primary care. The positioning of FPs in SSA health systems is probably due to their scarcity and the broader mal-distribution of physicians. Strengths such as being an “all- round specialist”, providing mentorship and supervision, as well as weaknesses such as unclear responsibilities and positioning in the health system were identified. Several studies showed positive perceptions of the impact of FM, although only a few health impact studies were done, with mixed results.

Conclusions

FM is a developing discipline in SSA. Stronger evidence on the impact of FM on the health of populations requires a critical mass of FPs and shared clarity of their position in the health system. As FM continues to grow in SSA, we suggest improved government support so that its added value and impact on health systems in terms of health equity and universal health coverage can be meaningfully explored.
Using hospital auxiliary worker and 24-h TB services as potential tools to overcome in-hospital TB delays: a quasi-experimental study
Authors: Lisboa Miguelhete , Fronteira Inês , Mason Paul H. , Martins Maria do Rosário O.
Published: April 2020

Background

In-hospital logistic management barriers (LMB) are considered to be important risk factors for delays in TB diagnosis and treatment initiation (TB-dt), which perpetuates TB transmission and the development of TB morbidity and mortality. We assessed the contribution of hospital auxiliary workers (HAWs) and 24-h TB laboratory services using Xpert (24h-Xpert) on the delays in TB-dt and TB mortality at Beira Central Hospital, Mozambique.

Methods

A quasi-experimental design was used. Implementation strategy—HAWs and laboratory technicians were selected and trained, accordingly. Interventions—having trained HAW and TB laboratory technicians as expediters of TB LMB issues and assurer of 24h-Xpert, respectively. Implementation outcomes—time from hospital admission to sputum examination results, time from hospital admission to treatment initiation, proportion of same-day TB cases diagnosed, initiated TB treatment, and TB patient with unfavorable outcome after hospitalization (hospital TB mortality). A nonparametric test was used to test the differences between groups and adjusted OR (95% CI) were computed using multivariate logistic regression.

Results

We recruited 522 TB patients. Median (IQR) age was 34 (16) years, and 52% were from intervention site, 58% males, 60% new case of TB, 12% MDR-TB, 72% TB/HIV co-infected, and 43% on HIV treatment at admission. In the intervention hospital, 93% of patients had same-day TB-dt in comparison with a median (IQR) time of 15 (2) days in the control hospital. TB mortality in the intervention hospital was lower than that in the control hospital (13% vs 49%). TB patients admitted to the intervention hospital were nine times more likely to obtain an early laboratory diagnosis of TB, six times more likely to reduce delays in TB treatment initiation, and eight times less likely to die, when compared to those who were admitted to the control hospital, adjusting for other factors.

Conclusion

In-hospital delays in TB-dt and high TB mortality in Mozambique are common and probably due, in part, to LMB amenable to poor-quality TB care. Task shifting of TB logistic management services to HAWs and lower laboratory technicians, to ensure 24h-Xpert through “on-the-spot strategy,” may contribute to timely TB detection, proper treatment, and reduction of TB mortality.
Epicardial left atrial appendage occlusion with a new medical device: assessment of procedural feasibility, safety and efficacy in a large animal model
Authors: Emmert Maximilian Y. , Firstenberg Michael S. , Martella Arthur T. , Lau Liming , Zlock Stephen , Mohan Ashik , Spangler Taylor , Currie Sarah , Salzberg Sacha P. , Caliskan Etem
Published: April 2020

Background

Left atrial appendage occlusion (LAAO) represents a treatment alternative to anticoagulation in patients with atrial fibrillation. We evaluate a novel device for epicardial LAAO in a translational canine model.

Methods

Nine hounds (n = 9) were used to assess usability, safety, and efficacy of the TigerPaw Pro (TPP) device for epicardial LAAO. Following baseline imaging (intra-cardiac echocardiography (ICE) and angiography) and intraoperative visual inspection, usability was tested via a ``closure/re-opening`` maneuver followed by deployment of a total of twenty TPP devices (n = 20) on the left and right atrial appendages respectively. Procedural safety was evaluated by assessing for adverse-events via direct Epicardial inspection and endocardial imaging. Efficacy evaluation included assessment of device positioning, presence of residual stumps and completeness of closure. Post-mortem evaluation was performed to confirm safety and efficacy.

Results

Usability testing of all TPP devices was successful (n = 20;100%, delivery-time range 22–120 s) without any procedural adverse-events (tissue damage or tears, bleeding, vessel-impingement, structural impact). All devices fully traversed the ostium (n = 18) or appendage body (n = 2), and conformed smoothly to adjacent cardiac anatomy. In nineteen deployments (n = 19;95%), all device connector pairs were fully engaged, while in one TPP device the most distal pair remained unengaged. ICE and post-mortem inspections revealed complete closure of all appendage ostia (n = 18;100%) and only in one case a small residual stump was detected. Intraoperative safety findings were further confirmed post-mortem. Devices created a nearly smooth line of closure via symmetric endocardial tissue-coaptation.

Conclusions

In this preclinical model, the TPP demonstrated good ease of use for ostial access, ability to re-position (after engagement) and rapid deployment, while achieving safe and effective LAAO.
Music to improve sleep quality in adults with depression-related insomnia (MUSTAFI): study protocol for a randomized controlled trial
Authors: Lund Helle Nystrup , Pedersen Inge Nygaard , Johnsen Søren Paaske , Heymann-Szlachcinska Agnieszka M. , Tuszewska Maryla , Bizik Gustav , Larsen Jens Ivar , Kulhay Eszter , Larsen Anelia , Grønbech Bettina , Østermark Helle , Borup Heidi , Valentin Jan Brink , Mainz Jan
Published: April 2020

Background

Insomnia is a common sleep disorder for adults with depression, with major impact on their quality of life. Previous trials suggest that listening to music may be helpful in the treatment of sleep disturbances in healthy populations, including students and elderly. In addition, small studies with clinical populations of traumatized refugees, adults with chronic insomnia and adults with depression insomnia add to the evidence base. However, the impact of music listening in the treatment of depression related insomnia is not well documented.

Objective

To examine the efficacy of music listening on sleep quality, symptoms of depression, and quality of life in adults with depression-related insomnia.

Method

A single-center randomized controlled trial (RCT) in a two-arm parallel-group design is conducted and reported according to the CONSORT guidelines. The trial consists of an experimental group and a standard care control group. Both groups receive standard treatment for depression following Danish clinical guidelines in an outpatient psychiatry unit. The experimental group listens to music for a minimum of 30 minutes at bedtime for 4 weeks.

Discussion

This trial will provide information on the efficacy of music intervention as a non-pharmacological intervention in the treatment of depression-related insomnia. This study will provide novel knowledge concerning music medicine as an evidence-based treatment for depression.

Trial Registration

Clinicaltrials.gov. ID NCT03676491, registered on 19 September 2018.
Effect of xenon and dexmedetomidine as adjuncts for general anesthesia on postoperative emergence delirium after elective cardiac catheterization in children: study protocol for a randomized, controlled, pilot trial
Authors: Devroe Sarah , Devriese Lisa , Debuck Frederik , Fieuws Steffen , Cools Bjorn , Gewillig Marc , Van de Velde Marc , Rex Steffen
Published: April 2020

Background

Emergence delirium, a manifestation of acute postoperative brain dysfunction, is frequently observed after pediatric anesthesia and has been associated with the use of sevoflurane. Both xenon and dexmedetomidine possess numerous desirable properties for the anesthesia of children with congenital heart disease, including hemodynamic stability, lack of neurotoxicity, and a reduced incidence of emergence delirium. Combining both drugs has never been studied as a balanced-anesthesia technique. This combination allows the provision of anesthesia without administering anesthetic drugs against which the Food and Drug Administration (FDA) issued a warning for the use in young children.

Methods/Design

In this phase-II, mono-center, prospective, single-blinded, randomized, controlled pilot trial, we will include a total of 80 children aged 0–3 years suffering from congenital heart disease and undergoing general anesthesia for elective diagnostic and/or interventional cardiac catheterization. Patients are randomized into two study groups, receiving either a combination of xenon and dexmedetomidine or mono-anesthesia with sevoflurane for the maintenance of anesthesia.

The purpose of this study is to estimate the effect size for xenon-dexmedetomidine versus sevoflurane anesthesia with respect to the incidence of emergence delirium in children. We will also describe group differences for a variety of secondary outcome parameters including peri-interventional hemodynamics, emergence characteristics, incidence of postoperative vomiting, and the feasibility of a combined xenon-dexmedetomidine anesthesia in children.

Discussion

Sevoflurane is the most frequently used anesthetic in young children, but has been indicated as an independent risk factor in the development of emergence delirium. Xenon and dexmedetomidine have both been associated with a reduction in the incidence of emergence delirium. Combining xenon and dexmedetomidine has never been described as a balanced-anesthesia technique in children. Our pilot study will therefore deliver important data required for future prospective clinical trials.

Trial registration

EudraCT, 2018–002258-56. Registered on 20 August 2018.https://www.clinicaltrialsregister.eu.
Recognizing and stabilizing miR-21 by chiral ruthenium(II) complexes
Authors: Feng Yin , Shu Jing , Yao Liangzhong , Lan Yutao , Ye Lianbao , Mei Wenjie , Ding Ying
Published: April 2020

MiR-21, a non-coding miRNA with 22 nucleotides, plays an important part in the proliferation, invasion, and metastasis of tumor cells. The present study demonstrates that isomers of chiral ruthenium(II) complexes with alkynes (Λ-1 and Δ-1) were synthesized by Songogashira coupling reaction by using microwave-assisted synthetic technology. The isomers can recognize and stabilize miR-21, with the Λ-isomer showing a stronger binding capacity than the Δ-isomer. Further studies showed that both isomers can be uptaken by MDA-MB-231 cells and enriched in the nucleus. Treatment with the Λ-/Δ-isomer downregulated the expression of miR-21. In a word, the development of chiral ruthenium(II) complexes act as potential inhibitors against tumor cells by recognizing, stabilizing, and regulating the expression of miR-21.
A method of fingerprint indoor localization based on received signal strength difference by using compressive sensing
Authors: Yu Xiao-min , Wang Hui-qiang , Wu Jin-qiu
Published: April 2020

With the development of network technology, WLAN-based indoor localization plays an increasingly important role. Most current localization methods are based on the comparison between the received signal strength indication (RSSI) and the RSS in the database, whose nearest reference point is the location point. However, since a uniform standard for measuring components of smartphones has not yet been established, the Wi-Fi chipsets on different smartphones may have different sensitivity levels to different Wi-Fi access points (APs) and channels. Even for the same signal, RSSI values obtained by different terminals at the same time and the same location may be different. Therefore, the impact of terminal heterogeneity on localization accuracy can be overlooked. To address this issue, a fusion method based on received signal strength difference and compressive sensing (RSSD-CS) is proposed in this paper, which can reduce the influence caused by the terminal heterogeneity. Besides, a fingerprint database is reconstructed from the existing reference point data. Experiments show that the proposed RSSD-CS algorithm can achieve high localization accuracy in indoor localization, and the accuracy is enhanced by 20.5% and 15.6% compared to SSD and CS algorithm.
On the solution of two-dimensional fractional Black–Scholes equation for European put option
Authors: Prathumwan Din , Trachoo Kamonchat
Published: April 2020

The purpose of this paper was to investigate the dynamics of the option pricing in the market through the two-dimensional time fractional-order Black–Scholes equation for a European put option. The Liouville–Caputo derivative was used to improve the ordinary Black–Scholes equation. The analytic solution is a powerful tool for describing the behavior of the option price in the European style market. In this study, analytic solution is carried out by the Laplace homotopy perturbation method. Moreover, the obtained solution showed that the Laplace homotopy perturbation method was an efficient method for finding an analytic solution of two-dimensional fractional-order differential equation.
Citizen Disaster Science Education for effective disaster risk reduction in developing countries
Authors: Parajuli Rishi Ram
Published: April 2020

This paper briefly discusses on the recent scenario in sustainable development goals and disaster risk reduction initiatives. Recent reports state that achievement of the target of SDG on 2030 is questionable however several strategies are placed internationally and locally. It raises the issue on paradigm shift in public awareness through citizen disaster science education, which will provide basic science behind any disaster of their locality that help in taking decisions in reducing exposure, improving preparedness and reaction, response and recovery to any disaster.
Image quality of late gadolinium enhancement in cardiac magnetic resonance with different doses of contrast material in patients with chronic myocardial infarction
Authors: Monti Caterina Beatrice , Codari Marina , Cozzi Andrea , Alì Marco , Saggiante Lorenzo , Sardanelli Francesco , Secchi Francesco
Published: April 2020

Background

Contrast-enhanced cardiac magnetic resonance (CMR) is pivotal for evaluating chronic myocardial infarction (CMI). Concerns about safety of gadolinium-based contrast agents favour dose reduction. We assessed image quality of scar tissue in CMRs performed with different doses of gadobutrol in CMI patients.

Methods

Informed consent was waived for this Ethics Committee-approved single-centre retrospective study. Consecutive contrast-enhanced CMRs from CMI patients were retrospectively analysed according to the administered gadobutrol dose (group A, 0.10 mmol/kg; group B, 0.15 mmol/kg; group C, 0.20 mmol/kg). We calculated the signal-to-noise ratio for scar tissue (SNRscar) and contrast-to-noise ratio between scar and either remote myocardium (CNRscar-rem) or blood (CNRscar-blood).

Results

Of 79 CMRs from 79 patients, 22 belonged to group A, 26 to group B, and 31 to group C. The groups were homogeneous for age, sex, left ventricular morpho-functional parameters, and percentage of scar tissue over whole myocardium (p ≥ 0.300). SNRscar was lower in group A (46.4; 40.3–65.1) than in group B (70.1; 52.2–111.5) (p = 0.013) and group C (72.1; 59.4–100.0) (p = 0.002), CNRscar-rem was lower in group A (62.9; 52.2–87.4) than in group B (96.5; 73.1–152.8) (p = 0.008) and in group C (103.9; 83.9–132.0) (p = 0.001). No other significant differences were found (p ≥ 0.335).

Conclusions

Gadobutrol at 0.10 mmol/kg provides inferior scar image quality of CMI than 0.15 and 0.20 mmol/kg; the last two dosages seem to provide similar LGE. Thus, for CMR of CMI, 0.15 mmol/kg of gadobutrol can be suggested instead of 0.20 mmol/kg, with no hindrance to scar visualisation. Dose reduction would not impact on diagnostic utility of CMR examinations.