bluuebunny/crossref_metadata_2025 huggingface dataset:
Trends and determinants of early initiation of breastfeeding and exclusive breastfeeding in Ethiopia from 2000 to 2016
Authors: Ahmed Kedir Y. , Page Andrew , Arora Amit , Ogbo Felix Akpojene
Published: September 2019

Background

At the national level in Ethiopia, there is limited knowledge of trends and factors associated with early initiation of breastfeeding and exclusive breastfeeding (EBF), particularly during the Millenium Development Goal (MDG) era (2000–2015). The study aimed to examine the trends and determinants of early initiation of breastfeeding and EBF in Ethiopia between 2000 and 2016.

Methods

Using the Ethiopia Demographic and Health Survey (EDHS) data for the years: 2000 (n = 3680), 2005 (n = 3528), 2011 (n = 4037) and 2016 (n = 3861), trends in early initiation of breastfeeding and EBF were estimated. Multivariate logistic regression models that adjusted for confounders, sampling weight, clustering and stratification were used to examine the association between socioeconomic, demographic, health service and community level factors with early initiation of breastfeeding and EBF from 2000 to 2016.

Results

The prevalence of early initiation of breastfeeding increased from 48.8% in 2000 to 75.7% in 2016 in Ethiopia. Improvement in EBF prevalence was not statistically significant (from 54.5% in 2000 to 59.9% in 2016). Over the study period, informal maternal employment (Adjusted Odds Ratio [aOR] 0.75; 95% Confidence Interval [CI] 0.68, 0.83), frequent antenatal care visits (aOR 0.74; 95% CI 0.65, 0.85), and cesarean birthing (aOR 0.22; 95% CI 0.17, 0.30) were associated with delayed initiation of breastfeeding. Birthing in the health facility (aOR 1.35; 95% CI 1.05, 1.75) and residing in the metropolis region (aOR 1.95; 95% CI 1.65, 2.32) were associated with timely initiation of breastfeeding. In a similar period, informally employed mothers (aOR 1.37; 95% CI 1.15, 1.63) and those with six or more family size (aOR 1.46; 95% CI 1.10, 1.93) were more likely to exclusively breastfeed their babies.

Conclusion

Early initiation of breastfeeding improved in Ethiopia during the MDG era but it is still below the national target; progress in EBF remained slow. To improve breastfeeding outcomes and meet the global breastfeeding targets in Ethiopia, infant feeding efforts should focus on improving key modifiable factors, including place and mode of birthing and socioeconomic status of mothers.
Skeletal muscle mass correlates with increased toxicity during neoadjuvant radiochemotherapy in locally advanced esophageal cancer: A SAKK 75/08 substudy
Authors:   for the Swiss Group for Clinical Cancer Research (SAKK), Panje Cédric M. , Höng Laura , Hayoz Stefanie , Baracos Vickie E. , Herrmann Evelyn , Garcia Schüler Helena , Meier Urs R. , Henke Guido , Schacher Sabina , Hawle Hanne , Gérard Marie-Aline , Ruhstaller Thomas , Plasswilm Ludwig
Published: September 2019

Background

Sarcopenia, the critical depletion of skeletal muscle mass, is an independent prognostic factor in several tumor entities for treatment-related toxicity and survival. In esophageal cancer, there have been conflicting results regarding the value of sarcopenia as prognostic factor, which may be attributed to the heterogeneous patient populations and the retrospective nature of previous studies. The aim of our study was therefore to determine the impact of sarcopenia on prospectively collected specific outcomes in a subgroup of patients treated within the phase III study SAKK 75/08 with trimodality therapy (induction chemotherapy, radiochemotherapy and surgery) for locally advanced esophageal cancer.

Methods

Sarcopenia was assessed by skeletal muscle index at the 3rd lumbar vertebra (L3) in cross-sectional computed tomography scans before induction chemotherapy, before radiochemotherapy and after neoadjuvant therapy in a subgroup of 61 patients from four centers in Switzerland. Sarcopenia was determined by previously established cut-off values (Martin et al., PMID: 23530101) and correlated with prospectively collected outcomes including treatment-related toxicity, postoperative morbidity, treatment feasibility and survival.

Results

Using the published cut-off values, the prevalence of sarcopenia increased from 29.5% before treatment to 63.9% during neoadjuvant therapy (p < 0.001). Feasibility of neoadjuvant therapy and surgery was not different in initially sarcopenic and non-sarcopenic patients. We observed in sarcopenic patients significantly increased grade ≥ 3 toxicities during chemoradiation (83.3% vs 52.4%, p = 0.04) and a non-significant trend towards increased postoperative complications (66.7% vs 42.9%, p = 0.16). No difference in survival according to sarcopenia could be observed in this small study population.

Conclusions

Trimodality therapy in locally advanced esophageal cancer is feasible in selected patients with sarcopenia. Neoadjuvant chemoradiation increased the percentage of sarcopenia. Sarcopenic patients are at higher risk for increased toxicity during neoadjuvant radiochemotherapy and showed a non-significant trend to more postoperative morbidity.
Modular hemipelvic endoprosthesis with a sacral hook: a finite element study
Authors: Wang Bo , Sun Peidong , Yao Hao , Tu Jian , Xie Xianbiao , Ouyang Jun , Shen Jingnan
Published: September 2019

Background

A novel hemipelvic endoprosthesis with a sacral hook was introduced previously, and its clinical outcome with midterm follow-up showed decreased prosthesis-related complications, especially decreased rate of aseptic loosening. The aim of present study was to evaluate the role of a sacral hook in prosthesis stability and the biomechanical properties of this hemipelvic endoprosthesis.

Methods

A three-dimensional model of the postoperative pelvis was developed using computed tomography (CT) images. A force of 500 N was applied, and the distribution of stress and displacement was evaluated. Comparisons were performed to explore the role of the sacral hook in prosthesis stability. Prosthesis improvement was simulated to reduce unexpected breakage of the pubic connection plate.

Results

In the reconstructed hemipelvis, stress distributions were concentrated on the superior area of the acetabulum, sacral connection component, and sacral hook. A maximum stress of 250 MPa was observed at the root of the sacral connection component. The sacral hook reduced the maximum stress and displacement by 14.1% and 32.5%, respectively, when the prosthesis was well fixed and by 10.0% and 42.1%, respectively, when aseptic loosening occurred. Increasing the thickness of the pubic connection plate from 2 to 3.5 mm reduced the maximum stress by 32.0% and 15.8%, respectively.

Conclusion

A hemipelvic endoprosthesis with a sacral hook fulfills the biomechanical demands of the hemipelvis and is safe under static conditions. The sacral hook is important for prosthesis stability. Increasing the thickness of the pubic connection plate can reduce the maximum stress and risk of fatigue breakage.
Comparative assessment of net CO2 exchange across an urbanization gradient in Korea based on eddy covariance measurements
Authors: Hong Je-Woo , Hong Jinkyu , Chun Junghwa , Lee Yong Hee , Chang Lim-Seok , Lee Jae-Bum , Yi Keewook , Park Young-San , Byun Young-Hwa , Joo Sangwon
Published: September 2019

Background

It is important to quantify changes in CO2sources and sinks with land use and land cover change. In the last several decades, carbon sources and sinks in East Asia have been altered by intensive land cover changes due to rapid economic growth and related urbanization. To understand impact of urbanization on carbon cycle in the monsoon Asia, we analyze net CO2exchanges for various land cover types across an urbanization gradient in Korea covering high-rise high-density residential, suburban, cropland, and subtropical forest areas.

Results

Our analysis demonstrates that the urban residential and suburban areas are constant CO2sources throughout the year (2.75 and 1.02 kg C m−2 year−1at the urban and suburban sites), and the net CO2emission indicate impacts of urban vegetation that responds to the seasonal progression of the monsoon. However, the total random uncertainties of measurement are much larger in the urban and suburban areas than at the nonurban sites, which can make it challenging to obtain accurate urban flux measurements. The cropland and forest sites are strong carbon sinks because of a double-cropping system and favorable climate conditions during the study period, respectively (− 0.73 and − 0.60 kg C m−2 year−1at the cropland and forest sites, respectively). The urban area of high population density (15,000 persons km−2) shows a relatively weak CO2emission rate per capita (0.7 t CO2 year−1 person−1), especially in winter because of a district heating system and smaller traffic volume. The suburban area shows larger net CO2emissions per capita (4.9 t CO2 year−1 person−1) because of a high traffic volume, despite a smaller building fraction and population density (770 persons km−2).

Conclusions

We show that in situ flux observation is challenging because of its larger random uncertainty and this larger uncertainty should be carefully considered in urban studies. Our findings indicate the important role of urban vegetation in the carbon balance and its interaction with the monsoon activity in East Asia. Urban planning in the monsoon Asia must consider interaction on change in the monsoon activity and urban structure and function for sustainable city in a changing climate.
Detection of NRAS mutation in cell-free DNA biological fluids from patients with kaposiform lymphangiomatosis
Authors: Ozeki Michio , Aoki Yoko , Nozawa Akifumi , Yasue Shiho , Endo Saori , Hori Yumiko , Matsuoka Kentaro , Niihori Tetsuya , Funayama Ryo , Shirota Matsuyuki , Nakayama Keiko , Fukao Toshiyuki
Published: September 2019

Background

Kaposiform lymphangiomatosis (KLA) has recently been distinguished as a novel subtype of generalized lymphatic anomaly (GLA) with foci of spindle endothelial cells. All cases of KLA involve multiple organs and have an unfavorable prognosis. However, the molecular pathogenesis is unknown, and there are no useful biomarkers. In the present study, we performed genetic analysis to elucidate the cause of this disease and detect biomarkers for it.

Methods

We performed whole-exome sequencing of DNA samples from leukocytes and a biopsy specimen and analyzed cell-free DNA (cfDNA) from plasma and pleural effusion of patients to identify the NRAS c.182A > G (p.Q61R) mutation using the droplet digital polymerase chain reaction (ddPCR).

Results

All KLA patients (patients 1–5) had invasive and aggressive features (hemorrhagic pleural effusions, coagulation disorder, and thrombocytopenia) and characteristic findings of KLA in their pathological examinations. In whole exome sequencing for patient 1, c.182A > G missense variant (p.Q61R) in NRAS was identified in fresh frozen samples of a mass on the left chest wall at a frequency of 5% of total alleles but not in his blood leukocytes. Furthermore, the same mutation was detected in cfDNA isolated from plasma and pleural effusion by using ddPCR. ddPCR analysis of plasma/pleural effusion samples from an additional four KLA patients showed that the same mutation was detected in isolated cfDNA in three of the four, as well as in a tissue sample from one of the three plasma/effusion-positive patients that had been obtained to confirm the mutation.

Conclusion

These results provide the first evidence that NRAS oncogenic variant was identified in DNA samples from KLA patients from not only two affected lesions but also plasma and pleural effusion.
Validation of a childhood eating disorder outcome scale
Authors: Nagamitsu Shinichiro , Fukai Yoshimitsu , Uchida So , Matsuoka Michiko , Iguchi Toshiyuki , Okada Ayumi , Sakuta Ryoichi , Inoue Takeshi , Otani Ryoko , Kitayama Shinji , Koyanagi Kenshi , Suzuki Yuichi , Suzuki Yuki , Sumi Yoshino , Takamiya Shizuo , Fujii Chikako , Tsurumaru Yasuko , Ishii Ryuta , Kakuma Tatsuyuki , Yamashita Yushiro
Published: September 2019

We developed and validated a childhood eating disorder outcome scale based on outcomes associated with body mass index standard deviation score (BMI-SDS). This prospective observational study included 131 children with eating disorders (aged 5–15 years). Participants’ outcomes scales were completed at the first visit and at 1, 3, 6, and 12 months. The scale evaluated 12 outcomes: body weight change (BW), eating attitude (EA), fear of being fat (FF), body image distortion (BD), menstruation (ME), perceived physical condition (PC), attending school (AS), disease recognition by school (RS), family function (FA), disease recognition by parent (RP), social adaptation (SA), and relationships with friends (RF). Responses to all items were on a four-point Likert scale. Exploratory factor analysis was used to determine the number of factors based on the 12 outcomes. The relation between outcome scale scores and BMI-SDS over the 12-month follow-up period was analyzed. Two types of factors were extracted: disease-specific factors (EA, FF, BD) and biopsychosocial factors (BW, PC, AS, FA, SA, RF). Three items (ME, RS, RP) were excluded because they showed no significant loading effect. There was a significant negative correlation between the outcome scale and BMI-SDS, and changes in outcome scale scores from baseline to 12 months were significantly associated with improvement in BMI-SDS. We developed a childhood eating disorder outcome scale characterized by disease-specific and biopsychosocial factors. Biopsychosocial management combined with a therapeutic approach for disease-specific symptoms may support body weight recovery for children with eating disorders.
Spectrum and prevalence of BRCA1/2 germline mutations in Pakistani breast cancer patients: results from a large comprehensive study
Authors: Rashid Muhammad Usman , Muhammad Noor , Naeemi Humaira , Khan Faiz Ali , Hassan Mariam , Faisal Saima , Gull Sidra , Amin Asim , Loya Asif , Hamann Ute
Published: September 2019

Background

Pathogenic germline mutations in BRCA1 and BRCA2 (BRCA1/2) account for the majority of hereditary breast and/or ovarian cancers worldwide. To refine the spectrum of BRCA1/2 mutations and to accurately estimate the prevalence of mutation in the Pakistani population, we studied 539 breast cancer patients selected for family history and age of diagnosis.

Methods

Comprehensive screening for BRCA1/2 germline mutations was performed using state-of-the-art technologies.

Results

A total of 133 deleterious mutations were identified in 539 families (24.7%), comprising 110 in BRCA1 and 23 in BRCA2. The prevalence of BRCA1/2 small-range mutations and large genomic rearrangements was 55.4% (36/65) for families with breast and ovarian cancer, 27.4% (67/244) for families with two or more cases of breast cancer, 18.5% (5/27) for families with male breast cancer, and 12.3% (25/203) for families with a single case of early-onset breast cancer. Nine mutations were specific to the Pakistani population. Eighteen mutations in BRCA1 and three in BRCA2 were recurrent and accounted for 68.2% (75/110) and 34.8% (8/23) of all identified mutations in BRCA1 and BRCA2, respectively. Most of these mutations were exclusive to a specific ethnic group and may result from founder effects.

Conclusions

Our findings show that BRCA1/2 mutations account for one in four cases of hereditary breast/ovarian cancer, one in five cases of male breast cancer, and one in eight cases of early-onset breast cancer in Pakistan. Our study suggests genetic testing of an extended panel of 21 recurrent BRCA1/2 mutations for appropriately selected patients and their families in Pakistan.
A functional role for the cancer disparity-linked genes, CRYβB2 and CRYβB2P1, in the promotion of breast cancer
Authors: Barrow Maya A. , Martin Megan E. , Coffey Alisha , Andrews Portia L. , Jones Gieira S. , Reaves Denise K. , Parker Joel S. , Troester Melissa A. , Fleming Jodie M.
Published: September 2019

Background

In the USA, the breast cancer mortality rate is 41% higher for African-American women than non-Hispanic White women. While numerous gene expression studies have classified biological features that vary by race and may contribute to poorer outcomes, few studies have experimentally tested these associations. CRYβB2 gene expression has drawn particular interest because of its association with overall survival and African-American ethnicity in multiple cancers. Several reports indicate that overexpression of the CRYβB2 pseudogene, CRYβB2P1, and not CRYβB2 is linked with race and poor outcome. It remains unclear whether either or both genes are linked to breast cancer outcomes. This study investigates CRYβB2 and CRYβB2P1 expression in human breast cancers and breast cancer cell line models, with the goal of elucidating the mechanistic contribution of CRYβB2 and CRYβB2P1 to racial disparities.

Methods

Custom scripts for CRYβB2 or CRYβB2P1 were generated and used to identify reads that uniquely aligned to either gene. Gene expression according to race and tumor subtype were assessed using all available TCGA breast cancer RNA sequencing alignment samples (n = 1221). In addition, triple-negative breast cancer models engineered to have each gene overexpressed or knocked out were developed and evaluated by in vitro, biochemical, and in vivo assays to identify biological functions.

Results

We provide evidence that CRYβB2P1 is expressed at higher levels in breast tumors compared to CRYβB2, but only CRYβB2P1 is significantly increased in African-American tumors relative to White American tumors. We show that independent of CRYβB2, CRYβB2P1 enhances tumorigenesis in vivo via promoting cell proliferation. Our data also reveal that CRYβB2P1 may function as a non-coding RNA to regulate CRYβB2 expression. A key observation is that the combined overexpression of both genes was found to suppress cell growth. CRYβB2 overexpression in triple-negative breast cancers increases invasive cellular behaviors, tumor growth, IL6 production, immune cell chemoattraction, and the expression of metastasis-associated genes. These data underscore that both CRYβB2 and CRYβB2P1 promote tumor growth, but their mechanisms for tumor promotion are likely distinct.

Conclusions

Our findings provide novel data emphasizing the need to distinguish and study the biological effects of both CRYβB2 and CRYβB2P1 as both genes independently promote tumor progression. Our data demonstrate novel molecular mechanisms of two understudied, disparity-linked molecules.
The clinical effect of arrhythmia monitoring after myocardial infarction (BIO-GUARD|MI):study protocol for a randomized controlled trial
Authors: Jons Christian , Sogaard Peter , Behrens Steffen , Schrader Jürgen , Mrosk Sascha , Bloch Thomsen Poul Erik
Published: September 2019

Background

The increasing use of implantable cardiac monitors (ICMs) allows early documentation of asymptomatic cardiac arrhythmias that would previously have gone unnoticed. The addition of remote monitoring to cardiac devices means that physicians receive an early warning in cases of new-onset arrhythmias. While remote monitoring has been suggested to increase survival in heart failure patients with implantable defibrillators, trials using ICMs for continuous electrocardiographic monitoring of cardiac arrhythmias in the postmyocardial infarction setting have shown that patients who experienced cardiac arrhythmias such as atrial fibrillation, bradycardia, and ventricular tachyarrhythmia have an increased risk of major adverse cardiac events.

Methods

The Biomonitoring in patients with preserved left ventricular function after diagnosed myocardial infarction (BIO-GUARD-MI) study is designed to investigate and clarify whether the incidence of major adverse cardiac events can be decreased by early detection and treatment of cardiac arrhythmias using an ICM in patients after myocardial infarction. In addition, the study will allow us to describe the interplay between baseline characteristics, arrhythmias, and clinical events to improve the treatment of this high-risk patient population. The study will enroll and randomize a cohort of high-risk postmyocardial infarction patients with CHA2DS2-VASc score ≥ 4 and left ventricular ejection fraction > 35% to an ICM or conventional treatment. Physicians are provided with suggestions on how to respond to ICM-documented arrhythmias. An estimated 1400 patients will be enrolled and followed until 372 primary endpoints have occurred. In this paper, we describe the literature and rationale behind the design and interventions towards new-onset arrhythmias, as well as future perspectives and limitations for the use of ICMs.

Discussion

Remote monitoring may improve clinical outcome if it uncovers conditions with low symptom burden which cause or indicate an increased risk. A simple and easily implementable response to the information is important. Cardiac arrhythmias frequently start as asymptomatic, shorter lasting, and nightly events. The BIO-GUARD-MI trial represents the first attempt to simplify the response to the rather complex nature of heart arrhythmias.

Trial registration

Clinical Trials, NCT02341534. Registered on 19 January 2015.
Is dangling of the lower leg after a free flap reconstruction necessary? Study protocol for a large multicenter randomized controlled study
Authors: Krijgh David D. , Teunis Teun , Schellekens Pascal P. A. , Mureau Marc A. M. , Luijsterburg Antonius J. M. , Tempelman Tallechien M. T. , van der Beek Eva S. J. , Maarse Wiesje , Coert J. Henk
Published: September 2019

Background

Within the field of plastic surgery, free tissue transfer is common practice for knee and lower leg defects. Usually, after such free flap reconstruction, patients undergo a dangling protocol in the postoperative phase. A dangling protocol is designed to gradually subject the free flap to increased venous pressure resulting from gravitational forces. Worldwide there are multiple variations of dangling protocols. However, there is no evidence available in the literature that supports the use of a dangling protocol.

Methods

This is a multicenter randomized controlled trial that includes patients with a free flap lower leg reconstruction. The primary outcome is to assess whether a no-dangling protocol is not inferior to a dangling protocol, in terms of proportion of partial flap loss, 6 months after surgery. Secondary objectives are to identify differences in major and minor complications, length of stay, and costs, and to objectify blood gaseous changes during dangling. Furthermore, at 2 years we will assess difference in physical function, infection rates, and osseous union rates.

Discussion

The primary outcome of this study will give a more decisive answer to the question of whether a dangling protocol is necessary after a free flap reconstruction of the lower leg. The secondary outcomes of this study will provide a better insight into the physical functions, infection rates, and union rates in these patients.

Trial registration

Central Committee on Research Involving Human Subjects (CCMO), NL63146.041.17. Registered on 11 July 2018. Netherlands Trial Register, NTR7545. Registered on 10 October 2018.
Manual acupuncture for the infertile female with polycystic ovary syndrome (PCOS): study protocol for a randomized sham-controlled trial
Authors: Wang Qiao , Deng Haiping , Cheng Ke , Huang Zouqin , Yin Xiuqi , Zhou Yichen , Yang Yiqin , Shen Weidong , Zhao Ling , Shen Xueyong
Published: September 2019

Background

Polycystic ovary syndrome (PCOS) is one of the most common endocrine diseases for women. Acupuncture is widely used for the infertile female because of it is non-invasive and has fewer side effects, but the powerful evidence for the clinic is still insufficient. Our study intends to explore the effect of manual acupuncture (MA) in the infertile female with PCOS.

Methods

This study is a randomized, sham-controlled, patient-and assessor-blinded trial and aims to evaluate the effect of MA in women with PCOS and infertility. We will recruit 86 women aged 20–40 years with a diagnosis of infertility with PCOS. Participants will be randomly allocated in a 1:1 ratio to the MA group and the sham acupuncture (SA) group. Both groups will receive real herbal medicine treatment as a basic treatment twice a day for three menstrual cycles, the MA group receive real acupuncture treatment and the SA group received placebo acupuncture treatment (non-penetrating). All patients will receive acupuncture treatment twice per week for three menstrual cycles. The primary outcome is pregnancy rate and secondary outcomes include ovulation rate, sex hormones, insulin resistance index (IRI), PCOS symptoms, and Traditional Chinese Medicine (TCM) syndrome scores. Outcome measures will be collected at baseline, each menstrual cycle, the end of treatments, and six months after the last acupuncture treatment. The present protocol followed the SPIRIT guidelines and fulfilled the SPIRIT checklist.

Discussion

This study will be conducted to compare the efficacy of MA versus SA. This trial will help to evaluate whether MA is effective in increasing pregnancy and ovulation rates of the infertile female with polycystic ovary syndrome.

Trial registration

Chinese Clinical Trial Registry, ChiCTR1800014997. Registered on 27 February 2018.
Simultaneous nutrition removal and high-efficiency biomass and lipid accumulation by microalgae using anaerobic digested effluent from cattle manure combined with municipal wastewater
Authors: Luo Lin , Ren Hongyu , Pei Xuanyuan , Xie Guojun , Xing Defeng , Dai Yingqi , Ren Nanqi , Liu Bingfeng
Published: September 2019

Background

Microalgae as a viable biodiesel feedstock show great potential to approach the challenges of energy shortage and environment pollution, but their economic feasibility was seriously hampered by high production cost. Thus, it is in urgent need to reduce the cost of cultivation and improve the biomass and lipid production of microalgae. In this work, anaerobic digestion effluent from cattle manure combined with municipal wastewater was used as a cost-effective medium for cultivating microalgae and expected to obtain high biomass. The pretreatment of anaerobic digested effluent containing dilution rate, sterilization and nutrient optimization was investigated. Then, initial pH and light intensity for algal growth, lipid production and wastewater purification were optimized in this study.

Results

Scenedesmus sp. could grow rapidly in 10% anaerobic digestion effluent from cattle manure combined with secondary sedimentation tank effluent without sterilization. Optimum nutrient additives for higher biomass were as follows: glucose 10 g/L, NaNO3 0.3 g/L, K2HPO4·3H2O 0.01 g/L, MgSO4·7H2O 0.075 g/L and trace element A5 solution 1 mL/L. Biomass of 4.65 g/L and lipid productivity of 81.90 mg/L/day were achieved during 7-day cultivation accompanying over 90% of COD, NO3−-N, NH4+-N, and 79–88% of PO43−-P removal with optimized initial pH of 7.0 and light intensity of 5000 l×. The FAME profile in ADEC growth medium consisted in saturated (39.48%) and monounsaturated (60.52%) fatty acids with the 16- to 18-chain-length fatty acids constituting over 98% of total FAME.

Conclusions

This study proves the potential of anaerobic digested effluent combined with municipal wastewater for microalgae culture, and provides an effective avenue for simultaneous microalgal lipid production and treatment of two kinds of wastewater.
Molecular identification and prevalence of tick-borne pathogens in zebu and taurine cattle in North Cameroon
Authors: Abanda Babette , Paguem Archile , Abdoulmoumini Mamoudou , Kingsley Manchang Tanyi , Renz Alfons , Eisenbarth Albert
Published: September 2019

Background

Public interest for tick-borne pathogens in cattle livestock is rising due to their veterinary and zoonotic importance. Consequently, correct identification of these potential pathogens is crucial to estimate the level of exposition, the risk and the detrimental impact on livestock and the human population.

Results

Conventional PCR with generic primers was used to identify groups of tick-borne pathogens in cattle breeds from northern Cameroon. The overall prevalence in 1260 blood samples was 89.1%, with 993 (78.8%) positive forTheileria/Babesiaspp., 959 (76.1%) forAnaplasma/Ehrlichiaspp., 225 (17.9%) forBorreliaspp., and 180 (14.3%) forRickettsia spp. Sanger sequencing of a subset of positively-tested samples revealed the presence ofTheileria mutans(92.2%, 130/141),T. velifera(16.3%, 23/141),Anaplasma centrale(10.9%, 15/137),A. marginale(30.7%, 42/137),A. platys(51.1%, 70/137),Anaplasmasp. ‘Hadesa’ (10.9%, 15/137),Ehrlichia ruminantium(0.7%, 1/137),E. canis(0.7%, 1/137),Borrelia theileri(91.3%, 42/46), Rickettsia africae(59.4%, 19/32) andR. felis(12.5%, 4/32). A high level of both intra- and inter-generic co-infections (76.0%) was observed. To the best of our knowledge,B. theileri, T. mutans,T. velifera,A. platys,Anaplasmasp. ‘Hadesa’,R. felisandE. canisare reported for the first time in cattle from Cameroon, and forR. felisit is the first discovery in the cattle host.Babesiaspp. were not detected by sequencing. The highest number of still identifiable species co-infections was up to four pathogens per genus group. Multifactorial analyses revealed a significant association of infection withBorrelia theileriand anemia. Whereas animals of older age had a higher risk of infection, the Gudali cattle had a lower risk compared to the other local breeds.

Conclusion

Co-infections of tick-borne pathogens with an overall high prevalence were found in all five study sites, and were more likely to occur than single infections. Fulani, Namchi and Kapsiki were the most infected breed in general; however, with regions as significant risk factor. A better-adapted approach for tick-borne pathogen identification in co-infected samples is a requirement for epidemiological investigations and tailored control measures.
A single triangular SS-EMVS aided high-accuracy DOA estimation using a multi-scale L-shaped sparse array
Authors: Ding Jin , Yang Minglei , Chen Baixiao , Yuan Xin
Published: September 2019

We propose a new array configuration composed of multi-scale scalar arrays and a single triangular spatially spread electromagnetic-vector-sensor (SS-EMVS) for high-accuracy two-dimensional (2D) direction-of-arrival (DOA) estimation. Two scalar arrays are placed along x-axis and y-axis, respectively, each array consists of two uniform linear arrays (ULAs), and these two ULAs have different inter-element spacings. In this manner, these two scalar arrays form a multi-scale L-shaped array. The two arms of this L-shaped scalar array are connected by a six-component SS-EMVS, which is composed of a spatially spread dipole-triad plus a spatially spread loop-triad. All the inter-element spacings in our proposed array can be larger than a half-wavelength of the incident source, thus to form a sparse array to mitigate the mutual coupling across antennas. In the proposed DOA estimation algorithm, we perform the vector-cross-product algorithm to the SS-EMVS to obtain a set of low-accuracy but unambiguous direction cosine estimation as a reference; we then impose estimation of signal parameters via rotation invariant technique (ESPRIT) algorithm to the two scalar arrays to get two sets of high-accuracy but cyclically ambiguous direction cosine estimations. Finally, the coarse estimation is used to disambiguate the fine but ambiguous estimations progressively and therefore a multiple-order disambiguation algorithm is developed. The proposed array enjoys the superiority of low redundancy and low mutual coupling. Moreover, the thresholds of the inter-sensor spacings utilized in the proposed array are also analyzed. Simulation results validate the performance of the proposed array geometry.
Chebyshev type inequalities via generalized fractional conformable integrals
Authors: Nisar Kottakkaran Sooppy , Rahman Gauhar , Mehrez Khaled
Published: September 2019

Our aim in this present paper is to establish several Chebyshev type inequalities involving generalized fractional conformable integral operator recently introduced by T.U. Khan and M.A. Khan (J. Comput. Appl. Math. 346:378–389, 2019). Also, we present Chebyshev type inequalities involving Riemann–Liouville type fractional conformable integral operators as a particular result of our main result.
Weighted dynamic inequalities of Opial-type on time scales
Authors: El-Deeb A. A. , Kh Fatma M. , Ismail Gamal A. F. , Khan Zareen A.
Published: September 2019

In this paper, we will state and prove some weighted dynamic inequalities of Opial-type involving integrals of powers of a function and of its derivative on time scales which not only extend some results in the literature but also improve some of them. The main results will be proved by using some algebraic inequalities, the Hölder inequality and a simple consequence of Keller’s chain rule on time scales. As special cases of the obtained dynamic inequalities, we will get some continuous and discrete inequalities.
Fractional-calculus-based control scheme for dynamical systems with input uncertainty
Authors: Aghababa Mohammad Pourmahmood
Published: September 2019

Since the existence of unwanted oscillations should be avoided in practical systems, this article investigates active vibration and oscillation suppression of two-degree-of-freedom dynamical systems using a novel variable structure control methodology. Owing to high stability and generality of the fractional-calculus-based differential equations, a non-integer-order sliding surface is proposed. Afterward, the occurrence of the sliding motion is ensured using a switching control rule. The effects of the input nonlinearities, which are usually existed in mechanical actuators, are fully dealt with using the introduced fractional sliding modes. In addition, unknown lumped uncertainties are considered to disturb the system dynamics. As a result, the proposed controller is robust against system and control fluctuations and can handle bounded external perturbations. Moreover, careful stability synthesis is developed to theoretically confirm the control designs. Finally, two numerical case studies, which include oscillation control of a magnetic bearing system and a gyroscope device, are provided to demonstrate the superior performance of the suggested control technology.
Role of some members of chemokine/cytokine network in the pathogenesis of thalassemia and sickle cell hemoglobinopathies: a mini review
Authors: Mousavi Zahra , Yazdani Zinat , Moradabadi Alireza , Hoseinpourkasgari Fatemeh , Hassanshahi Gholamhossein
Published: September 2019

The word of hemoglobinopathy is described for an array of disorders that affecting hemoglobin (Hb) functions. Hb is a molecule with 68 kDa molecular weight, serving as oxygen carrying metalloprotein. Hemoglobinopathy includes a wide range of Hb structural deficits varying from thalassemia to sickle cell disease. Cyto-chemokine network members are pivotally involved in the pathogenesis of hemoglobinopathies, however, the exact role of these mediators in the development of these disorders yet to be well addressed. Cytokines and chemokines are generated by inflamed endothelial cells that promote the expression of their respected receptors and further activate NF-κβ, recruit red blood cells (RBCs) and white blood cells (WBCs) toward the inflamed endothelium. Therefore, due to critical roles played by the cyto-chemokine network in several aspects of hemoglobinopathies pathophysiology including apoptosis of endothelial cells, RBC, WBC and etc.…, in the present review, we focused on the critical parts played by this network in the pathogenesis of hemoglobinopathies.
DIF as a pedagogical tool: analysis of item characteristics in ICILS to understand what students are struggling with
Authors: Bundsgaard Jeppe
Published: September 2019

International large-scale assessments like international computer and information literacy study (ICILS) (Fraillon et al. in International Association for the Evaluation of Educational Achievement (IEA), 2015) provide important empirically-based knowledge through the proficiency scales, of what characterizes tasks at different difficulty levels, and what that says about students at different ability levels. In international comparisons, one of the threats against validity is countrydifferential item functioning(DIF), also called item-by-country interaction. DIF is a measure of how much harder or easier an item is for a respondent of a given group as compared to respondents from other groups of equal ability. If students from one country find a specific item much harder or easier than students from other countries, it can impair the comparison of countries. Therefore, great efforts are directed towards analyzing for DIF and removing or changing items that show DIF. From another angle, however, this phenomenon can be seen not only as a threat to validity, but also as an insight into what distinguishes students from different countries, and possibly their education, on a content level, providing even more pedagogically useful information. Therefore, in this paper, the data from ICILS 2013 is re-analyzed to address the research question:Which kinds of tasks do Danish, Norwegian, and German students find difficult and/or easy in comparison with students of equal ability from other countries participating in ICILS 2013?The analyses show that Norwegian and Danish students find items related to computer literacy easier than their peers from other countries. On the other hand, Danish and, to a certain degree, Norwegian students find items related to information literacy more difficult. Opposed to this, German students do not find computer literacy easier, but they do seem to be comparably better at designing and laying out posters, web pages etc. This paper shows that essential results can be identified by comparing the distribution of difficulties of items in international large-scale assessments. This is a more constructive approach to the challenge of DIF, but it does not eliminate the serious threat to the validity of the comparison of countries.
Second generation from refugee backgrounds in Europe
Authors: Chimienti Milena , Bloch Alice , Ossipow Laurence , de Wenden Catherine Wihtol
Published: September 2019

This introduction to the special issue provides a critical state-of-the-art of the literature on second-generation migrants which has hitherto subsumed the case of the children of refugees. It highlights the theoretical and methodological orientations taken by the literature and examines the main findings on the second generation’s social, educational, economic, cultural and inter-generational lives, before turning to the few findings available on conditions and performances of children of refugees. The editorial concludes by suggesting gaps in our knowledge and areas for future research.
Factors associated with adherence to dietary prescription among adult patients with chronic kidney disease on hemodialysis in national referral hospitals in Kenya: a mixed-methods survey
Authors: Opiyo Rose Okoyo , Nyasulu Peter Suwirakwenda , Olenja Joyce , Zunza Moleen , Nguyen Kim A. , Bukania Zipporah , Nabakwe Esther , Mbogo Alexander , Were Anthony Omolo
Published: September 2019

Introduction

Adherence to dietary prescriptions among patients with chronic kidney disease is known to prevent deterioration of kidney functions and slow down the risk for morbidity and mortality. This study determined factors associated with adherence to dietary prescription among adult patients with chronic kidney disease on hemodialysis.

Methods

A mixed-methods study, using parallel mixed design, was conducted at the renal clinics and dialysis units at the national teaching and referral hospitals in Kenya from September 2018 to January 2019. The study followed a QUAN + qual paradigm, with quantitative survey as the primary method. Adult patients with chronic kidney disease on hemodialysis without kidney transplant were purposively sampled for the quantitative survey. A sub-sample of adult patients and their caregivers were purposively sampled for the qualitative survey. Numeric data were collected using a structured, self-reported questionnaire using Open Data Kit “Collect software” while qualitative data were collected using in-depth interview guides and voice recording. Analysis on STATA software for quantitative and NVIV0 12 for qualitative data was conducted. The dependent variable, “adherence to diet prescription” was analyzed as a binary variable. P values < 0.1 and < 0.05 were considered as statistically significant in univariate and multivariate logistic regression models respectively. Qualitative data were thematically analyzed.

Results

Only 36.3% of the study population adhered to their dietary prescriptions. Factors that were independently associated with adherence to diet prescriptions were “flexibility in the diets” (AOR 2.65, 95% CI 1.11–6.30, P 0.028), “difficulties in following diet recommendations” (AOR 0.24, 95% CI 0.13–0.46, P < 001), and “adherence to limiting fluid intake” (AOR 9.74, 95% CI 4.90–19.38, P < 0.001).

Conclusions

For patients with chronic kidney disease on hemodialysis, diet prescriptions with less restrictions and requiring minimal extra efforts and resources are more likely to be adhered to than the restrictive ones. Patients who adhere to their fluid intake restrictions easily follow their diet prescriptions. Prescribed diets should be based on the individual patient’s usual dietary habits and assessed levels of challenges in using such diets. Additionally, diet adherence messages should be integrated with fluid limitation messages. Further research on understanding patients’ adherence to fluid restriction is also suggested.
Qualitative analysis of Sudan IV in edible palm oil
Authors: Andoh Sampson Saj , Nuutinen Tarmo , Mingle Cheetham , Roussey Matthieu
Published: September 2019

Background

Palm oil is one of the most useful vegetable available. Sudan IV dye is used as hue enhancer in palm oil despite the ban as food colorant due to its carcinogenicity and mutagenicity by the International Agency for Research on Cancer (IARC).

Methods

Surface enhanced Raman spectroscopy (SERS) coupled with chemometric methods was applied to detect the presence of Sudan IV in some edible palm oil samples.

Results

We studied the samples within the 1200–1800 cm− 1 Raman frequency range. In predicting adulteration, we used 1388 cm− 1 Raman peak that is associated with Sudan IV as our marker. We were able to confirm adulteration in four of the five palm oil samples provided by the Food and Drug Authority of Ghana.

Conclusions

With these methods, we confirmed the results from Food and Drug Authorities of Ghana by proving that there were indeed Sudan IV adulteration in some palm oil samples.
The persistent effect of acute psychosocial stress on heart rate variability
Authors: Mohammadi Alireza , Emamgoli Asgar , Shirinkalam Marjan , Meftahi Golam Hossein , Yagoobi Keyvan , Hatef Boshra
Published: September 2019

Background

As stress occurs repetitively every day, the biological modifiers should also have enough time to restore the normal state of hemostasis; otherwise, chronic stress would be anticipated. The aim of the present study was to examine the persistence of stress based on subjective emotion, salivary cortisol, and linear and non-linear features of heart rate variability (HRV) in both genders.

Methods

Thirty-three healthy young volunteers (23 men and 10 women) participating in this study were exposed to the Trier Social Stress Test (TSST). Moreover, the emotional visual analog scale (EVAS), salivary cortisol, and ECG recording in the rest state were taken before and after TSST as well as 20 min after recovery.

Results

According to the results of the two-way mixed model ANOVA, all volunteers showed a significant increase in EVAS after TSST which was restored to the baseline state after recovery. Notably, the women’s base of cortisol was significantly higher than men and the standard range of kit. Cortisol elevation was only observed in the men, and the significant increase of LF/HF ratio was observed in the women, while both did not retain to the baseline after recovery. The SD1 of Poincaré plot and spectral entropy decreased after stress in both genders. Moreover, there was a significant negative correlation between baseline level of cortisol and its elevation due to stress and some features of HRV.

Conclusion

The base of cortisol played a critical role in modifying the physiological response to stress. In addition, after recovery, no stressful emotion remained, while the non-linear features of HRV did not return to baseline.
Radial artery perforation: when a friend turns against you
Authors: Elwany Mostafa , Latini Roberto Adriano , Di Palma Gaetano , Cortese Bernardo
Published: September 2019

Background

Radial artery approach is currently the most common access site for coronary angiography and percutaneous coronary intervention. It rarely results in complications, improves patient comfort, and reduces the duration of hospitalization.

Case presentation

A 91-year-old woman presented to our institution with ST-segment elevation myocardial infarction (STEMI). The right radial access was chosen for the performance of percutaneous coronary intervention. After the introduction of 6 F sheath, there was difficulty in the advancement of 0.035 J wire that was exchanged with a Terumo hydrophilic wire. After the procedure and before sheath removal, radial arteriography was done and revealed perforation. Protamine sulfate was administered and prolonged balloon inflation was attempted but failed to seal the perforation, so a 7-F-long vascular sheath was inserted to internally tamponade the vessel, and the patient was sent to the coronary care unit for monitoring. Over the next 3 days, serial radial angiographies were done revealing the persistence of the perforation, and on the fourth day, angiography revealed multiple thrombi. Thrombus aspiration was done using Pronto V4 extraction catheter (Vascular Solutions, USA) and was followed by the deployment of a covered stent. The stent was dislodged and successfully snared. Finally, the perforation was sealed spontaneously and there were no signs of intra-arterial thrombi.

Conclusion

Despite the very low complication rate of radial approach, the interventional cardiologist should be aware of any possible complication, and how to avoid or, eventually, manage it.
Reforming fitness to plead and stand trial legislation in England and Wales
Authors: Galappathie Nuwan , Shaw Angela
Published: September 2019

The legal decision on whether a defendant can fairly take part in a criminal trial in England and Wales is currently based on the leading case of R v Pritchard (1836), which despite subsequent case law updates does not embrace the concept of mental capacity or effectively identify defendants who are unable to meaningfully participate. Further to an extensive consultation process, the Law Commission published recommendations for reform in 2016, with a proposed new test of capacity to participate effectively in a trial and detailed suggestions for statutory reform of court procedures for managing defendants found unable to participate. Here we review the proposals and consider practical implications and suggestions regarding their implementation.

LEARNING OBJECTIVES

After reading this article you will be able to:

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appreciate the current problems with the law on fitness to plead in England and Wales

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understand the proposed test of capacity to participate effectively in a trial

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understand the proposed changes to the procedures available when a defendant is found unable to participate.