bluuebunny/crossref_metadata_2025 huggingface dataset:
Recent Developments in Nanomedicine for Pediatric Cancer
Authors: Yang Shicheng , Wallach Mia , Krishna Apurva , Kurmasheva Raushan , Sridhar Srinivas
Published: January 2021

Cancer is the second biggest cause of death in children. With the development of chemotherapy, there is a substantial increase in overall survival rate over recent 30 years. However, the overall mortality rate in children with cancer still remains 25%, and many survivors experience a decline in overall quality of life and long-term adverse effects caused by treatments. Although cancer cells share common characteristics, pediatric cancers are different from adult cancers in their prevalence, mutation load, and drug response. Therefore, there is an urgent unmet need to develop therapeutic approaches specifically designed for children with cancer. Nanotechnology can potentially overcome the deficiencies of conventional methods of administering chemotherapy and ultimately improve clinical outcomes. The nanoparticle-based drug delivery systems can decrease the toxicity of therapy, provide a sustained or controlled drug release, improve pharmacokinetic properties of loading contents, and achieve a targeted drug delivery with achievable modifications. Further, therapeutic approaches based on combining nanoformulated drugs with novel immunotherapeutic agents are emerging. In this review, we discuss the recently developed nanotechnology-based strategies for treating blood and solid pediatric cancers.
Preschool Children's Social Information Processing Mediates the Link Between the Quality of the Parent-Child Relationship and the Child's Learning Difficulties
Authors: Arbel Reout , Sofri Inbar , Elizarov Einat , Ziv Yair
Published: January 2021

Background: This study aims to explore children’s social information processing (SIP) as an ex-planatory mechanism in the link between parent-child relationship and children’s learning diffi-culties; (2) Methods: The sample included 115 kindergarteners (62 girls; 53 boys; Mage = 68.5 months, SD = 6.04), their parents and the school teacher. Parents reported on relationship quality with the child and teachers reported on children’s learning difficulties and school achievements. Children’s SIP was assessed with the social information processing interview – preschool version (3) Results: Mother and father relationship quality with the child associated with children’s SIP, however, only the father's but not the mother's quality of relationship with the child was associ-ated with children’s learning difficulties and school achievements. Children’s SIP mediated this latter link; (4) Conclusions: Parents’ relationship quality with the child and children’s SIP are pertinent factors in children’s learning in the early years. The father-child relationship seem to be a strong determinant of children approach to learning and achievement and may have long last-ing effect on children's mental health
Detection of Rare Germline Variants in the Genomes of B Cell Neoplasms
Authors: Mosquera Orgueira Adrian , Cid Lopez Miguel , Peleteiro Raindo Andres , Diaz Arias Jose Angel , Antelo Rodriguez Beatriz , Bao Perez Laura , Alonso Vence Natalia , Bendaña Lopez Angeles , Abuin Blanco Aitor , Melero Valentin Paula , Ferreiro Ferro Roi , Aliste Santos Carlos , Fraga Martinez Maximo Francisco , Gonzalez Perez Marta Sonia , Perez Encinas Manuel Mateo , Bello Lopez Jose Luis
Published: January 2021

Growing evidence has revealed the implication of germline variation in cancer predisposition and prognostication. Here, we describe an analysis of putatively disruptive rare variants across the genomes of 726 patients with B-cell lymphoid neoplasms. We discovered a significant enrichment of 26 genes in germline protein truncating variants (PTVs), affecting cell signaling (MET, JAK2, ANGPT2), energy metabolism (ACO1) and nucleic acid metabolism and repair pathways (NT5E, DCK). Interestingly, some of these variants were restricted to either chronic lymphocytic leukemia (CLL) (i.e., ANGPT2 and AKR1C3) or B-cell lymphoma cases (PNMT, TPT1 and IGHMBP2). Additionally, we detected 1,675 likely disrupting variants in genes associated with cancer, of which 44.75% were novel events and 7.88% were PTVs. Among these, the most frequently affected genes were ATM, BIRC6, CLTCL1A and TSC2. Homozygous or compound heterozygous variants were detected in 28 cases; and coexisting somatic events were observed in 17 patients, some of which affected key lymphoma drivers such as ATM, KMT2D and MYC. Finally, we observed that variants in the helicase gene WRN were independently associated with shorter survival in CLL. Our study results support an important role for rare germline variation in the pathogenesis, clinical presentation and disease outcome of B-cell lymphoid neoplasms.
Reality Capture of Buildings Using 3D Laser Scanners
Authors: Almukhtar Avar , Abanda Henry , Saeed Zaid O. , Tah Joseph H.M.
Published: January 2021

The urgent need to improve performance in the construction industry has led to the adoption of many innovative technologies. 3D laser scanners are amongst the leading technologies being used to capture and process assets or construction project data for use in various applications. Due to its nascent nature, many questions are still unanswered about 3D laser scanning, which in turn contribute to the slow adaptation of the technology. Some of these include the role of 3D laser scanners in capturing and processing raw construction project data. How accurate is the 3D laser scanner or point cloud data? How does laser scanning fit with other wider emerging technologies such as Building Information Modelling (BIM)? This study adopts a proof-of-concept approach, which in addition to answering the afore-mentioned questions, illustrates the application of the technology in practice. The study finds that the quality of the data, commonly referred to as point cloud data is still a major issue as it depends on the distance between the target object and 3D laser scanner’s station. Additionally, the quality of the data is still very dependent on data file sizes and the computational power of the processing machine. Lastly, the connection between laser scanning and BIM approaches is still weak as what can be done with a point cloud data model in a BIM environment is still very limited. The aforementioned findings reinforce existing views on the use of 3D laser scanners in capturing and processing construction project data.
On the Discretization of Continuous Probability Distributions for Flexible Count Regression
Authors: Tovissodé Chénangnon Frédéric , Glèlè Kakaï Romain , Honfo Sèwanou Hermann , Doumatè Jonas Têlé
Published: January 2021

Most existing flexible count regression models allow only approximate inference. This work proposes a new framework to provide an exact and flexible alternative for modeling and simulating count data with various types of dispersion (equi-, under- and overdispersion). The new method, referred as “balanced discretization”, consists in discretizing continuous probability distributions while preserving expectations. It is easy to generate pseudo random variates from the resulting balanced discrete distribution since it has a simple stochastic representation in terms of the continuous distribution. For illustrative purposes, we have developed the family of balanced discrete gamma distributions which can model equi-, under- and overdispersed count data. This family of count distributions is appropriate for building flexible count regressionmodels because the expectation of the distribution has a simple expression in terms of the parameters of the distribution. Using the Jensen–Shannon divergence measure, we have shown that under equidispersion restriction, the family of balanced discrete gamma distributions is similar to the Poisson distribution. Based on this, we conjecture that while covering all types of dispersion, a count regression model based on the balanced discrete gamma distribution will allow recovering a near Poisson distribution model fit when the data is Poisson distributed.
Synthesis and Deposition of Thermochromic VO2 Thin Films from Peroxide-based Chemical Solutions
Authors: Van Zele Matthias , Rijckaert Hannes , Deduytsche Davy , Detavernier Christophe , Van Driessche Isabel , Poelman Dirk , De Buysser Klaartje
Published: January 2021

In this paper, a novel synthesis for a chemical precursor for nanocrystalline VO2 coatings is elaborated. The compatibility of the precursor towards the substrate is optimized for spin coating. This is done by subjecting multiple solvents to contact angle measurements. A suitable thermal treatment is developed to densify the coating and to induce crystallization. Afterwards the microstructure of the coating is investigated using X-Ray diffraction, electron microscopy and ellipsometry techniques. To assess the thermochromic properties of the fabricated device, optical transmission experiments were conducted both at room temperature and at elevated temperature. A correlation between these thermochromic properties and coating thickness was investigated in order to obtain an optimized thermochromic device, where both high visual transparency and prominent thermochromic switching abilities are aimed for. In this work, an optimal coating thickness is proposed for a thermochromic coating with high switching ability and solar modulation.
Creatine Supplementation in Children and Adolescents
Authors: Jagim Andrew R. , Kerksick Chad M.
Published: January 2021

Creatine is a popular ergogenic aid among athletic populations with consistent evidence indicating that creatine supplementation also continues to be commonly used among adolescent populations. In addition, the evidence base supporting the therapeutic benefits of creatine supplementation for a plethora of clinical applications in both adults and children continues to grow. Among pediatric populations, a strong rationale exists for creatine to afford therapeutic benefits pertaining to multiple neuromuscular and metabolic disorders, with preliminary evidence for other subsets of clinical populations as well. Despite the strong evidence supporting the efficacy and safety of creatine supplementation among adult populations, less is known as to whether similar physiological benefits extend to children and adolescent populations, and in particular those adolescent populations who are regularly participating in high-intensity exercise training. While limited in scope, studies involving creatine supplementation and exercise performance in adolescent athletes generally report improvements in a number of ergogenic outcomes with limited evidence of ergolytic properties and consistent reports indicating no adverse events associated with supplementation. The purpose of this article is to summarize the rationale, prevalence of use, performance benefits, clinical applications, and safety of creatine use in children and adolescents.
Functional Connectivity in Multi-Habitat Marine Species
Authors: Porter Elizabeth , Ponchon Aurore , Allgayer Rebekka , Finnegan Samantha , Travis Justin , Layton Kara
Published: January 2021

Many marine species use different habitats at different stages of their life cycle. Functional connectivity, the degree to which the seascape facilitates or impedes movement between habitat patches, is poorly studied in marine systems. We reviewed the scientific literature to explore the various barriers preventing functional connectivity between marine habitats and how the removal of these barriers may restore connectivity. To our knowledge, this is the first systematic review to investigate functional connectivity between life cycle habitats for a range of marine species. A total of 4,499 records were identified and screened, leaving 69 publications eligible for review. The results highlighted a range of distances between nursery and adult habitats that limited functional connectivity for a number of species, predominantly reef fishes. For some species, adults were absent on reefs >9km from the closest nursery habitat, suggesting a threshold for connectivity. Similarly, increased distance between spawning and settlement habitats decreased settling success of larvae of various taxa. Pelagic larval duration, seascape topography and climate change were also shown to impact functional connectivity during the larval phase. The removal and mitigation of barriers preventing functional connectivity, including dams and habitat fragmentation, restored connectivity between disconnected life cycle habitats, but the efficacy of these approaches differed between species and studies. The results of this review deepen our understanding of marine functional connectivity between life cycle habitats via larval, juvenile, and adult dispersal. These findings have implications for the design and management of marine reserve networks.
Bismuth Vanadium Oxide can Promote the Growth and Activity of Roots in Arabidopsis thaliana
Authors: Gao Cong , Lu Shuai , Wang Yongzhou , Xu Hao , Gao Xiaoxiao , Gu Yiwen , Xuan Hongyun , Wang Baohua , Yuan Huihua , Cao Yunying
Published: January 2021

The excellent properties of nanomaterials have been confirmed in many fields, but the effects on plants are still unclear. In this study, we have found that bismuth vanadium promoted the growth of taproots and the development of lateral roots, increased the roots activity by regulating the expression of polyamine or hormone-related genes and reducing the accumulation of reactive oxygen species in Arabisdopsis thaliana. Meantime, BV had higher antimicrobial effect than that of graphene oxide (GO). These results showed us a new perspective possibility of nanomaterials assisting the development of plants and crops, which is expected to become one of the ways to solve the problem of controlling and promoting the development of plants and crops.
DANAE++: A Smart Approach for Denoising Underwater Attitude Estimation
Authors: Russo Paolo , Di Ciaccio Fabiana , Troisi Salvatore
Published: January 2021

One of the main issues for underwater robots navigation is represented by the accurate vehicle positioning, which heavily depends on the orientation estimation phase. The systems employed to this scope are affected by different noise typologies, mainly related to the sensors and to the irregular noise of the underwater environment. Filtering algorithms can reduce their effect if opportunely configured, but this process usually requires fine techniques and time. This paper presents DANAE++, an improved denoising autoencoder based on DANAE, which is able to recover Kalman Filter IMU/AHRS orientation estimations from any kind of noise, independently of its nature. This deep learning-based architecture already proved to be robust and reliable, but in its enhanced implementation significant improvements are obtained both in terms of results and performance. In fact, DANAE++is able to denoise the three angles describing the attitude at the same time, and that is verified also on the estimations provided by the more performing Extended KF. Further tests could make this method suitable for real-time applications on navigation tasks.
Color Modulates the Timing of Conscious Perception via Bottom-Up and Top-Down Attention
Authors: Valuch Christian
Published: January 2021

Color can direct visual attention to specific locations through bottom-up and top-down mechanisms. Using Continuous Flash Suppression (CFS) as way to investigate the factors that gate access to consciousness, the current study investigated whether color also directly affected the timing of conscious perception. Low or high spatial frequency (SF) gratings with different orientations were shown as targets to the non-dominant eye of human participants. CFS patterns were presented at a rate of 10Hz to the dominant eye to delay conscious perception of the targets, and participants had the task to report the target’s orientation as soon as they could see it. With low-SF targets, two types of color-based effects became evident. First, when the targets and the CFS patterns had different colors, the targets entered consciousness faster than in trials where the targets and CFS patterns had the same color. Second, when participants searched for a specific target color, targets that matched these search settings entered consciousness faster compared to conditions where the target color was irrelevant and could vary from trial to trial. Thus, the current study demonstrates that color is a central feature of human perception and leads to faster conscious perception of visual stimuli through bottom-up and top-down attentional mechanisms.
Thermodynamic Impact of Mineral Surfaces on Amino Acid Polymerization: Aspartate Dimerization on Ferrihydrite, Anatase and γ-alumina
Authors: Kitadai Norio , Nishiuchi Kumiko
Published: January 2021

The ubiquity of amino acids in carbonaceous meteorites has suggested that amino acids are widespread in the Universe, serving as a common class of components for the emergence of life. However, parameters for modeling amino acid polymerization at mineral–water interfaces remain limited, although the interfacial conditions inevitably exist on planets with surface liquid water. Here, we present a set of extended triple-layer model parameters for aspartate (Asp) and aspartyl-aspartate (AspAsp) adsorptions on ferrihydrite, anatase, and γ-alumina determined based on the experimental adsorption data. By combining the parameters with the reported thermodynamic constants for amino acid polymerization in water, the impacts of these minerals on Asp dimerization are calculable over a wide range of environmental conditions. It was predicted, for example, that ferrihydrite strongly increases the AspAsp/Asp equilibrium ratio in neutral to acidic pH; the ratio in the adsorbed state reaches 40% even from a low Asp concentration (0.1 mM) at pH 4. This percentage is approximately 5 × 107 times higher than that attainable without mineral (8.5 × 10–6%). Our exemplified approach enables us to screen wide environmental settings for abiotic peptide synthesis from a thermodynamic perspective, thereby narrowing down the geochemical situations to be explored for life’s origin on Earth and Earth-like habitable planets.
The Seneb´S EnigmA: Impact of a Hybrid Personal and Social Re-Sponsibility and Gamification Model-Based Practice on Motivation and Healthy Habits in Physical Education
Authors: Melero-Canas David , Manzano-Sánchez David , Navarro-Ardoy Daniel , Morales-Baños Vicente , Valero-Valenzuela Alfonso
Published: January 2021

Abstract: Increasing physical activity (PA) and personal and social values are two of the greatest demands in the current educational system. This study examined the effect of a hybrid pro-gramme based on the Personal and Social Responsibility Model and Gamification. A total of 58 students (13.89 years old, SD = 1.14) in two groups (Experimental and Control) participated dur-ing a complete academic year. Motivation, physical activity and sedentary behaviour were as-sessed though questionnaires. Physical fitness was evaluated using previously validated field tests. The results showed significant differences over time between EG and CG in afterschool physical activity (APA) at the weekend (p = 0.003), sedentary time (p = 0.04) and speed-agility (p = 0.04). There were no significant differences in motivation. Regarding the intervention, speed-agility (p = 0.000), strength (p = 0.000), agility (p = 0.000), cardiorespiratory fitness (p = 0.001), APA-weekend (p = 0.000), APA-week (p= 0.000) and sedentary time (p = 0.000) increased signifi-cantly in the EG. Speed-agility (p = 0.000), APA-weekend (p = 0.03) and sedentary time (p = 0.008) increased in the CG. The use of this hybrid program can be useful to produced improvements in physical fitness, physical activity and sedentary hevaviours. The use of a hybrid program based on teaching personal and social responsibility and gamification strategies, produced improvements in physical fitness, physical activity and sedentary behavior, but not in motivation variables. Further research is demanded in order to contrast this relevant findings due to the potential drawbacks and diversity found in the scientific literature among model-based practice.
Anomaly Detection of Wind Turbine Gearbox based on SCADA
Temperature Data using Machine Learning
Authors: Rashid Haroon , Batunlu Canras
Published: January 2021

Wind energy is becoming an essential source of power for countries which have the aim to reduce greenhouse gases emission and mitigate the effects of global warming. The Wind Turbines (WTs) installed around the globe is increasing significantly every year. The dramatic increase in wind power has encountered quite a few challenges, among which the major issues are availability and reliability. The unexpected failure in WTs Gearbox (GB) ultimately increases the Operation and Maintenance (O&M) cost. The identification of faults in the earlier stages before it turns to catastrophic damage to other components of WT is crucial. This research deals with the prediction of WT failures by using a Supervisory Control and Data Acquisition (SCADA) system. The main aim is to forecast the temperature of the WTs GB to predict the impending overheating of the GB at an early stage. The earlier prediction will help to optimize the maintenance period and to save maintenance expenses and, even more important, generate warnings in due time to avoid major damages or even technical disasters. In the proposed method we compared six different machine learning (ML) models based on error and accuracy of prediction. The bagging regressor is the best ML model, which results in the mean square error of 0.33 and R of 99.8 on training data. The bagging regressor is then used to predict the fault in the WT GB, which detected the anomalous behavior of WT GB 59 days earlier than the actual failure. This model also detects the extremely unusual behavior of the GB 9 days earlier than a complete failure.
Using GRACE/GRACE-FO, Data-Driven, and Modeling to Assess the Twentieth and Twenty-first Century Water Storage Changes in the Nile River Basin
Authors: Hasan Emad , Tarhule Aondover , Kirstetter Pierre-Emmanuel
Published: January 2021

This research assesses the changes in the total water storage (TWS) during the twentieth century and their future projections in the Nile River Basin (NRB) via TWSA (TWS anomalies) records from GRACE (Gravity Recovery and Climate Experiment), GRACE-FO (Follow-On), data-driven-reanalysis TWSA and land surface model (LSM), in association with precipitation, temperature records, and standard drought indicators. The analytical approach incorporates the development of 100+ yearlong TWSA records using a probabilistic conditional distribution fitting approach by the GAMLSS (Generalized Additive Model for Location, Scale, and Shape) model. The drought and flooding severity, duration, magnitude, frequencies, and recurrence were assessed during the studied period. The results showed, 1- The NRB between 2002 to 2020 has transited to substantial wetter conditions. 2- The TWSA reanalysis records between 1901 to 2002 revealed that the NRB had experienced a positive increase in TWS during the wet and dry seasons. 3- The projected TWSA between 2021 to 2050 indicated slight positive changes in TWSA during the rainy seasons. The analysis of drought and flooding frequencies between 1901 to 2050 indicated the NRB has ~64 dry-years compared to ~86 wet-years. The 100+ yearlong TWSA records assured that the NRB transited to wetter conditions relative to few dry spells. These TWSA trajectories call for further water resources planning in the region especially during flood seasons. This research contributes to the ongoing efforts to improve the TWSA assessment and its associated dynamics for transboundary river basins. It also demonstrates how an extended TWSA record provides unique insights for water resources management in the NRB and similar regions.
Bile acid diarrhoea: from diagnosis to treatment
Authors:   Saint Petersburg State Paediatric Medical University, Saint Petersburg, Russian Federation, Novikova V.P. , Belousova L.N. ,   I.I.Mechnikov North-Western State Medical University, Saint Petersburg, Russian Federation
Published: January 2021

Bile acid diarrhoea is a common cause of chronic diarrhoea associated with disturbance of the enterohepatic circulation: either excessive biosynthesis/secretion of bile acids or disordered absorption of bile acids in the ileum. At the same time bile acid diarrhoea is an insufficiently studied, frequently underestimated condition, and the questions remain concerning its diagnosis and management. The work discusses the main groups of causes of this pathology, modern diagnostic methods and the difficulties of a differential search. Also, the article offers information about the diet therapy of bile duct diarrhoea and the main groups of administered medications, in particular, modern enterosorbents.
Optimistion of the amino acid composition of combined products for school nutrition
Authors:   K.G.Razumovsky Moscow State University of Technologies and Management, Moscow, Russian Federation, Vasyukova A.T. , Tikhonov D.A. ,   K.G.Razumovsky Moscow State University of Technologies and Management, Moscow, Russian Federation, Moshkin A.V. ,   K.G.Razumovsky Moscow State University of Technologies and Management, Moscow, Russian Federation, Bogonosova I.A. ,   K.G.Razumovsky Moscow State University of Technologies and Management, Moscow, Russian Federation, Portnov N.М. ,   K.G.Razumovsky Moscow State University of Technologies and Management, Moscow, Russian Federation, Kulakov V.G. ,   K.G.Razumovsky Moscow State University of Technologies and Management, Moscow, Russian Federation
Published: January 2021

The article presents a comparative characteristic of the amino acid composition of the «ideal» protein and the developed formulation of combined products. The results of calculation of the amino acid score (AAS) of the essential amino acids in the novel protein product are given. AAS is within the range from 105 to 143%. The developed formulation of a combined product has an insignificantly limited amount of valine (98%). Based on AAS, the difference coefficients of the examined amino acids were calculated (from –0.2 to 4.36%) and the biological value of each of the components of the formulation was determined. The nonessential amino acid composition of the «ideal» protein, raw materials of vegetable and animal origin and products produced according to the developed formulation are considered. The formulation of the novel combined product has been characterised as a full and balanced amino acid composition, suitable for nutrition, containing all the amino acids necessary for protein synthesis. The maximum AAS has been noted in steamed meatballs with beef, mutton and cabbage, which by 7.61% exceeds the AAS of steamed meatballs with beef and mutton and by 9.38% – the AAS of steamed meatballs with beef. The examined product has a high biological value – from 95 to 99%. The developed mathematical model is applicable to specification of the formulation under more specific conditions, for instance, for a particular age category. The novelty of the model consists in its priority with respect to the organoleptic properties and consumer preferences of the developed formulation. Key words: combined products, simplex method, amino acid score, formulation composition, protein
Significant Surge and Swab Offshore Brazil Induced by Rig Heave during Drillpipe Connections
Authors: Godhavn John-Morten , Olorunju Banzi , Gorski Dmitri , Kvernland Martin , Sant`Ana Mateus , Aamo Ole Morten , Sangesland Sigbjørn
Published: January 2021

In this paper, we describe measured and simulated downhole pressure variations (“surge and swab”) during drillpipe connections when drilling an ultradeepwater well offshore Brazil on Bacalhau (former Carcará) Field. Floating rig motion caused by waves and swell (“rig heave”) induces surge and swab when the drillstring is suspended in slips to make up or break a drillpipe connection and topside heave compensation is temporarily deactivated. This is a known issue in regions with harsh weather, such as the North Sea, where pressure oscillations of up to 20 bar have been reported during connections. Recorded downhole drilling data from Bacalhau Field reveals significant pressure oscillations downhole (in the same order of magnitude as in the North Sea) each time the drillstring was suspended in slips to make a connection in the subsalt 8½-in. section of the well. Mud losses were experienced around the same well depth, and they might have been caused by surge and swab.

Measured surge and swab pressure variations have been reproduced in an advanced proprietary surge and swab simulator that considers rig heave, drillpipe elasticity, well friction, non-Newtonian drilling mud, well trajectory, and geometry. Moreover, findings in this paper suggest that surge and swab was in fact significantly higher than recorded by the measurement while drilling (MWD) tool. The true magnitude of surge and swab is not captured in the recorded MWD data due to low sampling frequency of the downhole pressure recording (one measurement every 6 seconds, a standard downhole pressure sampling rate used on many operations today).

This work shows that surge and swab during drillpipe connections on floaters may challenge the available pressure window for some wells, even in regions with calm weather such as Brazil. Managed pressure drilling (MPD) is a technique that improves control of the downhole pressure. It is, however, not possible to compensate fast downhole pressure transients, such as heave-induced surge and swab, using MPD choke topside. This is due to the long distance between the choke and the bit, which translates into a time delay in the same order of magnitude as typical wave and heave periods. A downhole choke combined with continuous circulation is one of the potential solutions.

Surge and swab during drillpipe connections can result in a loss or an influx and should be considered in the well planning phase when mud weight, section lengths, etc. are selected.
Prevalence and Determinants of Chronic Kidney Disease in Women With Hypertensive Disorders in Pregnancy in Nigeria: A Cohort Study
Authors: Ishaku Salisu , Olanrewaju Timothy , Browne Joyce , Klipstein-Grobusch Kerstin , Gbenga Kayode , Franx Arie , Grobbee Diederick , Warren Charlotte
Published: January 2021

BackgroundWorldwide, hypertensive disorders in pregnancy (HDPs) complicate between 5–10% of pregnancies. Sub-Saharan Africa is disproportionately affected by a high burden of HDPs and chronic kidney disease (CKD). Despite mounting evidence associating HDPs with the development of CKD, data from SSA are scarce.MethodsWomen with HDPs (n=410) and normotensive women (n=78) were recruited at delivery and prospectively followed-up for one year. Serum creatinine was measured and the estimated glomerular filtration rates(eGFR) using CKD-Epidemiology equation determined. CKD was defined as decreased eGFR<60mL/min/1.73m2 lasting for ≥ three months. Prevalence of CKD at six months and one year after delivery was estimated. Logistic regression analyses were conducted to evaluate predictors of CKD at six months and one year postpartum. ResultsWithin 24 hours of delivery, nine weeks and six months postpartum, women with HDPs were more likely to have a decreased eGFR compared to normotensive women (12%, 5.7%, 4.3% versus 0%, 2% and 2.4%, respectively). The prevalence of CKD in HDPs at six months and one year postpartum was 6.1% and 7.6%, respectively, as opposed to zero prevalence in the normotensive women for the corresponding periods. Proportions of decreased eGFR varied with HDP sub-types and intervening postpartum time since delivery, with pre-eclampsia/eclampsia showing higher prevalence than chronic and gestational hypertension. Only maternal age independently predicted occurrence of decreased eGFR at six months postpartum (aOR= 1.18/year; 95%CI 1.04-1.34).ConclusionPrior HDP was associated with risk of future CKD, with prior HDPs being more likely to experience evidence of CKD over periods of postpartum follow-up. Routine screening of women following HDP-complicated pregnancies should be part of a postpartum monitoring program to identify women at higher risk. Future research should report on both the eGFR and total urinary albumin excretion to enable detection of women at risk of future deterioration of renal function.
Towards Implementing Exercise into the Prostate Cancer Care Pathway: Development of a Theory and Evidence-Based Intervention to Train Community-Based Exercise Professionals to Support Change in Patient Exercise Behaviour
Authors: Reale Sophie , Turner Rebecca , Sutton Eileen , Taylor Stephanie , Bourke Liam , Morrissey Dylan , Brown Janet , Rosario Derek , Steed Liz , NA on behalf of the STAMINA co-investigators
Published: January 2021

Background: The National Institute for Health and Care Excellence (NICE) recommend that men on androgen deprivation therapy (ADT) for prostate cancer should receive supervised exercise to manage the side-effects of treatment. However, these recommendations are rarely implemented in practice. Community-based exercise professionals (CBEPs) represent an important target group to deliver the recommendations nationally, yet their standard training does not address the core competencies required to work with clinical populations, highlighting a need for further professional training. This paper describes the development of a training package to support CBEPs to deliver NICE recommendations. Methods: Development of the intervention was guided by the Medical Research Council guidance for complex interventions and the Behaviour Change Wheel. In step one, target behaviours, together with their barriers and facilitators were identified from a literature review and focus groups with CBEPs (n = 22) and men on androgen deprivation therapy (n = 26). Focus group outputs were mapped onto the Theoretical Domains Framework (TDF) to identify theoretical constructs for change. In step two, behaviour change techniques and their mode of delivery were selected based on psychological theories and evidence to inform intervention content. In step three, the intervention was refined following delivery and subsequent feedback from intervention recipients and stakeholders.Results: Six modifiable CPEPs target behaviours were identified to support the delivery of the NICE recommendations. Nine domains of the TDF were identified as key determinants of change, including: improving knowledge and skills and changing beliefs about consequences. To target the domains, we included 20 BCTs across 8 training modules and took a blended learning approach to accommodate different learning styles and preferences. Following test delivery to 11 CBEPs and feedback from 28 stakeholders, the training package was refined. Conclusion: Established intervention development approaches provided a structured and transparent guide to intervention development. A training package for CBEPs was developed and should increase trust amongst patients and health care professionals when implementing exercise into prostate cancer care. Furthermore, if proven effective, the development and approach taken may provide a blueprint for replication in other clinical populations where exercise has proven efficacy but is insufficiently implemented.
Assessing the Functionality of an Emergency Obstetric Referral System Among Public Healthcare Facilities in A Low Resource Setting: An Application of Process Mapping Approach
Authors: Ofosu Bernice , Ofori Dan , Ntumy Michael , Asah-Opoku Kwaku , Boafor Theodore
Published: January 2021

Background: Weak referral systems remain a major concern influencing timely access to the appropriate level of care during obstetric emergencies, particularly for Low-and Middle-Income Countries, including Ghana. It is a serious factor threatening the achievement of the maternal health Sustainable Development Goal. The objective of this study is to establish process details of emergency obstetric referral systems across different levels of public healthcare facilities to deepen understanding of systemic barriers and preliminary solutions in an urban district, using Ablekuma in Accra, Ghana as a case study.Methods: The study is an analytical cross-sectional study. Nine (9) in-depth interviews (IDI) were carried out for a three-weeks period in June and July 2019 after informed consent with two (2) Obstetrics & Gynaecology consultants, two (2) Residents, one family physician, and four (4) Midwives managing emergency obstetric referral across different levels of facilities. Purposeful sampling technique was used to collect data that included a narration of the referral process, and challenges experienced with each step. Qualitative data was transcribed, coded by topics and thematically analysed. Transcribed narratives were used to draft a process map and analyze the defects within the emergency obstetric referral system.Results: Out of the 33 main activities in the referral process within the facilities, the study identified that 24 (73%) had a range of barriers in relation to communication, transport system, resources (space, equipment and physical structures), staffing (numbers and attitude), Healthcare providers (HCP) knowledge and compliance to referral policy and guideline, and financing for referral. These findings have implication on delay in accessing care. HCP suggested that strengthening communication and coordination, reviewing referral policy, training of all stakeholders and provision of essential resources would be beneficial. Conclusion: Our findings clearly establish that the emergency obstetric referral system between a typical teaching hospital in an urban district of Accra-Ghana and periphery referral facilities, is functioning far below optimum levels. This suggests that the formulation and implementation of policies should be focused around structural and process improvement interventions, strengthening collaborations, communication and transport along the referral pathway is likely to ensure that women receive timely and quality care.
Psychometric Evaluation of the German Version of the Opening Minds Stigma Scale for Health Care Providers (OMS-HC)
Authors: Zuaboni Gianfranco , Elmer Timon , Rabenschlag Franziska , Heumann Kolja , Jaeger Susanne , Kozel Bernd , Mahlke Candelaria , Schori Dominik , Theodoridou Anastasia , Jaeger Matthias , Rüsch Nicolas
Published: January 2021

Background: Healthcare professionals can be a source of stigma and discrimination for people with mental illness, and anti-stigma programs are needed for this target group. However, there is no validated German language scale to assess attitudes of healthcare professionals towards people with mental illness. This study had the aim to validate the German language version of the Opening Minds Scale for Health Care Providers (OMS-HC), a self-report measure of stigmatizing attitudes.Methods: Staff (n = 392) on general psychiatric inpatient wards (excluding child, forensic and geriatric psychiatry) at five psychiatric hospitals in Switzerland (n = 3) and Germany (n = 2) participated in the study. The internal consistency of the OMS-HC was examined as well as its factor structure using exploratory and confirmatory factor analyses. To assess the scale’s concurrent validity, we used the Social Distance Scale.Results: Internal consistency for the OMS-HC total score was good (α = 0.73), it was acceptable for the subscales Attitudes (α = 0.62) and Social Distance (α = 0.69), but poor for the Disclosure subscale (α = 0.55). The original three-factor structure fit our data well. The OMS-HC total score and the Social Distance subscale score were significantly correlated with the Social Distance Scale, supporting concurrent validity.Conclusion: The German version of the OMS-HC demonstrated satisfactory psychometric properties and can be recommended for future research and intervention evaluation.
Effect of Women's Autonomy on Neonatal Mortality and Associated Factors in Ethiopia: A Cross-Sectional Population-Based Study
Authors: Dessie Habtamu
Published: January 2021

Introduction: Women’s decision-making autonomy is extremely important for the development of maternal, neonatal, and child healthcare utilization. However, there's no evidence on the association of women’s decision-making autonomy with neonatal mortality rate at a national level in Ethiopia. Therefore, this study aimed to assess the effect of women's autonomy on neonatal mortality rate and its associated factors in Ethiopia. Methods: A total of 5,128 neonates born 5 years before the survey from Ethiopian Demographic and Health Survey 2016 were reviewed. A multivariable logistic regression model was employed to assess the effect of women's autonomy and identify the determinate predictors of neonate death risk. Results: The rate of neonatal mortality in Ethiopia was 20.7 per 1000 live births). Women's hadn't autonomy in health care increase neonatal death by 2.72 times compared with those that had autonomy. Hadn’t postnatal care was caused to grown neonatal death by 5.48 times (AOR 5.48, 95%CI: 1.29, 23.26). Delivering at a health institution had 0.61 times lowered neonatal death risk compared with delivering at of health institution without a health facility(AOR 0.61, 95% CI: 0.38,0.97). Breastfeeding immediately within 1hr after birth had 0.17 times reduce neonatal death risk compared with not initiation of breastfeeding(AOR 0.17, 95% CI: 0.12,0.26). Women's gave birth single had 0.09 times reduced neonatal death risk than those that gave birth multiple (AOR 0.09, 95% CI: 0.05,0.18). Unknowingly, male neonates had a 1.84 times higher risk of death than females (AOR 1.84, 95%CI: 1.20,2.81). Conclusion: Neonatal mortality rate was significantly related to women's hadn't deciding power on health care, hadn’t postnatal care, delivered out of health institution, breastfed not immediately, and gave birth multiple. It is important to encourage mothers autonomy, use postnatal care service, and deliver in health institutions.
Comparing Nephrolithiasis with Nephrocalcinosis in Children; A Study From Two Tertiary Centers in Saudi Arabia
Authors: Alhasan Khalid , Shalaby Mohamed , Albanna Amr , Temsah Mohamad-Hani , Alhaik Zainab , Zaher Zaher , Alotaibi Najlaa , Kalakattawi Nada , Abdallah Mohammed , Kari Jameela
Published: January 2021

Background: Nephrolithiasis and nephrocalcinosis is uncommon in children; however, its incidence is increasing. Patients and Methods: A multicenter retrospective study of the clinical presentation, etiology, and outcome of childhood nephrolithiasis and compare it with nephrocalcinosis.Results: The study included 144 children; 93 with nephrolithiasis (formation of stones within renal pelvis or tubular lumen) and 51 with nephrocalcinosis. (deposition of calcium in the renal parenchyma) Mean age at presentation were 72 months and 54 months for nephrolithiasis and nephrocalcinosis, respectively. In 64.8% of the nephrolithiasis and 76% of nephrocalcinosis cases, a history of consanguinity was found. Congenital anomalies of the kidneys and urinary tract were present in 28% and 9.8% of those with nephrolithiasis and nephrocalcinosis, respectively. The most common symptoms of nephrolithiasis were flank pain (29%), hematuria (15%), and dysuria (11%). Urinary tract infection was the primary presentation in the nephrocalcinosis group (18%) followed by failure to thrive (16%), polyuria (12%), and dehydration (12%).The majority of nephrolithiasis cases were caused by metabolic disorders. In contrast, the most common underlying disorders for nephrocalcinosis were familial hypomagnesemia hypercalciuria nephrocalcinosis (35%), distal renal tubular acidosis (23%), and Bartter syndrome (6%).Clinical outcomes were significantly better in children with nephrolithiasis than those with nephrocalcinosis who had radiological evidence of worsening/persistent calcinosis and progressed more frequently to chronic kidney disease (stage II-IV) and end stage kidney disease.Conclusion: The etiology of nephrolithiasis can be identified in many children. Nephrocalcinosis is associated with worse clinical outcomes related to kidney function and disease resolution as compared to nephrolithiasis.
‘Surviving to Thriving’: A Meta-Ethnography of the Experiences of Healthcare Staff Caring for Persons With COVID-19
Authors: Agyei Frank , Bayuo Jonathan , Baffour Prince , Laari Cletus
Published: January 2021

Background: The emergence of the Coronavirus disease has heightened the experience of emotional burden among healthcare staff. To guide the development of support programmes, this review sought to aggregate and synthesise primary studies to establish a comparative understanding of the experiences of healthcare staff caring for persons with the disease. Design: A meta-ethnography approach was used to aggregate and synthesise primary qualitative studies. Database search was undertaken from January to November 2020. A standardised tool was used to extract data from the identified primary studies. The studies were translated into each other to formulate overarching concepts/ metaphors which formed the basis of undertaking a narrative synthesis. Results: Eight qualitative studies met the inclusion criteria. Two overarching concepts/ metaphors were formulated from the primary studies: 1) surviving to thriving in an evolving space and 2) support amid the new normal. The initial phase of entering the space of caring during the outbreak was filled with psychological chaos as healthcare staff struggled to survive within the context of an illness which was not fully understood. Gradually, healthcare staff may transition to a thriving phase characterised by resilience but still experienced heavy workload and physical/ emotional exhaustion. Fear persisted throughout their experiences. Fear of contracting the disease or infecting one’s family members/ loved ones remained a key concern among healthcare staff despite infection precaution measures. Healthcare staff who contracted the disease felt isolated with additional fears of dying alone. The sources of support were varied with a strong emphasis on peer support. Conclusions: Healthcare staff caring for persons infected with the Coronavirus disease require ongoing mental health support commensurate to their needs in the survival or thriving phase. Staff who contract the disease may require additional support to navigate through the illness and recovery. Concerted efforts are needed to strengthen support systems and build resilience among healthcare staff.