bluuebunny/crossref_metadata_2025 huggingface dataset:
The incidence of postoperative heterotopic ossification in cervical disc arthroplasty--A systematic review and meta-analysis
Authors: Yingjun Guo , Jiali Chen , Liu Hao , Yang Meng , Chen Ding , Beiyu Wang , Xin Rong
Published: October 2019

Background: Heterotopic ossification has become a common disease after CDA, which has attracted much attention. Understanding the law of its occurrence and development can provide theoretical basis for the formulation of HO prevention strategies. To acquire the objective data and the change rule of HO incidence, a meta-analysis of all available evidence was performed. Methods: A search of the literature was conducted on Pubmed/MEDLINE, EMBASE, and Web of Science. Relevant studies including incidence-relative data of HO were selected according to eligibility criteria. Results: 52 studies were eligible and finally included and the quality assessment showed a relative high score of them. The results of the analysis reminded us that the incidence of HO increased with the extension of follow-up time, both based on the number of cases and the number of segments, and the increase mainly occurred after 6 years. Grade III-IV HO showed us a positive correlation with follow-up time (R2=0.218), while Grade I-II HO did not change a lot in different follow-up time points. Conclusions: The follow-up time after CDA should be long enough, so as to ensure the true clinical results. HO occurs all the postoperative time and Grade I-II HO will gradually develop into Grade III-IV, while continuous new HO keeps the number of Grade I-II in a dynamic balance. Through this study, we can preliminarily define the relatively objective incidence and change rule of HO, which provides data basis and theoretical basis for the future research of HO prevention strategy.
The study of Wilson Disease in pregnancy management
Authors: Yu Xu-En , Pang Min , Han Yong-Zhu , Wang Juan , Gao Shan
Published: October 2019

Abstract Background: Pregnancy management in women with Wilson disease (WD) remains an important clinical problem. This research was conducted to investigate how to avoid worsening of WD symptoms during pregnancy and increase pregnancy success in women with WD by identifying the best pregnancy management approaches in these patients. Methods: The clinical data of 117 pregnancies among 75 women with WD were retrospectively analyzed. Related information of the fetus was also recorded and analyzed. At the same time, regression analysis was performed for data of 22 pregnant women without WD, as normal controls. Results: Of a total of 117 pregnancies among the 75 women with WD and 31 pregnancies among the 22control womenincluded in this study, there were 108 successful pregnancies and 9 spontaneous abortions. Among the 108 successful pregnancies, 97 women a history of copper chelation therapy before pregnancy; all 97 women stopped anti-copper therapy during pregnancy. The nine women with spontaneous abortion had no pre-pregnancy history of copper displacement therapy. The incidence of lower limb edema was higher in the WD group than in normal controls (P=0.036). Compared with the control group, there was a higher proportion in the WD group of male infants (P=0.022) and lower average infant birth weight (t=3.514, P=0.001). Conclusion: It is relatively safe for women with WD patients to become pregnant. The best management method for pregnancy in women with WD may be intensive pre-pregnancy copper chelation therapy and no anti-copper treatment during pregnancy.
Multicenter randomized study on comparison between electronic and traditional chest drainage systems
Authors: Marulli Giuseppe , Comacchio Giovanni Maria , Nosotti Mario , Rosso Lorenzo , Mendogni Paolo , Natale Giuseppe , Andriolo Luigi , Imbriglio Giovanna , Larocca Valentina , Brascia Debora , Rea Federico
Published: October 2019

Background: In patients submitted to major pulmonary resection, post-operative length of stay is mainly influenced by duration of air leaks and chest tube removal. The measurement of air leaks largely relies on traditional chest drainage systems which are prone to subjective interpretation. Difficulty in differentiating between active air leaks and bubbles due to a pleural space effect may also lead to tentative drain clamping and prolonged time for chest drain removal. New digital systems allow continuous monitoring of air leaks, identifying subtle leakage that may be not visible during daily patient evaluation. Moreover, an objective assessment of air leaks may lead to a reduced interobserver variability and to an optimized timing of chest tube removal.

Methods: This study is a prospective randomized, interventional, multicenter trial designed to compare the electronic chest drainage system (Drentech™ Palm Evo) with the traditional one (Drentech™ Compact) in a cohort of patients undergoing pulmonary lobectomy through a standard 3-ports VATS approach both for benign or malignant disease. It will enroll 382 patients in 3 Italian centers. Duration of chest drainage and length of hospital stay will be evaluated in the two groups. Moreover, it will be evaluated if the use of a digital chest system compared with a traditional system reduces theinterobserver variability. Finally, it will be evaluated if the digital drain system may help in distinguishing an active air leak from a pleural space effect, by the digital assessment of intrapleural differential pressure, and in identifying potential predictors of prolonged air leaks.

Discussion : To date, few studies have been performed to evaluate clinical impact of digital drainage systems. The proposed prospective randomized trial will provide new knowledge to this research area by investigating and comparing the difference between digital and traditional chest drain systems. In particular, the objectives of this project are to evaluate the feasibility and usefulness of digital chest drainages and to provide new tools to identify patients at higher risk of developing prolonged air leaks.
Genome wide association study (GWAS) for morphological and yield-related traits in oil palm hybrids (Elaeis oleifera x Elaeis guineensis)
Authors: Osorio Jaime , Garzón Gina , Delgadillo Paola , Bastidas Silvio , Moreno Leidy , Enciso Felix , Cornejo Omar , Barrero Luz Stella
Published: October 2019

Abstract
Background
The genus Elaeis has two species of economic importance for the oil palm agroindustry: Elaeis oleifera (O), native to the Americas, and Elaeis guineensis (G), native to Africa. The work presented herein provides, to our knowledge, the first association mapping study in an interspecific OxG hybrid population of oil palm which presents tolerance to pests and diseases, high oil quality, and acceptable fruit bunch production.
Results
Using genotyping-by-sequencing (GBS), we identified a total of 3,776 single nucleotide polymorphisms (SNPs) that were used to perform a genome-wide association analysis (GWAS) in 378 OxG hybrids for 10 agronomic traits. Twelve genomic regions were located near candidate genes implicated in multiple functional categories, such as tissue growth, cellular trafficking, and physiological processes.
Conclusions
We provide new insights on candidate genes that mapped on genomic regions involved in plant architecture and yield; however, these potential candidate genes need to be confirmed for future targeted functional analysis. The associated markers may be valuable resources for the development of marker-assisted selection in oil palm breeding.
Keywords: Association mapping, Elaeis guineensis, Elaeis oleifera, genotyping-by-sequencing, plant architecture, yield.
The impact of obstetric interventions and complications on women’s satisfaction with childbirth - a population based cohort study including 16000 women.
Authors: Falk Maja , Nelson Marie , Blomberg Marie
Published: October 2019

Background: As a quality marker and a tool for benchmarking between units, a visual analogue scale (VAS) (ranging from 1 to 10) to estimate woman’s satisfaction with childbirth was introduced in 2014. This study aimed to assess how obstetric interventions and complications affected women’s satisfaction with childbirth.

Methods: A retrospective cohort study including 16775 women with an available VAS score who gave birth between January 2016 and December 2017. VAS score, maternal and obstetric characteristics were obtained from electronic medical records and crude and adjusted odds ratios (aOR) were calculated.

Results: The total prevalence of dissatisfaction with childbirth (VAS 1-3) was 5.7%. The main risk factors for dissatisfaction with childbirth were emergency cesarean section, aOR 3.98 95% confidence interval (CI) 3.27-4.86, postpartum hemorrhage ³2000 ml, aOR 1.85 95%CI 1.24-2.76 and Apgar score <7 at five minutes, aOR 2.95 95%CI 1.95-4.47. The amount of postpartum hemorrhage showed a dose-response relation to dissatisfaction with childbirth. Moreover, labor induction, instrumental vaginal delivery, and obstetric anal sphincter injury were significantly associated with women´s dissatisfaction with childbirth. A total number of 4429/21204 (21%) women giving birth during the study period () had missing values on VAS. A comparison of characteristics between women with and without a recorded VAS score was performed. There were statistically significant differences in maternal age and maternal BMI between the study population and excluded women due to missing values on VAS. Moreover, 64% of the women excluded were multiparas, compared to 59% in the study population.

Conclusions: Obstetric interventions and complications, including emergency cesareans section and postpartum hemorrhage, were significantly related to dissatisfaction with childbirth.

Such events are common and awareness of these associations might lead to a more individualized care of women during and after childbirth.
Knockout of TLR4 promotes fracture healing by activating Wnt/β-catenin signaling pathway
Authors: Zhao Cunju , Yu Tao , Dou Qingjun , Guo Yue , Yang Xiaofei , Chen Yunzhen
Published: October 2019

Background: The aim of this study was to investigate the effect of Toll like receptor 4 (TLR4) on fracture healing. Methods: The open tibial fracture models in TLR4 knockout (TLR4 -/- ) and wild type (WT) C57BL-6J mice were established. The radiological examination, tartrate-resistant acid phosphatase (TRAP) staining , Micro-CT scan and biological torsion test were performed on 7, 14 and 21 days after operation. Enzyme Linked Immunosorbent Assay (ELISA) kit was used to detect the expression levels of tumor necrosis factor-α (TNF-α), interleukin-1 beta (IL-1β) and interleukin 6 (IL-6). Western blotting was used to detect the expression of β-catenin, Wingless-type MMTV integration site family, member 4 and 5B (Wnt4 and Wnt5B), proliferating cell nuclear antigen (PCNA) and bone morphogenetic protein-2 (BMP-2) of the callus tissue obtained from mice. Results: TLR4 knockout promoted fracture healing, reduced the number of osteoclasts, increased bone callus volume (BV) and callus mineralized volume fraction ( BV/TV% ) ( P < 0.05), increased the maximum torque and torsional stiffness of callus (P < 0.05), reduced TNF-α, IL-1β and IL-6 expression ( P < 0.01), and increased the expression of β-catenin, Wnt4, Wnt5B, PCNA and BMP-2 ( P < 0.01). Conclusions: TLR4 knockout reduced inflammatory and promoted fracture healing by activating Wnt/β-catenin signaling pathway.
Low red/far-red ratio as a signal promotes carbon assimilation of soybean seedlings by increasing the photosynthetic capacity
Authors: Yang Feng , Liu Qinlin , Cheng Yajiao , Feng Lingyang , Wu Xiaoling , Fan Yuanfang , Raza Muhammad Ali , Wang Xiaochun , Yong Taiwen , Liu Weiguo , Liu Jiang , Du Junbo , Shu Kai , Yang Wenyu
Published: October 2019

Background: Shading includes low light intensity and varying quality. However, a low red/far-red (R/Fr) ratio of light is a signal that affects plant growth in intercropping and close- planting systems. Thus, the low R/Fr ratio uncoupling from shading conditions was assessed to identify the effect of light quality on photosynthesis and CO2 assimilation. Soybean plants were grown in a growth chamber with natural solar radiation under four treatments, that is, normal (N, sunlight), N+Fr, Low (L) +Fr, and L light.
Results: Results showed that low R/Fr ratio significantly increased the total biomass, leaf area, starch and sucrose contents, chlorophyll content, net photosynthetic rate, and quantum efficiency of the photosystem II compared with normal R/Fr ratio under the same light intensity condition (P < 0.05). Proteomic analysis of soybean leaves under different treatments was performed to quantify the changes in photosynthesis and CO2 assimilation in the chloroplast. Among the 7834 proteins quantified, 12 showed a > 1.3-fold change in abundance, of which 1 was related to porphyrin and chlorophyll metabolism, 2 were involved in photosystem I (PS I), 4 were associated with PS II, 3 proteins participated in photosynthetic electron transport, and 2 were involved in starch and sucrose metabolism. The dynamic change in these proteins indicates that photosynthesis and CO2 assimilation were maintained in the L treatment by up-regulating the component protein levels compared with those in N treatment. Although low R/Fr ratio increased the photosynthetic CO2 assimilation parameters, the differences in most protein expression levels in N+Fr and L+Fr treatments compared with those in N treatment were insignificant. Similar trends were found in gene expression through quantitative reverse transcription polymerase chain reaction excluding the gene expression of sucrose synthase possible because light environment is one of the factors affecting carbon assimilation.
Conclusions: These results implied that low R/Fr ratio (high Fr light) increased the photosynthetic CO2 assimilation in the same light intensity by improving the photosynthetic efficiency of the photosystems.
Comparison of radiological changes after single- position versus dual- position for lateral interbody fusion and pedicle screw fixation
Authors: Hiyama Akihiko , Katoh Hiroyuki , Sakai Daisuke , Sato Masato , Tanaka Masahiro , Watanabe Masahiko
Published: October 2019

Background: There have been few comparisons between dual positions, which require a position change, and a single position, which does not require position change, and it is not clear whether there is a difference in indirect decompression achieved by the two procedures. Therefore, the purpose of this study was to compare perioperative and radiographic outcomes following lateral lumbar interbody fusion (LLIF) in two cohorts of patients who underwent surgery in a single position or dual position. Methods: This study involved 45 patients who underwent indirect decompression at 68 levels, with LLIF and percutaneous pedicle screw (PPS) fixation for lumbar degenerative spondylolisthesis with spinal canal stenosis. Patient demographics and perioperative data were compared between two groups: patients who remained in the lateral decubitus position for pedicle screw fixation (SP group) and those turned to the prone position (DP group). Results: A total of 26 DP and 19 SP patients were analyzed. We evaluated the pre- and postoperative image measurements, there was no significant difference for lumbar lordosis, segmental disc angle, slipping length, and disc height between the groups. The CSA of the dural sac and central canal diameter was significantly larger after surgery in both groups. However, there were no statistically significant differences between the two groups. Conclusions: We found that the effect of indirect decompression by SP-PPS fixation following LLIF was considered to be a useful technique with no difference in dural sac enlargement or disc angle obtained compared with DP-PPS fixation.
Preferences for HIV testing services among young people in Nigeria
Authors: Nwaozuru Ucheoma , juliet iwelunmor , Ong Jason J. , Salah Sawsan , Obiezu-Umeh Chisom , Ezechi Oliver , Tucker Joseph D.
Published: October 2019

Background Despite high HIV incidence rates among young people in Nigeria, less than 24% of this population have ever tested for HIV. These low HIV testing rates suggest that current testing services may not align with their testing preferences. To address this gap, the objective of this study was to assess preferences for HIV testing options among young people in Nigeria.Methods We conducted a cross-sectional study using survey to assess preferences for HIV testing options among 113 youth aged 14-24 years residing in Nigeria. The survey included a series of hypothetical HIV testing options, comprised of six characteristics centered around HIV testing service (i.e. location of testing, test administrator, mode of pre-test, mode of post-test counseling, type of HIV test, and cost of HIV test). For each characteristic, participants were asked to select one of the options that they prefer or indicate none of the above. A descriptive analysis of the preferences made by participants was conducted, summarizing proportions of participants who selected different options for HIV testing.Results The mean age of study participants was 19.5 years old (SD=2.7). Most youth (73, 64.6%) had at least a secondary school degree. There was pronounced heterogeneity in HIV testing preferences among young people. Although most youth preferred free HIV testing, 14 (16.7%) reported preferring paying a small amount compared to free testing. More youth preferred blood-based HIV self-testing 39(48.8%) compared to facility-based HIV testing and oral HIV self-testing.Conclusions Our finding suggest that young people have a range of HIV testing preferences in Nigeria. This suggests that a “one-size-fits-all” approach to delivering services to youth may be challenging in this context. HIV testing services can be optimized to reach young people if a variety options are provided to meet their unique preferences.
Association between homocysteine and white matter hyperintensities in asymptomatic intracranial arterial stenosis: results from a population-based study
Authors: Yin Hao , Wang Xiang , Zhao Yuan-yuan , Ji Xiao-kang , Sang Shao-wei , Shao Sai , Yan Peng , Li Shan , Xue Yuan , Wang Guang-bin , Lv Ming , Xue Fu-zhong , Du YiFeng , Sun Qinjian
Published: October 2019

Background: Although homocysteine (Hcy) and white matter hyperintensities (WMH) have been proven to be correlated with increased risks of ischemic stroke, there have been few studies addressing the association between serum Hcy and WMH in a population with asymptomatic intracranial arterial stenosis (aICAS). Thus, the aim of the present study is to describe the association between Hcy and WMH in rural-dwelling Chinese people with aICAS. Methods: In this study, 150 participants diagnosed as aICAS by magnetic resonance angiography were recruited from the Kongcun Town Study, which was a population-based study aimed to investigate the prevalence of aICAS in general population aged 40 to 90 years old, free of ischemic stroke history, and living in the Kongcun town, Pingyin county, Shandong, China. Data on demographics, risk factors, and serum Hcy levels were collected via interview, clinical examination, and laboratory tests. The WMH volumes were calculated through the lesion segmentation tool system for the Statistical Parametric Mapping package based on magnetic resonance imaging. The association between Hcy and WMH volume was analyzed using both linear and logistic regression analysis. Results: After adjusting for all confounders, high Hcy (HHcy) (serum Hcy ≥15umol/L) was significantly associated with severe WMH (the highest quartile in WMH volume) (OR: 2.972, 95%CI: 1.017-7.979, P <0.05). However, with changing of WMH volumes, only trends towards association with HHcy were observed in all 3 models (P values only slightly exceeded 0.05). After being stratified by age, sex, or ever smoking, the association between HHcy and WMH became more significant in participants who were ≥60 years old, male, or ever smoker. Conclusions: HHcy is associated with severe WMH in rural-dwelling Chinese people with aICAS, especially in participants ≥60 years old, male participants, or ever smokers, indicating these may be risk factors that contribute to the association between HHcy and severe WMH.
Anatomical parameters of the coracoclavicular ligament: A study of 480 cases
Authors: Zhang lei , Wen Youliang , Jia Wenli , Zhang Shaoqun , Zhou Xin , Fu shijie
Published: October 2019

Background: Although the optimal surgical technique for treatment of acromioclavicular (AC) joint dislocation still remains controversial, reconstruction of the coracoclavicular (CC) ligament has become the current tendency, particularly the transclavicular-transcoracoid drilling technique. The study investigated the anatomical characteristic of CC ligament by obtained anatomical parameters based on magnetic resonance imaging (MRI), for guiding surgeons to create transosseous tunnels precisely in reconstructing CC ligament. Material/Methods : Four hundred and eighty MRI scans of left shoulders from patients (ages from 11 years to 80 years, mean age of 51 years) were analyzed for the study. Some anatomical parameters were defined and measured in images of the coronal and sagittal plane, including four angles and seven distances. All measurement results were analyzed by SPSS 20.0. Results : In the coronal plane, the distance form the midpoint of AC joint to the insertion at the clavicle of male patients was greater than the average value of female patients. In the sagittal plane, in addition to the diameter of insertion at the coracoid process, other average distance values of male patients were greater than the average values of female patients, which were significantly different (P<0.05). Conclusion : These anatomical parameters obtained from MRI could completely describe the anatomical characteristic of CC ligament, which are beneficial for the reconstruction of CC ligament to create transosseous tunnels accurately, contributing to reduce the incidence of postoperative complications and promote the operative treatment of AC joint dislocation.
The prevalence of HIV among MSM in China: a large-scale systematic analysis
Authors: Dong Mengjie , Peng Bin , Liu Zhen-Feng , Ye Qian-ni , Liu Hao , Lu Xi-Li , Zhang Bo , Chen Jia-Jia
Published: October 2019

Background：The prevalence of HIV among men who have sex with men (MSM) has become a significant public health challenge. The aim was to comprehensively estimate the national prevalence of HIV among MSM and its time trends through a large-scale systematic analysis. Methods：Systematic search of Cochrane Library, PubMed, EMBASE, CNKI, VIP, and Wanfang Data databases without language restriction for studies on the prevalence of HIV among MSM published before Dec.31, 2018. Studies were eligible for inclusion if they were published in the peer-reviewed literature and used validated assessment methods to assess the prevalence of HIV among MSM. Estimates were pooled using random-effects analysis.Results：Data were extracted from 355 cross-sectional studies (571,328 individuals) covered 59 cities from 30 provinces and municipalities of China. The overall national prevalence of HIV among MSM from 2001 to 2018 was estimated to be 5.7% (95% CI: 5.4–6.1%), with high between-study heterogeneity (I2 = 98.0%, P < 0.001). Our study showed an increased tendency in the HIV prevalence as time progressed by meta-regression analysis (I2= 95.9%, P<0.0001). HIV prevalence was the highest in those aged 50 years and older with HIV prevalence of 19.3% (95%CI: 13.1-27.4%, N=13). HIV was more prevalent in the illiterate population (16.8%), than in those who had received an education. Although the internet was a major venue for Chinese MSM seeking male sex partners (35.6%, 95%CI: 32.3%-39.9%, N=101), seeking MSM in bathhouses/saunas had the highest associated prevalence of HIV (13.4%, 95%CI: 10.3%-17.1%, N=22). The HIV prevalence among MSM varied by location: compared with other regions in China, HIV was highly prevalent among MSM in the southwest (10.7%, 95%CI: 9.3%-12.2%, N=91). Compared to participants who sometimes or always used condoms, participants who had never used a condom in the past 6 months had a higher risk of HIV infection, with odds ratios of 0.1 (95%CI: 0.08-0.14). Conclusions：Our analysis provided reliable estimates of China’s HIV burden among MSM, which appears to present an increasing national public health challenge. Effective government responses are needed to address this challenge and include the implementation of HIV prevention.
Temporal Variation of Soil Microbial Properties in a Corn–Wheat–Soybean System
Authors: Hsiao Che‐Jen , Sassenrath Gretchen F. , Zeglin Lydia H. , Hettiarachchi Ganga M. , Rice Charles W.
Published: October 2019

Soil microbial properties vary temporally with crop development and species, but this change is poorly characterized. Our objective was to assess how tillage and crop development mediate changes in soil microbial properties in a corn–winter wheat–soybean system. We evaluated microbial activity through extracellular enzyme activities, microbial communities through phospholipid fatty acid profile, and soil physicochemical properties (including water content, pH, and soil nutrients) at different crop stages. Tillage reduced microbial activity and microbial biomass but only in the upper 5 cm. Hydrolase activities and microbial biomass exhibited temporal variation with crop growth, but measured microbial properties were unresponsive to tillage or fertilizer events. Wheat resulted in higher active C and soil organic matter quality than corn, as indicated by β‐glucosidase/oxidase activity ratio. Greater substrate availability after corn harvest stimulated the production of enzymes and higher bacterial and fungal biomass to decompose the recalcitrant C. The microbial lipid community was different in soybean than in either corn or wheat. These results suggest that, in addition to tillage, crop type was an important driver of change in soil microbial properties. Wheat resulted in higher soil hydrolase activity and microbial biomass than corn. The lack of residue from the preceding crop may explain the lower microbial biomass and activity during corn growth. Incorporating wheat in the crop rotation may provide rhizosphere C inputs that support greater microbial activity. Significant temporal variation in soil microbial properties indicates the need to consider time of soil sampling to better capture the variability of soil health assessments.
The impact of decentralization on the financial support of regional development
Authors: Tulai Oksana , Petrushenko Yuriy , Glova Jozef , Sydor Iryna , Ponomarenko Oksana
Published: October 2019

Nowadays in Ukrainian realities decentralization, as a process of expanding and strengthening the rights and powers of administrative-territorial units, contributes to the development of financial innovations, the accessibility of public goods, and improvements in the quality of life of the population.The aim of the article goal is developing the recommendations for improving the financial support of the regions by introducing new tools of influence of communities and local self-governments on the economic growth of territories.Using the methods of factor analysis, regression analysis, and significant components, the article determines the impact of regional economic development on the revenues of local budgets. The empirical findings show the close correlation between budgetary decentralization and industrial capabilities of the regions. A cluster analysis was carried out to identify the asymmetries of regional development in terms of financial capacity. It enabled to distinguish homogeneous groups of areas according to the indicators of their economic development. On this basis the authors substantiated the necessity of entrepreneurial activity stimulating, increasing the number of companies, and promoting a continuous flow of goods (works, services) from the producer to the consumer in different regions of Ukraine.
Ultrasound markers of open spina bifida in fetus at the 11–14 week:
a literature review
Authors: M.A. Esetov, A.M. Esetov
Published: October 2019

A literature review of ultrasound markers of open spina bifida (OSB) in fetus at first trimester of gestation
is presented. The literature data agree that most fetuses with OSB demonstrate in the first trimester positive
ultrasound markers in the brain, and the assessment of these structures can be a reliable tool in the early
identification of the OSB. Also literary review showed that additional prospective studies are needed to establish
the best protocol for OSB screening at 11–13 weeks gestation.
Finos Fios, Renda de Agulha... uma alternativa de trabalho, múltiplos olhares para a qualidade
Authors: Silveira Rogério Zanon da , Campos Ana Claudia Borges , Miguel Marcelo Calderari
Published: October 2019

Este artigo enfatiza o trabalho desenvolvido pelas rendeiras de Divina Pastora, município localizado na mesorregião do Leste Sergipano, na microrregião do Cotinguiba, região turística ‘Polo dos Tabuleiros’, tendo como destaque a produção de renda Irlandesa, produto do Ecoturismo. O objetivo desta pesquisa é avaliar a satisfação dos compradores de Renda Irlandesa em relação à qualidade dos serviços prestados pelas artesãs que comercializam e produzem os bordados - um elemento cultural central da identidade local. A metodologia deste estudo possui caráter descritivo, quantitativo e qualitativo e adaptativo da abordagem métrica-metodológica Servqual. Os resultados obtidos sugerem que os atributos da qualidade são delineados primordialmente pelos construtos tangíveis e empáticos. Ao final, são discutidas implicações comerciais, acadêmicas e socioculturais que cingem o contexto do Patrimônio Cultural e a arte de saber-fazer das mulheres artífices na região pesquisada.
Encapsulation of plant-derived bioactive ingredients through electrospraying for nutraceuticals and functional foods applications
Authors: Gómez-Mascaraque Laura G. , Rubio Amparo Lopez-
Published: October 2019

:

The electrospraying technique, which consists of electrohydrodynamic atomization of
polymeric fluids, can be used to generate dry nano- and microparticles by subjecting a polymer
solution, suspension or melt to a high voltage (typically in the range of 7-20 kV) electric field.
This potential can be exploited for developing nano- and microencapsulation structures under
mild temperature conditions. and, tThus, it constitutes a promising alternative to conventional
microencapsulation techniques for sensitive ingredients, like most plant-derived bioactive
compounds, especially for their application in the food sector. Given the importance of plants
as one of the major sources of dietary bioactive compounds, significant much research
attention has been recently paid to research to the encapsulation of phytochemicals through
novel techniques such as electrospraying, aiming to provide new tools for the development of
innovative functional food products and nutraceuticals. In this review, the latest advances in
the application of electrospraying for nano- and microencapsulation of phytochemicals are
discussed, with a focus on their potential use in the food sector.
Superparamagnetic Iron Oxide Nanoparticles (SPIONs) for Diagnosis and Treatment of Breast, Ovarian and Cervical Cancers
Authors: Talluri Sekhar , Malla Rama R.
Published: October 2019

Background:

The potential of Super Paramagnetic Iron Oxide Nanoparticles (SPIONs) as theranostic
agents for cancer has been investigated extensively. SPIONS can be utilized for diagnostic imaging, drug delivery as
well as for therapeutic applications. SPIONS are of particular interest because of their potential for non-invasive
diagnosis and non-invasive therapeutic applications. This article is a review of in vivo and clinical studies of SPIONs
for diagnosis and treatment of breast, ovarian and cervical cancer. The current limitations of this technology with
relation to clinical therapeutic applications and the potential to overcome these limitations are also discussed.

Methods:

NCBI Pubmed was searched for relevant documents by using keyword and MESH based search. The following
keyword combinations were used: ‘breast cancer’ and SPION, ‘ovarian cancer’ and SPION, and ‘cervical
cancer’ and SPION. The resulting list was manually scanned for the studies involving clinical and in vivo studies.

Results:

The 29 most relevant publications were identified and reviewed.

Conclusion:

Although numerous in vitro and in vivo studies have demonstrated the safety and effectiveness of the
use of SPIONs for both diagnostic and therapeutic applications, there is relatively little progress towards translation
to clinical applications involving breast, ovarian and cervical cancer.
Exploring the Clinical Impact of Predictive Biomarkers in Serous Ovarian Carcinomas
Authors: Le Page Cécile , Chung Jacqueline , Rahimi Kurosh , Köbel Martin , Provencher Diane , Mes-Masson Anne-Marie
Published: October 2019

Epithelial ovarian cancer (EOC) is the most lethal gynecologic malignancy. Although initial response rates to standard platinum-based treatment are at 70–80%, long-term response in advanced EOC disease is rarely achieved with the development of chemoresistance and recurrence, contributing to overall survival rates below 45%. Additional challenges stem from EOC heterogeneity, reflecting at least five histological subtypes, each with different underlying molecular characteristics and clinicopathology that have significant implications in treatment effectiveness and management. Since the last decade, technologies in genomics, proteomics and pathology have been deployed to find reliable clinical markers that can identify patients sensitive to standard chemotherapy treatments and stratify patients for more suitable targeted therapies. These efforts have identified several molecular markers of prognostic value that have been validated as biomarkers, such as BRCA and KRAS mutations, or are currently under investigation in clinical trials, such as CD8 T cells, immune checkpoint inhibitors and progesterone receptor. Recent advancements in biomarker research have also revealed new targets that have expanded treatment options, introducing poly (ADP-ribose) polymerase (PARP) inhibitors, anti-angiogenic agents, inhibitors targeting signaling pathways, and immunotherapy to improve maintenance therapies or enhance first-line therapy. This review presents a summary of current biomarkers, in clinical use or under evaluation, demonstrating a potential to inform on patient selection for treatment efficacy and predict response to EOC therapies, with particular focus on the serous subtypes, including high-grade and low-grade serous carcinomas.
Development of Long-Circulating and Fusogenic Liposomes Co-encapsulating Paclitaxel and Doxorubicin in Synergistic Ratio for the Treatment of Breast Cancer
Authors: Roque Marjorie Coimbra , Franco Marina Santiago , Vilela José Mário Carneiro , Andrade Margareth Spangler , de Barros André Luís Branco , Leite Elaine Amaral , Oliveira Mônica Cristina
Published: October 2019

Background:

The co-encapsulation of paclitaxel (PTX) and doxorubicin (DXR) in liposomes
has the potential to offer pharmacokinetic and pharmacodynamic advantages, providing delivery of both
drugs to the tumor at the ratio required for synergism.

Objective:

To prepare and characterize long-circulating and fusogenic liposomes co-encapsulating PTX
and DXR in the 1:10 molar ratio (LCFL-PTX/DXR).

Methods:

LCFL-PTX/DXR was prepared by the lipid film formation method. The release of PTX and
DXR from liposomes was performed using a dialysis method. Studies of cytotoxicity, synergism, and
cellular uptake were also carried out.

Results:

The encapsulation percentage of PTX and DXR was 74.1 ± 1.8 % and 89.6 ± 12.3%, respectively,
and the mean diameter of the liposomes was 244.4 ± 28.1 nm. The vesicles remained stable for
30 days after their preparation. The drugs were simultaneously released from vesicles during 36 hours,
maintaining the drugs combination in the previously established ratio. Cytotoxicity studies using 4T1
breast cancer cells showed lower inhibitory concentration 50% (IC50) value for LCFL-PTX/DXR treatment
(0.27 ± 0.11 µm) compared to the values of free drugs treatment. In addition, the combination
index (CI) assessed for treatment with LCFL-PTX/DXR was equal to 0.11 ± 0.04, showing strong synergism
between the drugs. Cell uptake studies have confirmed that the molar ratio between PTX and
DXR is maintained when the drugs are administered in liposomes.

Conclusion:

It was possible to obtain LCFL-PTX/DXR suitable for intravenous administration, capable
of releasing the drugs in a fixed synergistic molar ratio in the tumor region.
Polyfunctional CD8+ T-Cell Response to Autologous Peptides from Protease and Reverse Transcriptase of HIV-1 Clade B
Authors: Acevedo-Saenz Liliana , Perdomo-Celis Federico , Montoya Carlos J. , Velilla Paula A.
Published: October 2019

Background: :

The diversity of the HIV proteome influences the cellular response and development of an effective vaccine, particularly due to the generation of viral variants with mutations located within CD8+ T-cell epitopes. These mutations can affect the recognition of the epitopes, that may result in the selection of HIV variants with mutated epitopes (autologous epitopes) and different CD8+ T-cell functional profiles.

Objective::

To determine the phenotype and functionality of CD8+ T-cell from HIV-infected Colombian patients in response to autologous and consensus peptides derived from HIV-1 clade B protease and reverse transcriptase (RT).

Methods::

By flow cytometry, we compared the ex vivo CD8+ T-cell responses from HIV-infected patients to autologous and consensus peptides derived from HIV-1 clade B protease and RT, restricted by HLA-B*35, HLA-B*44 and HLA-B*51 alleles.

Results::

Although autologous peptides restricted by HLA-B*35 and HLA-B*44 did not show any differences compared with consensus peptides, we observed the induction of a higher polyfunctional profile of CD8+ T-cells by autologous peptides restricted by HLA-B*51, particularly by the production of interferon-γ and macrophage inflammatory protein-1β. The response by different memory CD8+ T-cell populations was comparable between autologous vs. consensus peptides. In addition, the magnitude of the polyfunctional response induced by the HLA-B*51-restricted QRPLVTIRI autologous epitope correlated with low viremia.

Conclusion::

Autologous peptides should be considered for the evaluation of HIV-specific CD8+ Tcell responses and to reveal some relevant epitopes that could be useful for therapeutic strategies aiming to promote polyfunctional CD8+ T-cell responses in a specific population of HIV-infected patients.
Target Oxygen Levels and Critical Care of the Newborn
Authors: Vettukattil Joseph J.
Published: October 2019

Despite our growing experience in the medical care of extremely preterm infants and critically ill neonates, there are serious gaps in the understanding and clinical application of the adaptive physiology of the newborn. Neonatal physiology is often misinterpreted and considered similar to that of adult physiology. The human psyche has been seriously influenced, both from an evolutionary and survival point of view, by the cause and effect of hypoxemia which is considered as a warning sign of impending death. Within this context, it is unimaginable for even the highly trained professionals to consider saturation as low as 65% as acceptable. However, all available data suggests that newborns can thrive in a hypoxemic environment as they are conditioned to withstand extreme low saturations in the fetal environment. An approach utilizing the benefits of the hypoxic conditioning would prompt the practice of optimal targeted oxygen saturation range in the clinical management of the newborn. Our current understanding of cyanotic congenital heart disease and the physiology of single ventricle circulation, where oxygen saturation in mid 70s is acceptable, is supported by clinical and animal studies. This article argues the need to challenge our current acceptable target oxygen saturation in the newborn and provides the reasoning behind accepting lower target oxygen levels in the critically ill newborn. Challenging the current practice is expected to open a debate paving the way to understand the risks of high target oxygen levels in the newborn compared with the benefits of permissive hypoxia in avoiding the associated morbidity and mortality of oxygen radical injury.
Accuracy of Wristband Fitbit Models in Assessing Sleep: Systematic Review and Meta-Analysis
Authors: Haghayegh Shahab , Khoshnevis Sepideh , Smolensky Michael H , Diller Kenneth R , Castriotta Richard J
Published: October 2019

Background

Wearable sleep monitors are of high interest to consumers and researchers because of their ability to provide estimation of sleep patterns in free-living conditions in a cost-efficient way.

Objective

We conducted a systematic review of publications reporting on the performance of wristband Fitbit models in assessing sleep parameters and stages.

Methods

In adherence with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, we comprehensively searched the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane, Embase, MEDLINE, PubMed, PsycINFO, and Web of Science databases using the keyword Fitbit to identify relevant publications meeting predefined inclusion and exclusion criteria.

Results

The search yielded 3085 candidate articles. After eliminating duplicates and in compliance with inclusion and exclusion criteria, 22 articles qualified for systematic review, with 8 providing quantitative data for meta-analysis. In reference to polysomnography (PSG), nonsleep-staging Fitbit models tended to overestimate total sleep time (TST; range from approximately 7 to 67 mins; effect size=-0.51, P<.001; heterogenicity: I2=8.8%, P=.36) and sleep efficiency (SE; range from approximately 2% to 15%; effect size=-0.74, P<.001; heterogenicity: I2=24.0%, P=.25), and underestimate wake after sleep onset (WASO; range from approximately 6 to 44 mins; effect size=0.60, P<.001; heterogenicity: I2=0%, P=.92) and there was no significant difference in sleep onset latency (SOL; P=.37; heterogenicity: I2=0%, P=.92). In reference to PSG, nonsleep-staging Fitbit models correctly identified sleep epochs with accuracy values between 0.81 and 0.91, sensitivity values between 0.87 and 0.99, and specificity values between 0.10 and 0.52. Recent-generation Fitbit models that collectively utilize heart rate variability and body movement to assess sleep stages performed better than early-generation nonsleep-staging ones that utilize only body movement. Sleep-staging Fitbit models, in comparison to PSG, showed no significant difference in measured values of WASO (P=.25; heterogenicity: I2=0%, P=.92), TST (P=.29; heterogenicity: I2=0%, P=.98), and SE (P=.19) but they underestimated SOL (P=.03; heterogenicity: I2=0%, P=.66). Sleep-staging Fitbit models showed higher sensitivity (0.95-0.96) and specificity (0.58-0.69) values in detecting sleep epochs than nonsleep-staging models and those reported in the literature for regular wrist actigraphy.

Conclusions

Sleep-staging Fitbit models showed promising performance, especially in differentiating wake from sleep. However, although these models are a convenient and economical means for consumers to obtain gross estimates of sleep parameters and time spent in sleep stages, they are of limited specificity and are not a substitute for PSG.
Cost-effective vital signs collecting system based on fast biosensors and a flexible Cloud microservices architecture for the prognosis of infectious diseases (Preprint)
Authors: Garces-Jimenez Alberto , Calderon-Gomez Huriviades , Gomez-Pulido Jose-Manuel , Vargas-Lombardo Miguel , Castillo-Sequera Jose-Luis , Polo-Luque Maria-Luz , Sencion-Martinez Gloria Lisette , Sanz-Moreno Jose
Published: October 2019

BACKGROUND

Quite often, patients arrive to consultation when the symptoms of an infectious disease are already serious, forcing doctors to divert them to the emergency services. Particularly, the possible anticipation of the diagnosis -prognostic- for institutionalized people would lead to soften the treatment, increasing resident’s wellness and alleviating the degradation of the emergency services. Big data, mobile communications, cloud services or machine learning technologies applied in medicine -e-Health- assist practitioners with efficient tools.

OBJECTIVE

This article describes a new data collection system for predicting infectious diseases in elderly people, supporting future telecare and medical recommender applications.

METHODS

The system provides a medical database updated with vital signs that nurses take with medical sensors from residents. The Cloud database is accessible with a flexible microservices software architecture.

RESULTS

The e-Health system components are cost-effective, leading to massive implementations for servicing disadvantaged areas. The scalable architecture is prepared for big data applications that may extract valuable knowledge patterns for medical research.

CONCLUSIONS

The innovation relies in the combination of advanced e-Health technologies and procedures that delivers ubiquitously available quality data to provide multifaceted scalable low-cost applications to improve resident’s wealth and release public health care services.
Benefits of Teledermatology for Geriatric Patients: Population-Based Cross-Sectional Study (Preprint)
Authors: G Bianchi Mara , Santos Andre , Cordioli Eduardo
Published: October 2019

BACKGROUND

Teledermatology is a health care tool that has been increasingly used around the world, mostly because dermatology has an emphasis on visual diagnosis. Many studies have shown that access to specialized care improves using teledermatology, which provides accurate diagnosis and reduces the time taken for treatment, with high patient satisfaction. As the population around the world grows old, there will be even more demand for dermatologists in years to come. It is essential to know which are the most prevalent skin conditions in the primary care population and if they can be addressed through teledermatology.

OBJECTIVE

Our main goal was to evaluate the proportion of lesions in individuals aged 60 years and older that could be managed using teledermatology in conjunction with primary care physicians. Second, we aimed to assess the most frequent skin lesions, the most common treatments provided to patients, and the distribution and causes of referrals made by the teledermatologists.

METHODS

This was a retrospective cohort study from July 2017 to July 2018 in São Paulo, Brazil. We included 6633 individuals aged 60 years and older who presented with 12,770 skin lesions. Teledermatologists had three options to refer patients: (1) to undergo biopsy directly, (2) to an in-person dermatologist visit, and (3) back to the primary care physician with the most probable diagnosis and treatment.

RESULTS

Teledermatology managed 66.66% (8408/12614) of dermatoses with the primary care physician without the need for an in-presence visit; 27.10% (3419/12614) were referred to dermatologists, and 6.24% (787/12614) directly to biopsy. The most frequent diseases were seborrheic keratosis, solar lentigo, onychomycosis, melanocytic nevus, benign neoplasms, actinic keratosis, epidermoid cyst, xerosis, leucoderma, and wart, with significant differences between sexes. Malignant tumors increased with age and were the leading cause for biopsies, while infectious skin conditions and pigmentary disorders decreased. Emollient was the most frequent treatment prescribed, in 31.88% (909/2856) of the cases.

CONCLUSIONS

Teledermatology helped to treat 67% of the dermatoses of older individuals, addressing cases of minor complexity quickly and conveniently together with the primary care physician, thus optimizing dermatological appointments for the most severe, surgical, or complex diseases. Teledermatology does not aim to replace a face-to-face visit with the dermatologist; however, it might help to democratize dermatological treatment access for patients and decrease health care expenses.