bluuebunny/crossref_metadata_2025 huggingface dataset:
A Needs Assessment for Postgraduate Training in Selected Public Health Disciplines at the University of Zambia: A Mixed Methods Study
Authors: Bulawayo Maio , Silumbwe Adam , Munakampe Margarate Nzala , Mukumbuta Nawa , Musabula Juliet , Chewe Mwimba , Mweemba Chriss , Michelo Charles , Hangoma Peter
Published: December 2019

Background: As most low and middle-income countries seek to achieve universal health coverage targets, there is an ever-increasing need to train human resources with the required core skills and competencies. This study reports on the needs assessment conducted to understand postgraduate training needs for three selected public health disciplines – Health Policy and Systems, Health Economics, and Healthcare Management and Planning – at the University of Zambia. Methods: The study adopted a cross sectional survey design. Data were collected through semi-structured interviews administered to 32 participants, identified through a comprehensive stakeholder mapping process, holding selected management positions in public and private health service organisations across Zambia. The organisations included regulatory authorities, research institutions, government ministries, insurance firms, multilateral and health services organisations. Results: Overall, more than 68% of the stakeholders reported that they had no employees that were formally trained in the three disciplines. More than 90% of the stakeholders opined that training in these disciplines would be beneficial in providing competencies to strengthen service provision. The horizontal skills mismatch for health economics, and health services management and planning were found to be 93% and 100%, respectively. Among the key public health training needs were: policy development and analysis, economic evaluation, and strategic management. Conclusions: This study confirms that introducing post graduate training in the proposed public health disciplines will not only benefit Zambian health services organisations, but also help strengthen the health systems in general. For other empirical contexts, the findings imply the need for the introduction of academic programmes which respond to ever-changing public health skills demanded; and should be matched with local priorities and service delivery. Key words: Health policy & systems, health services management & planning, health economics.
The COngenital HeARt Disease in adult and Pulmonary Hypertension (COHARD-PH) registry: a descriptive study from single-center hospital registry of adult congenital heart disease and pulmonary hypertension in Indonesia
Authors: Dinarti Lucia Kris , Hartopo Anggoro Budi , Kusuma Arditya Damar , Satwiko Muhammad Gahan , Hadwiono Muhammad Reyhan , Pradana Aditya Doni , Anggrahini Dyah Wulan
Published: December 2019

Backgrounds: The COngenital HeARt Disease in adult and Pulmonary Hypertension (COHARD-PH) registry is the first congenital heart disease (CHD) and CHD-related pulmonary hypertension (PH) in adults registry in Indonesia. The study aims to describe prevalence, characteristics, and hemodynamic the demographics, clinical presentation, and hemodynamics data of adult CHD and CHD-related PH in Indonesia.
Methods: The COHARD-PH registry is a hospital-based, single-center, and prospective registry which includes adult patients with CHD and CHD-related PH. The patients were enrolled consecutively. For this study, we evaluated the registry patients from July 2012 until July 2018 2019. The enrolled patients underwent clinical examination, electrocardiography, chest x-ray, 6 minute walking test, laboratory measurement, and transthoracic and transoesofageal echocardiography. Right heart catheterisation was performed to measure hemodynamics and confirmed the diagnosis of pulmonary artery hypertension (PAH).
Results: We registered 803 1012 patients during the study. The majority were young-adult females. The majority of CHD was secundum ASD (79.0%) (73.4%). The main symptom was dyspneu on effort. The majority of patients (78.1%) (77.1%) had already developed signs of PH assessed by echocardiography. The Eisenmenger syndrome was encountered in 17.3% 18.7% patients. Based on the right heart catheterisation, 67.8% 66.9% patients had developed PAH. Patients with PAH were significantly older, had lower peripheral oxygen saturation, had lower 6 minute walking distance, and had higher NTproBNP. There was an increased of proportion of PAH prevalence according to age range, with the highest prevalence between 51 and 60 years old.
Conclusions: The COHARD-PH registry is the first Indonesian adult-CHD and CHD-related PH registry. The prevalence, characteristics, and hemodynamics data demographics, clinical presentation, and hemodynamics data of this registry reflects situation in developing countries which need to be compared with similar registries from developed countries.
Factors Associated With Low Handgrip Strength In The Elderly: Data Of The Study Of Chronic Diseases (EDOC-I)
Authors: Amaral Cledir de Araújo , Amaral Thatiana Lameira Maciel , Monteiro Gina Torres Rego , de Vasconcellos Mauricio Teixeira Leite , Portela Margareth Crisostomo
Published: December 2019

Background Handgrip strength (HGS) is a recognized important health biomarker, whose low scores have showed an evident association with morbimortality of adults and elderly people from various parts of the world. This study aimed to analyze the factors associated with low HGS in elderly persons in Rio Branco, Acre, Brazil.Methods The study was carried out with data from the Study of Chronic Diseases (EDOC-I) – Elderly, performed with 1,016 people aged over 60 residing in Rio Branco. Associations between variables of health status (psychological and physical) and low HGS, by sex, were estimated using logistic regression.Results The reduction of the median HGS ​​was 6.0 kg per decade among men, and 2.6 kg among women. A greater reduction was observed in the lower quintile of HGS of women aged over 80 years, 4.1 kg in relation to the previous decade. Factors independently associated with low HGS in men and women, respectively, were low weigh in BMI [OR 2.80 (1.22-6.44) and OR 2.61 (1.49-4.57)], anemia [OR 4.15 (2.14-8.04) and OR 1.80 (1.08-3.01)] and diabetes as a risk factor in men [OR 1.95 (1.02-3.73)] and as protection factor in women [OR 0.53 (0.28-0.99)]. There was a higher chance of low HGS in men with partners [OR 2.44 (1.35-4.42)], smokers or former smokers [OR 3.25 (1.29-8.19)], with current self-assessment of health worse than the 12 previous months [OR 2.21 (1.16-4.21)] and dependence in ADL [OR 2.92 (1.39-6.15)]. Only among women, there was an increased chance of low HGS associated with altered WHR [OR 1.79 1.04-3.07)], insomnia [OR 1.83 (1.12-2.98)] and physical activity from displacement/occupation [OR 1.75 (1.10-2.80)]Conclusion Factors associated with low HGS are not common to gender and the inclusion of HGS as a component of health seems to be a promising strategy for disease prevention and health promotion.
Cardiac Surgical Outcome Prediction by Blood Pressure Variability Indices Poincaré plot and Coefficient of Variation: a Retrospective Study
Authors: K Senthil Packiasabapathy , Prasad Varesh , Rangasamy Valluvan , Popok David , Xu Xinling , Novack Victor , Subramaniam Balachundhar
Published: December 2019

Background
Recent literature suggests a significant association between blood pressure variability (BPV) and postoperative outcomes after cardiac surgery. However, its outcome prediction ability remains unclear. Current prediction models use static preoperative patient factors. We aimed to test the performance of Poincaré plots and coefficient of variation (CV) independently by measuring intraoperative blood pressure variability.

Methods
In this retrospective, observational, cohort study, 3687 adult patients (> 18 years) undergoing cardiac surgery requiring cardio-pulmonary bypass from 2008 to 2014 were included. Blood pressure variability was computed by Poincare plots and CV. Standard descriptors (SD) SD1, SD2 were measured with Poincare plots by ellipse fitting technique. The outcomes analyzed were the 30-day mortality and postoperative renal failure. Logistic regression models adjusted for preoperative and surgical factors were constructed to evaluate the association between BPV parameters and outcomes. C-statistics were used to analyse the predictive ability.

Results
Analysis found that, 99 (2.7%) patients died within 30 days and 105 (2.8%) patients suffered from in-hospital renal failure. Logistic regression models including BPV parameters (standard descriptors from Poincare plots and CV) performed poorly in predicting postoperative 30-day mortality and renal failure [Concordance(C)-Statistic around 0.5]. They did not add any significant value to the standard STS risk score [C-statistic: STS alone 0.7, STS + BPV parmeters 0.7].

Conclusions
In conclusion, BP variability computed from Poincare plots and CV were not predictive of mortality and renal failure in cardiac surgical patients. Patient co-morbid conditions and other preoperative factors are still the gold standard for outcome prediction. Future directions include analysis of dynamic parameters such as complexity of physiological signals in identifying high risk patients and tailoring management accordingly.
Comparison of videolaryngoscopy and direct laryngoscopy by German paramedics during out-of-hospital cardiopulmonary resuscitation. An observational prospective study.
Authors: Risse Joachim , Volberg Christian , Kratz Thomas , Plöger Birgit , Jerrentrup Andreas , Pabst Dirk , Kill Clemens
Published: December 2019

Introduction: Videolaryngoscopy (VL) has become a popular method of intubation (ETI). Although VL may facilitate ETI in less-experienced rescuers there are limited data available concerning ETI performed by paramedics during CPR. The goal was to show the benefit of VL during CPR performed by German paramedics.We investigated in an observational prospective study the superiority of VL by paramedics during CPR compared with direct laryngoscopy (DL). Methods: In a single Emergency Medical Service (EMS) in Germany with in total 32 ambulances paramedics underwent an initial instruction from in endotracheal intubation (ETI) with GlideScope ® (GVL) during resuscitation. The primary endpoint was good visibility of the glottis (Cormack-Lehane grading 1/2), and the secondary endpoint was successful intubation comparing GVL and DL. Results: In total n = 97 patients were included, n = 69 with DL (n = 85 intubation attempts) and n = 28 VL (n = 37 intubation attempts). Videolaryngoscopy resulted in a significantly improved visualization of the larynx compared with DL. In the group using GVL, 82% rated visualization of the glottis as CL 1&2 versus 55% in the DL group (p = 0.02). Despite better visualization of the larynx, there was no statistically significant difference in successful ETI between GVL and DL (GVL 75% vs. DL 68.1%, p = 0.63). Conclusions: We found no difference in Overall and First Pass Success (FPS) between GVL and DL during CPR by German paramedics despite better glottic visualization with GVL.Therefore, we conclude that education in VL should also focus on insertion of the endotracheal tube, considering the different procedures of GVL.
Rising Prevalence of Multiple Sclerosis in Saudi Arabia, a Descriptive Study
Authors: Jumah Mohammed Al , Bunyan Reem , Otaibi Hessa Al , Towaijri Ghada Al , Karim Abid , Malik Yasser Al , Kalakatawi Mamdouh , Alrajeh Saad , Mejally Mousa Al , Gahtani Hussein Al , Almubarak Ali , Cupler Edward , Alawi Sadaga , Qureshi Shireen , Naharir Shahpar , Almalki Abdulrahman , Alhazzani Adel , Althubaiti Ibtisam , Alzahrani Naser , Mohamednour Elgamri , Saeedi Jameela , Ishak Samah , Al-mudaiheem Hajer , El-Metwally Ashraf , Jedaie Ahmed Al
Published: December 2019

Introduction In 2015, the first nationwide, multi-center MS registry was initiated in Saudi Arabia mainly with an objective to describe current epidemiology, disease patterns, and clinical characteristics of MS in Saudi Arabia. This article aimed to report initial findings of the registry and regional prevalence of MS. Method The registry included patients with confirmed MS diagnosis according to the 2010 McDonald Criteria. It aimed to identify and recruit all healthcare facilities treating MS patients in the Kingdom, and collect data such as demographics, clinical characteristics, family history, and treatments. All included sites have obtained IRB/EC approvals for participating in the registry. Currently, the registry includes 20 hospitals from different regions across the Kingdom. The Projected prevalence was calculated based on the assumption that the number of diagnosed MS cases in participating hospitals (in each region) is similar to the number of cases in remaining nonparticipant hospitals in the same region. Results As of September 2018, the registry has included 20 hospitals and has collected comprehensive data on 2,516 patients from those hospitals, with median age 32(Range: 11-63) and 66.5% being females. The reported prevalence of MS for those hospitals was estimated to be 7.70/100,000 population and 11.80/100,000 Saudi nationals. Based on the assumption made earlier, we projected the overall prevalence of MS at the country level to be 40.40/100,000 population and 61.95/100,000 Saudi nationals. 77.5% were 40 years of age or younger. The prevalence was higher among females, young and educated individuals across all five regions of Saudi Arabia Conclusion The prevalence of MS has significantly increased in Saudi Arabia but is still much lower than that in the western and other neighboring countries like Kuwait, Qatar, and the UAE. However, compared to the past rates, Saudi Arabia’s projected prevalence of MS through this national study is 40.40/100,000 population, putting them above the low risk zone as per Kurtzke classification. The projected prevalence was estimated to be much higher among Saudi nationals (61.95/100,000 Saudi-nationals). The prevalence was higher among female, younger and educated individuals. Further studies are needed to assess the risk factors associated with increased prevalence in Saudi Arabia.
Twenty-five Years On: Revisiting Bosnia and Herzegovina after Implementation of a Family Medicine Development Program.
Authors: Hodgetts Geoffrey , Brown Glenn , Batić-Mujanović Olivera , Gavran Larisa , Jatić Zaim , Račić Maja , Tešanović Gordana , Zahilić Amra , Martin Mary Imelda , Birtwhistle Richard
Published: December 2019

Background: The wars that ravaged the former Socialist Federal Republic of Yugoslavia in the 1990’s resulted in the near destruction of the healthcare system, including education of medical students and the training of specialist physicians. In the latter stages of the war, inspired by Family Medicine programs in countries such as Canada, plans to rebuild a new system founded on a strong primary care model emerged. Over the next fifteen-years, the Queen’s University Family Medicine Development Program in Bosnia and Herzegovina (B-H) played an instrumental role in rebuilding the primary care system through educational initiatives at the undergraduate, residency, Masters, PhD, and continuing professional development levels. Changes were supported by new laws and regulations to insure sustainability. This study revisited B-H 8-years after the end of the program to explore the impact of initiatives through understanding the perspectives and experiences of individuals at all levels of the primary care system from students, deans of medical schools, Family Medicine residents, practicing physicians, , Health Centre Directors and Association Leaders. Methods: Qualitative exploratory design using purposeful sampling. Semi-structured interviews and focus groups with key informants were conducted in English or with an interpreter as needed and audiotaped. Transcripts and field notes analyzed using an interpretative phenomenological approach to identify major themes and subthemes. Results: Overall, 118 participants were interviewed. Three major themes and 9 subthemes were identified including (1) The Development of Family Medicine Education, (subthemes: establishment of departments of family medicine, undergraduate medical curriculum change), (2) Family Medicine as a Discipline (Family Medicine specialization, academic development, and Family Medicine Associations), and (3) Health Care System Issues (continuity of care, comprehensiveness of care, practice organization and health human resources). Conclusions: Despite the impact of years of war and the challenges of a complex and unstable postwar environment, initiatives introduced by the Queen’s Program succeeded in establishing sustainable changes, allowing Family Medicine in BH to continue to adapt without abandoning its strong foundations. Despite the success of the program, the undervaluing of Primary Care from a human resource and health finance perspective presents ongoing threats to the system.
Paroxetine suppresses reactive microglia-mediated but not lipopolysaccharide-induced inflammatory responses in primary astrocytes
Authors: Zhang Xiong , Zhu Lan-Bing , He Jia-Hui , Zhang Hong-Qiu , Ji Shu-Ya , Zhang Chao-Nan , Hou Na-Na , Huang Chen-Ping , Zhu Jian-Hong
Published: December 2019

Background: Astrocytes are the most abundant glial cells in a brain that mediate inflammatory responses and provide trophic support for neurons. We have previously disclosed that paroxetine, a common selective serotonin reuptake inhibitor, ameliorates LPS-induced microglia activation. However, it remains elusive of the role of paroxetine in astrocytic responses.
Methods: Isolated primary astrocytes were pretreated with paroxetine and stimulated with different stimuli, lipopolysaccharide (LPS) or microglia conditioned medium pre-activated with LPS (M/Lps). Inflammatory and neurotrophic responses, underlying mechanisms and the impact on neuronal survival were assessed.
Results: Paroxetine had no impact on LPS-stimulated iNOS, TNF-α and IL-1β expression, but inhibited M/Lps-induced TNF-α and IL-1β expression in primary astrocytes. Paroxetine suppressed M/Lps- but not LPS-induced activation of NF-κB and had no impact on activation of MAPKs and STAT3. Incubation with the resulted astrocyte conditioned media caused no change in viability of SH-SY5Y cells. BDNF and MANF mRNA expressions were upregulated by M/Lps and paroxetine, respectively. However, M/Lps- or LPS-induced extracellular releases of NO, TNF-α and/or BDNF in astrocytes were in minor amount compared to those by microglia.
Conclusions: Paroxetine ameliorates the reactive microglia-mediated inflammatory responses in astrocytes partially via inhibition of NF-κB pathway, but has no impact on LPS-stimulated astrocyte activation. While the effect of paroxetine on secondary astrocytic responses are not robust compared to its effect on the innate immune responses of microglia, the results together may implicate a therapeutic potential of paroxetine against neuroinflammation-associated neurological disorders such as Parkinson’s disease.
Keywords: paroxetine, astrocytes, microglia, neuroinflammation, Parkinson’s disease
Comparative cytological and transcriptome analysis reveals high pollen fertility and upregulation of related genes in neo-tetraploid rice
Authors: Wu Jinwen , Chen Yuanmou , Lin Hong , Chen Yang , Yu Hang , Lu Zijun , Li Xiang , Zhou Hai , Chen Zhixiong , Liu Xiangdong
Published: December 2019

Background: Autotetraploid rice is a useful germplasm for polyploid rice breeding; however, low seed setting is a major hindrance for the utilization of autotetraploid rice. Our previous study demonstrated that neo-tetraploid rice have great yield potential, which is thought to be one effective way to overcome the low fertility of autotetraploid rice. However, there is little known about the cause of high pollen fertility in neo-tetraploid rice. Here, we employed cytology and RNA-seq to study the molecular genetic mechanism of high pollen fertility in neo-tetraploid rice.Results: Cytological observations indicate that H1 displayed high pollen fertility (95.62%), lower percentage of PMC cell abnormalities, and stable chromosome configurations during the pollen development process compared with its two parents. RNA-seq analysis detected 1483 differentially expressed genes (DEGs) in neo-tetraploid rice compared with its two parents. Of these DEGs, 433 were annotated as pollen fertility-related genes, and 240 (~55.4%) exhibited significant upregulation in neo-tetraploid rice compared with its two parents, including nine cloned genes ( CSA , TMS5 etc.) that were validated by qRT-PCR and had been demonstrated to be pollen fertility-related genes. We further selected TMS5 as a candidate gene and analysed its phenotype in neo-tetraploid rice using the CRISPR/Cas9 technique. Significant variations have been detected in phenotypic charts, pollen development process and expression level in H1 and its TMS5 knockout lines.Conclusions: Our finding provides strong evidence for the regulatory mechanisms of neo-tetraploid rice, and upregulation of pollen fertility-related genes should be associated with high fertility. Moreover, the present study provides a new useful germplasm for polyploidy rice breeding.
Comparative analysis of the transcriptomes of two rice subspecies reveals differentially expressed genes associated with phenotypic differences and reproductive isolation
Authors: pang hongbo , Wang Junrui , Chen Qiang , Li Jiaqi , Li Yueying , Wu Longkun , Yang Qingwen , Zheng Xiaoming
Published: December 2019

Background: Rice has been used as a model plant to study adaptation, genome evolution and reproductive isolation among species and the genetics and evolution of complex traits. Two subspecies of cultivated rice, Oryza sativa ssp. indica and O. sativa ssp. japonica, with reproductive isolation and differences in morphology and phenotypic differences, were established during the process of rice domestication. Results: To understand how domestication has changed the transcriptomes of the two rice subspecies and given rise to the phenotypic differences, we obtained approximately 700 Gb RNA-Seq data from 26 indica and 25 japonica plants, and identified 97,005 transcribed fragments and 7702 novel transcriptionally active regions. We also identified 1857 (4.58% in all genes) differentially expressed genes (DEGs) between indica and japonica rice. According to previous population genetic analyses, these DEGs may associate with the phenotypic differences between the two subspecies. Functional annotation of these DEGs indicates that they are involved in cell wall biosynthesis and reproductive processes. Furthermore, compared with the non-DEGs, the DEGs from both subspecies had more 5′ flanking regions with low polymorphism to divergence ratios, indicating a stronger positive selection pressure on the regulation of the DEGs.Conclusion: This study improves our understanding of the rice genome by comparatively analyzing the transcriptomes of indica and japonica rice and identifies DEGs that may be responsible for the reproductive isolation and phenotypic differences between the two rice subspecies.
Enhancing Xanthine Dehydrogenase Activity is an Effective Way to Delay Leaf Senescence and Increase Rice Yield
Authors: Han Ruicai , He Xunfeng , Pan Xiaohua , Shi Qinghua , Wu Ziming
Published: December 2019

Xanthine dehydrogenase (XDH) is an important enzyme in purine metabolism. It is involved in regulation of the normal growth and non-biological stress-induced ageing processes in plants. The present study investigated XDH’s role in regulating rice leaf senescence. We measured physical characteristics, chlorophyll content and fluorescence parameters, active oxygen metabolism, and purine metabolism in wild-type Kitaake rice ( Oryza sativa L.), an OsXDH over-expression transgenic line ( OE9 ), and an OsXDH RNA interference line ( Ri3 ) during different growth stages. The expression patterns of the OsXDH gene confirmed that XDH was involved in the regulation of normal and abiotic stress-induced ageing processes in rice. There was no significant difference between the phenotypes of transgenic lines and wild type at the seedling stage, but differences were observed at the full heading and maturation stages. The OE9 plants were taller, with higher chlorophyll content, and their photosystems had stronger light energy absorption, transmission, dissipation, and distribution capacity, which ultimately improved the seed setting rate and 1000-seed weight. The opposite effect was found in the Ri3 plants. The OE9 line had a strong ability to remove reactive oxygen species, with increased accumulation of allantoin and alantoate. Experimental spraying of allantoin on leaves showed that it could alleviate chlorophyll degradation and decrease the content of H 2 O 2 and malonaldehyde (MDA) in rice leaves after the full heading stage. The urate oxidase gene ( UO ) expression levels in the interference line were significantly lower than those in the over-expression line and wild-type lines. The allantoinase ( ALN ) and allantoate amidinohydrolase ( AAH ) genes had significantly higher expression in the Ri3 plants than the in OE9 or wild-type plants, with OE9 plants showing the lowest levels. The senescence-related genes ACD1 , WRKY23 , WRKY53 , SGR , XERO1 , and GH27 in Ri3 plants had the highest expression levels, followed by those in the wild-type plants, with OE9 plants showing the lowest levels. These results suggest that enhanced activity of XDH can regulate the synthesis of urea-related substances, improve plant antioxidant capacity, effectively delay the ageing process in rice leaves, and increase rice yield.
Evaluating the efficacy of a low-cost, minimally-invasive cognitive MRI targeted biopsy protocol in the Prostate Imaging Reporting and Data System (PI-RADS) version 2 era.
Authors: Takeshima Yuta , Tanaka Yoshinori , Takemura Kotaro , Nakazono Shusaku , Yamashita Eiko , Kume Haruki
Published: December 2019

Background: New MRI-guided targeting biopsy methods have increased cancer yield of prostate biopsies. However, cost and time constraints have made it difficult for many institutions to implement these newer methods. We evaluated the diagnostic performance of a low-cost, minimally-invasive, cognitive MRI-targeted biopsy protocol based on 1.5T multiparametric MRI graded with Prostate Imaging Reporting and Data System version 2 that is easily implemented in any low- to intermediate- volume center. Methods: Retrospective analysis of 255 patients who underwent prostate biopsy between December 2016 and March 2019 at a single facility. Indication for biopsy was based on clinical parameters including 1.5T multiparametric MRI. In addition to 10-core systematic biopsy, targeted cores were obtained with cognitive recognition under ultrasound. A control group of 198 patients biopsied without prior MRI from January to December 2015 was also analyzed. Results: Prostate biopsy preceded by MRI had a significantly higher probability of detecting both prostate cancer (68.1% vs. 43.6%) and clinically significant cancer (56.2% vs. 29.4%) (p values< 0.01). Combination of systematic biopsy and targeted biopsy outperformed either regimen alone for detection of prostate cancer. Multivariate analysis showed PSA density and prostate imaging reporting and data system score were independent risk factors of prostate cancer. A proposed diagnostic model showed sensitivity of 88.6%, specificity of 55%, PPV of 81.2%, NPV of 68.8%, and accuracy of 78%. Prostate imaging reporting and data system score was correlated with a higher presence of prostate cancer, clinically significant prostate cancer, and a higher pathological grade. Conclusions: Incorporation of pre-biopsy MRI imaging, scoring, and targeted biopsy improved cancer yield and achieved diagnostic performance comparable to newer methods of higher cost. Future alterations of possible benefit included increasing the number of target cores per lesion, and combining prostate imaging reporting and data system score and PSA density as indicators for biopsy.
Echocardiographic evidence of left ventricular untwisting-filling interplay
Authors: Hodzic Amir , Garcia Damien , Saloux Eric , Ribeiro Paula A.B. , Ethier Amélie , Thomas James D. , Milliez Paul , Normand Hervé , Tournoux Francois
Published: December 2019

Background: Left ventricular untwisting generates an early diastolic intraventricular pressure gradient (DIVPG) than can be quantified by echocardiography. We sought to confirm the quantitative relationship between peak untwisting rate and peak DIVPG in a large adult population.Methods: From our echocardiographic database, we retrieved all the echocardiograms with a normal left ventricular ejection fraction, for whom color Doppler M-Mode interrogation of mitral inflow was available, and left ventricular untwisting rate was measurable using speckle tracking. Standard indices of left ventricular early diastolic function were assessed by Doppler (peaks E, e’ and Vp) and speckle tracking (peak strain rate Esr). Load dependency of DIVPG and untwisting rate was evaluated using a passive leg raising maneuver. Results: We included 154 subjects, aged between 18 to 77 years old, 63% were male. Test-retest reliability for color Doppler-derived DIVPG measurements was good, the intraclass correlation coefficients were 0.97 [0.91-0.99] and 0.97 [0.67-0.99] for intra- and inter-observer reproducibility, respectively. Peak DIVPG was positively correlated with peak untwisting rate (r = 0.73, P < 0.001). On multivariate analysis, peak DIVPG was the only diastolic parameter that was independently associated with untwisting rate. Age and gender were the clinical predictive factors for peak untwisting rate, whereas only age was independently associated with peak DIVPG. Untwisting rate and DIVPG were both load-dependent, without affecting their relationship. Conclusions: Color Doppler-derived peak DIVPG was quantitatively and independently associated with peak untwisting rate. It thus provides a reliable flow-based index of early left ventricular diastolic function.
Kids in a Candy Store: An objective analysis of children's interactions with food in convenience stores
Authors: McKerchar Christina , Smith Moira , Gage Ryan , Williman Jonathan , Abel Gillian , Lacey Cameron , Mhurchu Cliona Ni , Signal Louise
Published: December 2019

Background: Increasing rates of childhood obesity worldwide has focused attention on the obesogenic food environment and how it influences dietary behaviour and bodyweight in children. The neighbourhood convenience store is a key setting in children’s food environments. The Kids’Cam study enabled the objective measurement of the world in which children live. This paper reports on an analysis of children’s interaction with food in convenience stores.Methods: Kids’Cam NZ was a cross-sectional study conducted from July 2014 to June 2015 in the Wellington region of New Zealand, in which 168 randomly selected children aged 11-14 years old wore a wearable camera for a 4-day period. The camera captured a 136° image of the children’s surroundings every seven seconds. In this ancillary study, ‘Kids’Cam Convenience Stores’, images from children who visited a convenience store were manually coded for food and drink availability, marketing, purchase and consumption. Results: Twenty-two percent of children (n=37) visited convenience stores on 62 occasions during the 4-day data collection period. Non-core items dominated the food and drinks available to children in convenience stores at a rate of 8.3 to 1 (means, 300 non-core and 36 core, respectively). The food and drinks marketed in-store were overwhelmingly non-core, and promoted using accessible placement, price offers, product packaging, and signage. Most of the 70 items purchased by children were non-core foods or drinks (94.6%) and all of the purchased food or drink subsequently consumed by children was non-core. Confectionary and sugary drinks were the items most frequently purchased and consumed. Conclusions: This research highlights convenience stores as a key source of unhealthy food and drink for children, where unhealthy food and drinks are marketed, available, and subsequently purchased and consumed. Policies are urgently needed to reduce the role of convenience stores in the obesogenic food environment in which children live.
Development and application of loop-mediated isothermal amplification label-based nanoparticles lateral flow biosensor for detection of Mycobacterium tuberculosis
Authors: Wang Xingyun , Wang Yi , Jiao Weiwei , Wang Guirong , Wang Yacui , Quan Shuting , Qi Hui , Sun Lin , Shen Chen , Li Jieqiong , Huang Hairong , Shen Adong
Published: December 2019

Tuberculosis is a serious disease with high morbidity and mortality, thus rapid and cost-effective diagnostic test for Mycobacterium tuberculosis (MTB) is urgently needed. Here, a novel detection diagnostic technique, termed as loop-mediated isothermal amplification label-based nanoparticles with lateral flow biosensor (LAMP-LFB), was developed and evaluated for rapid, reliable and objective detection of MTB. Two sets of primers, which targeted IS 6110 and IS 1081 sequences of MTB, were simultaneously designed for establishment of LAMP-LFB assay. The optimal reaction conditions of MTB-LAMP-LFB assay confirmed were 66ºC for only 50min. The analytical sensitivity of MTB-LAMP-LFB is 10fg of genomic templates in pure culture, and the detection results obtained from LFB was in conformity with agarose gel electrophoresis. No cross-reactivity with other common bacteria and non-tuberculous mycobacteria strains (NTM) was obtained. A total of 158 clinical samples were collected from presumptive 158 TB patients, were used for evaluating the feasibility of MTB-LAMP-LFB assay. Among 98 TB patients diagnosed with composite reference standard, the positive rate for MTB detection using liquid culture, Xpert MTB/RIF and LAMP-LFB were 40.0% (39/98), 50.0% (48/98), and 86.7% (85/98), respectively. Among 39 culture confirmed samples, 84.6% (33/39) cases were Xpert MTB/RIF-positive and 92.3% (36/39) were LAMP-LFB-positive. For the 59 clinically diagnosed TB cases 25.4% (15/59) and 83.0% (49/59) were Xpert MTB/RIF-positive and LAMP-LFB positive, respectively. Therefore, MTB-LAMP-LFB assay is a simple, reliable, and sensitive method for MTB detection and maybe prospective in early diagnosis of MTB.
Aspirin for metal stent in malignant distal common bile duct obstruction (AIMS): Study protocol for a multicenter randomized controlled trial
Authors: Choi Jin Ho , Paik Woo Hyun , You Min Su , Lee Kyong Joo , Choi Young Hoon , Shin Bang-sup , Lee Sang Hyub , Ryu Ji Kon , Kim Yong-Tae
Published: December 2019

Background Endoscopic retrograde biliary drainage (ERBD) is the treatment of choice for patients with malignant distal common bile duct (CBD) obstruction. Self-expandable metal stents (SEMS), which are commonly used in unresectable cases, have many clinical advantages, including longer stent patency. Although the expected patency of SEMS is around eight months, it has recently been reported that the duration of SEMS patency in patients using aspirin is prolonged. Our study therefore aims to confirm the effect of aspirin on SEMS patency. Methods This is an investigator-initiated, prospective, multicenter, double-blind, randomized placebo-controlled trial that will be conducted from November 2017 in four tertiary centers in South Korea. We intend to include in our study 184 adult (≥ 20 years) patients with malignant distal CBD obstruction for whom ERBD with SEMS was successfully performed. The patients will be randomly allocated to two groups, which will comprise patients who have either taken 100 mg aspirin or a placebo for six months after index ERBD. The primary outcome will be the rate of stent dysfunction, and the secondary outcomes will be the duration of patency, the rate of reintervention, and the occurrence of adverse events. Discussion The aspirin for metal stents in malignant distal common bile duct obstruction (AIMS) study will determine the efficacy of aspirin in maintaining metal stent patency in patients with malignant distal CBD obstructive.
Transmissão do diagnóstico de câncer sob a perspectiva da observação psicológica
Authors: Silva Tamires Daiane da , Foger Débora , Pizato Elaine Cristina Gardinal , Santos Paulo Sérgio da Silva
Published: December 2019

Introdução: A transmissão do diagnóstico de câncer pode gerar ansiedade e nervosismo no indivíduo, por não saber lidar com essa situação, assim, o indivíduo entende como se a morte fosse o único desfecho nessa situação. Objetivo: observar como a pessoa com câncer e seus familiares se comportaram no momento do diagnóstico. Materiais e métodos: Para realizar este estudo, utilizou-se o relato de caso para avaliar como o paciente e seus familiares receberam informações sobre o diagnóstico de câncer. O procedimento utilizado foi a observação não participante, pois com ela foi possível descrever os dados e comportamentos expostos em um determinado momento. Resultados: Por meio da observação, ficou claro o quanto o diagnóstico de câncer sacode a estrutura familiar, uma vez que a doença se refere ao sinônimo de morte. Conclusões: foi possível observar os comportamentos em uma situação difícil, que é receber um diagnóstico de câncer. Com este estudo, os pontos comuns entre o que foi observado e o que a literatura traz sobre a transmissão do diagnóstico de câncer, como medo e ansiedade, foram percebidos.Descritores: Neoplasias; Diagnóstico Bucal; Psicologia; Observação.ReferênciasYamaguchi NH. O câncer na visão da oncologia. In: Carvalho MMMJ. Introdução à Psiconcologia. Campinas: Livro Pleno; 2003.Gimenes MGG. Definição, foco de estudo e intervenção. In: Carvalho MMMJ. Introdução à Psiconcologia. Campinas: Livro Pleno; 2003.Carvalho MMMJ. Psico-Oncologia: história, características e desafios. Psicologia USP. 2002;13:151-66.World Halth Organization (WHO). The World Health Organization’s fight against cancer: strategies that prevent, cure and care. 2007.Farinhas GV, Wendling MS, Dellazzana-Zanon LL. Impacto psicológico do diagnóstico de câncer na família: um estudo de caso a partir da percepção do cuidador. Pensando Fam. 2013;17: 111-29. Landskron LMF. Psicooncologia: as descobertas sobre o câncer ao longo da história. In: Hart CFM. Câncer: uma abordagem psicológica. Porto Alegre: AGE; 2008.Silva VCE, Fontão Zago MM. A revelação do diagnóstico de câncer para profissionais e pacientes. Rev Bras Enferm. 2005;58:476-80.Carvalho MMMJ. O sofrimento da dor em câncer. In: Carvalho MMMJ. Introdução à Psiconcologia. Campinas: Livro Pleno. 2003.Scorsolini-Comin F, Vilela e Sousa L, Santos MA. Tornanr-se psicólogo: experiência de estágio de Psico-Oncologia em equipe multiprofissional de saúde. Rev bras orientac prof. 2008;9(2):113-25.Donna MF, Matos MA. A necessidade da observação em ciência. In: Donna MF,  Matos MA. Ensinando observação: uma introdução. 4. ed. São Paulo:  Edicon; 1999.
Relevant Management Aspects of Health Tourism Networking
Authors: Banevičius Šarūnas
Published: December 2019

The article deals with the process, concept, system and management aspects of health tourism networking. Addressing the problem of research: how to manage the networking process in health tourism. Summarizing the analysed scientific literature it can be stated that the participants of the network are not analysed individually. They are analysed in relation to other network participants, thus connecting them to a common system. Connections (links, interactions, contacts) between participants are a kind of interaction between two or more participants in a network when resources are transmitted over specific channels. Relationship is a concept that encompasses both form and content aspects. The dyadic level explores the nature of the connection between two or more network nodes. Examining the aspects of networking process management highlights the importance of strategic management and synergies with management theories: Fayol (administrative theory); agent-contract theory for networking partnerships. The aspects of management theories have applicability in the management of health tourism networking, and the decision-making process plays a crucial role – both individual and group decision making begins with a set of information that defines the situation, assesses expected benefits, anticipates possible choices, and possible consequences. The decision-making process ends with the choice of a specific alternative. By applying the CMO configuration model to the decision making process, a systematic solution mechanism is created for each problematic situation. In order for the Lithuanian health tourism segment and its organizations to function as an integrated system and develop along the path of sustainable development, it is expedient to develop a common strategy in the planning process, envisaging the vision, goals and objectives of Lithuanian health tourism and ensuring a feedback mechanism. To implement this process, it is recommended that a formal health tourism network (involving health service organizations, the scientific community) would be established, based on participant agreements. The aim of this network is to create and develop a variety of health tourism services. The resulting networks are formalized through contracts, legal acts, memoranda of understanding, general agreements, so the relationships, functions and responsibilities of their participants are clearly defined.
The Predicted Effect of Projected Climate Change on the Economics of Conservation Tillage
Authors: Hodde Whitney , Sesmero Juan , Gramig Benjamin , Vyn Tony , Doering Otto
Published: December 2019

We evaluate the economics of conservation tillage (chisel till and no till) and examine the impact of projected climate change on the economic attractiveness of reduced tillage practices. We use data from a long‐term (39‐yr) field experiment in Indiana to estimate yield response functions describing the relationship between tillage practices and corn (Zea mays L.) and soybean (Glycine max L.) yields in poorly drained (but systematically tile‐drained) soils, and the mediating role of weather and crop rotation on that relationship. We subsequently couple estimated yield functions with stochastic simulations of weather variables under current and projected climatic regimes to construct distributions describing the probability that conservation tillage will result in higher profits than more intensive tillage under alternative crop rotations. We calculate the subsidy, if needed, that would make a risk‐neutral farmer indifferent between conservation and intensive tillage practices under alternative climatic regimes. A key finding of this study is that projected climate change enhances the economics of conservation tillage, thereby substantially reducing the economic hurdle required to induce its adoption in the study area. The framework developed and demonstrated can be applied to areas with different soils and growing conditions to examine the economics of conservation tillage under current and future climate.

Core Ideas

We examine effect of climate change on economics of reduced tillage.

We use data from a long‐term field experiment in Indiana

We calculate probability that reduced till will result in higher profit

Projected climate change enhances the economics of conservation tillage

Climate change may substantially reduce subsidies required for adoption
IMPACTOS AMBIENTAIS EM MANGUEZAIS NO CEARÁ: CAUSAS E CONSEQUÊNCIAS
Authors: Maia Rafaela Camargo , Silva e Sousa Kamila Nara , De Almeida Jorge Benevides Jorgeana , Amorim Veruska Guilherme , De Sousa Regina Maria
Published: December 2019

O manguezal é um ecossistema costeiro, com uma vegetação adaptada a variações de salinidade e solo não consolidado, funcionando como berçário natural para uma grande variedade de espécies da fauna. Esses atributos tornam o manguezal detentor de elevada importância ecológica e econômica, tornando-o susceptível a pressões decorrentes de atividades antrópicas. O presente estudo buscou investigar na literatura os bosques de mangue e as alterações que sofrem com os impactos ambientais negativos causados pelas atividades antrópicas, especialmente no estado do Ceará. Os resultados do estudo bibliográfico indicam que os manguezais têm sofrido inúmeras ações deletérias provenientes do desenvolvimento econômico e do crescimento desordenado das populações humanas, que sufocam esses ambientes promovendo a intensa utilização de seus recursos. No Ceará, merece destaque como fatores estressantes, o desmatamento, a carcinicultura e a disposição inadequada de resíduos sólidos, que influenciam na distribuição espacial, abundância e desenvolvimento das espécies. Sendo assim, necessário o monitoramento das áreas de manguezais remanescentes a fim de subsidiar a tomada de decisão, a elaboração de políticas públicas e planos de manejo para garantir a preservação efetiva desse ecossistema.
PROJETO DIVAS: DESENVOLVIMENTO DE AÇÕES SOCIOEDUCATIVAS PARA INCLUSÃO, DESMISTIFICAÇÃO E EMPODERAMENTO DA MULHER EM TECNOLOGIAS DA INFORMAÇÃO E COMUNICAÇÃO
Authors: De Oliveira Carina Teixeira , De Oliveira Karol Teixeira , Barbosa Alice Feitosa , Ferreira Hélen Abdala , Da Silva Neta Maria de Lourdes
Published: December 2019

A conquista da igualdade de gênero está diretamente atrelada ao empoderamento da mulher, que, por sua vez, caminha ao lado da educação formal e consequente profissionalização. Para tanto, deve-se investir na adesão feminina em todos os campos do saber, sendo maior o desafio da inclusão na área de Tecnologia da Informação e Comunicação (TIC), desmistificando o tradicional pensamento que costuma associar a área de ciências exatas a uma suposta "vocação masculina". Neste contexto, este trabalho tem como objetivo principal apresentar o projeto "DesenvolvImento de ações socioeducatiVas para inclusão, desmistificAção e empoderamento da mulher em tecnologiaS da informação e comunicação" (DIVAS), que atua em duas linhas principais: (i) desmistificando as TICs para estudantes de ensino fundamental, médio e superior da região de Aracati-CE; (ii) combatendo a evasão e retenção de mulheres no curso de Bacharelado em Ciência da Computação do IFCE Campus Aracati. Inicialmente, são apresentados dados quantitativos e qualitativos que contextualizam a relevância da proposta. Em seguida, é apresentada a metodologia detalhada do projeto, para que possa auxiliar professores, pesquisadores, instituições de educação ou financiadores interessados em realizar iniciativas semelhantes. Os resultados do presente artigo fortalecem as instituições (educacionais, governamentais etc) e contribuem para a mudança na percepção do papel da mulher na sociedade, incentivando e promovendo projetos educacionais, sociais, de direitos humanos e/ou de justiça com foco no empoderamento da mulher dentro e fora das TICs.