bluuebunny/crossref_metadata_2025 huggingface dataset:
Associations of self-reported atopic dermatitis with comorbid conditions in adults: a population-based cross-sectional study
Authors: Smirnova Jevgenija , Montgomery Scott , Lindberg Magnus , Svensson Åke , von Kobyletzki Laura
Published: December 2020

Background

The objective of this study was to investigate the relationships between atopic dermatitis (AD) and other common chronic health conditions in adults.

Methods

A cross-sectional survey was sent to a randomly selected population sample of 78,004 adults in Sweden. The questionnaires included measures of self-reported physical and mental health. Binary and multinomial logistic regression were used to examine the associations of AD with common chronic health conditions and psychological wellbeing.

Results

AD was self-reported by 4,175 respondents, representing almost 14% of the study population of 34,313 adults. Our results showed positive associations between AD and chronic health disorders, including conditions of the oral cavity: chronic obstructive pulmonary disease (adjusted odds ratio [aOR] = 1.58, 95% confidence interval [CI]: 1.30 to 1.92), asthma (aOR = 2.13, 95% CI: 1.91 to 2.38), mild recurrent gastrointestinal symptoms (adjusted relative risk ratio [aRRR] = 1.78, 95% CI: 1.64 to 1.92), high blood pressure (aOR = 1.16, 95% CI: 1.06 to 1.26), obesity (aOR = 1.34, 95% CI: 1.23 to 1.47), mild joint pain (aRRR = 1.47, 95% CI: 1.35 to 1.61), mild headache or migraine (aRRR = 1.50, 95% CI: 1.38 to 1.64), caries (aOR = 1.25, 95% CI: 1.04 to 1.49), bleeding gums (aOR = 1.69, 95% CI: 1.38 to 2.08), periodontitis (aOR = 1.42, 95% CI: 1.13 to 1.77), sensitive teeth (aOR = 1.57, 95% CI: 1.35 to 1.82), and dry mouth (aOR = 1.52, 95% CI: 1.33 to 1.74). Adjustment for asthma and depression attenuated the magnitude of the associations between AD and the study outcomes. AD was also associated with poorer general psychological wellbeing.

Conclusions

Adults reporting AD may be at increased risk of chronic disorders and decreased psychological wellbeing. Physicians should recognize that individuals with severe AD and those with comorbid asthma or depression may be especially vulnerable.
Effects of habitat edges on vegetation structure and the vulnerable golden-brown mouse lemur (Microcebus ravelobensis) in northwestern Madagascar
Authors: Andriatsitohaina Bertrand , Romero-Mujalli Daniel , Ramsay Malcolm S. , Kiene Frederik , Rasoloharijaona Solofonirina , Rakotondravony Romule , Lehman Shawn M. , Radespiel Ute
Published: December 2020

Background

Edge effects can influence species composition and community structure as a result of changes in microenvironment and edaphic variables. We investigated effects of habitat edges on vegetation structure, abundance and body mass of one vulnerableMicrocebusspecies in northwestern Madagascar. We trapped mouse lemurs along four 1000-m transects (total of 2424 trap nights) that ran perpendicular to the forest edge. We installed 16 pairs of 20 m2vegetation plots along each transect and measured nine vegetation parameters. To determine the responses of the vegetation and animals to an increasing distance to the edge, we tested the fit of four alternative mathematical functions (linear, power, logistic and unimodal) to the data and derived the depth of edge influence (DEI) for all parameters.

Results

Logistic and unimodal functions best explained edge responses of vegetation parameters, and the logistic function performed best for abundance and body mass ofM.ravelobensis. The DEI varied between 50 m (no. of seedlings, no. of liana, dbh of large trees [dbh ≥ 10 cm]) and 460 m (tree height of large trees) for the vegetation parameters, whereas it was 340 m forM. ravelobensisabundance and 390 m for body mass, corresponding best to the DEI of small tree [dbh < 10 cm] density (360 m). Small trees were significantly taller and the density of seedlings was higher in the interior than in the edge habitat. However, there was no significant difference inM. ravelobensisabundance and body mass between interior and edge habitats, suggesting thatM. ravelobensisdid not show a strong edge response in the study region. Finally, regression analyses revealed three negative (species abundance and three vegetation parameters) and two positive relationships (body mass and two vegetation parameters), suggesting an impact of vegetation structure onM. ravelobensiswhich may be partly independent of edge effects.

Conclusions

A comparison of our results with previous findings reveals that edge effects are variable in space in a small nocturnal primate from Madagascar. Such an ecological plasticity could be extremely relevant for mitigating species responses to habitat loss and anthropogenic disturbances.
Hydrology influences breeding time in the white-throated dipper
Authors: Nilsson Anna L. K. , Skaugen Thomas , Reitan Trond , L’Abée-Lund Jan Henning , Gamelon Marlène , Jerstad Kurt , Røstad Ole Wiggo , Slagsvold Tore , Stenseth Nils C. , Vøllestad L. Asbjørn , Walseng Bjørn
Published: December 2020

Background

Earlier breeding is one of the strongest responses to global change in birds and is a key factor determining reproductive success. In most studies of climate effects, the focus has been on large-scale environmental indices or temperature averaged over large geographical areas, neglecting that animals are affected by the local conditions in their home ranges. In riverine ecosystems, climate change is altering the flow regime, in addition to changes resulting from the increasing demand for renewable and clean hydropower. Together with increasing temperatures, this can lead to shifts in the time window available for successful breeding of birds associated with the riverine habitat. Here, we investigated specifically how the environmental conditions at the territory level influence timing of breeding in a passerine bird with an aquatic lifestyle, the white-throated dipper Cinclus cinclus. We relate daily river discharge and other important hydrological parameters, to a long-term dataset of breeding phenology (1978–2015) in a natural river system.

Results

Dippers bred earlier when winter river discharge and groundwater levels in the weeks prior to breeding were high, and when there was little snow in the catchment area. Breeding was also earlier at lower altitudes, although the effect dramatically declined over the period. This suggests that territories at higher altitudes had more open water in winter later in the study period, which permitted early breeding also here. Unexpectedly, the largest effect inducing earlier breeding time was territory river discharge during the winter months and not immediately prior to breeding. The territory river discharge also increased during the study period.

Conclusions

The observed earlier breeding can thus be interpreted as a response to climate change. Measuring environmental variation at the scale of the territory thus provides detailed information about the interactions between organisms and the abiotic environment.
Important aspects of conducting an interdisciplinary public preventive oral health project for children in areas with low socioeconomic status: staff perspective
Authors: Blomma C. , Krevers B.
Published: December 2020

Background

To achieve good and equal oral health in children, interdisciplinary preventive oral health actions, directed toward disadvantaged areas, can be an important means. Staff play a crucial role in the implementation of these actions. The aim of the present study was to analyze circumstances of importance for conducting an interdisciplinary public preventive oral health project for children, directed toward parents in areas with low socioeconomic status from the interdisciplinary perspective of the involved staff.

Method

The present study consisted of a qualitative content analysis with an inductive approach, based on interviews with interdisciplinary staff who had participated in a public preventive oral health project directed toward parents in areas with low socioeconomic status. The interviews were analyzed using text-driven analysis.

Results

The main category concerned the staff members’ prerequisites and understanding necessary to perform their tasks in interdisciplinary public preventive oral health project. To have the right prerequisites and understanding regarding the oral health project enabled staff to be committed, able and willing to perform in it. Important aspects of this are to have knowledge, motivation and to experience a supportive professional context, to have good leadership and for certain resources to fulfilled. A crucial aspect was to reach the targeted mothers.

Conclusions

For interdisciplinary cooperation in preventive oral health care to be achieved, it is essential for the involved disciplines and professions to embrace a common view on the project’s aim, their duties, and oral health, from the leadership to the individual level. Staff require competent leadership but also allocated time and adapted method support to be successful in this context. When allocating preventive health actions directed at low SES areas, it is important to acknowledge the risk of stigmatization and for staff to understand that families might be facing social challenges that prevent them from taking part in health-promoting actions. An important conclusion is that to be able to reach people, it is important for both those who design preventive programs for oral health and the staff who administer them to have sufficient knowledge about the target group.
Factors associated with the performance of routine health information system in Yaoundé-Cameroon: a cross-sectional survey
Authors: Nguefack-Tsague Georges , Tamfon Brian Bongwong , Ngnie-Teta Ismael , Ngoufack Marie Nicole , Keugoung Basile , Bataliack Serge Marcial , Bilounga Ndongo Chanceline
Published: December 2020

Background

Routine Health Information Systems (RHIS) of low-income countries function below the globally expected standard, characterised by the production and use of poor-quality data, or the non-use of good quality data for informed decision making.
This has negatively influenced the health service delivery and uptake. This study focuses on identifying the factors associated with the performance of RHIS of the health facilities (HF) in Yaoundé, so as to guide targeted RHIS strengthening.

Methods

A HF-based cross-sectional study in the 6 health districts (HDs) of Yaoundé was conducted. HFs were chosen using stratified sampling with probability proportional to size per HD. Data were collected, entered into Microsoft Excel 2013 and analysed with IBM- SPSS version 25. Consistency of the questionnaire was measured using Cronbach’s alpha coefficient. Pearson’s chi-square (and Fisher exact where relevant) tests were used to establish relationships between qualitative variables. Associations were further quantified using unadjusted Odd ratio (OR) for univariable analysis and adjusted odds ratio (aOR) for multivariable analysis with 95% confidence interval (CI). A p-value of less than 0.05 was considered statistically significant.

Results

Of 111 selected HFs; 16 (14.4%) were public and 95 (85.6%) private. Respondents aged 24–60 years with an average of 38.3 ± 9.3 years; 58 (52.3%) males and 53(47.7%) females. Cronbach’s alpha was 0.96 (95%CI: 0.95–0.98, p < 0.001), proving that the questionnaire was reliable in measuring RHIS performances. At univariable level, the following factors were positively associated with good performances: supportive supervision (OR = 3.03 (1.1, 8.3); p = 0.02), receiving feedback from hierarchy (OR = 3.6 (0.99, 13.2); p = 0.05), having received training on health information (OR = 5.0 (1.6, 16.0); p = 0.003), and presence of a performance evaluation plan (OR = 3.3 (1.4, 8.2), p = 0.007). At multivariable level, the only significantly associated factor was having received training on health information (aOR = 3.3 (1.01, 11.1), p = 0.04).

Conclusion

Training of health staff in the RHIS favors RHIS good performance. Hence, emphasis should be laid on training and empowering staff, frequent and regular RHIS supervision, and frequent and regular feedback, for an efficient RHIS strengthening in Yaoundé.
Data quality of the routine health management information system at the primary healthcare facility and district levels in Tanzania
Authors: Rumisha Susan F. , Lyimo Emanuel P. , Mremi Irene R. , Tungu Patrick K. , Mwingira Victor S. , Mbata Doris , Malekia Sia E. , Joachim Catherine , Mboera Leonard E. G.
Published: December 2020

Background

Effective planning for disease prevention and control requires accurate, adequately-analysed, interpreted and communicated data. In recent years, efforts have been put in strengthening health management information systems (HMIS) in Sub-Saharan Africa to improve data accessibility to decision-makers. This study assessed the quality of routine HMIS data at primary healthcare facility (HF) and district levels in Tanzania.

Methods

This cross-sectional study involved reviews of documents, information systems and databases, and collection of primary data from facility-level registers, tally sheets and monthly summary reports. Thirty-four indicators from Outpatient, Inpatient, Antenatal care, Family Planning, Post-natal care, Labour and Delivery, and Provider-Initiated Testing and Counselling service areas were assessed. Indicator records were tracked and compared across the process of data collection, compilation and submission to the district office. Copies of monthly report forms submitted by facilities to the district were also reviewed. The availability and utilization of HMIS tools were assessed, while completeness and data accuracy levels were quantified for each phase of the reporting system.

Results

A total of 115 HFs (including hospitals, health centres, dispensaries) in 11 districts were involved. Registers (availability rate = 91.1%; interquartile range (IQR) 66.7–100%) and report forms (86.9%; IQR 62.2–100%) were the most utilized tools. There was a limited use of tally-sheets (77.8%; IQR 35.6–100%). Tools availability at the dispensary was 91.1%, health centre 82.2% and hospital 77.8%, and was low in urban districts. The availability rate at the district level was 65% (IQR 48–75%). Wrongly filled or empty cells in registers and poor adherence to the coding procedures were observed. Reports were highly over-represented in comparison to registers’ records, with large differences observed at the HF phase of the reporting system. The OPD and IPD areas indicated the highest levels of mismatch between data source and district office. Indicators with large number of clients, multiple variables, disease categorization, or those linked with dispensing medicine performed poorly.

Conclusion

There are high variations in the tool utilisation and data accuracy at facility and district levels. The routine HMIS is weak and data at district level inaccurately reflects what is available at the source. These results highlight the need to design tailored and inter-service strategies for improving data quality.
Stability of canine and feline cerebrospinal fluid samples regarding total cell count and cell populations stored in “TransFix®/EDTA CSF sample storage tubes”
Authors: Meier Laura , Carlson Regina , Neßler Jasmin , Tipold Andrea
Published: December 2020

Background

Because of fast leucocyte degeneration in cerebrospinal fluid (CSF) laboratory examinations of CSF samples should be performed approximately within 30 min after withdrawal. This study examines the storage of canine and feline CSF samples in “TransFix®/EDTA CSF Sample Storage Tubes” (Cytomark, Buckingham, UK) for preventing leucocytes from degeneration, so that routine and flow cytometry examinations are feasible up to 3 days after sampling.

Results

After storage in TransFix® tubes, leukocytes could not be adequately stained with Türk’s solution and differentiating between erythrocytes and leukocytes was cumbersome. In addition, the cell morphology could not be sufficiently assessed on cytospin preparations because of shrunken leukocytes and indistinct cell nuclei. In contrast, by flow cytometry, a significantly higher cell count was measured over the entire study period in the samples stored in TransFix® tubes compared to the untreated samples. The antibodies (AB) against CD3, CD4 and CD21, against CD11b and against CD45 showed a good binding strength and thus enabled a good differentiation of cell populations. However, after storage in the TransFix® tubes, monocytes were no longer detectable using an AB against CD14.

Conclusion

Based on these results, “TransFix®/EDTA CSF Sample Storage Tubes” can be used for extended storage prior to flow cytometric analysis of lymphocytes and granulocytes in CSF samples but not for detecting monocytes. However, standard examinations, such as microscopic cell counting and morphological cell assessment should be performed on fresh CSF samples.
Predicting EQ-5D-5L crosswalk from the PROMIS-29 profile for the United Kingdom, France, and Germany
Authors: Klapproth Christoph Paul , van Bebber J. , Sidey-Gibbons C. J. , Valderas J. M. , Leplege A. , Rose M. , Fischer F.
Published: December 2020

Background

EQ-5D health state utilities (HSU) are commonly used in health economics to compute quality-adjusted life years (QALYs). The EQ-5D, which is country-specific, can be derived directly or by mapping from self-reported health-related quality of life (HRQoL) scales such as the PROMIS-29 profile. The PROMIS-29 from the Patient Reported Outcome Measures Information System is a comprehensive assessment of self-reported health with excellent psychometric properties. We sought to find optimal models predicting the EQ-5D-5L crosswalk from the PROMIS-29 in the United Kingdom, France, and Germany and compared the prediction performances with that of a US model.

Methods

We collected EQ-5D-5L and PROMIS-29 profiles and three samples representative of the general populations in the UK (n = 1509), France (n = 1501), and Germany (n = 1502). We used stepwise regression with backward selection to find the best models to predict the EQ-5D-5L crosswalk from all seven PROMIS-29 domains. We investigated the agreement between the observed and predicted EQ-5D-5L crosswalk in all three countries using various indices for the prediction performance, including Bland–Altman plots to examine the performance along the HSU continuum.

Results

The EQ-5D-5L crosswalk was best predicted in France (nRMSEFRA = 0.075, nMAEFRA = 0.052), followed by the UK (nRMSEUK = 0.076, nMAEUK = 0.053) and Germany (nRMSEGER = 0.079, nMAEGER = 0.051). The Bland–Altman plots show that the inclusion of higher-order effects reduced the overprediction of low HSU scores.

Conclusions

Our models provide a valid method to predict the EQ-5D-5L crosswalk from the PROMIS-29 for the UK, France, and Germany.
The prevalence of stress, anxiety and depression within front-line healthcare workers caring for COVID-19 patients: a systematic review and meta-regression
Authors: Salari Nader , Khazaie Habibolah , Hosseinian-Far Amin , Khaledi-Paveh Behnam , Kazeminia Mohsen , Mohammadi Masoud , Shohaimi Shamarina , Daneshkhah Alireza , Eskandari Soudabeh
Published: December 2020

Background

Stress, anxiety, and depression are some of the most important research and practice challenges for psychologists, psychiatrists, and behavioral scientists. Due to the importance of issue and the lack of general statistics on these disorders among the Hospital staff treating the COVID-19 patients, this study aims to systematically review and determine the prevalence of stress, anxiety and depression within front-line healthcare workers caring for COVID-19 patients.

Methods

In this research work, the systematic review, meta-analysis and meta-regression approaches are used to approximate the prevalence of stress, anxiety and depression within front-line healthcare workers caring for COVID-19 patients. The keywords of prevalence, anxiety, stress, depression, psychopathy, mental illness, mental disorder, doctor, physician, nurse, hospital staff, 2019-nCoV, COVID-19, SARS-CoV-2 and Coronaviruses were used for searching the SID, MagIran, IranMedex, IranDoc, ScienceDirect, Embase, Scopus, PubMed, Web of Science (ISI) and Google Scholar databases. The search process was conducted in December 2019 to June 2020. In order to amalgamate and analyze the reported results within the collected studies, the random effects model is used. The heterogeneity of the studies is assessed using the I2 index. Lastly, the data analysis is performed within the Comprehensive Meta-Analysis software.

Results

Of the 29 studies with a total sample size of 22,380, 21 papers have reported the prevalence of depression, 23 have reported the prevalence of anxiety, and 9 studies have reported the prevalence of stress. The prevalence of depression is 24.3% (18% CI 18.2–31.6%), the prevalence of anxiety is 25.8% (95% CI 20.5–31.9%), and the prevalence of stress is 45% (95% CI 24.3–67.5%) among the hospitals’ Hospital staff caring for the COVID-19 patients. According to the results of meta-regression analysis, with increasing the sample size, the prevalence of depression and anxiety decreased, and this was statistically significant (P < 0.05), however, the prevalence of stress increased with increasing the sample size, yet this was not statistically significant (P = 0.829).

Conclusion

The results of this study clearly demonstrate that the prevalence of stress, anxiety and depression within front-line healthcare workers caring for COVID-19 patients is high. Therefore, the health policy-makers should take measures to control and prevent mental disorders in the Hospital staff.
Maternal mortality in six low and lower-middle income countries from 2010 to 2018: risk factors and trends
Authors: Bauserman Melissa , Thorsten Vanessa R. , Nolen Tracy L. , Patterson Jackie , Lokangaka Adrien , Tshefu Antoinette , Patel Archana B. , Hibberd Patricia L. , Garces Ana L. , Figueroa Lester , Krebs Nancy F. , Esamai Fabian , Nyongesa Paul , Liechty Edward A. , Carlo Waldemar A. , Chomba Elwyn , Goudar Shivaprasad S. , Kavi Avinash , Derman Richard J. , Saleem Sarah , Jessani Saleem , Billah Sk Masum , Koso-Thomas Marion , McClure Elizabeth M. , Goldenberg Robert L. , Bose Carl
Published: December 2020

Background

Maternal mortality is a public health problem that disproportionately affects low and lower-middle income countries (LMICs). Appropriate data sources are lacking to effectively track maternal mortality and monitor changes in this health indicator over time.

Methods

We analyzed data from women enrolled in the NICHD Global Network for Women’s and Children’s Health Research Maternal Newborn Health Registry (MNHR) from 2010 through 2018. Women delivering within research sites in the Democratic Republic of Congo, Guatemala, India (Nagpur and Belagavi), Kenya, Pakistan, and Zambia are included. We evaluated maternal and delivery characteristics using log-binomial models and multivariable models to obtain relative risk estimates for mortality. We used running averages to track maternal mortality ratio (MMR, maternal deaths per 100,000 live births) over time.

Results

We evaluated 571,321 pregnancies and 842 maternal deaths. We observed an MMR of 157 / 100,000 live births (95% CI 147, 167) across all sites, with a range of MMRs from 97 (76, 118) in the Guatemala site to 327 (293, 361) in the Pakistan site. When adjusted for maternal risk factors, risks of maternal mortality were higher with maternal age > 35 (RR 1.43 (1.06, 1.92)), no maternal education (RR 3.40 (2.08, 5.55)), lower education (RR 2.46 (1.54, 3.94)), nulliparity (RR 1.24 (1.01, 1.52)) and parity > 2 (RR 1.48 (1.15, 1.89)). Increased risk of maternal mortality was also associated with occurrence of obstructed labor (RR 1.58 (1.14, 2.19)), severe antepartum hemorrhage (RR 2.59 (1.83, 3.66)) and hypertensive disorders (RR 6.87 (5.05, 9.34)). Before and after adjusting for other characteristics, physician attendance at delivery, delivery in hospital and Caesarean delivery were associated with increased risk. We observed variable changes over time in the MMR within sites.

Conclusions

The MNHR is a useful tool for tracking MMRs in these LMICs. We identified maternal and delivery characteristics associated with increased risk of death, some might be confounded by indication. Despite declines in MMR in some sites, all sites had an MMR higher than the Sustainable Development Goals target of below 70 per 100,000 live births by 2030.

Trial registration

The MNHR is registered at NCT01073475.
Gender variations in neonatal and early infant mortality in India and Pakistan: a secondary analysis from the Global Network Maternal Newborn Health Registry
Authors: Aghai Zubair H. , Goudar Shivaprasad S. , Patel Archana , Saleem Sarah , Dhaded Sangappa M. , Kavi Avinash , Lalakia Parth , Naqvi Farnaz , Hibberd Patricia L. , McClure Elizabeth M. , Nolen Tracy L. , Iyer Pooja , Goldenberg Robert L. , Derman Richard J.
Published: December 2020

Background

To determine the gender differences in neonatal mortality, stillbirths, and perinatal mortality in south Asia using the Global Network data from the Maternal Newborn Health Registry.

Methods

This study is a secondary analysis of prospectively collected data from the three south Asian sites of the Global Network. The maternal and neonatal demographic, clinical characteristics, rates of stillbirths, early neonatal mortality (1–7 days), late neonatal mortality (8–28 days), mortality between 29–42 days and the number of infants hospitalized after birth were compared between the male and female infants.

Results

Between 2010 and 2018, 297,509 births [154,790 males (52.03%) and 142,719 females (47.97%)] from two Indian sites and one Pakistani site were included in the analysis [288,859 live births (97.1%) and 8,648 stillbirths (2.9%)]. The neonatal mortality rate was significantly higher in male infants (33.2/1,000 live births) compared to their female counterparts (27.4/1,000, p < 0.001). The rates of stillbirths (31.0 vs. 26.9/1000 births) and early neonatal mortality (27.1 vs 21.6/1000 live births) were also higher in males. However, there were no significant differences in late neonatal mortality (6.3 vs. 5.9/1000 live births) and mortality between 29–42 days (2.1 vs. 1.9/1000 live births) between the two groups. More male infants were hospitalized within 42 days after birth (1.8/1000 vs. 1.3/1000 live births, p < 0.001) than females.

Conclusion

The risks of stillbirths, and early neonatal mortality were higher among male infants than their female counterparts. However, there was no gender difference in mortality after 7 days of age. Our results highlight the importance of stratifying neonatal mortality into early and late neonatal period to better understand the impact of gender on neonatal mortality. The information from this study will help in developing strategies and identifying measures that can reduce differences in sex-specific mortality.
Rates and risk factors for preterm birth and low birthweight in the global network sites in six low- and low middle-income countries
Authors: Pusdekar Yamini V. , Patel Archana B. , Kurhe Kunal G. , Bhargav Savita R. , Thorsten Vanessa , Garces Ana , Goldenberg Robert L. , Goudar Shivaprasad S. , Saleem Sarah , Esamai Fabian , Chomba Elwyn , Bauserman Melissa , Bose Carl L. , Liechty Edward A. , Krebs Nancy F. , Derman Richard J. , Carlo Waldemar A. , Koso-Thomas Marion , Nolen Tracy L. , McClure Elizabeth M. , Hibberd Patricia L.
Published: December 2020

Background

Preterm birth continues to be a major public health problem contributing to 75% of the neonatal mortality worldwide. Low birth weight (LBW) is an important but imperfect surrogate for prematurity when accurate assessment of gestational age is not possible. While there is overlap between preterm birth and LBW newborns, those that are both premature and LBW are at the highest risk of adverse neonatal outcomes. Understanding the epidemiology of preterm birth and LBW is important for prevention and improved care for at risk newborns, but in many countries, data are sparse and incomplete.

Methods

We conducted data analyses using the Global Network’s (GN) population-based registry of pregnant women and their babies in rural communities in six low- and middle-income countries (Democratic Republic of Congo, Kenya, Zambia, Guatemala, India and Pakistan). We analyzed data from January 2014 to December 2018. Trained study staff enrolled all pregnant women in the study catchment area as early as possible during pregnancy and conducted follow-up visits shortly after delivery and at 42 days after delivery. We analyzed the rates of preterm birth, LBW and the combination of preterm birth and LBW and studied risk factors associated with these outcomes across the GN sites.

Results

A total of 272,192 live births were included in the analysis. The overall preterm birth rate was 12.6% (ranging from 8.6% in Belagavi, India to 21.8% in the Pakistani site). The overall LBW rate was 13.6% (ranging from 2.7% in the Kenyan site to 21.4% in the Pakistani site). The overall rate of both preterm birth and LBW was 5.5% (ranging from 1.2% in the Kenyan site to 11.0% in the Pakistani site). Risk factors associated with preterm birth, LBW and the combination were similar across sites and included nulliparity [RR − 1.27 (95% CI 1.21–1.33)], maternal age under 20 [RR 1.41 (95% CI 1.32–1.49)] years, severe antenatal hemorrhage [RR 5.18 95% CI 4.44–6.04)], hypertensive disorders [RR 2.74 (95% CI − 1.21–1.33], and 1–3 antenatal visits versus four or more [RR 1.68 (95% CI 1.55–1.83)].

Conclusions

Preterm birth, LBW and their combination continue to be common public health problems at some of the GN sites, particularly among young, nulliparous women who have received limited antenatal care services.

Trial registration The identifier of the Maternal and Newborn Health Registry at ClinicalTrials.gov is NCT01073475.Trial registration: The identifier of the Maternal and Newborn Health Registry at ClinicalTrials.gov is NCT01073475.
Disclosing suboptimal indications for emergency caesarean sections due to fetal distress and prolonged labor: a multicenter cross-sectional study at 12 public hospitals in Nepal
Authors: Litorp Helena , Gurung Rejina , Målqvist Mats , Kc Ashish
Published: December 2020

Background

Global caesarean section (CS) rates have raised concern of a potential overuse of the procedure in both high- and low-resource settings. We sought to assess management and outcomes of deliveries with emergency CSs due to fetal distress and prolonged labor at 12 public hospitals in Nepal and determine factors associated with suboptimal CS indications.

Methods

We conducted a cross-sectional study on all deliveries between the 14th of April 2017 and the 17th of October 2018 at 12 public hospitals in Nepal and included all emergency CSs due to fetal distress and prolonged labor. Analysis was conducted using Pearson chi-square test and bivariate and multivariate logistic regression.

Results

The total cohort included 104,322 deliveries of which 18,964 (18%) were CSs (13,095 [13%] emergency CSs and 5230 [5.0%] elective CSs). We identified 1806 emergency CSs due to fetal distress and 1322 emergency CSs due to prolonged labor. Among CSs due to fetal distress, only 36% had fetal heart rate monitoring performed according to protocol, and among CSs due to prolonged labor, the partograph was completely filled in only 8.6%. Gestational age < 37 weeks and birth weight < 2500 g were associated with more suboptimal CS indications due to fetal distress (adjusted odds ratio [aOR] 1.4, 95% confidence interval [CI] 1.1–1.8 and aOR 1.7, 95% CI 1.3–2.2 respectively) than those with gestational age > 37 weeks and birth weight > 2500 g. We found no association between suboptimal CS indications and maternal ethnicity or education level.

Conclusions

As fetal heart rate monitoring and partograph are fundamental to diagnose fetal distress and prolonged labor, the inappropriate monitoring proceeding CS decisions disclosed in our study indicate that CSs were performed on suboptimal indications. We call for improved quality of intrapartum monitoring, enhanced documentation in medical records, and structured auditing of CS indications in order to curb the potentially harmful CS trend.
Cross-border COVID-19 spread amidst malaria re-emergence in Venezuela: a human rights analysis
Authors: Correa-Salazar Catalina , Amon Joseph J.
Published: December 2020

Background

Since 2016 Venezuela has seen a collapse in its economy and public health infrastructure resulting in a humanitarian crisis and massive outward migration. With the emergence of the novel coronavirus SARS-CoV-2 at the end of 2019, the public health emergency within its borders and in neighboring countries has become more severe and as increasing numbers of Venezuelans migrants return home or get stuck along migratory routes, new risks are emerging in the region.

Results

Despite clear state obligations to respect, protect and fulfil the rights to health and related economic, social, civil and political rights of its population, in Venezuela, co-occurring malaria and COVID-19 epidemics are propelled by a lack of public investment in health, weak governance, and violations of human rights, especially for certain underserved populations like indigenous groups. COVID-19 has put increased pressure on Venezuelan and regional actors and healthcare systems, as well as international public health agencies, to deal with a domestic and regional public health emergency.

Conclusions

International aid and cooperation for Venezuela to deal with the re-emergence of malaria and the COVID-19 spread, including lifting US-enforced economic sanctions that limit Venezuela’s capacity to deal with this crisis, is critical to protecting rights and health in the country and region.
Promoting factors and barriers to participation in working life for people with spinal cord injury
Authors: Sturm Christian , Bökel Andrea , Korallus Christoph , Geng Veronika , Kalke Yorck B. , Abel Rainer , Kurze Ines , Gutenbrunner Christoph M.
Published: December 2020

Background

It is still difficult for people with physical impairments to be and remain equally integrated into the labour market. For this reason, the question of occupational activity has explicitly been examined by the German Spinal Cord Injury Survey (GerSCI) in order to identify barriers and facilitators for labour market participation.

Methods

Cross-sectional explorative observational study. The GerSCI survey is the German part of the International Spinal Cord Injury Survey (InSCI). Using survey data from persons recruited at eight specialised SCI-centres in Germany. Participants: 1.479 persons with Spinal Cord Injury (SCI) aged 18 years and older.

Results

In a self-disclosure questionnaire, persons with SCI show themselves as a professionally well-educated and highly motivated group with most of them aiming at gainful employment and considering themselves fit for work. Many changeable and non-changeable factors have been found, which showed a high correlation with the return to work after acquired SCI.

Conclusion

Education and pain belong to the most critical factors and thereby possible approaches to increase the level of employment, which is essential and highly relevant not only for earning money but also for self-confidence and social integration. SCI has many dimensions in itself; support also should be multidimensional. Study results might help to improve participation.
Clinical characteristics, outcomes, and risk factors for mortality in hospitalized patients with COVID-19 and cancer history: a propensity score-matched study
Authors: Sorouri Majid , Kasaeian Amir , Mojtabavi Helia , Radmard Amir Reza , Kolahdoozan Shadi , Anushiravani Amir , Khosravi Bardia , Pourabbas Seyed Mohammad , Eslahi Masoud , Sirusbakht Azin , Khodabakhshi Marjan , Motamedi Fatemeh , Azizi Fatemeh , Ghanbari Reza , Rajabi Zeynab , Sima Ali Reza , Rad Soroush , Abdollahi Mohammad
Published: December 2020

Background

COVID-19 has caused great concern for patients with underlying medical conditions. We aimed to determine the prognosis of patients with current or previous cancer with either a PCR-confirmed COVID-19 infection or a probable diagnosis according to chest CT scan.

Methods

We conducted a case control study in a referral hospital on confirmed COVID-19 adult patients with and without a history of cancer from February25thto April21st, 2020. Patients were matched according to age, gender, and underlying diseases including ischemic heart disease (IHD), diabetes mellitus (DM), and hypertension (HTN). Demographic features, clinical data, comorbidities, symptoms, vital signs, laboratory findings, and chest computed tomography (CT) images have been extracted from patients’ medical records. Multivariable logistic regression was used to estimate odd ratios and 95% confidence intervals of each factor of interest with outcomes.

Results

Fifty-three confirmed COVID-19 patients with history of cancer were recruited and compared with 106 non-cancerous COVID-19 patients as controls. Male to female ratio was 1.33 and 45% were older than 65. Dyspnea and fever were the most common presenting symptoms in our population with 57.86 and 52.83% respectively. Moreover, dyspnea was significantly associated with an increased rate of mortality in the cancer subgroup (p = 0.013). Twenty-six patients (49%) survived among the cancer group while 89 patients (84%) survived in control (p = 0.000). in cancer group, patients with hematologic cancer had 63% mortality while patients with solid tumors had 37%. multivariate analysis model for survival prediction showed that history of cancer, impaired consciousness level, tachypnea, tachycardia, leukocytosis and thrombocytopenia were associated with an increased risk of death.

Conclusion

In our study, cancer increased the mortality rate and hospital stay of COVID-19 patients and this effect remains significant after adjustment of confounders. Compared to solid tumors, hematologic malignancies have been associated with worse consequences and higher mortality rate. Clinical and para-clinical indicators were not appropriate to predict death in these patients.
A consolidated potential analysis of bio-methane and e-methane using two different methods for a medium-term renewable gas supply in Germany
Authors: Matschoss Patrick , Steubing Michael , Pertagnol Joachim , Zheng Yue , Wern Bernhard , Dotzauer Martin , Thrän Daniela
Published: December 2020

Background

The German energy transition has entered a new phase and one important aspect is the question, to what degree the gas sector could be supplied with so-called “green” gases, i.e., gases from renewable sources. This paper focuses on the potential of domestic methane from biological origin (bio-CH4) until 2030 that is estimated with two different methods. The comparison of the results provides a consolidated estimate.

Methods

In a bottom-up approach, a GIS-based cluster analysis was undertaken to estimate the potential on bio-CH4 from the existing cogeneration biogas plant (BP) stock. In a top-down approach a meta-analysis of GHG-reduction scenarios with respect to bio-CH4 was performed. The meta-analysis was also extended to methane from renewable electricity (e-CH4) since the BP stock may play a role in the provision of CO2. Further, it included the year 2050 (the target year for most scenario studies) as well as issues like energy imports.

Results

The bottom-up approach yields a potential of 24.9 TWh of bio-CH4 for 2030. This is well within the range of the top-down analysis of 11–54 TWh (average: 32.5 TWh) for that year. In some scenarios values for e-CH4 where considerably higher, especially with respect to 2050, but in these studies the sources—including the CO2 sources—are either not explained at all or they are due to imports of e-CH4 in combination with direct air capture (DAC) rather than biogenic sources. Concerning the regional dispersion, the bottom-up analysis shows that the largest potentials (53% or 905 of the biogas plants) are located in the northern part of Germany, more particular in Lower-Saxony, Schleswig-Holstein, Mecklenburg-Western Pomerania. These represent 54% or 602 MW of the installed capacity of the clusters.

Conclusion

The consistency of the outcomes of the two methodologically very different approaches may be called the main result of this research. Therefore, it provides a consolidated analysis of the potential for domestic supply of bio-CH4 in 2030. Furthermore, the amount corresponds to 2.7–3.5% of the German natural gas consumption in 2018. Taken bio-CH4 and e-CH4 together it corresponds to 7.2–8.0%.
Molecular mechanisms and the vital roles of resistin, TLR 4, and NF-κB in treating type 2 diabetic complications
Authors: Gudise Venkataiah , Chowdhury Bimalendu
Published: December 2020

Background

Type 2 diabetes in obese (≥ 25 and ≥ 30 kg/m2) patients is the foremost cause of cardiovascular complications like stroke, osteoarthritis, cancers (endometrial, breast, ovarian, liver, kidney, colon, and prostate), and vascular complications like diabetic neuropathy, diabetic and retinopathy, and diabetic nephropathy. It is recognized as a global burden disorder with high prevalence in middle-income nations which might lead to a double burden on health care professionals. Hence, this review emphasizes on understanding the complexity and vital signaling tracts involved in diabetic complications for effective treatment.

Main body

Type 2 diabetes in overweight patients induces the creation of specific ROS that further leads to changes in cellular proliferation, hypothalamus, and fringe. The resistin, TLR4, and NF-κB signalings are mainly involved in the progression of central and fringe changes such as insulin resistance and inflammation in diabetic patients. The overexpression of these signals might lead to the rapid progression of diabetic vascular complications induced by the release of proinflammatory cytokines, chemokines, interleukins, and cyclooxygenase-mediated chemicals. Until now, there has been no curative treatment for diabetes. Therefore, to effectively treat complications of type 2 diabetes, the researchers need to concentrate on the molecular mechanisms and important signaling tracts involved.

Conclusion

In this review, we suggested the molecular mechanism of STZ-HFD induced type 2 diabetes and the vital roles of resistin, TLR4, and NF-κB signalings in central, fringe changes, and development diabetic complications for its effective treatment.

Graphical abstract
Gefitinib Versus Vinorelbine Plus Cisplatin as Adjuvant Treatment for Stage II-IIIA (N1-N2) EGFR-Mutant NSCLC: Final Overall Survival Analysis of CTONG1104 Phase III Trial
Authors: Zhong Wen-Zhao , Wang Qun , Mao Wei-Min , Xu Song-Tao , Wu Lin , Wei Yu-Cheng , Liu Yong-Yu , Chen Chun , Cheng Ying , Yin Rong , Yang Fan , Ren Sheng-Xiang , Li Xiao-Fei , Li Jian , Huang Cheng , Liu Zhi-Dong , Xu Shun , Chen Ke-Neng , Xu Shi-Dong , Liu Lun-Xu , Yu Ping , Wang Bu-Hai , Ma Hai-Tao , Yang Jin-Ji , Yan Hong-Hong , Yang Xue-Ning , Liu Si-Yang , Zhou Qing , Wu Yi-Long
Published: December 2020

PURPOSE

ADJUVANT-CTONG1104 (ClinicalTrials.gov identifier: NCT01405079 ), a randomized phase III trial, showed that adjuvant gefitinib treatment significantly improved disease-free survival (DFS) versus vinorelbine plus cisplatin (VP) in patients with epidermal growth factor receptor ( EGFR) mutation-positive resected stage II-IIIA (N1-N2) non–small-cell lung cancer (NSCLC). Here, we report the final overall survival (OS) results.

METHODS

From September 2011 to April 2014, 222 patients from 27 sites were randomly assigned 1:1 to adjuvant gefitinib (n = 111) or VP (n = 111). Patients with resected stage II-IIIA (N1-N2) NSCLC and EGFR-activating mutation were enrolled, receiving gefitinib for 24 months or VP every 3 weeks for four cycles. The primary end point was DFS (intention-to-treat [ITT] population). Secondary end points included OS, 3-, 5-year (y) DFS rates, and 5-year OS rate. Post hoc analysis was conducted for subsequent therapy data.

RESULTS

Median follow-up was 80.0 months. Median OS (ITT) was 75.5 and 62.8 months with gefitinib and VP, respectively (hazard ratio [HR], 0.92; 95% CI, 0.62 to 1.36; P = .674); respective 5-year OS rates were 53.2% and 51.2% ( P = .784). Subsequent therapy was administered upon progression in 68.4% and 73.6% of patients receiving gefitinib and VP, respectively. Subsequent targeted therapy contributed most to OS (HR, 0.23; 95% CI, 0.14 to 0.38) compared with no subsequent therapy. Updated 3y DFS rates were 39.6% and 32. 5% with gefitinib and VP ( P = .316) and 5y DFS rates were 22. 6% and 23.2% ( P = .928), respectively.

CONCLUSION

Adjuvant therapy with gefitinib in patients with early-stage NSCLC and EGFR mutation demonstrated improved DFS over standard of care chemotherapy. Although this DFS advantage did not translate to a significant OS difference, OS with adjuvant gefitinib was one of the longest observed in this patient group compared with historic data.
Tunable chiral-selective electromagnetically induced transparency-like effect in VO2-based metamaterial for slow light applications
Authors: Gao Fan , Yuan Peicheng , Ma Hongfeng , Xu Tao , Zhu Junwen , Li Kexue , Yang Feng , Yan Bo
Published: December 2020

A chiral metamaterial based on vanadium dioxide (VO2) is proposed to realize the ultrafast active control of an electromagnetically induced transparency-like (EIT-like) effect. The design of the tunable metamaterial is based on the heat-induced insulator-to-metal transition of VO2 and a tunable transmission peak with circular polarization selectivity is achieved. For the right circular polarization (RCP) laser incidence, the sharp EIT-like peak is generated and rises with the increasing signal powers, which has not happened in the left circular polarization (LCP) incident condition. The spin-dependent phenomenon in time domain is also observed and the slow light effect in the metamaterial yields a tunable time delay up to 4 ns. Therefore, the tunable EIT-like effect with chiral selectivity is presented and highlights its practical applications in programmable metamaterial regions and slow light devices, etc.