bluuebunny/crossref_metadata_2025 huggingface dataset:
Associations Between Neighborhood Violence During Pregnancy and Birth Outcomes: Evidence From São Paulo’s Western Region Birth Cohort
Authors: Santos Angelica Carreira dos , Brentani Alexandra , Fink Günther
Published: July 2020

Background: Low birth weight and prematurity remain leading causes of infant mortality and morbidity globally. Although an extensive literature has highlighted the importance of socioenvironmental characteristics for birth outcomes, the role of indirect violence on health remains fairly understudied.Methods: Using geocoded birth records from the ongoing Western Region Birth Cohort (Região Oeste Coorte – ROC-Cohort) of infants born between 2012-2014 and geocoded crime reports, we assessed the associations between exposure to violent crimes during pregnancy within a 1-km radius of mother’s residence and low birth weight, preterm delivery, and being born small-for-gestational-age. Violent crime exposure was categorized into quintiles. Multivariate logistic regressions were used to examine the associations between violence exposure and birth outcomes. Models were adjusted for sex, maternal age and education, socioeconomic status, and risk factors such as hypertension, diabetes, smoking, and drinking during pregnancy.Results: Among the 5,268 infants included, the average crime exposure during the first two trimesters of pregnancy ranged from 0.44 violent crimes in the least exposed quintile to 12.74 crimes in the most exposed. Compared to children with the lowest violence exposure, children in the highest exposure quintile were at higher odds of being born small-for-gestational-age (1.41[1.06-1.89]), preterm (1.35[1.01-1.80]), and low birth weight (1.42[1.03-1.98]). While socioeconomic status and maternal education were positively associated with lower violence exposure, no associations were found between these characteristics and the birth outcomes.Conclusions: Higher exposure to external violent crimes in the close vicinity are associated with substantial increases in the odds of adverse birth outcomes. Policies to improve neighborhood safety can contribute not only to the short-term well-being of populations but may also have large social, economic, and health benefits in the long run.
Smartphone-based dispatch of Community First Responders to Out-of-Hospital Cardiac Arrest - Statements from an International Consensus Conference
Authors: Metelmann Camilla , Metelmann Bibiana , Kohnen Dorothea , Brinkrolf Peter , Andelius Linn , Böttiger Bernd W , Burkart Roman , Hahnenkamp Klaus , Krammel Mario , Marks Tore , Müller Michael P , Prasse Stefan , Stieglis Remy , Strickmann Bernd , Thies Karl
Published: July 2020

Background: Over the past decade Smartphone-based activation (SBA) of Community First Responders (CFR) to out-of-hospital cardiac arrests (OHCA) has gained much attention and popularity throughout Europe. Various programmes have been established, and interestingly there are considerable differences in technology, responder spectrum and the degree of integration into the prehospital emergency services. It is unclear whether these dissimilarities affect outcome. This consensus paper reviews the current state in Europe, reveals similarities and controversies, and aims to help aligning future strategies for SBA of CFR in Europe.Methods: In a consensus conference a three-step approach was used: (i) presentation of current research from five European countries; (ii) workshops discussing evidence amongst the audience to generate consensus statements; (iii) anonymous real-time voting applying the modified RAND-UCLA methodology to adopt or reject the statements. The consensus panel aimed to represent all stakeholders involved in this topic.Results: While 21 of 25 generated statements gained approval, consensus was only found for 5 of them. One statement was rejected but without consensus. Members of the consensus conference confirmed that CFR save lives. They further acknowledged the crucial role of emergency medical control centres and called for nationwide strategies. Conclusions: Smartphone-based alert of CFR to OHCA saves lives. The statement generated by the consensus conference help to advise the public, healthcare services and governments to utilise these systems to their full potential, and direct the research community towards fields that still need to be addressed.
An Arbuscular Mycorrhizal Fungus Alters the Dstribution of Photosynthesized Carbon in a Plant-Soil System: A 13C Labeling Microcosm Study
Authors: Bi Yinli , Xiao Li , Cai Yun
Published: July 2020

Background: Quantification of carbon allocation in mycorrhizal plant parts is an important task in mycorrhizal physiology and ecology, especially for arid and semi-arid barren ecosystem. Here, we investigate the effects of arbuscular mycorrhizal fungi (AMF) on the distribution of photosynthetic carbon in different plant parts and the influence factors. A 13C pulse-labeling method was used to investigate the effects of AMF on the carbon absorption and photosynthate distribution in parts of maize, determined the concentrations of P, K and Mg in plant parts and their correlations with AMF and soil physicochemical properties using redundancy analysis. Results: The total amount of 13C in plants inoculated with AMF was significantly higher than controls. The 13C distribution rates in true leaves 6-7 and 8-12 were higher 26.2% and 41.7% than in the controls indicating that AMF promoted plant fixation of more photosynthetic carbon in plant parts. Soil EEG, HD and SOC were identified as the edaphic factors affecting carbon distribution in different plant part. Conclusion: The study demonstrates that AMF can lead to elevated photosynthetic carbon sequestration and increased transfer of photosynthetic products to roots and soil compared with non-mycorrhizal maize, provide baseline data for assessing carbon accumulation effects of AMF on semi-arid soil.
CitRWP May not be the Major or Only Major Gene that Regulates Apomixis in Citrus and Its Close Related Genus
Authors: Hou Yanhong , Gong Guizhi , Peng Zhuchun , Luo Ai , Cheng Yang , Hong Qinbin
Published: July 2020

Background: Nucellar embryony in citrus and its close related genus is a kind of apomixis, it interferes the cross breeding and affects the genetic evolution and taxonomy in citrus. Many hypotheses have been suggested on regulation of apomixes in citrus but none of them are able to lock the true regulatory sequence until the recently reported candidate gene citRWP. However, the support evidences for the judgment of citRWP as the major or only major gene are still not very sound.Results: Firstly, M/P (Monoembryonic / Polyembryonic) marker, which was designed according to the upper stream sequence of citRWP, was used to check whether the marker exhibiting consistent segregation in different embryonic genotypes. The result showed that all sweet orange selections either monoembryonic or polyembryonic contained the P-marker, but no P-marker was detected in polyembryonic Poncirus, and a new band pattern was dectected in 9 polyembryonic progenies of W-Murcott × Flying dragon trifoliate orange. Subsequently, CitRWP expressions were analyzed with RT-PCR and Realtime RT-PCR. RT-PCR revealed that CitRWP expressed in ovule of all varieties. Realtime RT-PCR results in ovule were consistent with RT-PCR. The expression value of monoembryonic pummelo was the lowest, and there was no significant difference between polyembroynic and monoembryonic sweet orange cultivars. In the hybrid offsprings, the expression of the CitRWP gene showed an extreme two-stage differentiation. The expression in young leaf and ovule of polyembryonic and monoembryonic sweet orange cultivars were different, with a higher expression level in young leaf and a lower expression level in ovule of polyembryonic cultivars. Finally, the cDNA sequences of CitRWP from ovules were cloned and sequenced. Results revealed that the CitRWP has great variations in Poncirus, which included SNPs in start-codon and/or stop-codon as well as fragment insertion/deletion causing incorrect translation. The monoembryonic/polyembryonic sweet orange cultivars and pummelo varieties had similar variations also.Conclusion: CitRWP were not consistently distributed and expressed in different embryonic genotypes. It may not be the major or only major gene that regulates apomixis in citrus and its close related genus.
Effects of Arbuscular Mycorrhizal Inoculation on Growth, Photosynthesis and Antioxidant Enzymatic Activity of Euonymus Maackii Rupr. Under Gradient Water Deficit Levels
Authors: Wu Na , Li Zhen , Meng Sen , Wu Fei
Published: July 2020

The role of arbuscular mycorrhizal (AM) fungus (Rhizophagus intraradices) in amelioration of water deficit mediated negative influence on growth, photosynthesis and antioxidant system in Euonymus maackii Rupr. was examined. E. maackii seedlings were subjected to 5 water deficit levels: soil water contents of 20 %, 40 %, 60 %, 80 % and 100 % field capacity (FC) respectively, and 2 inoculation treatment: with and without AM inoculation. Water deficit increasingly limited seedlings growth of height, biomass accumulation of shoot and root, chlorophyll content, gas exchange and chlorophyll fluorescence parameters along the increase of water deficit level. In addition, Water deficit stimulated the activities of antioxidant enzymatic activities, including superoxide dismutase (SOD), peroxidase (POD) and catalase (CAT) of both shoot and root, except under 20 % FC condition. E. maackii seedlings under all water deficit conditions formed AM symbiosis well with AM fungi, which ameliorated the drought mediated negative effect significantly, especially under 40 % and 60 % FC conditions. Under 40 % to 80 % FC conditions, AM formation improved seedlings growth and photosynthesis by significantly enhancing biomass accumulation, chlorophyll content and assimilation. Mycorrhizal seedlings showed better tolerance and less sensitive to water deficit, reflected in lower SOD activities of shoot and root, and CAT activity of shoot under 40 % and 60 % FC conditions. Down-regulation of antioxidant system in mycorrhizal seedlings suggested better maintenance of redox homeostasis and protection of metabolism, including biomass accumulation and assimilation. All the results advocated the positive role of R. intraradices inoculation in E. maackii against water deficit, which suggested the potential role of AM fungi in ecological restoration in arid region.
Control of Graves’ Hyperthyroidism with Very Long-Term Methimazole Treatment: A Clinical Trial
Authors: Azizi Fereidoun , Abdi Hengameh , Amouzegar Atieh
Published: July 2020

Background: Long-term antithyroid drugs therapy has become one of the options for treatment of Graves’ hyperthyroidism. The aim of this study was to compare thyroid status in those who discontinued methimazole (MMI) treatment after 12.8 years with those who continued MMI as long as 24 years.Methods: Fifty nine patients with Graves’ disease on long-term MMI for 14.2±2.9 years were recruited; 32 patients (54%) decided to discontinue MMI and 27 (46%) preferred additional years of MMI treatment. All patients were followed for a mean of 6 additional years.Results: Of 27 patients who continued MMI, 16 and 11 subjects completed median of 20 and 24 years of MMI treatment, respectively. Suppressed serum thyrotropin (TSH) was not observed in any patient after seventh years of treatment. Serum free thyroxine, triiodothyronine, TSH and TSH receptor antibody concentrations remained normal up to the length of the study. Mean daily dose of MMI to maintain TSH in the reference range decreased gradually and reached to 2.8±1.7 mg by 24 years of MMI treatment. No adverse reaction related to MMI occured during additional years of therapy. In 32 patients who discontinued MMI, hyperthyroidism relapsed in 6 patients (19%), one left follow-up and 25 (78%) remained euthyroid during the study.Conclusions: Long-term low dose MMI treatment may be a lifelong effective and safe therapeutic modality in patients with Graves’ hyperthyroidism for prevention of relapse.Trial registration: IRCT201009224794N, 2010-10-25. Retrospectively registered.www. IRCT.IR/Trial/5143.
The Effect of Labor Participation on The Health of Middle-Aged People——An Empirical Analysis From China
Authors: Zhang Jian , Gao Jianmin , Li Dan , Dong Wanyue , Yang Wei , Shen Chi , Cao Dan
Published: July 2020

Background: China has entered into an aging society and will continue to age rapidly in the future. The middle-aged (45~59 years old) is aging, and the workforce participating in labor is shrinking. Since there is few empirical researches on the relationship between labor participation and the health of middle-aged people, the aim of this study is to study the effect of labor participation on the health of middle-aged people. Methods: The data of CHARLS in 2015 were adopted. In this study, self-assessed health, chronic diseases and depression were used as health measurement indicators, and the work status was used to measure the labor participation. To control possible endogenousness, our study used Propensity Score Matching to match people who participated in labor and those who did not; Then logit regression analysis was used among matched data to study the association of labor participation with the health of middle-aged people. Results: The study showed that the self-rated health of middle-aged people with labor participation was 1.3 times higher than those without labor participation. In terms of the probability of suffering from chronic diseases, middle-aged people who participated in labor were 0.6 lower than those who did not participate in labor. In terms of the probability of depression, the middle-aged people who participated in labor were 0.8 times lower than those who did not participate in labor. Conclusions: The health of middle-aged people participating in labor was obviously better than those who did not participate in labor. Our study provided the evidence for policy making on health promotion, delayed retirement and employment promotion.
Assessing Current And Preferred Sources Of Information On Adolescents’ Sexual And Reproductive Health In Southeast Nigeria: Improving Adolescent Health Programming
Authors: Agu Chibuike Innocent , Mbachu Chinyere Ojiugo , Agu Ifunanya Clara , Okeke Chinyere , Ezenwaka Uchenna , Ndubuisi Mildred , Ezumah Nkoli , Onwujekwe Obinna
Published: July 2020

Background: Many adolescents lack appropriate information about their sexual and reproductive health (SRH). Although there are numerous information on SRH, they vary in content and quality, and these have implications for the accuracy and appropriateness of SRH information adolescents can access. This study examined the sources of SRH information for adolescents, the value adolescents place on these sources and their significance for adolescent health programming.Method: This was a mixed methods, community-based, cross-sectional study that was conducted in six local government areas in Ebonyi state, Nigeria. Quantitative data were collected using pre-tested questionnaire that was administered to 1057 unmarried adolescents aged 13-18 years. The qualitative data were: Seventy-seven in-depth interviews (IDIs) with stakeholders; twelve (12) focus group discussions (FGDs) with adolescents; and six FGDs with village head. Descriptive and inferential analyses were performed for quantitative data using Stata software while thematic framework approach was used to analyze qualitative data.Result: It was found that 60.5% and 39.8% of adolescents reported that school teachers and mothers respectively were their major sources of information about pubertal changes, while teachers (36.3%) and friends (29.8%) were the commonest sources of information on relationship with opposite sex. There were statistically significant associations between sources of information about relationships and age category (p≤0.09). Additional common sources of SRH information elicited through IDIs with adolescents include internet, social media and mass media. Although adolescents valued the information provided by teachers and parents, they preferred information on SRH from their friends/peers, social media and mass media because these sources are easy to access with a guarantee of some level of confidentiality. In the opinion of parents and other stakeholders, sources of appropriate SRH information for adolescents were health workers, teachers, parents and adult family members; whereas peers/friends and social media were considered as inappropriate sources of SRH information for adolescents.Conclusion: Efforts at addressing the need of adolescents for SRH information should be targeted at their valued and preferred sources, whilst maintaining a delicate balance with the choices and expectations of their parents and adult family members.
Talking But Not Always Understanding: Couple Communication About Infertility Concerns After Cancer
Authors: Hawkey Alexandra Jane , Ussher Jane Maria , Perz Janette , Parton Chloe
Published: July 2020

Background: Cancer survivorship and infertility are widely acknowledged to be relational experiences, with couple communication facilitating coping. However, little is known about the ways in which couples communicate about cancer related fertility concerns.Objective: The aim of the study was to examine how couples communicate about cancer related fertility concerns, and the perceived quality of such communication from the perspective of cancer survivors and their partners. Methods: Eight-hundred and seventy-eight cancer survivors (693 women, 185 men) and 144 partners (82 women, 62 men), across a range of tumour types and age groups, completed a survey which examined cancer related fertility concerns. Seventy-eight people with cancer (61 women and 17 men), and 26 partners (13 women and 13 men), participated in semi-structured interviews to examine the relational context of infertility. Thematic analysis was used to analyse the interviews and open ended survey questions about fertility concerns and relationships. Valid percentages for single items from the relationships subscale of the Fertility Preservation Inventory (FPI), related to themes identified in the qualitative data, identified the commonality of responses across the sample. Results: Our findings suggest that the majority of couples could both communicate about cancer related fertility concerns and had concerns about the adequacy and impact of such communication. This is reflected in the overarching theme identified in our analysis: Talking but not always understanding: Couple communication about infertility concerns after cancer. Subthemes included: Positive couple communication about fertility concerns leads to support, understanding and relationship growth; Conflict and silencing of conversations surrounding cancer and infertility leads to relationship tension; and Managing infertility disclosure in new and future relationships. Conclusion: Open and honest couple communication about cancer related fertility concerns is associated with feeling supported and understood, facilitating relationship satisfaction and coping. Health-care professionals working in cancer care should include partners of cancer survivors in discussions of fertility. Couple interventions developed in general psycho-oncology should be extended to the domain of fertility, in order to facilitate effective couple communication. Communication in future relationships needs to be addressed for single people and adolescents and young adults (AYAs) who have oncofertility concerns.
Urinary cytology as a tool for differential diagnosis between acute tubular necrosis and proliferative glomerulonephritis in patients with nephrotic syndrome and acute kidney injury
Authors: de Melo Caroline Vilas Boas , Tavares Maria Brandão , Fernandes Paula Neves , Silva Carlos Alberto Santos , Couto Ricardo David , Oliveira Marília Bahiense , dos-Santos Washington LC
Published: July 2020

Objective Acute tubular necrosis (ATN) is a frequent cause of acute kidney injury (AKI). In patients with nephrotic syndrome (NS), AKI demands the differential diagnosis between ATN and rapidly progressive glomerulonephritis. In some cases, conclusive diagnosis is possible only by kidney biopsy. We aimed to study the potential use of urine cytology in the differential diagnosis between ATN and proliferative glomerular lesion in patients with NS.Results Cell size analysis showed a higher proportion of small cells and a lower proportion of large cells in the urine of patients with AKI. Cells phenotypes were easily defined using cytological preparations. Leukocytes were found to be a primary classifier of NS groups, with higher number in patients with AKI and patients with proliferative glomerular lesions. Our data suggests that urinary cytology can be readily performed and support the differential diagnosis between proliferative glomerular lesion and ATN in patients with NS and AKI.
Whole-Exome Sequencing in 168 Korean Patients with Inherited Retinal Degeneration
Authors: Ma Dae Joong , Lee Hyun-Seob , Kim Kwangsoo , Choi Seongmin , Jang Insoon , Cho Seo-Ho , Yoon Chang-Ki , Lee Eun Kyoung , Yu Hyeong Gon
Published: July 2020

Background: To date, no genetic analysis of inherited retinal disease (IRD) using whole-exome sequencing (WES) has been conducted in a large-scale Korean cohort. The aim of this study was to identify the genetic profile of IRD patients in Korea using WES.Methods: We performed comprehensive molecular testing in 168 unrelated Korean IRD patients using WES. The potential pathogenicity of candidate variants was assessed using the American College of Medical Genetics and Genomics and the Association for Molecular Pathology variant interpretation guidelines, in silico prediction tools, the published literature, and compatibility with known phenotypes or inheritance patterns.Results: Causative variants were detected in 86/168 (51.2%) IRD patients, including 58/107 (54.2%) with retinitis pigmentosa, 7/15 (46.7%) with cone and cone-rod dystrophy, 2/3 (66.6%) with Usher syndrome, 1/2 with (50.0%) congenital stationary night blindness, 2/2 (100.0%) with Leber congenital amaurosis, 1/1 (100.0%) with Bietti crystalline dystrophy, 1/1 (100.0%) with Joubert syndrome, 9/10 (90.0%) with Stargardt macular dystrophy, 1/10 (10.0%) with vitelliform macular dystrophy, 1/11 (9.1%) with other forms of macular dystrophy, and 3/4 (75.0%) with choroideraemia. USH2A, ABCA4, and EYS were the most common causative genes associated with IRD. For retinitis pigmentosa, variants of USH2A and EYS were the most common causative gene mutations.Conclusions: This study demonstrated the distribution of causative genetic mutations in Korean IRD patients. The data will serve as a reference for future genetic screening and the development of treatment modalities for Korean IRD patients.
The gaps in health-adjusted life years (HALE) by income and region in Korea: a national representative bigdata analysis
Authors: Kim Young-Eun , Ock Minsu , Park Hyesook , Kim Ki-beom , Go Dun-Sol , Jung Yoon-Sun , Yoon Seok-Jun
Published: July 2020

Background: This study aims to calculate the health-adjusted life years (HALE) by using years lived with disability from the national claims data and aims to identify the differences and inequalities in income level and region. Methods: The study was carried out on total population receiving health insurance and medical benefits. We calculated incidence-based years lived with disability (YLD) for 260 disease groups, and this was used as the number of healthy years lost to calculate HALE. We adopted the insurance premium to calculate the income as a proxy indicator. For the region classification, we chose 250 administrative districts to cover the whole country.Results: The primary outcome was HALE in the Korean population. The second outcome was the HALE’s gap in terms of income and region. HALE increased from 2008 to 2016. Results by gender suggest that HALE in males increases faster than in females. Results by income level show that HALE is higher in higher income level. In 2016, the gap in HALE between Q1 and Q2, the lower income group, was about 5.10 years. The gap in females by income level was smaller than that in males, which can be because males have greater inequality in terms of HALE by income level. Moreover, the gap in HALE by region was found to increase.Conclusions: Results suggest that there is an inequality in years of living with disability in terms of income level in Korea. Therefore, we need intensive management for the low-income group to promote HALE at the national level.
Association between social capital and depression among older people: evidence from Anhui Province, China
Authors: Bai Zhongliang , Xu Zhiwei , Xu Xiaoru , Qin Xia , Hu Wenbiao , Hu Zhi
Published: July 2020

Background: To examine the relationship between social capital and depression among community-dwelling older adults in Anhui Province, China.Methods: A cross-sectional study was conducted among older people selected from three cities of Anhui Province, China using a multi-stage stratiﬁed cluster random sampling method. Data were collected through questionnaire interviews and information on demographic characteristics, social capital, and depression was collected. The generalized linear model and classification and regression tree model were employed to assess the association between social capital and depression. Results: Totally, 1,810 older people aged ≥ 60 years were included in the final analysis. Overall, all of the social capital dimensions were positively associated with depression: social participation (coefficient: 0.35, 95% CI: 0.22 - 0.48), social support (coefficient:0.18, 95% CI:0.07 - 0.28), social connection (coefficient: 0.76, 95% CI:0.53 - 1.00), trust (coefficient:0.62, 95% CI:0.33 - 0.92), cohesion (coefficient:0.31, 95% CI:0.17 - 0.44) and reciprocity (coefficient:0.30, 95% CI:0.11 - 0.48), which suggested that older people with higher social capital had a smaller chance to develop depression. A complex joint effect of certain social capital dimensions on depression was also observed. The association with depression and the combinative effect of social capital varied among older adults across the cities. Conclusions: Our study suggests that improving social capital could aid in the prevention of depression among older adults.
Heavy metal levels in drinking water sources of Chingola District, Zambia
Authors: Hamwiinga Francis , Meki Chisala D. , Mubita Patricia , Halwiindi Hikabasa
Published: July 2020

Background: One of the factors impeding access to safe water is water pollution. Of particular concern is heavy metal contamination of water bodies. This study was aimed at determining the levels of heavy metals in drinking water sources of Chingola District of Zambia. Methods: A cross sectional study was employed. A total of 60 water samples were collected. Thirsty (30) samples were collected in the dry season in the month of October 2016 and another 30 in the wet season in the months of February and March, 2017. For each season 10 water samples were collected from each of the three water sources. i.e. Tap water, Urban ground water sources and Rural ground water sources. Heavy metal analysis was done using Atomic Absorption Spectrophotometer (AAS).Results: This study revealed that the concentrations of Iron, Manganese, Lead, Nickel and Arsenic were beyond maximum permissible levels in various water sources. Combined averages for both dry and wet seasons were as follows: Iron: 2.3, Copper: 0.63, Cobalt: 0.02, Manganese: 0.36, Lead: 0.04, Zinc:3.2, Nickel: 0.03, Arsenic: 0.05. Chromium and Cadmium were below detection limit in all water samples. The median concentrations of iron, arsenic, copper, manganese in drinking water from the Tap, rural and urban ground water sources were different, and this difference was statistically significant (p<0.05). The median concentrations of arsenic, nickel, manganese and cobalt were different between dry and wet season, and this difference was statistically significant (p<0.05).Conclusions: Sources of heavy metals in water seems to be both natural and from human activities. The concentration of heavy metals in different water sources in this study was found to be above the recommended levels. This calls for improvement in water monitoring to protect the health of the public. Therefore, there is need for continuous monitoring of heavy metals in drinking water sources by regulatory authorities.
Disparities in Child Survival in Ethiopia: Evidence From Nationally Represented Data
Authors: Feng Cindy Xin , Geda Nigatu Regassa , Whiting Susan J. , Janzen Bonnie , Lepnurm Rein , Henry Carol J.
Published: July 2020

Background: Even though Ethiopia has made considerable progress in improving child health and survival, the country is experiencing one of the highest infant and under 5 mortality rates. The purpose of this study was to examine the disparities in child health and survival in Ethiopia.Method: Data were drawn from the 2016 Ethiopian Demographic and Health Surveys (EDHS). Proportional odds regression was used to identify the determinants of poor child health and survival outcomes. The Mosley and Cohen’s child health framework was used to measure child survival. Results: The proportion of both poor health and mortality were high. The likelihood of falling into the poor health and survival category increases for: male children; children born with preceding birth interval of <18 months; those never breastfed; born to mothers having higher deprivation index or having poor health service utilization score; poor diet diversity score; living in a household with non-improved toilet facility; having a father with low education level; and those living in a community where mothers’ education is low (p<0.05). Conclusion: Inequalities hamper Ethiopia’s true progress in improving child health and survival. Given the fact that nearly two-thirds of Ethiopian women have no education and half live in financially disadvantaged households, this study recommends aggressive intervention in promoting women’s status at the grassroots level through community education and behavioral communication strategies that will eventually help to significantly reduce huge disparity in early mortality in the population.
Antimicrobial Resistance of Escherichia coli and Salmonella isolated from Raw Retail Broiler Chicken Carcasses in Zambia
Authors: Muonga Elizabeth Muligisa , Mainda Geoffrey , Mukuma Mercy , Kwenda Geoffrey , Hang'ombe Bernard , Bumbangi Flavien , Phiri Nelson , Mwansa Mwaba , Munyeme Musso , Muma John Bwalya
Published: July 2020

BackgroundAntimicrobial resistance (AMR) of foodborne pathogens is of public health concern, especially in developing countries such as Zambia. This study was undertaken to determine the antimicrobial resistance profiles of Escherichia coli ( E. coli ) and Salmonella isolated from raw retail broiler chicken carcasses purchased from open and supermarkets in Zambia.ResultsA total of 189 E. coli and five Salmonella isolates were isolated. Identification and confirmation of the isolates were done using Analytical Profile Index (API 20E) (Biomerieux ® ) and 16S rRNA sequencing. Antimicrobial susceptibility tests (AST) were performed using the Kirby Bauer disk diffusion technique using a panel of 10 antibiotics. Multiplex PCR was used to determine the presence of three target genes encoding for resistance: tet A, Sul 1 and bla CTX-M . WHONET 2018 software was used to analyse AST results. The E. coli isolates were mostly resistant to tetracycline (79.4%), ampicillin (51.9%), and trimethoprim/sulfamethoxazole (49.7%). Two of the five Salmonella isolates were resistant to at least one antibiotic. Forty- seven (45.2%) of the 104 isolates that were screened for the presence of the resistant genes possessed at least one of the targeted resistance genes.ConclusionThis study has demonstrated the presence of AMR E. coli and Salmonella on raw retail broiler chicken carcasses from open and supermarkets, which is of public health concern.
Inverse Problem for Identification of Infectivity and Recovery Rates in SIR Epidemic Models as Functions of Time Illustrated with Corona Virus Dynamics up to July 09, 2020
Authors: Marinov Tchavdar , Marinova Rossitza
Published: July 2020

This work deals with the inverse problem in epidemiology based on a SIR model with time-dependent infectivity and recovery rates, allowing for a better prediction of the long term evolution of a pandemic. The method is used for investigating the COVID-19 spread by first solving an inverse problem for estimating the infectivity and recovery rates from real data. Then, the estimated rates are used to compute the evolution of the disease. The time-depended parameters are estimated for the World and several countries (The United States of America, Canada, Italy, France, Germany, Sweden, Russia, Brazil, Bulgaria, Japan, South Korea, New Zealand) and used for investigating the COVID-19 spread in these countries.
Early initiation of Extracorporeal Blood Purification using the AN69ST (oXiris®) hemofilter as a treatment modality for COVID - 19 patients: a single-centre case series
Authors: Ugurov Petar , Popevski Dijana , Gramosli Tanja , Neziri Dashurie , Vuckova Dragica , Stoicovski Emil , Veljanovska-Kiridjievska Lidija , Ignevska Katerina , Mehandziska Sanja , Ambarkova Elena , Rosalia Rodney Alexander , Mitrev Zan
Published: July 2020

Introduction: Our understanding of the COVID-19 disease has been steadily evolving since the original outbreak in December 2019. Advanced disease is characterised by a hyperinflammatory state, systemic coagulopathies and multiorgan involvement, in particular respiratory distress. We here describe our initial experience with treating of COVID-19 patients based on early initiation of extracorporeal blood purification, systemic heparinisation and respiratory support.Methods: 15 patients were included; 2 were females. We monitored real-time several biochemical, immunological and coagulation biomarkers associated with disease severity following admission to our dedicated COVID-19 intensive care unit. To guide personalised treatment, we monitored among others levels of IL-6, IL-8, TNF-α, C-Reactive Protein (CRP), Neutrophil-to-Lymphocyte ratios, Thrombocyte counts, D-Dimers, Fibrinogen, and Activation Clotting time (ACT).Treatment consisted of individualised respiratory support supplemented with 1 - 4 cycles of 24-hour Extracorporeal Organ Support (ECOS) and Blood Purification using the AN69ST (oXiris®) hemofilter. We administered heparin (300 U/kg) to counter suspected hypercoagulability (= elevated Fibrinogen or D-dimers) states to maintain ACT ≥ 180 seconds.Results: N = 10 presented with severe to critical disease (= dyspnoea, hypoxia, respiratory rate > 30/min, peripheral oxygen saturation < 90%, or > 50% lung involvement on X-ray imaging). A single case was admitted with a critical condition (= respiratory failure). One patient died after 5 days of hospitalisation after developing Acute Respiratory Syndrome. 8 Patients have been discharged - average ICU length-of-stay was 9.9 ± 2.4 days. Clinical improvement was associated with normalisation (increase) of thrombocytes, white blood cells, stable levels of IL-6 (< 50 ng/mL) and a decrease of CRP and Fibrinogen. Conclusion: Means to monitor COVID-19 disease severity during hospitalisation are crucial to control disease progression and prevent hyperinflammation and irreversible multiorgan failure. We present here a real-time monitoring system accounting for biochemical, immunological, coagulation parameters and radiological imaging. The combination of systemic heparin anticoagulation regimens and blood purification may prevent hyperinflammation, thromboembolism during hospitalisation and thus support clinical recovery.
Expectations and Experiences with Physician Care Among Patients Receiving Post-Acute Care in US Skilled Nursing Facilities
Authors: Ryskina Kira L , Foley Kierra A. , Karlawish Jason H. , Uy Joshua D. , Lott Briana , Goldberg Erica , Hodgson Nancy A.
Published: July 2020

Background and Objectives: In the US, post-acute care in skilled nursing facilities (SNFs) is common and outcomes vary greatly across facilities. Little is known about the expectations of patients and their caregivers about physician care during the hospital to SNF transition. Our objectives were to (1) describe the experiences and expectations of patients and their caregivers with SNF physicians (or advanced practitioners such as nurse practitioners) in SNFs, and (2) identify patterns that differed between patients with vs. without cognitive impairment.Research Design and Methods: This qualitative study used grounded theory approach to analyze data collected from semi-structured interviews at five SNFs in January-August 2018. Patients admitted for short-term SNF care 5-10 days prior were eligible to participate. Thematic analysis was performed to detect recurrent themes with a focus on modifiable aspects of physician care. Analysis was stratified by patient cognitive impairment (measured by the Montreal Cognitive Assessment at the time of the interview). Results: Fifty patients and six caregivers were interviewed. Major themes were: (1) patients had poor awareness of the physician in charge of their care; (2) they were dissatisfied with the frequency of interaction with the physician; and (3) participants valued the perception of receiving individualized care from the physician. Less cognitively impaired patients were more concerned about limited interactions with the clinicians and were more likely to report attempts to seek out the physician. Discussion and Implications: Patient and caregiver expectations of SNF physicians were not well aligned with their experiences. SNFs aiming to improve satisfaction with care may focus efforts in this area, such as facilitating frequent communication between physicians, patients and caregivers.
Differential effects of serum lipoprotein-associated phospholipase A2 on periventricular and deep subcortical white matter hyperintensity in brain
Authors: Jiang Junying , Gao Yuanyuan , Zhang Rui , Wang Lin , Zhao Xiaoyuan , Dai Qi , Zhang Wei , Xu Xiujian , Chen Xuemei
Published: July 2020

Background: High lipoprotein-associated phospholipase A2 (Lp-PLA2) was associated with white matter hyperintensity (WMH). There were differences in the anatomical structure and pathophysiological mechanism between periventricular WMH (PVWMH) and deep subcortical WMH (DSWMH). In this study, we aimed to investigate the effects of serum Lp-PLA2 on the PVWMH and DSWMH. Methods: This cross-sectional study recruited 711 Chinese adults aged ≥45 years presented to the Department of Neurology, the Affiliated Jiangning Hospital of Nanjing Medical University between January 2016 and July 2019. Enzyme linked immunosorbent assay (ELISA) was utilized to determine the serum Lp-PLA2. Fazekas scale was used to measure the severity of PVWMH and DSWMH. Ordinal logistic regression analysis was carried out to investigate the relationship between serum Lp-PLA2 and PVWMH or DSWMH. Results: A total of 567 cases were included in this study. Ordinal logistic regression analysis indicated that, after adjusting for the confounding variables, there was a lower risk of PVWMH in the patients with normal and moderately elevated serum Lp-PLA2 compared with those with significantly elevated serum Lp-PLA2. In addition, PVWMH was correlated to advanced age, hypertension, diabetes mellitus, and lacunar infarction. DSWMH was correlated to advanced age and lacunar infarction. There was no correlation between serum Lp-PLA2 and DSWMH. Conclusions: Serum Lp-PLA2 was closely associated with the pathogenesis of PVWMH rather than DSWMH. There might be different pathological mechanisms between PVWMH and DSWMH.
Multiple gene targeting siRNAs for down regulation of Immediate Early-2 (Ie2) and DNA polymerase genes mediated inhibition of novel rat Cytomegalovirus (strain All-03)
Authors: Balakrishnan Krishnan Nair , Abdullah Ashwaq Ahmed , Bala Jamilu Abubakar , Jesse Faez Firdaus Abdullah , Abdullah Che Azurahanim Che , Noordin Mustapha Mohamed , Azmi Mohd Lila Mohd
Published: July 2020

Background
Cytomegalovirus (CMV) is an opportunistic pathogen that causes severe complications in congenitally infected newborns and non-immunocompetent individuals. Developing an effective vaccine is a major public health priority and current drugs are fronting resistance and side effects on recipients. In the present study, with the aim of exploring new strategies to counteract CMV replication, several anti-CMV siRNAs targeting IE2 and DNA polymerase gene regions were characterized and used as in combinations for antiviral therapy.
Methods
The rat embryo fibroblast (REF) cells were transfected with multi siRNA before infecting with CMV strain ALL-03. Viral growth inhibition was measured by TCID50, cytopathic effect (CPE) and droplet digital PCR (ddPCR) while IE2 and DNA polymerase gene knockdown was determined by real-time PCR. Ganciclovir was deployed as a control to benchmark the efficacy of antiviral activities of respective individual siRNAs.
Results
There was no cytotoxicity encountered for all the combinations of siRNAs on REF cells analyzed by MTT colorimetric assay (P > 0.05). Cytopathic effects (CPE) in cells infected by RCMV ALL-03 developed significantly less and at much slower rate compared to control group. The expression of targeted genes was downregulated successfully resulted in significant reduction (P < 0.05) of viral mRNA and DNA copies (dpb + dpc: 79%, 68%; dpb + ie2b: 68%, 60%; dpb + dpc + ie2b: 48%, 42%). Flow cytometry analysis showed a greater percentage of viable and early apoptosis of combined siRNAs-treated cells compared to control group. Notably, the siRNAs targeting gene regions were sequenced and no any mutation was identified, thereby avoiding the formation of mutant with potential resistant viruses.
Conclusions
In conclusion. The study demonstrated a tremendous promise of innovative approach with the deployment of combined siRNAs targeting at several genes simultaneously with the aim to control CMV replication in host cells.
Test–Retest Reproducibility Analysis of Bone Mineral Densitometry Radiomics Features
Authors: Qasempour Younes , Akhash Mohammad Rashid , Shiri Isaac , Hajianfar Ghasem , Abdalvand Neda , Abdollahi H
Published: July 2020

Background

Radiomics features reproducibility assessment is a critical issue in imaging biomarker development era. In the present study, we aimed to assess test–retest reproducibility analysis of bone mineral densitometry (BMD) image radiomics features.
Methods

In this prospective research work, eighteen patients were included and were subjected to DXA BMD scans acquired within 10 min of each other under an approved protocol. Seven regions of interest (ROIs) including four lumbar spine regions (L1-L4) and three hip regions (trochanteric, inter trochanteric and neck) in both test and re-test images were segmented and 107 radiomics features from seven different feature sets were extracted. Intra-class correlation coefficient (ICC) were initially used to estimate radiomics features reproducibility.
Results

We showed that there is no radiomics feature with 90% < ICC < 100% in all ROIs, but there are three feature including Strength (from NGTDM feature set), SALGLE (Small Area Low Gray Level Emphasis) (from GLSZM feature set) and Busyness (from NGTDM feature set) with ICC < 70% in all eight ROIs. Shape features has features with ICC < 70%.
Conclusion

Our study on test–retest reproducibility analysis of bone mineral densitometry radiomics features shows radiomics features have several variations against changes of time of image acquisition. The reproducible features may be used as imaging biomarkers in the field of clinical densitometry. The results of this study may be repeated by more radiomics features and more BMD scanners as first line for bone mineral biomarker discovery.
The association of parent-child communication with Internet addiction in left-behind children in China
Authors: Cai Jingjing , Wang Yun , Wang Feng , Lu Jingjing , ZHOU Xudong , Li Lu
Published: July 2020

Background

Long-term absence of parents has been proven to lead to negative health outcomes on left-behind children (LBC). We saw numerous studies that explored the association of parental absence with mental health and risky behaviors among LBC. Recently, Internet addiction has emerged as a growing concern, however, it was seldom studied among LBC community. This study aimed to compare the prevalence of Internet addiction between LBC and non-left-behind children (non-LBC), and explore the role of paternal and maternal parent-child communication on LBC.
Methods

We conducted a questionnaire survey in rural areas in Anhui, China, including the Parent-Adolescent Communication Scale and Young’s Internet addiction Test. LBC who reported both migrating parents and children who lived with both non-migrating parents were included in this study.
Results

The complete data were available from 699 LBC and 740 non-LBC. After adjustment of social-demographic characteristics, the result indicated LBC had a higher likelihood to report internet-addiction when compared to non-LBC (OR = 2.03, 95%CI = 1.43–2.88, p < 0.001). Among LBC, parent-child communication (both mother-child and father-child) was protective factors for children’s Internet addiction. Also, the role of mother-child communication played well in preventing boys from Internet addiction.
Conclusions

Our findings suggested the lack of parental supervision may lead to Internet addiction. It is highly recommended for migrant parents to improve the quality of communication with their children. Also, gender-matching effects should be considered in the relationship between children’s behavior and parental factors.
Drug-induced liver injury due to the infliximab biosimilar CT-P13 on switching from original infliximab in a patient with Crohn’s disease
Authors: Fujiya Mikihiro , Kashima Shin , Kobayashi Yu , Sugiyama Yuya , Murakami Yuki , Sato Hiroki , Sasaki Takahiro , Kunogi Takehito , Hayashi Hidemi , Takahashi Keitaro , Hasebe Takumu , Nakajima Shunsuke , Ando Katsuyoshi , Ueno Nobuhiro , Goto Takuma , Sawada Koji , Moriichi Kentaro , Tanabe Hiroki , Mizukami Yusuke , Okumura Toshikatsu
Published: July 2020

Background

IBD are chronic immune disorders of unclear etiology. TNF inhibitors are effective for IBD treatment but are much more expensive than traditional treatments. A large number of clinical trials of infliximab biosimilar (CT-P13) have suggested that the administration of biosimilars provides high efficacy and safety similar to that of the originators, with a lower cost, so switching from the originator to the biosimilar is recommended. While several abnormalities of blood examination have been observed in patients with CT-P13 administration, no cases of drug-induced liver injury (DILI) caused by CT-P13 has been reported.
Case presentations:

A 32-year-old woman had been diagnosed with Crohn’s disease and was treated with original infliximab (O-IFX) for 9 years. She developed severe jaundice one month after switching from O-IFX to CT-P13. Serologic tests of auto-immune and hepatitis viruses were negative, and ultrasonography, computed tomography and magnetic resonance cholangiopancreatography revealed no abnormalities. A liver biopsy showed prominent pericentral canalicular cholestasis, without features of steatosis or sclerosing cholangitis, which was consistent with drug-induced cholestasis. The cholestasis improved 10 weeks after the discontinuation of CT-P13, and no DILI redeveloped even after re-switching from CT-P13 to O-IFX. This is the first report of DILI due to switching from O-IFX to CT-P13.
Conclusions

This is the first report of DILI due to switching from O-IFX to CT-P13, and our case suggests the different immunogenicity between O-IFX and CT-P13. While the efficacy and safety of CT-P13 are considered equal to those of O-IFX, clinicians need to be alert for certain severe DILIs when switching from O-IFX to CT-P13 with careful monitoring and appropriate treatment.