bluuebunny/crossref_metadata_2025 huggingface dataset:
Correlates Of Intimate Partner Violence Among Women In Union In Uganda: A Cross-Sectional Survey
Authors: Gubi Derrick , Nansubuga Elizabeth , Wandera Stephen Ojiambo
Published: December 2019

Background In Uganda, just like in many sub-Saharan countries, studies on Intimate Partner Violence (IPV) are limited. The aim of this paper was to determine the correlates of emotional, sexual, physical and any IPV among women in union in Uganda.Methods The 2016 Uganda Demographic and Health Survey (UDHS) data was used, and a weighted sample of 6879 women who had been in a union were selected from the Domestic Violence module. Frequency distributions were used to obtain the background and other IPV related characteristics of the women while chi-square tests established the relationship between IPV and the explanatory variables. Binary logistic regressions established the factors that were associated with IPV.Results More than half (56%) of the women in union experienced some form of IPV. Sexual IPV was the least prevalent (23%) and 4 in 10 women (41% and 40%) experienced physical and emotional IPV respectively. Factors associated with all the different forms of IPV included, age, region, witnessing parental violence, partner’s controlling behaviors, duration of union, and frequency of being drunk by the partner.Conclusion IPV towards Ugandan women in union was high. This calls for its reduction through collective efforts that target men to address issues like excessive alcohol consumption, controlling behaviors and raising awareness among others. Intervention programs aimed at countering perpetration and tolerance of violence in the home setting should be promoted.
The social determinants of otitis media in Aboriginal children in Australia: are we addressing the primary causes? A systematic content review
Authors: Author) Jack DeLacy(Former Corresponding , Author) Tinashe Dune(New Corresponding , Macdonald John
Published: December 2019

Background Aboriginal and Torres Strait Islander children experience some of the highest rates of otitis media in the world. Key risk factors for otitis media in Aboriginal children in Australia are largely social and environmental factors such as overcrowded housing, poverty and limited access to services. Despite this, little is known about how to address these risk factors. A scoping content review was performed to determine the relationship between social determinants of health and otitis media in Aboriginal and Torres Strait Islander children as described by peer-reviewed and grey literature.Method Search terms were established for location, population and health condition. The search terms were used to conduct a literature search using six health research databases. Following the exclusion process, articles were scoped, analysed and categorised using scoping parameters and a social determinants of health framework.Results Housing-related issues were the most frequently reported determinants for otitis media (56%). Two articles (4%) directly investigated the impact of social determinants of health on rates of otitis media within Aboriginal and Torres Strait Islander children. The majority of the literature (68%) highlight social determinants as playing a key role in the high rates of otitis media seen in Aboriginal populations. There were no intervention studies targeting social determinants as a means to reduce otitis media rates among Aboriginal and Torres Strait Islander children.Conclusions This review identifies a disconnect between otitis media drivers and the focus of public health interventions within Aboriginal and Torres Strait Islander populations. Despite consensus that social determinants play a key role in the high rates of otitis media in Aboriginal and Torres Strait Islander children, the majority of literature consists of intervention studies aimed at developing vaccines and antibiotics. This review highlights the need for otitis media intervention studies to shift away from a purely biomedical model and toward investigating the underlying social determinants of health. By shifting interventions upstream, otitis media rates may decrease within Aboriginal and Torres Strait Islander children, as focus is shifted away from a treatment-focussed model and toward a more preventative model.
Characterising urban green space density and accessibility in models of BMI
Authors: Carthy Philip , Lyons Sean , Nolan Anne
Published: December 2019

Background : While exposure to urban green spaces has been associated with various physical health benefits, the evidence linking these spaces to lower BMI, particularly among older people, is mixed. We suggest that dimensions of urban green space accessibility, which are generally unobserved in the existing literature, may be a source of this volatility in results. The aim of this study is to add to the literature on the association between urban green space and BMI by considering alternative measures of urban green space that incorporate measures of footpath availability. Methods: We conduct a cross-sectional study combining data from The Irish Longitudinal Study on Ageing and detailed land use information. We proxy respondents’ exposure to urban green spaces at their residential addresses in network buffers, which are adjusted to account for the density of local footpaths. Generalised linear models are used to test the association between exposure to accessible urban green space and BMI. Results: Relative to the third quintile, exposure to the lowest quintile of urban green space, as measured within a 1600m accessible network buffer, is associated with slightly higher BMI (marginal effect: 0.80; 95% CI: 0.16-1.44). The results, however, are not robust to small changes in how green space is measured and no statistically significant association between urban green spaces and BMI is found under other variants of our regression model. Conclusion : The relationship between urban green spaces and BMI among older adults is highly sensitive to the characterisation of local green space. Our results suggest that there are some other unobserved factors, other than footpath availability, that mediate the relationship between urban green spaces and weight status.
Motor Vehicle Fatalities during Memorial Day Weekends, 1981-2016
Authors: Tang Yuni , Ratnapradipa Kendra L , Xiang Henry , Zhu Motao
Published: December 2019

Objective: Motor vehicle crashes are a leading cause of injury death in the United States, and Memorial Day weekend is one of six holiday periods with an increased number of motor vehicle fatalities in the United States. However, few motor vehicle fatality comparisons were made between Memorial Day weekend and non-holiday periods. Our aims were to determine which day(s) during the holiday had highest motor vehicle fatality risk compared to non-holiday travel and to identify potential risk factors.
Results: Of 43,457 traffic fatalities studied, 15,292 (35%) occurred during the holiday, with Saturday being deadliest but Monday having highest odds. Both sexes, all years, age <65, drivers and passengers, rural and urban, and all regions in the United States were at increased risk during the holiday versus non-holiday periods.
Comparison of erythrocyte sedimentation rate between blood anticoagulated with sodium citrate and EDTA among Tuberculosis suspected patients at University of Gondar Hospital, North West Ethiopia
Authors: Getaneh Zegeye , Ayelgn Fekadu , Asemahegn Geletaw , Geleta Habtamu , Yalew Aregawi , Melak Tadele
Published: December 2019

Objective: The purpose of this study was comparison of erythrocyte sedimentation rate results of sodium citrate and ethylene diamine tetra-acetic acid anticoagulant. A comparative cross-sectional study was conducted at University of Gondar Referral Hospital, Northwest, Ethiopia. A total of 70 TB suspected study participants were recruited. From each study participants, 3ml blood was collected in to EDTA tube and 1.6ml blood was collected in to a test tube containing 0.4ml Sodium Citrate anticoagulant. Results: The mean ± SD values for ESR were 57.9 ± 41.45 in EDTA and 50.99 ± 43.5 in citrate anticoagulated blood. The mean difference of ESR values between EDTA and citrated blood was 6.91 ± 13.66 mm/hr with a significant difference. The mean ± SD of ESR for EDTA and citrate blood was 59.57 ± 42.31 and 54.71 ± 40.44 mm/hr for males and 53.57 ± 44.61 and 46.04 ± 41.82 mm/hr for females, respectively. This study indicated that there was a significant difference between ESR values with EDTA and tri-sodium citrate anticoagulants.
18F-Flutemetamol PET post-stroke - a seven year follow-up study
Authors: Hagberg Guri , Ihle-Hansen Hege , Fure Brynjar , Thommessen Bente , Ihle-Hansen Håkon , Øksengård Anne Rita , Beyer Mona K. , Wyller  , Müller Ebba Gløersen , Pendlebury Sarah T. , Selnes Per
Published: December 2019

Background: Cognitive impairment (CI) with mixed vascular and neurodegenerative pathologies after stroke is common. The role of amyloid pathology in post-stroke CI is unclear. We hypothesize that amyloid deposition, measured with Flutemetamol (18F-Flut) positron emission tomography (PET), is common in 7-year stroke survivors diagnosed with CI and, further, that quantitatively assessed 18F-Flut-PET uptake after seven years correlates with amyloid-β peptide (Aβ₄₂) levels in cerebrospinal fluid (CSF) at one year, and with measures of neurodegeneration and cognition at seven years post-stroke. Methods: 208 patients with first-ever stroke or TIA without pre-existing CI were included during 2007 and 2008. At one- and seven-years post-stroke, cognitive status was assessed, and categorized into dementia, mild cognitive impairment or none. Etiologic sub-classification was based on magnetic resonance imaging (MRI) findings, CSF biomarkers and clinical cognitive profile. At seven years, patients were offered 18F-Flut-PET, and amyloid-positivity was assessed visually and semi-quantitatively. The associations between 18F-Flut-PET standardized uptake value ratios (SUVr) and measures of neurodegeneration (medial temporal lobe atrophy (MTLA), global cortical atrophy (GCA)) and cognition (Mini-Mental State Exam (MMSE), Trail-making test A (TMT-A)) and CSF Aβ₄₂ levels were assessed using linear regression. Results: In all, 111 patients completed 7-year follow-up, and 26 patients agreed to PET imaging, of whom 13 had CSF biomarkers from one year. Thirteen out of 26 patients were diagnosed with CI seven years post-stroke, but only one had visually assessed amyloid positivity. CSF Aβ₄₂ levels at one year, MTA grade, GCA scale, MMSE score or TMT-A at seven years did not correlate with 18F-Flut-PET SUVr in this cohort.Conclusions: Amyloid binding were not common in 7-year stroke survivors diagnosed with CI. Quantitatively assessed amyloid did not correlate with other measures related to neurodegeneration and cognition. Therefore amyloid pathology may not be a key mediator of neurodegeneration seven years post-stroke.
Environmental factors and spatiotemporal distribution of Japanese encephalitis after vaccination campaign in Guizhou Province, China (2004–2016)
Authors: zhao suye , Wang Huanyu , Tian Huaiyu
Published: December 2019

BackgroundAlthough a vaccination campaign has been conducted since 2004, Japanese encephalitis (JE) is still a public health problem in Guizhou, one of the provinces with the highest incidence of JE in China. The aim of this study was to understand the spatiotemporal distribution of JE and its relationship with environmental factors in Guizhou Province in the post-vaccination era, 2004–2016.Methods/Principal FindingsWe collected data on human JE cases in Guizhou Province from 2004 to 2016 from the national infectious disease reporting system. A Poisson regression model was used to analyze the relationship between JE occurrence and environmental factors amongst counties. Our results showed that the incidence and mortality of JE decreased after the initiation of vaccination. JE cases were mainly concentrated in preschool and school-age children and the number of cases in children over age 15 years was significantly decreased compared with the previous 10 years; the seasonality of JE before and after the use of vaccines was unchanged. JE incidence was positively associated with cultivated land and negatively associated with gross domestic product (GDP), vegetation coverage, and developed land. In areas with cultivated land coverage <25%, vegetation coverage >55%, and urban area coverage >25%, the JE risk was lower. The highest JE incidence was among mid-level GDP areas and in moderately urbanized areas.Conclusions /SignificanceThis study assessed the relationship between incidence of JE and environmental factors in Guizhou Province. Our results highlight that the highest risk of JE transmission in the post-vaccination era is in mid-level developed areas. Keywords: Japanese encephalitis; spatial analysis; spatial epidemiology;mosquito;vaccine
Health-related quality of life among 13–14 year old adolescents with overweight - a mixed methods approach
Authors: Sundar Turid Kristin Bigum , Riiser Kirsti , Småstuen Milada , Opheim Randi , Løndal Knut , Glavin Kari , Helseth Sølvi
Published: December 2019

BackgroundOverweight and obesity are public concerns with risk of adverse health outcomes. Health-related quality of life (HRQoL) is lower in adolescents than children in general. An increase in body mass index (BMI) is associated with a decrease in HRQoL. The purpose of this study was to measure and explore the HRQoL among adolescents with overweight or obesity who had participated in an intervention study with the aim of increasing PA, reducing BMI and promoting HRQoL.Methods Mixed methods, with a convergent design, were used to investigate how different methodological approaches could expand our understanding of the adolescents’ HRQoL. Quantitative post-intervention data on HRQoL were collected among the 84 intervention participants, aged 13–14 years, using the KIDSCREEN 52 questionnaire. The data were compared with a Norwegian reference population of 244 individuals, and analysed using a non-parametric Mann-Whitney test. Qualitative semi-structured interviews were conducted with 21 adolescents from the intervention. A directed approach to content analysis was adopted, using the ten sub-scales from KIDSCREEN 52.ResultsHRQoL in the intervention sample was significantly reduced on the sub-scale of physical well-being compared to the reference population. The reference population scored significantly lower than the intervention sample on the sub-scale of parent relation and home life. No significant differences were found on the other sub-scales. The qualitative data supported the quantitative findings on the sub-scale of physical well-being, but showed that perceptions of fitness, energy level or health could vary. Regarding parent relations, the interviewees extended this to include relationships to other family members as equally important. Most of the interviewees expressed a negative view of their bodies, but not their clothing or accessories. This may explain why no statistically significant differences were found on these aspects in the results from the KIDSCREEN questionnaire. ConclusionThe use of the KIDSCREEN 52 instrument gave important indications about the adolescents’ HRQoL. Combining methods enabled a comprehensive approach to research on HRQoL, indicating better ways of providing help. More research using the benefits of mixed methods approaches is needed to further elucidate these findings.
Recurrent disc herniation following percutaneous endoscopic lumbar discectomy preferentially occurs when Modic changes are present
Authors: Hao Lu , Li Shengwen , Liu Junhui , Shan Zhi , Fan Shunwu , Zhao Fengdong
Published: December 2019

Objective: To investigate the effect of Modic changes (MCs) and the herniated disc component on recurrent lumbar disc herniation (rLDH) following percutaneous endoscopic lumbar discectomy (PELD).Methods: We included 102 (65 males,37 females, aged 20–66 yr) inpatients who underwent PELD from August 2013 to August 2016. All patients underwent CT and MRI preoperative. The presence and type of Modic changes were assessed. During surgery the herniated disc component of each patient was classified into two groups: Nucleus pulposus group, Hyaline cartilage group. The association of herniated disc component with Modic changes was investigated. The incidence of recurrent disc herniation was assessed on more than 2-year follow-up.Results: In total, 11 patients were lost to follow up; the other 91 were followed up for 24–60 months. Of the 91 patients, 99 discs underwent PELD; 28/99 (28.3%) had MCs. Type I and II MCs were seen in 9 (9.1%) and 19 (19.2%), respectively; no type III MCs were found. Among 28 endplates with MCs, according to the herniated disc component, 18/28 (64.3%) showed evidence of hyaline cartilage in the intraoperative specimens, including 6/9 and 12/19 endplates with type I and II MCs, respectively. Among 71 endplates without MCs, 14/71 (19.7%) showed evidence of hyaline cartilage in the intraoperative specimens. Hyaline cartilage was more common in patients with MCs (P<0.05). We found 2 cases of rLDH in the non-MC group (n=71); 6 cases rLDH were found in the MC group (n=28), including 2 and 4 cases for types I and II, respectively. There was no significant difference between types I and II (P>0.05). rLDH was more common in patients with MCs (P<0.05). We found 5 rLDH cases in the hyaline cartilage group (n=32); 3 rLDH cases were found in the nucleus pulposus group (n=67). rLDH was more common in the hyaline cartilage group (P<0.05). Conclusions: MCs were associated with the herniated cartilage disc component. rLDH following PELD preferentially occurs when MCs or the herniated cartilage are present.
Does zero-profile anchored cage accompanied by a higher postoperative subsidence compared with cage-plate construct? A meta-analysis
Authors: Lu Yingjie , Fang Yuepeng , Shen Xu , Lu Dongdong , Zhou Liyu , Gan Minfeng , Zhu Xuesong
Published: December 2019

Background Zero-profile anchored cage (ZP) has been widely used for its lower occurrence of dysphagia. However, it is still controversial whether it has the same stability as the cage-plate construct (CP) and increases the incidence of postoperative subsidence. We compared the rate of subsidence after anterior cervical discectomy and fusion (ACDF) with ZP and CP to determine whether the zero-profile device had a higher subsidence rate?Methods We performed a meta-analysis of studies which compared the subsidence rate of ZP and CP. An extensive and systematical search covered Medline, Embase and Web of Science databases according to PRISMA guidelines and identified ten articles that satisfied our inclusion criteria. Relevant clinical and radiological data were extracted and analysed by RevMan 5.3 software.Results Ten trials involving 626 patients were included in this meta-analysis. The incidence of postoperative subsidence in ZP group was significantly higher than with CP group [15.1% (89/588) vs. 8.8% (51/581), OR = 1.97 (1.34, 2.89), P = 0.0005]. In subgroup analysis, we found that the definition of subsidence did not affect the higher subsidence rate in the ZP group. Considering the quantity of operative segments, there was no significant difference in the incidence of subsidence between the two groups after single-level fusion (OR 1.43, 95% CI 0.61-3.37, P = 0.41). However, the subsidence rate of the ZP group was significantly higher than the CP group (OR 2.61, 95% CI 1.55-4.40, P = 0.0003) after multi-level surgery. There were no significant differences in intraoperative blood loss, JOA score, NDI score, fusion rate and cervical aligment in the final followup between the two groups. In addition, the CP group had a longer operation time and a higher incidence of dysphagia at each follow-up time than the ZP group.Conclusion ZP had a higher risk of postoperative subsidence than CP. Although there was a high occurrence of swallowing discomfort, we are more agreed that the anterior plate should be used in multi-level surgery as far as possible to reduce the subsidence and adverse clinical symptoms in the long term.
Out-of-hours workload among Norwegian general practitioners – an observational study
Authors: Rebnord Ingrid Keilegavlen , Morken Tone , Maartmann-Moe Kjell , Hunskaar Steinar
Published: December 2019

Background Repeated studies of working hours among Norwegian regular general practitioners (RGPs) have shown that the average total weekly working hours have remained unchanged since 1994 until 2014. For both male and female RGPs the mean total weekly working hours were almost 50 hours in 2014. In recent years there has been an outcry of dissatisfaction among Norwegian RGPs. They experience significantly increased workload without compensation, such as more doctors or better payments. A study from the Norwegian Directorate of Health in 2018 (the RGP study) showed that Norwegian RGPs worked 55.6 hours weekly (median 52.5). 25% of the respondents worked more than 62.2 hours weekly. Based on data from the RGP-study we investigated Norwegian RGPs work out-of-hours (OOH), how the working time was distributed, and to which extent the OOH work affected the regular working hours.Methods In early 2018, an electronic survey was sent to all 4716 RGPs in Norway. Each RGP reported prospectively how many minutes per day they used on various tasks during one week. Working time also included additional tasks in the municipality, other professional medical work and OOH primary health care. Differences were analyzed by independent t-tests, and regression analyses.Results 1876 RGPs (39.8%) responded, 640 (34.1%) had registered OOH work. Male RGPs worked in average 1.5 hours more with regular work than females (p=0.001) and in average 2.3 hours more OOH work than females (p=0.079). RGPs with no OOH work registered a mean of 1.0 hours more clinical work than RGPs working OOH (p=0.043). There was a large variation in OOH working hours. A linear regression analysis showed that male RGPs and RGPs in rural areas had the highest OOH workload.Conclusions Every third of Norwegian RGPs participated in OOH work during the registration week in the RGP study. OOH work was done in addition to a high regular workload as RGP. We found small gender differences. OOH work did not lead to reduced regular RGP work.
Drug resistance occurred in a newly characterized preclinical model of lung cancer brain metastasis.
Authors: Shah Neal , Liu Zhongwei , Tallman Rachel M. , Mohammad Afroz , Sprowls Samuel A , Saralkar Pushkar A. , Vickers Schuyler D. , Pinti Mark V. , Gao Weimin , Lockman Paul R
Published: December 2019

Background Cancer metastasis and drug resistance have traditionally been studied separately, though these two lethal pathological phenomena almost always occur concurrently. Brain metastasis occurs in a large proportion of lung cancer patients (~30%). Once diagnosed, patients have a poor prognosis surviving typically less than 1 year due to lack of treatment efficacy. Methods Human metastatic lung cancer cells (PC-9-Br) were injected into the left cardiac ventricle of female athymic nude mice. Brain lesions were allowed to grow for 21 days, animals were then randomized into treatment groups and treated until presentation of neurological symptoms or when moribund. Prior to tissue collection mice were injected with Oregon Green and 14C-Aminoisobutyric acid followed by an indocyanine green vascular washout. Tracer accumulation was determined by quantitative fluorescent microscopy and quantitative autoradiography. Survival was tracked and tumor burden was monitored via bioluminescent imaging. Extent of mutation differences and acquired resistance was measured in-vitro through half-maximal inhibitory assays and qRT-PCR analysis. Results A PC-9 brain seeking line (PC-9-Br) was established. Mice inoculated with PC-9-Br resulted in a significantly decreased survival time compared with mice inoculated with parental PC-9. Non-targeted chemotherapy with cisplatin and etoposide (51.5 days) significantly prolonged survival of PC-9-Br brain metastases in mice compared to vehicle control (42 days) or cisplatin and pemetrexed (45 days). Further in-vivo imaging showed greater tumor vasculature in mice treated with cisplatin and etoposide compared to non-tumor regions, which was not observed in mice treated with vehicle or cisplatin and pemetrexed. More importantly, PC-9-Br showed significant resistance to gefitinib by in-vitro MTT assays (IC50>2.5 µM at 48hrs and 0.1 µM at 72hrs) compared with parental PC-9 (IC50: 0.75 µM at 48hrs and 0.027 µM at 72hrs). Further studies on the molecular mechanisms of gefitinib resistance revealed that EGFR and phospho-EGFR were significantly decreased in PC-9-Br compared with PC-9. Expression of E-cadherin and vimentin did not show EMT in PC-9-Br compared with parental PC-9, and PC-9-Br had neither T790 mutation nor amplifications of MET and HER2 compared with parental PC-9. Conclusion Our study demonstrated that brain metastases of lung cancer cells may independently prompt drug resistance without drug treatment.
Is menopause still evolving? Evidence from a longitudinal study of multiethnic populations and its relevance to women's health
Authors: Singh Rama Shankar , Chan Shirley , Gomes Alyssa
Published: December 2019

To reflect on the impact of changing patterns of delayed marriage and reproduction and to seek evidence as to whether menopause is still evolving, characteristics of the menopause transition were investigated within and between ethnic populations in this study. A cross-sectional analysis was conducted using data on 747 middle-aged women obtained from the Study of Women’s Health Across the Nation (SWAN) from 1996 to 2008. The ethnic groups included: Afro-American, Chinese, Japanese, Caucasian, and Hispanic. Perimenopause age and duration, menopause age, and hormonal indicators of menopause were examined across five ethnicities. We found a similar window of menopause age within populations, but no significant difference in perimenopause and menopause age between populations. The rate of increase of follicle-stimulating hormone and testosterone differed significantly in Hispanics and African-Americans during the menopause transition period. The broad window of variation in age at menopause within the population (45-60 years) and the absence of significant differences between populations, in combination with population variation in menopause symptoms, suggest that menopause is a relatively recently evolved and still evolving trait. Under the mate choice theory of menopause, menopause is the result of the accumulation of infertility mutations in older women due to men’s preference for younger mates. We propose a shifting mate choice-shifting menopause model which posits that, as the age of mate choice/marriage shifts to older age, so will the age at menopause, and that menopause is a transient phase of female fertility; it can de-evolve, be delayed and even disappear, in theory.
Usual physical activity and subsequent hospital usage over 20 years in a general population: the EPIC-Norfolk cohort
Authors: Luben Robert N , Hayat Shabina , Wareham Nicholas , Pharoah Paul , Khaw Kay-Tee
Published: December 2019

Background While physical activity interventions have been reported to reduce hospital stays, it is not clear if, in the general population, usual physical activity patterns may be associated with subsequent hospital use independently of other lifestyle factors. We examined the relationship between reported usual physical activity and subsequent admissions to hospital and time spent in hospital for 11,228 men and 13,786 women aged 40–79 years in the general population. MethodsParticipants from a British prospective population-based study were followed for 20 years (1999–2019) using record linkage to document hospital usage. Total physical activity was estimated by combining workplace and leisure time activity reported in a baseline lifestyle questionnaire and repeated in a subset at a second time point approximately 12 years later. Results Compared to those reporting no physical activity, participants who were the most active had a lower likelihood of spending more than 20 days in hospital odds ratio (OR) 0.88 (95% confidence interval (CI) 0.81–0.96) over the next 20 years after multivariable adjustment for age, sex, smoking status, education, social class and body mass index. Participants reporting any activity had a mean of 0.42 fewer hospital days per year between 1999 and 2009 compared to inactive participants, an estimated saving to the National Health Service (NHS) of £247 per person per year, or approximately 7% of UK health expenditure. Participants who remained physically active or became active 12 years later had lower risk of subsequent hospital usage than those who remained inactive or became inactive, p-trend < 0.001. Conclusions Usual physical activity in this middle-aged and older population predicts lower future hospitalisations - time spent in hospital and number of admissions independently of behavioural and sociodemographic factors. Small feasible differences in usual physical activity in the general population may potentially have a substantial impact on hospital usage and costs.
Incidence and risk factors of post operative delirium in elderly patients who underwent spinal anesthesia in Orotta, Halibet and Sembel Hospitals: A Cross sectional analytic study in ERITREA
Authors: Mengistu Michael Beraki , Andemeskel Yonatan Mehari , Emehatsion Ariam Tsegay , Wrieta Habtom Tareke , Gebreyessus Natsnet Yacob
Published: December 2019

BackgroundDelirium is a common but often underdiagnosed set of transient symptomin the elderly patients following surgeries under spinal anesthesia. Delirium can be improved with early recognition and diagnosis based on the established standard criteria. The identification of the possible contributing factors and magnitude of the burden will help in the management of the fragile elderly patients. Managing delirium with environmental, supportive and pharmacological interventions will possibly reduce the incidence, and complication associated with postoperative delirium. The aim of this study is to determine the incidence of postoperative delirium and associated risk factors in elderly patients who did surgery under spinal anesthesia. MethodThis cross sectional study was conducted in the National Referral Hospitals in Eritrea (Orotta and Halibet), including Sembel hospital from February to May, 2019. The study participants were elderly patients (age ≥65 years) having no mental disorder, no history of acute cerebrovascular disease, no known history of delirium and/or dementia. Basic background and clinical characteristics of the patients was collected. To assess the status of cognitive impairment level, the Mini Mental State Examination and Confusion Assessment Method tools were used. Data was collected through an interview method. After the data was entered into SPSS version 22 software, it was conducted with frequency, percentage, bivariate and multivariate logistic regression analysis method as appropriate. P value at<0.05 was considered as statistically significant. ConclusionPostoperative delirium occurred in 14 out of 129 case (10.9%). The multivariate analysis showed that only age was significantly associated with postoperative delirium. The other variables did not significantly influence the occurrence of POD. Therefore, t he incidence of postoperative delirium after spinal anesthesia was relatively high (10.9%). Similarly, old age was found as the risk factor for the development of delirium in those elderly patients who underwent spinal anesthesia. This findings might help to develop preventive strategies to decrease POD through targeted factors.
Myositis-specific autoantibodies and their clinical associations in Idiopathic Inflammatory Myopathies
Authors: Wong Victor Tak Lung , SO Ho , Yip Ronald Man Lung
Published: December 2019

Background The aims of the study were to investigate the prevalence of myositis specific autoantibodies (MSAs) and their associated complications in a cohort of patients with idiopathic inflammatory myopathies (IIMs). Methods A total of 201 consecutive patients with IIMs being followed up in the Rheumatology clinics of the participating regional hospitals in Hong Kong from July 2016 to January 2018 were recruited. Clinical characteristics, treatment history and disease complications were documented. Immunoblot assay was used to detect the MSAs.Results Out of the 201 patients, at least one MSA was found in 63.2% of patients. The most common MSAs were the anti-melanoma differentiation-associated gene 5 antibody (anti-MDA5 Ab) and the anti-transcriptional intermediary factor 1-gamma antibody (anti-TIF1-γ Ab) (both 13.9%), followed by anti-Jo-1 antibody (12.4%). Anti-MDA5 Ab was present exclusively in dermatomyositis (DM) and was strongly associated with digital ulcers, the clinically amyopathic phenotype and rapidly progressive interstitial lung disease (RP-ILD). Anti-TIF1γ Ab was strongly associated with refractory rash and malignancy. Multivariate analysis showed that the independent risk factors of RP-ILD included anti-MDA5 Ab (OR 14.5, p=0.001), clinically amyopathic DM (OR 13.9, p=0.015) and history of pulmonary tuberculosis (OR 12.2, p=0.026). Cox regression analysis showed that the independent predictors of malignancy included anti-TIF1γ Ab (HR 3.55, p=0.002), DM (HR 3.82, p=0.009) and family history of cancer (HR 3.40, p=0.038). Conclusions MSA testing enables dividing of patients with IIMs into phenotypically homogenous subgroups and prediction of potentially life-threatening complications.
Impact of environmental cleaning on the colonization and infection rates of multidrug-resistant Acinetobacter baumannii in patients within the intensive care unit in a tertiary hospital
Authors: Li Yang , Ge Hai , Zhou Hui , Zhou Wanqing , Zheng Jie , Chen Wei , Cao Xiaoli
Published: December 2019

Objective: To continuously evaluate the effect of environmental cleaning on the colonization and infection rates of multidrug-resistant Acinetobacter baumannii (MDR-AB) in the patients within a intensive care unit (ICU). Methods: Environmental cleaning on the high-touch clinical surfaces (HTCS) within a comprehensive ICU was evaluated through monitoring fluorescent marks. In the meanwhile, samples from the HTCS and inpatient were collected and sent for bacterial culture and identification. The drug susceptibility testing was further implemented to monitor the prevalence of MDR-AB. The genetic relatedness of MDR-AB collected either from the HTCS or inpatient was analyzed by pulsed field gel electrophoresis (PFGE) when an outbreak was doubted. Results: From the beginning to the end of 2013, the clearance rate of fluorescence marks on the environmental surfaces within ICUs significantly increased from 21.9% to 85.7%, and accordingly the colonization and infection rates of MDR-AB decreased from 16.5‰ to 6.6‰ and 7.4‰ to 2.8‰, respectively. However, during the year 2014, because of frequent change and movement of cleaning workers, the clearance rate of fluorescence marks decreased below 50%, and the overall colonization and infection rates of MDR-AB correspondingly increased from 9.1‰ to 11.1‰, 1.5‰ to 3.9‰, respectively. PFGE displayed a genetic relatedness between the MDR-AB strains analyzed, indicating a dissemination of MDR-AB during the surveillance period. Conclusion: For MDR-AB, both the colonization rates and the infection rates of the patients within ICUs can be directly influenced by environmental cleaning, and the bad environmental cleaning may result in MDR-AB outbreak. The invisible fluorescence labelling is an effective and convenient method to continuously monitor environmental cleaning within hospitals.
Extended-Spectrum Beta-Lactamase and Carbapenemase Producing Enterobacteriaceae among Patients with Gastrointestinal Complaints in North West Ethiopia
Authors: Worku Minichil , Getie Michael , Moges Feleke , Getaneh Alem
Published: December 2019

Background Antimicrobial resistance is an increasing threat to health systems which leads to treatment failure, high treatment costs and increased mortality. Infections due to extended spectrum beta-lactamase (ESBL) and carbapenemase producing Enterobacteriaceae(CPE) impose a major global issues, because they are usually resistance to multiple antimicrobial agents. Data on the fecal ESBL producing Enterobacteriaceae (ESBL-PE) and CPE in developing countries including Ethiopia is limited mainly due to resource constraints. Thus, the aim of this study was to determine the prevalence of MDR, ESBL and CPE among patients with gastrointestinal complaints at the University of Gondar Comprehensive Specialized Hospital, Gondar; Northwest Ethiopia.Materials and Methods A Hospital based cross-sectional study was conducted among 384 patients with gastrointestinal complaints from January - April 2019 at the University of Gondar Comprehensive Specialized Hospital. A stool sample was aseptically collected and inoculated on MacConkey agar plate. After getting pure colonies, biochemical testing and antimicrobial susceptibility testing were done following standard microbiological techniques. ESBL production was screened by using ceftazidime and cefotaxime and confirmed using a combined disk diffusion test based on CLSI 2019 guidline. Carbapenemases were screened by meropenem disc and confirmed by modified carbapenem inactivation method. Data was checked, cleaned and entered using Epi-Info version 7.1 and transferred to SPSS version 20 for analysis. P-value <0.05 at 95% CI was considered as statistically significant.Result Out of the 384 study participants, 404 Enterobacteriaceae were isolated. Among these, 196 (48.5%) were MDR. The overall prevalence of fecal ESBL and CPE were 66(16.3%) and 4(1%) respectively. Of the total ESBL-PE, E.coli 41/66(62.1%) and K.pneumoniae 18/66(27.3%) were the most predominant isolates.Conclusion Finding high rate of MDR Enterobacteriaceae,ESBL-PE and CPE require strict infection control measures and careful selection of empirical therapy in the study area. Therefore, active surveillance with large sample size and better infection prevention and control is needed.
Financial crisis of real sector enterprises: an integral assessment
Authors: Shkolnyk Inna , Pisula Tomasz , Loboda Liliia , Nebaba Natalia
Published: December 2019

Successful crisis resolution of the enterprise depends heavily on its timely detection, which is facilitated by the use of forecasting models. This allows understanding the scale of the problems in a timely manner and developing the appropriate measures, applying various financial mechanisms to prevent it, and in case of occurrence, reducing the amount of losses. In this context, it is important to choose the most optimal informational model that would provide the most objective forecasts, considering the financial activity peculiarities of the analyzed enterprise. Given a wide list of models that predict the financial crisis, there is a need to analyze and select the most accurate model for enterprises in the real economy. Ten Ukrainian machine builders are used to assess the bankruptcy probability using the most popular models; a taxonomic analysis was carried out, which allows systematizing a large amount of data and analyzing their impact on enterprise development. An integral index was determined, which allowed predicting the financial performance dynamics. For each enterprise, ten indicators were used characterizing their financial state for the period 2014–2018. It is substantiated that the selected models differ from each other by the set of initial data and the number of coefficients from four to seven. It is also determined that the efficient use of studied models is quite different; so when choosing a model to predict the bankruptcy probability, it is necessary to consider the peculiarities of the enterprise’s production activity, the accuracy in creating the financial statements and many other factors, including the presence of company’s shares in circulation at the stock market. It is worthwhile to use a taxonomic analysis to make a comprehensive comparison of the enterprise financial state and to substantiate the final choice of the bankruptcy forecasting model.
Knowledge management overview of feature selection problem in high-dimensional financial data: cooperative co-evolution and MapReduce perspectives
Authors: N M Bazlur Rashid A , Choudhury Tonmoy
Published: December 2019

The term “big data” characterizes the massive amounts of data generation by the advanced technologies in different domains using 4Vs – volume, velocity, variety, and veracity - to indicate the amount of data that can only be processed via computationally intensive analysis, the speed of their creation, the different types of data, and their accuracy. High-dimensional financial data, such as time-series and space-time data, contain a large number of features (variables) while having a small number of samples, which are used to measure various real-time business situations for financial organizations. Such datasets are normally noisy, and complex correlations may exist between their features, and many domains, including financial, lack the al analytic tools to mine the data for knowledge discovery because of the high-dimensionality. Feature selection is an optimization problem to find a minimal subset of relevant features that maximizes the classification accuracy and reduces the computations. Traditional statistical-based feature selection approaches are not adequate to deal with the curse of dimensionality associated with big data. Cooperative co-evolution, a meta-heuristic algorithm and a divide-and-conquer approach, decomposes high-dimensional problems into smaller sub-problems. Further, MapReduce, a programming model, offers a ready-to-use distributed, scalable, and fault-tolerant infrastructure for parallelizing the developed algorithm. This article presents a knowledge management overview of evolutionary feature selection approaches, state-of-the-art cooperative co-evolution and MapReduce-based feature selection techniques, and future research directions.
AN INVESTIGATION OF FAMILY IMPACT OF CHILDREN WITH CONGENITAL AND ACQUIRED BRAIN INJURY
Authors: İNAL Özgü , KARAHAN Sevilay , ÖKSÜZ Çiğdem
Published: December 2019

Purpose: This study aimed to investigate the family impact of children with congenital andacquired brain injury, the levels of depression in mothers, and the factors that might affect familyfunctioning.Methods: This study included 42 children with brain injury (20 congenital, 22 acquired) and theircaregiver mothers. Impact on Family Scale (IFS) was used to evaluate family impact and the BeckDepression Inventory for the level of depression in the mothers. The Functional Oral Intake Scalefor the status of oral intake of children.Results: This study illustrated that the levels of family impact (z=-1.161, p=0.246) and mothers'depression (z=-0.177, p=0.860) were similar in children with congenital and acquired brain injury.In this study, a relationship was found between the child's feeding position (z=-0.684, p=0.043) andfamily income level (z=5.981, p=0.046) with family impact.Conclusion: The family impact of having children with disabilities may be related to many factors.In order to understand this mechanism, future studies should be planned with a holistic approach.The results of these studies, provide information to be used in the development of interventions

for parents of children with disabilities.
Development of mass-transfer evaporation model for Lake Nasser, Egypt
Authors: El-Mahdy Mohamed El-Sayed , Abbas Mohamed S. , Sobhy Hassan M.
Published: December 2019

Evaporation from free water surface is considered a very important constituent in both the energy and hydrologic cycles. Precise measurement of evaporation from the free water surface is almost impossible. This is why we need a calculation model for free water evaporation. In this study, a simple mass-transfer evaporation model was developed to be applicable over Lake Nasser in the hyper-arid region located in the south of Egypt. Measured meteorological data (2011–2014) at two stations, Aswan and Abu-Simbel, were used to calculate free water surface evaporation using Priestly–Taylor equation. Priestly–Taylor equation was used because it is the most appropriate equation for Lake Nasser evaporation according to the literature. Results from this model were used to develop a simple mass-transfer evaporation model. The statistical analysis for both calibration and validation periods were very good. The slope of the regression line is about 0.9, with a coefficient of determination of 0.98. The t value is 0.6, at p value of 0.544, which is much greater than 0.05. The developed model could be used with confidence at Aswan meteorological station or on the average of the two meteorological stations, while it should be used carefully on Abu-Simbel meteorological station.
Identification of behavioural model input data sets for WWTP uncertainty analysis
Authors: Lindblom E. , Jeppsson U. , Sin G.
Published: December 2019

Uncertainty analysis is important for wastewater treatment plant (WWTP) model applications. An important aspect of uncertainty analysis is the identification and proper quantification of sources of uncertainty. In this contribution, a methodology to identify an ensemble of behavioural model representations (combinations of input data, model structure and parameter values) is presented and evaluated. The outcome is a multivariate conditional distribution of input data that is used for generating samples of likely inputs (such as Monte Carlo input samples) to perform WWTP model uncertainty analysis. This article presents an approach to verify uncertainty distributions of input data (otherwise often assumed) by using historical observations and actual plant data.
Research on the application of compound microorganism preparation in reusing urban reclaimed water in circulating cooling water system
Authors: Chen Chuanmin , Wang Yu , Liu Songtao , Feng Rongrong , Gu Xingjia , Qiao Chuanxi
Published: December 2019

A biological method was developed for reusing urban reclaimed water in circulating cooling water systems (CCWS), in which the compound microorganism preparation (CMP) mainly included nitrobacteria, Bacillus subtilis, photosynthetic bacteria and Thiobacillus denitrificans, was used to control the scaling, corrosion and biofouling of CCWS. The abundant carbon, nitrogen and phosphorus in urban reclaimed water met the needs of microbial growth. Compared with chemical agents, CMP had the advantages of high efficiency, no additional chemicals and being more economical. The research results showed that CMP improved water quality and decreased ammonia nitrogen (NH3-N) and chemical oxygen demand (COD). The concentration ratio of CCWS reached 3.87 using CMP. The corrosion inhibition rate of CMP and the removal rate on biofouling achieved 99.69% and 22.21%, respectively. The mechanisms of CMP to control scaling, corrosion and biofouling were discussed, and the surface characteristics and chemical compositions of corrosion products and biofouling were analyzed.