Transl Androl Urol. 2019 Sep;8(Suppl 4):S436-S441. doi: 10.21037/tau.2019.08.16.
Latest advancements in ureteral stent technology.
De Grazia A1,2, Somani BK3, Soria F4, Carugo D1,2, Mosayyebi A1,2.
Author information
1
Bioengineering Science Research Group, Faculty of Engineering and the Physical Sciences, University of Southampton, Southampton, UK.
2
Institute for Life Sciences (IfLS), University of Southampton, Southampton, UK.
3
Department of Urology, University Hospital Southampton NHS Trust, Southampton, UK.
4
Department of Endoscopy-Endourology, Minimally Invasive Surgery Centre-Jesus Usón, Cáceres, Spain.
Abstract
Urological diseases such as tumours, kidney stones, or strictures in the ureter can lead to a number of health consequences, including life-threatening complications. Ureteral stents have been widely used as a valid solution to restore compromised urological function. Despite their clinical success, stents are subject to failure due to encrustation and biofilm formation, potentially leading to urinary tract infection. The current review focuses on recent advancements in ureteral stent technology, which have been reported in recent scientific journals or patents. Web of Science and Google Scholar have been used as a search engine to perform this review, using the keywords "Ureteral + Stent + Design", "Ureteral + Stent + Material + Coating", "Ureteric + Stent" and "Ureteral + Stent". A significant proportion of technological developments has focused on innovating the stent design to overcome migration and urinary reflux, as well as investigating novel materials and coatings to prevent biofilm formation, such as poly(N,N-dimethylacrylamide) (PDMMA) and swellable polyethylene glycol diacrylate (PEGDA). Biodegradable ureteral stents (BUS) have also emerged as a new generation of endourological devices, overcoming the "forgotten stent syndrome" and reducing healthcare costs. Moreover, efforts have been made to develop pre-clinical test methods, both experimental and computational, which could be employed as a screening platform to inform the design of novel stent technologies.

2019 Translational Andrology and Urology. All rights reserved.

KEYWORDS:
Ureteral stents; biofilm; computational fluid dynamics (CFD); design; encrustation; material; migration; reflux; test

PMID: 31656749 PMCID: PMC6790420 DOI: 10.21037/tau.2019.08.16
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Select item 31656704
22.
PeerJ. 2019 Oct 21;7:e7919. doi: 10.7717/peerj.7919. eCollection 2019.
Mercuric pollution of surface water, superficial sediments, Nile tilapia (Oreochromis nilotica Linnaeus 1758 [Cichlidae]) and yams (Dioscorea alata) in auriferous areas of Namukombe stream, Syanyonja, Busia, Uganda.
Omara T#1,2,3, Karungi S#4, Kalukusu R2,5, Nakabuye B5,6, Kagoya S2,7, Musau B2,5.
Author information
1
Department of Chemistry and Biochemistry, School of Biological and Physical Sciences, Moi University, Uasin Gishu County, Kesses, Eldoret, Kenya.
2
Department of Chemistry, Faculty of Science, Kyambogo University, Kyambogo, Kampala, Uganda.
3
Department of Quality Control and Quality Assurance, Product Development Directory, AgroWays Uganda Limited, Kyabazinga way, Jinja, Uganda.
4
Department of Mining and Water Resources Engineering, Faculty of Engineering, Busitema University, Busitema, Tororo, Uganda.
5
Department of Quality Control and Quality Assurance, Leading Distillers Uganda Limited, Kampala, Uganda.
6
Department of Food Processing Technology, Faculty of Science, Kyambogo University, Kyambogo, Kampala, Uganda.
7
Department of Quality Control and Quality Assurance, Product Development Directory, Sweets and Confectionaries Section, Kakira Sugar Limited, Jinja, Uganda.
#
Contributed equally
Abstract
The mercury content and the contamination characteristics of water, sediments, edible muscles of a non-piscivorous fish (Oreochromis nilotica Linnaeus 1758 [Cichlidae]) and yams (Dioscorea alata) from Namukombe stream in Busia gold district of Uganda were evaluated. Human health risk assessment from consumption of contaminated fish and yams as well as contact with contaminated sediments from the stream were performed. Forty-eight (48) samples of water (n = 12), sediments (n = 12), fish (n = 12) and yams (n = 12) were taken at intervals of 10 m from three gold recovery sites located at up, middle and down sluices of the stream and analyzed for total mercury (THg) using US EPA method 1631. Results (presented as means  ±  standard deviations) showed that water in the stream is polluted with mercury in the range of < detection limit to 1.21  ±  0.040 mg/L while sediments contain mean THg from < detection limit to 0.14  ±  0.040 ugg-1. Mean THg content of the edible muscles of O. nilotica ranged from < detection limit to 0.11 ± 0.014 ugg-1while D. alata contained from < detection limit to 0.30  ±  0.173 ugg-1mean THg. The estimated daily intake ranged from 0.0049 ugg-1day-1 to 0.0183 ugg-1day-1 and 0.0200 ugg-1day-1 to 0.0730 ugg-1day-1 for fish consumed by adults and children respectively. The corresponding health risk indices ranged from 0.0123 to 0.0458 and 0.0500 to 0.1830. Estimated daily intake was from 0.0042 ugg-1day-1 to 0.1279 ugg-1day-1 and 0.0130 ugg-1day-1 to 0.3940 ugg-1day-1 for D. alata consumed by adults and children respectively. The health risk indices recorded were from 0.011 to 0.320 and 0.033 to 0.985 for adults and children respectively. The mean THg content of the sediments, edible muscles of O. nilotica and D. alata were within acceptable WHO/US EPA limits. About 91.7% of the water samples had mean THg above US EPA maximum permissible limit for mercury in drinking water. Consumption of D. alata grown within 5 m radius up sluice of Namukombe stream may pose deleterious health risks as reflected by the health risk index of 0.985 being very close to one. From the pollution and risk assessments, mercury use should be delimited in Syanyonja artisanal gold mining areas. A solution to abolish mercury-based gold mining in the area needs to be sought as soon as possible to avert the accentuating health, economic and ecological disaster arising from the continuous discharge of mercury into the surrounding areas. Other mercury-free gold recovering methods such as use of borax, sluice boxes and direct panning should be encouraged. Waste management system for contaminated wastewater, used mercury bottles and tailings should be centralized.

©2019 Omara et al.

KEYWORDS:
Artisanal gold mining; Busia gold district; Contamination factor; Dioscorea alata; Estimated Daily Intake; Geoaccumulation index; Mercury contamination; Namukombe stream; Oreochromis nilotica Linnaeus 1758 [Cichlidae]; Sediments

PMID: 31656704 PMCID: PMC6812675 DOI: 10.7717/peerj.7919
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Conflict of interest statement
Select item 31656701
23.
PeerJ. 2019 Oct 21;7:e7900. doi: 10.7717/peerj.7900. eCollection 2019.
RNA-seq transcriptome profiling of porcine lung from two pig breeds in response to Mycoplasma hyopneumoniae infection.
Ni L1,2, Song C1, Wu X1, Zhao X2, Wang X1, Li B1, Gan Y3.
Author information
1
College of Animal Science and Technology, Yangzhou University, Yangzhou, Jiangsu, China.
2
Department of Animal Science and Technology, Jiangsu Agri-animal Husbandry Vocational College, Taizhou, Jiangsu, China.
3
Institute of Veterinary Medicine, Jiangsu Academy of Agricultural Sciences, Nanjing, Jiangsu, China.
Abstract
BACKGROUND:
Mycoplasma hyopneumoniae (Mhp) is the main pathogen causing respiratory disease in the swine industry. Mhp infection rates differ across pig breeds, with Chinese native pig breeds that exhibit high fecundity (e.g., Jiangquhai, Meishan, Erhualian) more sensitive than Duroc, Landrace, and other imported pig breeds. However, the genetic basis of the immune response to Mhp infection in different pig breeds is largely unknown.

AIMS:
The aims of this study were to determine the relative Mhp susceptibility of the Chinese native Jiangquhai breed compared to the Duroc breed, and identify molecular mechanisms of differentially expressed genes (DEGs) using an RNA-sequencing (RNA-seq) approach.

METHODS:
Jiangquhai and Duroc pigs were artificially infected with the same Mhp dose. The entire experiment lasted 28 days. Daily weight gain, Mhp-specific antibody levels, and lung lesion scores were measured to evaluate the Mhp infection susceptibility of different breeds. Experimental pigs were slaughtered on the 28th day. Lung tissues were collected for total RNA extraction. RNA-seq was performed to identify DEGs, which were enriched by gene ontology (GO) and the Kyoto Encyclopedia annotation of Genes and Genomes (KEGG) databases. DEGs were validated with real-time quantitative polymerase chain reaction (RT-qPCR).

RESULTS:
Infection with the same Mhp dose produced a more serious condition in Jiangquhai pigs than in Duroc pigs. Jiangquhai pigs showed poorer growth, higher Mhp antibody levels, and more serious lung lesions compared with Duroc pigs. RNA-seq identified 2,250 and 3,526 DEGs in lung tissue from Jiangquhai and Duroc pigs, respectively. The two breeds shared 1,669 DEGs, which were involved in immune-relevant pathways including cytokine-cytokine receptor interaction, PI3K-Akt signaling pathway, and chemokine signaling pathway. Compared to Jiangquhai pigs, more chemokines, interferon response factors, and interleukins were specifically activated in Duroc pigs; CXCL10, CCL4, IL6 and IFNG genes were significantly up-regulated, which may help Duroc pigs enhance immune response and reduce Mhp susceptibility.

CONCLUSION:
This study demonstrated differential immune-related DEGs in lung tissue from the two breeds, and revealed an important role of genetics in the immune response to Mhp infection. The biological functions of these important DEGs should be further confirmed and maybe applied as molecular markers that improve pig health.

©2019 Ni et al.

KEYWORDS:
Candidate gene; Duroc pig; Jiangquhai pig; Mycoplasma hyopneumoniae; RNA-seq

PMID: 31656701 PMCID: PMC6812673 DOI: 10.7717/peerj.7900
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Conflict of interest statement
Select item 31656683
24.
J Thorac Dis. 2019 Sep;11(9):4072-4084. doi: 10.21037/jtd.2019.09.38.
Next-generation care pathways for allergic rhinitis and asthma multimorbidity: a model for multimorbid non-communicable diseases-Meeting Report (Part 2).
Bousquet J1,2,3,4,5,6,7,8, Pham-Thi N9, Bedbrook A2, Agache I10, Annesi-Maesano I11, Ansotegui I12, Anto JM13,14,15, Bachert C16, Benveniste S17,18, Bewick M19, Billo N20, Bosnic-Anticevich S21, Bosse I22, Brusselle G23, Calderon MA24, Canonica GW25, Caraballo L26, Cardona V27, Carriazo AM28, Cash E29, Cecchi L30, Chu DK31, Colgan E32, Costa E33, Cruz AA34, Czarlewski W35, Durham S36, Ebisawa M37, Erhola M38, Fauquert JL39, Fokkens WJ8,40, Fonseca JA41, Guldemond N42, Iinuma T43, Illario M44, Klimek L45, Kuna P46, Kvedariene V47, Larenas-Linneman D48, Laune D49, Le LTT50, Lourenço O51, Malva JO52, Marien G8, Menditto E53, Mullol J54, Münter L55, Okamoto Y43, Onorato GL2, Papadopoulos NG56,57, Perala M58, Pfaar O59, Phillips A60, Phillips J61, Pinnock H62, Portejoie F2, Quinones-Delgado P63, Rolland C64, Rodts U65, Samolinski B66, Sanchez-Borges M67, Schünemann HJ30, Shamji M68, Somekh D69, Togias A70, Toppila-Salmi S71, Tsiligianni I72, Usmani O73, Walker S74, Wallace D75, Valiulis A76, Van der Kleij R77, Ventura MT78, Williams S79, Yorgancioglu A80, Zuberbier T81.
Author information
1
University Hospital Montpellier, Montpellier, France.
2
MACVIA-France, Fondation partenariale FMC VIA-LR, Montpellier, France.
3
INSERM U1168, VIMA, Ageing and Chronic Diseases Epidemiological and Public Health Approaches, Villejuif, France.
4
Université Versailles St-Quentin-en Yvelines, UMR-S 1168, Montigny le Bretonneux, France.
5
Euforea, Brussels, Belgium.
6
Charité, Universitätsmedizin Berlin, Humboldt-Universitätzu Berlin, Berlin, Germany.
7
Berlin Institute of Health, Comprehensive Allergy Center, Department of Dermatology and Allergy, Berlin, Germany.
8
EUFOREA, Brussels, Belgium.
9
Allergy Department, Pasteur Institute, Paris, France.
10
Faculty of Medicine, Transylvania University, Brasov, Romania.
11
Epidemiology of Allergic and Respiratory Diseases, Department Institute Pierre Louis of Epidemiology and Public Health, INSERM and Sorbonne Universités, Medical School Saint Antoine, Paris, France.
12
Department of Allergy and Immunology, Hospital Quirónsalud Bizkaia, Erandio, Spain.
13
ISGlobAL, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.
14
Universitat Pompeu Fabra (UPF), Barcelona, Spain.
15
CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
16
Upper Airways Research Laboratory, ENT Department, Ghent University Hospital, Ghent, Belgium.
17
National Center of Expertise in Cognitive Stimulation (CEN STIMCO), Broca Hospital, Paris, France.
18
Mines ParisTech CRI - PSL Research University, Fontainebleau, France.
19
iQ4U Consultants Ltd, London, UK.
20
Independent Consultant, Joensuu, Finland.
21
Woolcock Institute of Medical Research, University of Sydney and Woolcock Emphysema Centre and Sydney Local Health District, Glebe, NSW, Australia.
22
Allergist, La Rochelle, France.
23
Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium.
24
Imperial College London-National Heart and Lung Institute, London, UK.
25
Personalized Medicine Clinic Asthma & Allergy, Humanitas Clinical and Research Center IRCCS, Rozzano (MI), and Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy.
26
Institute for Immunological Research, University of Cartagena, Campus de Zaragocilla, Edificio Biblioteca Primer piso, Cartagena, Colombia, and Foundation for the Development of Medical and Biological Sciences (Fundemeb), Cartagena, Colombia.
27
Allergy Section, Department of Internal Medicine, Hospital Vall d'Hebron & ARADyAL research network, Barcelona, Spain.
28
Regional Ministry of Health of Andalusia, Seville, Spain.
29
College of Psychology, Nova Southeastern University and School-related Psychological Assessments and Clinical Interventions Clinic, Ft Lauderdale, Florida, USA.
30
SOS Allergology and Clinical Immunology, USL Toscana Centro, Prato, Italy.
31
Department of Health Research Methods, Evidence, and Impact, Division of Immunology and Allergy, Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
32
Department of Health, Social Services and Public Safety, Northern Ireland, Belfast, UK.
33
UCIBIO, REQUIMTE, Faculty of Pharmacy, and Competence Center on Active and Healthy Ageing of University of Porto (AgeUPNetWork), University of Porto, Porto, Portugal.
34
ProAR-Nucleo de Excelencia em Asma, Federal University of Bahia, Brasil and WHO GARD Executive Committee, Bahia, Brazil.
35
Medical Consulting Czarlewski, Levallois, France.
36
Allergy and Clinical Immunology Section, National Heart and Lung Institute, Imperial College London, London, UK.
37
Clinical Research Center for Allergy and Rheumatology, National Hospital Organization, Sagamihara National Hospital, Sagamihara, Japan.
38
National Institute for Health and Welfare, Helsinki, Finland.
39
CHU Clermont-Ferrand, Unité d'Allergologie de l'Enfant, Pôle Pédiatrique, Hôpital Estaing, Clermont-Ferrand, France.
40
Department of Otorhinolaryngology, Amsterdam University Medical Centres, AMC, Amsterdam, the Netherlands.
41
CINTESIS, Center for Research in Health Technology and Information Systems, Faculdade de Medicina da Universidade do Porto; and Medida, Lda Porto, Portugal.
42
Institute of Health Policy and Management iBMG, Erasmus University, Rotterdam, the Netherlands.
43
Department of Otorhinolaryngology, Chiba University Hospital, Chiba, Japan.
44
Division for Health Innovation, Campania Region and Federico II University Hospital Naples (R&D and DISMET), Naples, Italy.
45
Center for Rhinology and Allergology, Wiesbaden, Germany.
46
Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland.
47
Institute of Biomedical Sciences, Department of Pathology, Faculty of Medicine, Vilnius University, and Institute of Clinical Medicine, Clinic of Chest diseases and Allergology, Faculty of Medicine, Vilnius, Lithuania.
48
Center of Excellence in Asthma and Allergy, Médica Sur Clinical Foundation and Hospital, México City, Mexico.
49
KYomed INNOV, Montpellier, France.
50
University of Medicine and Pharmacy, Hochiminh City, Vietnam.
51
Faculty of Health Sciences and CICS-UBI, Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal.
52
Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, and Ageing@Coimbra EIP-AHA Reference Site, Coimbra, Portugal.
53
CIRFF, Center of Pharmacoeconomics, University of Naples Federico II, Naples, Italy.
54
Rhinology Unit & Smell Clinic, ENT Department, Hospital Clínic; Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES, University of Barcelona, Barcelona, Spain.
55
Danish Committee for Health Education, Copenhagen East, Denmark.
56
Division of Infection, Immunity & Respiratory Medicine, Royal Manchester Children's Hospital, University of Manchester, Manchester, UK.
57
Allergy Department, 2nd Pediatric Clinic, Athens General Children's Hospital "P&A Kyriakou", University of Athens, Athens, Greece.
58
University of Oulu, Faculty of Medicine, Oulun Yliopisto, Finland.
59
Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Phillipps-Universität Marburg, Germany.
60
Department of Health and Social Services, Welsh Government, Cardiff, UK.
61
Director, Centre For Empowering Patients and Communities, Dublin, Ireland.
62
Asthma UK Centre for Applied Research, The Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK.
63
Agency for Social Services and Dependency, Regional Government for Equality, Social Policies and Conciliation of Andalucia, Seville, Spain.
64
Association Asthme et Allergie, Paris, France.
65
KanopyMed, Paris, France.
66
Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland.
67
Allergy and Clinical Immunology Department, Centro Medico-Docente La Trinidad, Caracas, Venezuela.
68
Immunomodulation and Tolerance Group, Imperial College London, and Allergy and Clinical Immunology, Imperial College London, London, UK.
69
European Health Futures Forum (EHFF), Dromahair, Ireland.
70
Division of Allergy, Immunology, and Transplantation (DAIT), National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD, USA.
71
Skin and Allergy Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
72
Health Planning Unit, Department of Social Medicine, Faculty of Medicine, University of Crete, Crete, Greece and International Primary Care Respiratory Group IPCRG, Aberdeen, Scotland.
73
National Heart and Lung Institute (NHLI), Imperial College London & Royal Brompton Hospital, Airways Disease Section, London, UK.
74
Asthma UK, London, UK.
75
Nova Southeastern University, Fort Lauderdale, Florida, USA.
76
Vilnius University Faculty of Medicine, Institute of Clinical Medicine & Institute of Health Sciences, Vilnius, Lithuania.
77
Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands.
78
University of Bari Medical School, Unit of Geriatric Immunoallergology, Bari, Italy.
79
International Primary Care Respiratory Group IPCRG, Aberdeen, Scotland.
80
Department of Pulmonary Diseases, Celal Bayar University, Faculty of Medicine, Manisa, Turkey.
81
Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Uniersität zu Berlin and Berlin Institute of Health, Comprehensive Allergy-Centre, Department of Dermatology and Allergy, Member of GA2LEN, Berlin, Germany.
PMID: 31656683 PMCID: PMC6790426 DOI: 10.21037/jtd.2019.09.38
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Publication type
Select item 31656662
25.
J Thorac Dis. 2019 Sep;11(9):3887-3895. doi: 10.21037/jtd.2019.09.11.
Peri-operative risk factors for in-hospital mortality in acute type A aortic dissection.
Wen M1, Han Y1, Ye J2, Cai G3, Zeng W1, Liu X1, Huang L1, Lian Z4, Zeng H1.
Author information
1
Department of Intensive Care Unit 1, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China.
2
Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China.
3
School of Medicine, South China University of Technology, Guangzhou 510641, China.
4
Department of Public Health, Tufts University, School of Medicine, Boston, MA, USA.
Abstract
BACKGROUND:
Acute type A aortic dissection (TAAD) is cardiovascular emergency and requires surgical interventions. In-hospital mortality rate of surgical-treated TAAD patients remains high. We aim to examine the prognostic implications of peri-operative parameters to identify high-risk patient for in-hospital mortality.

METHODS:
A total of 264 surgically treated TAAD patients were included in this study. The association between in-hospital mortality and peri-operative parameters were examined.

RESULTS:
Thirty patients (11.36%) died during hospitalization. Patients with higher Apache II score had a significantly higher rate of in-hospital mortality when compared with patients scored ≤20 in unadjusted model [Score 21-25: HR =12.9 (1.7-100.8), P=0.0148; Score >25: HR =94.5 (12.6-707.6), P<0.0001]. Patients with Sbp >120 mmHg, Cr >200 mmol/L (both at admission and after surgery), BUN >8.2 mmol/L (both at admission and after surgery), AST >80 µ/L, aortic cross-clamping time >120 min and cardiopulmonary bypass time (CPBT) >230 min were also significantly related to higher rate of in-hospital mortality in univariate analysis. In multivariable analysis, APACHE II score [Score 21-25: HR =9.5 (1.2-74.4), P=0.032; Score >25: HR =51.0 (6.7-387.7), P=0.0001], AST >80 µmol/L [HR =2.3 (1.1-4.8), P=0.0251], aortic cross-clamping time >120 min (HR =2.9 (1.1-7.7), P=0.0315) remained significant in predicting TAAD in-hospital mortality.

CONCLUSIONS:
APACHE II score could be a useful tool to predict TAAD in-hospital mortality. AST >80 µ/L and aortic cross-clamping time >120 min were also independent predictors.

2019 Journal of Thoracic Disease. All rights reserved.

KEYWORDS:
APACHE II score; Acute type A aortic dissection (TAAD); in-hospital mortality; peri-operative risk factor

PMID: 31656662 PMCID: PMC6790434 DOI: 10.21037/jtd.2019.09.11
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Conflict of interest statement
Select item 31656643
26.
J Thorac Dis. 2019 Sep;11(9):3712-3720. doi: 10.21037/jtd.2019.09.36.
Intracavitary chemotherapy with epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) is not superior to TKI monotherapy in controlling malignant pleural effusion recurrence in EGFR-mutated lung cancer patients.
Wang W1,2, Jiang X3, Zhang Y1,2,3,4, Song Y5, Song Z1,2,3,4.
Author information
1
Department of Medical Oncology, Cancer Hospital of the University of Chinese Academy of Sciences, Hangzhou 310022, China.
2
Zhejiang Cancer Hospital, Hangzhou 310022, China.
3
Department of Medical Oncology, Zhejiang Medical and Health Group Hangzhou Hospital/Hangzhou Hanggang Hospital, Hangzhou 310000, China.
4
Key Laboratory Diagnosis and Treatment Technology on Thoracic Oncology, Hangzhou 310000, China.
5
Department of Respiratory Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, China.
Abstract
BACKGROUND:
Epidermal growth factor receptor (EGFR) mutated non-small cell lung cancer (NSCLC) patients benefit from EGFR-tyrosine kinase inhibitors (TKIs) therapy. There are few studies comparing the efficacy between intrapleural chemotherapy combination with TKIs and TKIs alone in controlling re-accumulation of malignant pleural effusions (MPEs). The purpose of the study was to determine if patients with EGFR-mutated NSCLC and MPEs would benefit from intrapleural chemotherapeutics with an oral EGFR-TKI than EGFR-TKI alone.

METHODS:
We evaluated EGFR-mutated lung cancer patients with MPEs in Zhejiang Cancer Hospital. We evaluated the efficacy. Progression-free survival (PFS) and overall survival (OS) was evaluated by Kaplan-Meier method.

RESULTS:
One hundred one NSCLC patients with MPEs at the time of diagnosis were included. We divided the patients into two groups. The overall response rate (ORR) with respect to MPE recurrence between the TKI alone and combination therapy groups was 65.5% (38/58) and 58.1% (25/43) (P=0.449). The disease control rate was 89.7% (52/58) and 86.0% (37/43) (P=0.579), respectively. The PFS in the TKI alone and TKI plus intrapleural drugs was 10.3 and 9.9 months, respectively (P=0.746). The intrapleural PFS was 11.4 and 11.0 months for the TKI alone and combination groups, respectively (P=0.188). The OS was 24.9 and 22.6 months (P=0.543), respectively. Hematologic toxicity and chest pain were more frequent in the combination therapy than TKI alone groups.

CONCLUSIONS:
Intrapleural chemotherapy with TKI did not improve the efficacy of controlling MPEs in patients with EGFR-mutated NSCLC, but may increase adverse events, which are typical side effects of chemotherapy. We could treat these patients with TKI drugs alone combined with pleural effusion drainage.

2019 Journal of Thoracic Disease. All rights reserved.

KEYWORDS:
Epidermal growth factor receptor (EGFR); intrapleural chemotherapy; lung cancer; pleural effusion; tyrosine kinase inhibitor (TKI)

PMID: 31656643 PMCID: PMC6790470 DOI: 10.21037/jtd.2019.09.36
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Conflict of interest statement
Select item 31656632
27.
Digit Health. 2019 Oct 10;5:2055207619882181. doi: 10.1177/2055207619882181. eCollection 2019 Jan-Dec.
Use of mobile health applications for health-promoting behavior among individuals with chronic medical conditions.
Mahmood A1, Kedia S2, Wyant DK3, Ahn S1, Bhuyan SS4.
Author information
1
Division of Health Systems Management and Policy, School of Public Health, The University of Memphis, Memphis, TN, USA.
2
Division of Social and Behavioral Sciences, School of Public Health, The University of Memphis, Memphis, TN, USA.
3
The Jack C Massey Graduate School of Business, Belmont University, Nashville, TN, USA.
4
Edward J Bloustein School of Planning and Public Policy, Rutgers University, New Brunswick, NJ, USA.
Abstract
BACKGROUND:
Chronic medical conditions (CCs) are leading causes of morbidity and mortality in the United States. Strategies to control CCs include targeting unhealthy behaviors, often through the use of patient empowerment tools, such as mobile health (mHealth) technology. However, no conclusive evidence exists that mHealth applications (apps) are effective among individuals with CCs for chronic disease self-management.

METHODS:
We used data from the Health Information National Trends Survey (HINTS 5, Cycle 1, 2017). A sample of 1864 non-institutionalized US adults (≥18 years) who had a smartphone and/or a tablet computer and at least one CC was analyzed. Using multivariable logistic regressions, we assessed predisposing, enabling, and need predictors of three health-promoting behaviors (HPBs): tracking progress on a health-related goal, making a health-related decision, and health-related discussions with a care provider among smart device and mHealth apps owners.

RESULTS:
Compared to those without mHealth apps, individuals with mHealth apps had significantly higher odds of using their smart devices to track progress on a health-related goal (adjusted odds ratio (aOR) 8.74, 95% confidence interval (CI): 5.66-13.50, P < .001), to make a health-related decision (aOR 1.77, 95% CI: 1.16-2.71, P < .01) and in health-related discussions with care providers (aOR 2.0, 95% CI: 1.26-3.19, P < .01). Other significant factors of at least one type of HPB among smart device and mHealth apps users were age, gender, education, occupational status, having a regular provider, and self-rated general health.

CONCLUSION:
mHealth apps are associated with increased rates of HPB among individuals with CCs. However, certain groups, like older adults, are most affected by a digital divide where they have lower access to mHealth apps and thus are not able to take advantage of these tools. Rigorous randomized clinical trials among various segments of the population and different health conditions are needed to establish the effectiveness of these mHealth apps. Healthcare providers should encourage validated mHealth apps for patients with CCs.

© The Author(s) 2019.

KEYWORDS:
Chronic disease; digital divide; health-promoting behavior; mHealth; smartphone; tablet

PMID: 31656632 PMCID: PMC6791047 DOI: 10.1177/2055207619882181
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Select item 31656615
28.
Eur J Hosp Pharm. 2019 Sep;26(5):275-279. doi: 10.1136/ejhpharm-2017-001465. Epub 2018 Apr 18.
Comparisons of doxycycline solution with talc slurry for chemical pleurodesis and risk factors for recurrence in South Korean patients with spontaneous pneumothorax.
Park EH#1,2, Kim JH#3,4, Yee J4, Chung JE5, Seong JM4, La HO2,6, Gwak HS1,4.
Author information
1
Graduate School of Converging Clinical & Public Health, Ewha Womans University, Seoul, Republic of Korea.
2
Department of Pharmacy, the Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Republic of Korea.
3
College of Pharmacy & Institute of Pharmaceutical Science and Technology, Ajou University, Suwon-si, Republic of Korea.
4
College of Pharmacy & Division of Life and Pharmaceutical Sciences, Ewha Womans University, Seoul, Republic of Korea.
5
College of Pharmacy, Hanyang University, Ansan-si, Republic of Korea.
6
College of Pharmacy, The Catholic University of Korea, Seoul, Republic of Korea.
#
Contributed equally
Abstract
PURPOSE:
Talc slurry (TS) has been commonly used with high success rates in managing spontaneous pneumothroax (SP), but there were concerns of post-procedural complications. Alternatively, doxycycline solution (DS) was used successfully. This retrospective study aims to compare the effectiveness and safety between talc and doxycycline as a sclerosing agent and to investigate risk factors for recurrence in patients with SP.

METHODS:
The review of medical records between January 2011 and December 2014 was conducted on 83 patients with SP who underwent pleurodesis with either TS (n=16) or DS (n=67). Recurrence and complications were compared between the DS and TS groups. Associations between recurrence after DS treatment and various factors were analysed.

RESULTS:
Recurrence was significantly higher in the DS group than in the TS group (P=0.033), whereas complications were higher in the TS group than the DS group: fever was significantly higher in the TS group (P=0.001). Recurrences associated with doxycycline use were found significantly more often in patients with recurrent diagnosis of SP, height/weight ≥3.25 cm/kg and weight <55 kg.

CONCLUSION:
Talc was more effective without recurrence compared with doxycycline. Clinically insignificant fever associated with pleurodesis was more common with talc. Low weight, high height to weight ratio and recurrent diagnosis of SP were associated with higher recurrence after doxycycline treatment.

© European Association of Hospital Pharmacists (unless otherwise stated in the text of the article) 2019. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

KEYWORDS:
doxycycline; pleurodesis; pneumothorax; recurrence; talc

PMID: 31656615 PMCID: PMC6788261 [Available on 2020-09-01] DOI: 10.1136/ejhpharm-2017-001465
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29.
J Glob Health. 2019 Dec;9(2):020315. doi: 10.7189/jogh.09.020315.
Portugal's voluntary food reformulation agreement and the WHO reformulation targets.
Goiana-da-Silva F1,2, Cruz-E-Silva D3, Allen L4, Nunes AM5, Calhau C6,7, Rito A8, Bento A9, Miraldo M10, Darzi A11.
Author information
1
Centre for Health Policy, Institute of Global Health Innovation, Imperial College London, London, United Kingdom.
2
Faculdade de Ciências da Saúde, Universidade da Beira Interior, Covilhã, Portugal.
3
Center for Innovation, Technology and Policy Research, IN+, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal.
4
Nuffield Department of Primary Care Health Sciences, University of Oxford, United Kingdom.
5
Centre for Public Administration and Public Policies, Institute of Social and Political Sciences, University of Lisbon, Lisbon, Portugal.
6
Nutrition and Metabolism, NOVA Medical School, Faculty of Medical Sciences, NOVA University of Lisbon, Lisbon, Portugal.
7
Center for Health Technology Services Research (CINTESIS), Porto, Portugal.
8
INSA, National Institute of Health, Lisbon, Portugal.
9
Portuguese Order of Nutritionists, Porto, Portugal.
10
Department of Management & Centre for Health Economics & Policy Innovation (CHEPI), Imperial College Business School, London, United Kingdom.
11
Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, United Kingdom.
PMID: 31656602 PMCID: PMC6790236 DOI: 10.7189/jogh.09.020315
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Select item 31656599
30.
J Glob Health. 2019 Dec;9(2):020309. doi: 10.7189/jogh.09.020309.
Access to palliative care: discrepancy among low-income and high-income countries.
Poudel A1,2, Kc B2,3, Shrestha S2,4, Nissen L1,4.
Author information
1
School of Clinical Sciences, Queensland University of Technology, Queensland, Australia.
2
Sankalpa Foundation Pvt. Ltd., Pokhara, Nepal.
3
School of Pharmacy, Monash University, Malaysia.
4
School of Pharmacy, University of Queensland, Queensland, Australia.
PMID: 31656599 PMCID: PMC6812938 DOI: 10.7189/jogh.09.020309
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Select item 31656595
31.
Health Inf Sci Syst. 2019 Oct 12;7(1):22. doi: 10.1007/s13755-019-0081-5. eCollection 2019 Dec.
Modeling and classification of voluntary and imagery movements for brain-computer interface from fNIR and EEG signals through convolutional neural network.
Rahman MA1, Uddin MS2, Ahmad M3.
Author information
1
1Department of Biomedical Engineering, Khulna University of Engineering & Technology (KUET), Khulna, Bangladesh.
2
2Department of Computer Science and Engineering, Jahangirnagar University, Dhaka, Bangladesh.
3
3Department of Electrical and Electronic Engineering, Khulna University of Engineering & Technology (KUET), Khulna, Bangladesh.
Abstract
Practical brain-computer interface (BCI) demands the learning-based adaptive model that can handle diverse problems. To implement a BCI, usually functional near-infrared spectroscopy (fNIR) is used for measuring functional changes in brain oxygenation and electroencephalography (EEG) for evaluating the neuronal electric potential regarding the psychophysiological activity. Since the fNIR modality has an issue of temporal resolution, fNIR alone is not enough to achieve satisfactory classification accuracy as multiple neural stimuli are produced by voluntary and imagery movements. This leads us to make a combination of fNIR and EEG with a view to developing a BCI model for the classification of the brain signals of the voluntary and imagery movements. This work proposes a novel approach to prepare functional neuroimages from the fNIR and EEG using eight different movement-related stimuli. The neuroimages are used to train a convolutional neural network (CNN) to formulate a predictive model for classifying the combined fNIR-EEG data. The results reveal that the combined fNIR-EEG modality approach along with a CNN provides improved classification accuracy compared to a single modality and conventional classifiers. So, the outcomes of the proposed research work will be very helpful in the implementation of the finer BCI system.

© Springer Nature Switzerland AG 2019.

KEYWORDS:
Brain–computer interface (BCI); Convolutional neural network (CNN); Electroencephalography (EEG); Functional near-infrared spectroscopy (fNIR); Modeling and classification; Voluntary and imagery movements

PMID: 31656595 PMCID: PMC6790205 [Available on 2020-12-01] DOI: 10.1007/s13755-019-0081-5
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Select item 31656594
32.
Health Inf Sci Syst. 2019 Oct 12;7(1):21. doi: 10.1007/s13755-019-0084-2. eCollection 2019 Dec.
Neural attention with character embeddings for hay fever detection from twitter.
Du J1, Michalska S1, Subramani S1, Wang H1, Zhang Y1.
Author information
1
Institute of Sustainable Industries & Liveable Cities, Victoria University, Melbourne, VIC Australia.
Abstract
The paper aims to leverage the highly unstructured user-generated content in the context of pollen allergy surveillance using neural networks with character embeddings and the attention mechanism. Currently, there is no accurate representation of hay fever prevalence, particularly in real-time scenarios. Social media serves as an alternative to extract knowledge about the condition, which is valuable for allergy sufferers, general practitioners, and policy makers. Despite tremendous potential offered, conventional natural language processing methods prove limited when exposed to the challenging nature of user-generated content. As a result, the detection of actual hay fever instances among the number of false positives, as well as the correct identification of non-technical expressions as pollen allergy symptoms poses a major problem. We propose a deep architecture enhanced with character embeddings and neural attention to improve the performance of hay fever-related content classification from Twitter data. Improvement in prediction is achieved due to the character-level semantics introduced, which effectively addresses the out-of-vocabulary problem in our dataset where the rate is approximately 9%. Overall, the study is a step forward towards improved real-time pollen allergy surveillance from social media with state-of-art technology.

© The Author(s) 2019.

KEYWORDS:
Deep learning; Hay fever; Pollen allergy; Twitter

PMID: 31656594 PMCID: PMC6790203 DOI: 10.1007/s13755-019-0084-2
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33.
Health Inf Sci Syst. 2019 Oct 3;7(1):20. doi: 10.1007/s13755-019-0083-3. eCollection 2019 Dec.
Cognitive modelling of Chinese herbal medicine's effect on breast cancer.
Lee D1,2, Xu H2, Liu H3, Miao Y2.
Author information
1
Harmony Chinese Medicine Osteopathy and Acupuncture, Kew, 3101 VIC Australia.
2
2College of Engineering and Science, Victoria University, Melbourne, Australia.
3
3Department of Computer Science and Software Engineering, Swinburne University of Technology, Hawthorn, 3122 VIC Australia.
Abstract
PURPOSE:
Traditional Chinese medicine (TCM) has recently attracted increasing interests in cancer treatment. It was found that TCM-based treatment, combined with other therapies, can help improve patients' life quality. However, the existing research in TCM lacks a systematic modelling for the causal relationship of the factors related to the diagnosis and decision making.

METHODS:
In this paper, we proposed the use of fuzzy cognitive map (FCM) to represent the cognition of TCMs usage in cancer treatment.

RESULTS:
Through a case analysis, we analyse and summarise the effects of Chinese herbal medicine in breast cancer management.

CONCLUSION:
FCMs can visually represent the cognitive knowledge, particularly the causal relationship among key factors of TCM effects and the related breast cancer status.

© Springer Nature Switzerland AG 2019.

KEYWORDS:
Cancer treatment; Fuzzy cognitive map; Traditional Chinese medicine

PMID: 31656593 PMCID: PMC6775180 [Available on 2020-12-01] DOI: 10.1007/s13755-019-0083-3
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34.
F1000Res. 2019 Aug 28;8:1518. doi: 10.12688/f1000research.20083.1. eCollection 2019.
Performance characteristics of a modified HIV-1 drug resistance genotyping method for use in resource-limited settings.
Magomere EO1, Nyangahu DD2,3, Kimoloi S4, Webala BA5, Ondigo BN1,6,7.
Author information
1
Department of Biochemistry and Molecular Biology, Egerton University, Nakuru, Nakuru, 20115, Kenya.
2
Center for Global Infectious Disease Research, Seattle Children's Research Institute, Seattle, Washington, USA.
3
Department of Pediatrics, University of Washington, Seattle, Seattle, Washington, USA.
4
Department of Medical Laboratory Sciences, Masinde Muliro University of Science and Technology, Kakamega, Kakamega, Kenya.
5
Faculty of Health Sciences, Egerton University, Nakuru, Nakuru, Kenya.
6
Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kisumu, Kenya.
7
Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, NIH, USA, Bethesda, Maryland, USA.
Abstract
Background: HIV-1 drug resistance (HIVDR) assays are critical components of HIV clinical management programs in the face of emerging drug resistance. However, the high costs associated with existing commercial HIVDR assays prohibit their routine usage in resource-limited settings. We present the performance characteristics of a modified commercial HIVDR testing assay. Methods: A total of 26 plasma samples were used to validate and assess the accuracy, precision, reproducibility and amplification sensitivity of a modified HIVDR assay by HIV genotyping. In addition, a cost comparison between the original and the modified assay was performed using the ingredient costing approach. Results: The performance characteristics of the modified assay were in agreement with the original assay. Accuracy, precision and reproducibility showed nucleotide sequence identity of 98.5% (confidence interval (CI), 97.9-99.1%), 98.67% (CI, 98.1-99.23) and 98.7% (CI, 98.1-99.3), respectively.  There was no difference in the type of mutations detected by the two assays (χ 2 = 2.36, p = 0.26). Precision and reproducibility showed significant mutation agreement between replicates (kappa = 0.79 and 0.78), respectively ( p < 0.05). The amplification sensitivity of the modified assay was 100% and 62.5% for viremia ≥1000 copies/ml and <1000 copies/ml respectively. Our assay modification translates to a 39.2% reduction in the cost of reagents. Conclusions: Our findings underscore the potential of modifying commercially available HIVDR testing assays into cost-effective, yet accurate assays for use in resource-limited settings.

Copyright: © 2019 Magomere EO et al.

KEYWORDS:
Accuracy; Amplification sensitivity; Assay validation; HIV-1 drug resistance testing; Precision; Reproducibility

PMID: 31656591 PMCID: PMC6798314 DOI: 10.12688/f1000research.20083.1
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Select item 31656552
35.
Wiley Interdiscip Rev Data Min Knowl Discov. 2019 Sep-Oct;9(5):e1303. doi: 10.1002/widm.1303. Epub 2019 Feb 8.
A comprehensive survey of error measures for evaluating binary decision making in data science.
Emmert-Streib F1, Moutari S2, Dehmer M3,4,5.
Author information
1
Predictive Society and Data Analytics Lab, Faculty of Information Technology and Communication Sciences Tampere University Tampere Finland.
2
Mathematical Sciences Research Centre, School of Mathematics and Physics Queen's University Belfast Belfast UK.
3
Institute for Intelligent Production, Faculty for Management University of Applied Sciences Upper Austria Steyr Campus Austria.
4
Department for Biomedical Computer Science and Mechatronics UMIT-The Health and Life sciences University Hall in Tyrol Austria.
5
College of Computer and Control Engineering Nankai University Tianjin P. R. China.
Abstract
Binary decision making is a topic of great interest for many fields, including biomedical science, economics, management, politics, medicine, natural science and social science, and much effort has been spent for developing novel computational methods to address problems arising in the aforementioned fields. However, in order to evaluate the effectiveness of any prediction method for binary decision making, the choice of the most appropriate error measures is of paramount importance. Due to the variety of error measures available, the evaluation process of binary decision making can be a complex task. The main objective of this study is to provide a comprehensive survey of error measures for evaluating the outcome of binary decision making applicable to many data-driven fields. This article is categorized under: Fundamental Concepts of Data and Knowledge > Key Design Issues in Data MiningTechnologies > PredictionAlgorithmic Development > Statistics.

© 2019 The Authors. Wiley Interdisciplinary Reviews: Data Mining and Knowledge Discovery published by Wiley Periodicals, Inc.

KEYWORDS:
classification; data science; decision making; error measures; machine learning; statistics

PMID: 31656552 PMCID: PMC6777486 DOI: 10.1002/widm.1303
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36.
Ann Appl Stat. 2019 Sep;13(3):1927-1956. doi: 10.1214/19-AOAS1260. Epub 2019 Oct 17.
BAYESIAN METHODS FOR MULTIPLE MEDIATORS: RELATING PRINCIPAL STRATIFICATION AND CAUSAL MEDIATION IN THE ANALYSIS OF POWER PLANT EMISSION CONTROLS.
Kim C1, Daniels MJ2, Hogan JW3, Choirat C4,5, Zigler CM4,6.
Author information
1
Boston University School of Public Health.
2
University of Florida.
3
Brown University School of Public Health.
4
Harvard T.H. Chan School of Public Health.
5
Swiss Data Science Center.
6
University of Texas at Austin.
Abstract
Emission control technologies installed on power plants are a key feature of many air pollution regulations in the US. While such regulations are predicated on the presumed relationships between emissions, ambient air pollution, and human health, many of these relationships have never been empirically verified. The goal of this paper is to develop new statistical methods to quantify these relationships. We frame this problem as one of mediation analysis to evaluate the extent to which the effect of a particular control technology on ambient pollution is mediated through causal effects on power plant emissions. Since power plants emit various compounds that contribute to ambient pollution, we develop new methods for multiple intermediate variables that are measured contemporaneously, may interact with one another, and may exhibit joint mediating effects. Specifically, we propose new methods leveraging two related frameworks for causal inference in the presence of mediating variables: principal stratification and causal mediation analysis. We define principal effects based on multiple mediators, and also introduce a new decomposition of the total effect of an intervention on ambient pollution into the natural direct effect and natural indirect effects for all combinations of mediators. Both approaches are anchored to the same observed-data models, which we specify with Bayesian nonparametric techniques. We provide assumptions for estimating principal causal effects, then augment these with an additional assumption required for causal mediation analysis. The two analyses, interpreted in tandem, provide the first empirical investigation of the presumed causal pathways that motivate important air quality regulatory policies.

KEYWORDS:
Ambient PM2.5; Bayesian nonparametrics; Gaussian copula; Multi-Pollutants; Natural indirect effect

PMID: 31656548 PMCID: PMC6814408 DOI: 10.1214/19-AOAS1260
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Select item 31656520
37.
Iran J Vet Res. 2019 Summer;20(3):167-172.
Humic acid as a feed additive in poultry diets: a review.
Arif M1, Alagawany M2, Abd El-Hack ME2, Saeed M3, Arain MA3, Elnesr SS4.
Author information
1
Department of Animal Sciences, College of Agriculture, University of Sargodha, Punjab, 40100, Pakistan.
2
Department of Poultry, Faculty of Agriculture, Zagazig University, Zagazig, 44511, Egypt.
3
Department of Animal Nutrition, College of Animal Sciences and Technology, Northwest A&F University, Yangling, 712100, China.
4
Poultry Production Department, Faculty of Agriculture, Fayoum University, Fayoum, 63514, Egypt.
Abstract
Many studies tested different feed additives, among these additives, humic substances (HS) have been used in livestock and poultry diets. Humic substances commonly present in nature as they are created from the organic matter decomposition, and are normally found in the soil and natural water. Active components of HS consist of humic acid (HA), humus, ulmic acid, fulvic acid, humin and certain microelements. Humic acid is widely used as an alternative growth promoter for antibiotics in improving poultry performance and health. Moreover, supplementation of a commercial substance as a source of HS through the drinking water or diet improved the feed consumption, feed efficiency and weight gain of broiler chickens, and also improved egg weight, egg mass, and egg production of laying hens. This review describes the useful applications and recent facets of HA including its modes of action and various valuable uses in improving the production and health safeguarding of livestock and poultry.

KEYWORDS:
Growth promoter; Health; Humic acid; Performance; Poultry

PMID: 31656520
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Select item 31656512
38.
Afr Health Sci. 2019 Jun;19(2):2263-2269. doi: 10.4314/ahs.v19i2.52.
Challenges faced by student accoucheurs during clinical placement at the free state maternal health care institutions.
Sibiya MN1, Madlala ST2, Ngxongo TS3.
Author information
1
Faculty of Health Sciences, Durban University of Technology, Durban, South Africa.
2
Department of Nursing Science, Faculty of Health Sciences, University of Zululand, Empangeni, South Africa.
3
Department of Nursing, Faculty of Health Sciences, Durban University of Technology, Durban.
Abstract
BACKGROUND:
Anecdotal evidence suggests that student accoucheurs studying at the Free State School of Nursing in South Africa are faced with resistance, discrimination, rejection and unacceptability by pregnant women during their clinical placement at the Free State maternal health care institutions.

OBJECTIVE:
The aim of the study was to explore and describe the challenges faced by student accoucheurs regarding the maternal health care services they render to women.

METHODS:
An explorative, descriptive, and qualitative research design was employed to conduct the study. Purposive sampling was used to select student accoucheurs who met the inclusion criteria. Focus group discussion was used to collect data from the selected student accoucheurs. Data were analysed thematically, and the findings were triangulated with the integration of Peplau's Theory of Interpersonal Relations as a theoretical framework that guided the study.

RESULTS:
The findings in relation to the research question were synthesised under four themes: transcultural diversity, socio-economic factors, social interactions and relations, and gender inequality in the work place.

CONCLUSION:
The study is a contribution to the emerging education and training of student accoucheurs body of knowledge in the Free State Province and to the global existing body of knowledge regarding the phenomena.

© 2019 Sibiya et al.

KEYWORDS:
Acceptance; South Africa; free state province; maternal health care; pregnant women; student accoucheurs

PMID: 31656512 PMCID: PMC6794507 DOI: 10.4314/ahs.v19i2.52
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39.
Afr Health Sci. 2019 Jun;19(2):2219-2229. doi: 10.4314/ahs.v19i2.47.
Annona stenophylla aqueous extract stimulate glucose uptake in established C2Cl2 muscle cell lines.
Taderera T1, Chagonda LS1, Gomo E2, Katerere D3, Shai LJ3.
Author information
1
School of Pharmacy, College of Health Sciences, University of Zimbabwe, P. O. Box MP 167, Mount Pleasant, Harare, Zimbabwe.
2
Department of Medical Laboratory Sciences, University of Zimbabwe, P. O. Box A178, Avondale Harare, Zimbabwe.
3
Department of Biomedical Sciences, Tshwane University of Technology, Private Bag X680, Pretoria 0001, South Africa.
Abstract
BACKGROUND:
Annona stenophylla is a folk medicine popularly used in Zimbabwe for the treatment of many ailments. This study was carried out to determine some of the possible anti diabetic mechanisms of its action using in vitro cell culturing methods.

METHODS:
A. stenophylla's effects on glucose uptake were tested using muscle cells (C2Cl2). Expression of glucose 4 transporters was determined by treating cell lines with plant extract. Total RNA was isolated and using RT-PCR, GLUT 4 expression levels were quantified. Translocation of GLUT 4 was assessed using FITC fluorescence measured by flow cytometry.

RESULTS:
Treatment of cells with plant extract significantly increased glucose uptake in a concentration dependent manner, with the highest concentration (250 µg/ml) giving 28% increased uptake compared to the negative control. The increase in glucose uptake (2.5 times more than control) was coupled to increase in GLUT 4 mRNA and subsequently GLUT 4 translocation. Wortmannin expunged the A. stenophylla induced increase in GLUT 4 mRNA and glucose uptake.

CONCLUSION:
The results suggest that A. stenophylla aqueous extract increases glucose uptake partly through increasing the GLUT 4 mRNA and translocation potentially acting via the PI-3-K pathway. This study confirms the ethnopharmacological uses of A. stenophylla indicating potential for anti-diabetic products formulation.

© 2019 Taderera et al.

KEYWORDS:
Annona stenophylla; GLUT 4; diabetes; glucose uptake; wortmannin

PMID: 31656507 PMCID: PMC6794551 DOI: 10.4314/ahs.v19i2.47
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Select item 31656505
40.
Afr Health Sci. 2019 Jun;19(2):2198-2207. doi: 10.4314/ahs.v19i2.45.
Aerobic exercise modulates cytokine profile and sleep quality in elderly.
Abd El-Kader SM1, Al-Jiffri OH2.
Author information
1
Department of Physical Therapy, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia.
2
Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia.
Abstract
BACKGROUND:
Sleep disturbance is a major problem for older adults which can be exacerbated by increased inflammation as aging is associated with increased circulating pro-inflammatory and lower anti-inflammatory cytokines. There is a need to develop alternative medicine techniques to help improve sleep quality in the elderly.

OBJECTIVE:
To investigate the effects of aerobic exercise training on the sleep quality and inflammatory cytokines in elderly subjects.

MATERIAL AND METHODS:
Forty previously sedentary elderly subjects participated in this study, their age ranged from 61- 67 years. All subjects were randomly assigned to supervised aerobic exercise intervention group (group A, n=25) or control group (group B, n=25). Polysomnographic recordings for sleep quality assessment, interleukin- 6 (IL-6), tumor necrosis factor- alpha (TNF-α) and interleukin-10 (IL-10) were measured before and after 6 months at the end of the study.

RESULTS:
There was a significant increase in total sleep duration, sleep efficiency and sleep onset latency in group(A) after 6 months of aerobic exercise training, while, wake time after sleep onset and rapid eye movement (REM) latency significantly reduced after 6 months of aerobic training compared with values obtained prior to aerobic exercise training. Also, the mean values of TNF- α and IL-6 decreased significantly and the mean value of IL-10 significantly increased in group (A) after the aerobic exercise training, however the results of the control group were not significant. Moreover, there were significant differences between both groups at the end of the study.

CONCLUSION:
Exercise training can be considered as a non-pharmacological modality for modifying sleep quality and inflammation among elderly.

© 2019 Abd El-Kader et al.

KEYWORDS:
Sleep quality; aerobic exercise; aging; inflammatory cytokines

PMID: 31656505 PMCID: PMC6794533 DOI: 10.4314/ahs.v19i2.45