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75, 95%CI 0.63 to 0.89), maternal hospitalization (RR 0.13, 95%CI 0.02 to 0.98) and postpartum hemorrhage (RR 0.47, 95%CI 0.22 to 1.00). Several adverse neonatal complications including neonatal hyperbilirubinemia (RR 0.47, 95%CI 0.33 to 0.67), giant children (RR 0.58, 95%CI 0.38 to 0.89), polyhydramnios (RR 0.42, 95% CI 0.24 to 0.72), fetal distress (RR 0.46, 95%CI 0.24 to 0.90) and premature delivery (RR 0.43, 95% CI 0.26 to 0.72) were also significantly reduced.

This meta-analysis suggested that supplementation of GDM women with vitamin D may lead to an improvement in glycemic control and reduction of adverse maternal-neonatal outcomes.

This meta-analysis suggested that supplementation of GDM women with vitamin D may lead to an improvement in glycemic control and reduction of adverse maternal-neonatal outcomes.The success of vaccination programs depends on the level of acceptance of the vaccine to achieve high vaccine coverage rates (VCR). Vaccine hesitancy is a challenge, especially concerning new vaccines. Dengue vaccine, Dengvaxia®, was licensed in Brazil in 2015 and implemented, in a pioneering publicly-funded initiative in the state of Paraná, between 2016 and 2018. The vaccination program took place in five phases in the 30 municipalities most affected by dengue in the state, targeting individuals from nine to 44 years-old in two cities and from 15 to 27 years-old in the other 28 municipalities, totaling a target population of 500,000 individuals. A cross-sectional descriptive study was carried out to assess VCR and adherence to the dengue vaccine in this program. VCR, dropout ratio (DR), and compliance with the vaccination schedule (CVS) were analyzed by sex, age group, and municipality size. A total of 302,603 individuals (60.5%) received ≥ 1 dose, 44.2% received ≥ 2 doses, and 28.6% 3 doses. The DR was 52.8%. 2,3-Butanedione-2-monoxime molecular weight Among individuals who started vaccination, 40.6% achieved CVS. The highest VCR, highest CVS, and lowest DR occurred in the age group from 9 to 14 years old and from 28 to 44 years old and in smaller municipalities. A greater proportion of men started vaccination (male 64.0%; female 57.1%) however, the DR was higher in men (male 55.4%; female 49.9%), and a higher percentage of women completed the vaccination schedule according to the recommendations (CVS male 37.8%; female 43.6%). Differences were noted in the CVS according to the initial phase of the program (first phase 50.8%; second phase 18.8%). The heterogeneity in vaccine uptake and compliance according to sex, age, and municipality size suggests the need for differentiated strategies to address challenges with new and multiple-dose vaccines.The parental rotavirus strain 116E (G9P[11]) used to generate Rotavac® vaccine was isolated in 1986 in New Delhi. Thenceforward, there is no comprehensive report on diversity of G9 rotavirus strains from 116E; therefore, the present study evaluates the VP7 gene sequence diversity of G9 strains (retrieved from GenBank) from different geographical regions (1987-2016). Additionally, 22 recently collected G9 strains from Himachal Pradesh and Delhi (2013-2016) were included in the phylogenetic analysis. Interestingly, unlike 116E which belong to lineage-II all other G9 rotavirus including these 22 samples clustered together in a separate lineage (III). Further, six amino acid substitutions including one novel, K143M (epitope 7-2) different from 116E were detected mostly in the neutralization epitopes of VP7 protein (neutralization escape mutants). Overall, the accumulation of identified substitutions in VP7 epitopes and evolution of G9 strains in India may have impact on Rotavac® efficacy.Primary health care workers (HCWs) provide almost all vaccine services in Croatia, so they play an essential role in vaccine recommendations and uptake. The aim of this study was to determine the level of vaccine hesitancy among primary HCWs, to identify differences between nurses and physicians in attitudes, beliefs and behaviours towards vaccination, and to determine predictors of vaccine hesitancy among HCWs. We conducted a cross-sectional study from July to December in 2018 among physicians and nurses employed in the services of epidemiology, public health, school medicine, pediatrics and general practice/family medicine in Primorje-Gorski Kotar County, a primarily urban region with a population around 300 000 in the northern part of Croatia. The list of primary HCWs offices was obtained from the Croatian Health Insurance Fond website. We used a self-administered questionnaire on their attitudes, beliefs and behaviours relative to vaccination. Obtained response rate was 65.5% (324/495) of eligible primaryrease vaccination knowledge and confidence among primary health care workers, especially nurses.The role of Ureaplasma diversum in the porcine respiratory disease complex (PRDC), its circulation among herds and prevalence in live pigs is unknown; thus, the objectives of this study were to determine the presence of U. diversum in indoor intensive pig herds and to determine the individual frequency of pigs with U. diversum from pooled samples. A cross sectional study was carried out in 16 indoor intensive herds from Córdoba and La Pampa provinces, collecting eight nasal swabs specimens that were further processed by two pools of four specimens each by a PCR targeting a fragment of 16S ribosomal RNA gene. Four PCR products were sequenced and aligned against data bases. U. diversum - Ureaplasma sp. were detected in 56.3% of the analyzed herds, with 16.5% (95% CI 8.2-30.8) of positive pigs. It was concluded that U. diversum - Ureaplasma sp. are present in the nasal cavity of live pigs, being widely distributed among herds.Financial conflicts of interest (FCOI) between pharmaceutical companies and physicians may negatively impact patient care. This is particularly relevant regarding clinical practice guidelines (CPG), where FCOI may inappropriately influence individual drugs' promotion or use. In a cross-sectional analysis of pharmaceutical company payments, we sought to elucidate the extent of FCOI between Japanese hematologists and drug promotion in CPG. Data collected from two professional medical associations and companies belonging to the Japanese Pharmaceutical Manufacturers Association included the type and amount of company payments, individual financial disclosures, and new drug or indication approvals between 2015 and 2017. Of the 74 hematologists drafting CPG, 70 (94.6 %) received at least one payment during the study period. The cumulative median (interquartile range) value of these payments was $31,553 ($11,449-$74,390). Also, during this period, 26 new drugs or indications were approved and discussed in the CPG. Among the 79 pharmaceutical companies, the 11 (13.9 %) with newly approved and discussed drugs in the CPG made median (interquartile range) payments of $210,388 ($85,141-$292,536), while the remaining 68 (86.1 %) made $0 ($0-$9607) in payments. Disclosure of these payments was inconsistent. Such discrepancies suggest an association between pharmaceutical payments and drug approvals that only greater transparency can clarify. Consequently, a comprehensive overhaul of the current framework to control FCOI that includes legal regulation may be necessary.We present a novel 'proof-of-concept' electrochemically based membrane filtration process for the recovery of nitrogen and phosphorus from livestock wastewater following an anaerobic digestion step. link2 Reactive electrically conducting membranes are shown to precipitate and separate struvite, an eco-friendly fertilizer from synthetic livestock wastewater, resulting in the production of a solid fertilizer and a high-quality water stream, fit for irrigation. The recovery process is based on electrochemical hydrolysis and control of local pH in proximity to the surface of the membrane, and therefore, does not require chemical additives for pH adjustment. The system was assessed at varying concentrations of nitrogen and phosphorus corresponding to diluted and concentrated livestock wastewater (up to 1000 mg/L of N and P). Experimental results show up to 65% removal of phosphorus and nitrogen in the first 30 min of electrochemical filtration, and the precipitates were analytically confirmed to be struvite. In addition, the recovery process was shown efficient as it resulted in limited membrane fouling and flux reduction. Fouling and precipitation results were explained by a mathematical model describing the concentration of N, P, Mg ions in the presence of an external electric field. Accordingly, precipitation takes place in proximity to the membrane's surface but not directly on it, thus, limiting surface fouling. The electrochemical filtration system does not require chemical additives for pH adjustment, and the cost associated with electrochemical membrane-based struvite recovery was calculated to be $158 per ton of dry struvite, which is about 1.4 times lower in comparison to conventional recovery approaches. Overall, the electrochemical filtration system may be a promising alternative for nutrient recovery from livestock wastewater in terms of operational costs, recovery efficiency, and fouling mitigation.The diagnosis of cardiac tumors has been dramatically improved by modern cardiac imaging. In cases presenting with right intracavitary mass the diagnosis can rely on right endomyocardial biopsy. We report here a case of right ventricle tumor whose diagnosis was established as a colonic metastasis by using right endomyocardial biopsy.The effects of amino acid variants encoded by human leukocyte antigen (HLA) class II on the development of Graves' disease (GD) and Hashimoto's thyroiditis (HT) have not been fully elucidated. We investigated the HLA-DRB1 genes of 243 GD patients and 82 HT patients in the Japanese population and compared the frequencies of HLA-DRB1 alleles and HLA-DRB1 amino acid variants between these patients and the Japanese populations previously reported by another institution. The frequencies of HLA-DRB1*0405 and -DRB1*1403 alleles were significantly higher and those of HLA-DRB1*0101 and -DRB1*1502 alleles were lower in GD patients than in controls. The frequencies of HLA-DRB1*0803 and -DRB1*0901 alleles were significantly higher and that of the HLA-DRB1*1302 allele was lower in HT patients than in controls. A blind association analysis with all amino acid positions identified DRß9 and DRß31 for GD and DRß9, DRß13, and DRß21 for HT. The frequency of Glu-9 was significantly higher and that of Cys-9 was lower in GD patients than in controls. link3 The frequencies of Lys-9 and Phe-13 were significantly higher in HT patients than in controls. DRß9 and DRß13 could be critical amino acid positions in the development of GD and HT.We developed a cost-efficient workflow for genotyping HLA-E by NGS and applied it for genotyping more than 2.5 million potential stem cell donors. The data obtained were used to determine HLA-E allele frequency distributions for 104 populations. Our results confirm the known dominance of the alleles E*0101 and E*0103, which have a combined frequency of more than 0.99 in 97 of the 104 populations. E*0101 is more frequent in Africa and the western part of South America, E*0103 in Southeast and East Asia. E*0103 shows a pronounced regional substructure at the high-resolution level with E*010301G being particularly common in a large connected region extending from Turkey to China, E*010302G in Northwestern Europe and E*010303 in Central and Eastern Europe as well as Central Asia. The presented results are relevant both as a basis for further population genetics studies and for optimizing stem cell donor searches.