bluuebunny/crossref_metadata_2025 huggingface dataset:
An Analytical Study on Machine Learning Techniques
Authors: Singh Law Kumar , Pooja  , Garg Hitendra , Khanna Munish , Bhadoria Robin Singh
Published: October 2020

The last few months have produced a remarkable expansion in research and deep study in the field of machine learning. Machine learning is a technique in which the set of the methods are used by the computers to make prediction, improve prediction and behavior prediction based on dataset. The learning techniques can be classified as supervised and unsupervised learning. The focus is on supervised machine learning that covers all the predictions problem for which we had the dataset in which the outcome is already known. Some of the algorithm like naive bayes, linear regression, SVM, k-nearest neighbor, especially neural network have gain growth in this area. The classifiers of machine learning are completely unconstrained with the assumptions of statistical and for that they are adapted by complex data. The authors have demonstrated the application of machine learning techniques and its ethical issues.
The Myth of Motherhood in Communist and Postcommunist Romania
Authors: Marinescu Roxana-Elisabeta
Published: October 2020

This chapter analyses how the myth of motherhood was construed and enforced on Romanian women in two recent epochs. While in the latter part of communism women were expected to be “mothers of the nation” and produce five or more children for the country and the party, due to an infamous decree passed in 1966, the postcommunist period saw the same pressure put on women to fulfill their “patriotic duty,” this time in the neoliberal logic and in congruence with the Western model. Women imagery is consistent with this role, and this chapter provides insights into how primary school textbooks, together with the main documents and legal initiatives of the two periods, impacted the social expectations of motherhood and affected the Romanian women.
The Legacy of the Terrible Mother Archetype in Post-War British Drama
Authors: Şahin Gülter Işıl
Published: October 2020

The theatre provides the playwrights with a public platform through which they open up a more comprehensive framework to reinterpret the concept of the feminine. The chapter, in which translation remains a fundamental instrument that will be utilized to offer new interpretations to old ideas about the feminine, explores how the post-war British woman playwright Ann Jellicoe translates a women-related myth and reinterprets the concept of the feminine in The Sport of My Mad Mother (w.1958, r.1962). In this context, the chapter focuses on the concept of the Terrible Mother archetype which represents the female creative power as well as the potential for destruction in the play within a special reference to Jung's premises on the archetypal nature of the femininity and maternity. Thus, the chapter indicates that Ann Jellicoe, taking on board and challenging the perceived social, ideological, and psychological ideals of femininity, reclaims the legacy of the female strength.
The Magician, the Savior, and the Cyborg
Authors: Grosu-Rădulescu Lucia-Mihaela
Published: October 2020

The chapter analyses female protagonists in recent young adult movies with a focus on the educational side of such productions. The text approaches femininity and empowerment of three well-known heroines: Hermione (from the Harry Potter series), Lyra (from His Dark Materials Season 1 TV series), and Alita (from Alita: Battle Angel). The chapter centers on the roles played by the three characters in the economy of the respective cinematic productions and on how their girlhood is framed by the visual text. The author's purpose is to unearth interpretations of gender-specific roles that impact the young viewers and their understanding of femininity. The chapter intends to open a conversation about the implication of possible worlds theory and social cognitive theory in interpreting depictions of girlhood in fantasy and Sci-Fi young adult movies. From the magician (Hermione) to the (supernatural) savior (Lyra) and ending with the cyborg (Alita), the analysis will also take into account tenets of feminism, Techno Feminism, and behavioral psychology.
Images of the Female Body in Émile Zola's Novels
Authors: David Irina
Published: October 2020

The aim of this chapter is to highlight how the female body and the social practices that it is subject to are depicted in Émile Zola's literary work as indicators of dominating perceptions in 19th century patriarchal French society with regard to social roles in general and women's role in society in particular. Rather than focusing on an anatomic, biological analysis of the body, the discussion will turn to the body as a social construct, as metaphor for the overall treatment of women as beings whose appearance and behavior have to constantly be regulated for them to no longer constitute a threat to the male-centric society they live in.
Christine de Pizan
Authors: Antunes Maria Helena Marques
Published: October 2020

In creating her own particular style and legitimizing her status as a literary woman, a reflection on the female condition emerges from her work. This chapter considers two key texts: Cité des dames and Epistre Othea. The author's aim in the latter may not initially seem to be the exploration of women's dignification, since we are dealing with a text in which a goddess, called Othéa, teaches the young Hector morality. The creation of a new female mythological figure, however, establishing a parallel with Plutarch, as well as the positive reappraisal of some mythological characters reveals that Epistre Othea implicitly proposes a reflection on female rehabilitation. The introduction into this corpus of Ovide moralisé and the 15th century translation of Boccaccio's De mulieribus claris, which served as a reference for Pizan, is therefore highly significant.
Data Discovery Over Time Series From Star Schemas Based on Association, Correlation, and Causality
Authors: Pinheiro Wallace Anacleto , Xexéo Geraldo , Moreira de Souza Jano , Pinheiro Ana Bárbara Sapienza
Published: October 2020

This work proposes a methodology applied to repositories modeled using star schemas, such as data marts, to discover relevant time series relations. This paper applies a set of measures related to association, correlation, and causality to create connections among data. In this context, the research proposes a new causality function based on peaks and values that relate coherently time series. To evaluate the approach, the authors use a set of experiments exploring time series about a particular neglected disease that affects several Brazilian cities called American Tegumentary Leishmaniasis and time series about the climate of some cities in Brazil. The authors populate data marts with these data, and the proposed methodology has generated a set of relations linking the notifications of this disease to the variation of temperature and pluviometry.
Fault Lines in Virtual Team Leadership and Team Performance in Undergraduate Virtual Team Short-Term Projects
Authors: Graham Christian , Daniel Harold
Published: October 2020

This article provides a literature review on virtual team leaderships impact on project quality, team effectiveness, and team commitment to short-term projects. The authors summarize several negative findings related to virtual teams and posit that these negative outcomes contribute to the negative impact of organisational fault lines. The article concludes by exploring a theoretical model on the relationship between fault lines in virtual teams and team performance. The authors specifically propose that transformational leadership in virtual teams will positively moderate this relationship.
A Retrospective Analysis of the International Journal of Knowledge Management
Authors: Kataria Aakanksha , Kumar Satish , Pandey Nitesh
Published: October 2020

The International Journal of Knowledge Management (IJKM) has been providing a platform for research in knowledge management since 2005. This study assesses its 15-year milestone and lends insight into the major trends in the establishment and development of the journal. The primary objective of this paper is to present an overview of the intellectual structure of the IJKM using bibliometric analysis. The paper focuses on the leading trends of the journal over the years and traces the subsequent developments. Using the Scopus database, the bibliographic data of the journal was extracted in order to highlight the major influences in its growth history and the central themes of the journal employing different bibliometric tools. Analysis of the content and context of the journal illustrates the inclusive nature of knowledge management research in the journal. The IJKM provides an important context for interdisciplinary and international research and draws attention from a wide section of the academic community for the research it showcases.
Customer Knowledge Acquisition in Omani Organizations
Authors: Al-Busaidi Kamla Ali
Published: October 2020

Customer knowledge (CK) can empower organizations and improve their operational, innovative, and competitive performance. CK has been classified into three categories: knowledge for customers, knowledge about customers, and knowledge from customers. The literature has highlighted the importance of assessing the value of external CK in enabling organizations to obtain the support of top management. Very limited empirical studies have examined the specific impact of acquiring each type of CK. Consequently, the objective of this study is to empirically assess the impact of acquiring each type of CK. Based on an analysis of 41 organizations in Oman, this study detected that the overall acquisition of each type of customer knowledge has significant positive links with business process benefits, product benefits, customer benefits, and financial benefits, but a low significant positive link with employee benefits, and no significant link with market benefits. This study developed an integrated framework and measures to assess the value of acquiring different types of customer knowledge.
Relating Knowledge Management Enablers, Knowledge Management Processes, and Organizational Effectiveness
Authors: Bezzina Frank , Baldacchino David , Cassar Vincent
Published: October 2020

This study investigates the relationship between knowledge management (KM) enablers (aspects of organizational structure, learning, strategy, transformational leadership, and information technology) and organizational effectiveness. It also examines the mediating role of KM processes (knowledge creation, knowledge organization, knowledge application, and knowledge protection). Using a web-based questionnaire and the responses from 201 organizations in the Maltese Pharmaceutical Sector, structural equation modelling revealed that various KM enablers produced direct effects on KM processes, and in turn, two KM processes produced direct effects on organizational effectiveness and also mediated the relationship between some KM enablers and organizational effectiveness. This study contributes towards a better understanding of specific aspects of the KM phenomenon and provides several implications that could better assist the management of knowledge to enhance organizational effectiveness.
View on the Buildup of New Service Capability of National Library of China From the Point of Development Trend of Reference Work
Authors: Wang Lei
Published: October 2020

With the change of information environment, the emergence of new technology, services, and new media, reference librarians and users have more choices in information acquisition methods, tools, and means. The reference consulting service is the most valuable part of developing collections, increasing comprehensive service ability, and revealing a library's social roles in the information age. The change in user demands has accelerated the transfer process which shifts the focus of library reference work from the literature retrieval to the individualized, information-oriented deep content mining, or metrology analysis. Improving the new service capacity to accomplish library service transformation is also an important goal of functional improvements to the National Library of China. In the coming years, the National Library of China will promote new services through improving the reading guidance, developing literature resources, innovating service methods, supporting national development strategy, strengthening the library's essentials, and promoting business cooperation.
A Predictive Analytics Approach to Building a Decision Support System for Improving Graduation Rates at a Four-Year College
Authors: Wang Xuan , Schneider Helmut , Walsh Kenneth R.
Published: October 2020

Although graduation rates have interested stakeholders, educational researchers, and policymakers for some time, little progress has been made on the overall graduation rate at four-year state colleges. Even though selective admission based on academic indicators such as high school GPA and ACT/SAT have widely been used in the USA for years, and recent statistics show that less than 40% of students graduate from four-year state colleges in four years in the US. The authors propose using an ensemble of analytic models that considers cost as a better form of analysis that can be used as input to decision support systems to inform decision makers and help them choose intervention methods. This article uses ten years of data for 10,000 students and applies ten analytical models to find the best predictor of at-risk students. This research also uses the receiver operating characteristic curve to help determine the most cost-effective trade-off between false positive and false negative levels.
Metastatic extramammary paget disease, a remarkable clinical case and a brief review of a rare disease
Authors: Fernandes Leonor , Graça Joana , Vasconcelos de Matos Leonor , Sampaio Rita , Baleiras Mafalda Miranda , Ferreira Filipa , Mesquita Pinto Marta , Miranda Helena , Martins Ana
Published: October 2020

Extramammary Paget Disease (EMPD) is an often-misdiagnosed rare disorder, whose cause remains unknown. Diagnosis is confirmed by skin biopsy. Primary treatment for EMPD is surgery. Recurrence is common in the first two years and prognosis is good if the disease is localized and there is no underlying associated cancer. Patients with invasive and metastatic EMPD are uncommon and exhibit a poor prognosis, even when there is good response to a first chemotherapy line. Multiple chemotherapeutic regimens, with varying levels of success, have been attempted, but standard of care is not established. The central nervous system seems to be a common metastatic site with better survival than visceral metastasis.We report a case of metastatic EMPD that addresses the difficulties associated with the treatment of this rare disease, that has no current guidelines.
A case of dorsal agenesis of pancreas associated with unilateral renal agenesis, unicornuate uterus, and ovarian ectopia: A brief review and learning points
Authors: Bhandari Arindam , Mandal Samrat
Published: October 2020

Dorsal agenesis of the pancreas is a rare entity, with about 100 cases reported. It can be overlooked on ultrasound due to the non visualization of the body and tail of the pancreas.This is due to overlying gas in the stomach, which offers a poor acoustic window and obscures visualization. Renal agenesis and Mullerian duct anomalies are uncommon associations of dorsal agenesis of the pancreas because of the separate embryological origin of the pancreas and genitourinary organs. Here, we present a case of a 17-year-old patient who had dorsal agenesis of the pancreas, associated with unilateral renal agenesis, unicornuate uterus, and ectopic ovary. We describe the anomalies and discuss the radiological differential diagnosis and potential pitfalls. We provide a brief review of the literature with few radiological teaching points and possible genetic implications of the case.
A rare case of pituitary metastasis from breast cancer detected on fluorodeoxyglucose positron emission tomography/computed tomography that presented as insipid diabetes
Authors: Sahel Omar , Benameur Yassir , Nabih Salah , Biyi Abdelhamid , Doudouh Abderrahim
Published: October 2020

Pituitary metastases are rare, are generally asymptomatic, and often remain undiagnosed. Breast cancer is the most common primary cancer metastasizing to hypophysis in women. However, it is difficult to clinically and radiologically differentiate pituitary metastases from pituitary adenomas. We report a case of pituitary metastases diagnosed on magnetic resonance imaging and positron emission tomography/computed tomography, which was the prime manifestation of a breast cancer in a 46-year-old female. This cancer was revealed by insipid diabetes.
Detection of Nocardia, Streptomyces and Rhodococcus from bronchoalveolar lavage specimens of patients with HIV by Multiplex PCR Assay
Authors: Ali Rahdar Hossein , Reza Salehi Mohammad , Bahador Abass , Jasemi Seyedesomaye , Karami-Zarandi Morteza , Hasan Nejad Malehe , Shahraki- Zahedani Hahram , Amani Jafar , Gizaw Feyisa Seifu , Kardan-Yamchi Jalil , Mehdi Feizabadi Mohammad
Published: October 2020

Background: Nocardia, Streptomyces and Rhodococcus are life threatening opportunistic pathogens under immunodeficiency conditions, particularly among patients infected with HIV. Rapid and accurate detection of these infections can improve immune health quality, patient management and appropriate treatment. The aim of this study was to design a novel multiplex-PCR assay for rapid diagnosis of these three organisms directly from bronchoalveolar lavage (BAL) specimens of patients infected with HIV.Methods: The genus specific primers were designed for directdetection of Nocardia, Streptomyces and Rhodococcus in a single tube multiplex PCR. This PCR specifically amplified the target genes from pure cultures. It subsequently was applied on BAL specimens of 29 HIV positive patients that had previously been culture negative for actinomycete bacteria, of which Nocardia, Streptomyces and Rhodococcus are members.Results: Of 29 respiratory clinical specimens, there were positive for Nocardia spp. and one was positive for Streptomyces spp using the multiplex PCR assay. The sequencing of the PCR products identified the species as Nocardia cyriacigeorgica (n=2), Nocardia farcinica and Streptomyces albus.Conclusion: This novel multiplex PCR assay yielded reliable results for accurate identification of Nocardia, Streptomyces and Rhodococcus from BAL while the results of bacterial culture were negative.
Using the Methodology of Systematic Review of Reviews for Evidence-Based Medicine
Authors: Hasanpoor Edris , Hallajzadeh Jamal , Siraneh Yibeltal , Hasanzadeh Ebrahim , Haghgoshayie Elaheh
Published: October 2020

Systematic Review of Reviews without abstract. Authors' invited you to read the whole review article since it is short.
Assessment of Patient Counseling on Dispensing of Medicines in Outpatient Pharmacy of Tikur-Anbessa Specialized Hospital, Ethiopia
Authors: Ali Sara , Shimels Tariku , Bilal And Arebu I.
Published: October 2020

Background: Patients’ care when dispensing of Medicines could be ensured through the delivery of drug information either orally or in written form. Pharmacists are expected to ascertain that patients or caregivers have gained clear and complete information. The objective of this study was to assess patient counseling during dispensing of medicines and associated factors in Tikur-Anbessa Specialized Hospital.Method: A cross sectional study was conducted to assess patients’ counseling and a convenient sampling technique was employed to select study participants. Data was collected using a structured questionnaire and observation checklist and, analyzed by using SPSS version 20. Descriptive statistics and odds ratio were used to present study results.Results: A total of 286 respondents were included in this study. Most (93.7%; 94.4%; 91%) of the respondents were told the drug unit dose, frequency of administration and duration of therapy respectively. Less than a third of the patients received information on drug-drug interactions, storage of medications and side -effects. None of the patients were told what to do on missed dose and, none were asked back to repeat their understanding. Three fourth of the patients reported that they were satisfied with the counseling services provided. Females were more likely to be satisfied than males whereas, level of education showed a negative association with pharmacist counseling services.Conclusion: Drug dose, frequency of administration and duration of therapy were the most frequently delivered information to patients. Gender and level of education have significant association with medication counseling service in the study setting.
Editorial message
Authors: Haileamlak Abraham
Published: October 2020

Editorial message
Factors Associated with Surgical Site Infection in Post-Cesarean Section: A Case-Control Study in a Peruvian Hospital
Authors: Kelly Yerba  , Virgilio Failoc-Rojas  , Sandra Zeña-Ñañez  , Mario Valladares- Garrido
Published: October 2020

BACKGROUND: Surgical site infection is the main cause of morbidity and mortality in post-cesarean section patients. The objective of this study was to determine the preoperative factors associated with the surgical site infection in patients undergoing cesarean emergency section in the Goyeneche Hospital of Arequipa.METHODS: We conducted a cases-control study on women who presented with surgical site infection after cesarean section in a hospital in Arequipa, Peru. We evaluated associated factors to surgical site infection after cesarean section (sociodemographics and clinical variables). For the inferential analysis, we estimated logistic regression using odds ratio.RESULTS: Out of a total of 4346 cesarean sections, only 2.4% developed surgical site infection. The associated factors to surgicalsite infection were mild anemia (OR: 2.80), moderate anemia (OR:2.71), number of vaginal examinations higher than five (OR:2.71) and onset of labor (OR: 1.95).CONCLUSION: Patients with risk factors such as anemia, onset of labor and five or more vaginal examinations should be evaluated after surgery to prevent surgical site infection.
Epidemiology, Diagnosis and Therapeutic Approaches of Cryptorchidism at the Panzi General Hospital, DR Congo: A 5-year Retrospective Study
Authors: Alumeti Munyali Désiré  , Cikwanine Buhendwa  , Tetsatsi Momo Aimé Césaire  , Kavira Ise Somo Prisca  , Luhiriri Ndanda Levi  , Nanga Batende David  , Ahuka Ona Longombe  , Watcho Pierre
Published: October 2020

BACKGROUND: Cryptorchidism is a common congenital malformation characterized by unilateral or bilateral undescended testis in the scrotum. It is a common disease in pediatric urology although the prevalence is yet to be determined in the East DR Congo. The aim of this study was to describe the prevalence, clinical and therapeutic features of cryptorchidism at the Panzi General Hospital.METHODS: Medical records of patients who underwent pediatric surgery between January 2011 and December 2016 were reviewed. The prevalence of cryptorchidism, associated malformations, sociodemographic features of patients and therapeutic protocols were examined. Collected data were analyzed using SPSS software.RESULTS: A total of 5066 children were received during the study period in the service, of which 76 suffered from cryptorchidism giving a prevalence of 1.50% and an annual incidence of 12.70. Unilateral cases were found in 53(69.74%) patients among which 66.04% and 33.96% had unilateral right and left cryptorchidism respectively. Cryptorchidism was associated with other malformations in 71.1% of patients. The age of patients ranged from 0 to 15 years and 78.9% were older than two years. Surgery was the only therapeutic approach and fixation of cryptorchid testis in dartos through inguinal incision was the preferred therapeutic used method.CONCLUSION: This study indicates that cryptorchidism is a relatively common and neglected disease in the Est-DR Congo, due to late consultation. Therefore, the local population and pediatricians should be sensitized on scrotal palpation techniques in order to shorten the consultation delay and prevent testis damages.
Willingness to Pay for Community-Based Healthcare Insurance Schemes in Developing Countries: A Case of Lahore, Pakistan
Authors: Akhtar Sana  , Fatima Rida  , Ishaq Tayyaba  , Mehmood Masooma  , Zulfqar Ayesha  , Akhtar Kalsoom
Published: October 2020

BACKGROUND: Healthcare costs and poverty are significant barriers to achieving universal access to healthcare. Thus, Community-Based Health Insurance Schemes (CBHIS) are regarded as an influential instrument for providing access to healthcare. For this purpose, this study was carried out in order to assess the community’s Willingness to Pay (WTP) for CBHIS and its determinants among the residents of Lahore City.METHODS: A cross-sectional study was adopted during the period of May 2018 to August 2018 to conduct a standardized questionnaire survey among targeted population of Lahore. A total of 250 households from lower, middle and upper-middle-class areas were approached randomly from which 200 participated in the survey, rendering a response rate of 90.9%. Sample size was determined by using single population proportion formula assuming 5% margin of error and 95% Confidence Interval (CI). Moreover, multiple regression analysis, Pearson’s correlation and t-test were employed to determine relationships between different variables affecting WTP.RESULTS: Sixty-four percent of the respondents were willing to pay for CBHIS. Among the remaining thirty-six% of unwilling the community, income level (p< 0.05, CI=0.34 to 1.11) and education level (p< 0.05, CI=0.52-1.37) were significant predictors of WTP. Moreover, strong positive relation (p<0.05) between people’s awareness and WTP for CBHIS was witnessed. The findings further suggested that the larger population of the willing community was not willing to pay more than 5000 Rs annually.CONCLUSION: Henceawareness level of the community regarding the benefits of CBHIS is a major hindrance. The key policy priority is to increase the community’s awareness regarding the benefits of CBHIS and to increase willingness to pay rate among public.
Prevalence and Associated Factors of Thyroid Incidentaloma among Adult People Attending Gondar University Hospital, Northwest Ethiopia Temesgen Tadesse1
Authors: Tadesse Temesgen , Hailu Tigist , Getachew Assefa , M Abebe Solomon
Published: October 2020

BACKGROUND: Incidentally discovered thyroid lesions have become highly common in the development and more frequent utilization of highly sensitive imaging modalities, like ultrasound. However, little is known about its prevalence and associated factors in Ethiopia. The aim of this study was to determine the prevalence of thyroid incidentalomas and associated factors through ultrasound (US) among adults attending Gondar University Hospital.METHODS: A hospital-based cross-sectional study was carried out on 290 adults aged 15 years and above. Out of the adults who visited the hospital during the study, those who neither had history of thyroid disease, thyroid surgery, nor clinically palpable thyroid nodules were involved in the investigation. The participants were examined using a high frequency linear-array transducer (7MHz). For comparing men and women, the unpaired t-test wasused. Binary logistic analysis was used to identify the associated factors, and a P-value < 0.05 was considered statistically significant.RESULT: The frequency of thyroid incidentaloma was found to be 33.4% (95% CI: 27.9, 38.9). Thyroid incidentaloma was detected in 42.4% of the females and 22.7% of the males (P<0.001). About 63% had single and 37% multiple thyroid nodules. About 25.8% had thyroid nodules greater than 1cm. In the multivariable logistic regression analysis, increasing age (AOR=5.96; 2.34, 15.15) and female sex (AOR=3.01; 1.73, 5.26) were significantly associated with thyroid incidentalomas.CONCLUSION: The frequency of thyroid incidentaloma (TI) was found to be high in this study and much higher among older women. Solitary and small sized thyroid nodules were commonly seen in the study.
Characterization of HIV-1 Integrase Gene and Resistance Associated Mutations Prior to Roll out of Integrase Inhibitors by Kenyan National HIV-Treatment Program in Kenya
Authors: Sepha Mabeya , Nyamache Anthony  , Ngugi Caroline  , Nyerere Andrew  , Lihana Raphael
Published: October 2020

BACKGROUND: Antiretroviral therapy containing an integrase strand transfer inhibitor plus two Nucleoside Reverse Transcriptase inhibitors has now been recommended for treatment of HIV-1-infected patients. This thus determined possible pre-existing integrase resistance associated mutations in the integrase gene prior to introduction of integrase inhibitors combination therapy in Kenya.METHODS: Drug experienced HIV patients were enrolled at Kisii Teaching and Referral in Kenya. Blood specimens from (33) patients were collected for direct sequencing of HIV-1 polintegrase genes. Drug resistance mutations were interpreted according to the Stanford algorithm and phylogenetically analysed using insilico tools.RESULTS: From pooled 188 Kenyan HIV integrase sequences that were analysed for drug resistance, no major mutations conferring resistance to integrase inhibitors were detected. However, polymorphic accessory mutations associated with reduced susceptibility of integrase inhibitors were observed in low frequency; M50I (12.2%), T97A (3.7%), S153YG, E92G (1.6%), G140S/A/C (1.1%) and E157Q (0.5%). Phylogenetic analysis (330 sequences revealed that HIV-1 subtype A1 accounted for majority of the infections, 26 (78.8%), followed by D, 5 (15.2%) and C, 2 (6%).CONCLUSION: The integrase inhibitors will be effective in Kenya where HIV-1 subtype A1 is still the most predominant. However, occurring polymorphisms may warrant further investigation among drug experienced individuals on dolutegravir combination or integrase inhibitor treatment.
HIV/AIDS Preventive Practice and Associated Factors among Female Sex Workers in Afar Region, Ethiopia: A Community Based Study
Authors: Abay Woday Tadesse  , Wossen Chernet  , Osman Ahmed  , Woldemichael Tadesse
Published: October 2020

BACKGROUND: Female Sex Workers (FSWs) are a high-risk population for Human Immune Virus (HIV) infection. However, HIV related services for sex workers are given little attention in developing nations like Ethiopia. Thus, this study attempted to assess HIV preventive practice and associated factors among FSWs in the Afar region.METHODS: Community-based cross-sectional study was conducted on 419 FSWs from April 1st to May 2nd in 2018 in four hotspot towns (i.e. Logia, Mille, Gedamayitu and Awash) found in Afar region. The study participants were selected using snowball sampling technique. The sociodemographic and behavioral data were collected using face-toface interview. Logistic regression analyses were done to determine factors associated with HIV prevention practices. The statistically significant level was declared at a P-value < 0.05.RESULTS: The HIV/AIDS preventive practice among FSWs was 61.1% [95% CI 56.2% - 65.9%]. The multivariable logistic regression analysis showed that being single [AOR=2.57: 95% CI 1.06, 6.21:P<0.05] and urban residence before being FSWs [AOR= 3.26: 95% CI 1.25, 8.54: P<0.05] were found to be enhancing factors of the preventive practice of HIV/AIDS. However, being illiterate [AOR=0.133: 95% CI 0.032, 0.557: P<0.01], young age [AOR=0.065: 95% CI 0.021, 0.196:P<0.001], being alcohol drinker [AOR= 0.104: 95% CI 0.026, 0.417: P<0.01], being cigarette smoker [AOR= 0.096: 95% CI 0.022, 0.414:P<0.01] and lack of aware of HIV transmission [AOR= 0.08: 95% CI0.03, 0.22: P<0.001] were the hindering factors of the preventive practice of HIV among FSWs.CONCLUSION: The HIV/AIDS preventive practice among FSWs in Afar region hotspot towns (61.1%) is still very low compared to the country progress report on HIV response for FSWs (98%). The regional health bureau should design inclusive strategies to improve the HIV preventive practice among FSWs. These includes regular HIV testing campaigns, sustainable condom distribution in the hotspot towns. The region should encourage NGOs to work on inclusive HIV prevention upon FSWs. Female sex workers should be aware of the risky behaviors that lead to HIV. Additional qualitative methods are also recommended.
Disparities in Maternal Healthcare Services
Authors: Abraham Haileamlak
Published: October 2020

Editorial message
Work-related Stress and Associated Factors among Academic Staffs at the University of Gondar, Northwest Ethiopia: An Institutionbased Cross-sectional Study
Authors: Gebisa Guyasa Kabito  , Sintayehu Daba Wami  , Daniel Haile Chercos  , Tesfaye Hambisa Mekonnen
Published: October 2020

BACKGROUND: Work-related stress is described as a physiological and psychological reaction to the harmful aspects of workplace content. Current evidence indicates that the world of education is a highly stressful occupation. However, in academicians in sub-Saharan African countries, such as Ethiopia,the prevalence and contributing factors are not well studied. This study was, therefore, aimed at filling this gap.METHODS: A cross-sectional study was conducted from March to April 2018. Stratified sampling technique was used to select 535 study participants. To measure work-related stress, we used the pre-tested and structured self-administered University and College Union stress questionnaire. Finally, a significant association was established at p< 0.05 and adjusted odds ratio (AOR) with 95% confidence intervals (CI) in the multivariable model.RESULTS: The overall prevalence of work-related stress in 12 months was 60.4% [95% CI (57.4, 63.5%)].The multivariable logistic regression analysis showed that smoking cigarette (AOR:2.84, 95% CI (1.25, 6.50), high job demand (AOR: 3.27, 95% CI(2.05, 5.21), low job control (AOR:2.25, 95% CI (1.21, 4.20) and age < 28 (AOR:0.25, 95% CI (0.10, 0.63) were the factors associated with work-related stress.CONCLUSION: The prevalence of work-related stress was high. Furthermore, higher emphasis required on job demand, job control, and cigarette smoking to ease the burden of work-related stress factors. This research, therefore, recommended that other causes of WRS, such as working conditions and further large-scale study, be considered for future research.
Potentials of Actinomycetes from Reserved Environments as Antibacterial Agents Against Drug-Resistant Clinical Bacterial Strains
Authors: AHMED Risikat Nike  , DANIEL Folake  , GBALA Ifeoluwa Deborah  , SANNI Alhassan
Published: October 2020

BACKGROUND: Increased antibiotic resistant properties of pathogens has led to a pronounced search for new effective antibiotics from microbes in diverse ecological niches. This study focused on isolating actinomycetes from soil of reserved areas and profiling them for antibacterial potentials.METHODS: The isolates (IS-2, IS-4, IS-6, IS-10, IS-14) were assessed for antagonistic activity against ten multi-drug resistant bacterial strains (Gram positive and negative) by cross streak and well diffusion methods.RESULTS: During the primary screening, four of the isolates showed good antagonistic activity against the test strains. Notably, all the bacterial strains except Pseudomonas aeruginosa responded sensitively to at least one of the actinomycetes screened. The crude extracts of the secondary metabolites of the four actinomycetes (IS-2, IS-4, IS-6, IS-10) with considerably significant antagonistic activities inhibited the growth of all the bacterial strains efficiently. All the test bacterial strains were sensitive to at least one of the extracts at a concentration of 100μg/ml. The minimum inhibitory concentration of the extracts against the isolates ranged from 12.5 - 25μg/ml. The crude extracts of IS-4 and IS-6 identified as Streptomyces glauciniger NBRC 100913 and Streptomyces griseoplanus NRRL-ISP 5009 by I6s rRNA sequencing, showed higher antibacterial activities against the bacterial strains. Significantly, the ethyl acetate crude extract of the actinomycetes demonstrated better antibacterial activities than the standard antibiotics (ofloxacin, amoxicillin/clavulanate, cefuroxime and ceftriaxone).CONCLUSION: This study reports remarkable anti-MRSA activities as well as broad spectrum antibacterial potentials of extracts of Streptomyces spp. worthy of further exploration.
Variation of Pediatric Doses Undergoing Digital and Computed Radiography Examination in Addis Ababa, Ethiopia
Authors: Seife Teferi  , Daniel Zewdeneh
Published: October 2020

BACKGROUND: Various researchers who carried out national and international surveys have reported wide variations in patient dose arising from specific X-ray examinations. Thus, assessment of radiation dose is an essential part in the optimization process. The aim of this study was to compare the entrance surface doses delivered to pediatric patients undergoing digital and computed radiography X-ray examination.MATERIAL AND METHODS: A cross-sectional study was conducted on 389 pediatric X-ray projections less than 15 years of age on eight X-ray machines in Addis Ababa in February 2009 E.C. The tube output of the X-ray machines in air was measured using RaySafe XI dosimeters. Then, entrance surface dose was estimated for common x-ray examinations like chest, skull, extremities and pelvis using established relation between X-ray tube output and radiographic parameters. These data were analyzed statistically using computer (Excel and SPSS method).RESULT: The third quartile estimated ESDs in mGy for both computed and digital radiography examinations of chest (AP) for age (0-1 year) were 0.24 and 0.15, (1-5 year) 0.3and 0.16. For the age group (5-10 year), it was 1.97 and 0.26 and for the(10-15 year)group, 0.56 and 0.18 respectively.These values were higher than those of the United Nations Scientific Committee’s on the Effects of Atomic Radiation’s established dose reference levels(in mGy for age (0-1 year) 0.02, (1-5 year) 0.03, (5-10 year) 0.04, and (10-15 year) 0.05 respectively).CONCLUSION: The wider dose variation between computed and digital radiography shows that there is a pressing need to minimize the detriment caused by unnecessary computed radiography.
Giant Pituitary Adenoma Presenting with Foster-Kennedy Syndrome in a 21-Year Old Ethiopian Patient: A Rarely Reported Phenomenon: A Case Report
Authors: Biniyam Ayele  , Abenet Mengesha  , Abdi Wotiye  , Yodit Alemayehu
Published: October 2020

BACKGROUND: Disorders of the pituitary gland and the sellar region present a wide spectrum of clinical problems. A variety of lesions in this area tend to present with similar problems; namely, headache, hormonal disorders, and loss of vision. Benign adenomas of the pituitary gland are by far the most common disorders of sellar region. Rarely, patients with pituitary adenoma may present with blindness in one eye and visual field cut (temporal hemianopia) in the contralateral eye. This rare clinical entity is called Foster-Kennedy Syndrome (FKS).CASE PRESENTATION: We present a 21-year-old male patient, presented with progressive visual disturbance of the left eye, associated with global headache. The headache was refractory to over-counter medications. In addition, he had history of sleep disturbance and loss of appetite. Neurological examination was pertinent for left side visual loss with optic atrophy and right eye temporal visual field cut with disc edema. Brain MRI showed 4 cm X 3.5 cm sized lobulated intra and supra sellar mass with heterogeneous contrast enhancement and minimal surrounding edema. Serum prolactin level was 6,705 ng/mL. Otherwise, the other pituitary hormones were in normal range.CONCLUSION: This case highlighted that pituitary adenoma may present with the full picture of Foster Kennedy syndrome. Therefore, we recommend considering pituitary adenoma as a possible differential diagnosis of intracranial lesions presenting as Foster Kennedy syndrome, as early detection and management could potentially salvage patients’ vision and quality of life.
COVID-19, a Disease of Enigma: Why Pregnant Women are Less Vulnerable?
Authors: Yifru Berhan
Published: October 2020

Editorial messages
Will Africa be Devastated by Covid-19 as Many Predicted? Perspective and Prospective
Authors: Yifru Berhan
Published: October 2020

Viewpont on COVID-19.
Magnitude and Pattern of Inpatient Surgical Mortality in a Tertiary Hospital in Addis Ababa, Ethiopia
Authors: Firaol Dandena  , Belayneh Leulseged  , Yisihak Suga  , Berhanetsehay Teklewold
Published: October 2020

BACKGROUND: Inpatient mortality is among regularly collected data in Key performance indicators in the Ethiopian healthcare system, and it is generally reported to the Federal Ministry of Health and is used as one of inpatient services quality indicators. This study was undertaken to identify the magnitude, causes and pattern of mortalities among patients who are admitted and treated in surgical wards in Saint Paul Hospital Millennium Medical College for a period of three years.METHODS: A retrospective review was done on all patients admitted and died in the Department of Surgery in St. Paul's Hospital Millennium Medical College from January 1, 2016–Dec 30, 2018.RESULT: There were 10,259 admissions over three years and out of which there were 350 deaths between 2016-2018 making a crudemortality rate of 3.41 %. The commonest mode of admission was for emergency conditions, 195(62.7%). Out of emergency admissions, 139 mortalities were from general emergency surgery and 75 patients died from elective general surgery admissions. Eighty-four (26.9%) patients had comorbidity and the commonest comorbidity was anemia 21(25%). The commonest possible cause of death was multi-organ failure secondary to septic shock, 159(51%). Mortality rate patterns along the three years (2016, 2017, 2018) showed 3.34% (112/3360), 2.87% (102/3552) and 2.92% (98/3347) respectively.CONCLUSION: The mortality rate of this study is much higher than global rates, but still there is a significant difference from other developing countries and also other researches in this country. Pattern of mortality did not show any difference across years of the study period.
Modern Contraception: Uptake and Correlates among Women of Reproductive Age-Group in a Rural Community of Osun State, Nigeria
Authors: Ajibola Idowu  , Grace Chinyere Ukandu  , Jeremiah Mattu  , Damilola Olawuyi  , Adeola Abiodun  , Phillip Adegboye  , Chiamaka Chibu-Jonah  , Anita Eseogene Siakpere  , Esther Ishola  , Titilola Adeyeye  , Samuel Alabi
Published: October 2020

BACKGROUND: Universal contraceptive access is one of the key strategies for achieving sustainable developments in any country. Yet, uptake has remained low in most developing nations like Nigeria. The reasons for low use must be contextually understood to aid effective contraceptive programming. This study assessed contraceptive use and its determinants among reproductive aged women in Ejigbo, Osun State, Nigeria.METHOD: A quantitative study involving 405 participants which were recruited using multi-stage sampling method was carried out. Data were collected using pretested semi-structured, intervieweradministered questionnaire. Chi-Square test and binary logistic regression analysis were used for inferential statistics.RESULTS: The mean age of the respondents was 28±6. The majority (92.8%) of the respondents were aware of family planning, 68.9% of them possessed good knowledge but only 53% of them demonstrated favorable contraceptive attitude. Less than half (33.0%) of those who had heard about contraception were current users of modern methods. Injectables (45.0%) and male condoms (30.0%) were the most prevalent contraceptive methods among the respondents. The main determinants of contraceptive uptake were respondents’ educational status (AOR=0.525, 95%CI=0.284-0.972), contraceptive knowledge (OR=0.512, 95%CI=1.242-1.968) and attitude (OR=0.512, 95%CI=1.242- 1.968). Fear of perceived side effects (45.2%), low pregnancy risk perception (35.7%) and spousal refusal (12.5%) were the main reasons for non-contraceptive use among non-users.CONCLUSION: Contraceptive demand in the study population was low in spite of high awareness level. There is a need to increase contraceptive literacy in the study population and make the services more acceptable to rural dwellers so as to meet the SDG-3 target in Nigeria.
Assessment of Level of Patient Satisfaction after Prostatectomy for Benign Prostatic Hyperplasia in Referral Hospitals in Addis Ababa.
Authors: Andualem Deneke  , Mezgeb Gedefe
Published: October 2020

BACKGROUND: Benign Prostatic hyperplasia is a very common problem in aging men. TURP comprises 95% of all surgical procedures and is the treatment of choice for prostates sized between 30ml and 80 –100ml. Open surgery is the treatment of choice for large glands (bigger than 80–100ml) and for those with associated complications that have indication for open surgery. Many literatures show that the overall patient satisfaction rate and clinical outcome of TURP for BPH are very good. The objective of this study was ‘assessing the level of patient satisfaction after undergoing TURP and TVP for BPH.METHODS: In this research, convenient sampling technique was used. The study design was prospective cohort study. Standardized questioner was prepared in English and later translated into Amharic. Information about demographic characteristics, preoperative data, intraoperative data, and immediate postoperative data were taken while the patient was in the hospital. At the first and the third months after the prostatectomy, patients were inquired on their level of satisfaction about their disease specific satisfaction on the urinary function and their sexual function. We used HCAHPS Measure of Patient Satisfaction Tool, to collect data and analyzed using SPSS version 18.RESULTS: A total of 89 patients were enrolled in the study among which 65.2% had undergone TURP. The rate of major perioperative complication was found to be low. Over half of the patients had postoperative hospital stay of three or less days. Majority of the patients were satisfied with the care given by the nurses (68.2%) and doctors (84.3%) with relatively higher physicians’ care satisfactionlevel. More than 60% of the patients were highly satisfied with their urinary surgical outcome. With regard to hospital environment,around 60% of the patients reported that they were very satisfied with cleanliness of the rooms, bath rooms and the quietness of the rooms at night.CONCLUSIONS: Both TURP and TVP have high level of patient satisfaction associated with low perioperative major complications. Therefore both can be recommended for patients with clear indications for prostatectomy.
Pattern and Outcomes of Injuries among Trauma Patients in Gedeo Zone, Dilla, South Ethiopia: A 5 Years Retrospective Analysis
Authors: Bedru Jemal Abafita  , Semagn Mekonnen Abate  , Hilemariam Mulugeta Kasim  , Bivash Basu
Published: October 2020

BACKGROUND: Injury has become a life threatening community health problem associated with significant mortality and morbidity worldwide. The aim of this study was to assess the burden of injury in Dilla University Hospital.METHODS: Institution-based retrospective cross-sectional study was conducted from January 2015 to June 2019. Data was collected using questionnaire adapted from WHO injury surveillance guideline. Bivariate and multivariate logistic regressions were performed to determine the factors associated with hospital mortality.RESULTS: Road traffic accident was the commonest cause of injury 178(47.3%) followed by interpersonal violence 113(30.1%). Revised trauma score (RTS) < 10 (AOR=2.5; 95% CI, 1.8-25.6), Glasgow coma scale (GCS) (AOR =0.3; 95% CI, 0.13-0.5), length of hospitalization (LOS) 1-7 days (AOR=0.1; 95% CI, 0.01-0.8) and time of arrival >24hr were predictors of mortality in a patient with injury.CONCLUSION: Lower extremity injury was common and mostly associated with RTA. Pre-hospital emergency medical service system and trauma registry need to be established to decrease the burden of injury.