bluuebunny/crossref_metadata_2025 huggingface dataset:
Low psoas muscle index is a poor prognostic factor for lower gastrointestinal perforation: a single-center retrospective cohort study
Authors: Kayano Hajime , Nomura Eiji , Abe Rin , Ueda Yasuhiko , Machida Takashi , Fujita Chikara , Uchiyama Shohei , Endo Kazuyuki , Murakami Katsuki , Mukai Masaya , Makuuchi Hiroyasu
Published: August 2019

Background Various body composition indices have been reported as prognostic factors for different cancers. However, whether body composition affects prognosis after lower gastrointestinal tract perforation requiring emergency surgery and multidisciplinary treatment has not been clarified. This study examined whether body composition evaluations that can be measured easily and quickly from computed tomography (CT) are useful for predicting prognosis. Methods Subjects comprised 64 patients diagnosed with perforation at final diagnosis after emergency surgery for a preoperative diagnosis of lower gastrointestinal tract perforation and penetration. They were divided into a survival group and a non-survival (in-hospital mortality) group and compared. Body composition indices (psoas muscle index (PMI); psoas muscle attenuation (PMA); subcutaneous adipose tissue index (SATI); visceral adipose tissue index (VATI); visceral-to-subcutaneous fat area ratio (VSR)) were measured from preoperative CT. Cross-sectional psoas muscle area at the level of the 3rd lumbar vertebra was quantified. Optimal cut-off values were calculated using receiver operating characteristic curve analysis. Poor prognostic factors were investigated from multivariate logistic regression analyses that included patient factors, perioperative factors, intraoperative factors, and body composition indices as explanatory variables. Results The cause of perforation was malignant disease in 12 cases (18.7%), and benign disease in 52 cases (81.2%). The most common cause was diverticulum of the large intestine. Emergency surgery for the 64 patients led to survival in 52 patients and death in 12 patients. On multivariate logistic regression analysis, independent predictors of poor prognosis were Sequential Organ Failure Assessment score (odds ratio 1.908; 95% confidence interval (CI) 1.235–3.681; P =0.0020) and PMI (odds ratio 13.478; 95%CI 1.342–332.690; P =0.0252). The cut-off PMI was 4.75 cm 2 /m 2 for males and 2.89 cm 2 /m 2 for females. Among survivors, duration of hospitalization was significantly longer in the low PMI group (29 days) than in the high PMI group (22 days, p=0.0257). Conclusions PMI is easily determined from CT and allows rapid evaluation of prognosis following lower gastrointestinal perforation.
Factors associated with permanent hypothyroidism in infants with congenital hypothyroidism
Authors: Park Eun Sil , Yoon Ju Young
Published: August 2019

Background Congenital hypothyroidism (CH) is one of the most common endocrine diseases in childhood. A significant proportion of CH cases are transient, but the risk factors for permanent CH (PCH) are not yet well established. The current guidelines suggest using levothyroxine until the age of 3 years, but some studies suggest the possibility of earlier discontinuation. However, few, if any, studies have followed up on the results of early discontinuation. This study aimed to identify predictive factors of transient CH among infants with CH. We also investigated the results in patients who underwent a trial of early discontinuation. Methods We gathered data regarding infants with CH born between July 2005 and July 2014 by retrospective chart review. Among them, early discontinuation subgroup was defined as those who discontinued levothyroxine before 30 months of age. Results From the 80 infants (40 males, 40 females) enrolled in this study, 51 were preterm. Nine (11.3%) were diagnosed with PCH. Compared with transient cases, those with PCH were on higher levothyroxine dose at discontinuation (4.3 vs 2.9 µg/kg, P < 0.001). There was no difference in the proportion of permanent cases between preterm and full-term groups. In preterm group,infants with PCH required higher levothyroxine dose at discontinuation than those with transient CH(3.8 vs 2.5 µg/kg, P = 0.018). Levothyroxine discontinuation at a dose of 2.86 µg/kg could suggest PCH (sensitivity, 88.9%; specificity, 71.0%). Among the 9 patients who underwent a trial of early discontinuation, 8 successfully discontinued levothyroxine. Conclusion The majority of CH patients discontinued levothyroxine successfully, including those who underwent a trial of early discontinuation. Higher levothyroxine dose at the time of discontinuation was found to be a predictive factor for PCH.
The disease stage-associated imbalance of Th1/Th2 and Th17/Treg in uterine cervical cancer patients and their recovery with the reduction of tumor burden
Authors: Lin Wei , Zhang Hua-ling , Niu Zhao-yuan , Wang Zhen , Kong Yan , Yang Xing-sheng , Yuan Fang
Published: August 2019

Background

Nearly all uterine cervical cancer (UCC) cases result from human papillomavirus (HPV) infection. After high-risk HPV infection, most HPV infections are naturally cleared by humoral and cell-mediated immune responses. Thus, cervical lesions of only few patients progress into cervical cancer via cervical intraepithelial neoplasia (CIN) and lead to persistent oncogenic HPV infection. This suggests that immunoregulation plays an instrumental role in the carcinogenesis. However, there was a rare study on the relation between the immunologic dissonance and clinical characteristics of UCC patients.Method

We examined the related immune cells (Th1, Th2, Th17, and Treg cells) by flow cytometric analysis and analyzed their relations with UCC stages, tumor size, differentiation, histology type, lymph node metastases, and vasoinvasion. Next, we quantified the Th1, Th2, Th17, and Treg cells before and after the operation both in UCC and CIN patients.Results

When compared with stage I patients, decreased levels of circulating Th1 cells and elevated levels of Th2, Th17, and Treg cells were detected in stage II patients. In addition, the imbalance of Th1/Th2 and Th17/Treg cells was related to the tumor size, lymph node metastases, and vasoinvasion. We found that immunological cell levels normalized after the operations. In general, immunological cell levels in CIN patients normalized sooner than in UCC patients.Conclusions

Our findings suggested that peripheral immunological cell levels reflect the patient’s condition.
How do urban slum women manage excessive vaginal discharge? A community based cross sectional study
Authors: Ilankoon IMPS , Goonewardena CSE , Fernandopulle RC , Perera PPR
Published: August 2019

Background:
Early detection of gnaecological morbidities is an important factor in treating and managing the underline disease. Abnormal vaginal discharge, which is a recurring problem for most of the women at reproductive age is a good predictor for many gynaeclogical morbidities. Many women constantly neglect abnormal vaginal discharge because of the prevailing “culture of silence”. Women who live in urban slum are vulnerable for many unhealthy practices and lifestyles and having a high prevalence of reproductive tract infection especially sexually transmitted infections. Hence, this study was aimed to describe urban slum women’ understanding, attitudes and related practices for abnormal vaginal discharge.
Methods: This community based cross sectional study was conducted among 550 women living in urban slum in the Colombo Municipal Council area, Colombo District, Sri Lanka during September- March 2016. A multistage cluster sampling technique was used. A validated, pretested Interviewer Administered Questionnaire was used to collect information from females. Data were analysed using descriptive and relevant inferential statistics (Chi square test and one-way analysis of variance (ANOVA).
Results: The majority of women (89.5%) was unemployed and were married (92%). The mean age of the women was 32.51 (SD±7.94) years. Mean knowledge score was 29.18 (SD± 8.68). Most of the women (97.1%) had inadequate level of knowledge (<50%). A significant association was observed between the knowledge score levels with the participants’ educational level (p=0.00). Major areas of knowledge deficit include causes for pathological vaginal discharge and reproductive tract infections. Majority (95.9%) agreed that abnormal vaginal discharge should be taken seriously but from the women who accepted (78.2%) that vaginal discharge has ever been a concern to them, only 59% had consulted a general practitioner. There was a significant relationship with having accompanying symptoms such as burning sensation and lower abdominal pain and consulting a general practitioner (p<0.05).
Conclusion: The findings of the study imply the importance of health education to improve the health seeking behaviours. The culture specific health education intervention measures need to be targeted in order to improve their knowledge, attitudes and practices towards vaginal discharge as well as disease prevention and health promotion.
Predictors Of Time To Obstetric Fistula Repair; A Case Study Of Fistula Survivors In Kitovu Mission Hospital (Masaka), Uganda
Authors: Bomboka John Bosco , Nakilembe Jennifer
Published: August 2019

Background: Obstetrical fistula (OF) is a public health challenge that is among the previously neglected components of maternal health in the developing world. The condition, which in the recent past has increasingly drawn more attention from the public, has a devastating impact on the health and wellbeing of both women and girls worldwide. The most common cause of obstetric fistula in developing countries is prolonged obstructed labor affecting approximately 2 million women and girls across Africa and Asia.
The objective of this study was to examine the predictors of time to obstetric fistula repair among women who successfully received fistula treatment in Kitovu Mission Hospital.
Methods: Hospital records of 149 obstetric fistula survivors from Kitovu Mission Hospital which is located in Masaka district were analysed.
Results: Out of 149 participants, 68(45.6%) women were aged 18-24 years and only 28(18.8%) had attained education beyond primary school level. About 72(48.3%) of the survivors received fistula treatment within the first three years of its occurrence. There was a significant relationship among married women (RR = 0.28, p = 0.044), women below 18 years of age (RR = 0.16, p = 0.038), and primiparous mothers (RR = 13.58, p = 0.013) observed at a time to surgery of above 7 years relative to a time to surgery of less than 4 years.
Conclusion: In addition to advocacy for a national or community-based health insurance schemes to reduce of the cost for health care, there is need to incorporate campaigns against GBV and increase community sensitization on the importance of ANC among other public health issues on top of fistula.
Vitamin D3 reduced helicobacter pylori infection of gastric cells by strengthening liver lipid metabolism, blocking gastric JAK-STAT3 and NF-ĸB signalling pathways and inhibiting gastric mucosal inflammation
Authors: Xu Wenjiao , Kang Min , Zhong Xiaolin , lü Muhan , Shi Lei , Li Ping Chang
Published: August 2019

Background:
Helicobacter pylori (Hp) is a unipolar, multi-flagellate, spiral,Gram-negative bacterium that is the only stomach bacterium found in humans.Hp is the leading cause of digestive tract disease and can cause stomach diseases, such as chronic gastritis, peptic ulcer, gastric cancer and gastric mucosa-associated lymphoma. Clinical studies have shown that Hp infection rates are significantly higher in patients with hyperlipidaemia than they are in non-hyperlipidaemic patients. In addition,many studies have shown that the serum vitamin D3 levelsare reduced in patients with obesity and hyperlipidaemia.Lower serum vitamin D3 levels diminish the role of fat cells in storing fat;as a result,fat is released into the bloodstream,leading to elevated blood lipid levels.However, a specificmechanism has not been proposed to explain how VD3 can reduce HP
infection in patients with hyperlipidaemia by lowering blood lipids.
Methods
real-time PCR was used to detect the expression of gastrin in VDR, insign-2 and gastric tissues of mice in each group. The expression of jak, stat 3, cox2 and lkba protein in gastric tissue of mice was detected by western blotting. We also detected the expression of IL-6 and IL-8 in the gastric tissue of mice by Elisa method. The liver tissues of each group were stained with HE to observe the balloon-like changes of liver tissue, and the gastric tissues of mice in each group were stained by HE. The degree of gastritis in each group of mice.

Conclusions
In this article, we conducted animal experiments using VD3 as an intervention in hp-infected mice and then examined molecular changes in the VDR/Insig-2/SREBP-2 pathways in the mouse liver, the serum cholesterol levels, and the JAK-STAT3 and NF-ĸB pathways.Vitamin D3 further reduced the gastric mucosa cholesterol level,destroyed lipid rafts,and reduced assembly of IL-6 receptor subunits by lowering the circulating cholesterol levels, thereby blocking the JAK-STAT3 signalling pathway. Infection of the gastric mucosa by CagA-positive Helicobacter pylori reduced gastrin secretion and inhibited COX2 expression. Moreover, NF-κB activation and inflammatory cytokine expression were inhibited by blocking the JAK-STAT3 signalling pathway. Furthermore, the degree of infection of the gastric mucosal tissue was reduced.
Development of an interactive, web-based shared care plan to facilitate the follow-up care of colorectal cancer patients
Authors: Taggart Jane , Chin Melvin , Liauw Winston , Lewis John , Dolezal Alex , Plahn John , Harris Mark Fort
Published: August 2019

Introduction
A shared model of care between cancer services and primary health care is safe and acceptable and can address the increasing demands on cancer services for long term follow-up. This paper describes the challenges developing an interactive shared care plan for colorectal cancer follow-up care.

Methods
A systematic literature review identified the use, functionality, and impact of web-based shared care plans to support cancer follow-up. Workshops with key stakeholders and consultations with clinicians, consumers and information service providers were conducted to agree on a model of care and technology options to interactively share a care plan.

Results
Seventeen papers reported five web-based shared care plan systems for cancer follow-up. These systems supported the creation and/or access to view or share the care plans using email or by downloading and printing a copy.
The challenges we found included issues with the security, privacy and sharing of patient information between public health services and primary health care and poor integration of clinical information systems. We selected a primary care practitioners’ care planning system as it was interactive, integrated with primary care practitioner’ clinical information systems, was relatively inexpensive and addressed the sharing of clinical information with external clinicians to the public health system.

Conclusion
Primary care shared care planning systems seem a suitable option for sharing clinical information between a cancer service and primary care practitioners. We plan to evaluate the feasibility and acceptability of this interactive shared care plan to support shared cancer follow-up care.
Prevalence and factors associated with frailty in hospitalized older Patients
Authors: HAMMAMI sonia , Zarrouk Amira , Piron Cecile , Almas Ioana , Sakly Nabil , Latteur Veronique
Published: August 2019

Background

Frailty is a multidimensional syndrome that leads to an increase of an age-related disorder of several physiological systems, and cognitive abilities decline. The aim of this study was to evaluate the prevalence of frailty among older persons in Belgium and we examined the factors associated with frailty with a principal focus en cognitive, dietary status, and inflammatory parameters

Methods

A total of 124 participants (90 women, 34 men; age: mean ± SD: 85.9 ± 5.5 years) were studied, recruited from the Geriatrics department, Belgium. Nutritional, cognitive status and physical activity were assessed using MNA, MMSE, and Katz score, respectively. Frailty syndrome was evaluated using SEGA score. Medication and medical history were recorded. Analyzed biochemical parameters included C-reactive protein (CRP), complete blood count, blood creatinine, vitamin D level, and serum protein electrophoresis. According to SEGA score, participants were divided into non-frail (n=19), frail (n=25) and severely frail patients (n= 80).

Results

The SEGA score was inversely correlated with MMSE, MNA and Katz score. SEGA score was negatively correlated to albumin levels (r=-0.30; p<0.001) and positively correlated to CRP, polypharmacy and age. Logistic regression showed a strong association between frailty, Katz score, dementia, polypharmacy and living in nursing home.

Conclusion

Our results provide useful information for understanding mechanisms of frailty. This will help to develop preventive strategies for the elderly at the pre-frailty stage.
H19/miR-194/E2F3 regulating loop promotes gastric cancer growth and metastasis
Authors: Qin Wanxiang , Shi Ying , Zhu Dan , Chen Yaohua , Li Yuping , Cui Jian
Published: August 2019

Background: Gastric cancer (GC) is one of the most frequent malignant digestive tumors, and second fatal cancer. This study was to investigate whether lncRNA-H19 can regulate E2F3 expression through competitive binding to microRNA-194 (miR-194), thus regulating GC growth and metastasis. Methods: H19, miR-194 and E2F3 expression levels in GC tissues and cell lines were investigated using quantitative reverse transcriptase-polymerase chain reaction (QRT-PCR). Meanwhile, the mRNA levels of H19 and E2F3 in gastric cancer tissues were also analyzed though the GEPIA web tool. The binding condition of miR-194 with H19 and E2F3 were investigated using a dual-luciferase reporter gene assay. The regulatory effects of H19 on proliferative, migratory and invasive abilities of AGS cells and SGC-7901 cells were detected by transwell assay and cell counting kit-8 (CCK-8). The regulatory interaction between H19 and miR-194, miR-194 and E2F3 were investigated using rescue experiments. Results: The results revealed that H19 was highly expressed in GC tissues and cell lines than those of controls. Downregulated H19 decreased the proliferation, migration and invasion of AGS cells and SGC-7901 cells. H19 was demonstrated that being the molecular sponge of miR-194 in regulating the growth of the GC cells. The level of E2F3 expression was also found significantly higher in GC tissues and cell lines than those of controls. And then, the mimics of miR-194 inhibited the expression of E2F3 in the GC cells. CCK-8 assay showed decreased proliferative ability induced by miR-194 mimics were reversed by E2F3 overexpression. Transwell assays showed decreased migratory and invasive ability induced by miR-194 mimics were reversed by E2F3 overexpression. Conclusions: This study demonstrates that H19 promotes GC growth and metastasis by regulating E2F3 via competitive binding to miRNA-194.
Chinese Classical Prescription(Liang-Xue-Di-Huang Decoction)for Hemorrhoidal Disease: study protocol for a randomized controlled trial
Authors: Zhou Qing , Shi Shuo-yang , He Zong-qi , Xu Cheng-biao , Geng Ji , Chen Tuo , Shen Zhao-feng , Zhang Dan , Jiang Feng , Chen Yu-Gen , Wu Ben-sheng
Published: August 2019

Abstract

Background: Hemorrhoidal disease (HD) is one of the commonest proctologic condition in the general population. Medical therapy for HD has not been formally confirmed due to the inconsistent of results. Liang-Xue-Di-Huang Decoction, a kind of ancient Chinese classical prescription, has been used to treat HD from the 19th century in China. However, clinical research of Liang-Xue-Di-Huang Decoction in the treatment of HD is lack. We designed this study to evaluate the efficacy and safety of Liang-Xue-Di-Huang Decoction in the treatment of HD.

Methods/Design: A randomized, controlled, double blind, double-mimetic agent and multicenter trial to evaluate the efficacy and safety of Liang-Xue-Di-Huang Decoction is proposed. HD patients (stage I, Ⅱ, Ⅲ) will be randomly assigned into Liang-Xue-Di-Huang Decoction with the addition of Diosmine mimetic agent group and Diosmine with the addition of Liang-Xue-Di-Huang Decoction mimetic agent group. Patients will receive a 7-day treatments and a 7-day follow-up. The primary outcome measure is the French Bleeding Score in 7 and 14 days. The Secondary outcome measures are Goligher Prolapse Score and Quality-of-Life Score in 7 and 14 days.

Discussion: This study will provide objective evidence to evaluate the efficacy and safety of Liang-Xue-Di-Huang Decoction in treatment of HD.

Trial registration: Chinese Clinical Trial Registry. ChiCTR-1900022531.Registered 15 Apr 2019, http://www.chictr.org.cn/listbycreater.aspx.
Community Based Essential Newborn Care Practices and Associated Factors among Women Who Gave Birth at Home in Last Twelve Months in Amaro Woreda, Southern Ethiopia, 2019
Authors: Agonafir Mamush , Shimbre Mulugeta Shegaze , Hussen Sultan , Temesgen Gebremaryam , Girmay Goytom , Tsegaye Behailu , Gebretsadik Woiynshet , Boda Belay , Fikadu Teshale
Published: August 2019

Introduction:- Significant numbers of women are giving birth at home; in this case community based newborn care is a means of bringing life-saving care to mothers and newborns at the community level. However, practice is challenging within the Ethiopian health system.

Objective:- The aim of this study was to assess prevalence of community based newborn care practices and its associated factors among women who gave birth at home in Amaro Woreda, southern Ethiopia, 2019.

Methods:- Across-sectional study was conducted on 490 women in the reproductive age groups of 15-49 in Amaro district and by using simple random sampling technique individual was recruited. Data collected through face-to-face interview at household level. EpiData version 3.1 statistical software was used for entry and SPSS version 20 for was used for data cleaning, management and analysis. Bi-variate and multivariate logistic regression analysis employed for analysis of factors associated with Community based newborn care practices.

Results:- A total 490 of study participants were included in the analysis and only 29% practiced community based essential newborn care. Educational status of father [AOR=2.28; 95%CI:1.07-4.84] & mother [AOR=0.35; 95%CI: 0.16-0.75], last delivery assisted by relative/friends [AOR=3.58; 95%CI: 1.66-7.73], having awareness about Community based newborn care [AOR=3.49; 95%CI: 2.11-5.77], awareness about newborn danger sign [AOR=2.18; 95%CI: 1.29-3.68] and having birth preparedness and complication readiness plan [AOR=3.52; 95%CI: 1.97-6.29] were an identified independent factors associated with Community based newborn care Practice.

Conclusion and recommendation:- Around three-fourth (71%) of mothers were not practicing Community based newborn care. Educational status of family, awareness about community based newborn care and newborn danger sign, last delivery assisted by relative or friends at home, and having birth preparedness and complication readiness plan were identified as independent factors for community based newborn care practice. Promotion of information at community level, women empowerment and health extension program strengthening are recommending.
Full Prevalence Of Gestational Diabetes In Urban Women In Blantyre, Malawi: A Cross Sectional Study And Comparison Of Who And IADPSG Criteria
Authors: Phiri Tamara Joy , Kasiya Marianne , Allain Theresa J
Published: August 2019

Aims This study aimed to establish the prevalence of gestational diabetes mellitus (GDM) among urban women in Blantyre where the prevalence was previously unknown. A comparison was made between the prevalence determined using WHO criteria and that using the recent International Association of Diabetes in Pregnancy Study Group (IADPSG) criteria. Methods 2274 consecutive women presenting to five antenatal clinic sites in Blantyre had a screening random blood glucose (RBG). Of these, a subsample of 250 women were randomly selected for an oral glucose tolerance test (OGTT). Logistic regression was used to quantify the association between various exposure variables and prevalence of diabetes. Results Mean age was 25 years (range 14 – 43 years), 66% were in the third trimester. Mean RBG was 5.1mmol/L (range 2.4 - 10.6). Overall prevalence of GDM was 1.6% and 24% using the WHO and IADPSG criteria respectively. GDM was associated with older maternal age, high parity and attendance at government antenatal clinics but not with MUAC, BMI, positive family history of diabetes or previous poor neonatal outcome. There was no correlation between random blood glucose and gestational diabetes diagnosed on the oral glucose tolerance test. Conclusions The prevalence of GDM in Blantyre using WHO criteria was low in the predominantly young population that was screened. A much higher proportion had GDM based on the IADPSG criteria and these may warrant long term follow up. GDM was not associated with some previously described risk factors for GDM suggesting a different risk factor profile compared to high income countries.
First referral to an Integrated Onco-Palliative Care program: a retrospective analysis of its timing
Authors: Barth Claire , Colombet Isabelle , Montheil Vincent , Huillard Olivier , Boudou-Rouquette Pascaline , Tlemsani Camille , Alexandre Jérôme , Goldwasser François , Vinant Pascale
Published: August 2019

Background

Palliative care (PC) referral is recommended early in the course of advanced cancer. This study aims to describe, in an integrated onco-palliative care program (IOPC), patient’s profile when first referred to this program, timing of this referral and its impact on end-of-life care.

Patients and Methods

The IOPC combined the weekly onco-palliative meeting (OPM) dedicated to patients for whom goals and organization of care need to be discussed, and/or the clinical evaluation by the PC team. We analyzed all patients first referred at OPM in 2011-2013. We defined the index of precocity (IP), as the ratio of the time from first referral to death by the time from diagnosis of incurability to death, ranging from 0 (late referral) to 1 (early referral).

Results

Of the 416 patients included, 57% presented with lung, urothelial cancers, or sarcoma. At first referral to IOPC, 76% were receiving antitumoral treatment, 63% were outpatients, 56% had a PS ≤2 and 46% had a serum albumin level >35g/l. The median [1st-3rd quartile] IP was 0.39 [0.16-0.72], ranging between 0.53 [0.20-0.79] (earliest, for lung cancer) to 0.16 [0.07-0.56] (latest, for prostate cancer). Among 367 decedents, 42 (13%) received antitumoral treatment within 14 days before death, and 157 (43%) died in PC units.

Conclusions

The IOPC is an effective organization to enable early integration of PC and decrease aggressiveness of care near the end-of life. The IP is a useful tool to model the trajectory of care while taking into account each cancer types and therapeutic advances.
Global, regional, and national prevalence of diabetes mellitus in patients with pulmonary tuberculosis: a systematic review and meta-analysis
Authors: Li Minmin , Chen Tao , Hua Zhongqiu , Zhu Ni , Wang Duolao , Li Jiamin , Li Zhaoqing , Kang yijun , Li Chao , Yan Hong
Published: August 2019

Background. The concept that people with pulmonary tuberculosis are at risk of developing diabetes mellitus has been raised. However, the prevalence of diabetes mellitus in patients with pulmonary tuberculosis have not been well established. We aim to estimate the global, regional, and national prevalence of diabetes mellitus in population with pulmonary tuberculosis.
Methods. In this systematic review and meta-analysis, we assessed observational studies of diabetes mellitus in people with pulmonary tuberculosis, using PubMed and Embase electronic bibliographic databases in English language, to identify articles published until August 31, 2018. We included original research studies published in a peer-reviewed journal and reported the prevalence of diabetes mellitus or had enough data to compute these estimates. Studies were excluded if they did not provide primary data or were case studies and reviews. Independent extraction of articles and collected detailed information by 2 authors using predefined questionnaire, including study quality indicators. The country-specific random-effects meta-analyses for countries with two or more available studies and a fractional response regression model to predict individual studies prevalence of diabetes mellitus in patients with pulmonary tuberculosis for countries with one or no study. The study is registered with PROSPERO, registration number CRD42018101989.
Results. We identified 18042 studies, and 127 were retained for data extraction across 46 countries. The global prevalence of diabetes mellitus in patients with pulmonary tuberculosis were estimated to be 12.07% (95%CI: 10.43-14.85). The prevalence of diabetes mellitus in patients with pulmonary tuberculosis was 13.38% (95%CI: 11.16-16.05) in region of Americas, 13.34% (95%CI: 12.82-14.61) in European region, 12.68% (95%CI: 9.15-16.37) in South-East Asia, 12.56% (95%CI: 11.79-22.70) in Western Pacific region, 10.95% (95%CI: 9.04-17.83) in Eastern Mediterranean region and 7.54% (95%CI: 6.51-8.77)in African region. The country with the highest estimated prevalence of pulmonary tuberculosis combined diabetes mellitus were Mauritius (39.65%, 95%CI: 4.22-90.74).
Conclusion. Our findings suggest that pulmonary tuberculosis combined diabetes mellitus is still prevalent. As such, diabetes mellitus deserves more attention from PTB health-care providers, researchers, policy makers, and stakeholders for improved detection, overall proper management, and efficient control of diabetes mellitus in people with pulmonary tuberculosis.
Contraceptive use and preference of HIV infected pregnant women living with HIV-negative partners in the central region of Cameroon: a cross sectional survey
Authors: Kuete Martin , Ngueye Hilary Christiane Sipeuwou , Wang Sean Zhe , Yuan HongFang , Ma XiuLan , Mandengue Christine , Ndaya Berthine Marie Miste , Nyangono Yannick Zomnyate , Zangue Carrel Raspail Founou , Xiong ChengLiang , Zhang HuiPing
Published: August 2019

Background

Evidences in sub-Saharan Africa including Cameroon indicate that most of HIV discordant couples want more children despite their HIV status. Investigate and establish contraception preferences among HIV infected individuals are fundamental and crucial to provide effective reproductive healthcare.Methods

We performed a cross-sectional study using structured questionnaire to explore HIV-positive pregnant women patterns including their family planning services, their preferences and its use, and their knowledge related to HIV/AIDS. Bivariate and multivariate analyses were conducted to explore associations and predictors of contraception preference and use; all tests were two sided significant at P < 0.05.Results

Overall, 94 HIV-positive pregnant women aged 30.70±5.50 years living with HIV-negative partners were from the different areas of the central region of Cameroon. Three-fourths were aware of the effectiveness of modern contraceptives and condoms, and only 28% had experienced modern contraption. 98% preferred to use traditional methods associated with infrequent condoms use. Multiple sociodemographic factors (marital status, group age, educational level, religion, occupation) affected contraceptive method preferences and its use ( P <0.05). These factors are the landmarks to predict discordant couples’ behavior in HIV disclosure, discussion and decision making for contraception, preventing mother to-child transmission and HIV-negative partner infection ( P <0.05).Conclusion

Despite the awareness of participants related both on contraception methods and HIV/AIDS matters, participants faced societal, cultural and demographic barriers to make own decision for contraception use. Promoting effective family planning services and given the entire range of contraception options may help women living with HIV to choose for effective ones and consequently reduce newly HIV infections.
Amount of maternal factor within the male pronucleus affects the reprogramming and developmental efficiency of androgenetic embryos
Authors: Liao Chen , Shen Xinghui , Zhang Yuwei , Lei Lei
Published: August 2019

Background

Uniparental embryos have uniparental genomes and are very useful models for studying parental specific gene expression or for exploring the biological significance of genomic imprinting in mammals. However, the early developmental efficiency of androgenetic embryos is significantly lower than that of parthenogenetic embryos. In addition, oocytes are able to reprogram the nuclei of sperm after fertilization to guarantee embryonic development by maternal derived reprogramming factors, which accumulate during oogenesis. However, importance of maternal materials in the efficiency of reprogramming the pronucleus of androgenetic embryos has not been ascertained.Results

Androgenetic embryos were constructed artificially by pronucleus transfer (PT) or double sperm injection (DS) in our experiments. Compared with the androgenetic embryos constructed artificially by DS, those constructed by PT, which derived from two zygotes, contained more maternal material (like Tet3 and H3.3). This study confirmed the better developmental potential of PT embryos, with higher blastocyst rates, the stronger expression of pluripotent genes, the lower expression of apoptotic genes, and superior blastocyst quality.Conclusions

The aggregation of more maternal materials in the paternal pronucleus facilitated the reprogramming of the paternal genome, improving embryonic development in pronucleus transfer androgenesis.
Virtual System can be considered interchangeable with shuttle run in healthy children: a cross-sectional study
Authors: moran cristiane , CORSO SIMONE DAL , BOMBIG MARIA TERESA , SERRA ANDREY JORGE , PEREIRA SILVANA ALVES , PECCIN MARIA STELLA
Published: August 2019

Background

Previous studies have evaluated the physiological responses to video game in children with different clinical conditions, however, although no study has compared video game active with an incremental field test in healthy children. The purpose of this study was to compare the maximum heart rate (HRmax) of children, their perceived exertion and motivation during the shuttle run test (SRT) and the Virtual Systems (VS) test, an interactive video game.Methods

This is a cross-sectional study of 235 children (9.0 ± 0.8 years, 109 boys). The two tests were performed one week apart and the children were instructed not to engage in any physical exercise or sports in the 24 hours preceding each test. Their heart rate was monitored at rest for one minute and then throughout the tests. To evaluate the influence of motivation on test execution (SRT and VS), at the end of the tests the children were asked to rate their motivation based on a scale from zero to 10, zero being “not cool” and 10 “awesome”. Perceived exertion at the end of the tests was assessed using the modified Borg scale.Results

HRmax did not differ between the SRT and VS (194.4 ± 10.2 bpm vs. 193.2 ± 13.8 bpm, respectively). Both tests were similar in intensity > and < 96% HRmax. The children showed greater exertion on the Borg scale and motivation during the VS. The multiple logistic regression model showed that motivation (p=0.98), sex (p=0.53), age (p=0.61), nutritional status (p=0.65), and speed (p=0.18) were not predictive factors of whether the child would reach HRmax.Conclusion

The VS can be used as a tool to evaluate the intensity of maximal exercise tests given that the percentage of children who achieved HRmax did not differ between the VS and SRT. The perceived exertion scales were correlated, but only the modified Borg scale correlated with HRmax in the SRT. The tests are motivational, and most children obtained the maximum score in the VS
Process Evaluation of Implementation Fidelity of the Integrated Chronic Disease Management Model in two districts, South Africa
Authors: Lebina Limakatso , Alaba Olufunke , Ringane Ashley , Hlongwane Khuthadzo , Pule Pogiso , Oni Tolu , Kawonga Mary
Published: August 2019

Background

The Integrated Chronic Disease Management (ICDM) model has been implemented in South Africa to enhance efficiency and quality of clinical services in Primary Healthcare (PHC) clinics in a context of a high prevalence of chronic conditions and multi-morbidity. This study aimed to assess implementation fidelity (adherence to guidelines) of the ICDM model.Methods

A cross-sectional study in sixteen PHC clinics in two health districts in South Africa: Dr Kenneth Kaunda (DKK) and West Rand (WR). A fidelity assessment tool with 89 activities and a total maximum score of 158, was developed from the four interrelated ICDM model components: facility re-organization, clinical supportive management, assisted self-management and strengthening of support systems. Value stream mapping of patient flow was used to analyze waiting time and identify areas of inefficiencies. ICDM items were scored based on structured observations, records reviews and interviews with healthcare workers. Fidelity scores were summarized using medians and proportions and compared by facilities and districts using Chi-Square and Kruskal Wallis test.Results

The monthly patient headcount over a six-months in these 16 PHC clinics was a median of 2430 (IQR: 1685-2942) individuals over 20 years. DKK district had more newly diagnosed TB patients per month [median 5.5 (IQR: 4.00-9.33) vs 2.0 (IQR: 1.67-2.92)], and fewer medical officers per clinic [median 1 (IQR: 1-1) vs 3.5 (IQR:2-4.5)] compared to WR district. The median fidelity scores in both districts for facility re-organization, clinical supportive management, assisted self-management and strengthening of support systems were 78% [29/37, IQR: 27-31)]; 77% [30/39 (IQR: 27-34)]; 77% [30/39 (IQR: 28-34)]; and 80% [35/44 (IQR: 30-37)], respectively. The overall median implementation fidelity of the ICDM model was 79% (125/158, IQR: 117-132); WR was 80% (126/158, IQR: 123-132) while DKK was 74% (117/158, IQR: 106-130), p=0.1409. The lowest clinic fidelity score was 66% (104/158) while the highest was 86% (136/158). Patient flow analysis showed long (2-5 hours) waiting times and one stream of care for acute and chronic services.Conclusion

There was some variability of scores on components of the ICDM model by PHC clinics. More research is needed on contextual adaptations of the model.
Investigation on the satisfaction degree of scientific research environment of leprosy prevention and control personnel in China
Authors: Zhou Guojiang , Li Chengyue , Wang Jingquan , Zhang Guocheng , Sun Hong , Law Chi Kin
Published: August 2019

Summary Objective: To understand the situation of scientific research environment of leprosy prevention and control personnel in China, and to provide policy basis for improving its scientific research conditions, improving the scientific research ability of leprosy prevention and control, and then improving the prevention and treatment level of leprosy. Methods Through multi-stage stratified random sampling, 95 organizations and 351 leprosy prevention and control personnel were recruited. by using homemade organization interview questionnaire and scientific research environment satisfaction questionnaire. Results The overall satisfaction of the scientific research environment of leprosy prevention and control personnel in china was low (14.6%). Single factor analysis shows that the satisfaction of leprosy epidemic areas category IIwith the use of scientific research funds and the difficulty of applying for the research projects is high;and the satisfaction of scientific research at the county level and below institutions is higher than that of provincial and ministerial institutions;and the standard of scientific research award of the skin disease hospitals (Institutes) is higher than that of the CDCs. The respondents considered that the main problems at present were poor scientific research conditions, lack of scientific research and academic atmosphere, and respondents generally agreed that the construction of scientific research infrastructure was the prioritize issue that needed to be solved urgently at present. Conclusion The satisfaction of the current research environment of leprosy prevention and treatment personnel in China is not high. The construction of scientific research infrastructure and scientific research technology platform, as well as the introduction, training and reform of compensation system of leprosy prevention and treatment talents, need to be improved.
Regulation of access to hospital beds in emergency care and the development of integrated health services
Authors: Konder Mariana , O'Dwyer Gisele
Published: August 2019

Background: Comprehensive health care delivery is a major challenge for the Brazilian Unified Health System. Inadequate coordination among different health care levels and facilities produces poor access to health care and low degree of integration across levels of care, that is worse in emergency care delivery. Health policy has focused on health care networks development and regulation of access to health care provision. In the city of Rio de Janeiro, local health policy has prioritized the development of an Emergency Care Network. This research aimed at assessing the access to hospital beds and diagnostic resources, fundamental to continuity of care this network.
Methods: Triangulation technique was employed, collecting of data from different sources and analysis resorting to multiple methods. Analysis of data from primary and secondary databases was performed. Interviews were conducted with managers and healthcare professionals involved in guaranteeing continuity of care in Emergency Care Network. Data analysis resorted to descriptive statistics and the interviews along with the data were interpreted under the conceptual framework of Integrated Health Care.
Results: Poor access to hospital beds constituted a major obstacle to improvements in continuity of care for patients in Emergency Care Network. An insufficient number of hospital beds is the primary issue. Other aspects of hospital care contribute to aggravate this deficiency: the predominance of general hospitals, the existence of small and underequipped hospitals, prolonged lengths of stay and significant discrepancies of bed occupancy rates among specialized and general hospitals. Hospitals further face disrupted internal workflows due to inadequacy and limited availability of human and physical resources. Moreover, weak cooperation between federal, state and local government leads to persistence of a fragmented network with little or absent interaction among health care facilities and professionals from different government spheres.
Conclusion: To reach a better degree of integration among health services in the city of Rio de Janeiro investments in hospital capacity and quality are needed in order to meet health care necessities. Besides, federal, state and local government need to find common ground concerning each ones’ duties in health care delivery to achieve better results in providing comprehensive health care.
Mothers satisfaction on delivery service and associated factors among mothers who gave birth at Gondar University specialized and teaching hospital, Northwest Ethiopia 2018.
Authors: Agimas Yohannes Tibebu , Boke Moges Muluneh , Abebe Solomone Mokennen
Published: August 2019

Abstract
Background: Assessing maternal satisfaction level on maternal health care services is agreeable proxy to improve the quality of health care service, maternal health service utilization and providing client centered care. Therefore, the aim of this study was to assess the mothers’ satisfaction level and associated factors on delivery care of Gondar specialized teaching hospital, Northwest Ethiopia.
Methods: A Hospital based cross-sectional study with an exit interview was conducted in Gondar university referral hospital, from November 1 to 31 2018. Total of Four hundred seventy-one postpartum mothers were participated in the study. Systematic random sampling method was employed to recruit study participants. The collected data was checked visually for incompleteness and entered to Epi-info version 7 statistical software and exported to SPSS version 20 software to descriptive, bi-variable and multivariable logistic analysis. Finally, the result was presented in tables and graphs.
Results: The magnitude of mothers’ satisfaction on delivery service was 21.2%, with 95% Cl (17.6, 25.1). In multivariable logistic analysis, Residence being Urban with odd ratio 0.34 (AOR=0.34; 95% CI 0.17, 0.68), Spontaneous vaginal delivery with odd ratio 0.28 [AOR=0.28; 95%; Cl (0.14, 0.57] and Child birth space interval of 12-24 months with odd ratio 0.22 [AOR=0.22; 95%; Cl (0.08,0.55)] were inversely associated with mothers’ satisfaction. while, short waiting time to see health care providers with odd ratio 9.69 [AOR=9.69; 95% Cl: (3.16,29.76)] was positively associated with mothers’ satisfaction on childbirth care services.
Conclusion and Recommendation: The overall satisfaction of mothers on facility based child birth care is low when compared with other studies. Urban dwellers, mode of delivery and short child birth space interval and short waiting time to see health care providers were significantly associated with mother’s satisfaction level of facility delivery care services. Therefore, to elating the faced maternal health care services quality difficulty, the policymakers and quality improvement program designers need to give attention on activities that change wrong perceptions of mothers on mode of delivery and intervention that ensure normal healthy child birth space time interval.
Strategic Environment Assessment of Catchment Water Management: A Comparative Analysis of the Adequacy of SEA Reports using Case Studies from Uganda, Tanzania, South Africa, Ireland and Vietnam
Authors: Kahangirwe Pius
Published: August 2019

This paper reflects on the adequacy of strategic environmental assessment (SEA) reports based on a comparative analysis of SEA reports from five country contexts randomly selected. It briefly examines the role of SEA in basin or catchment planning and management. An overview on institutional and organizational context of SEA in Uganda is discussed. Although, SEA has been described as being a tool to improve strategic decision-making by integrating environmental issues into plans, policies and programmes, there is a growing concern on the adequacy of the SEA reports being prepared and how these reports come about. To be able to determine the adequacy of these SEA reports, the analysis focused on the stages of SEA that guide the SEA process. The results of the study show some examples of effective SEA practice, but still some of the case studies never dug deep but rather scratched the surface in terms of SEA process effectiveness. Based on key findings of the study, some recommendations for improving SEA practice for catchment planning are provided. SEA reports should be presenting key issues, providing clear proposals and conclusive results to facilitate the integration of SEA findings in decision-making. As that’s what SEA is about.