bluuebunny/crossref_metadata_2025_split huggingface dataset:
HIV-exposed infant follow-up in Mozambique: Formative research findings for the design of a cluster randomized controlled trial to improve testing and ART initiation
Authors: Vieira Lúcia Da Costa , Mahumane Arlete Miloque , Napua Manuel , Chale Falume Azamo , Manuel João , Cowan Jessica , Sherr Kenneth , Chapman Rachel , Pfeiffer James 
Published: October 2019

Abstract
Background HIV-exposed infant diagnosis (EID) and initiation of HIV-positive infants on anti-retroviral therapy (ART) requires a well-coordinated cascade of care. Loss-to-follow-up (LTFU) can occur at multiple steps and effective EID is impeded by human resource constraints, difficulty with patient tracking, and long waiting periods. The objective of this research was to conduct formative research to guide the development of an intervention to improve the pediatric HIV care cascade in central Mozambique. The study was conducted in Manica and Sofala Provinces where the adult HIV burden is higher than the national average. The research focused on 3 large clinics in each province, along the highly populated Beira corridor.Methods The research was initiated in 2014 over 3 months at six facilities and consisted of 1) patient flow mapping and collection of health systems data from postpartum, child-at-risk, and ART service registries, 2) measurement of patient waiting times, and 3) patient and health worker focus groups.Results HIV testing and ART initiation coverage for mothers tends to be high, but EID and pediatric ART initiation are hampered by lack of patient tracking, long waiting times, and inadequate counseling to navigate the care cascade. About 76% of HIV+ infants were LTFU and did not initiate ART.Conclusions Effective interventions to reduce LTFU in EID and improve pediatric ART initiation should focus on patient tracking, active follow-up of defaulting patients, reduction in waiting times for PCR results, and initiation of ART by nurses in child-at-risk services.
Decomposing the educational inequalities in the risk factors of severe acute malnutrition among under-five children in low and middle-income countries
Authors: Fagbamigbe Adeniyi Francis , Kandala Ngianga- Bakwin , Uthman Olalekan 
Published: October 2019

Abstract
Background Low- and Middle-income countries (LMIC) are still plagued with the burden of severe acute malnutrition (SAM). While studies have identified factors that influence SAM, efforts have not been made to decompose the educational inequalities across the individual, neighbourhood and national levels in LMIC. This study aims to decompose educational-related inequalities in the prevalence of SAM across LMIC.Methods We pooled successive secondary data from the Demographic and Health Survey (DHS) conducted between 2010 and 2018 in 51 LMIC. We analysed data of 532,680 under-five children nested within 55,823 neighbourhoods. Severe acute malnutrition was the outcome variable while the literacy status of mothers (literate vs illiterate) was the main exposure variable. The explanatory variables cut across the individual-, household and neighbourhood-level factors of the mothers-children pair. Oaxaca-Blinder decomposition method was used to analyse the educational gap in the factors associated with SAM.Results Mothers with no formal education ranged from 0.1% in Armenia and Kyrgyz to as much as 86.1% in Niger. The overall prevalence of SAM in the group of children whose mothers had no education was 5.8% compared with 4.2% among those whose mothers were educated. Thirteen countries had statistically significant pro-illiterate inequality (i.e. SAM concentrated among uneducated mothers) while none of the countries showed statistically significant pro-literate inequality. There were variations in the important factors responsible for the educational inequalities across the countries. On average, neighbourhood socioeconomic status disadvantage, location of residence were the most important factors in most countries. Other contributors to the explanation of educational inequalities are birth weight, maternal age and toilet type.Conclusions We identified that SAM is prevalent in most LMIC with wide educational inequalities. The occurrence of SAM was explained by the individual, household and community-level factor. A potential strategy to reduce the burden of SAM to reduce educational inequalities among mothers in the low- and middle-income countries through the promotion of women education.
Anthropometrical measurements and maternal visceral fat during first half of pregnancy: a cross-sectional survey
Authors: Kretzer Daniela Cortez , Matos Salete , Von Diemen Lisia , Magalhães José Antônio de Azevedo , Rocha Alexandre da Silva , Bernardi Juliana Rombaldi 
Published: October 2019

Abstract
Background Prenatal care is fundamental for achieving good results in the outcome of pregnancy, however, the coverage in Brazil is still low. In the impossibility of pre-gestational weight measure and subsequent body mass index (BMI) values, the others anthropometric measurements are useful and may be ideal for measuring the nutritional status of pregnant women, especially in low- and middle-income countries. The aim of this study was to assess the anthropometrical measurements during pregnancy and compared it to maternal ultrasound visceral adipose tissue.Methods A cross-sectional study was conducted with pregnant women from the city of Porto Alegre (city), capital of Rio Grande do Sul (state), southern Brazil, from October 2016 until January 2018. Anthropometrical variables (weight, height, mid-upper arm circumference (MUAC), circumferences of calf and neck and triceps skin folds – TSF and subscapular skin folds – SBSF), and ultrasound variables (visceral adipose tissue – VAT and total adipose tissue – TAT) were collected. To verify the correlation of anthropometric and ultrasound measurements, non-adjusted and adjusted Spearman correlation was used. The study was approved by the ethics committees.Results Among the 149 pregnant women, 54.8% (n=80) were white race. The age median was 25 years [21 - 31], pre-pregnancy BMI was 26.22kg/m 2 [22.16 – 31.21] and gestational age was 16.2 weeks [13.05 – 18.10]. The best measurements correlated with VAT and TAT were MUAC and SBSF, being anthropometric measurements with a higher correlation than pre-pregnancy BMI.Conclusion It is possible to provide a practical and reliable estimate of VAT and TAT from anthropometric evaluation (MUAC or SBSF) that is low cost, efficient and replicable in outpatient clinic environment, especially in low- and middle-income countries.
Prioritising pathogens for the management of severe febrile patients to improve clinical care in low- and middle-income countries
Authors: Osborn Jennifer , Roberts Teri , Guillen Ethan , Bernal Oscar , Roddy Paul , Ongarello Stefano , Sprecher Armand , Page Anne-Laure , Ribeiro Isabela , Piriou Erwan , Tamrat Abiy , Tour Roberto de la , Rao V. Bhargavi , Flevaud Laurence , Jensen Tomas , McIver Lachlan , Kelly Cassandra , Dittrich Sabine 
Published: October 2019

Abstract
Background: Severe febrile illness without a known source (SFWS) is a challenge for clinicians when deciding how to manage a patient, particularly given the wide spectrum of potential aetiologies that contribute to fever. These infections are difficult to distinguish clinically, and accurate diagnosis requires a plethora of diagnostics including blood cultures, imaging techniques, molecular or serological tests, and more. When laboratory services are available, a limited test menu hinders clinical decision-making and antimicrobial stewardship, leading to empiric treatment and suboptimal patient outcomes. To specifically address SFWS, this work aimed to identify priority pathogens for a globally applicable panel for fever causing pathogens. Method: A pragmatic two-pronged approach combining currently available scientific data in an analytical hierarchy process and systematically gathered expert input, was designed to address the lack of comprehensive global aetiology data. The expert re-ranked list was then further adapted for a specific use case to focus on community acquired infections in whole blood specimens. The resulting list was further analysed to address different geographical regions (Asia, Africa, and Latin America), and Cohen kappa scores of agreement were calculated. Results: The expert ranked prioritized pathogen list generated as part of this two-pronged approach included typhoidal Salmonella , Plasmodium species and Mycobacterium tuberculosis as the top 3 pathogens. This pathogen list was then further adapted for the SFWS use case to develop a final pathogen list to inform product development. Subsequent analysis comparing the relevance of the SFWS pathogen list to multiple populations and geographical regions showed that the SFWS prioritized list had considerable utility across Africa and Asia, but less so for Latin America. In addition, the list showed high levels of agreement across different patient sub-populations, but lower relevance for neonates and symptomatic HIV patients. Conclusion: This work highlighted once again the challenges of prioritising in global health, but it also shows that taking a two-pronged approach, including the actionability, can result in a broadly applicable priority list. This broad utility is particularly important in the context of product development, where a sufficient market size is essential to achieve a sustainable commercialized diagnostic product to address SFWS.
Application of the adenosine triphosphate sensitivity assay in infantile vascular anomalies
Authors: Li Li , Yang Bin , Wei Li , Zhang Bin , Han Xiao-feng , Xu Zi-gang , Ma Lin 
Published: October 2019

Abstract
BACKGROUND: The term vascular anomalies include various vascular tumors and vascular malformations, among them infantile hemangiomas and capillary malformations are the most well-known associated diseases in early ages. Multiple drugs have been introduced for intervention, but susceptibility test in vitro were scarcely reported.OBJECTIVE: To evaluate the inhibition effect of adenosine triphosphate sensitivity assay in vitro before the treatment of infantile hemangiomas and capillary malformations. METHODS: Specimens were selected from 5 cases of infantile hemangiomas and 11 cases of capillary malformations. Propranolol, rapamycin, sildenafil and itraconazole were tested for their growth inhibition effect by using the adenosine triphosphate sensitivity assay. RESULTS: Propranolol demonstrated inhibitory effects on infantile hemangiomas cells. Rapamycin and itraconazole both showed inhibitory effects on infantile hemangiomas cells and capillary malformations cells. Sildenafil has no growth inhibitory effect on infantile hemangiomas cells or capillary malformations cells. CONCLUSION: Adenosine triphosphate sensitivity assay is a sensitive and useful testing method before the management of vascular anomalies, and individualized medication suggestions for the choice of therapeutic drugs were offered based on the testing result and together with a comprehensive evaluation of each infant.
Treatment of Distal Clavicle Fractures using a Scorpion Plate and Influence of Timing on Surgical Outcomes: A Retrospective Cohort Study of 105 Cases
Authors: Furuhata Ryogo , Takahashi Masaaki , Hayashi Teppei , Inagawa Miyu , Kono Aki , Matsumura Noboru , Kiyota Yasuhiro , Kamata Yusaku , Yoshiyama Akira , Arino Hiroshi , Morioka Hideo 
Published: October 2019

Abstract
Background Plate fixation is the established method of treating unstable distal clavicle fractures. However, the appropriate timing of surgery for acute distal clavicle fractures remains unclear. The present study aimed to evaluate the clinical outcomes of osteosynthesis using a Scorpion plate and to assess the influence of surgery timing on the surgical outcomes for acute unstable distal clavicle fractures. Methods We retrospectively reviewed 105 patients who underwent fixation for acute unstable distal clavicle fractures (Neer type II and V) using the Scorpion plate between 2008 and 2018. Patients were divided into early (45 patients) and delayed (60 patients) treatment groups based on the timing of the surgical intervention (within or after seven days). The outcomes were postoperative complications (delayed union, peri-implant fracture, plate loosening, plate-related pain, and stiffness). We evaluated the outcomes from X-ray radiographs and clinical notes.Results Among the 105 patients, delayed union, plate loosening, plate-related pain, and stiffness were observed in six patients (5.7%), four patients (3.8%), seven patients (6.7%), and one (1.0%) patient, respectively. The delayed union rate was significantly higher in the delayed treatment group than that in the early treatment group (P=0.036). Although the difference was not significant, plate loosening and stiffness were only observed in the delayed treatment group. Conclusion Our results demonstrated that osteosynthesis using Scorpion plates achieved satisfactory surgical outcomes for unstable distal clavicle fractures . In addition, this study suggested that performing surgery within six days after injury is recommended to reduce postoperative complications .
Using Intervention Mapping to Develop a Motivational Interviewing Training and Support Program for HIV Lay Counsellors to Improve ART Uptake in The Primary Health Care Setting in Gauteng, South Africa
Authors: Mokhele Idah , Sineke Tembeka , Vuyovic Marnie Vuyovic , Fox Matthew A , Ruiter Robert AC , Onoya Dorina 
Published: October 2019

Abstract
Background Worldwide, countries are striving to achieve universal antiretroviral treatment (ART) coverage. In South Africa, given the shortage of specialist health care professionals in the public sector, lay HIV counsellors are at the forefront of many HIV related behavioural interventions. They have limited formal counselling training and little ongoing in-service support, leading to considerable variability in skills, knowledge, and approaches to counselling. We aimed to use the Intervention Mapping approach to develop a motivational interviewing counselling training and support program for lay HIV counsellors practising in primary health care (PHC) clinics in Gauteng, South Africa. Methods We applied the steps of Intervention Mapping. This included the analysis of key informant data collected among clinic managers and counsellors (target group), in-depth literature reviews on determinants of critical elements of target behaviours and approaches for influencing these. Extensive consultations with an expert team led to two program objectives: 1) improved general HIV counselling skills among lay HIV counsellors; and 2) sustained motivational interviewing skills for ART and HIV care demand creation. Matrices of change objectives were produced specifying performance and change objectives as well as evidence and theory-based training methods to achieve these. Result We developed a motivational interviewing counselling training and support program titled “Thusa-Thuso - helping you help”. For objective one, we partnered with a seasoned psychologist and counselling trainers to recap and strengthen essential counselling skills and resilience. For objective two, we adapted the Boston University Brief Negotiated Interviewing motivational interviewing counselling training. Adaptations include adjusting the English readability level of training materials; translating materials to spoken Zulu and Sotho; anchoring the training around interactive sessions; producing contextually-relevant modelling videos, in-training role plays and on-site (clinic) mentoring using the Motivational Interviewing Treatment Integrity coding system (MITI) as a training and self-correction tool. The planned support component comprises of quarterly support and mentoring sessions over 12-months. Conclusion The “Thusa-Thuso” motivational interviewing counselling training and support program is a contextually relevant, locally-produced, scalable training and support program designed to impart sustained motivational interviewing counselling skills in lay HIV counsellors for improved ART uptake in the UTT era.
Evaluation of water shortage crisis in the Middle East and possible remedies
Authors: Bozorg-Haddad Omid , Zolghadr-Asli Babak , Sarzaeim Parisa , Aboutalebi Mahyar , Chu Xuefeng , Loáiciga Hugo A. 
Published: October 2019

AbstractWater resources in the Middle East region are becoming scarce, while millions of people already do not have access to adequate water for drinking and sanitary purposes. Water resources depletion has become a significant problem in this region that is likely to worsen. Current research by remote sensing analysis indicates a descending trend of water storage in the Middle East region, where agriculture plays a crucial role in socio-economic life. This study introduces an approach quantifying water depletion in the Middle Eastern countries, which are being challenged in the management of their water resources. Furthermore, this paper presents results of a survey assessing the status of water use and supply in Middle Eastern countries and outlines some potential remedies. Specifically, Iran's water use is evaluated and compared with its neighbors'. The water equivalent anomaly (WEA) and total water storage (TWS) depletion are two indexes of water scarcity calculated for Middle Eastern countries surveyed herein. Our analysis reveals that Lebanon, Syria, Iraq, and Iran are countries with very negative water scarcity indexes. These estimates prove that international cooperation is needed to manage available regional water resources and reverse depletion of natural water sources. It is demonstrated herein that virtual water trade can help remediate regional water shortage in Middle Eastern countries.
Spatial conservation areas for water yield hydrological ecosystem services with their economic values effects under climate change: a case study of Teshio watershed located in northernmost of Japan
Authors: Fan Min , Mawuko Daniel Ocloo , Shibata Hideaki , Ou Wei 
Published: October 2019

Abstract
Water resources prioritization conservation planners are increasingly becoming aware of the economic value of water supply ecosystem services (ESs) under climate changes. Here we assessed how the water yield ES framework is implemented in the current spatial prioritization conservation of the water resources under climate change across the Teshio River watershed. We applied the systematic conservation model to optimize the area for water resources which satisfied the protection targets with and without considering economic values of the water yield provision service. The model indicated that the areas of spatial optimal ES protection for water yield with considering economic values were totally different from those without considering economic values of water resources. The optimal priority conservation areas were concentrated in southwestern, southeastern, and some northern areas of this watershed. These places could guarantee water resources sustainability from both environmental protection and socio-economic development standpoints. Moreover, the spatial priority conservation areas for water yield with economic value from hydro-power electricity production were traded off against the areas for water yield with economic values from resident water-use and irrigation for rice. Therefore, the systematic conservation planning of water yield with economic values under climate changes may provide a useful argument to promote the conservation of water resources.
Integrated model projections of climate change impacts on water-level dynamics in the large Poyang Lake (China)
Authors: Li Yunliang , Zhang Qi , Tao Hui , Yao Jing 
Published: October 2019

Abstract
This study outlines a framework for examining potential impacts of future climate change in Poyang Lake water levels using linked models. The catchment hydrological model (WATLAC) was used to simulate river runoffs from a baseline period (1986–2005) and near-future (2020–2035) climate scenarios based on eight global climate models (GCMs). Outputs from the hydrological model combined with the Yangtze River's effects were fed into a lake water-level model, developing in the back-propagation neural network. Model projections indicate that spring–summer water levels of Poyang Lake are expected to increase by 5–25%, and autumn–winter water levels are likely to be lower and decrease by 5–30%, relative to the baseline period. This amounts to higher lake water levels by as much as 2 m in flood seasons and lower water levels in dry seasons in the range of 0.1–1.3 m, indicating that the lake may be wet-get-wetter and dry-get-drier. The probability of occurrence for both the extreme high and low water levels may exhibit obviously increasing trends by up to 5% more than at present, indicating an increased risk in the severity of lake floods and droughts. Projected changes also include possible shifts in the timing and magnitude of the lake water levels.
Hydrological functioning of cattle ranching impoundments in the Dry Chaco rangelands of Argentina
Authors: Magliano Patricio N. , Mindham David , Tych Wlodek , Murray Francisco , Nosetto Marcelo D. , Jobbágy Esteban G. , Niborski Marcos J. , Rufino Mariana C. , Chappell Nick A. 
Published: October 2019

Abstract
Rainwater harvesting and associated storage is essential for cattle ranching in the drylands of Argentina and elsewhere. This is the first study to attempt to quantify the hydrological inflows and losses from rainwater harvesting impoundments. To address the direct effect of cattle within impoundments, a typical cattle-affected impoundment was instrumented and compared with that of a similar impoundment but without cattle access. Analysis of the storage dynamics with reference to the controlling variables demonstrated the highly episodic nature of the generation of infiltration-excess overland flow that recharged the impoundments. The impoundments experienced 43 and 35% of storage loss to open-water-evaporation for the cattle-affected and control impoundments, respectively. Critically, the cattle-effected impoundment lost only 15% of storage to leakage (after cattle consumption was taken into account), while the control lost 65% of its water to basal leakage. Indeed systems modelling of the rainfall-storage dynamics showed that the cattle-affected impoundment, despite consumption by 300 cows, maintained water in the impoundment (per a unit input of rainfall) for longer than the control (a 65- versus 25-day residence time). These results highlight the unintended beneficial effect of cattle trampling on the floor of the impoundment reducing leakage losses.
Effect of Siberian high and remote forcings on winter precipitation in the Kingdom of Saudi Arabia
Authors: Fahad Riaz Syed Muhammad , Iqbal M. J. , Khan Farheen 
Published: October 2019

AbstractIn the current literature, little is known about the role of Siberian High (SbH) on precipitation variability over the Kingdom of Saudi Arabia. The technique of centers of action (COA) has been employed here to study the possible impact of SbH on interannual variations in winter precipitation over the kingdom because the COA methodology helps us to find changes in interannual variations of pressure intensity, latitudinal and longitudinal positions of the pressure system using sea-level pressure data. The results show that there are two regions of the kingdom whose precipitation is significantly affected by SbH, the southeast region and the region from northeast to central Saudi Arabia. The precipitation over the southeastern region is significantly influenced by the intensity of SbH as well as its meridional displacement whereas the precipitation variability from northeast to the central kingdom is significantly influenced by the meridional displacement of SbH. The effect of remote forcings of North Atlantic Oscillation and El Niño–Southern Oscillation on precipitation of the kingdom has also been discussed in the paper. The empirical results can be understood by the mechanism of changes and circulations in the atmosphere.