bluuebunny/crossref_metadata_2025_split huggingface dataset:
Interleukin-6 Receptor Antibodies for Modulating the Systemic Inflammatory Response after Out-of-Hospital Cardiac Arrest (IMICA): study protocol for a randomized clinical trial
Authors: Meyer Martin A. S. , Wiberg Sebastian , Grand Johannes , Kjaergaard Jesper , Hassager Christian 
Published: December 2019

Abstract
Background: Resuscitated out-of-hospital cardiac arrest (OHCA) patients who remain comatose at admission are at high risk of morbidity and mortality. This has been attributed to the post-cardiac arrest syndrome (PCAS) which encompasses multiple interacting components, including systemic inflammation. Elevated levels of circulating interlukin-6 (IL-6), a pro-inflammatory cytokine, is associated with worse outcomes in OHCA patients, including, higher vasopressor requirements and higher mortality rates. For other indications, an IL-6 receptor antibody, tocilizumab has been approved. In this study we aim to reduce systemic inflammation after OHCA by administering a single infusion of tocilizumab. Methods: Investigator-initiated, randomized, double blind, placebo-controlled clinical trial in OHCA patients remaining unconscious after hospital admission. Intervention: Intravenous administration of an interleukin-6 receptor antibody (IL-6RA), tocilizumab, or placebo after admission. Primary endpoint: reduction in C-reactive protein (CRP). Secondary endpoints (abbreviated): cytokine levels, markers of brain, cardiac, kidney and liver damage, and hemodynamic and haemostatic function, adverse events, as well as follow-up assessment of cerebral function and mortality. Discussion: We hypothesise that reducing the effect of circulating IL-6 by administering an IL-6 receptor antibody will mitigate the systemic inflammatory response and thereby modify the severity of PCAS, in turn leading to decreased need of vasopressor support, more normal hemodynamics, as well as better organ function. A previous trial of IL6-RA in patients with non-ST elevation myocardial infarction showed a reduction in CRP and troponin levels, as well as a change in cytokine levels. Following these findings, we will be measuring a range of both pro-inflammatory and anti-inflammatory cytokines to possibly reveal a change in cytokine patterns following blockage of the IL-6 receptor, as well as investigate whether IL-6RA leads to reduced organ damage. Infection after OHCA is not uncommon and IL6-RA has previously been shown to increase the frequency of infections. Accordingly, we will monitor for infections, and patients will be treated with prophylactic antibiotics. Trial registration: ClinicalTrials.gov Identifier: NCT03863015; submitted February 22 2019, first posted March 5, 2019. EudraCT: 2018-002686-19; First entered August 10 2019.
The SPARKLE registry: a multicenter, multinational, noninterventional, prospective cohort registry study in patients with alpha-mannosidosis
Authors: Hennermann Julia , Guffon Nathalie , Cattaneo Federica , Ceravolo Ferdinando , Borgwardt Line , Lund Allan M. , Gil-Campos Mercedes , Tylki-Szymanska Anna , Muschol Nicole M. 
Published: December 2019

Abstract
Background Alpha-mannosidosis is a lysosomal storage disorder caused by reduced enzymatic activity of alpha-mannosidase. Intracellular accumulation of mannose-rich oligosaccharides leads to a continuum of various heterogeneous clinical symptoms. Velmanase alfa (Lamzede®) is a human recombinant alpha-mannosidase approved in Europe in 2018 as the first enzyme replacement therapy for the treatment of non-neurologic manifestations in patients with mild-to-moderate alpha-mannosidosis. SPARKLE is an alpha-mannosidosis registry study intended to obtain long-term safety and effectiveness data on the use of velmanase alfa during routine clinical care in patients with alpha-mannosidosis and is a post-approval commitment to European marketing authorization. In addition, SPARKLE will expand the current understanding of alpha-mannosidosis by collecting data on the clinical manifestations, progression, and natural history of the disease in treated and untreated patients, respectively. Results SPARKLE is a post-authorization safety and efficacy registry designed as a multicenter, multinational, noninterventional, prospective cohort study of patients with alpha-mannosidosis, starting in 2020. Patients will be followed for up to 15 years. Safety and effectiveness outcomes under routine clinical care will be evaluated. The primary safety outcomes are the rate of adverse events (anti-velmanase alfa-immunoglobulin G antibody development, infusion-related reactions, and hypersensitivity). Secondary safety outcomes include the evaluation of medical events, change in vital signs, laboratory tests, physical examination, and electrocardiogram results. The primary effectiveness outcome is a global treatment response rate, evaluated as the individual aggregate of single endpoints from pharmacodynamic, functional, and quality of life effectiveness outcomes; secondary effectiveness outcomes are to characterize the population of patients with alpha-mannosidosis with regard to clinical manifestation, progression, and natural history of the disease. Any patient in the European Union with a diagnosis of alpha-mannosidosis who is willing to participate will likely be eligible for inclusion in the registry. Publications to disseminate scientific insights from the registry are planned. Conclusion This study will provide real-world data on the long-term safety and effectiveness of velmanase alfa in patients with alpha-mannosidosis during routine clinical care and increase the understanding of the natural course, clinical manifestations, and progression of this ultra-rare disease.
Malaria Knowledge and Experiences with Community Health Workers among Recently Pregnant Women in Malawi
Authors: Malpass Ashley , Chinkhumba Jobiba , Davlantes Elizabeth , Munthali John , Wright Katherine , Ramsey Kathryn , Troell Peter , Kayange Michael , Kachale Fannie , Mathanga Don P. , Chatata Dziko , Gutman Julie R 
Published: December 2019

Abstract
Background The World Health Organization (WHO) recommends three or more doses of intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) to mitigate the negative effects of malaria in pregnancy (MIP). Many pregnant women in Malawi are not receiving the recommended number of doses. Community delivery of IPTp (cIPTp) is being piloted as a new approach to increase coverage. This survey assessed recently pregnant women’s knowledge of MIP and their experiences with community health workers (CHWs) prior to implementing cIPTp.Methods Data were collected via a household survey in Ntcheu and Nkhata Bay Districts, Malawi, from women aged 16-49 years who had a pregnancy resulting in a live birth in the previous 12 months. Survey questions were primarily open response and utilized review of the woman’s health passport whenever possible. Analyses accounted for selection weighting and clustering at the health facility level and explored heterogeneity between districts.Results A total of 370 women were interviewed. Women in both districts found their CHWs to be helpful (77.9%), but only 35.7% spoke with a CHW about antenatal care and 25.8% received assistance for malaria during their most recent pregnancy. A greater proportion of women in Nkhata Bay than Ntcheu reported receiving assistance with malaria from a CHW (42.7% vs 21.9%, p=0.01); women in Nkhata Bay were more likely to cite IPTp-SP as a way to prevent MIP (41.0% vs 24.8%, p=0.02) and were more likely to cite mosquito bites as the only way to spread malaria (70.6% vs 62.0% p=.03). Women in Nkhata Bay were more likely to receive 3+ doses of IPTp-SP (IPTp3) (59.2% vs 41.8%, p=0.0002). Adequate knowledge was associated with increased odds of receiving IPTp3, although not statistically significantly so (adjusted odds ratio = 1.50, 95% confidence interval 0.97- 2.32, p-value 0.066).Conclusions Women reported positive experiences with CHWs, but there was not a focus on MIP. Women in Nkhata Bay were more likely to be assisted by a CHW, had better knowledge, and were more likely to receive IPTp3+. Increasing CHW focus on the dangers of MIP and implementing cIPTp has the potential to increase IPTp coverage. Keywords: Malaria Pregnancy Community Health Workers Malawi Intermittent preventive treatment Sulfadoxine-pyrimethamine
Linking insecticide mosquito nets to malaria: the roles of malaria Knowledge and household-income
Authors: Mohammed Mohammed Aliye , Hong Tao 
Published: December 2019

Abstract
Background: Drawing on the theory of the health belief model, this study examined the interplay of insecticide mosquito nets, malaria-knowledge, household income, and malaria. The study premised on the notion that insecticide mosquito nets proposed to be positively related to malaria, and knowledge was proposed to mediate the relationship between insecticide mosquito nets and malaria. Furthermore, household-income was anticipated to have a moderating effect on the direct and indirect relationships (through malaria knowledge) between insecticide mosquito nets and malaria. Methods: The hypothesized relationships were examined using the panel data collected from 10 regions of Ethiopia during 2011 – 2015. Structural equation modeling and random effect model used to test the articulated hypothesis. Statistical analyses were performed using Stata version 13.0. Results: The results were consistent with our proposed hypotheses, showing a significant and positive relationship between the research variables. Accordingly, our estimate suggests that malaria knowledge contributed to improving insecticide mosquito nets and malaria disease relationships. The result revealed a significant and positive effect (β = 0.47, p = 0.003) of the indirect effect where the direct effect coefficient is also positive (β = 0.28, p = 0.001). The study also reported a positive impact of household-income in strengthening the relationship between insecticide mosquito nets and malaria via knowledge with considerable value (β = 0.13, p = 0.000). Conclusion: The findings are potentially useful for the health sector to assure the success regarding infectious disease prevention and control, particularly malaria, explaining how such factors contribute to the relationship.
Secondary school students’ awareness of contraceptive methods, understanding of HIV/AIDS prevention and perception of HIV/AIDS risk in Dar es Salaam, Tanzania
Authors: Mika Nishihara , Sebalda Leshabari , Junichi Tanaka , Ohnishi Mayumi 
Published: December 2019

Abstract
Background To assess awareness of contraceptive methods, understanding of HIV/AIDS prevention and perception of HIV risk among secondary school students in Tanzania. Methods An anonymous self-administered questionnaire survey was conducted among secondary school students in 2017 in Tanzania. The questionnaire included sociodemographic characteristics, awareness of contraceptive methods, understanding of HIV/AIDS prevention and perception of HIV/AIDS risk. Three secondary schools in Dar es Salaam were selected considering gender balance and location, which included urban and surrounding areas. After the research objectives, methods and ethical considerations were explained, the students voluntarily completed and submitted the questionnaire in the designated place. Submission of the questionnaire was considered agreement to participate in the study. Results A total of 233 responses were collected, and 204 responses were valid for the analysis. The mean and standard deviation of age were 18.5 ± 1.0. Spearman’s rank correlation coefficient between understanding of HIV/AIDS prevention and perception of HIV/AIDS risk was ρ=0.184 (P=0.036). However, there was no correlation between awareness of contraceptive methods and understanding of HIV/AIDS prevention (ρ=0.019, P=0.782) or perception of HIV/AIDS risk (ρ=-0.138 P=0.116). Regardless of gender, age, religion, and major course of study, mother’s educational status (β=0.150, P=0.031 and β=0.232, P=0.034, respectively) and the number of information sources (β=0.584, P<0.001 and β=-0.311, P=0.006, respectively) demonstrated associations with awareness of contraceptive methods and perception of HIV/AIDS risk. Respondents who lived outside of a dormitory (β=0.295, P=0.001) and currently had a partner (β=0.243, P=0.009) demonstrated a higher understanding of HIV/AIDS prevention regardless of gender, age, religion, and major course of study. Conclusions The factors associated with awareness of contraceptive methods, understanding of HIV/AIDS prevention and perception of HIV/AIDS risk were not consistent. To improve awareness of contraceptive methods, understanding of HIV/AIDS prevention and perception of HIV/AIDS risk among secondary school students, educational programs should be integrated and holistically provided as sexual health education.
Zika outbreak, resilient health systems, and women’s sexual and reproductive health: a qualitative study in Colombia
Authors: Rivillas-García Juan Carlos , Forero-Martinez Luz Janeth , Calderon-Jaramillo Mariana , Vargas-Pinzón Victoria , Murad-Rivera Rocío , Perez Freddy 
Published: December 2019

Abstract
Background There is substantial evidence of the profound consequences of Zika on women's Sexual and Reproductive Health. Health system resilience begins by measuring critical capacities ahead of a crisis such as zika outbreak. Even though zika as vector-borne disease is well documented, there is dearth of studies linking Zika with women's Sexual and Reproductive Health. The main objective of this study was to analyze the national response to the Zika epidemic and its relation to women’s sexual and reproductive health matters through key implementation mechanisms in order to promote resilience of the health system in five cities in Colombia.Methods This study used a qualitative design to enable an in-depth exploration of the national response to the Zika epidemic and sexual and reproductive health matters through key implementation mechanisms (based on facilitators and gaps) within the health system. The overall data set was comprised of 31 semi-structured individual interviews (23 women and 8 men), 25 interviews with key informants responsible for the implementation of the Zika Virus Response Plan; six interviews with pregnant women diagnosed with Zika; and five focus groups discussions with communities (n=122 participants) in five cities in Colombia: Barranquilla, Cucuta, Los Patios, San Andres and Soledad.Results The findings revealed the three major facilitators that promoted the implementation of actions to address the Zika epidemic: i) the role of health care providers; ii) the development of technical equipment capabilities; and iii) inter-institutional coordination. The study also identified implementation gaps: i) absence of a human rights and sexual and reproductive health approach; ii) focus on territorial actions centered on mosquito management; and iii) limited attitudes, behaviors and knowledge at the community level.Conclusion This study provided a comprehensive insight of critical facilitating processes and gaps in the implementation of the government response during the Zika epidemic in Colombia. This study reveals that the lack of understanding of the intersection between gender, the Zika epidemic and Sexual and Reproductive Health limited the adoption, development and implementation of a more comprehensive responses to address the impact on women’s sexual and reproductive health.
Comparisons of clinical characteristics of lens-subluxated eye with or without acute angle closure: A retrospective study
Authors: Zhang Hong-Yang , Lin Hong-Liang , Qin Yong-Jie , Zhang Yu-Lin , Zhang Yu-Qiao , Niu Yong-Yi , Chen Yan-Lei , Hu Yun-Yan , Xie Wen-Juan 
Published: December 2019

Abstract
BackgroundTo compare clinical characteristics of lens subluxation between eyes with or without acute angle closure (AAC).MethodsThis is a retrospective and case control study. Thirty-four cases with lens subluxation were recruited from 2015 to 2017. Patients with acute angle closure were assigned to the AAC group (n=17 eyes) and those without AAC were in the non-AAC group (n=17 eyes). Quantitative anterior segment was evaluated by ultrasound biomicroscopy (UBM). Axial length (AL) was measured with IOL master. All patients underwent lens extraction surgery and were followed up for 6 months. ResultsThe history of blunt trauma was accounted for 11 (64.7%) cases in the AAC group and 14 (82.3%) cases in the non-AAC group. Nine (52.9%) patients in the AAC group had LPI or SPI treatment history, and high intraocular pressure was recurred. The UBM analysis showed that the average central ACD of affected eyes in the AAC group was 1.75 mm, which was significantly shallower than the fellow eyes (2.39 mm, P < 0.05) or both eyes in the non-AAC group (affected eye 3.24mm vs fellow eye 3.81mm). Lens vault and AOD500 also showed a remarkable difference between affected eye than fellow eye (P < 0.001) in the AAC group. The both eyes in the AAC group presented a shorter AL and shallower anterior chamber, comparing with those in the non-AAC group. Besides, the affected eyes in the AAC group presented significantly higher LV. ConclusionsThe crowded anterior chamber structure and shorter AL might be an anatomic basis for the eye with lens subluxation induced AAC. Quantitative evaluation of these ocular structures to identify zonular compromise, increased LV and shorter AL are valuable for the diagnosis of lens subluxation induced AAC.
Invasive cattle ticks in East Africa: morphological and molecular confirmation of the presence of Rhipicephalus microplus in south-eastern Uganda
Authors: Muhanguzi Dennis , Byaruhanga Joseph , Amanyire Wilson , Ndekezi Christian , Ochwo Sylvester , Nkamwesiga Joseph , Mwiine Frank Nobert , Tweyongyere Robert , Fourie Josephus , Madder Maxime , Schetters Theo , Ivan Ivan , Juleff Nick , Jongejan Frans 
Published: December 2019

Abstract
Background: Rhipicephalus microplus; an invasive tick species of Asian origin and the main vector of Babesia species, is considered one of the most widespread ectoparasites of livestock. The tick has spread from its native habitats on translocated livestock to large parts of the tropical world, where it has replaced some of the local populations of Rhipicephalus decoloratus ticks. Although the tick was reported in Uganda 70 years ago, it has not been found in any subsequent surveys. This study was carried out to update the national tick species distribution on livestock in Uganda as a basis for tick and tick-borne disease control, with particular reference to R.microplus.Methods: The study was carried out in Serere district, south-eastern Uganda, which is dominated by small scale livestock producers. All the ticks collected from 240 cattle were identified microscopically. Five R. microplus specimens were further processed for phylogenetic analysis and species confirmation.Results: The predominant tick species found on cattle was Rhipicephalus appendiculatus (86.9 %; n=16,509). Other species found were Amblyomma variegatum (7.2 %; n=1,377), Rhipicephalus evertsi (2.3 %; n=434) and R. microplus (3.6 %; n= 687). Phylogenetic analysis of the 12S rRNA, 16S rRNA and ITS2 gene sequences of R. microplus confirmed the morphological identification.Conclusions : It is concluded that R. microplus has replaced Rhipicephalus decoloratus, since the latter was not any longer found in this area. There is currently no livestock movement policy in force in Uganda, which could possibly limit the further spread of R. microplus ticks. Future surveys, but also retrospective surveys of museum specimens, will reveal the extent of distribution of R. microplus in Uganda and also for how long this tick has been present on livestock without being noticed.
Factors affecting under-five mortality in Ethiopia: a multi-level negative binomial model
Authors: Geremew Bisrat Misganew , Gelaye Kassahun Alemu , Melesse Alemakef Wagnew , Akalu Temesgen Yihunie , Baraki Adhanom Gebreegziabher 
Published: December 2019

Abstract
Introduction: Under-five mortality is a key indicator of countries’ developmental status. Even though remarkable declines in under-five mortality rates, nearly 5.6 million children still die annually worldwide before their fifth birthday. The 2016 Ethiopian Demographic and Health Survey (EDHS) report revealed that 67 children per 1,000 live births died before the fifth birthday. This study was aimed at determining factors affecting under-five mortality in Ethiopia using EDHS, 2016.Methods: The data was retrieved from the EDHS 2016. A total weighted number of 11,023 under-five children were included in this study. Descriptive statistics were done and reported using tables, graphs, and texts. The multilevel negative binomial regression model was fitted to identify significant factors of under-five mortality. Adjusted Incidence rate (AIRR) with a 95% confidence interval (CI) and p-value <0.05 in the multivariable model were reported. The goodness of fit was checked using the deviance test.Results: Mother attained higher education (AIRR=0.25, 95% CI: 0.10-0.66); female-headed household (AIRR=1.32, 95%CI:1.05-1.66); age of household head (AIRR=1.07, 95%CI: 1.03,1.11); preceding birth interval ≥48 months (AIRR=0.51, 95%CI: 0.42-0.61); child’s had history of diarrhea (AIRR=1.23, 95% CI:1.08-1.41); multiple birth type (AIRR=1.80, 95% CI:1.34-2.42); mothers delivered in health facility (IRR=0.86, 95% CI:0.73,0.94), residents of Addis Ababa (AIRR=0.52, 95%CI: 0.28-0.98), and Amhara region (AIRR=1.43, 95%CI: 1.09, 1.88) were statistically significant factors to under-five mortality in Ethiopia.Conclusion: In this study, under-five mortality remains a public health problem in Ethiopia. Mothers education level, women delivered at health institution, preceding birth interval 24-35 and ≥48, and residents of Addis Ababa have reduced the incidence of under-five mortality. On the other hand, being a female household head, age of mother at first giving birth, being employment, having multiple births and having childhood diarrhea was associated with a higher incidence of under-five mortality. This finding suggests that enhancing opportunities to female education, addressing regional disparities, and encouraging mothers to deliver at health institutions will help to combat the burden of under-five mortality. Keywords: Under-five mortality, negative binomial, multilevel analysis, Ethiopia