bluuebunny/crossref_metadata_2025_split huggingface dataset:
A counseling intervention to address HIV stigma at entry into antenatal care in Tanzania (Maisha): Study protocol for a pilot randomized controlled trial
Authors: Watt Melissa H. , Knippler Elizabeth T. , Minja Linda , Kisigo Godfrey , Knettel Brandon A. , Ngocho James S. , Renju Jenny , Osaki Haika , Mwamba Rimel , Rogathi Jane J. , Mmbaga Blandina T. 
Published: November 2019

Abstract
Background: HIV-related stigma significantly impacts HIV care engagement, including in prevention of mother-to-child transmission of HIV (PMTCT) programs. Maisha is a stigma-based counseling intervention delivered during the first antenatal care (ANC) visit, complementing routine HIV counselling and testing. The goal of Maisha is to promote readiness to initiate and sustain treatment among those who are HIV-positive, and to reduce HIV stigmatizing attitudes among those who test negative. Methods : A pilot randomized control trial (RCT) will assess the feasibility and acceptability of delivering Maisha in a clinical setting, and the potential efficacy of the intervention on HIV care engagement outcomes (for HIV-positive participants) and HIV stigma constructs (for all participants). 1000 women and approximately 700 male partners will be recruited from two study clinics in the Moshi municipality of Tanzania. Participants will be enrolled at their first ANC visit, prior to HIV testing. It is estimated that 50 women (5%) will be identified as HIV-positive. Following consent and a baseline survey, participants will be randomly assigned to either the control (standard of care) or the Maisha intervention. The Maisha intervention includes a video and counseling session prior to HIV testing, and two additional counseling sessions if the participant tests positive for HIV or has an established HIV diagnosis. A sub-set of approximately 500 enrolled participants (all HIV-positive participants, and a random selection of HIV-negative participants who have elevated stigma attitude scores) will complete a follow-up assessment at 3 months. Measures will include health outcomes (care engagement, antiretroviral adherence, depression) and HIV stigma outcomes. Quality assurance data will be collected and the feasibility and acceptability of the intervention will be described. Statistical analysis will examine potential differences between conditions in health outcomes and stigma measures, stratified by HIV status. Discussion : Antenatal care (ANC) provides a unique and important entry point to address HIV stigma. Interventions are needed to improve retention in PMTCT care and to improve community attitudes toward people living with HIV. Results of the Maisha pilot will be used to generate parameter estimates and potential ranges of values to estimate power for a full cluster-randomized trial in PMTCT settings, with extended follow-up and enhanced adherence measurement using a biomarker.
The effect of season and post-fire on habitat preferences of the endangered Swayne’s hartebeest (Alcelaphus buselaphus swaynei) in Maze National Park, Ethiopia
Authors: Tamrat Misganaw , Atickem Anagaw , Tsegaye Diress , Evangelista Paul , Bekele Afework , Stenseth Nils Christian 
Published: November 2019

Abstract
Background: The availability of preferred habitats determines the spatial and temporal distribution of herbivores in savanna ecosystems. Understanding habitat preference of a targeted wildlife species is crucial for developing effective conservation strategies. Habitat preference of large grazers in connection to grass height and post-fire effect has been debated for the last century. Here, we examined the effects of season, grass height and burning on the habitat preference on Swayne’s hartebeest (Alcelaphus buselaphus swaynei) in Maze National Park. Data for seasonal habitat selection were collected using both direct observation along established transect lines and pellet counting using permanently established plots. Every month, we measured grass height commonly preferred by Swayne’s hartebeest in grassland habitat. Starting from the first week of burning, we recorded the abundance of Swayne’s hartebeest in both burned and unburned grassland patches. Results: From detected pellets, 94.3% were recorded in the grassland habitat indicating that other habitat types are less used despite their extensive cover > 50% of the Park. During wet and early dry seasons, Swayne’s hartebeest exclusively preferred grassland habitat. We found that 85.2% (n=1,079) and 85.3% (n=593) of individuals observed in areas with a grass height below 30 cm during wet and early dry seasons, respectively; while 70.9% (n=2,288) preferred grass height below 30 cm during the dry season. The density of Swayne’s hartebeest in burned grassland area was higher than unburned grassland areas up to 150 days since burning. However, in unburned grassland areas, the density was initially low but showed increasing trend for consecutive days, reaching similar density with burned areas after 150 days since burning. Conclusion: Swayne’s hartebeest exclusively preferred grassland habitat, particularly during wet and early dry seasons, shortest available grass height in all seasons and were attracted to burned grassland areas. Our results suggested that fire played an important role in maintaining habitat quality in grassland, and that management should continue using controlled burning as a tool for the conservation of Swayne’s hartebeest. However, we remain cautious of our findings given the paucity of information regarding other confounding factors and the absence of long-term data on fire disturbance.
Improving management of comorbidity in patients with colorectal cancer using comprehensive medical assessment: A pilot study
Authors: Signal Virginia , Jackson Christopher , Signal Louise , Hardie Claire , Holst Kirsten , McLaughlin Marie , Steele Courtney , Sarfati Diana 
Published: November 2019

Abstract
Background: Screening for and active management of comorbidity soon after cancer diagnosis shows promise in altering cancer treatment and outcomes for comorbid patients. Prior to a large multi-centre study, piloting of the intervention (comprehensive medical assessment) was undertaken to investigate the feasibility of the comorbidity screening tools and proposed outcome measures, and the feasibility, acceptability and potential effect of the intervention. Methods: In this pilot intervention study, 72 patients of all ages (36 observation/36 intervention) with newly diagnosed or recently relapsed colorectal adenocarcinoma were enrolled and underwent comorbidity screening and risk stratification. Intervention patients meeting pre-specified comorbidity criteria were referred for intervention, a comprehensive medical assessment carried out by geriatricians. Each intervention was individually tailored but included assessment and management of comorbidity, polypharmacy, mental health particularly depression, functional status and psychosocial issues. Recruitment and referral to intervention were tracked, verbal and written feedback were gathered from staff, and semi-structured telephone interviews were conducted with 13 patients to assess screening tool and intervention feasibility and acceptability. Interviews were transcribed and analysed thematically. Patients were followed for 6 - 12 months after recruitment to assess feasibility of proposed outcome measures (chemotherapy uptake and completion rates, grade 3 - 5 treatment toxicity, attendance at hospital emergency clinic, and unplanned hospitalisations) and descriptive data on outcomes collated. Results: Of the 29 intervention patients eligible for the intervention, 21 received it with feedback indicating that the intervention was acceptable. Those in the intervention group were less likely to be on 3+ medications, to have been admitted to hospital in previous 12 months, or to have limitations in daily activities. Collection of data to measure proposed outcomes was feasible with 55% (6/11) of intervention patients completing chemotherapy as planned compared to none (of 14) of the control group. No differences were seen in other outcome measures. Overall the study was feasible with modification, but the intervention was difficult to integrate into clinical pathways. Conclusions: This study generated valuable results that will be used to guide modification of the study and its approaches prior to progressing to a larger-scale study. Trial registration: Retrospective, 26 August 2019, ACTRN12619001192178.
How to collect non-medical data in a pediatric trial: diaries and interviews
Authors: JEANNIC Anaïs LE , Maoulida Hassani , Guilmin-Crépon Sophie , Alberti Corinne , Tubiana-Rufi Nadia , Durand-Zaleski Isabelle 
Published: November 2019

Abstract
Background: Non-medical data such as patients’ and caregivers’ time can be relevant to assess therapeutic strategies. For chronic pediatric conditions, patients’ and caregivers’ time spent in seeking and providing care (i.e. indirect cost in an economic evaluation) can be significantly different depending on the treatment arm. In order to explore methods to collect information on care burden for caregivers and patients, we investigated whether or not a patient diary provided additional information compared to retrospective investigator-led interviews and whether a diary filled intermittently produced more or less information than a continuous diary. The main objective of this study was to identify which type of data collection was most effective to measure caregivers’ time and estimate indirect treatment costs over a 9-month period.
Methods: Start-In! is a randomized controlled trial comparing the efficacy of three strategies of real-time continuous glucose monitoring (CGM) for 12 months in children and adolescents with type 1 diabetes. We designed an ancillary study to assess methods of patients’ and caregivers’ time (indirect costs): data entered was retrospectively in the case report form by investigators during quarterly follow-up visits, with the help of diaries filled prospectively by children or caregivers either continuously or intermittently. Data about absence from school and work as well as caregivers’ time for diabetes care were collected and comparisons carried out between the three collection methods.
Results: At the end of the 9-month study, 42% of study participants failed to return their diary. For the diaries that were received, less than 10 were contributive on top of the information entered on 82 patients directly by investigators .Based upon this information, we calculated that over 9 months, caregivers lost on average 3.9 days of working time, (€786), and 4 days of personal time, i.e. the equivalent of €526, as well as around 15 minutes of care per day, i.e. the equivalent of €1,700.
Conclusions: Data collection by investigators during quarterly visits cannot be replaced by a diary. The completion of diaries appeared to represent an important additional burden to children and their caregivers and provided limited additional information compared to investigators ‘entries in the CRF.
Trial registration: Start-In! trial registry name: Study of Insulin Therapy Augmented by Real Time Sensor IN Type 1 Children and Adolescents (START-IN!). ClinicalTrials.gov Identifier: NCT00949221. Registered on July 30, 2009.
The Prevalence, Awareness, Management and Control of Hypertension in Men and Women in Benin, West Africa: the TAHES study.
Authors: DESORMAIS ILEANA , Amidou Salimanou Ariyoh , Houehanou Yessito Corine , Houinato Stephan Dismand , Gbagouidi Gwladys Nadia , Preux Pierre Marie , Aboyans Victor , Lacroix Philippe 
Published: November 2019

Abstract
Background Sub-Saharan Africa is facing a growing burden of non-communicable diseases, including cardiovascular diseases (CVDs), due to epidemiological transitions. Among their risk factors, hypertension is a major determinant of CVDs, but the prevalence and level of awareness and management of this condition are poorly studied in African populations. The aim of this study was to determine the prevalence of hypertension and identify its associated risk factors as well as the awareness and management of this condition in a community-dwelling cohort in Benin. Methods A cross-sectional door-to-door study was conducted in the population over the age of 25 years in Tanve, a rural setting in Benin. The questionnaire and anthropometric measurements of the World Health Organization STEPWISE survey were used. Blood pressure was measured using standard procedures. Results The sample included 1777 subjects (60.9% females, mean age was 42.5±16.5 years). The prevalence of hypertension was 32.9%, similar in men (32.8%) and women (33.0%, p=0.9342). Age and obesity were significantly associated with hypertension. Less than half (42%) of hypertensive people were aware about their condition and only 46.3% of them were treated. Awareness ratios differed between men and women (respectively 32.9% vs. 47.5%; p= 0.0039) and was not influenced by age, education, occupation, marital status or income. Female sex was the only factor associated with better controlled HTN, independent of socio-economic parameters. Conclusion This large population-based study confirms the high prevalence, low awareness, and low control of hypertension in men and women in sub-Saharan Africa. Only half of the populations with hypertension are aware of their hypertension, indicating a high burden of undiagnosed and un-controlled high blood pressure in these populations.
Trauma induced tissue survival in vitro with a muscle-biomaterial based osteogenic organoid system: a proof of concept study
Authors: He Tao , Hausdorf Jörg , Chevalier Yan , Klar Roland Manfred 
Published: November 2019

Abstract
Background The translation from animal research into the clinical environment remains problematic, as animal systems do not adequately replicate the human in vivo environment. Bioreactors have emerged as a good alternative that can reproduce part of the human in vivo processes at an in vitro level. However, in vitro bone formation platforms primarily utilizes stem cells only, with tissue based in vitro systems remaining poorly investigated. As such, the present pilot study explored the tissue behavior and cell survival capability within a new in vitro skeletal muscle tissue-based biomaterial organoid bioreactor system to maximize future bone tissue engineering prospects. Results Three dimensional printed β-tricalcium phosphate/hydroxyapatite devices were either wrapped in a sheet of rat muscle tissue or first implanted in a heterotopic muscle pouch that was then excised and cultured in vitro for up to 30 days. Devices wrapped in muscle tissue showed cell death by day 15. Contrarily, devices in muscle pouches showed angiogenic and limited osteogenic gene expression tendencies with consistent TGF-ß 1 , COL4A1 , VEGF-A , RUNX-2 , and BMP-2 upregulation, respectively. Histologically, muscle tissue degradation and fibrin release was seen being absorbed by devices acting possibly as a support for new tissue formation in the bioceramic scaffold that supports progenitor stem cell osteogenic differentiation.Conclusions These results therefore demonstrate that the skeletal muscle pouch-based biomaterial culturing system can support tissue survival over a prolonged culture period and represents a novel organoid tissue model that with further adjustments could generate bone tissue for direct clinical transplantations.
Government Spending, Recession, and Suicide: Evidence from Japan
Authors: Matsubayashi Tetsuya , Sekijima Kozue , Ueda Michiko 
Published: November 2019

Abstract
Backgrounds: Austerity has been shown to have an adverse influence on people’s mental health and suicide rates. Most existing studies have focused on the governments’ reactions to a single event, for example, the Great Recession of 2008. Methods: This study focused on significant changes in fiscal policy between 2001 and 2014 in Japan. The size of expenditures by national and local governments decreased dramatically between 2001 and 2006 under the neoliberal reform and then increased after the global economic crisis and the Great East Japan Earthquake. Using the data from 47 prefectures between 2001 and 2014, we tested whether more spending by the local governments was associated with a lower suicide rate in their jurisdiction. We also investigated whether this relationship was particularly salient during a more severe recession. Results: Our analysis revealed that an increase of 1% in the per capita local government expenditures was associated with a decrease of 0.2% in the suicide rates among males and females aged between 40 and 64 and that this correlation was strengthened as the unemployment rate increased, particularly among males. Conclusions: Government’s reaction to economic crises can either exacerbate or mitigate the negative impact of the economic recession on people’s mental health and suicide rates.
Fatty acid biosynthesis and transcriptional regulation of Stearoyl-CoA Desaturase 1 (SCD1) in Buffalo milk
Authors: Li Zhipeng , Lu Suyu , Cui Kuiqing , Shafique Laiba , Rehman Saif ur , Luo Chan , Wang Zhiqiang , Liu Qingyou 
Published: November 2019

Abstract
Background: Nutritionally, buffalo milk is of immense importance due to high contents of fatty acid (FA), highly energetic and nutritive value. The composition of FA has been regarded as functional food component, which facilitate to manufacture a variety of processed milk products. Moreover, Buffalo milk contains more unsaturated FAs (UFA) such as oleic and linolenic acids, which have been shown to exert a number of physiological effects. However, inadequate information reported about the chemical composition and mechanism of FA synthesis in buffalo milk. Our conducted research hypothesize that, the expression of SCD1 gene could alter the biosynthesis of fatty acid (FA) in epithelial cells of mammary gland and subsequently affect the FA contents in buffalo milk. Present study investigated transcriptional and biological role of Stearoyl-CoA Desaturase 1 (SCD1) in the buffalo mammary epithelial cells (BMECs) during FA and triacylglycerol (TAG) synthesis. Results: Results showed that unsaturated fatty acid contents are much higher in concentration in buffalo milk as compared to Holstein cow. Significantly, higher expression level of FAS, ACACA, SREBP1, PPARG, GPAT and AGPAT genes were also been observed with the expression of the SCD1 in buffalo milk. Moreover, studies showed that, SCD1 gene alteration in BMECs also causes the change in the expression of FA synthesis related genes mentioned above and subsequently affect the FA composition in the cells. Overexpression of SCD1 significantly increased the expression of genes associated with FA and TAG synthesis and also improved the FA and unsaturated FA contents in BMECs, while down-regulation of SCD1 appear opposite consequences. Conclusion: Thus, present study clearly demonstrated that, alteration in the expression of SCD1 plays an important role in FA and TAG synthesis and can directly or indirectly affect biosynthesis and metabolic pathways in BMECs and may be used as a symbol for important mechanism that contributes the characterization of buffalo milk.
Roles and strategies of international humanitarian organisations in handling the Liberia Ebola outbreak
Authors: Kangbai Jia Bainga , Alameldeen Ahmed 
Published: November 2019

Abstract
Background In Early August 2014, the World Health Organisation declared an Ebola Virus Disease (EVD) outbreak in the region of West Africa. The West African EVD outbreak was the largest, most severe, and complex in the nearly four-decade history of this disease. The management of EVD cases in Liberia was similar to the other affected West African countries. Methods We reviewed the method and strategies used by some of the international humanitarian organisations in handling the 2013-2016 Ebola outbreak in Liberia. This report is a collection of personal field experiences in Liberia as well as personal interviews of healthcare personnel working for some of these international organisations working on the Ebola emergency in Liberia. Findings Medecins Sans Frontieres (MSF) was the first humanitarian NGO to deploy medical staff to the field in Liberia during the 2013-2016 EVD outbreak. MSF staffs were already operating in Liberia even before the declaration of the outbreak in August 2014.Conclusions The slow response by the international humanitarian organisations to lend their support in bringing the EVD outbreak to and exhibited the fear the international community have for deadly infectious diseases more than armed conflicts.Recommendations We recommend regularly training in public health emergency preparedness for third world countries that are highly susceptible to health emergencies such as Ebola outbreak to help prepared them ahead of such outbreak.
Whole Genome Sequencing of Nontuberculous Mycobacterium (NTM) Isolates from Sputum and Environmental Specimens in Co-Habiting Patients with NTM Pulmonary Disease
Authors: Yoon Jung-Ki , Kim Taek Soo , Kim Jong-Il , Yim Jae-Joon 
Published: November 2019

Abstract
Background : Nontuberculous mycobacterium (NTM) species are ubiquitous microorganisms. NTM pulmonary disease (NTM-PD) is caused not by human-to-human transmission but by independent environmental acquisition. However, recent studies using next-generation sequencing (NGS) have reported trans-continental spread of Mycobacterium abscessus among patients with cystic fibrosis. Results : We investigated NTM genomes through NGS to examine transmission patterns in three pairs of co-habiting NTM-PD patients who were suspected of patient-to-patient transmission. Three pairs of patients with NTM-PD co-habiting for at least 15 years were enrolled: a mother and a daughter with M. avium PD, a couple with M. intracellulare PD, and a second couple, one of whom was infected with M. intracellulare PD and the other of whom was infected with M. abscessus subsp. massiliense PD. Whole genome sequencing was performed using NTM colonies isolated from patients and environmental specimens. Genetic distances were estimated based on single nucleotide polymorphisms (SNPs) in the NTM genomes. Comparing SNPs in the consensus regions, the minimum pairwise SNP distances of NTM isolates derived from the two pairs of patients infected with the same NTM species were over 10,000. In phylogenetic analysis, the NTM isolates from patients with M. avium PD clustered with isolates from different environmental sources. Conclusions : In conclusion, considering the genetic distances between NTM strains, the likelihood of patient-to-patient transmission in pairs of co-habiting NTM-PD patients without overt immune deficiency is minimal.