bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mass testing and treatment for malaria followed by weekly fever screening, testing and treatment in Northern Senegal: feasibility, cost and impact
Authors: Conner Ruben O. , Dieye Yakou , Hainsworth Michael , Tall Adama , Cissé Badara , Faye Farba , Sy Mame Demba , Ba Amadou , Sene Doudou , Ba Souleymane , Doucouré Elhadji , Thiam Tidiane , Diop Moussa , Schneider Kammerle , Cissé Moustapha , Ba Mady , Earle Duncan , Guinot Philippe , Steketee Richard W. , Guinovart Caterina 
Published: July 2020

Abstract
Background
Population-wide interventions using malaria testing and treatment might decrease the reservoir of Plasmodium falciparum infection and accelerate towards elimination. Questions remain about their effectiveness and evidence from different transmission settings is needed.

Methods
A pilot quasi-experimental study to evaluate a package of population-wide test and treat interventions was conducted in six health facility catchment areas (HFCA) in the districts of Kanel, Linguère, and Ranérou (Senegal). Seven adjacent HFCAs were selected as comparison. Villages within the intervention HFCAs were stratified according to the 2013 incidences of passively detected malaria cases, and those with an incidence ≥ 15 cases/1000/year were targeted for a mass test and treat (MTAT) in September 2014. All households were visited, all consenting individuals were tested with a rapid diagnostic test (RDT), and, if positive, treated with dihydroartemisinin-piperaquine. This was followed by weekly screening, testing and treatment of fever cases (PECADOM++) until the end of the transmission season in January 2015. Villages with lower incidence received only PECADOM++ or case investigation. To evaluate the impact of the interventions over that transmission season, the incidence of passively detected, RDT-confirmed malaria cases was compared between the intervention and comparison groups with a difference-in-difference analysis using negative binomial regression with random effects on HFCA.

Results
During MTAT, 89% (2225/2503) of households were visited and 86% (18,992/22,170) of individuals were tested, for a combined 77% effective coverage. Among those tested, 291 (1.5%) were RDT positive (range 0–10.8 by village), of whom 82% were < 20 years old and 70% were afebrile. During the PECADOM++ 40,002 visits were conducted to find 2784 individuals reporting fever, with an RDT positivity of 6.5% (170/2612). The combination of interventions resulted in an estimated 38% larger decrease in malaria case incidence in the intervention compared to the comparison group (adjusted incidence risk ratio = 0.62, 95% CI 0.45–0.84, p = 0.002). The cost of the MTAT was $14.3 per person.

Conclusions
It was operationally feasible to conduct MTAT and PECADOM++ with high coverage, although PECADOM++ was not an efficient strategy to complement MTAT. The modest impact of the intervention package suggests a need for alternative or complementary strategies.
Polymorphisms in Plasmodium vivax antifolate resistance markers in Afghanistan between 2007 and 2017
Authors: Rakmark Kasama , Awab Ghulam R. , Duanguppama Jureeporn , Boonyuen Usa , Dondorp Arjen M. , Imwong Mallika 
Published: July 2020

AbstractBackgroundPlasmodium vivaxis the predominantPlasmodiumspecies in Afghanistan. National guidelines recommend the combination of chloroquine and primaquine (CQ-PQ) for radical treatment ofP. vivaxmalaria. Artesunate in combination with the antifolates sulfadoxine-pyrimethamine (SP) has been first-line treatment for uncomplicated falciparum malaria until 2016. Although SP has been the recommended treatment for falciparum and not vivax malaria, exposure of theP. vivaxparasite population to SP might still have been quite extensive because of community based management of malaria. The change in theP. vivaxantifolate resistance markers between 2007 and 2017 were investigated.MethodsDried blood spots were collected (n = 185) from confirmedP. vivaxpatients in five malaria-endemic areas of Afghanistan bordering Tajikistan, Turkmenistan and Pakistan, including Takhar, Faryab, Laghman, Nangarhar, and Kunar, in 2007, 2010 and 2017. Semi-nested PCR, RFLP and nucleotide sequencing were used to assess the pyrimethamine resistant related mutations inP. vivax dihydrofolate reductase(pvdhfrI13L, P33L, N50I, F57L, S58R, T61I, S93H, S117N, I173L) and the sulfonamide resistance related mutations inP. vivax dihydropteroate synthase(pvdhpsA383G, A553G).ResultsIn the 185 samples genotyped forpvdhfrandpvdhpsmutations,11 distinct haplotypes were observed, which evolved over time. In 2007, wild typepvdhfrandpvdhpswere the most frequent haplotype in all study sites (81%, 80/99). However, in 2017, the frequency of the wild-type was reduced to 36%, (21/58;pvalue ≤ 0.001), with an increase in frequency of the double mutantpvdhfrandpvdhpshaplotype S58RS117N (21%, 12/58), and the singlepvdhfrmutant haplotype S117N (14%, 8/58). Triple and quadruple mutations were not found. In addition,pvdhfrmutations at position N50I (7%, 13/185) and the novel mutation S93H (6%, 11/185) were observed. Based on in silico protein modelling and molecular docking, thepvdhfrN50I mutation is expected to affect only moderately pyrimethamine binding, whereas the S93H mutation does not.ConclusionsIn the course of ten years, there has been a strong increase in the frequency pyrimethamine resistance related mutations inpvdhfrin theP. vivaxpopulation in Afghanistan, although triple and quadruple mutations conferring high grade resistance were not observed. This suggests relatively low drug pressure from SP on theP. vivaxparasite population in the study areas. The impact of two newly identified mutations in thepvdhfrgene on pyrimethamine resistance needs further investigation.
Tackling segmentation to advance universal health coverage: analysis of policy architectures of health care in Chile and Uruguay
Authors: Bernales-Baksai Pamela 
Published: July 2020

AbstractBackgroundWith the turn of the century, most countries in Latin America witnessed an increased concern with universalism and redistribution. In the health sector, this translated into a wide range of reforms to advance Universal Health Coverage (UHC) that, however, have had to cope with health systems that stratified the population since their foundation and the further segmentation inherited by market-oriented policies in the 1980s and 1990s.Studies on social welfare stress the relevance of cross-class alliances between the middle and working classes to reach universal and sustainable social benefits. Consequently, the endurance of separate health schemes across groups of the population in most countries in Latin America may seriously hamper the efforts towards UHC.AimThis article addresses the potential of current policy architectures of health care to tackle segmentation between social classes in access to health services in two of the best performers of health coverage in the region, namely Chile and Uruguay.MethodsThe article is a comparative case study based on a literature review and applies an analytical framework that links universal outputs to the policy architectures of health care. The study assesses universal outputs in terms of coverage, generosity and financial protection, identifying equity gaps in each of these dimensions across groups of the population.FindingsLatest processes of reform for UHC in Chile and Uruguay perform highly regarding population coverage. Nevertheless, equity gaps in access to quality services and financial protection remain. In both countries, such gaps relate to the eligibility criteria. In Chile, segmentation is reinforced by the persistence of separated pools of resources that hinder solidarity. Besides, the significant role of private actors and differences in quality between public and private service providers continue to push middle and upper-middle classes to private options. Uruguay’s health reform reinforced the public system and promoted financial solidarity by pooling and progressively allocating resources. Despite this, fragmentation in service provision continues the segmentation of access to health care.ConclusionsThe study shows differences in the options of reforms for UHC in Chile and Uruguay and the relevance of policy architectures to reverse, or conversely deepen, segmentation across groups of the population.
Health-related quality of life and post-traumatic stress disorder in inpatients injured in the Ludian earthquake: a longitudinal study
Authors: Yang Wanqiu , Cui Ke , Sim Timothy , Zhang Jun , Yang Yanchun , Ma Xiaohong 
Published: July 2020

Abstract
Background
The aim of this longitudinal study was to identify risk factors for posttraumatic stress disorder (PTSD) in inpatients injured in the Ludian earthquake and examine the relationship between PTSD symptoms and health-related quality of life (HRQoL) following the earthquake.

Methods
Three assessments were performed during an 18-month follow-up period. In total, one-hundred forty-seven inpatients of one-hundred seventy-four inpatients (85% of the initial sample) underwent all the assessments. Injured inpatients admitted to the No. 1 People’s Hospital of Zhaotong City after a severe earthquake (6.5 on the Richter scale) were enrolled in the study and assessed using the Posttraumatic Stress Disorder Checklist-Civilian Version, Clinician-Administered Posttraumatic Stress Disorder Scale, and Medical Outcomes Study Short Form-36 Scale.

Results
At the first, third and eighteenth months after the earthquake, the prevalence rates for PTSD were 23, 14, and 7%, respectively. In a regression model, bereavement, history of major diseases, and severe injury in the earthquake were associated with severe PTSD symptoms. HRQoL was negatively correlated with PTSD symptoms. Compared to that of Chinese norms, participants’ HRQoL was significantly lower in all eight HRQoL domains of the Medical Outcomes Study Short Form-36 Scale.

Conclusions
The findings suggest that a substantial proportion of inpatients injured in the earthquake experienced severe PTSD symptoms and poor HRQoL. Therefore, early preventive programs and interventions should be implemented following disasters, to reduce PTSD and improve HRQoL in injured individuals.
Subclinical cardiovascular risk signs in adults with juvenile idiopathic arthritis in sustained remission
Authors: Aranda-Valera Inmaculada Concepción , Arias de la Rosa Iván , Roldán-Molina Rosa , Ábalos-Aguilera María del Carmen , Torres-Granados Carmen , Patiño-Trives Alejandra , Luque-Tevar María , Ibáñez-Costa Alejandro , Guzmán-Ruiz Rocío , Malagón María del Mar , Escudero-Contreras Alejandro , López-Pedrera Chary , Collantes-Estévez Eduardo , Barbarroja Nuria 
Published: July 2020

Abstract
Background
Juvenile Idiopathic Arthritis (JIA) is one of the most common chronic diseases of childhood that often persists into adulthood and can result in significant long-term morbidity. As a long lasting chronic inflammatory disease, concern has been raised regarding the risk of premature development of cardiovascular disease (CVD) in JIA. This study aims to determine whether adults with JIA in clinical remission display clinical and subclinical signs of CVD risk: inflammatory mediators, adipokines, endothelial dysfunction and oxidative stress markers.

Methods
This is a cross-sectional study including 25 patients diagnosed with JIA according to the International League of Associations for Rheumatology criteria (ILAR 2001) and 25 age- and sex-matched controls. Remission was determined by JADAS10 < 1 and according to Wallace criteria. The presence of traditional CVD risk factors was analyzed. An extensive clinical analysis including body mass index (BMI), lipid profile, homeostatic model assessment – insulin resistance (HOMA-IR) and arterial blood pressure was performed. Intima media thickness of the common carotid artery (CIMT) was measured as a marker of subclinical atherosclerosis. Several proinflammatory cytokines, molecules involved in the endothelial dysfunction, oxidative stress and adipokines were quantified on serum by ELISA and on peripheral blood mononuclear cells (PBMCs) by RT-PCR. In vitro studies were carried out in healthy PBMCs, adipocytes and endothelial cells which were treated with serum from JIA patients under sustained remission.

Results
Mean duration of the disease was 13.47 ± 5.47 years. Mean age was 25.11 ± 7.21. Time in remission was 3.52 ± 3.33 years. Patients were in remission with no treatment (40%) and with treatments (60%). CVD risk factors and CIMT were similar in JIA patients and controls. However, cholesterol levels were significantly elevated in JIA patients. Levels of adipocytokines, oxidative stress and endothelial activation markers were elevated in serum and PBMCs from JIA patients. Serum of those JIA patients induced the activation of adipocytes, endothelial cells and healthy PBMCs.

Conclusions
JIA adult patients in remission have subclinical signs of inflammation and CVD risk, showed by an increase in the levels of inflammatory cytokines, endothelial activation and oxidative stress markers and adipokines, molecules closely involved in the alteration of the vascular system.
The paediatric global musculoskeletal task force - ‘towards better MSK health for all’
Authors: Foster Helen E. , Scott Christiaan , Tiderius Carl J. , Dobbs Matthew B. 
Published: July 2020

AbstractThere is increasing concern about the emerging global non-communicable diseases (NCDs) burden. The focus has mainly been on NCDs in adults but it is important that MSK morbidity in both children and adults is included in strategic planning. There have been considerable advances in the understanding and treatment options for children and young people (CYP) and clinical outcomes are improving for those who can access such high quality care. However vast inequity exists and there are many CYP who live in areas of the world with high burden of health care challenges, compounded by paucity of specialist care and limited access to treatments. The Paediatric Global Musculoskeletal Task Force aims to raise awareness about unmet needs for CYP with MSK conditions, promotion of MSK health through lifestyle and the avoidance of injury. We aim to leverage change through ‘working together better’.
Assessment of Parkinsonian gait in older adults with dementia via human pose tracking in video data
Authors: Sabo Andrea , Mehdizadeh Sina , Ng Kimberley-Dale , Iaboni Andrea , Taati Babak 
Published: July 2020

Abstract
Background
Parkinsonism is common in people with dementia, and is associated with neurodegenerative and vascular changes in the brain, or with exposure to antipsychotic or other dopamine antagonist medications. The detection of parkinsonian changes to gait may provide an opportunity to intervene and address reversible causes. In this study, we investigate the use of a vision-based system as an unobtrusive means to assess severity of parkinsonism in gait.

Methods
Videos of walking bouts of natural gait were collected in a specialized dementia unit using a Microsoft Kinect sensor and onboard color camera, and were processed to extract sixteen 3D and eight 2D gait features. Univariate regression to gait quality, as rated on the Unified Parkinson’s Disease Rating Scale (UPDRS) and Simpson-Angus Scale (SAS), was used to identify gait features significantly correlated to these clinical scores for inclusion in multivariate models. Multivariate ordinal logistic regression was subsequently performed and the relative contribution of each gait feature for regression to UPDRS-gait and SAS-gait scores was assessed.

Results
Four hundred one walking bouts from 14 older adults with dementia were included in the analysis. Multivariate ordinal logistic regression models incorporating selected 2D or 3D gait features attained similar accuracies: the UPDRS-gait regression models achieved accuracies of 61.4 and 62.1% for 2D and 3D features, respectively. Similarly, the SAS-gait models achieved accuracies of 47.4 and 48.5% with 2D or 3D gait features, respectively.

Conclusions
Gait features extracted from both 2D and 3D videos are correlated to UPDRS-gait and SAS-gait scores of parkinsonism severity in gait. Vision-based systems have the potential to be used as tools for longitudinal monitoring of parkinsonism in residential settings.
Next generation sequencing to decipher concurrent loss of PMS2 and MSH6 in colorectal cancer
Authors: Moreno Esther , Rosa-Rosa Juan M. , Caniego-Casas Tamara , Ruz-Caracuel Ignacio , Perna Cristian , Guillén Carmen , Palacios José 
Published: July 2020

Abstract
Background
Immunohistochemistry (IHQ) is commonly used for the detection of mismatch repair proteins deficiency (MMRD). One very infrequent abnormal pattern of MMR protein expression is the loss of PMS2 and MSH6, with intact expression of MLH1 and MSH2.

Case presentation
We review the frequency of this MMRD IHC pattern among 108 colorectal (CRCs) and 35 endometrial cancers in our files with loss of expression of at least one protein, and present two CRCs showing loss of PMS2 and MSH6 protein expression (1.9% of CRCs). NGS analysis of these tumours identified PMS2 mutations (R134* germline mutation in one tumour and M1R and c.1239delA somatic mutation in the other) as the primary event and somatic MSH6 mutation (c.3261dupC) as the secondary event in both tumours.

Conclusions
This study suggests that Next Generation Sequencing (NGS) tumour analysis should be considered in the algorithm of Lynch syndrome screening to detect MMR gen somatic mutation in inconclusive cases.
Effectiveness of the baby-friendly community initiative in promoting exclusive breastfeeding among HIV negative and positive mothers: a randomized controlled trial in Koibatek Sub-County, Baringo, Kenya
Authors: Samburu Betty Mogesi , Young Sera Lewise , Wekesah Frederick Murunga , Wanjohi Milkah Njeri , Kimiywe Judith , Muriuki Peter , Griffiths Paula L. , McGarvey Stephen T. , Madise Nyovani Janet , Kimani-Murage Elizabeth W. 
Published: July 2020

AbstractBackgroundAlthough the baby-friendly community initiative (BFCI) has been proposed as a community-level approach to improve infant feeding practices, there is little data on its variation in effectiveness by HIV status. We conducted a study to determine the effectiveness of BFCI in changing knowledge and attitudes towards exclusive breastfeeding (EBF) and increasing the rates among HIV negative and HIV positive women in rural Kenya.MethodsA community-based cluster-randomized controlled trial was implemented from April 2015 to December 2016 among 901 women enrolled across 13 clusters. The intervention groups received a minimum of 12 personalized home-based counselling sessions on infant feeding by trained community health volunteers from their first or second trimester of pregnancy until 6 months postpartum. Other interventions included education sessions at maternal child clinics, mother-to-mother support group meetings and bi-monthly baby-friendly gatherings targeting influencers. The control group received standard health education at the facility and during monthly routine home visits by community health volunteers not trained on BFCI. Primary outcome measures were the rates of EBF at week 1, months 2, 4 and 6 postpartum. Secondary outcomes included knowledge and attitudes regarding breastfeeding for HIV-exposed infants. Statistical methods included analysis of covariance and logistic regression.ResultsAt 6 months, EBF rates among HIV negative mothers were significantly higher in the BFCI intervention arm compared to the control arm (81.7% versus 42.2%p = 0.001). HIV positive mothers in the intervention arm had higher EBF rates at 6 months than the control but the difference was not statistically significant (81.8% versus 58.4%;p = 0.504). In HIV negative group, there was greater knowledge regarding EBF for HIV-exposed infants in the intervention arm than in the control (92.1% versus 60.7%p = 0.001). Among HIV positive mothers, such knowledge was high among both the intervention and control groups (96% versus 100%,p > 0.1). HIV negative and positive mothers in the intervention arm had more favourable attitudes regarding EBF for HIV-exposed infants than the control (84.5% versus 62.1%,p = 0.001) and (94.6% versus 53.8% top = 0.001) respectively.ConclusionsBFCI interventions can complement facility-based interventions to improve exclusive and continued breastfeeding knowledge, attitudes, and behaviours among HIV negative and positive women.
Genotype-phenotype correlation in 75 patients with small supernumerary marker chromosomes
Authors: Li Tingting , Sang Haiquan , Chu Guoming , Zhang Yuanyuan , Qi Manlong , Liu Xiaoliang , Cui Wanting , Zhao Yanyan 
Published: July 2020

Abstract
Background
Small supernumerary marker chromosomes (sSMCs) are rare structural abnormalities in the population; however, they are frequently found in children or fetuses with hypoevolutism and infertile adults. sSMCs are usually observed first by karyotyping, and further analysis of their molecular origin is important in clinical practice. Next-generation sequencing (NGS) combined with Sanger sequencing helps to identify the chromosomal origins of sSMCs and correlate certain sSMCs with a specific clinical picture.

Results
Karyotyping identified 75 sSMCs in 74,266 samples (0.1% incidence). The chromosomal origins of 27 of these sSMCs were detected by sequencing-related techniques (NGS, MLPA and STR). Eight of these sSMCs are being reported for the first time. sSMCs mainly derived from chromosomal X, Y, 15, and 18, and some sSMC chromosomal origins could be correlated with clinical phenotypes. However, the chromosomal origins of the remaining 48 sSMC cases are unknown. Thus, we will develop a set of economical and efficient methods for clinical sSMC diagnosis.

Conclusions
This study details the comprehensive characterization of 27 sSMCs. Eight of these sSMCs are being reported here for the first time, providing additional information to sSMC research. Identifying sSMCs may reveal genotype-phenotype correlations and integrate genomic data into clinical care.
Central venous pressure measurement is associated with improved outcomes in septic patients: an analysis of the MIMIC-III database
Authors: Chen Hui , Zhu Zhu , Zhao Chenyan , Guo Yanxia , Chen Dongyu , Wei Yao , Jin Jun 
Published: July 2020

Abstract
Purpose
Measurement of central venous pressure (CVP) can be a useful clinical tool. However, the formal utility of CVP measurement in preventing mortality in septic patients has never been proven.

Methods
The Medical Information Mart for Intensive Care III (MIMIC-III) database was searched to identify septic patients with and without CVP measurements. The primary outcome was 28-day mortality. Multivariate regression was used to elucidate the relationship between CVP measurement and 28-day mortality, and propensity score matching (PSM) and an inverse probability of treatment weighing (IPTW) were employed to validate our findings.

Results
A total of 10,275 patients were included in our study, of which 4516 patients (44%) underwent CVP measurement within 24 h of intensive care unit (ICU) admission. The risk of 28-day mortality was reduced in the CVP group (OR 0.60 (95% CI 0.51–0.70; p < 0.001)). Patients in the CVP group received more fluid on day 1 and had a shorter duration of mechanical ventilation and vasopressor use, and the reduction in serum lactate was greater than that in the no CVP group. The mediating effect of serum lactate reduction was significant for the whole cohort (p = 0.04 for the average causal mediation effect (ACME)) and patients in the CVP group with an initial CVP level below 8 mmHg (p = 0.04 for the ACME).

Conclusion
CVP measurement was associated with decreased risk-adjusted 28-day mortality among patients with sepsis and was proportionally mediated through serum lactate reduction.