bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of otoendoscope as a preoperative tool in tympanoplasty
Authors: Showkat Showkat Ahmad , Bhagat Nadhia , Bhat Mohammed Shafi , Shafiq Bilal 
Published: March 2020

<p class="abstract"><strong>Background:</strong> Chronic suppurative otitis media (CSOM) is one of the common causes for hearing impairment and disability. Despite continuous technical improvement, the basic optical principles and their limitations have remained the same over the past three decades. This study aimed at visualizing and evaluating the middle ear structures with the aid of 0 and 30-degree otoendoscopes preoperatively in cases of chronic suppurative otitis media.</p><p class="abstract"><strong>Methods:</strong> In this prospective study, 70 patients (40 females and 30 males) above the age of 10 years with CSOM were subjected to otoendoscopy using 0- and 30-degree endoscopes. The various middle ear structures and hidden spaces like facial recess, sinus tympani, hypotympanum were visualized preoperatively. </p><p class="abstract"><strong>Results:</strong> Middle ear structures and blind niches were better evaluated preoperatively using 0 and 30-degree otoendoscopes and a definitive operative plan was formulated.</p><p class="abstract"><strong>Conclusions:</strong> Otoendoscopy provided a significant better visualization of all the middle ear structures and various hidden spaces.</p>
A rare case of primary nasal tuberculosis
Authors: M. V. George , Theresa Lina , R. Aswathi 
Published: March 2020

<p>Even though tuberculosis is not uncommon, primary nasal tuberculosis is extremely rare. This is the story of a 46 years old man, diabetic, who had not any chest symptoms suggestive of tuberculosis, presented to us with nasal block, sneezing for a long time. The symptoms didn't improve with the usual lines of management from Dubai where he was working. When we saw the patient, he had a deviated nasal septum towards right side, and highly boggy pale mucosa of the nose with mucoid discharge on left side. He was on antibiotics for a long time. Hence a CT scan was taken. The CT scan showed typical features of sinusitis. Therefore, he was advised septoplasty with functional endoscopic sinus surgery (FESS). On surgery, the inferior turbinate was seen boggy with pale mucosa. It obscured the vision of the middle turbinate. There was granuloma on the turbinate. This was taken for biopsy and the report was granulomatous tissue with areas of necrosis and the possibility of tuberculosis is there. His blood samples were negative for other granulomatous disease and therefore was advised antituberculosis treatment. His symptoms improved. There was no evidence of a pulmonary tuberculosis in the chest and therefore was diagnosed as a case of primary nasal tuberculosis<em>. </em></p>
Un nuevo encuentro con el recurrente problema de Basilea: ∑_(K=1)^∞ (1/K^2)
Authors: Vacca Harold , Conde Nicolás , Rojas Lucio 
Published: March 2020

Los espacios vectoriales se han considerado una herramienta fundamental para las aplicaciones modernas del álgebra lineal; en este sentido, las funciones –señales- se consideran como vectores. Cuando el espacio vectorial se dota con un producto interior, la proyección de una función sobre un subespacio es análoga al cálculo de una aproximación a un vector del espacio, generalmente de dimensión finita, mediante un número finito de funciones de una base de tipo ortogonal. En el presente artículo se realiza una mirada de los antecedentes y soluciones al problema de Basilea (PB) o ∑_(K=1)^∞ (1/K^2), desde su origen a mediados del siglo XVII hasta hoy, es decir: 372 años de un problema que aparece recurrentemente en el ambiente matemático; y se presenta como novedad una solución por medio de la teoría de los espacios vectoriales, más concretamente utilizando proyecciones de una función sobre un subespacio; se exhiben los resultados de aplicar la solución en el cálculo de y su comparación con fracciones que lo han representado históricamente.
Field Adaptation for Watermelon Cultivation under Shallow Ground Water Table in Tidal Lowland Reclamation Area
Authors: Imanudin Momon Sodik , JP Satria , , Bakri , Armanto M. Edi 
Published: March 2020

<p> </p><ul><li>Agriculture productivity of tidal lowland reclamation areas in South Sumatra is still low. It leads to the increasing of agricultural land conversion into plantation areas. Controlling the water table is the main factor in the tidal lowlands; this research aimed to develop micro drainage system in tertiary block for controlling water table under wet condition. Watermelon was used as a crop indicator and planted in mid- March 2015. The location of the research was in a tidal lowland agriculture with land typology B, where the tide can only be as irrigation during the rainy season. The method of this research was surveying and monitoring. Groundwater observation, measurement value hydraulic conductivity and land drainage applications were included in the field activities. The design of land drainage used an<strong> </strong>intensive shallow drainage concept; the effect of the depth of the water table to water status was evaluated by the UPFLOW model. A micro drainage on tertiary block was used by 8 m drain spacing, with channel depth of 20 cm. The results showed that the tertiary gate operation was maximum drainage option. The water table depth was 25 cm in soil depth.The watermelon crops grew well and production reached 20 t ha-1</li></ul><pre>. </pre><p> </p>
Antimicrobial resistance and novel mutations detected in the gyrA and parC genes of Pseudomonas aeruginosa strains isolated from companion dogs
Authors: Park Youjin , Oh Jaeyoung , Park Sowon , Sum Samuth , Song Wonkeun , Chae Jongchan , Park Hee-Myung 
Published: March 2020

Abstract
Background: Fluoroquinolone agents, such as enrofloxacin and marbofloxacin, are commonly used for pseudomonal infection in veterinary medicine. However, the rate of resistance to fluoroquinolones is rapidly increasing, according to multiple studies in various countries. Point mutations in the quinolone resistance-determining region (QRDR) are closely related to the increased fluoroquinolone resistance of Pseudomonas aeruginosa. The aim of this study was to investigate current antimicrobial susceptibility and fluoroquinolone resistance in P. aeruginosa strains isolated from dogs. The presence of point mutations in the QRDR was confirmed by gyrA and parC polymerase chain reaction and nucleotide sequencing analysis.Results: A total of 84 nonduplicated P. aeruginosa strains were obtained from 228 healthy dogs (healthy group) and 260 dogs with clinical signs (infected group). Among these isolates, 38 strains from the healthy group were detected in several sample types, whereas 46 strains from the infected group were obtained mostly from dogs’ ears with otitis externa (41/260, 15.8%). All strains were resistant to nalidixic acid, while some were also resistant to enrofloxacin (23/84, 27.4%), marbofloxacin (17/84, 20.2%), levofloxacin (12/84, 14.3%), or ciprofloxacin (11/84, 13.1%). Enrofloxacin resistance was significantly higher in strains from the infected group than in those from the healthy group (p<0.05). Among the 23 fluoroquinolone-resistant strains, 8 and 4 different mutations were detected in the gyrA and parC genes, respectively. Mutations in gyrA were significantly common in the infected group (p<0.05). Hotspots for the gyrA and parC mutations were Thr83 (34.8%, 8/23) and Pro116 (91.3%, 21/23), respectively. Double and triple mutations were also found in 5 of the strains.Conclusion: Novel mutations in the gyrA and parC genes were first found in P. aeruginosa isolated from companion dogs in South Korea. These findings suggest that it is important to encourage prudent use of fluoroquinolone antibiotics in canine pseudomonal infection treatment.
Access to health care for people with disabilities in rural Malawi: what are the barriers?
Authors: Harrison Josephine , Thomson Rachael , Banda Hastings T. , Mbera Grace B. , Gregorius Stefanie , Stenberg Berthe , Marshall Tim 
Published: March 2020

Abstract
Background People with disabilities experience significant health inequalities. In Malawi, where most individuals live in low-income rural settings, many of these inequalities are exacerbated by restricted access to health care services. This qualitative study explores the barriers to health care access experienced by individuals with a mobility or sensory impairment, or both, living in rural villages in Dowa district, central Malawi. In addition, the impact of a chronic lung condition, alongside a mobility or sensory impairment, on health care accessibility is explored. Methods Using data from survey responses obtained through the Research for Equity And Community Health (REACH) Trust’s randomised control trial in Malawi, 12 adult participants, with scores of either 3 or 4 in the Washington Group Short Set (WGSS) questions, were recruited. The WGSS questions concern a person’s ability in core functional domains (including seeing, hearing and moving), and a score of 3 indicates ‘a lot of difficulty’ whilst 4 means ‘cannot do at all’. People with cognitive impairments were not included in this study. All who were selected for the study participated in an individual in-depth interview and full recordings of these were then transcribed and translated. Results Through thematic analysis of the transcripts, three main barriers to timely and adequate health care were identified: 1) Cost of transport, drugs and services, 2) Insufficient health care resources, and 3) Dependence on others. Attitudinal factors were explored and, whilst unfavourable health seeking behaviour was found to act as an access barrier for some participants, community and health care workers’ attitudes towards disability were not reported to influence health care accessibility in this study. Conclusions This study finds that health care access for people with disabilities in rural Malawi is hindered by closely interconnected financial, practical and social barriers. There is a clear requirement for policy makers to consider the challenges identified here, and in similar studies, and to address them through improved social security systems and health system infrastructure, including outreach services, in a drive for equitable health care access and provision.
Knowledge and practices regarding tuberculosis infection control among nurses in Ibadan, South-West Nigeria: a cross-sectional study
Authors: Akande Patrick Aboh 
Published: March 2020

Abstract
Background: Nurses are particularly vulnerable to nosocomial tuberculosis (TB) infection because, being in the frontline of healthcare provision, they are frequently exposed to patients with infectious TB disease. Although cost-effective measures are available for TB infection control (TBIC), they are often poorly implemented. Knowledge of TBIC is known to positively influence the practice of the measures. There is, however, paucity of data on the knowledge and practices regarding TBIC among nurses in Nigeria. This study was aimed at determining the levels of TBIC-related knowledge and practices of nurses in Ibadan, and their associated socio-demographic factors. Methods: This cross-sectional study utilized a self-administered questionnaire to collect data from 200 nurses in two secondary health facilities, in May 2014. The mean knowledge and practice scores of the nurses were determined and logistic regression was utilized to explore the association between the scores and socio-demographic characteristics. Results: The respondents had mean knowledge and practice scores of 68.2% and 79.9% respectively. Using cut-off points of 80% and 100% for good knowledge and practice scores respectively, small proportions of the nurses had good scores – knowledge (10.5%) and practice (6%). Knowledge was not significantly associated with the socio-demographic characteristics of the nurses. Work experience was the only factor that was significantly associated with practices, with the more experienced nurses (>18 years of work experience) having lower odds of obtaining good practice scores (OR 0.25, 95% CI 0.06-0.94). There was also no significant association between knowledge and practice scores (the nurses were yet to be trained on the newly-introduced TBIC package at the time of the study). Conclusions: The study revealed that small proportions of the nurses had good knowledge and practice scores. Its findings will be useful for the designing of interventions to improve TBIC among nurses and other healthcare workers, and to benchmark evaluation of the interventions. It is recommended that nurses should be trained on TBIC to equip them with necessary knowledge and skills. This, together with appropriate policy directives, and adequate monitoring and supervision will contribute to optimal implementation of TB preventive measures.
Catastrophic health expenditure: A comparative study between hypertensive patients with and without complication in rural Shandong, China
Authors: Zhang Xinyi , Xu Qiongqiong , Guo Xiaolei , Jing Zhengyue , Sun Long , Li Jiajia , Zhou Chengchao 
Published: March 2020

Abstract
Background: Some previous studies have assessed catastrophic health expenditure (CHE) in households with hypertensive patients, but few have examined the difference of CHE in hypertensive patients with and without complications. The purpose of this study is to compare the incidence and determinants of CHE between hypertensive patients with and without complications. Methods: Data of this study were from a cross-sectional study in Shandong Province in China in 2016. Of the recruited 3,457 hypertensive patients registered in the NCDs management system in the sampling villages, 3,113 completed the survey, with a response rate of 90.05%.CHE was defined as out-of-pocket payments for hypertensive care that equaled or exceeded 40% of the household capacity to pay (non-food expenditure). Hypertension complications (e.g., stroke, coronary heart disease, hypertensive kidney disease, etc.) were collected in this study, which was categorized into 0 (no), 1(single), and 2 and more according to the types of hypertensive complications. We employed Chi-square test to explore associated factors and logistic regression model to identify the determinants of CHE. Results: The incidence of CHE and impoverishment is 13.6% and 10.8% among hypertensive patients. The incidence of CHE with one complication is 25.3% ( R =0.000, OR=2.29 ) and 47.3% ( P =0.000, OR=3.60 ) in patients with two or more complications, which are both statistically higher than that in patients without complication (6.1%). Across all types of patients, income levels are inversely related to the incidence of CHE. Patients who use outpatient or inpatient service are more likely to experience CHE ( R =0.000 ). Factors including living arrangements, family size, educational attainment are found to be significantly associated with CHE in some subgroups ( P ＜ 0.05 ). Conclusions: CHE and impoverishment incidence among hypertensive patients are both high in rural China. Patients with hypertensive complication are at higher catastrophic risk than those without complication.More attention needs to be paid to households with hypertension patients, especially for those with hypertension complications.
Effect of Smoking on Treatment Outcome Among Tuberculosis Patients in Malaysia; a Multicentre Study
Authors: Khan Amer Hayat , Sulaiman Syed Azhar Syed , Hassali Mohamed Azmi , Khan Kashif Ullah , Ming Long Chiau , Mateen Umer , Malik Obaid Ullah 
Published: March 2020

Abstract
Background: Smoking plays a key role in the development of tuberculosis (TB) infection and is also a predictor of poor TB treatment prognosis and outcomes.Objectives:To determine the prevalence of smoking and to assess the effects of smoking on treatment outcomes among TB patients.Methods: A multi-center retrospective study design was used to collect data from TB patients in four different states of Malaysia, namely Penang, Sabah, Sarawak, and Selangor. The study included medical records of TB patients admitted to the selected hospitals in the period from January 2006 to March 2009. Medical records with incomplete data were not included. Patient demographics and clinical data were collected using a validated data collection form.Results: Of all patients with TB (9337), the prevalence of smokers was 4313 (46.2%). Among smoker’s, 3584 (83.1%) were associated with pulmonary TB, while 729 (16.9%) were associated with Extra-pulmonary TB. Male gender (OR= 1.43, 95% CI 1.30-1.58), Chinese ethnicity (OR= 1.23, 95% CI 1.02-1.49), Sarawak indigenous ethnicity (OR= 0.74, 95% CI 0.58-0.95), urban residents (OR= 1.46, 95% CI 1.33-1.61), employed individuals (OR= 1.21, 95% CI 1.09-1.34), alcoholics (OR= 4.91, 95% CI 4.04-5.96), drug abusers (OR= 7.43, 95% CI 5.70-9.60) and presence of co-morbid condition (OR= 1.27, 95% CI 1.16-1.40) showed significant association with smoking habits. This study found that 3236 (75.0 %) patients were successfully treated in the smoker group, while 4004 (79.7 %) patients were non-smokers. The proportion of death rate 283 (6.6%), defaulters 284 (6.6%) and treatment interruption 204 (4.7%) was high in the smoker's group.Conclusions: Smoking had a strong influence on TB and is a major barrier towards treatment success (OR= 0.76, 95% CI 0.69-0.84, p< 0.001). Therefore, the findings point out that smoking cessations are an effective way to decrease treatment failure and drug resistance.
Lonely places or lonely people? Investigating the relationship between loneliness and place of residence
Authors: Victor Christina R , Pikhartova Jitka 
Published: March 2020

Abstract
Background: Loneliness in later life is largely presented as a problem of the individual focusing upon antecedents such as demographic or health factors. Research examining the role of the broader living environments is much rarer. We examined the relationship between loneliness and three dimensions of the lived environment: geographical region, deprivation, and area classification (urban or rural).Methods: Our sample consisted of 4,663 core members (44% males) aged 50+ (wave 7 mean age 72.8, S.D.= 7.1) present both in waves 3 (2006) and 7 (2014) of the English Longitudinal Study of Ageing (ELSA). Loneliness was measured using two approaches, individual and area-based, and both waves included these questions. Individual-based (self-reported) loneliness was assessed using the three item University of California Los Angeles (UCLA) scale (ranging from 3 =not lonely to 9= lonely with a score of 6+ defining loneliness. We also used a novel question which asked participants to evaluate how often they felt lonely in their area of residence (area-based; ranging from 1=often to 7=never, using cut off 4+ to define loneliness). The lived environment was classified in three different ways: the Index of Multiple Deprivation (IMD), Government Office Regions (GOR), and area classification (urban or rural). Covariates with established relationship with loneliness including demographic factors, social engagement and health, were included in the analyses. Results: In wave 7, the prevalence of individual-based loneliness was 18% and area-based was 25%. There was limited congruence between measures: 68% participants reported no individual- or area-based loneliness and 9% reported loneliness for both measures. After adjusting for individual co-variates only one significant relationship was observed between loneliness and area -based characteristics. A significant association was observed between area-based loneliness and deprivation score, with higher levels of loneliness in more deprived areas (OR=1.4 for highest quintile of deprivation). Conclusions: Our results indicate that loneliness in older adults is higher in the most deprived areas independent of individual-level factors. In order to develop appropriate interventions further research is required to investigate how area-level factors combine with individual-level loneliness vulnerability measures to generate increased levels of loneliness in deprived areas.
Are we doing enough? Improved breastfeeding practices at 14weeks but challenges of non-initiation and early cessation of breastfeeding remain: findings of two consecutive cross-sectional surveys in KwaZulu-Natal, South Africa
Authors: Horwood Christiane , Haskins Lyn , Engebretsen Ingunn Marie , Connolly Catherine , Coutsoudis Anna , Spies Lenore 
Published: March 2020

Abstract
Background KwaZulu-Natal (KZN) Initiative for breastfeeding support (KIBS) was a multipronged intervention to support breastfeeding initiation and sustained breastfeeding implemented between 2014 and 2017. We present results of two surveys conducted before and after KIBS implementation to assess changes in feeding practices in KZN over this time period. Methods Two cross-sectional surveys were conducted in primary health care clinics. Multistage stratified random sampling was used to select clinics and participants. Sample size was calculated to provide district estimates of 14-week exclusive breastfeeding (EBF) rates at baseline (KIBS1), and provincial estimates at endpoint (KIBS2). At KIBS1 the sample required was nine participating clinics in each of 11 districts (99 clinics) with 369 participants per district (N=4059), and at KIBS2 was 30 clinics in KZN with 30 participants per clinic (N=900). All caregivers aged ≥ 15 years attending the clinic with infants aged 13- <16 weeks were eligible to participate. Data was collected using structured interviews on android devices. Multi-variable logistic regression was used to adjust odds ratios for differences between time points. Results At KIBS1 (May2014- March2015), 4172 interviews were conducted with carers, of whom 3659 (87.6%) were mothers. At KIBS2 (January-August 2017), 929 interviews were conducted which included 788 (84.8%) mothers. Among all carers the proportion of EBF was 44.6% and 50.5% (p= 0.1) at KIBS1 and KIBS2 respectively, but greater improvements in EBF were shown among mothers (49.9 vs 59.1: p=0.02). There were reductions in mixed feeding among all infants (23.2% vs 16.3%; p=0.016). Although there was no change in the proportion of carers reporting not breastfeeding (31.9% vs 32.8%; p= 0.2), the duration of breastfeeding among mothers who had stopped breastfeeding was longer at KIBS2 compared to KIBS1 (p=0.0015). Mothers who had returned to work or school were less likely to be breastfeeding (AOR 3.76; 95% CI 3.1-4.6), this was similar among HIV positive mothers (AOR 2.1; 95% CI 1.7-2.6). Conclusion Despite improvements to exclusive breastfeeding, failure to initiate and sustain breastfeeding is a challenge to achieving optimal breastfeeding practices. Interventions are required to address these challenges and support breastfeeding particularly among working mothers and HIV positive mothers.