bluuebunny/crossref_metadata_2025_split huggingface dataset:
Essential Newborn Care Utilization and Associated Factors in Ethiopia: A Systematic Review and Meta-Analysis
Authors: Merkeb Yoseph , Adane Fentahun , Yirga Tadesse , Desta Melaku 
Published: January 2020

Abstract
Background: Globally, newborn death accounted for 46% of under-five deaths and more than 80% of newborn deaths are the result of preventable and treatable conditions. Reports on the prevalence and associated factors of essential newborn care utilization are highly variable and inconsistent across Ethiopia. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence of essential newborn care utilization and associated factors in Ethiopia.
Methods : The international databases include: MEDLINE/PubMed, EMBASE, Web of Sciences, Scopus, Google Scholar, Science Direct, Cochrane library and others were scientifically explored. We considered all primary studies reporting the prevalence of essential newborn care utilization and associated factors in Ethiopia. We retrieved all necessary data by using a standardized data extraction format spreadsheet. STATA 14 statistical software was used to analyze the data and Cochrane Q test statistics and I 2 test was used to assess the heterogeneity between the studies.Random effect model was employed.
Results: The pooled estimate of essential newborn care utilization from 11 studies in Ethiopia was 48.768% (95% CI: 27.891, 69.645). Residence [ OR = 2.50 (95% CI: 1.64, 3.88)], Postnatal care [OR=5.53, 95% CI = (3.02, 10.13], counseling during pregnancy and delivery [OR=4.39, 95% CI = (2.99, 6.45], antenatal care follows up (OR=6.84; 95% CI: 1.15, 4.70) and maternal educational status [OR = 1.63 (95% CI: 1.12, 2.37)] were identified as the associated factors of essential newborn care utilization.
Conclusion: Based on the current study essential newborn care utilization in Ethiopia was significantly low as compared to the current global recommendation on essential newborn care utilization. Place of residence, Postnatal care, counseling during pregnancy and delivery, antenatal care follows up and maternal educational status were associated risk factors variables. Therefore, on the basis of the results, it is suggested that special attention should be given to attempts to ensure that education should focus on women during ante and postnatal follow-up, counseling during pregnancy and delivery, as well as rural and illiterate mothers. Finally, appropriate newborn services utilization at health facilities and raising mother’s level of awareness about newborn care practices should be recommended.
“When my mother called to say that the time of cutting had arrived, I escaped to Belgium with my daughter”: Identifying turning points in the change of attitudes towards the practice of Female Genital Mutilation among migrant women in Belgium
Authors: Agboli Afi A. , Richard Fabienne , Aujoulat Isabelle 
Published: January 2020

Abstract
Background Female Genital Mutilation (FGM) remains a public health concern with negative consequences on women’s health. It is a harmful practice and recognized in international discourses on public health as a form of gender-based violence of which women are not only victims, but also perpetrators. Although the practice of FGM remains a social norm which is difficult to change because of its deep roots in tradition and how it is embedded in the patriarchal system, some women have changed their attitudes towards it and speak out against it. This study identifies and describes turning points (TP) defined as significant events in the lives of the women, that create changes towards the practice of FGM.Methods We conducted an inductive qualitative study based on the life story approach where we interviewed 15 women with FGM. During the interviews the turning points that gave them the courage to change were identified together with the research participants. The analysis drew on lifeline reconstructions and thematic analysis.Results Six common turning points relating to a change in attitude towards FGM were identified: TPs related to encounters with health professionals, education, social interactions with other cultures and their own culture, experiences of motherhood, repeated pain during sexual or reproductive activity and to the fact witnessing some harmful consequences of FGM towards loved ones.Conclusion The turning points identified challenged the understanding of what it means to be a ‘member’ of the community in a patriarchal system, a ‘normal woman’ according to the community and what it means to be a good mother. In addition, the TPs found were expressed together with some issues related to emotional responses and coming to terms with conflict of loyalty, which we see as possible mechanisms to explain the change experienced by the women in our sample.
In vitro and Numerical Simulation of Blood Removal from Cerebrospinal Fluid: Comparison of Lumbar Drain to Neurapheresis Therapy
Authors: Khani Mohammadreza , Sass Lucas , Sharp M. Keith , McCabe Aaron , Verbick Laura Zitella , Lad Shivanand , martin bryn 
Published: January 2020

Abstract
Background: Blood removal from cerebrospinal fluid (CSF) in post-subarachnoid hemorrhage patients may reduce the risk of related secondary brain injury. We formulated a computational fluid dynamics (CFD) model to investigate the impact of a dual-lumen catheter-based CSF filtration system, called Neurapheresis TM therapy, on blood removal from CSF compared to lumbar drain. Methods: A subject-specific multiphase CFD model of CSF system-wide solute transport was constructed based on MRI measurements. The Neurapheresis catheter geometry was added to the model within the spinal subarachnoid space. Neurapheresis flow aspiration and return rate was 2.0 and 1.8 (mL/min), versus 0.2 (mL/min) drainage for lumbar drain. Blood was modeled as a bulk fluid phase within CSF with a 10% initial tracer concentration and identical viscosity and density as CSF. Subject-specific oscillatory CSF flow was applied at the model inlet. The dura and spinal cord geometry were considered to be stationary. Spatial-temporal tracer concentration was quantified based on time-average steady-streaming velocities throughout the domain under Neurapheresis therapy and lumbar drain. To help verify CFD results, an optically clear in vitro CSF model was constructed with fluorescein used as a blood surrogate. Quantitative comparison of numerical and in vitro results was performed by linear regression of spatial-temporal tracer concentration over 24-hours. Results: After 24-hours, tracer concentration was reduced to 4.9% under Neurapheresis therapy compared to 6.5% under lumbar drain. Tracer clearance was most rapid between the catheter aspiration and return ports. Neurapheresis therapy was found to have a greater impact on steady-streaming compared to lumbar drain. Steady-streaming in the cranial SAS was ~50X smaller than in the spinal subarachnoid space for both cases. CFD results were strongly correlated with the in vitro spatial-temporal tracer concentration under Neurapheresis therapy (R 2 =0.89 with +2.13% and -1.93% tracer concentration confidence interval). Conclusion: A subject-specific CFD model of CSF system-wide solute transport was used to investigate the impact of Neurapheresis therapy on tracer removal from CSF compared to lumbar drain over a 24-hour period. Neurapheresis therapy was found to substantially increase tracer clearance compared to lumbar drain. The multiphase CFD results were verified by in vitro fluorescein tracer experiments.
Magnitude of virologic failure and associated factors among adult patients on antiretroviral therapy at Debre Markos Referral Hospital, Northwest Ethiopia, 2018
Authors: Abebaw Addisu , Taddele Mekuanint , Alem Girma , Birlew Tesfa , Berihun sileshi 
Published: January 2020

Abstract
Background : Viral load monitoring is used as an important marker for diagnosing early treatment failure in patients with HIV infection/AIDS. Ethiopia has started targeted viral load monitoring recently. However, factors leading to virological failure are not well understood. The aim of this study is to assess magnitude of virologic failure and associated factors among adult patient on ART at Debre Markos Referral Hospital, North West Ethiopia. Methods : Cross sectional study was conducted on 304 participants who had started first line HAAR. Data were collected from patients’ chart starting from ART commencement and face to face interview using semi structured questionnaire. Viral load from separated plasma were analyzed according to protocols. The collected data were analyzed using SPSS version 20. Binary and multiple logistic regression models were fitted to identify factors associated with virological failure among adult patient on ART and to control confounding effect. The results were presented as odds ratio (OR) with 95% confidence intervals. Independent associations were considered with p<0.05. Results: Magnitude of virological failure was 10.5%. Lower income, (AOR = 3.5, 95% CI = 1.2 - 10.5, P = 0.024), lack of social support (AOR = 2.9, 95% CI = 1.01 – 8.2, P = 0.024), Interruption of ART, (AOR = 3.5, 95% CI = 1.01 – 12.1, P = 0.046), drug adherence (AOR = 3.6, 95% CI = 1.1 – 11.3, P = 0.028), non-working functional status (AOR = 3.5, 95% CI = 1.2 – 9.7, P = 0.018), WHO stage III or IV (AOR = 2.9, 95% CI = 1.01 – 8.0, P = 0.040), CD4 count < 200 cells/ml (AOR = 3.0, 95% CI = 1.1 – 8.0, P = 0.031) and TB co-infection (AOR = 3.7, 95% CI = 1.2 – 11.3, P = 0.018) were significantly associated with virological failure. Conclusions and recommendations : The prevalence of virologic failure was high. Lower income, lack of social support, interruption of ART, drug non-adherence, baseline non-working functional status, WHO stage, CD4 count < 200 cells/ml and TB co-infection Conducting faith healing, TB co infection, WHO stage III and IV, adherence, and income were determinants of virologic failure. Therefore early identification of associated factors and monitoring of virologic failure has to be strengthened to benefit patients to prevent from further complication. Keywords : HIV, virological failure, ART, Ethiopia
Surgical site infection following elective mesh repair of inguinal hernia: an analysis of risk factors
Authors: Zhuo Yeye , Li Xinxin , Chen Juntian , Zhang Qian , Cai De 
Published: January 2020

Abstract
Background: Surgical site infection (SSI) is a complication of mesh repair of inguinal hernia (IH) with an increase in length of stay and costs. We investigated both controllable and non-controllable risk factors for SSI following elective mesh repair of IH. Methods: A retrospective analysis was conducted of 1177 adult patients who underwent elective mesh repair of IH (not receiving antibiotic prophylaxis) from January 2010 to September 2019. Demographics, surgical variables and laboratory data were extracted from the electronic medical records. Receiver operating characteristic (ROC) analysis was performed to determine the optimal threshold of continuous variables. Independent risk factors for SSI were identified by univariate and multivariate analyses. Results: In total, 647 open and 530 laparoscopic IH repairs were included. The overall SSI rate within 30 days after surgery was 3.2% (39/1342 hernias) in the absence of antibiotic prophylaxis. Both the preoperative neutrophil‐lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) were negatively correlated with the postoperative period of SSI (r = -0.368, P = 0.021; r = -0.334, P = 0.038, respectively). On multivariate analyses, body mass index (BMI) > 24.6 kg/m 2 (odds ratio [OR], 1.152; 95% confidence interval [CI], 1.041-1.275), current smoker (OR, 4.226; 95% CI, 1.222-14.611), preoperative NLR > 1.97 (OR, 3.670; 95% CI, 1.675-8.041), and open approach (OR, 4.866; 95% CI, 1.877-12.618) were significantly related to postoperative SSI. Conclusion: The controllable risk factors (elevated BMI, current smoker) found out here may help to identify patients at high-risk of SSI, allowing targeted preventive measures. Preoperative NLR > 1.97 is a previous unrecorded predictor for SSI following elective mesh repair of IH. Further study is needed to ascertain the magnitude of their effect.
A novel genotyping technique for discriminating LVAS-associated hotspot mutations in SLC26A4 gene
Authors: Zhou Chen , Zou Xiangman , Peng Cuiying , Gao Guoqiang , Guo Zifen 
Published: January 2020

Abstract
An increasing number of biological and epidemiological evidence suggests that IVS7-2A>G and 2168A>G mutations of solute carrier family 26, member 4 ( SLC26A4 ) gene plays a critical role in the development of large vestibular aqueduct syndrome (LVAS). In this study, we developed a rapid genotyping method for discriminating LVAS-associated hotspot mutations in SLC26A4 gene. The genotyping technique consists of 3’ terminal exonuclease-resistant phosphorothioate-modified allele specific primer extension mediated by exo + polymerase. In PCR amplification by Pfu polymerase, allelic specific primers perfectly matching wild type allele were extended while no specific products were yielded from primers targeting mutant type allele. Similarly, allelic specific primers perfectly matching mutant type allele were extended and no specific products were observed from primers targeting wild type allele . The clinical application of 3’ terminal phosphorothioate-modified allele specific primers extension mediated by Pfu polymerase identified both homozygous for SLC26A4 gene IVS7-2A>G mutation in two LVAS patients diagnosed as by temporal bone CT scan. The genetic results from this method is consistent with that of DNA sequencing. The data suggest that exo + polymerase-mediated 3’ terminal phosphorothioate-modified primer extension is reliable in the identification of SLC26A4 gene hotspot mutation prior to high resolution CT scan. The method is extremely suitable for quickly molecular etiologic screening and early diagnosis and aggressive prevention therapy of LVAS.
Comparison of statistical methods for analysis of small sample sizes for detecting the differences in efficacy between treatments for knee osteoarthritis
Authors: Shih Chia-Lung , Hung Te-Yu 
Published: January 2020

Abstract
Background A small sample size (n < 30 for each treatment group) is usually enrolled to investigate the differences in efficacy between treatments for knee osteoarthritis (OA). The objective of this study was to use simulation for comparing the power of four statistical methods for analysis of small sample size for detecting the differences in efficacy between two treatments for knee OA. Methods A total of 10,000 replicates of 5 sample sizes (n=10, 15, 20, 25, and 30 for each group) were generated based on the previous reported measures of treatment efficacy. Four statistical methods were used to compare the differences in efficacy between treatments, including the two-sample t-test (t-test), the Mann-Whitney U-test (M-W test), the Kolmogorov-Smirnov test (K-S test), and the permutation test (perm-test). Results The bias of simulated parameter means showed a decreased trend with sample size but the CV% of simulated parameter means varied with sample sizes for all parameters. For the largest sample size (n=30), the CV% could achieve a small level (<20%) for almost all parameters but the bias could not. Among the non-parametric tests for analysis of small sample size, the perm-test had the highest statistical power, and its false positive rate was not affected by sample size. However, the power of the perm-test could not achieve a high value (80%) even using the largest sample size (n=30). Conclusion The perm-test is suggested for analysis of small sample size to compare the differences in efficacy between two treatments for knee OA.
Carriage of Methicillin-resistant Staphylococcus aureus among people living with HIV-AIDS in inner São Paulo State, Brazil: molecular and spatial epidemiology
Authors: Lastória Leticia Chamma , Cunha Maria de Lourdes Ribeiro de Souza da , Souza Camila Sena Martins de , Souza Lenice do Rosário de , Victória Cassiano , Fortaleza Carlos Magno Castelo Branco 
Published: January 2020

Abstract
Background: Methicillin-resistant Staphylococcus aureus (MRSA) is increasingly recognized as a threat for people living with HIV/AIDS (PLWHA). However, the magnitude of asymptomatic MRSA colonization in that group varies among different countries and geographic regions. Methods: We conducted a study that aimed at identifying the prevalence, risk factors and spatial epidemiology of both overall S. aureus and MRSA colonization among PLWHA from small cities from inner São Paulo State, Brazil. MRSA isolates were characterized using Pulsed-Field Gel Electrophoresis (PFGE), and submitted to typing of the Staphylococcal Chromosome Cassete (SCC)mec. Spatial analysis was performed to search for geographical clusters and correlation with socioeconomic indicators. Results: In a first point prevalence survey, nasal and oropharyngeal swabs of 368 people were collected. Sixty-seven subjects from the city of Botucatu were surveyed for colonization in two other occasions, and had swabs collected from household members. The prevalence rates for S. aureus and MRSA in the first survey were 25.8% and 2.7%. The overall S. aureus colonization was negatively associated with the use of beta-lactams and of illicit drugs. On the other hand, MRSA colonized subjects were more likely to use crack and to have been admitted to a hospital during the past year. Repeated surveys found additional cases of MRSA colonization, but all subjects were positive in only one occasion. Four PFGE clusters were characterized, grouping subjects in household, city and region level. Of 19 total MRSA isolates, only one did not harbor SCCmec type IV. Spatial analysis of households of subjects living in the city of Botucatu found significant overdispersion of cases, but no association with socio-economic indicators. Conclusion: We found small but relevant prevalence of MRSA among PLWHA. Community and healthcare-associated risk factors were identified, so that predominant routes of transmission could not be determined on epidemiological grounds.
Descriptive Epidemiology and Outcomes of Soft Tissue Sarcomas in Adolescent and Young Adult Patients in Japan
Authors: Fukushima Takashi , Ogura Koichi , Akiyama Toru , Takeshita Katsushi , Kawai Akira 
Published: January 2020

Abstract
Background: Compared to young children or older adults, the prognoses of adolescent and young adult (AYA) patients with cancer, i.e., those aged from 15 to 39 years, have not improved. In this study, we focused on soft tissue sarcoma (STS) in AYA patients and aimed to determine whether there is a correlation between the AYA age group and overall poor cancer survival in STS. We further aimed to determine which histologic subtypes are more common in AYA patients and investigate the cause of poor outcomes in this group.Methods: The medical records of 5853 Japanese patients diagnosed with STS between 2006 and 2013 were accessed from the Bone and Soft Tissue Tumor registry (BSTT). We analyzed and compared the epidemiological features of AYA patients with those of other age groups. The cancer survival rates were calculated using the Kaplan-Meier method. Cox proportional hazards models were used to analyze the prognostic factors for cancer survival. The primary endpoint for prognosis was the occurrence of tumor-related death.Results: On multivariate analysis, age was not a prognostic factor for poor cancer survival among these patients. Compared to the same categories in other age groups, the proportions of myxoid/round cell liposarcomas, synovial sarcomas, malignant peripheral nerve sheath tumors (MPNST), primitive neuroectodermal tumor, and rhabdomyosarcoma in AYA patients were the highest, but none of the categories were significantly more prevalent in AYA patients. The cancer survival rates of AYA patients with MPNST were poorer than those of the other age groups; however, AYA age was not a prognostic factor on multivariate analysis in MPNST patients.Conclusions: Our study is the first to investigate STS in AYA patients using the nationwide BSTT registry. Our findings demonstrate that AYA age is not a prognostic factor for poor cancer survival among those with STS in Japan.
Pre-operative hemoglobin level and use of sedative-hypnotics are independent risk factors for post-operative delirium following total knee arthroplasty
Authors: Kijima Eiji , Kayama Tomohiro Thomas , Saito Mitsuru , Kurosaka Daisaburo , Ikeda Ryo , Hayashi Hiroteru , Kubota Daisuke , Hyakutake Takashi , Marumo Keishi 
Published: January 2020

Abstract
Background: Delirium is a well-known complication following surgery, especially with the increasing age of patients undergoing surgery. The increasing demands resulting from a prolonged healthy life expectancy has resulted in more arthroplasties despite their age and existing comorbidities. The purpose of this study is to explore the various risk factors that may contribute to delirium in unilateral and bilateral total knee arthroplasties in the elderly population. Methods: 170 patients who underwent unilateral or bilateral total knee arthroplasties were analyzed retrospectively for delirium. Age, sex, comorbidities, use of sedative-hypnotics, intra-operative blood loss, pre- and post-operative laboratory blood test results were investigated and analyzed. Results: The incidence of post-operative delirium was 6.5% (11 out of 170 patients) with a mean age of 79.5 (± 6.9) years, compared to 73.0 (± 9.0) years in the non-delirium group. Higher age, use of sedative-hypnotics, low pre-operative Hb and Ht, low post-operative Hb, Ht and BUN were observed in the delirium group. Multivariate logistic regression analysis identified that the use of sedative-hypnotics and pre-operative Hb level were independent risk factors for post-operative delirium after TKA. The odds ratios for the use of sedative-hypnotics and pre-operative Hb level were 4.6 and 0.53, respectively. Receiver operating characteristic curve analysis showed that pre-operative Hb of less than 11.1 g/dL was a predictor for the development of delirium, with a sensitivity of 54.6% and a specificity of 91.6%. Conclusion: Patients with a pre-operative Hb level of <11.1 g/dL or those using sedative-hypnotics have an increased risk for post-operative delirium. Peri-operative management and preventative measures are therefore needed to reduce the risks of post-operative delirium in such patients.