bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Comprehensive Environmental Scanning and Strategic Analysis of Iranian Public Hospitals: A Prospective Approach
Authors: pourmohammadi Kimia , Bastani Peivand , Shojaei Payam , hatam nahid , Salehi Asiyeh 
Published: March 2020

Abstract
Objectives: This study was conducted to provide a strategic direction to public hospitals in Iran via environmental scanning in order to equip hospitals to plan and perform proactively and adapt with the ever-changing environment. Results: A mixed method study including in-depth interview and survey were used to determine influential environmental factors based on PESTLE (Political, Economic, Social, Technological, Legal and Environmental) and Douglas West framework (to determine the effectiveness and feasibility of factors). Issues identified at micro environmental level were over prescription, inequality in distribution of healthcare services and high demands for luxurious health services. Issues identified at the macro environmental level were related to changes in disease patterns, inappropriate hospital budgeting, economic sanctions, government corruption and healthcare centralization. In order to tackle the issues identified, it is paramount to enhance bed distribution management, improve strategic policies for a more equitable payment system, and enhance the efficiency and effectiveness of services by implementing a strategic inventory control. Furthermore, the considerable impact of economic sanctions on financial resources of Iranian hospitals should not be ignored.
Understanding implementation barriers in the national scale-up of Differentiated ART delivery in Uganda
Authors: ZAKUMUMPA HENRY , Rujumba Joseph , Kwiringira Japheth , Katureebe Cordelia , Spicer Neil 
Published: March 2020

Abstract
Background Although Differentiated Service Delivery (DSD) for anti-retroviral therapy (ART) has been rolled-out nationally in several countries since World Health Organization (WHO)’s landmark 2016 guidelines, there is little research evaluating post-implementation outcomes. The objective of this study was to explore patients’ and HIV service managers’ perspectives on barriers to implementation of Differentiated ART delivery in Uganda. Methods We employed a qualitative descriptive design involving 124 participants. Between April and June 2019 we conducted 76 qualitative interviews with national-level HIV program managers (n=18), District Health Team leaders (n=24), representatives of PEPFAR implementing organizations (11), ART clinic in-charges (23) in six purposively selected Uganda districts with a high HIV burden (Kampala, Luwero, Wakiso, Mbale, Budadiri, Bulambuli). Six focus group discussions (48 participants) were held with patients enrolled in DSD models in case-study districts. Data were analyzed by thematic approach as guided by a multi-level analytical framework: Individual-level factors; Health-system factors; Community factors; and Context. Results Our data shows that multiple barriers have been encountered in DSD implementation. Individual-level: Individualized stigma and a fear of detachment from health facilities by stable patients enrolled in community-based models were reported as bottlenecks. Socio-economic status was reported to have an influence on patient selection of DSD models. Health-system: Insufficient training of health workers in DSD delivery and supply chain barriers to multi-month ART dispensing were identified as constraints. Patients perceived current selection of DSD models to be provider-intensive and not sufficiently patient-centred. Community: Community-level stigma and insufficient funding to providers to fully operationalize community drug pick-up points were identified as limitations. Context: Frequent changes in physical addresses among urban clients were reported as an impediment to the running of patient groups of rotating ART refill pick-ups. Conclusion This is one of the first multi-stakeholder evaluations of national DSD implementation in Uganda since initial roll-out in 2017. Multi-level interventions are needed to accelerate further DSD implementation in Uganda from demand-side (addressing HIV-related stigma, community engagement) and supply-side dimensions (strengthening ART supply chain capacities, increasing funding for community models and further DSD program design to improve patient-centeredness).
Is Leishmaniasis adequately notified in Sri Lanka? A survey among doctors from high endemic district of Sri Lanka.
Authors: Hewawasam Chandana , Weerakoon Hema S , Thilakan Vyshnavi , Lelwala Tishni , Prasanka Kalana , Rathnayaka Amila S , Gamage Shanika , Agampodi Suneth 
Published: March 2020

Abstract
Background: Leishmaniasis is a notifiable disease in Sri Lanka since 2008. Previous studies show a gap in the notification of leishmaniasis. Purpose of the present study was to determine the Knowledge, attitudes and practice of medical officers regarding leishmaniasis. Methods: A cross-sectional study was conducted in the Anuradhapura district which reported the highest prevalence of leishmaniasis. Medical officers from public and private health care institutes in the area filled a self-administered questionnaire in the presence of the investigators. Results: One hundred and eighty-eight (188) medical officers completed the questionnaire. Of them, 95.7% were aware of leishmaniasis as a parasitic infection and 84.7% correctly identified Leishmania donovani as the causative organism in Sri Lanka. From the respondents, 181 (96.8%) knew that the vector of leishmaniasis is sandfly. Cutaneous leishmaniasis was reported as the most prevalent form of leishmaniasis in the country by 176 (94.1%). Nearly half of the respondents (98, 54.1%) was aware of the fact that the Anuradhapura district has the highest prevalence of the disease. Many of them had the idea that leishmaniasis is an emerging disease (155, 84.3%,) and early diagnosis is important in controlling the disease (163, 89.1%). Although about three fourth (123, 73.7 %,) of the participants mentioned that leishmaniasis should be notified at first clinical suspicion, only 74 (42.5%) were aware that it is a legal requirement. Some medical officers (39, 22%) believed that the current notification system in the country is not effective. Unavailability of notification forms (60, 36.8%) heavy workload (85, 50.3%) and inadequate supportive staff (55, 35.1%) were reported as barriers for timely notification. Even though 105 (58.0%) of medical officers had suspected leishmaniasis during last eight years period only 35 (19.4%) had notified. Conclusions: Even though more than 90% of the participants had good theoretical knowledge about leishmaniasis; notification of leishmaniasis is considerably inadequate. This study emphasizes the need for greater efforts to improve the notification of leishmaniasis in Sri Lanka.
Homoprejudiced violence among Chinese men who have sex with men: A cross-sectional analysis in Guangzhou, China
Authors: Wu Dan , Yang Eileen , Huang Wenting , Tang Weiming , Xu Huifang , Liu Chuncheng , Baral Stefan , Day Suzanne , Tucker Joseph D. 
Published: March 2020

Abstract
Background
Homoprejudiced violence, defined as physical, verbal, psychological and cyber aggression against others because of their actual or perceived sexual orientation, is an important public health issue. Most homoprejudiced violence research has been conducted in high-income countries. This study aimed to examine the experience and perpetration of homoprejudiced violence among men who have sex with men (MSM) in Guangzhou, China.
Methods
MSM in a large Chinese city, Guangzhou, completed an online survey instrument that was distributed through community-based organizations. Descriptive analysis was conducted to describe the sample characteristics. Multivariable logistic regression analyses, controlling for age, residence, occupation, heterosexual marriage, education and income, were carried out to explore associated factors.
Results
A total of 777 responses were analyzed and most (64.9%) were under the age of 30. Three-hundred-ninety-nine (51.4%) reported experiencing homoprejudiced violence, while 205 (25.9%) reported initiating homoprejudiced violence against others. Compared to respondents who self-identified as gay, respondents who were heterosexual were 0.6 times (AOR=0.6, 95% CI: 0.4-0.9) as likely to have experienced homoprejudiced violence, whereas those who were unsure about their sexual orientation were 2.6 times (AOR=2.6, 95% CI: 1.2-5.5) more likely to have experienced homoprejudiced violence before. Furthermore, a strong association (AOR=2,4. 95% CI: 1.6-3.5) was identified between experiencing homoprejudiced violence and initiating violence. MSM who had disclosed their sexual orientation to people other than their partners were more likely to have experienced homoprejudiced violence (AOR=1.8, 95% CI:1.3-2.5).
Conclusions
These findings suggest the importance of research and the implementation of interventions focused on preventing and mitigating the effects of homoprejudiced violence affecting MSM in China.
Polystyrene microplastics do not affect juvenile brow trout (Salmo trutta f. fario) or modulate effect of the pesticide methiocarb
Authors: Schmieg Hannah , Huppertsberg Sven , Knepper Thomas P. , Krais Stefanie , Reitter Katharina , Rezbach Felicitas , Ruhl Aki S. , Köhler Heinz R. , Triebskorn Rita 
Published: March 2020

Abstract
Background

There has been a rising interest within the scientific community and the public about the environmental risk related to the abundance of microplastics in aquatic environments. Up to now, however, scientific knowledge in this context has been scarce and insufficient for a reliable risk assessment.
To remedy this scarcity of data, we investigated possible adverse effects of polystyrene particles (10^4 particles/L) and the pesticide methiocarb (1 mg/L) in juvenile brow trout (Salmo trutta f. fario) both by themselves as well as in combination after a 96 h laboratory exposure. PS beads (density 1.05 g/mL) were cryogenically milled and fractionated resulting in irregular shaped particles (<50 µm). Besides body weight of the animals, biomarkers for proteotoxicity (stress protein family Hsp70), oxidative stress (superoxide dismutase, lipid peroxidation), and neurotoxicity (acetylcholinesterase, carboxylesterases) were analysed. As an indicator of overall health, histopathological effects were studied in liver and gills of exposed fish.

Results

Polystyrene particles by themselves did not influence any of the investigated biomarkers. In contrast, the exposure to methiocarb led to a significant reduction of the activity of acetylcholinesterase and the two carboxylesterases. Moreover, the tissue integrity of liver and gills was impaired by the pesticide. Body weight, the oxidative stress and the stress protein levels were not influenced by methiocarb. Effects caused by co-exposure of polystyrene microplastics and methiocarb were the same as those caused by methiocarb alone.

Conclusions

Overall, methiocarb led to negative effects in juvenile brown trout. In contrast, polystyrene microplastics in the tested concentration did not affect the health of juvenile brown trout and did not modulate the toxicity of methiocarb in this fish species.
Can direct smear results that are routinely collected at health centre level be used for monitoring the impact of mass drug administration with praziquantel on schistosomiasis in Burundi? A preliminary assessment.
Authors: BIZIMANA Paul , POLMAN Katja , ORTU Giuseppina , KRIT Meryam , NSABIYUMVA Frédéric , NKESHIMANA Audace , BIJABUKA Urlich , NIBAKIRE Marcelline , GEERTRUYDEN Jean-Pierre VAN 
Published: March 2020

Abstract
Background : Intestinal schistosomiasis is still a public health problem in Burundi. Since 2008, annual mass drug administration with praziquantel have been rolled out in 11 endemic districts. The national programme relies on school-based surveys with Kato-Katz to monitor the impact of mass drug administration. We explored whether routine data on intestinal schistosomiasis as determined by direct fecal smears at health centre level could be used.

Methods : From the Burundian National Health Information System, we collected routine incidence data on intestinal schistosomiasis as determined by direct smear examination in all 45 sanitary districts between 2011 and 2015. A temporal trends analysis was performed using a mixed negative binomial regression. Sanitary districts with mass drug administration campaigns with praziquantel (n=11) were compared with those without (n=34). In addition, prevalence data on intestinal schistosomiasis based on Kato-Katz results from a school-based national mapping in 2014 were compared with the incidence data in health centres based on direct smear results, in the same 45 sanitary districts.

Findings : In the 11 sanitary districts applying mass drug administration with praziquantel, the incidence rate decreased significantly for the years 2014 (β 2014 = -0.826, p = 0.010) and 2015 (β 2015 = -1.294, p < 0.001) and for the five-year period (β = -0.286, p < 0.001), whereas in the 34 districts where mass drug administration was not delivered, there was no significant decrease over time (β = -0.087, p = 0.219). In most of the 45 sanitary districts, the low prevalences based on Kato-Katz in schoolchildren were confirmed by low incidence rates based on direct smear in the health centres.

Conclusions : National Health Information System surveillance data, based on routinely collected direct smear results at health centre level, may be able to monitor the impact of mass drug administration with praziquantel on intestinal schistosomiasis in Burundi. Control and elimination of intestinal schistosomiasis call for integration of adequate diagnosis and treatment into routine activities of primary health care facilities, as recommended by the World Health Organization since more than 20 years. When moving towards elimination, more sensitive tests, such as the Point-of-care Circulating Cathodic Antigen assay are desirable.

Keywords : Burundi; direct smear; health centre; mass drug administration; monitoring; routine data; praziquantel; schistosomiasis
Incidence of Hypertension among Persons Living with HIV in China: A Multicenter Cohort Study
Authors: Fan Hongwei , guo fuping , Hsieh Evelyn , Chen Wei-Ti , Lv Wei , Han Yang , Xie Jing , Li Yanling , Song Xiaojing , Li Taisheng 
Published: March 2020

Abstract
Background

Life expectancy among persons living with HIV (PLWH) has improved with increasing access to antiretroviral therapy (ART), however incidence of chronic comorbidities has simultaneously increased. No data are available regarding the incidence of hypertension among Chinese PLWH.

Methods

We analyzed data collected from patients enrolled in two prospective longitudinal multicenter studies of PLWH initiating ART in China. Incidence rate of hypertension per 100 person-years (PYs) among PLWH was calculated, and Cox proportional hazards models was used to evaluate the association between incident hypertension and traditional and HIV-associated risk factors.

Results

Of 1078 patients included in this analysis, 984 ART-naïve patients were hypertension-free at baseline, and contributed 2337.7 PYs of follow up, with a median follow-up period of 1.8 years (range: 1.2-3.2) after initiation of ART. Incidence of hypertension was 7.6 [95% confidence interval (CI): 6.5-8.7] per 100 PYs. In the Cox regression analysis, incidence of hypertension was positively associated with body mass index [adjusted hazard ratio (aHR) 1.07 (1.01,1.13), p=0.02] and recent viral load (aHR 1.28, 95% CI:1.08-1.51, p=0), and negatively associated with recent CD4+/CD8+ ratio (aHR 0.14, 95% CI:0.06-0.31, p<0.001), zidovudine exposure (aHR 0.15, 95% CI: 0.10-0.24, p<0.001) and tenofovir disoproxil fumarate exposure (aHR 0.13, 95% CI: 0.08-0.21, p<0.001).

Conclusions

The incidence of hypertension was relatively high among Chinese PLWH initiating ART. Recent low CD4+/CD8+ ratio and detectable HIV viremia were associated with incident hypertension, whereas receipt of ART was associated with reduced risk . Hypertension may be mitigated, in part, by excellent HIV care, including viral suppression with ART.
An educational pathway and teaching materials for first aid training of children in Sub-Saharan Africa based on the best available evidence
Authors: De Buck Emmy , Laermans Jorien , Vanhove Anne-Catherine , Dockx Kim , Vandekerckhove Philippe , Geduld Heike 
Published: March 2020

Abstract
Background

First aid training is a cost-effective way to decrease the burden of disease and injury in low- and middle-income countries (LMIC). Since evidence from Western countries has shown that children are able to learn first aid, first aid training of children in LMIC may be a promising way forward. Hence, our project aim was to develop contextualized materials to train Sub-Saharan African children in first aid, based on the best available evidence.

Methods

Systematic literature searches were conducted to identify studies on first aid education to children up to 18 years old (research question one), and studies investigating different teaching approaches (broader than first aid) in LMIC (research question two). A multidisciplinary expert panel translated the evidence to the context of Sub-Saharan Africa, and evidence and expert input were used to develop teaching materials.

Results

For question one, we identified 58 studies, measuring the effect of training children in resuscitation, first aid for skin wounds, poisoning etc. For question two, two systematic reviews were included from which we selected 36 studies, revealing the effectiveness of several pedagogical methods, such as problem-solving instruction and small-group instruction. However, the certainty of the evidence was low to very low. Hence expert input was necessary to formulate training objectives and age ranges based on “good practice” whenever the quantity or quality of the evidence was limited. The experts also placed the available evidence against the African context.

Conclusions

The above approach resulted in an educational pathway (i.e. a scheme with educational goals concerning first aid for different age groups), a list of recommended educational approaches, and first aid teaching materials for children, based on the best available evidence and adapted to the African context.
Genome-wide genetic structure and selection signatures for color in 10 traditional Chinese yellow-feathered chicken breeds
Authors: Huang Xunhe , Otecko Newton O. , Peng Minsheng , Weng Zhuoxian , Li Weina , Chen Jiebo , Zhong Ming , Zhong Fusheng , Jin Sihua , Geng Zhaoyu , Luo Wei , He Danlin , Ma Cheng , Han Jianlin , Ommeh Sheila C. , Zhang Yaping , Zhang Xiquan , Du Bingwang 
Published: March 2020

Abstract
Background: Yellow-feathered chickens (YFCs) have a long history in China. They are well-known for the nutritional and commercial importance attributable to their yellow color phenotype. Currently, there is a huge paucity in knowledge of the genetic determinants responsible for phenotypic and biochemical properties of these iconic chickens. This study aimed to uncover the genetic structure and the molecular underpinnings of the YFCs trademark coloration.Results: The whole-genomes of 100 YFCs from 10 major traditional breeds and 10 Huaibei partridge chickens from China were re-sequenced. Comparative population genomics based on autosomal single nucleotide polymorphisms (SNPs) revealed three geographically based clusters among the YFCs. Compared to other Chinese indigenous chicken genomes incorporated from previous studies, a closer genetic proximity within YFC breeds than between YFC breeds and other chicken populations is evident. Through genome-wide scans for selective sweeps, we identified RALY heterogeneous nuclear ribonucleoprotein (RALY), leucine rich repeat containing G protein-coupled receptor 4 (LGR4), solute carrier family 23 member 2 (SLC23A2), and solute carrier family 2 member 14 (SLC2A14), besides the classical beta-carotene dioxygenase 2 (BCDO2), as major candidates pigment determining genes in the YFCs.Conclusion: We provide the first comprehensive genomic data of the YFCs. Our analyses show phylogeographical patterns among the YFCs and potential candidate genes giving rise to the yellow color trait of the YFCs. This study lays the foundation for further research on the genome-phenotype cross-talks that define important poultry traits and for formulating genetic breeding and conservation strategies for the YFCs.
Comparison transcriptome analysis revealed resistance differences of Cavendish bananas to Fusarium oxysporum f.sp. cubense race1 and race4
Authors: Dong Honghong , Ye Yiting , Guo Yongyi , Li Huaping 
Published: March 2020

Abstract
Background: Banana Fusarium wilt is a devastating disease of bananas caused by Fusarium oxysporum f. sp. cubense (Foc) and is a serious threat to the global banana industry. Knowledge of the pathogenic molecular mechanism and interaction between the host and Foc is limited. Results: In this study, we confirmed the changes of gene expression and pathways in the Cavendish banana variety ‘Brazilian’ during early infection with Foc1 and Foc4 by comparative transcriptomics analysis. 1862 and 226 differentially expressed genes (DEGs) were identified in ‘Brazilian’ roots at 48 h after inoculation with Foc1 and Foc4, respectively. After Foc1 infection, lignin and flavonoid synthesis pathways were enriched. Glucosinolates, alkaloid-like compounds and terpenoids were accumulated. Numerous hormonal- and receptor-like kinase (RLK) related genes were differential expressed. However, after Foc4 infection, the changes in these pathways and gene expression were almost unaffected or weakly affected. Furthermore, the DEGs involved in biological stress-related pathways also significantly differed after infection with two Foc races. The DEGs participated in phenylpropanoid metabolism and cell wall modification were also differentially expressed. By measuring the expression patterns of genes associated with disease defense, we found that five genes that can cause hypersensitive cell death were up-regulated after Foc1 infection. Therefore, the immune responses of the plant may occur at this stage of infection. Conclusion: Results of this study contribute to the elucidation of the interaction between banana plants and Foc and to the development of measures to prevent banana Fusarium wilt.
Augmented Reality Guided Osteotomy in Hallux Valgus Correction
Authors: Viehöfer Arnd , Wirth Stephan Hermann , Zimmermann Stefan Michael , Jaberg Laurenz , Dennler Cyrill , Fürnstahl Philipp , Farshad Mazda 
Published: March 2020

Abstract
Background An optimal osteotomy angle avoids shortening of the first metatarsal bone after hallux valgus surgery and therefore reduces the risk of transfer-metatarsalgia. The purpose of the present ex-vivo study was to investigate whether augmented reality (AR) would improve accuracy of the distal osteotomy during hallux valgus surgery. Methods Distal osteotomies of the first metatarsals were performed on a foot model by two surgeons with different levels of surgical experience each with (AR, n=15x2) or without (controls, n=15x2) overlay of a hologram depicting an angle of osteotomy perpendicular to the second metatarsal. Subsequently, the deviation of the osteotomy angle in the transverse plane was analyzed. Results Overall, the AR decreased the range of impression and the AR guided osteotomies were more accurate (4.9 ± 4.2°) compared to the freehand cuts (6.7± 6.1°) by tendency (p=0.2). However, while the inexperienced surgeon performed more accurate osteotomies with AR with a mean angle of 6.4± 3.5° compared to freehand 10.5 ± 5.5° (p=0.02), no significant difference was noticed for the experienced surgeon with an osteotomy angle of around 3° in both cases. Conclusion This pilot-study suggests that AR guided osteotomies can potentially improve accuracy during hallux valgus correction, particularly for less experienced surgeons.