bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk factors for hospital-acquired influenza A and patient characteristics: A matched case-control study
Authors: Yang Kui , Zhang Ni , Gao Chunchen , Qin Hongyan , Wang Anhui , Song Liqiang 
Published: November 2020

Abstract
Background: While hospital-acquired influenza A results in an additional cost burden and considerable mortality in patients, its risk factors are unknown. We aimed to describe the characteristics of patients vulnerable to hospital-acquired influenza A and to identify its risk factors to assist clinicians control hospital-acquired infections and reduce the burden of treatment.Methods: A case-control study was conducted among hospitalized patients aged ≥18 years at a tertiary level teaching hospital during the 2018–2019 influenza A season. Patient data were retrieved from hospital-based electronic medical records. Hospital-acquired influenza A was defined as a case of influenza A diagnosed 7 days or more after admission, in a patient with no evidence of influenza A infection on admission. The controls without influenza A were selected among patients exposed to the same setting and time period. We identified risk factors using conditional logistic regression and described the characteristics of hospital-acquired influenza A by comparing the clinical data of infected patients and the controls.Results: Of the 412 hospitalized patients with influenza A from all the departments in the study hospital, 93 (22.6%) cases were classified as hospital-acquired. The most common comorbidities of the 93 cases were hypertension (41.9%), coronary heart disease (21.5%), and cerebrovascular disease (20.4%). Before the onset of hospital-acquired influenza A, patients presented more lymphocytopenia (51.6% vs 35.5%, P=0.027), hypoalbuminemia (78.5% vs 57.0%, P=0.002), and pleural effusion (26.9% vs 9.7%, P=0.002) than the matched controls. Infected patients also had longer hospital stays (18 days vs 14 days, P=0.002), and higher mortality rates (10.8% vs 2.2%, P=0.017) than the matched controls. Lymphocytopenia (odds ratio [OR]: 3.11; 95% confidence interval [CI]: 1.24–7.80; P=0.016), hypoalbuminemia (OR: 2.24; 95% CI: 1.10–4.57; P=0.027), and pleural effusion (OR: 3.09; 95% CI: 1.26–7.58; P=0.014) were independently associated with hospital-acquired influenza A.Conclusions: Lymphocytopenia, hypoalbuminemia and pleural effusion are independent risk factors that can help identify patients at high risk of hospital-acquired influenza A, which can extend hospital stay and is associated with a high mortality.
Hypertension prevalence, awareness, treatment, and control and predicted 10-year CVD risk: a cross-sectional study of Seven Communities in East and West Africa (SevenCEWA)
Authors: Okello Samson , Muhihi Alfa , Mohamed Shukri F , Ameh Soter , Ochimana Caleb , Oluwasanu Abayomi Olabayo , Bolarinwa Oladimeji Akeem , Sewankambo Nelson , Danaei Goodarz 
Published: November 2020

Abstract
Background: Few studies have characterized epidemiology and management of hypertension across several communities with comparable methodology in sub-Saharan Africa. We assessed prevalence, awareness, treatment, and control of hypertension and predicted 10-year cardiovascular disease risk across seven sites in East and West Africa. Methods: Between June and August 2018, we conducted household surveys among adults aged 18 years and above in 7 communities in Kenya, Nigeria, Tanzania, and Uganda. We collected data on socio-demographics, health insurance, and healthcare utilization. We measured blood pressure using digital blood pressure monitors and following a standardized protocol. We estimated 10-year cardiovascular disease (CVD) risk using a country-specific risk score and fitted hierarchical models to identify determinants of hypertension prevalence, awareness and treatment. Results: We analyzed data of 3549 participants. The mean age was 39·7 years (SD 15·4), 60·5% of whom were women, 9·6% had ever smoked, and 32·7% were overweight/obese. A quarter of the participants (25·1% had hypertension, half of whom (57·6%) were diagnosed. Among diagnosed, 50·5% were taking medication, and among those taking medication 47·3% had controlled blood pressure. After adjusting for other determinants, older age was associated with increased hypertension prevalence, awareness, and treatment whereas primary education was associated with lower hypertension prevalence. Health insurance was associated with lower hypertension prevalence and higher chances of treatment. Median predicted 10-yr CVD risk across sites was 4·9% Interquartile range, IQR (2·4%, 10·3%) and 13·2% had risk of 20% or greater while 7·1% had risk of >30%. Conclusion: In seven communities in east and west Africa, a quarter of adults had hypertension, about 40% were unaware, half of those aware were treated and half of those treated were controlled blood pressure. Access to health insurance is needed to improve awareness, treatment, and control of hypertension in sub-Saharan Africa.
Application of refrigerated and frozen sorghum malt slurries in preservation of starter cultures for Obushera from Uganda
Authors: Mukisa Ivan Muzira , Byakika Stellah , Serwanga Arnold 
Published: November 2020

Abstract
Industrial production of traditional fermented beverages is limited by lack of quality commercial starter cultures. Saccharomyces cerevisiae MNC21Y and Lactobacillus plantarum MNC21 can be used to ferment cereal beverages such as Obushera. These cultures are unavailable as commercial starters due to lack of appropriate propagating and distributing procedures. The purpose of this study was to evaluate the use of refrigerated and frozen sorghum slurries as carrier media for the starters. Starters were propagated in sorghum slurries (30°C for 24 h) and stored at 5°C and -18°C for 90 days. Viability of Saccharomyces cerevisiae and Lactobacillus plantarum was determined by cell counts after surface plating and pour plating, respectively. Fermentation ability was determined by inoculating sorghum slurries with starters and monitoring pH, acidity and flavor development. Viability was higher for starters stored at 5°C (S. cerevisiae: 6 log cfu.g-1 and Lb. plantarum: 7-9 log cfu.g-1 during 90 days) than those at -18°C (S. cerevisiae: 2 cfu.g-1 and Lb. plantarum: 4 log cfu.g-1 after 30 days). Refrigerated starters acidified Obushera (pH  4.5) faster (10-20 h) than frozen ones (18-24 h). Refrigerated or frozen S. cerevisiae + Lb. plantarum starters in sorghum malt slurries can remain viable for at least one or three months, respectively and produce Obushera with characteristic flavors.
Estimating transmission dynamics and serial interval of the first wave of COVID-19 infections under different control measures: A statistical analysis in Tunisia from February 29 to May 5, 2020&nbsp;
Authors: Talmoudi Khouloud , Safer Mouna , Letaief Hejer , Hchaichi Aicha , Harizi Chahida , Dhaouadi Sonia , Derouiche Sondes , Bouaziz Ilhem , Gharbi Donia , Najar Nourhene , Osman Molka , Cherif Ines , Mlallekh Rym , Ben-Ayed Oumaima , Ayedi Yosr , Bouabid Leila , Bougatef Souha , Ben-Alaya Nissaf Bouafif ép , Chahed Mohamed Kouni 
Published: November 2020

Abstract
Background: Describing transmission dynamics of the outbreak and impact of intervention measures are critical to planning responses to future outbreaks and providing timely information to guide policy makers decision. We estimate serial interval (SI) and temporal reproduction number (Rt) of SARS-CoV-2 in Tunisia. Methods: We collected data of investigations and contact tracing between March 1, 2020 and May 5, 2020 as well as illness onset data during the period February 29-May 5, 2020 from National Observatory of New and Emerging Diseases of Tunisia. Maximum likelihood (ML) approach is used to estimate dynamics of Rt. Results: 491 of infector-infectee pairs were involved, with 14.46% reported pre-symptomatic transmission. SI follows Gamma distribution with mean 5.30 days [95% Confidence Interval (CI) 4.66-5.95] and standard deviation 0.26 [95% CI 0.23-0.30]. Also, we estimated large changes in Rt in response to the combined lockdown interventions. The Rt moves from 3.18 [95% Credible Interval (CrI) 2.73-3.69] to 1.77 [95% CrI 1.49-2.08] with curfew prevention measure, and under the epidemic threshold (0.89 [95% CrI 0.84-0.94]) by national lockdown measure.Conclusions: Overall, our findings highlight contribution of interventions to interrupt transmission of SARS-CoV-2 in Tunisia.
A modelling study highlights the power of detecting and isolating asymptomatic or very mildly affected individuals for COVID-19 epidemic management.
Authors: Mayorga Lia , Samartino Clara García , Flores Gabriel , Masuelli Sofía , Sánchez María V. , Mayorga Luis S. , Sánchez Cristián G. 
Published: November 2020

Abstract
Background: Mathematical modelling of infectious diseases is a powerful tool for the design of management policies and a fundamental part of the arsenal currently deployed to deal with the COVID-19 pandemic. Methods: We present a compartmental model for the disease where symptomatic and asymptomatic individuals move separately. We introduced healthcare burden parameters allowing to infer possible containment and suppression strategies. In addition, the model was scaled up to describe different interconnected areas, giving the possibility to trigger regionalized measures. It was specially adjusted to Mendoza-Argentina’s parameters, but is easily adaptable for elsewhere. Results: Overall, the simulations we carried out were notably more effective when mitigation measures were not relaxed in between the suppressive actions. Since asymptomatics or very mildly affected patients are the vast majority, we studied the impact of detecting and isolating them. The removal of asymptomatics from the infectious pool remarkably lowered the effective reproduction number, healthcare burden and overall fatality. Furthermore, different suppression triggers regarding ICU occupancy were attempted. The best scenario was found to be the combination of ICU occupancy triggers (on: 50%, off: 30%) with the detection and isolation of asymptomatic individuals. In the ideal assumption that 45% of the asymptomatics could be detected and isolated, there would be no need for complete lockdown, and Mendoza’s healthcare system would not collapse. Conclusions: Our model and its analysis inform that the detection and isolation of all infected individuals, without leaving aside the asymptomatic group is the key to surpass this pandemic.
Harmonization of medical products regulation: A key factor for improving regulatory capacity in the East African Community
Authors: Ndomondo-Sigonda Margareth , Miot Jacqueline , Naidoo Shan , Masota Nelson Enos , Ng'andu Brian , Ngum Nancy , Kaale Eliangiringa 
Published: November 2020

Abstract
AbstractBackground: Limited capacity to regulate medical products is associated with circulation of products which do not meet standards of quality, safety and efficacy with negative public health and economic outcomes. This study focused on assessing the effect of the East African Community (EAC) medicines regulatory harmonization initiative on the capacity of national medicines regulatory agencies, with a focus on registration and inspection systems. Methods: An exploratory mixed-method design using both qualitative and quantitative data was employed. Data was collected from six national medicines regulatory authorities (NMRAs) and the EAC Secretariat through a combination of semi-structured interviews, questionnaires, and checklists for the period 2010/11-2015/16 whereas 2010/11 data served as baseline. Interviews were conducted with heads of NMRAs, regulatory and monitoring and evaluation experts, and the EAC Secretariat Project Officer. A set of 14 indicators grouped into 6 categories were used to measure NMRAs performance. Results: Policy and legal frameworks provide a foundation for effective regulation. Collaboration, harmonization, joint dossier reviews and inspections of manufacturing sites, reliance and cooperation are key factors for building trust and capacity among NMRAs. Five out of six of the EAC Partner States have comprehensive medicines laws with autonomous NMRAs. All the NMRAs have functional registration and good manufacturing practice inspection systems supported by regional harmonised guidelines for registration, inspection, quality management and information management systems with four NMRAs attaining ISO 9001:2015 certification.Conclusions: The EAC regulatory harmonization initiative has contributed to improved capacity to regulate medical products. The indicators generated from this research can be replicated for evaluation of similar initiatives across and beyond the African continent and contribute to public health policy.
Provision of Immediate Postpartum Contraception to Women living with HIV in the&nbsp;&nbsp;Eastern Cape, South Africa; A Cross-sectional Analysis
Authors: ADENIYI OLADELE VINCENT , Ajayi Anthony Idowu , Somefun Oluwaseyi Dolapo , Lambert John Shearer 
Published: November 2020

Abstract
Background: Universal access to contraception is an important strategy adopted by the South African government to reduce the high rate of unintended pregnancies, especially in women living with HIV. In this article, we describe the choices of contraception and also, examine the influencing factors of the choices of contraception in the immediate postpartum period in parturient women with HIV in the Eastern Cape, South Africa.Methods: In this prospective cross-sectional study, 1617 parturient women with HIV completed a survey on the choice of contraception received in the immediate postpartum period (within 72 hours) across three large maternity services in the Eastern Cape between September 2015 to May 2016. Additional information was extracted from their medical records. Choices of contraception were categorised as; short-acting (injectables), long-acting reversible (intrauterine device and implants) and permanent contraception (tubal ligation). Adjusted and unadjusted logistic regression models were employed to determine the influencing factors of the choices of contraception received by the cohort.Results: Participants were predominantly single (69.1%), unemployed (75.1%), had a grade 7-12 level of education (88.4%) and were HIV positive before their index pregnancy (81.3%). The prevalence of immediate postpartum contraception was high (n=1507; 93.2%) with Injectables being the preferred choice in the majority of the participants (n= 1218; 75.3%). After controlling for all relevant covariates, single marital status was associated with a higher likelihood of immediate postpartum contraceptive initiation (AOR;1.82 95% CI;1.10-3.03). Overall, women were more likely to initiate a long-acting reversible and irreversible methods when older than 35 years and having had more than two children.Conclusions: We found a high prevalence of immediate postpartum contraception with a preference for Injectables in the study setting. Long-term monitoring of this cohort will elucidate on contraceptive discontinuation and risk of unintended pregnancies in the region.
Serum Hydroxybutyrate dehydrogenase as an early predictive marker of the severity of acute pancreatitis: a retrospective study
Authors: xiao weiming , Liu Weili , Yin Ling , Li Yong , Lu Guotao , Liu Xinnong , Gong Weijuan , Ding Yanbing , Wang Mei , Yan Zhigang 
Published: November 2020

Abstract
Background: To investigate the value of serum hydroxybutyrate dehydrogenase (HBDH) level, an isozyme of lactate dehydrogenase (LDH), in evaluating the severity of acute pancreatitis (AP).Methods: Patients diagnosed with AP from January 2013 to December 2018 were included in this retrospective study. Patients were divided into the normal serum HBDH levels group (n-HBDH group) and the high serum HBDH levels group (h-HBDH group) according to the criteria HBDH ≥ 182 U/L after admission. The demographic parameters, laboratory data and the severity of AP in the two groups were compared. The receiver operating curve (ROC) was used to evaluate the efficacy of serum HBDH in predicting persistent organ failure and systemic inflammatory response syndrome (SIRS).Results: A total of 260 AP patients were enrolled, including 176 cases in the n-HBDH group and 84 cases in the h-HBDH group. The incidence of SIRS and organ failure in the h-HBDH group were significantly higher than those in n-HBDH group (both P < 0.001). In addition, the HBDH level was significantly decreased in 110 patients who were re-measured after AP treatment. The serum HBDH levels were positively correlated with Atlanta classification, Ranson score, and BISAP score (all P < 0.05). ROC analysis showed that a serum HBDH cut-off point of 195.0 U/L had optimal predictive value for the development of persistent organ failure (AUC = 0.778) and 166.5 U/L for the development of SIRS (AUC = 0.724).Conclusion: The elevated serum HBDH in early stage of AP is closely related to the adverse prognosis of AP patients, which can be used as a potential early biomarker for predicting the severity of AP.
Human amnion-derived mesenchymal stem cells promote osteogenic differentiation of lipopolysaccharide-induced human bone marrow mesenchymal stem cells via ANRIL/miR-125a/APC axis
Authors: Wang Yuli , Lv Fengyi , Huang Lintong , Zhang Hengwei , Li Bing , Zhou Weina , Li Xuan , Du Yifei , Pan Yongchu , Wang Ruixia 
Published: November 2020

Abstract
Background and aim: Periodontitis is a chronic inﬂammatory disease inducing the absorption of alveolar bone and leading to tooth loss. Human amnion–derived mesenchymal stem cells (HAMSCs) have been used for studying inﬂammatory processes. This study aimed to explore the role of long noncoding RNA (lncRNA) antisense noncoding RNA in the INK4 locus (ANRIL) in HAMSC-driven osteogenesis in lipopolysaccharide (LPS)-induced human bone marrow mesenchymal stem cells (HBMSCs).Methods: The cells were incubated with a co-culture system. Reactive oxygen species (ROS) level and superoxide dismutase (SOD) activity were used to detect the oxidative stress level. Flow cytometry was performed to determine cell proliferation. The alkaline phosphatase (ALP) activity, Alizarin red assay, cell transfection, and rat mandibular defect model were used to evaluate the osteogenic differentiation. Quantitative real-time reverse transcription–polymerase chain reaction (RT-PCR), Western blot analysis, dual-luciferase reporter assay, and immunofluorescence staining were used to evaluate the molecular mechanisms.Results: This study showed that HAMSCs promoted the osteogenesis of LPS-induced HBMSCs, while the ANRIL level in HBMSCs decreased during co-culture. ANRIL had no significant influence on the proliferation of LPS-induced HBMSCs. However, its overexpression inhibited the HAMSC-driven osteogenesis in vivo and in vitro, whereas its knockdown reversed these effects. Mechanistically, this study found that downregulating ANRIL led to the overexpression of microRNA-125a (miR-125a), and further contributed to the competitive binding of miR-125a and adenomatous polyposis coli (APC), thus significantly activating the Wnt/β-catenin pathway.Conclusion: The study indicated that HAMSCs promoted the osteogenic differentiation of LPS-induced HBMSCs via the ANRIL/miR-125a/APC axis, and offered a novel approach for periodontitis therapy.
Three-Dimensional (3D) Magnetic Resonance Volume Assessment and Loco-regional Failure in Anal Cancer: early evaluation case-control study
Authors: Sekhar Hema , Kochhar Rohit , Carrington Bernadette , Kaye Thomas , Tolan Damian , Saunders Mark , Sperrin Matthew , Sebag-Montefiore David , Herk Marcel van , Renehan Andrew 
Published: November 2020

Abstract
Background: The primary aim was to test the hypothesis that deriving pre-treatment 3D magnetic resonance tumour volume (mrTV) quantification improves performance characteristics for the prediction of loco-regional failure compared with standard maximal tumour diameter (1D) assessment in patients with squamous cell carcinoma of the anus undergoing chemoradiotherapy.Methods: We performed an early evaluation case-control study at two UK centres (2007-2014) in 39 patients with loco-regional failure (cases), and 41 patients disease-free at 3 years (controls). mrTV was determined using the summation of areas method (Volsum). Reproducibility was assessed using intraclass concordance correlation (ICC) and Bland-Altman limits of agreements. We derived receiver operating curves using logistic regression models and expressed accuracy as area under the curve (ROCAUC).Results: The median time per patient for Volsum quantification was 7.00 (inter-quartile range, IQR: 0.57-12.48) minutes. Intra and inter-observer reproducibilities were generally good (ICCs from 0.79 to 0.89) but with wide limits of agreement (intra-observer: -28% to 31%; inter-observer: -28% to 46%). Median mrTVs were greater for cases (32.6 IQR: 21.5-53.1 cm3) than controls (9.9 IQR: 5.7-18.1 cm3, p <0.0001). The ROCAUC for mrT-size predicting loco-regional failure was 0.74 (95% CI: 0.63-0.85) improving to 0.82 (95% CI: 0.72-0.92) when replaced with mrTV (test for ROC differences, p = 0.024).Conclusion: Preliminary results suggest that the replacement of mrTV for mrT-size improves prediction of loco-regional failure after chemoradiotherapy for squamous cell carcinoma of the anus. However, mrTV calculation is time consuming and variation in its reproducibility are drawbacks with the current technology.
Patterns of breast, prostate and cervical cancer incidence and mortality in Colombia: An administrative registry data analysis
Authors: Vargas Juliana Alexandra Hernández , Barbosa Paula Ximena Ramírez , Quijano Ana Milena Gil , García Ana María Valbuena , Merchán Lizbeth Acuña , González Jaime 
Published: November 2020

Abstract
Background: Cancer is widely recognized as a global public health problem. Breast, prostate, and cervical cancer are among the most frequent types in developing countries. Assessing their incidence and mortality by regions and municipalities is important to guide evidence-based health policy. Our aim was to describe the incidence and mortality trends for breast, cervical, and prostate cancer across regions and municipalities in Colombia during 2018.Methods: We performed a cross-sectional analysis with data from people with breast, prostate, or cervical cancer, reported to the National Administrative Cancer Registry during 2018. A descriptive analysis was performed. Age-standardized incidence and mortality rates were estimated at national, regional, and municipal levels. Finally, we identify the regions and municipalities with significantly higher or lower incidence and mortality rates compared to national estimations. Results: Breast cancer was the most frequent type among all new cases and deaths in Colombia. Breast, prostate and cervical cancer incidence and mortality rates per 100,000 were: 18.69 (CI 95%: 18.15-19.25) and 10.48 (CI 95%: 10.07-10.91); 11.34 (CI 95%: 10.90-11.78) and 7.58 (CI 95%: 7.22-7.96); 5.93 (CI 95%: 5.62-6.25) and 4.31 (CI 95%: 4.05-4.58), respectively. Eastern region had both, incidence and mortality rates, significantly lower than national for all types of cancer. By municipalities, there was a heterogeneous pattern. Nonetheless, Agua de Dios (Cundinamarca), had one of the highest incidence rates for all types. Conclusions: We observed clear differences in cancer incidence and mortality across regions and municipalities, depending on each type of cancer. Our findings are important to improve screening coverage, early detection, and treatment in the country.