bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical efficacy of artemisinin-lumefantrine and status of antifolate drug resistance markers in western Kenya
Authors: kishoyian gabriel m , Njagi Eliud N.M. , Orinda George O. , Thiongo Kevin , Kimani Francis T. , Matoke-Muhia Damaris 
Published: December 2019

Abstract
Background: The development of Plasmodium falciparum resistance to sulfadoxine-pyrimethamine (SP) necessitated its replacement with artemether-lumefantrine (AL) in Kenya. However, the delayed parasite clearance following treatment with artemisinin derivatives has now spread in the Greater Mekong Sub region and may emerge or spread to other malaria endemic regions. Since parasites resistance to drugs is correlated with specific gene mutations, molecular markers associated with antimalarial drugs offer a powerful tool to monitor the emergence and spread of resistance. In this study, we assessed the clinical efficacy of AL following its adoption and the current levels of antifolate drug resistant markers after its ban in Kenyan health facilities. Methods: We conducted a therapeutic efficacy study between May and November 2015 in Chulaimbo sub-County, Kisumu, Kenya. A total of 76 patients ≥6 and ≤60 months of age with confirmed Plasmodium falciparum mono-infection were enrolled, treated with AL and followed up for a period of 28 days. Study endpoints were adequate clinical and parasitological response (ACPR) on the 28 day and known SP molecular markers of resistance were also determined. Results: The study showed that 97% of the participants had cleared parasitemia within 48 hours with an adequate clinical and parasitological response (ACPR) of 100% clearance on day 3. On Pfdhfr/Pfdhps mutants, N51I was identified in the P. falciparum isolates with a prevalence of 94% while C59R and S108N had 92% each. The prevalence of mutation at Pfdhps codons A437G and K540E stood at 94% and 91% respectively. Conclusion: AL was found to be highly efficacious since no plasmodium falciparum parasites were observed after day 3 making it a drug of choice in Kenya. Evidence of quintuple mutations frequency is high in the study population threatening the future use of SP.
Microglia prevent beta-amyloid plaque formation in the early stage of an Alzheimer’s disease mouse model with suppression of glymphatic clearance
Authors: Feng Weixi , Zhang Yanli , Wang Ze , Xu Hanrong , Wu Ting , Marshall Charles , Gao Junying , Xiao Ming 
Published: December 2019

Abstract
BackgroundSoluble beta-amyloid (Aβ) can be cleared from the brain through various mechanisms including enzymatic degradation, glial cell phagocytosis, transport across the blood-brain barrier and glymphatic clearance. However, the relative contribution of each clearance system and their compensatory effects in delaying the pathological process of Alzheimer’s disease (AD) are currently unknown. MethodsFluorescent trace, immunofluorescence and Western blot analyses were performed to compare glymphatic clearance ability and Aβ accumulation among 3-month-old APPSwe/PS1dE9 transgenic (APP/PS1) mice, wild-type mice, aquaporin 4 knock out (AQP4-/-) mice and AQP4-/-/APP/PS1 mice. The consequence of selectively eliminating microglial cells, or downregulating apolipoprotein E (apoE) expression, on Aβ burden was also investigated in the frontal cortex of AQP4-/-/APP/PS1 mice and APP/PS1 mice.ResultsAQP4 deletion in APP/PS1 mice significantly exaggerated glymphatic clearance dysfunction and intraneuronal accumulation of Aβ and apoE, although it did not lead to Aβ plaque deposition. Notably, microglia, but not astrocytes, increased activation and phagocytosis of Aβ in the cerebral cortex of AQP4-/-/APP/PS1 mice, compared with APP/PS1 mice. Selectively eliminating microglia in the frontal cortex via local injection of clodronate liposomes resulted in deposition of Aβ plaques in AQP4-/-/APP/PS1 mice, but not APP/PS1 mice. Moreover, knockdown of apoE reduced intraneuronal Aβ levels in both APP/PS1 mice and AQP4-/-/APP/PS1 mice, indicating an inhibitory effect of apoE on Aβ clearance. ConclusionThe above results suggest that the glymphatic system mediated Aβ and apoE clearance and microglia mediated Aβ degradation synergistically prevent Aβ plague formation in the early stages of the AD mouse model. Protecting one or both of them might be beneficial to delaying the onset of AD.
Hepcidin and GDF-15 are potential biomarkers of Iron Deficiency Anaemia in Chronic Kidney Disease Patients in South Africa
Authors: NALADO AISHATU MUHAMMAD , Olorunfemi Gbenga , Dix-Peek Therese , Dickens Caroline , Khambule Lungile , Snyman Tracy , Paget Graham , Mahlangu Johnny , Duarte Raquel , George JAYA , Naicker Saraladevi 
Published: December 2019

Abstract
BackgroundIron deficiency anaemia is a significant cause of morbidity and mortality among chronic kidney disease (CKD) patients. There is a paucity of information on the role of hepcidin and growth differentiation factor-15 (GDF-15) as potential biomarkers of iron deficiency anaemia among non-dialysis CKD patients. This study aimed to determine the utility of hepcidin and GDF-15 as biomarkers of iron deficiency among non-dialysis CKD patients at an academic hospital in Johannesburg, South Africa. MethodA cross-sectional study of 312 consecutive consenting non-dialysis CKD patients and 184 controls at Charlotte Maxeke Academic Hospital was conducted from June 2016 to December 2016. Socio-demographic and clinical characteristics were recorded. Plasma hepcidin and GDF-15 were measured using mass spectrometry and ELISA, respectively. Spearman rank correlation, linear and logistic regression and receiver operator curves were utilised to evaluate the predictive and diagnostic/reference values of hepcidin and GDF-15 in absolute and functional iron deficiency anaemia. ResultsThe mean age of participants was 49.7 ±15.8 years, and 50.6% of them were females. The predictive value of diagnosing iron deficiency anaemia among CKD patients using GDF-15 and hepcidin was high (AUC=0.723 and 0.714, respectively). There was a weak negative correlation between hepcidin levels and GFR (r=-0.19, p=0.04) in anaemic CKD patients, and between serum GDF-15 and haemoglobin (r=-0.34, p=0.001). Serum ferritin (β=0.005, P-value<0.001), MCV (β=0.0276, P-value=0.029) and gender (β=-0.2188, P-value=0.042) were predictors of log hepcidin. Urea (β=0.0062, P-value=0.044), MCHC (β= -0.0816, P-value<0.001) and gender (β=-0.0755, P-value=0.001) were predictors of logGDF-15. Both GDF-15 (P=0.028) and hepcidin (P=0.049) were associated with iron deficiency anaemia. Subgroup analysis showed that GDF-15 predicted absolute iron deficiency, while hepcidin predicted functional iron deficiency anaemiaConclusionGDF-15 and hepcidin are potential predictors of iron deficiency anaemia among CKD patients.
Pore texture analysis in automated 3D breast ultrasound images for implanted lightweight hernia mesh identification: a preliminary study
Authors: Yang Jiting , Li Haiyan , Wu Jun , Sun Liang , Xu Dan , Wang Yuanyuan , Zhang Yufeng , Chen Yue , Chen Lin 
Published: December 2019

Abstract
BackgroundPrecise visualization of meshes and their position would greatly aid in mesh shrinkage evaluation, hernia recurrence risk assessment, and the preoperative planning of salvage repair. Lightweight (LW) meshes are able to preserve abdominal wall compliance by generating less post-implant fibrosis and rigidity. However, conventional 3D imaging techniques such as computed tomography (CT) and magnetic resonance imaging (MRI) cannot visualize the LW meshes. Patients sometimes have to undergo a second-look operation for visualizing the mesh implants. The goal of this work is to investigate the potential advantages of Automated 3D breast ultrasound (ABUS) pore texture analysis for implanted LW hernia mesh identification.MethodsIn vitro, the appearances of four different flat meshes in both ABUS and 2D hand-held ultrasound (HHUS) images were evaluated and compared. In vivo, pore texture patterns of 87 hernia regions were analyzed both in ABUS images and their corresponding HHUS images. ResultsIn vitro studies, the imaging results of ABUS for implanted LW meshes are much more visualized and effective in comparison to HHUS. In vivo, the inter-class distance of 40 texture features were calculated. The texture features of 2D sectional plans (axial and sagittal plane) have no significant contribution for implanted LW mesh identification. Significant contribution was observed in coronal plane. However, since the mesh may have spatial variation such as shrinkage after implant surgery, the inter-class distance of 3D coronal plane pore texture features are bigger than 2D coronal plane, so the contribution of 3D coronal plane pore texture features are more valuable than 2D coronal plane for implanted LW mesh identification. The use of 3D pore texture features significantly improved the robustness of the identification method in distinguishing the LW mesh and fascia.ConclusionsAn innovative new automated 3D breast ultrasound (ABUS) provides additional pore texture visualization, by separating the LW mesh from the fascia tissues. Therefore, ABUS having the potential to provide more accurate features to characterize pore texture patterns, and ultimately provide more accurate measures for implanted LW mesh identification.
Liquid Based Cytology for the Detection of Cervical Intraepithelial Lesion among Women in Jimma town, Ethiopia
Authors: Tesfaw Getnet , Ahmed Yesuf , Gedefaw Lealem , Dube Lamessa , Godu Samson , Eshetu Kirubel , Nigussie Mesfin , Hailekiros Haftamu , Joloba Moses , Goba Gelila Kidane , Abdissa Alemseged 
Published: December 2019

Abstract
BackgroundCervical cancer is the second leading type of female cancer in Ethiopia and screening is based on visual inspection with 5% acetic acid (VIA). Liquid-based cytology (LBC) has not yet been used. MethodWomen aged 21-65 years were enrolled. Liquid based cytology and VIA were done for the detection of cervical dysplasia. Logistic regression analysis were conducted to identify factors associated. Finally Cohen’s K was done to test agreement between the methods of diagnostics.ResultsFrom the total 448 participants, (296, 66%) were 35-65 years old. Four hundred nineteen (93.5 %) were screened using LBC of which, 97 (23.2%) had low grade squamous intraepithelial lesion (LSIL) and 17 (4.1%) had high grade squamous intraepithelial lesion (HSIL). Among women with LSIL, 84(86.6%) women as well as all those HSIL were 35-65 years old and women aged 35-65 years old had 4.7 times higher odds of having intraepithelial lesions (P=0.00). A total of 294/448 (65.6%) women underwent VIA examination, of these 18 (6.1%) were found positive. Two hundred seventy two (60.7%) women screened using both LBC and VIA. Of this 6 (2.2%) were positive with both LBC and VIA screening tests. The level of agreement between the two methods was weak and statistically significant (kappa value=0.155, p=0.006). ConclusionPrevalence of cervical lesions is higher among older women. There is high variability in LBC and VIA results. Though more expensive and requiring equipment, using LBC where possible would increase cervical cancer case detection.
Evaluation of a Rapid Immunochromatographic test kit to the Gold Standard Fluorescent Antibody test for diagnosis of rabies in animals in Bhutan
Authors: Tenzin Tenzin , Lhamo Kelzang , Rai Purna B , Tshering Dawa , Gyamtsho Pema , Namgyal Jamyang , Wangdi Thrinang , Letho Sangay , Rai Tuku , Jamtsho Sonam , Dorji Chendu , Rinchen Sangay , Lungten Lungten , Wangmo Karma , Lungten Lungten , Wangchuk Pema , Gempo Tshewang , Jigme Kezang , Phuntshok Karma , Tenzinla Tenzin , Gurung Ratna B , Dukpa Kinzang 
Published: December 2019

Abstract
Background: Rabies kills approximately 59,000 people in the world each year worldwide. Rapid and accurate diagnosis of rabies is important for instituting rapid containment measures and for advising the exposed people for postexposure treatment. The application of a rapid diagnostic tests in the field can greatly enhance disease surveillance activities, especially in resource poor settings.Methods: From 2012 to 2017, a total of 179 brain tissue samples collected from different animal species (113 dogs, 50 cattle, 10 cats, 3 goats, 2 horses, and 1 bear) suspected of having died due to rabies were selected and tested using the rapid immunochromatographic kit from BioNote© company and compared to the Gold Standard Fluorescent Antibody test (FAT) for diagnosis of rabies.Results: Among 179 samples examined in this study, there was concordance in results by the rapid test and FAT in 115 positive samples and 54 negative samples. Test result were discordant in 10 samples which were positive by FAT, but negative (false negative) by rapid kit. The rapid test kit showed a sensitivity of 92% (95% CI: 85.9 – 95.6) and specificity of 100% (95% CI: 93.4 – 100) using FAT as the gold standard. The positive and negative predicative values were found to be 100% (95% CI:96.7 – 100) and 84% (95% CI: 73.6 – 91.3), respectively. Overall there was 94.41% (95% CI: 90 – 96.9) test agreement (almost perfect agreement) between rapid test and FAT (Kappa value = 0.874).Conclusions: Our results demonstrate the potential value of the rapid test kit for countries with limited diagnostic resources, including Bhutan. The rapid kit’s inability to correctly detect 10 FAT-positive samples (10 out of 179 (5.6%) were false negatives) in our study could have been due to the low viral load in the samples (< 102.0LD50/0.03ml) which could not be detected by the rapid kit as compared with the FAT. The human factor related to the varying experiences of the technicians who performed the test in the field also may have influenced the test result. The rapid test kit is inexpensive, rapid and easy to use in the field or in laboratory setting without the need for special training and can support to enhance rabies surveillance in resource poor countries.
A benchmark study of ab initio gene prediction methods in diverse eukaryotic organisms
Authors: Scalzitti Nicolas , Jeannin-Girardon Anne , Collet Pierre , Poch Olivier , Thompson Julie Dawn 
Published: December 2019

Abstract
Background: The draft genome assemblies produced by new sequencing technologies present important challenges for automatic gene prediction pipelines, leading to less accurate gene models. New benchmark methods are needed to evaluate the accuracy of gene prediction methods in the face of incomplete genome assemblies, low genome coverage and quality, complex gene structures, or a lack of suitable sequences for evidence-based annotations. Results: We describe the construction of a new benchmark, called G3PO (benchmark for Gene and Protein Prediction PrOgrams), designed to represent many of the typical challenges faced by current genome annotation projects. The benchmark is based on a carefully validated and curated set of real eukaryotic genes from 147 phylogenetically disperse organisms, and a number of test sets are defined to evaluate the effects of different features, including genome sequence quality, gene structure complexity, protein length, etc. We used the benchmark to perform an independent comparative analysis of the most widely used ab initio gene prediction programs and identified the main strengths and weaknesses of the programs. More importantly, we highlight a number of features that could be exploited in order to improve the accuracy of current prediction tools. Conclusions: The experiments showed that ab initio gene structure prediction is a very challenging task, which should be further investigated. We believe that the baseline results associated with the complex gene test sets in G3PO provide useful guidelines for future studies.
“To guide my life and art”: A triangulated study on the behavioral competencies for effective medical practice in Nigeria
Authors: Chukwuma Adanna , Obi Uche , Agu Ifunanya , Mbachu Chinyere 
Published: December 2019

Abstract
Background: Variation in clinical performance is attributable to factors outside academic and clinical skills. Selection processes and training programs for medical professionals should be adapted to consider these behavioral factors, which may vary across contexts. This study was conducted to identify behavioral competencies considered relevant for effective medical practice among medical students and practitioners in Nigeria.Methods: We drew on a scoping review to develop a starting list of behavioral attributes that correlate with effective service provision. Drawing on nominal group technique exercises with 17 medical students and 11 physicians, this starting list was modified with scoring and ranking of selected competencies. We compared the list of competencies and rankings between medical students, doctors, and the scoping review.Results: The scoping review identified nine articles for full-text review, resulting in a starting list of 21 behavioral competencies defined in studies conducted in non-African countries. The nominal group technique exercises conducted with medical students and doctors yielded a condensed list of 32 and 27 behavioral competencies respectively. For doctor-client interactions, the behavioral competencies considered most important included effective communication and patient-centeredness. Whereas, for doctor-colleague interactions, team work, respectfulness, and management ability were ranked highly. However, there were clear divergences between groups and with the scoping review.Conclusions: This study is one of the first to identify the perspectives of medical students and physicians on behavioral competencies considered essential for effective medical practice in an African country. We found differences in the perspectives of medical physicians and students, and in the prioritized competencies across contexts. This illustrates the need for careful consideration in identifying subject matter experts and in generalizing competencies across contexts. Future research in this field in Nigeria should examine effective ways of testing for key behavioral competencies among medical students and for residency programs. Also, investigating the perspectives of medical faculty and administrators on important competencies, and exploring the generalizability of these competencies across cultures in Nigeria should be considered.
A framework for distributed health professions training: using participatory action research to build consensus
Authors: Schalkwyk Susan C Van , Couper Ian D , Blitz Julia , De Villiers Marietjie Rene 
Published: December 2019

Abstract
Introduction There is a global trend towards providing training for health professions students outside of tertiary academic complexes. In many countries, this shift places pressure on available sites and the resources at their disposal, specifically within the public health sector. Introducing an educational remit into a complex health system is challenging, requiring commitment from a range of stakeholders, including national authorities. To facilitate the effective implementation of distributed training, we developed a guiding framework through an extensive, national consultative process with a view to informing both practice and policy.Methods We adopted a participatory action research approach over a four year period across three phases, which included seven local, provincial and national consultative workshops, reflective work sessions by the research team, and expert reviews. Approximately 240 people participated in these activities. Engagement with the national department of health and health professions council further informed the development of the Framework.Results Each successive ‘feedback loop’ contributed to the development of the Framework which comprised a set of guiding principles, as well as the components essential to the effective implementation of distributed training. Analysis further pointed to the centrality of relationships, while emphasising the importance of involving all sectors relevant to the training of health professionals. A tool to facilitate the implementation of the Framework was also developed, incorporating a set of ‘Simple Rules for Effective DHPT’. A national consensus statement was adopted.Conclusions In this project, we drew on the thinking and practices of key role players to enable a synthesis between their embodied and inscribed knowledge, and the prevailing literature, this with a view to further enaction as the knowledge generators become knowledge users. The Framework and its subsequent implementation has not only assisted us to apply the evidence to our educational practice, but also to begin to influence policy at a national level.
Survey on satisfaction and needs of pharmacists in prescription-checking training: a cross-sectional study
Authors: Cheng Wei , Wang Chen , Ma Jing , Ji Wen , Yang Xiangli , Wu Bei , Hou Ruigang 
Published: December 2019

Abstract
Background Prescription-checking is becoming increasingly popular in medical institutions, but the prescription-checking ability of pharmacists needs improvement. This study aimed to explore the key aspects of the prescription-checking training and provide an empirical reference for standardizing the prescription-checking training for pharmacists in medical institutions.Methods Trainees who were willing to complete the Likert questionnaire were enrolled in this study. Percentage and composition ratio were used for statistical description. The chi-square test and exploratory factor analysis were used for statistical analysis. A difference with p<0.05 was considered statistically significant.Results The questionnaire had good internal consistency and validity. The overall satisfaction of the trainees was 90%. Three dimensions, training organization, teaching mode as well as consolidation and assessment of knowledge were extracted using exploratory factor analysis. The average examination score of the 20 courses was 89.21±2.62 points. From the perspective of needs, 94.66% of the trainees preferred face-to-face lectures, 89.33% of the trainees expected high professional skills of the lecturers, and 62.27% of the trainees believed that clinical expertise was highly desirable.Conclusion There was a great demand for prescription-checking training among pharmacists. Trainees enrolled in this training showed high satisfaction and good examination results. The key aspects of prescription-checking training were training organization, as well as consolidation and assessment of knowledge. It is recommended to conduct training in a stratified manner according to pharmacists’ educational background, in order to effectively improve their prescription-checking competence. The pharmacists preferred face-to-face lectures and interaction to supplement clinical disease-related knowledge.