bluuebunny/crossref_metadata_2025_split huggingface dataset:
Non adherence to secondary prophylaxis for rheumatic fever
Authors: Saha Santosh K. , Choudhury Kamrun N. , Sarker Nihar R. , Ahmed Gias U. , Hoque Nazmul 
Published: October 2020

Background: Secondary prophylaxis with benzathine penicillin G (BPG) is a cost-effective intervention for preventing morbidity and mortality related to rheumatic fever (RF). There is no reliable data available with regards to adherence to secondary prophylaxis and rates of recurrent RF in many developing countries, including Bangladesh. So, aim of this study was to estimate rate of non-adherence and find out risk of non-adherence to secondary prophylaxis for rheumatic fever.Methods: Total 230, 5-30 years patients of both sexes with definite previous history of RF taking secondary prophylaxis with injection benzathine penicillin G (BPG) were enrolled by simple random fashion. Last one-year injection profile of the patient was collected from the injection card. Patients were then classified as “non-adherent” when the rate of adherence was <80% of the expected injections and as “adherent” when it was ≥80%. After collection of data selective patients were invited for blood tests and echocardiography to identify recurrence of rheumatic fever. Results: Out of 230 patients, male were 96 (41.7%) and female were 134 (58.3%). Male and female ratio were 0.7. 173 (75.2%) were adherent with benzathine penicillin and 57 (24.8%) patients not adherent with benzathine penicillin. In adherent group only 5 (2.2%) and in non-adherent group 19 (8.3%) patients develop rheumatic recurrence and this finding was statistically significant (p-value 0.001). Conclusions: Non adherence to secondary prophylaxis with BPG was found a major risk factor for recurrent rheumatic fever. The main reasons of non-adherence were lack of counselling, fare of pain and fail to remember.
Risk factors of Toxoplasma encephalitis among people living with HIV/AIDS at Wangaya hospital in Denpasar, Bali, Indonesia: a case control study
Authors: Suharsono Hamong , Suryana Ketut , Pujasakti Mochamad P. 
Published: October 2020

Background: Toxoplasma encephalitis (TE) is the most frequent AIDS-related opportunistic infection. T. gondii infects the human population in both developed and developing countries. Toxoplasmosis among PLWHA manifests primarily as a life-threatening condition, TE, brain abscesses and death. Objective was to identify the risk factors of Toxoplasma encephalitis (TE) among people living with HIV/AIDS (PLWHA). Methods: A case control study was conducted during May to November 2018. The study participants consisted of 90 PLWHA; 30 PLWHA with history of TE (cases) and 60 PLWHA without history of TE (controls). Data such as: socio-demographic, laboratory results, head CT scan findings were collected from the medical record and was analyzed using SPSS version 18.Results: A total of 90 participants PLWHA were enrolled, 30 participants as cases and 60 participants as a control. 49 (54.4%) participants were males and 41 (45.6%) participants were females. Among the risk factors evaluated; the lower lymphocyte level (p=0.016), the lower cluster differentiation (CD) 4 level (p=0.003), no taking highly active antiretroviral therapy (HAART) (p=0.000) were observed to be an independent associated risk factor of TE.Conclusions: Our findings suggest lower lymphocyte levels, lower CD4 count and no taking HAART may constitute a significant associated risk factor for TE in PLWHA.
Evaluation of minimally invasive plate osteosynthesis of distal femoral fracture by mini-open technique with femoral distractor and traction table: a prospective review of 26 cases
Authors: Ghosh Tapas Kumar , Banik Rajeeb , Bhattacharjya Bijoy 
Published: October 2020

<p class="abstract"><strong>Background:</strong> Different methods exist for fracture reduction and submuscular plating in distal femur intra-articular and metaphyseal extra-articular fractures. Apart from knee flexion, femoral distractor and traction table are commonly used for alignment of fractures in minimally invasive techniques.</p><p class="abstract"><strong>Methods:</strong> 26 distal femoral fractures (all closed fractures) were operated (14 cases in traction table, 12 cases in femoral distractor). Partial articular/unicondylar fractures were excluded from our study. Mean patient age was 42 years (range 18 to 60 years). Evaluation was done by knee society score (KSS).<strong></strong></p><p class="abstract"><strong>Results:</strong> Mean time of radiological union was 23.2 weeks (range 20-28 weeks). 23 fractures united uneventfully, one patient had wound infection, and 2 cases had non-union with implant failure. Debridement in infected implant and re-fixation with long plate and bone grafting were done for fracture union in these two cases. According to KSS, excellent outcome were seen in 6 patients, 10 had good, 8 had fair and 2 had poor outcome.</p><p class="abstract"><strong>Conclusions:</strong> Distraction by traction table or femoral distractor helps us to reduce the fracture by overcoming the pull of gastrocnemius in 2 week old fracture correcting hyperextension/recurvatum deformity. This method can be used as viable alternative in minimally invasive plating causing less chance of infection preserving maximal joint movement.</p><p class="abstract"> </p>
Bilaterally symmetrical lupus profundus with livedo reticularis as a sole cutaneous manifestation in a case of systemic lupus erythematosus
Authors: Thiruveedhula Haritha , Kurapati Arunasree , Samanthula Haritha , Bora Madhu K. Reddy 
Published: October 2020

<p>A 31-year-old female diagnosed as a case of systemic lupus erythematosus (SLE) two years back with no cutaneous lesions, with lupus nephritis and anti-ds DNA positivity presented with the hardness of skin over the inner aspect of both thighs for four months associated with mild pain and itching. Lupus profundus was diagnosed clinically and histopathologically. She had livedo reticularis over the left leg, which can be a sign of the central nervous system's future involvement. The recent development of bilaterally symmetrical lupus profundus over thighs and livedo reticularis in a case of SLE with lupus nephritis diagnosed two years back is a rare presentation. </p>
Diagnostic Accuracy of a Liquid Chromatography-Tandem Mass Spectrometry Assay for Rifampin-resistant Tuberculosis Drug Concentrations in a Routine Care Setting
Authors: Metcalfe John , Bacchetti Peter , Esmail Ali , Reckers Andrew , Aguilar David , Wen Anita , Huo Shu , Muyindike Winnie R. , Hahn Judith A. , Dheda Keertan , Gandhi Monica , Gerona Roy 
Published: October 2020

Abstract
BackgroundTreatment monitoring of drug-resistant tuberculosis (DR-TB) in resource-limited settings is challenging. We developed a multi-analyte assay for eleven anti-TB drugs in small hair samples as an objective metric of drug exposure.MethodsSmall hair samples were collected from participants at various timepoints during directly observed RR-TB treatment at an inpatient tertiary referral facility in South Africa (DR-TB cohort). We assessed qualitative determination (i.e., detection above limit of detection) of bedaquiline, linezolid, clofazimine, pretomanid, levofloxacin, moxifloxacin, pyrazinamide, isoniazid, ethambutol, ethionamide, and prothionamide in an LC-MS/MS index panel assay against a reference standard of inpatient treatment records. Because treatment regimens prior to hospitalization were not available, we also analyzed specificity (for all drugs except isoniazid) using an external cohort of HIV-positive patients treated for latent TB infection with daily isoniazid (HIV/LTBI cohort) in Uganda.ResultsAmong the 57 DR-TB patients (58% with pre-XDR/XDR-TB; 70% HIV-positive) contributing analyzable hair samples, the sensitivity of the investigational assay was 94% or higher for all drugs except ethionamide (58.5%, 95% confidence interval [CI], 40.7-99.9). Assay specificity was low across all tested analytes within the DR-TB cohort; conversely, assay specificity was 100% for all drugs in the HIV/LTBI cohort.ConclusionsHair drug concentrations reflect long-term exposure, and multiple successive regimens commonly employed in DR-TB treatment may result in apparent false-positive qualitative and falsely elevated quantitative hair drug levels when prior treatment histories within the hair growth window are not known.
Evaluation of TaqMan Array Card (TAC) for the Detection of 28 Respiratory Pathogens
Authors: Liu Keke , Jing Hongbo , Chen Ying , Zheng Xin , Jiang Hua , Kong Decong , Zheng Yvling , Chen Shuiping , Liu Peng , Jiang Yongqiang 
Published: October 2020

Abstract
Background: Respiratory infections are a serious threat to human health. So, rapid detection of all respiratory pathogens can facilitate prompt treatment and prevent the deterioration of respiratory disease. Previously published primers and probes of the TaqMan array card (TAC) for respiratory pathogens are not sensitive to Chinese clinical specimens. This study aimed to develop and improve the TAC assay to detect 28 respiratory viral and bacterial pathogens in a Chinese population. Methods: To improve the sensitivity, we redesigned the primers and probes, and labeled the probes with minor groove binders. The amplification efficiency, sensitivity, and specificity of the primers and probes were determined using target-gene containing standard plasmids. The detection performance of the TAC was evaluated on 754 clinical specimens and the results were compared with those from conventional methods.Results: The performance of the TAC assay was evaluated using 754 clinical throat swab samples and the results were compared with those from gold-standard methods. The sensitivity and specificity were 95.4% and 96.6%, respectively. The lowest detection limit of the TAC was 10 to 100 copies/μL. Conclusions: TAC is an efficient, accurate, and high-throughput approach to detecting multiple respiratory pathogens simultaneously and is a promising tool for the identification of pathogen outbreaks.
Generation of small interfering RNA (siRNA) database from SARS-CoV-2 genome sequences
Authors: Medeiros Inácio Gomes , Khayat André Salim , Stransky Beatriz , Santos Sidney Emanuel Batista dos , Assumpção Paulo Pimentel de , Souza Jorge Estefano Santana de 
Published: October 2020

Abstract
This protocol aims to describe the building of a database of SARS-CoV-2 targets for siRNA approaches. Starting from the virus reference genome, we will derive sequences from 18 to 21nt-long and verify their similarity against the human genome and coding and non-coding transcriptome, as well as genomes from related viruses. We will also calculate a set of thermodynamic features for those sequences and will infer their efficiencies using three different predictors. The protocol has two main phases: at first, we align sequences against reference genomes. In the second one, we extract the features. The first phase varies in terms of duration, depending on computational power from the running machine and the number of reference genomes. Despite that, the second phase lasts about thirty minutes of execution, also depending on the number of cores of running machine. The constructed database aims to speed the design process by providing a broad set of possible SARS-CoV-2 sequences targets and siRNA sequences.
Knowledge, attitudes, beliefs, and stigma related to latent tuberculosis infection: a qualitative study among Eritreans in the Netherlands
Authors: Spruijt Ineke , Haile Dawit Tesfay , Hof Susan van den , Fiekert Kathy , Jansen Niesje , Jerene Degu , Klinkenberg Eveline , Leimane Ieva , Suurmond Jeanine 
Published: October 2020

Abstract
Background: Tailored and culturally appropriate latent tuberculosis (TB) infection screening and treatment programs, including interventions against TB stigma, are needed to reduce TB incidence in low TB incidence countries. However, we lack insights in stigma related to latent TB infection (LTBI) among target groups, such as asylum seekers and refugees. We therefore studied knowledge, attitudes, beliefs, and stigma associated with LTBI among Eritrean asylum seekers and refugees in the Netherlands.Methods: We used convenience sampling to interview adult Eritrean asylum seekers and refugees: 26 semi-structured group interviews following TB and LTBI related health education and LTBI screening, and 31 semi-structured individual interviews with Eritreans during or after completion of LTBI treatment (November 2016-May 2018). We used a thematic analysis to identify, analyse and report patterns in the data.Results: Despite TB/LTBI education, misconceptions embedded in cultural beliefs about TB transmission and prevention persisted. Fear of getting infected with TB was the cause of reported enacted (isolation and gossip) and anticipated (concealment of treatment and self-isolation) stigma by participants on LTBI treatment.Conclusion: The inability to differentiate LTBI from TB disease and consequent fear of getting infected by persons with LTBI led to enacted and anticipated stigma comparable to stigma related to TB disease among Eritreans. Additional to continuous culturally sensitive education activities, TB prevention programs should implement evidence-based interventions reducing stigma at all phases in the LTBI screening and treatment cascade.
Cost of investigations during the acute hospital stay following total hip or knee arthroplasty, by complication status
Authors: Cheng Emma Tsz Lou , Lewin Adriane , Churches Tim , Harris Ian A , Naylor Justine 
Published: October 2020

Abstract
Background: Total hip and total knee arthroplasties are among the most common types of surgery performed in Australia today and are effective treatments for severe osteoarthritis. However, the increasing financial burden on the health system owing to the increasing rates of surgery has led to a growing interest in improving the cost-effectiveness and safety of arthroplasty care. This study was designed to quantify the association between post-operative complications, a major cost driver, and the cost of investigations following total hip or knee arthroplasty.Methods: This is a prospective cohort study of consecutive patients undergoing primary total hip or knee arthroplasty at an Australian public hospital. We measured the number and cost of imaging and pathology tests performed during the acute hospital stay and used linear regression to quantify the association between complication status and investigation costs.Results: Five hundred patients were included in the analysis. On average, those with complications received more tests, and more expensive tests. The mean combined cost of imaging and pathology tests in patients with no complications was AU$ 187 (SD: 12.0). In comparison, patients with minor complications had a mean additional cost of AU$ 270 (SD: 31.0), and those with major complications had a mean additional cost of AU$ 493 (SD: 54.2) (p<0.001).Conclusions: In patients undergoing hip or knee arthroplasty, investigation costs are substantially greater in the presence of either minor or major complications. With growing volumes of total hip and total knee arthroplasties, a potential focus of future research could include optimising investigation practices for patients with and without complications.
Clinically oriented contour evaluation using geometric and dosimetric indices based on simple geometric transformations
Authors: Xian Lixun , Li Guangjun , Xiao Qing , Li Zhibin , Zhang Xiangbin , Chen Li , Hu Zhenyao , Bai Sen 
Published: October 2020

Abstract
Background: In radiotherapy, geometric indices are often used to evaluate the accuracy of contouring; however, the ability of geometric indices to identify the error of contouring results is limited, mainly because it does not consider any clinical background. To study the relationship between geometric indices and dosimetric indices, four different types of targets were selected to introduce the systematic and random geometric errors in the delineation process. Materials and Methods: The C-shaped target outlined in the American Association of Physicists in Medicine (AAPM) TG-119 report (The report of Task Group 119 of the AAPM) and the targets of three actual cases of oropharyngeal cancer, metastatic spine cancer, and prostate cancer were selected as the test contours that needed to be modified. Python software was used to perform translation, scaling, rotating and sine function transformation to introduce systematic and random errors into the above contours. These geometrically transformed contours were regarded as reference contours corrected by systematic and random errors. The corresponding dosimetric indices were obtained from the original dose distribution of the radiotherapy plan, and correlations (R²) between geometric and dosimetric indices were quantified through linear regression. The Wilcoxon signed rank test was used to compare the ability of spatial-direction discrimination between the geometric indices of different directions of transformations. Results: The correlations between the geometric and dosimetric indices were inconsistent for the targets. For systematic errors, except for the sine function transformation (R²: 0.023–0.04, p＞0.05), the geometric transformations of the C-shaped target’s planning target volume (C-PTV) had correlations with the dosimetric indices D98% and Dmean (R²: 0.689–0.988), 80% of which were strongly correlated (R² > 0.8). For the random errors, the correlation coefficients of the actual cases were also high, R2 > 0.384, p < 0.05. The results of Wilcoxon signed rank test showed that only the p-values of volumetric geometric indices of C-PTV were less than 0.05. Conclusions: Clinically, an assessment of the contour accuracy of the region of interest is not feasible based on geometric indices alone, and should be combined with dosimetric indices. Keywords: Contour evaluation, Geometric indices, Dosimetric indices, Geometric transformation
A Human Factors Intervention in a Hospital - Evaluating the Outcome of a TeamSTEPPS Program in a Surgical Ward
Authors: Aaberg Oddveig Reiersdal , Hall-Lord Marie Louise , Husebø Sissel Iren Eikeland , Ballangrud Randi 
Published: October 2020

Abstract
Background: Patient safety in hospitals is being jeopardized, since too many patients experience adverse events. Most of these adverse events arise from human factors, such as inefficient teamwork and communication failures, and the incidence of adverse events is greatest in the surgical area. Previous research has shown the effect of team training on patient safety culture and on different areas of teamwork. Limited research has investigated teamwork in surgical wards. The aim of this study was to evaluate the professional and organizational outcomes of a team training intervention among healthcare professionals in a surgical ward after 6 and 12 months. Systems Engineering Initiative for Patient Safety 2.0 was used as a conceptual framework for the study.Methods: This study had a pre-post design with measurements at baseline and after 6 months and 12 months of intervention. The intervention was conducted in a urology and gastrointestinal surgery ward in Norway, and the study site was selected based on convenience and the leaders’ willingness to participate in the project. Survey data from healthcare professionals were used to evaluate the intervention. The organizational outcomes were measured by the unit-based sections of the Hospital Survey of Patient Safety Culture Questionnaire, and professional outcomes were measured by the TeamSTEPPS Teamwork Perceptions Questionnaire and the Collaboration and Satisfaction about Care Decisions in Teams Questionnaire. A paired t-test, a Wilcoxon signed-rank test, a generalized linear mixed model and linear regression analysis were used to analyze the data.Results: After six months, improvements were found in organizational outcomes in two patient safety dimensions. After 12 months, improvements were found in both organizational and professional outcomes, and these improvements occurred in three patient safety culture dimensions and in three teamwork dimensions. Furthermore, the results showed that one of the significant improved teamwork dimensions “Mutual Support” was associated with the Patient Safety Grade, after 12 months of intervention.Conclusion: These results demonstrate that the team training program had effect after 12 months of intervention. Future studies with larger sample sizes and stronger study designs are necessary to examine the causal effect of a team training intervention in this context.Trial registration number: ISRCTN13997367 (retrospectively registered)
Local Use of Dexamethasone in the Treatment of Ocular Myasthenia Gravis
Authors: Shi Minghua , Ye Yingjia , Zhou Junping , Qin Aijiao , Cheng Jing , Ren Hongxing 
Published: October 2020

Abstract
Background: At present, patients with ocular myasthenia gravis (OMG) are typically treated with systemic drugs. We investigated the use of dexamethasone injected in the peribulbar region or extraocular muscle to treat patients with OMG.Methods: Patients with OMG were given dexamethasone via peribulbar injection or direct injection into the main paralyzed extraocular muscles, once a week, for 4-6 weeks. The severity of diplopia, blepharoptosis, eye position, and eye movement were evaluated before and after treatment. The duration of follow-up time was ≥6 months.Results: Among the 14 patients with OMG who received this treatment, mean age was 38.7 ± 29.7 years. After treatment, symptoms were relieved in 12 patients (85.7%), 1 patient (7.1%) had partial response to treatment, and 1 patient (7.1%) had no response. Two patients (14.2%) experienced symptom recurrence during the follow-up period.Conclusions: Dexamethasone peribulbar or extraocular muscle injection is effective in the treatment of patients with OMG and may replace systemic drug therapy.Trial registration: Chinese Clinical Trial Registry, ChiCTR2000038863, October 7, 2020.Retrospectively registered.