bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spatio-temporal variation of malaria hotspots in Central Senegal, 2008–2012
Authors: Dieng Sokhna , Ba El Hadj , Cissé Badara , Sallah Kankoe , Guindo Abdoulaye , Ouedraogo Boukary , Piarroux Martine , Rebaudet Stanislas , Piarroux Renaud , Landier Jordi , Sokhna Cheikh , Gaudart Jean 
Published: June 2020

Abstract
Background
In malaria endemic areas, identifying spatio-temporal hotspots is becoming an important element of innovative control strategies targeting transmission bottlenecks. The aim of this work was to describe the spatio-temporal variation of malaria hotspots in central Senegal and to identify the meteorological, environmental, and preventive factors that influence this variation.

Methods
This study analysed the weekly incidence of malaria cases recorded from 2008 to 2012 in 575 villages of central Senegal (total population approximately 500,000) as part of a trial of seasonal malaria chemoprevention (SMC). Data on weekly rainfall and annual vegetation types were obtained for each village through remote sensing. The time series of weekly malaria incidence for the entire study area was divided into periods of high and low transmission using change-point analysis. Malaria hotspots were detected during each transmission period with the SaTScan method. The effects of rainfall, vegetation type, and SMC intervention on the spatio-temporal variation of malaria hotspots were assessed using a General Additive Mixed Model.

Results
The malaria incidence for the entire area varied between 0 and 115.34 cases/100,000 person weeks during the study period. During high transmission periods, the cumulative malaria incidence rate varied between 7.53 and 38.1 cases/100,000 person-weeks, and the number of hotspot villages varied between 62 and 147. During low transmission periods, the cumulative malaria incidence rate varied between 0.83 and 2.73 cases/100,000 person-weeks, and the number of hotspot villages varied between 10 and 43. Villages with SMC were less likely to be hotspots (OR = 0.48, IC95%: 0.33–0.68). The association between rainfall and hotspot status was non-linear and depended on both vegetation type and amount of rainfall. The association between village location in the study area and hotspot status was also shown.

Conclusion
In our study, malaria hotspots varied over space and time according to a combination of meteorological, environmental, and preventive factors. By taking into consideration the environmental and meteorological characteristics common to all hotspots, monitoring of these factors could lead targeted public health interventions at the local level. Moreover, spatial hotspots and foci of malaria persisting during LTPs need to be further addressed.

Trial registration
The data used in this work were obtained from a clinical trial registered on July 10, 2008 at www.clinicaltrials.gov under NCT00712374.
Late-onset MELAS syndrome with mtDNA 14453G→A mutation masquerading as an acute encephalitis: a case report
Authors: Yokota Yuki , Hara Makoto , Akimoto Takayoshi , Mizoguchi Tomotaka , Goto Yu-ichi , Nishino Ichizo , Kamei Satoshi , Nakajima Hideto 
Published: June 2020

Abstract
Background
A unique patient with MELAS syndrome, who initially masqueraded as having acute encephalitis and was eventually diagnosed with MELAS syndrome harboring a mtDNA 14453G → A mutation, is described.

Case presentation
A 74-year-old Japanese man was admitted to another hospital due to acute onset of cognitive impairment and psychosis. After 7 days he was transferred to our hospital with seizures and deteriorating psychosis. The results of primary ancillary tests that included EEG, CSF findings, and brain MRI supported the diagnosis of an acute encephalitis. HSV-DNA and antibodies against neuronal surface antigens in the CSF were all negative. With the assistance of the lactate peak on the brain lesions in the magnetic resonance spectroscopy image and genetic analysis of the biopsied muscle, he was eventually diagnosed with MELAS syndrome harboring mtDNA 14453G → A mutation in the ND6 gene.

Conclusions
This case provides a caveat that MELAS syndrome can manifest in the symptoms and ancillary tests masquerading as an acute encephalitis caused by infection or autoimmunity. This is the first adult patient seen to harbor the mtDNA14453G → A with a unique onset, which broadens the phenotypic spectrum of MELAS syndrome associated with ND6 gene mutation.
Differentiation of suprasellar meningiomas from non-functioning pituitary macroadenomas by 18F-FDG and 13N-Ammonia PET/CT
Authors: Ding Lei , Zhang Fangling , He Qiao , Li Zhoulei , Shi Xinchong , Li Ruocheng , Zhang Xiangsong 
Published: June 2020

Abstract
Background
Differentiation of suprasellar meningiomas (SSMs) from non-functioning pituitary macroadenomas (NFPMAs) is useful for clinical management. We investigated the utility of 13N-ammonia combined with 18F-FDG positron emission tomography (PET)/computed tomography (CT) in distinguishing SSMs from NFPMAs retrospectively.

Methods
Fourteen NFPMA patients and eleven SSM patients with histopathologic diagnosis were included in this study. Every patient underwent both 18F-FDG and 13N-ammonia PET/CT scans. The tumor to gray matter (T/G) ratios were calculated for the evaluation of tumor uptake.

Results
The uptake of 18F-FDG was higher in NFPMAs than SSMs, whereas the uptake of 13N-ammonia was obviously lower in NFPMAs than SSMs. The differences of 18F-FDG and 13N-ammonia uptake between the two groups were significant respectively (0.92[0.46] vs 0.59[0.29], P < 0.05, 18F-FDG; 1.58 ± 0.56 vs 2.80 ± 1.45, P < 0.05, 13N-ammonia). Tumor classification demonstrated a high overall accuracy of 96.0% for differential diagnosis. When the two traces were combined, only 1 SSM was misclassified into the NFPMA group.

Conclusion
SSMs and NFPMAs have different metabolic characteristics on 18F-FDG and 13N-ammonia PET images. The combination of these two tracers can effectively distinguish SSMs from NFPMAs.
Refractive, visual, and subjective quality of vision outcomes for very high myopia LASIK from − 10.00 to − 13.50 diopters
Authors: Wallerstein Avi , Kam Joseph Wai Keung , Gauvin Mathieu , Adiguzel Eser , Bashour Mounir , Kalevar Ananda , Cohen Mark 
Published: June 2020

Abstract
Background
To evaluate laser-assisted in situ keratomileusis (LASIK) outcomes, subjective quality of vision (QoV) and patient satisfaction in eyes with very high myopia (VHM) above − 10.00 diopters (D).

Methods
Consecutive myopic and myopic-astigmatism eyes with spherical equivalent (SEQ) ranging between − 10.00 to − 13.50 D underwent LASIK with the WaveLight® Allegretto Wave® Eye-Q 400 Hz excimer laser. Treatment accuracy, efficacy, safety, stability, cylinder vectors, and higher-order aberrations were evaluated, together with subjective QoV and night vision disturbances (NVDs).

Results
114 eyes had a preoperative SEQ of − 11.02 ± 0.81 D, with a median follow-up of 24 months. A total of 72, 84, and 94% of eyes were within ± 0.50, ± 0.75 and ± 1.00 D of intended SEQ (R2 = 0.71). The efficacy index was 0.93 ± 0.20, with 51 and 81% of eyes achieving 20/20 and 20/25. The astigmatism correction index was 0.95 ± 0.33. The safety index was 1.05 ± 0.12. The average myopic regression was − 0.51 ± 0.38 D. Preoperative QoV scores improved significantly postoperatively (7.5 ± 0.8 vs. 9.1 ± 0.7; P <  0.001), with less NVDs (P <  0.001). Total, spherical and coma root mean square (RMS) postoperative ocular higher-order aberrations were 1.07 ± 0.34, 0.67 ± 0.25, and 0.70 ± 0.40 μm.

Conclusions
Very high myopia LASIK between − 10.00 to − 13.50 D is safe and results in good visual outcomes, with high patient satisfaction and a significant improvement in patient-reported QoV after surgery. Appropriately selected patients within this very high myopia group can be included as LASIK candidates.
Short-time evaluation on intraocular scattering after implantable collamer lens implantation for correcting high myopia
Authors: Yu Zhe , Li Jun , Song Hui 
Published: June 2020

Abstract
Background
To compare the intraocular scattering before and after implantation of implantable collamer lens (ICL) V4c for correction of high myopia in a short term.

Methods
In this study, 38 eyes of 19 patients who underwent the implantation of ICL V4c were followed up for 3 months. Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), objective scattering index (OSI), modulation transfer function cutoff frequency (MTF cutoff), strehl ratio (S/R), OV100%, OV20% and OV9% were measured pre- and postoperatively. Meantime, the Pseudophakic Dysphotopsia Questionnaire (PDQ) was scored to evaluate the subjective satisfaction of intraocular scattering pre- and postoperatively.

Results
The UCVA were − 0.02 ± 0.06, − 0.03 ± 0.07 and − 0.04 ± 0.07 logMAR at 1 week, 1 month and 3 months postoperatively which were significantly better than those preoperatively (P < 0.05). The BCVA were − 0.09 ± 0.09, − 0.09 ± 0.1 and − 0.1 ± 0.11 logMAR at 1 week, 1 month and 3 months after surgery, which were better than those before surgery significantly (t = 15.64, P < 0.05). The mean OSI were 2.37 ± 1.6, 1.63 ± 0.94, 1.5 ± 0.86 and 1.43 ± 1.05 preoperatively, 1 week, 1 month and 3 months postoperatively which was found significant difference (F = 12.92 P < 0.05). No significant differences were found in MTF cut off (F = 0.61, P = 0.62), S/R (F = 0.58, P = 0.36), OV100% (F = 0.966, P = 0.65), OV20% (F = 0.121, P = 0.96) and OV9% (F = 1.01, P = 0.30) between pre- and postoperatively. The PDQ results indicated that intraocular scattering reduced at 3 months after surgery significantly (P < 0.05).

Conclusions
The ICL V4c implantation for correcting high myopia induced less intraocular scattering and visual disorder than spectacle correction.
Trajectories of posttraumatic stress symptoms during and after Narrative Exposure Therapy (NET) in refugees
Authors: Kaltenbach Elisa , Hermenau Katharin , Schauer Maggie , Dohrmann Katalin , Elbert Thomas , Schalinski Inga 
Published: June 2020

Abstract
Background
Trauma-focused therapy approaches are recommended as treatment for posttraumatic stress disorder (PTSD). This includes the treatment of trauma-related suffering in refugee populations. However, there is a lack of knowledge about symptom trajectories in refugees living in volatile conditions. This has led to fear of “retraumatisation” and general skepticism in clinicians concerning the use of exposure therapy.

Methods
To test the relevance of this concern, we investigated PTSD symptom trajectories and potentially influencing factors during the course of Narrative Exposure Therapy (NET) in a refugee sample living in Germany. Refugees filled out the PTSD Checklist prior to each treatment session and also during follow-up interviews. Therapists continuously documented positive and negative life events as well as the content of the treatment sessions. Additionally, structured clinical interviews were conducted pre-treatment and at follow-up time points.

Results
On average, clients presented with substantial decreases in PTSD symptoms already during and after NET. However, symptom trajectories differed and ranged from fast responders to slow responders to no immediate response during treatment. Importantly, a persistent worsening of symptoms was not observed, also not after exposure to the most distressing events. In contrast, stressful life experiences seemed to aggravate PTSD symptoms.

Conclusions
Consistent with earlier studies, NET leads to clinically and behaviorally relevant reductions in PTSD symptoms both throughout and following treatment in refugees living in volatile conditions. Concerns about imaginal exposure in refugees were not substantiated. While stressful life events contributed to transient symptom increases, they weren’t found to prevent the overall effectiveness of NET.

Trial registration
NCT02852616.
A process for developing a sustainable and scalable approach to community engagement: community dialogue approach for addressing the drivers of antibiotic resistance in Bangladesh
Authors: King Rebecca , Hicks Joseph , Rassi Christian , Shafique Muhammad , Barua Deepa , Bhowmik Prashanta , Das Mahua , Elsey Helen , Questa Kate , Fieroze Fariza , Hamade Prudence , Huque Sameena , Newell James , Huque Rumana 
Published: June 2020

Abstract
Background
Community engagement approaches that have impacted on health outcomes are often time intensive, small-scale and require high levels of financial and human resources. They can be difficult to sustain and scale-up in low resource settings. Given the reach of health services into communities in low income countries, the health system provides a valuable and potentially sustainable entry point that would allow for scale-up of community engagement interventions. This study explores the process of developing an embedded approach to community engagement taking the global challenge of antibiotic resistance as an example.

Methods
The intervention was developed using a sequential mixed methods study design. This consisted of: exploring the evidence base through an umbrella review, and identifying key international standards on the appropriate use of antibiotics; undertaking detailed formative research through a) a qualitative study to explore the most appropriate mechanisms through which to embed the intervention within the existing health system and community infrastructure, and to understand patterns of knowledge, attitudes and practice regarding antibiotics and antibiotic resistance; and b) a household survey – which drew on the qualitative findings - to quantify knowledge, and reported attitudes and practice regarding antibiotics and antibiotic resistance within the target population; and c) drawing on appropriate theories regarding change mechanisms and experience of implementing community engagement interventions to co-produce the intervention processes and materials with key stakeholders at policy, health system and community level.

Results
A community engagement intervention was co-produced and was explicitly designed to link into existing health system and community structures and be appropriate for the cultural context, and therefore have the potential to be implemented at scale. We anticipate that taking this approach increases local ownership, as well as the likelihood that the intervention will be sustainable and scalable.

Conclusions
This study demonstrates the value of ensuring that a range of stakeholders co-produce the intervention, and ensuring that the intervention is designed to be appropriate for the health system, community and cultural context.
Level of quality of option B+PMTCT service provision in public health facilities in Mekelle zone, northern Ethiopia: cross-sectional study
Authors: Ajemu Kiros Fenta , Desta Alem 
Published: June 2020

Abstract
Background
Substantial improvements have been observed in coverage and access to maternal health services in Ethiopia. However, the quality of care has been lagging behind. Therefore, this study aimed to assess the level of quality of Option B+ PMTCT in Northern Ethiopia.

Methods
A facility based survey was conducted from February to April 2016 in Northern Ethiopia. Twelve health facilities were enrolled in the study. Mixed method approach was used in line with Donabedian (Input- Process-Output) service quality assessment model. Data of 168 HIV positive mothers & their infant were abstracted from registers, and follow up charts. During the Option B+ service consultation, a total of 60 sessions were involved for direct observation. Of which, 30 clients and 12 service providers were subjected for exit and in-depth interview respectively. Facilities were categorized rendering good service quality based on predetermined quality judgment criteria. Reasons of good and bad service quality were thematically fitted with each quality component based on emerging themes (TM1-TM3), and categories (CA1-CA6).

Results
Of the total 12 study health facilities, 2(16.7%) were achieved the desired level of service quality based on the three quality components. The input quality was better and judged as good in 33.3% health facilities. However; process and output service quality were realized in one - fourth of them.

Conclusion
Insignificant numbers of facilities fulfilled the aspired level of service quality. Quality of care was found influenced by multiple inputs, processes, and output related barriers and facilitators. Comprehensive Program monitoring is needed based on three quality components to improve the overall service quality.
A prospective longitudinal study on the
microbiota composition in amyotrophic lateral sclerosis
Authors: Di Gioia Diana , Bozzi Cionci Nicole , Baffoni Loredana , Amoruso Angela , Pane Marco , Mogna Luca , Gaggìa Francesca , Lucenti Maria Ausiliatrice , Bersano Enrica , Cantello Roberto , De Marchi Fabiola , Mazzini Letizia 
Published: June 2020

Abstract
Background
A connection between amyotrophic lateral sclerosis (ALS) and altered
gut microbiota composition has previously been reported in animal models. This
work is the first prospective longitudinal study addressing the microbiota
composition in ALS patients and the impact of a probiotic supplementation on the
gut microbiota and disease progression.

Methods
Fifty patients and 50 matched controls were enrolled. The microbial
profile of stool samples from patients and controls was analyzed via
PCR-Denaturing Gradient Gel Electrophoresis, and the main microbial groups
quantified via qPCR. The whole microbiota was then analyzed via next generation
sequencing after amplification of the V3–V4 region of 16S rDNA. Patients were
then randomized to receive probiotic treatment or placebo and followed up for
6 months with ALSFRS-R, BMI, and FVC%.

Results
The results demonstrate that the gut microbiota of ALS patients is
characterized by some differences with respect to controls, regardless of the
disability degree. Moreover, the gut microbiota composition changes during the
course of the disease as demonstrated by the significant decrease in the number
of observed operational taxonomic unit during the follow-up. Interestingly, an
unbalance between potentially protective microbial groups, such as
Bacteroidetes, and other with potential neurotoxic or pro-inflammatory activity,
such as Cyanobacteria, has been shown. The 6-month probiotic treatment
influenced the gut microbial composition; however, it did not bring the
biodiversity of intestinal microbiota of patients closer to that of control
subjects and no influence on the progression of the disease measured by ALSFRS-R
was demonstrated.

Conclusions
Our study poses the bases for larger clinical studies to
characterize the microbiota changes as a novel ALS biomarker and to test new
microbial strategy to ameliorate the health status of the gut.

Trial registration
CE 107/14, approved by the Ethics Committee of the “Maggiore della
Carità” University Hospital, Italy.
Exploiting collateral sensitivity controls growth of mixed culture of sensitive and resistant cells and decreases selection for resistant cells in a cell line model
Authors: Grolmusz Vince Kornél , Chen Jinfeng , Emond Rena , Cosgrove Patrick A. , Pflieger Lance , Nath Aritro , Moos Philip J. , Bild Andrea H. 
Published: June 2020

AbstractBackgroundCDK4/6 inhibitors such as ribociclib are becoming widely used targeted therapies in hormone-receptor-positive (HR+) human epidermal growth factor receptor 2-negative (HER2−) breast cancer. However, cancers can advance due to drug resistance, a problem in which tumor heterogeneity and evolution are key features.MethodsRibociclib-resistant HR+/HER2− CAMA-1 breast cancer cells were generated through long-term ribociclib treatment. Characterization of sensitive and resistant cells were performed using RNA sequencing and whole exome sequencing. Lentiviral labeling with different fluorescent proteins enabled us to track the proliferation of sensitive and resistant cells under different treatments in a heterogeneous, 3D spheroid coculture system using imaging microscopy and flow cytometry.ResultsTranscriptional profiling of sensitive and resistant cells revealed the downregulation of the G2/M checkpoint in the resistant cells. Exploiting this acquired vulnerability; resistant cells exhibited collateral sensitivity for the Wee-1 inhibitor, adavosertib (AZD1775). The combination of ribociclib and adavosertib achieved additional antiproliferative effect exclusively in the cocultures compared to monocultures, while decreasing the selection for resistant cells.ConclusionsOur results suggest that optimal antiproliferative effects in heterogeneous cancers can be achieved via an integrative therapeutic approach targeting sensitive and resistant cancer cell populations within a tumor, respectively.
Building capacities of Auxiliary Nurse Midwives (ANMs) through a complementary mix of directed and self-directed skill-based learning—A case study in Pune District, Western India
Authors: Karvande Shilpa , Purohit Vidula , Gopalakrishnan Somasundari Somla , Subha Sri B. , Mathai Matthews , Mistry Nerges 
Published: June 2020

AbstractAuxiliary nurse midwives (ANMs) play a pivotal role in provision of maternal and newborn health at primary level in India. Effective in-service training is crucial for upgrading their knowledge and skills for providing appropriate healthcare services. This paper aims at assessing the effectiveness of a complementary mix of directed and self-directed learning approaches for building essential maternal and newborn health-related skills of ANMs in rural Pune District, India.MethodsDuring directed learning, the master trainers trained ANMs through interactive lectures and skill demonstrations. Improvement and retention of knowledge and skills and feedback were assessed quantitatively using descriptive statistics. Significant differences at the 0.05 level using the Kruskal-Wallis test were analysed to compare improvement across age, years of experience, and previous training received. The self-directed learning approach fulfilled their learning needs through skills mall, exposure visits, newsletter, and participation in conference. Qualitative data were analysed thematically for perspectives and experiences of stakeholders. The Kirkpatrick model was used for evaluating the results.ResultsDirected and self-directed learning was availed by 348 and 125 rural ANMs, respectively. Through the directed learning, ANMs improved their clinical skills like maternal and newborn resuscitation and eclampsia management. Less work experience showed relatively higher improvement in skills, but not in knowledge. 56.6% ANMs either improved or retained their immediate post-training scores after 3 months.Self-directed learning helped them for experience sharing, problem-solving, active engagement through skill demonstrations, and formal presentations. The conducive learning environment helped in reinforcement of knowledge and skills and in building confidence. This intervention could evaluate application of skills into practice to a limited extent.ConclusionsIn India, there are some ongoing initiatives for building skills of the ANMs like skilled birth attendance and training in skills lab. However, such a complementary mix of skill-based ‘directed’ and ‘self-directed’ learning approaches could be a plausible model for building capacities of health workforce. In view of the transforming healthcare delivery system in India and the significant responsibility that rests on the shoulder of ANMs, a transponder mechanism to implement skill building exercises at regular intervals through such innovative approaches should be a priority.