bluuebunny/crossref_metadata_2025_split huggingface dataset:
Microbial Risk Assessment of Vegetables Irrigated with Akaki River Water in Addis Ababa.
Authors: Mengesha Sisay Derso , Asfaw Yosef Beyene , Kidane Abel Weldetinsae , Teklu Kirubel Tesfaye , Serte Melaku Gizaw , Kenea Moa Abate , Dinssa Daniel Abera , Woldegabriel Mesay Getachew , Alemayehu Tsigereda Assefa , Girmay Aderajew Mekonnen 
Published: May 2021

Abstract
Background: Consumption of vegetable plays important role in human health. Above 60% of Addis Ababa, vegetable demand is covered by smallholder farmers who grow various vegetables by using the Akaki River as their main water source for irrigation. However, applying faecally contaminated water for irrigation could expose fresh vegetable consumers to many health problems. Therefore, this study aimed to evaluate the microbial contamination of irrigation water and freshly produced vegetables. The study assessed the quality of Akaki river water and vegetables. Fresh vegetables including Ethiopian Kale, Lettuce, Cabbage, and Spinach were collected from 14 farmlands, irrigated with Akaki River water, in the dry and wet seasons. Using standard methods, analysis of E.coli, Non-E.coli, Total coliform, fecal coliform, and Total Aerobic Plate Count were done among the Akaki River water and vegetables. Result: The finding of the study indicated that all fresh vegetables were contaminated with total coliforms, fecal coliforms, and Total aerobic in the dry and wet seasons. The overall mean count of E. coli and Non-E. Coli from water samples were 2.09 and >3.48 log10 CFU 10 mL−1. The mean count of TC, FC, and TAC on sampled vegetables were 3.22, 1.37, and 4.72 in the dry season, and 3.87, 2.57, and 5.09 log10 CFU per gram in the wet season, respectively.Conclusion: The Akaki River has been contaminated with non-E. Coli & E. coli coliforms and did not meet the WHO guideline criteria for safe irrigation. The microbial contamination of vegetables was found high and exceeded the HACCPTQM and ICMSF limit values for safe consumption. This calls for farmers and the consumer has to insist on properly processed/stored/sliced fresh vegetables needs to be aware.
Impact of COVID-19 Policy Measures on Food Security Among Urban Residents in Blantyre City, Malawi
Authors: Dzimbiri Mastano , Mwanjawala Patrick , Chilanga Emmanuel , Munthali George N. 
Published: May 2021

Abstract
Background

Malawi, a vulnerable country in Sub Saharan Africa (SSA) is at the helm of experiencing food insecurity amidst COVID-19 as the vast majority survives on the hand-to-mouth economy. However, knowledge about how COVID-19 policy measures lead to food insecurity among the urban residents in Malawi is scanty. Understanding this link is crucial for designing the interventions that can help reduce the risk of being food insecure while containing further spread of the virus. Using Bronfenbrenner’s ecological theory as a conceptual framework, we explore the impact of COVID-19 policy measures on food security experienced by Blantyre residents in Malawi. We interviewed fifteen participants composed of private secondary school teachers and informal workers to understand their experiences of food insecurity linked to COVID-19 policy measures in place by the Malawi government.
Results

Our results show that participants face difficulties to access adequate food and have also changed their eating habits by skipping meals in some days due to loss of jobs, underpayment as well as business disruption.
Conclusion

Based on the findings, we argue that the COVID-19 policies have aggravated severe challenges among urban residents to access adequate food rendering them food insecure. To ensure sustained livelihood, we suggest the Malawi government should design immediate interventions such as relief fund packages targeting the urban poor to rescue them from facing acute food shortages while containing the pandemic.
Saline and Alkaline Stresses Alter Soil Properties And Composition And Structure of Gene-Based Nitrifier And Denitrifier Communities In A Calcareous Desert Soil
Authors: Guo Jiaxin , Zhou Yongxue , Guo Huijuan , Min Wei 
Published: May 2021

Abstract
Background: Saline and alkaline stresses damages the health of soil systems. Meanwhile, Little is known about how saline or alkaline stress affects soil nitrifier and denitrifier communities. Therefore, we compared the responses of gene-based nitrifier and denitrifier communities to chloride (CS), sulfate (SS), and alkaline (AS) stresses with those in a no-stress control (CK) in pots with a calcareous desert soil. Results: Compared with CK, saline and alkaline stress decreased potential nitrification rate (PNR) and NO3-N; increased pH, salinity, water content, and NH4-N; and decreased copy numbers of amoA-AOA and amoA-AOB genes but increased those of denitrifier nirS and nosZ genes. Copies of nirK increased in SS and AS but decreased in CS. There were more copies of amoA-AOB than of amoA-AOA and of nirS than of nirK or nosZ. Compared with CK, SS and AS decreased operational taxonomic units (OTUs) of amoA-AOB but increased those of nirS and nosZ, whereas CS decreased nirK OTUs but increased those of nosZ. The numbers of OTUs and amoA-AOB genes were greater than those of amoA-AOA. There were positive linear relations between PNR and amoA-AOA and amoA-AOB copies. Compared with CK, the Chao 1 index of amoA-AOA and amoA-AOB decreased in AS, that of nirK increased in CS and SS, but that of nirS and nosZ increased in all treatments.The Shannon index of amoA-AOB decreased but that of nirS increased in CS and SS, whereas the index of nirK decreased in all treatments. Saline and alkaline stress greatly affected the structure of nitrifier and denitrifier communities and decreased potential biomarkers of nirS-type; however, AS increased those of nirK- and nosZ-type, and SS decreased those of nosZ-type. Soil water content, pH, and salinity were important in shaping amoA-AOA and denitrifier communities, whereas soil water and pH were important to amoA-AOB communities. Conclusion: These results indicate that the nitrifier and denitrifier communities respond to saline and alkaline stresses conditions. Communities of amoA-AOA and amoA-AOB contribute to nitrification in alluvial gray desert soil, and those of nirS are more important in denitrification than those of nirK or nosZ.
Comparison of an Improved Self-consistent Lower Bound Theory with Lehmann’s Method for Low-lying Eigenvalues
Authors: Ronto Miklos , Pollak Eli , Martinazzo Rocco 
Published: May 2021

Abstract
Ritz eigenvalues only provide upper bounds for the energy levels, while obtaining lower bounds requires at least the calculation of the variances associated with these eigenvalues. The well-known Weinstein and Temple lower bounds based on the eigenvalues and variances converge very slowly and their quality is considerably worse than that of the Ritz upper bounds. Lehmann presented a method that in principle optimizes Temple’s lower bounds with significantly improved results. We have recently formulated a Self-Consistent Lower Bound Theory (SCLBT), which improves upon Temple’s results. In this paper we further improve the SCLBT and compare its quality with Lehmann’s theory. The Lánczos algorithm for constructing the Hamiltonian matrix simplifies Lehmann’s theory and is essential for the SCLBT. Using two lattice Hamiltonians, we compared the improved SCLBT with its previous implementation as well as with Lehmann’s lower bound theory. The novel SCLBT exhibits a significant improvement over the previous version. Both Lehmann’s theory and the SCLBT provide significantly better lower bounds than those obtained from Weinstein’s and Temple’s methods. Compared to each other, the Lehmann and SCLBT theories exhibit similar performance in terms of the quality and convergence of the lower bounds. By increasing the number of states included in the calculations, the lower bounds are tighter and their quality becomes comparable with that of the Ritz upper bounds. Both methods are suitable for providing lower bounds for low-lying excited states as well. Compared to Lehmann’s theory, one of the advantages of the SCLBT method is that it does not necessarily require the Weinstein lower bound for its initial input, but Ritz eigenvalue estimates can also be used. Especially owing to this property the SCLBT method sometimes exhibits improved convergence compared to that of Lehmann’s lower bounds.
A Multicomponent Intervention to Improve Blood Pressure Management in Chronic Kidney Disease: A Protocol for a Pragmatic Clinical Trial
Authors: Kilgallon John L. , Gannon Michael , Burns Zoe , McMahon Gearoid , Dykes Patricia , Linder Jeffrey A. , Bates David W. , Waikar Sushrut , Lipsitz Stuart , Baer Heather J. , Samal Lipika 
Published: May 2021

Abstract
BackgroundChronic kidney disease is common, leads to end stage renal disease, and is a major risk factor for cardiovascular disease. Although both chronic kidney disease and hypertension, the main risk factor for disease progression, are not difficult to diagnose, both often go unrecognized by primary care providers. It has yet to be determined whether a multicomponent intervention that leverages electronic health records and behavioral economic principles can improve diagnosis, treatment, and control of hypertension in chronic kidney disease. MethodsThe aim of this pragmatic, cluster-randomized controlled trial is to evaluate a clinical decision support system based in behavioral economic and user-centered design principles that will: 1) synthesize existing laboratory tests, medication orders, and vital sign data; 2) increase recognition of chronic kidney disease, 3) increase recognition of uncontrolled hypertension in chronic kidney disease patients, and 4) deliver evidence-based chronic kidney disease and hypertension management recommendations. The intervention has been designed and piloted. The primary endpoint is the change in mean systolic blood pressure between baseline and 6 months compared across arms. We will use an effectiveness-implementation hybrid trial type 2 design and the RE-AIM framework to guide evaluation of process and outcome measures. Patients with two prior eGFR 16-59 mL/min/1.73m2 separated by 90 days or two prior UACR >30mg/g, one SBP >140 mmHg within the 2 years preceding the enrollment visit, and SBP >140 mmHg at enrollment will be included; patients with a most recent eGFR ≤ 20 or 2 previous eGFRs within 2 years separated by at least 90 days ≤ 15 will be excluded. Rao-Scott chi-square tests and GEE z-tests will be used. We calculated that 497 evaluable patients per arm and an average of 6 patients per provider would provide over 80% power to detect an average 3 mmHg SBP decrease in the intervention arm. Discussionhe proposed study, if successful, would be the first to improve hypertension in chronic kidney disease patients through a multicomponent intervention that incorporates clinical decision support and behavioral methods. Trial RegistrationClinicalTrials.gov identifier: NCT03679247. Registered September 20, 2018, https://clinicaltrials.gov/ct2/show/NCT03679247?term=Samal&draw=2&rank=1.
Scaling-up Shared Decision Making in Multidisciplinary Osteoarthritis Care Teams: A Qualitative Study Using the Consolidated Framework for Implementation Research With Three Demonstration Sites
Authors: Trevena Lyndal , Mac Olivia , Muscat Danielle M , Bakhit Mina , Shepherd Heather L , Dimopoulos-Bick Tara , Osten Regina , Hoffmann Tammy , Thompson Rachel 
Published: May 2021

Abstract
BackgroundDespite the development of theory-driven frameworks to guide implementation strategies, their application thus far has largely been limited to evaluating effectiveness within specific contexts. This study describes the use of these frameworks to inform a scale-up strategy for shared decision making (SDM) implementation across a state-wide government-funded health program. MethodsTailored SDM strategies were implemented in three multidisciplinary osteoarthritis care teams over a 3-6 month period during 2019-20 in New South Wales, Australia. Staff interviews occurred across 3 timepoints based on the Organisational Readiness for Change Scale, the Theoretical Domains Framework and the Preparation for Decision-Making (PreP-DM) Scales. Patient interviews based on the PreP-DM were also completed. A hybrid inductive-deductive thematic analysis was followed by mapping the results to the Consolidated Framework for Implementation Research (CFIR) and the OMERACT core domains for SDM. Finally, a ranked list of Expert Recommendations for Implementing Change (ERIC) was derived using a published tool.Results47 interviews were conducted with 18 staff along with 20 interviews with patients. We identified 39 themes for SDM implementation across the five CFIR domains: 1) Interventions need to be flexible to align with different clinical workflows and busy clinics; 2) Outer Settings such as senior managers should formally endorse SDM and clinical protocols and standards need to better align with an SDM approach; 3) Inner Setting teams need early engagement, role clarification and communities of practice in SDM; 4) Individuals are strongly motivated by better patient outcomes and need SDM training and support; and 5) Processes such as patient-reported measures and feedback along with adequate resourcing were key. Recommended strategies therefore focussed on Stakeholder Engagement, Evaluative and Iterative Strategies, Education and Training and Adaptation/Tailoring to the Context. Skills in the identification of decision points, values clarification and deliberation were particularly challenging for staff.Conclusions﻿Theory-driven scale-up strategies can be developed using qualitative research within demonstration sites. By combining the CFIR and TDF frameworks and prior mapping to the ERIC strategies, health system and program planners can obtain a relevant and evidence-informed roadmap for implementation across complex health systems.
Obstructive Sleep Apnea and Associated Factors Among Hypertensive Patients Attending a Tertiary Cardiac Center in Tanzania: a Comparative Cross-sectional Study
Authors: Pallangyo Pedro , Mgopa Lucy R. , Mkojera Zabella , Komba Makrina , Millinga Jalack , Misidai Nsajigwa , Swai Happiness J. , Mayala Henry , Bhalia Smita , Wibonela Salma , Janabi Mohamed 
Published: May 2021

Abstract
Background: There is mounting evidence for a reciprocal yet bidirectional association between sleep-disordered breathing and hypertension. Obstructive sleep apnea (OSA), a common cause of systemic hypertension is an independent risk factor for hypertension-related cardiovascular morbidity and mortality. In this comparative hospital-based cross-sectional study, we sought to explore the burden of obstructive sleep apnea and its associated risk factors among hypertensive patients attending Jakaya Kikwete Cardiac Institute.Methodology: A total of 1974 individuals (i.e. 1289 hypertensive and 685 normotensives) were consecutively enrolled in this study. The Berlin questionnaire and Epworth Sleepiness Scale were utilized in the assessment of OSA and excessive daytime sleepiness (EDS) respectively. Logistic regression analyses were employed in the determination of associated factors for OSA. Results: The mean age was 53.4 years and females constituted the large majority (60.4%) of participants. About three quarters (74.1%) of participants had excess body weight, 11.6% had diabetes, 8.0% had asthma and 18.6% had history of recurrent nasal congestion. Positive family history of snoring was reported by 43.1% of participants and 36.9% had a personal history of snoring. Persons with hypertension displayed a higher frequency (42.1%) of OSA compared to their normotensive counterparts (11.8%), p<0.001. Multivariate logistic regression analyses revealed hypertension (OR 5.1, 95% CI 3.2-8.2, p<0.001), diabetes mellitus (OR 2.2, 95% CI 1.3-3.5, p<0.01), chronic nasal congestion (OR 1.6, 95% CI 1.1-2.5, p = 0.01), obesity (OR 2.4, 95% CI 1.8-3.3, p<0.001), increased neck circumference (OR 2.7, 95% CI 1.2-6.4, p = 0.02), family history of snoring (OR 5.5, 95% CI 4.0-7.5, p<0.001), and working >8hrs/24hr (OR 0.6, 95% CI 0.4-1.0, p = 0.03) to have an independent association for OSA. Furthermore, participants with hypertension displayed superior odds for OSA compared to their normotensive counterparts across all subgroup analyses. Conclusion: OSA is considerably common among hypertensives in a tertiary health care setting in Tanzania. Positive family history of snoring was the strongest associated factor; however, excess body weight proved to be the strongest modifiable risk factor. In view of its pervasiveness, OSA should be an integral part of the medical evaluation in hypertensive individuals.
Percutaneous posterior transiliac plate versus iliosacral screw fixation for posterior fixation of Tile C-type pelvic fractures
Authors: Kim Chul-Ho , Kim Jung Jae , Kim Ji Wan 
Published: May 2021

Abstract
Background: This study aimed to compare the clinical outcomes and complications between two minimally invasive surgical techniques: percutaneous transiliac plate fixation and iliosacral (IS) screw fixation for the treatment of Tile C-type pelvic bone fractures.Materials and Methods: We retrospectively reviewed the data of 77 consecutive patients with Tile C pelvic ring injuries who underwent either percutaneous transiliac plate fixation or IS screw fixation in a single academic center between November 2007 and January 2018. Posterior plating was indicated for those with sacral dysmorphism or bilateral sacral fractures, including spinopelvic dissociation. We recorded patients’ demographics, surgery-related data, and postoperative surgical outcomes and compared the incidence of complications and revision surgery rates between the two groups.Results: Overall, 14 patients were included in the plate group, while 63 were included in the IS screw fixation group. No significant differences were observed in the patients’ demographics between the two groups except for a longer interval from injury to surgery (13.5 days vs. 5.4 days, P = 0.001). Both groups acquired fracture union in all cases. There was one case of infection requiring surgical debridement in the plating group. Notably, nerve injury (n = 3) and implant loosening (n = 5) occurred in the IS screw group, but the difference was not significant.Conclusions: Both percutaneous posterior transiliac plating and IS screw fixation in patients with Tile C-type pelvic bone fractures showed good results. We recommend IS screw fixation as the primary treatment and propose posterior plating as treatment for sacral dysmorphism and bilateral sacral alar fractures in patients with spinopelvic dissociation.
Short Term Clinical Results of Single Injection Autologous BMAC (Bone Marrow Aspirate Concentrate) As A Therapeutic Option/Tool in Knee Osteoarthritis
Authors: Subramanyam Krishna , Poornima Subhadra , Kumar Satish , Hasan Qurratulain 
Published: May 2021

Abstract
Background: Knee Osteoarthritis (KOA) is a common degenerative joint disease characterized by loss of articular cartilage, osteophyte formation, resulting in disability and affecting the quality of life. There is no treatment as on today to reverse the progression of KOA. The present available treatments for KOA are palliative. Therefore, there is a need for an alternative treatment modality in the treatment of KOA during the early grades, which should help in not only giving a symptomatic relief but also downturn the disease process. Bone marrow aspirate concentrate (BMAC) has gained a considerable importance change in the management/treatment of KOA in the recent times due to its potential advantages of disease modifying and regeneration capacities. The latest studies on usage of Autologous BMAC injection in KOA showed promising and encouraging results in terms of decrease in the pain, improved knee range of movement, daily activities of living and thus improved expectations for good quality lives. The current study aimed to assess the role of single injection- autologous BMAC as a therapeutic option in the treatment of KOA and evaluate the functional and clinical outcome of KL grade II&III patients.Methods: One Hundred and thirty-two patients with KOA (KL grade II&III) were included in the study as per the inclusion criteria. Autologous Bone marrow aspiration was done and the separation was done using density gradient centrifugation and final aspirate was injected into the knee joint. Results: The clinical outcomes of the patients were evaluated at different time points both objectively [Visual Analogue Scale (VAS) & WOMAC (Western Ontario Mac Master Universities Score)] and subjectively (radiographs & MRI) and the follow up was done for a period of one year. At the end of the study period, BMAC therapy showed promising results with encouraging clinical outcome.Conclusion:BMAC therapy has more potential with satisfactory, efficient and durable results in KOA. BMAC/mononuclear cells with enriched stem cell therapy can be an alternative therapy as an early intervention option for knee osteoarthritis.
Socio-economic and Household Determinants of Malaria in Adults Aged 45 and Above: Analysis of Longitudinal Ageing Survey in India (2017-2018)
Authors: Mohan Indumathi , Kodali Naveen Kumar , Chellappan Savitha , Karuppusamy Balasubramani , Behera Sujit Kumar , Natarajan Gopalan , Nina Praveen Balabaskaran 
Published: May 2021

Abstract
BackgroundEven though malaria cases have drastically come down in the last decade, malaria remains a serious public health concern in many parts of India. National Framework for Malaria Elimination in India (2016-30) has been launched with the goal to eliminate malaria by 2030. Understanding the socio-economic and household determinants of malaria at the national level will greatly aid in India’s malaria elimination efforts.MethodsThe data from Longitudinal Ageing Survey of India (LASI) Wave 1 (2017-2019) survey comprising 70671 respondents ≥45 years across all the States and Union Territories were used for analysis.Simple and multiple logistic regressions were used to obtain the unadjusted and adjusted odds ratio respectively of the socio-economic and household variables.ResultsThe major socio-economic variables that increase the likelihood of malaria are caste (Schedule Tribes), rural residence and low education levels.The scheduled tribes have 1.8 times higher odds of malaria than the scheduled castes (AOR: 1.8; 95% CI: 1.5-2.1). Respondents withhigh school education (6-12 grade) (AOR: 0.7; 95% CI: 0.6-0.8) and college education (AOR: 0.5; 95% CI: 0.4-0.6) had a very low risk of malaria than those with no school years. Rural residence and occupation (agriculture and allied jobs) also increases the odds of malaria. The major housing determinants are household size (≥6), housing type (kutcha), use of unclean fuel, outside water source, improper sanitation (toilet facilities) and damp wall/ceiling.ConclusionsIn addition to vector and parasite control strategies, improving literacy and housing conditions, especially in tribal dominated regions will greatly aid in India’s malaria elimination efforts.