bluuebunny/crossref_metadata_2025_split huggingface dataset:
Integrating gestational diabetes and type 2 diabetes care into primary health care: Lessons from prevention of mother-to-child transmission of HIV in South Africa - A mixed methods study
Authors: Mutabazi Jean Claude , Enok Bonong Pascal Roland , Trottier Helen , Ware Lisa Jayne , Norris Shane A. , Murphy Katherine , Levitt Naomi , Zarowsky Christina 
Published: January 2021

BackgroundImplementation of the programmes for the Prevention of Mother to Child Transmission (PMTCT) of Human Immunodeficiency Virus (HIV) into antenatal care over the last three decades could inform implementation of interventions for other health challenges such as gestational diabetes mellitus (GDM). This study assessed PMTCT outcomes, and how GDM screening, care, and type 2 diabetes (T2DM) prevention were integrated into PMTCT in Western Cape (WC), South Africa.MethodsA convergent mixed methods and triangulation design were used. Content and thematic analysis of PMTCT-related policy documents and of 30 semi-structured interviews with HIV/PMTCT experts, health care workers and women under PMTC diagnosed with GDM complement quantitative longitudinal analysis of PMTCT implementation indicators across the WC for 2012–2017.ResultsProvincial PMTCT and Post Natal Care (PNC) documents emphasized the importance of PMTCT, but GDM screening and T2DM prevention were not covered. Data on women with both HIV and GDM were not available and GDM screening was not integrated into PMTCT. Women who attended HIV counselling and testing annually increased at 17.8% (95% CI: 12.9% - 22.0%), while women who delivered under PMTCT increased at 3.1% (95% CI: 0.6% - 5.9%) annually in the WC. All 30 respondents favour integrating GDM screening and T2DM prevention initiatives into PMTCT.ConclusionPMTCT programmes have not yet integrated GDM care. However, Western Cape PMTCT integration experience suggests that antenatal GDM screening and post-partum initiatives for preventing or delaying T2DM can be successfully integrated into PMTCT and primary care.
Perceived barriers to the uptake of health services among first-year university students in Johannesburg, South Africa
Authors: Musakwa Nozipho Orykah , Bor Jacob , Nattey Cornelius , Lönnermark Elisabet , Nyasulu Peter , Long Lawrence , Evans Denise 
Published: January 2021

Background
Young people face many barriers to accessing appropriate health care services including screening for HIV and tuberculosis (TB). The study aimed to identify perceived barriers to the uptake of health services among young adults entering the tertiary education system in South Africa.

Methods
We conducted a cross-sectional study among first-year students aged 18–25 years, registered at one of three universities in Johannesburg, South Africa, in 2017. Participants completed a self-administered paper-based questionnaire. We describe perceived barriers to accessing health services, stratified by gender and recent engagement in TB or HIV services, together with sources of information about HIV and TB.

Results
Seven hundred and ninety-two (792) students were included in the study of which 54.8% were female. Perceived barriers to accessing services included long waiting time (n = 342,43.2%), attitude of health workers (n = 263,33.2%), lack of sufficient information/poor health literacy (n = 148,18.7%), and inability to leave/stay away from studies (n = 137,17.3%). Among participants who tested for HIV in the past 6 months (n = 400, 50.5%), waiting time and attitude of health care workers were perceived as barriers to accessing services. Compared to males, females were more likely to view attitudes of health workers (40.3% vs. 25.0%; p = 0.001) and inability to leave/stay away from studies (20.5% vs.13.4%; p = 0.025) as potential barriers. While just over half of the students (50.5%; 400/792) in this study had accessed health services in the past 6 months, very few (15.0%) opted to use campus health services, and even less (5%) reported receiving information about HIV and TB from the university itself.

Conclusion
Despite perceived barriers to accessing HIV and TB services off campus, fewer than one in five students starting out at university opted to use campus health services. Campus health services could address many of the barriers unique to university students.
Hepatocellular carcinoma incidence at national and provincial levels in Iran from 2000 to 2016: A meta-regression analysis
Authors: Fattahi Nima , Rezaei Negar , Asadi-Lari Mohsen , Yousefi Moein , Madadi Zahra , Gohari Kimiya , Sheidaei Ali , Mohammadi Esmaeil , Rezaei Nazila , Parsaeian Mahboubeh , Kompani Farzad , Farzadfar Farshad 
Published: January 2021

Background
The incidence of Hepatocellular carcinoma (HCC), the most common primary liver cancer with high mortality, is undergoing global change due to evolving risk factor profiles. We aimed to describe the epidemiologic incidence of HCC in Iran by sex, age, and geographical distribution from 2000 to 2016.

Methods
We used the Iran Cancer Registry to extract cancer incidence data and applied several statistical procedures to overcome the dataset’s incompleteness and misclassifications. Using Spatio-temporal and random intercept mixed effect models, we imputed missing values for cancer incidence by sex, age, province, and year. Besides, we addressed case duplicates and geographical misalignments in the data.

Results
Age-standardized incidence rate (ASIR) increased 1.17 times from 0.57 (95% UI: 0.37–0.78) per 100,000 population in 2000 to 0.67 (0.50–0.85) in 2016. It had a 21.8% total percentage change increase during this time, with a 1.28 annual percentage change in both sexes. Male to female ASIR ratio was 1.51 in 2000 and 1.57 in 2016. Overall, after the age of 50 years, HCC incidence increased dramatically with age and increased from 1.19 (0.98–1.40) in the 50–55 age group to 6.65 (5.45–7.78) in the >85 age group. The geographical distribution of this cancer was higher in the central, southern, and southwestern regions of Iran.

Conclusion
The HCC incidence rate increased from 2000 to 2016, with a more significant increase in subgroups such as men, individuals over 50 years of age, and the central, southern, and southwestern regions of the country. We recommend health planners and policymakers to adopt more preventive and screening strategies for high-risk populations and provinces in Iran.
Development of a brain-computer interface for patients in the critical care setting
Authors: Eliseyev Andrey , Gonzales Ian Jerome , Le Anh , Doyle Kevin , Egbebike Jennifer , Velazquez Angela , Agarwal Sachin , Roh David , Park Soojin , Connolly E. Sander , Claassen Jan 
Published: January 2021

Objective
Behaviorally unresponsive patients in intensive care units (ICU) are unable to consistently and effectively communicate their most fundamental physical needs. Brain-Computer Interface (BCI) technology has been established in the clinical context, but faces challenges in the critical care environment. Contrary to cue-based BCIs, which allow activation only during pre-determined periods of time, self-paced BCI systems empower patients to interact with others at any time. The study aims to develop a self-paced BCI for patients in the intensive care unit.

Methods
BCI experiments were conducted in 18 ICU patients and 5 healthy volunteers. The proposed self-paced BCI system analyzes EEG activity from patients while these are asked to control a beeping tone by performing a motor task (i.e., opening and closing a hand). Signal decoding is performed in real time and auditory feedback given via headphones. Performance of the BCI system was judged based on correlation between the optimal and the observed performance.

Results
All 5 healthy volunteers were able to successfully perform the BCI task, compared to chance alone (p<0.001). 5 of 14 (36%) conscious ICU patients were able to perform the BCI task. One of these 5 patients was quadriplegic and controlled the BCI system without any hand movements. None of the 4 unconscious patients were able to perform the BCI task.

Conclusions
More than one third of conscious ICU patients and all healthy volunteers were able to gain control over the self-paced BCI system. The initial 4 unconscious patients were not. Future studies will focus on studying the ability of behaviorally unresponsive patients with cognitive motor dissociation to control the self-paced BCI system.
Provision of HIV viral load testing services in Zimbabwe: Secondary data analyses using data from health facilities using the electronic Patient Monitoring System
Authors: Apollo Tsitsi , Takarinda Kudakwashe C. , Phillips Andrew , Ndhlovu Chiratidzo , Cowan Frances M. 
Published: January 2021

Introduction
Routine viral load (VL) testing among persons living with Human Immunodeficiency Virus (PLHIV) enables earlier detection of sub-optimal antiretroviral therapy (ART) adherence and for appropriate management of treatment failure. Since adoption of this policy by Zimbabwe in 2016, the extent of implementation is unclear. Therefore we set out to determine among PLHIV ever enrolled on ART from 2004–2017 and in ART care for ≥12 months at health facilities providing ART in Zimbabwe: numbers (proportions) with VL testing uptake, VL suppression and subsequently switched to 2nd-line ART following confirmed virologic failure.

Materials and methods
We used retrospective data from the electronic Patient Monitoring System (ePMS) in which PLHIV on ART are registered at 525 public and 4 private health facilities.

Results
Among the 392,832 PLHIV in ART care for ≥12 months, 99,721 (25.4%) had an initial VL test done and results available of whom 81,932 (82%) were virally suppressed. Among those with a VL>1000 copies/mL; 6,689 (37.2%) had a follow-up VL test and 4,086 (61%) had unsuppressed VLs of whom only 1,749 (42.8%) were switched to 2nd-line ART. Lower age particularly adolescents (10–19 years) were more likely (ARR 1.34; 95%CI: 1.25–1.44) to have virologic failure.

Conclusion
The study findings provide insights to implementation gaps including limitations in VL testing; low identification of high- risk PLHIV in care and lack of prompt utilization of test results. The use of electronic patient-level data has demonstrated its usefulness in assessing the performance of the national VL testing program. By end of 2017 implementation of VL testing was sub-optimal, and virological failure was relatively common, particularly among adolescents. Of concern is evidence of failure to act on VL test results that were received. A quality improvement initiative has been planned in response to these findings and its effect on patient management will be monitored.
Learning strategies and their correlation with academic success in biology and physiology examinations during the preclinical years of medical school
Authors: Hogh Annemarie , Müller-Hilke Brigitte 
Published: January 2021

BackgroundEfficient learning is essential for successful completion of the medical degree and students use a variety of strategies to cope with university requirements. However, strategies that lead to academic success have hardly been explored. We therefore evaluated the individual learning approaches used by a cohort of medical students in their first and second preclinical years and analyzed possible correlations with examination scores.Methods107 students participated in our longitudinal survey on cognitive, meta-cognitive and resource-oriented learning strategies using the LIST-questionnaire (Lernstrategien im Studium). The students were surveyed twice while in their first and second year of medical school, respectively and academic performances were assessed as scores obtained in two examinations written shortly after the LIST surveys. Statistical evaluations included comparisons and cluster analyses.ResultsWe here identified four different patterns of learning strategy combinations, describing the relaxed, diligent, hard-working, and sociable learners. About half of the students stayed true to their initially registered pattern of learning strategy combinations while 53 students underwent a change between the first and second surveys. Changes were predominantly made between therelaxedand thesociableand between thediligentand thehard-workinglearners, respectively. Examination results suggested that thediligentandhard-workinglearners were academically more successful than therelaxedandsociableones.ConclusionEarly habits of sociable learning were quickly abandoned however, not in favor of more successful patterns. It is therefore essential to develop interventions on learning skills that have a lasting impact on the pattern of the students´ learning strategy combinations.
Cervical Gardnerella vaginalis in women with preterm prelabor rupture of membranes
Authors: Kacerovsky Marian , Pliskova Lenka , Bolehovska Radka , Lesko Daniel , Gerychova Romana , Janku Petr , Matlak Petr , Simetka Ondrej , Stranik Jaroslav , Faist Tomas , Mls Jan , Vescicik Peter , Jacobsson Bo , Musilova Ivana 
Published: January 2021

ObjectiveTo determine the association between microbial invasion of the amniotic cavity (MIAC) and/or intra-amniotic inflammation (IAI) and the cervical prevalence ofGardnerella vaginalisDNA in pregnancies with preterm prelabor rupture of membrane (PPROM).MethodIn total, 405 women with singleton pregnancies complicated with PPROM were included. Cervical fluid and amniotic fluid samples were collected at the time of admission. Bacterial andG.vaginalisDNA were assessed in the cervical fluid samples using quantitative PCR technique. Concentrations of interleukin-6 and MIAC were evaluated in the amniotic fluid samples. Loads ofG.vaginalisDNA ≥ 1% of the total cervical bacterial DNA were used to define the cervical prevalence ofG.vaginalisas abundant. Based on the MIAC and IAI, women were categorized into four groups: with intra-amniotic infection (both MIAC and IAI), with sterile IAI (IAI without MIAC), with MIAC without IAI, and without either MIAC or IAI.ResultsThe presence of the abundant cervicalG.vaginaliswas related to MIAC (with: 65% vs. without: 44%;p= 0.0004) but not IAI (with: 52% vs. without: 48%;p= 0.70). Women with MIAC without IAI had the highest load of the cervicalG.vaginalisDNA (median 2.0 × 104copies DNA/mL) and the highest presence of abundant cervicalG.vaginalis(73%).ConclusionsIn women with PPROM, the presence of cervicalG.vaginaliswas associated with MIAC, mainly without the concurrent presence of IAI.
Arts-based research in Psychiatry: A way to the examination of the popular beliefs about mental disorders
Authors: Pavez Fabián 
Published: January 2021

Research about the depictions of psychiatry and mental disorders in popular culture has been scarce and often lacks systematized research strategies. However, this tendency has changed in the last few years and it is now possible to find articles which investigate the social representations of mental illness through the analysis of the media, music, films, and other artistic manifestations. One possible indication of the emerging relevance of this topic is the inclusion of the MeSH term 'Medicine in the Arts' in the database of the U.S. National Library of Medicine in 2018.
The study of the products of popular culture can give us information about common ideas present in the social imaginary regarding mental disease. One advantage of this type of study is the public character of the data. In addition, the fact that artistic productions persist over time enables access to information which could not be gathered through other qualitative research designs. In this way, the products of popular culture could be seen as what I call 'cultural fossils', which can be traced back' to the historical time in which they were produced.
Estudio de la cristaluria: efectividad de la incorporación de medidas higiénico-dietéticas en los informes de laboratorio
Authors: Sienes Bailo Paula , Santamaría González María , Izquierdo Álvarez Silvia , Lahoz Alonso Raquel , Serrano Frago Patricia , Bancalero Flores José Luis 
Published: January 2021

Resumen

Objetivos
El presente estudio evalúa la efectividad de incorporar medidas higiénico-dietéticas en los informes de laboratorio comparando la incidencia de cólicos nefríticos (CN) en dos grupos de pacientes que presentaron, al menos, un evento de cristaluria asociada con riesgo litogénico, indicando solo a uno de ellos la introducción de estas recomendaciones.

Métodos
Estudio observacional retrospectivo. Grupo A: 1.115 pacientes que en el año 2017 presentaron al menos un episodio de cristaluria asociada con riesgo litogénico y no recibieron recomendaciones higiénico-dietéticas con el informe de laboratorio. Grupo B: 1.692 pacientes que en el año 2018 presentaron al menos un episodio de cristaluria asociada con riesgo litogénico y recibieron recomendaciones higiénico-dietéticas con el informe de laboratorio. Las diferencias entre grupos según sexo, edad y tipo de cristales urinarios fueron analizadas mediante pruebas χ2 y U de Mann–Whitney.

Resultados
La incidencia de CN fue de 2,24% en el grupo A v 1,12% en el grupo B. Los pacientes del grupo A presentaron 2,02 veces más CN que los del grupo B. No se encontraron diferencias significativas en la incidencia de CN según el tipo de cristal urinario. La incidencia de CN en pacientes que presentaron al menos un evento de cristaluria asociada con riesgo litogénico durante el año de estudio fue mucho mayor que la de la población general en el mismo período (0,46%, similar a las publicadas previamente).

Conclusiones
La introducción de mensajes que alertan sobre el riesgo litogénico junto con la inclusión de medidas higiénico-dietéticas en los informes de laboratorio son herramientas para tratar de reducir la incidencia de CN.
Increased concentrations of procalcitonin in patients with paracetamol intoxication
Authors: García de Guadiana Romualdo Luis , Rodríguez Rojas Carlos , Ramos Arenas Verónica , Cárdenas Gámez Rubén , López Abellán María Dolores , González Morales Mercedes 
Published: January 2021

Abstract

Objectives
Paracetamol intoxication is one of the causes of elevated procalcitonin concentrations unrelated to infection. We report a case series of two patients intoxicated with paracetamol whose laboratory data revealed a significant elevation of serum procalcitonin concentrations without clinical, radiological and/or biological evidence of infection. The underlying mechanism by which paracetamol triggers an increase in procalcitonin concentrations is still unclear.

Case presentation
We report two cases of paracetamol intoxication. Both patients were admitted to the Emergency Department (ED) and subsequently transferred to the Intensive Care Unit (ICU). The patients exhibited elevated procalcitonin levels during the first hours of admission without clinical and/or microbiological evidence of infection that could explain such increase. Notably, only Case 1 developed liver injury, with alterations in alanine aminotransferase (ALT), aspartate aminotransferase (AST), bilirubin and esterified bilirubin concentrations, which were not observed in Case 2.

Conclusions
The two patients showed elevated procalcitonin concentrations resulting from paracetamol intoxication, although only a patient exhibited signs of liver injury. These findings suggest that increased procalcitonin levels induced by a paracetamol overdose cannot be fully explained by hepatocyte injury alone, but other mechanisms involving other organs and tissues may also be associated. In any case, although this mechanism is not well understood, it is important to be aware of this limitation when using procalcitonin as a biomarker of infection in patients intoxicated with paracetamol.
Management of postanalytical processes in the clinical laboratory according to ISO 15189:2012 Standard requirements: considerations on the review, reporting and release of results
Authors: López Yeste Mᵃ Liboria , Izquierdo Álvarez Silvia , Pons Mas Antonia R. , Álvarez Domínguez Luisa , Marqués García Fernando , Rodríguez Mᵃ Patrocinio Chueca , Blanco Font Aurora , Bernabeu Andreu Francisco A. , García Álvarez Ana , Contreras Sanfeliciano Teresa , Pascual Gómez Natalia , Sánchez Gancedo Lorena , Guiñón Muñoz Leonor 
Published: January 2021

Abstract
The objective of this paper is to share some considerations about the management of postanalytical processes in relation to the review, reporting and release of test results in accordance with UNE-EN ISO 15189:2013 Standard requirements. The scope of this paper includes postanalytical activities and the personnel involved (laboratory management and staff). We describe the criteria and information required to review and validate analytical results and ensure that clear reports are sent to requesters. These criteria also guarantee that results are transcribed in a reliable way and that all necessary information is provided for the correct interpretation of results. Likewise, the requirements for the correct release of laboratory results are described, with special emphasis on the release of alarming or critical results. In some European countries, clinical laboratories are required to hold partial or full ISO 15189 accreditation, which is a global trend. Therefore, understanding ISO 15189 requirements is imperative for a progressive and more effective implementation of the Standard.
Differential migration in Pacific salmon and trout: Patterns and hypotheses
Authors: Quinn Thomas P. 
Published: January 2021

AbstractMigrations affect the population dynamics, life history, evolution, and connections of animals to natural ecosystems and humans. Many species and populations display partial migration (some individuals migrate and some do not), and differential migration (migration distance varies). Partial migration is widely distributed in fishes but the term differential migration is much less commonly applied, despite the occurrence of this phenomenon. This paper briefly reviews the extent of differential migration in Pacific salmon and trout (genusOncorhynchus), a very extensively studied group. Three hypotheses are presented to explain the patterns among species: 1) phylogenetic relationships, 2) the prevalence of partial migration (i.e., variation in anadromy), and 3) life history patterns (iteroparous or semelparous, and duration spent feeding at sea prior to maturation). Each hypothesis has some support but none is consistent with all patterns. The prevalence of differential migration, ranging from essentially non-existent to common within a species, reflects phylogeny and life history, interacting with the geographic features of the region where juvenile salmon enter the ocean. Notwithstanding the uncertain evolution of this behavior, it has very clear implications for salmon conservation, as it strongly affects exposure to predators, patterns of fishery exploitation and also uptake of toxic contaminants.
Fabrication and function of polymer membranes
Authors: Abetz Volker , Brinkmann Torsten , Sözbilir Mustafa 
Published: January 2021

AbstractThe paper gives an introduction to membrane science and technology, an area of research of high significance for the development of a sustainable life for human beings. It is therefore intended to be a guide for teachers in the areas of chemistry, physics, or biology, who can incorporate the presented materials in their respective courses. The paper gives some insights into the different types of membranes, their functions, production and use in some selected areas.