bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sero-prevalence of syphilis and associated factors among pregnant women in Ethiopia: a systematic review and meta-analysis
Authors: Geremew Habtamu , Geremew Demeke 
Published: August 2021

AbstractBackgroundSyphilis remained a major cause of reproductive morbidity and poor pregnancy outcomes in developing countries. Previously, studies showed inconsistent results and failed to show the actual picture of the diseases in Ethiopia. Thus, the aim of this meta-analysis was, first, to determine the updated pooled prevalence of syphilis among pregnant women in Ethiopia and, second, to assess its associated factors.MethodsA comprehensive search was made on PubMed, Google scholar, Science Direct, and African Journals Online databases to identify relevant articles. A random effects model was used to estimate pooled syphilis prevalence and odds ratio (OR) with the respective 95% confidence intervals (CIs) using STATA 14 statistical software.I2statistics and Egger’s regression test in conjunction with funnel plot was used to determine heterogeneity and publication bias among included studies respectively.ResultWe identified 13 suitable studies in this analysis. Accordingly, the pooled prevalence of syphilis among pregnant women in Ethiopia was 2.32% (95% CI, 1.68–2.97). Specifically, syphilis prevalence was 2.53% (95% CI, 1.92–3.14%) and 1.90% (95% CI, 0.40–3.40%) as per the treponemal and non-ytreponemal diagnostic test, respectively. On the other hand, regional analysis indicated that 4.06% (95% CI, 2.86–5.26) in Southern Nations Nationalities and Peoples (SNNP), 2.16% (95% CI, 1.57–2.75) in Amhara and 1.46% (95% CI, 0.69–2.23) in Oromia region. Being married (OR, 0.37 (95% CI, 0.12–0.91%)) was less likely to develop syphilis. On the other hand, women with history of multiple sexual partner (OR, 2.98 (95% CI, 1.15–7.70)) and women with history of previous sexually transmitted infection (STI) (OR, 4.88 (95% CI, 1.35–17.62)) have higher risk to develop syphilis. Besides, the pooled syphilis-HIV coinfection was 0.80% (95% CI, 0.60–1.01%).ConclusionThis study provides evidence of relatively high prevalence of syphilis among pregnant women in Ethiopia. Therefore, it is recommended to further ramping up of current intervention measures to prevent future generations.Systematic review registrationPROSPEROCRD42020211650
‘Treat my whole person, not just my condition’: qualitative explorations of hepatitis C care delivery preferences among people who inject drugs
Authors: Tsui Judith I. , Barry Michael P. , Austin Elizabeth J. , Sweek Elsa W. , Tung Elyse , Hansen Ryan N. , Ninburg Michael , Scott John D. , Glick Sara N. , Williams Emily C. 
Published: August 2021

AbstractBackgroundThe advent of direct-acting antivirals (DAAs)—a form of hepatitis C (HCV) treatment associated with shorter treatment course and greater efficacy—offers an unprecedented opportunity to eliminate HCV, but only if care delivery systems are developed to extend treatment to people who inject drugs (PWID). To support the design of a community-pharmacy program, we explored perspectives of PWID with chronic HCV with regard to barriers, motivators, preferences, and prior experiences related to HCV treatment and pharmacists.MethodsWe conducted semi-structured interviews with people living with HCV who reported active injection drug use. Participants were recruited from local community service and clinical organizations in the Seattle, Washington region, and focus groups and interviews were conducted in-person or via phone/video-conference. Rapid Assessment Process was used to analyze qualitative data. Dual coders used structured templates to summarize findings and engaged in iterative review to identify themes.ResultsAmong the 40 participants, 65% were male, 52.5% were white, and 80% were not stably housed. On average, participants had been injecting drugs for 14 years and living with HCV for 6 years. Analyses revealed 3 themes: (1) limited knowledge regarding HCV and DAA treatments; (2) barriers/motivators for receiving treatment included fear of side effects, prior stigmatizing behaviors from physicians, and desire to protect relatives and the PWID community from HCV transmission; and (3) preferences for HCV care delivery, including a need for person-centered, low-barrier, and collaborative treatment integrated with other care (e.g. primary care and addiction treatment) for PWID. Participants were generally receptive to a community-pharmacy model for HCV treatment, but prior interactions with pharmacists were mixed and there were some concerns expressed that care delivered by pharmacists would not be equivalent to that of physicians.ConclusionsEven in the direct-acting antivirals era, people who inject drugs still face major barriers to hepatitis C treatment which may be reduced by providing low-barrier points of access for care through pharmacists. Key recommendations for community-pharmacy design included providing care team training to reduce stigma and ensuring care team structures and culture target PWID-specific needs for education and engagement.
Safety, tolerability of ES16001, a novel varicella zoster virus reactivation inhibitor, in healthy adults
Authors: Hwang-Bo Jeon , Kim Byungwook , Park Dae Won , Lee Yeong-Geun , Kwon Jeong Eun , Chung Jae-Yong , Kang Se Chan 
Published: August 2021

Abstract
Purpose
Herpes zoster (HZ), or shingles, is a clinical syndrome resulting from the reactivation of latent varicella zoster virus (VZV) within the sensory ganglia. We evaluated the safety and tolerability of ES16001 (ethanol extract of Elaeocarpus sylvestris var. ellipticus), a novel inhibitor of varicella zoster virus reactivation in healthy adults.

Method
Single-center, randomized, double-blind, placebo-controlled, single and multiple ascending dose (SAD and MAD, respectively) studies were conducted in 20- to 45-year-old healthy adults without chronic disease. In the SAD study (n = 32), subjects randomly received a single oral dose of 240, 480, 960, or 1440 mg ES16001 or a placebo. In the MAD study (n = 16), subjects randomly received once daily doses of 480 or 960 mg ES16001 or a placebo for 5 days. The safety and tolerability of the drug were evaluated by monitoring participants’ treatment emergent adverse events (TEAEs) and vital signs, electrocardiograms (ECGs), physical examinations, and clinical laboratory tests.

Results
In the SAD study, 11 adverse reactions were seen in 5 subjects, and in the MAD study, 8 adverse reactions were seen in 6 subjects. All adverse reactions were mild, and no serious adverse reactions occurred. The most common adverse reaction was an increase in alanine aminotransferase (ALT), but all test values were in the clinically non-significant range, and their clinical significance was judged to be small considering the fact that most of the test values returned to normal immediately after the end of drug administration.

Conclusion
ES16001 has good safety and tolerability when administered both once and repeatedly to healthy subjects. Further research is needed to identify any possible drug-induced hepatotoxicity, which appears infrequently. Our findings provide a rationale for further clinical investigations of ES16001 for the prevention of HZ.
Trial registration: CRIS, KCT0006066. Registered 7 April 2021—Retrospectively registered, https://cris.nih.go.kr/cris/search/detailSearch.do/19071).
Developing a process-oriented approach towards Positive Energy Blocks: the wind-analysis contribution
Authors: Sibilla Maurizio 
Published: August 2021

AbstractPositive Energy Block (PEB) is an emerging paradigm to transform cities into low carbon cities. It is expected that buildings will become the main components of the future energy infrastructure. This scenario demands a structural integration of the cyclical environmental variables in designing our buildings and cities as a whole. However, such an integration continue to be rare due to the dominance of object-oriented approaches. This study contributes to reducing these difficulties by developing a process-oriented approach, focusing on the wind contribution. The assumption posed herein is that the transition towards PEBs should be an opportunity to redefine the rules to organise the built environment structure integrating energy and urban environmental qualities. A case study, involving three public school buildings located in three different urban patterns in Rome, illustrates a preliminary step in developing an integrated platform to orient strategic design solutions towards PEBs. This is done by developing and assessing three indexes: wind form index, wind thermal-loss index, and wind energy production index. The results point out the usability and limits concerning the approach adopted, stressing the relevance of an integrated platform to support decision-makers in planning the agenda to transform buildings as components of PEBs.
Co- and postseismic slip behaviors extracted from decadal seafloor geodesy after the 2011 Tohoku-oki earthquake
Authors: Watanabe Shun-ichi , Ishikawa Tadashi , Nakamura Yuto , Yokota Yusuke 
Published: August 2021

AbstractInvestigations of the co- and postseismic processes of the 2011 Tohoku-oki earthquake provide essential information on the seismic cycle in the Japan Trench. Although almost all of the source region lies beneath the seafloor, recent seafloor geophysical instruments have enabled to detect the near-field signals of both the coseismic rupture and the postseismic stress relaxation phenomena. Annual-scale seafloor geodesy contributed to refining the postseismic deformation models, specifically to the incorporation of viscoelastic effects. However, because of the insufficiency in the spatial coverage and observation period of seafloor geodetic observations, no consensus on crustal deformation models has been reached, especially on the along-strike extent of the main rupture, even for the coseismic process. To decompose the postseismic transient processes in and around the source region, i.e., viscoelastic relaxation and afterslip, long-term postseismic geodetic observations on the seafloor play an essential role. Here, from decadal seafloor geodetic data, we provide empirical evidence for offshore aseismic afterslip on the rupture edges that had almost decayed within 2–3 year. The afterslip regions are considered to have stopped the north–south rupture propagation due to their velocity strengthening frictional properties. In the southern source region (~ 37° N), despite not being resolved by coseismic geodetic data, shallow tsunamigenic slip near the trench is inferred from postseismic seafloor geodesy as a subsequent viscoelastic deformation causing persistent seafloor subsidence at a geodetic site off-Fukushima. After a decade from the earthquake, the long-term viscoelastic relaxation process in the oceanic asthenosphere is currently in progress and is still dominant not only in the rupture area, but also in the off-Fukushima region.
Clinical outcomes of contemporary lateral augmentation techniques in primary ACL reconstruction: a systematic review and meta-analysis
Authors: Beckers Lucas , Vivacqua Thiago , Firth Andrew D. , Getgood Alan M. J. 
Published: August 2021

Abstract
Purpose
The purpose of this investigation was to systematically review the contemporary literature to determine if a lateral augmentation (LA) added to an Anterior Cruciate Ligament Reconstruction (ACLR) provides better clinical and patient reported outcomes compared to an isolated ACLR.

Methods
A systematic review and meta-analysis was performed according to the Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA) criteria. Two authors independently conducted an electronic search using MEDLINE® and Embase® on February 6th, 2021 for level I-III randomized controlled trials (RCT) and prospective cohort studies without randomization, published after 2012 and with a minimum of two year follow-up. Publications were included when they reported on the objective knee stability examination, patient reported outcome scores, return to sports or graft rupture rate of any type of primary, isolated ACLR compared to ACLR combined with any type of LA.

Results
A total of 11 studies that reported on a combined total of 1892 unique patients were eligible for data extraction, including five RCTs and six prospective cohort studies. In 6 studies, an Anterolateral Ligament reconstruction (ALLR) was the LA of choice, while the 5 other publications used different types of Lateral Extra-articular Tenodesis (LET). A significant reduction in graft ruptures was found in patients treated with ACLR + LA (3%) compared to isolated ACLR (12%). Rotational laxity was significantly higher in isolated ACLR (14%) compared to ACLR + LA (6%). Addition of a LA reduced anterior translation when assessed via instrumented laxity testing. No significant difference was found in the patient reported outcome scores (IKDC and Tegner) between both patient groups, except for the Lysholm Score which was significant in favour of the ACLR + LA group.

Conclusion
Combination of a primary ACLR with a LA can significantly reduce the risk of graft rupture and provide better rotatory stability, without jeopardizing patient reported outcomes.

Level of evidence
Level III, Systematic Review of Level I, II and III studies.
Successful endoscopic surgical treatment of pleuroperitoneal communication in two infant cases
Authors: Mori Teizaburo , Fujino Akihiro , Takahashi Masataka , Furugane Ryoya , Kobayashi Tamotsu , Kano Motohiro , Yoneda Akihiro , Kanamori Yutaka , Suzuki Ryutaro , Nishi Kentaro , Kamei Koichi , Kitamura Masayuki 
Published: August 2021

Abstract
Background
Pleuroperitoneal communication (PPC) is an uncommon, but potentially life-threatening complication of peritoneal dialysis (PD). If a fistula does not close with conservative treatment, surgical repair is required. However, approximately half of these patients are forced to shift from PD to hemodialysis. Although it is important to confirm the site of the fistula to achieve a successful surgical treatment, this identification is more difficult in pediatric patients than in adults.

Case presentation
We report two infantile cases of severe PPC associated with PD. In both cases, the age at onset was less than 2 years, and right-sided pleural effusion with dyspnea was observed. PPC was diagnosed by the change in color of the pleural fluid after the injection of a dye into the peritoneal cavity. Peritoneal scintigraphy and single-photon emission computed tomography and computed tomography (SPECT/CT) were performed, and these were effective in locating the fistula site. Endoscopic surgery (video-assisted thoracic surgery (VATS) and laparoscopic surgery) was performed. Indocyanine green (ICG), which was injected into the abdominal cavity, showed the exact site of the fistula. The fistula was successfully closed by attaching an absorbable sheet to it from the thoracic side and an autograft (the falciform ligament) to it from the abdominal side in one patient. In the other patient, the fistula site was resected and sutured, and reinforced with an absorbable sheet. In both cases, PD was resumed without any complication.

Conclusion
We successfully treated two infants of PPC by endoscopic surgery. To identify the fistula site, the ICG navigation method was useful. Even in small infants, PPC can be treated successfully by endoscopic surgical repair if the site of the fistula is identified.
Isolation, characterization, antimicrobial and other bioactivity profiles of three Streptomyces strains isolated from Lake Gerio, Yola, Adamawa State, Nigeria
Authors: Adeyemo Olumuyiwa Moses , Ja’afaru Mohammed Inuwa , Adams Feyisayo Victoria 
Published: August 2021

AbstractBackgroundActinomycetes are prolific producers of bioactive compounds which can be used to combat microbial infections. Microbial infections have resulted to increase in mortality and morbidity rates world-wide, especially in developing nations. This study was carried out to isolate and identify actinomycetes with potentials of synthesizing bioactive compounds, to produce and partially purify antimicrobial extracts, to characterize bioactive compounds in the extracts, to assess their antibacterial activity and to profile other biological properties of the bioactive compounds synthesized by the actinomycetes.ResultsStreptomycessp. SUI (MT584797),Streptomycessp. SW72IV (MT584818) andStreptomycessp. SW72VII (MT584816) were isolated and identified. Ultraviolet–visible spectra absorption ranged between 241 and 251 nm wavelengths showing the polyene or chromone and unsaturation nature of the natural compounds. Infrared (IR) spectra indicated functional groups such as hydroxyl, aliphatic bromo, carbonyls, esters, carboxylic acids and silicon oxy compounds in the compounds produced by the three strains. Gas Chromatography-Mass Spectrum (GC–MS) identified elaidic acid isopropyl ester (32.11%), Octadec-9-enoic acid (17.44%) and 2, 3-dihydroxyl elaidate (10%) to be mostly produced byStreptomycessp. SUI,Streptomycessp. SW72IV andStreptomycessp. SW72VII respectively. The three strains exhibited antimicrobial activity againstBacillussp.Pseudomonas aeruginosaATCC 9077,Staphylococcus aureusATCC 700699,Candida albicansandAspergilus flavus.ConclusionThe results showed that the three strains ofStreptomycescould be sources of antimicrobial bioactive compounds and other secondary metabolites that can be used in the production of pharmaceutical bioactive agents that are effective against pathogens, and production of biological materials that can be used in cosmetics and food industries.
Does automated breast ultrasound (ABUS) add to breast tomosynthesis (DBT) in assessment of lesions in dense breasts?
Authors: Hegazy Rania Mohamed , Nada Omnia Mokhtar , Ali Engy A. 
Published: August 2021

Abstract
Background
As mammography has its known limitations in dense breast, additional imaging is usually needed. We aimed to evaluate the role of automated breast ultrasound in addition to tomosynthesis in detection and diagnosis of breast lesions in dense breasts. Seventy patients with dense breasts subjected to full-field digital mammography (FFDM) including digital breast tomosynthesis (DBT) and automated breast ultrasound (ABUS). Both studies were evaluated by two experienced radiologists to assess breast composition, mass characterization, asymmetry, calcification, axillary lymphadenopathy, extent of disease (EOD), skin thickening, retraction, architectural distortion, and BIRADS classification. All breast masses were interpreted as above described and then correlated with final pathological diagnosis.

Results
Study included 70 females presenting with different types of breast lesions. Eighty-two masses were detected: 53 benign (n = 53/82), 29 malignant (n = 29/82). Histopathology of the masses was reached by core biopsy (n = 30), FNAC (n = 14), and excisional biopsy (n = 11). The rest of the masses (n = 27/82) were confirmed by their characteristic sonographic appearances; 20 cases of multiple bilateral anechoic simple cysts, 7 typical fibroadenomas showed stationary course on follow-up. As regards the final BIRADS score given for both modalities, tomosynthesis showed accuracy of 93.1% in characterization of malignant masses with accuracy of 94.3% in benign masses, on the other hand automated ultrasound showed 100% accuracy in characterization of malignant masses with 98.1% accuracy in benign masses.

Conclusion
Adding ABUS to tomosynthesis has proven a valuable imaging tool for characterization of breast lesions in dense breasts both as screening and diagnostic tool. They proved to be more sensitive and specific than digital mammography alone in showing tissue overlap, tumor characterization, lesion margins, extent, and multiplicity of malignant lesions.
Machine Learning to Predict Tamoxifen Nonadherence Among US Commercially Insured Patients With Metastatic Breast Cancer
Authors: Yerrapragada Gayathri , Siadimas Athanasios , Babaeian Amir , Sharma Vishakha , O'Neill Tyler J. 
Published: August 2021

PURPOSE Adherence to tamoxifen citrate among women diagnosed with metastatic breast cancer can improve survival and minimize recurrence. This study aimed to use real-world data and machine learning (ML) methods to classify tamoxifen nonadherence. METHODS A cohort of women diagnosed with metastatic breast cancer from 2012 to 2017 were identified from IBM MarketScan Commercial Claims and Encounters and Medicare claims databases. Patients with < 80% proportion of days coverage in the year following treatment initiation were classified as nonadherent. Training and internal validation cohorts were randomly generated (4:1 ratio). Clinical procedures, comorbidity, treatment, and health care encounter features in the year before tamoxifen initiation were used to train logistic regression, boosted logistic regression, random forest, and feedforward neural network models and were internally validated on the basis of area under receiver operating characteristic curve. The most predictive ML approach was evaluated to assess feature importance. RESULTS A total of 3,022 patients were included with 40% classified as nonadherent. All models had moderate predictive accuracy. Logistic regression (area under receiver operating characteristic 0.64) was interpreted with 94% sensitivity (95% CI, 89 to 92) and 0.31 specificity (95% CI, 29 to 33). The model accurately classified adherence (negative predictive value 89%) but was nondiscriminate for nonadherence (positive predictive value 48%). Variable importance identified top predictive factors, including age ≥ 55 years and pretreatment procedures (lymphatic nuclear medicine, radiation oncology, and arterial surgery). CONCLUSION ML using baseline administrative data predicts tamoxifen nonadherence. Screening at treatment initiation may support personalized care, improve health outcomes, and minimize cost. Baseline claims may not be sufficient to discriminate adherence. Further validation with enriched longitudinal data may improve model performance.
National Study of Pain Medicine Access Among Māori and Non-Māori Patients With Lung Cancer in New Zealand
Authors: Gurney Jason K. , Stanley James , Adler Jonathan , McLeod Heather , Atkinson June , Sarfati Diana 
Published: August 2021

PURPOSE Pain is among the most common and consequential symptoms of cancer, particularly in the context of lung cancer. Māori have extremely high rates of lung cancer, and there is evidence that Māori patients with lung cancer are less likely to receive curative treatment and more likely to receive palliative treatment and to wait longer for their treatment than non-Māori New Zealanders. The extent to which Māori patients with lung cancer are also less likely to have access to pain medicines as part of their supportive care remains unclear. METHODS Using national-level Cancer Registry and linked health records, we describe access to subsidized pain medicines among patients with lung cancer diagnosed over the decade spanning 2007-2016 and compare access between Māori and non-Māori patients. Descriptive and logistic regression methods were used to compare access between ethnic groups. RESULTS We observed that the majority of patients with lung cancer are accessing some form of pain medicine and there do not appear to be strong differences between Māori and non-Māori in terms of overall access or the type of pain medicine dispensed. However, Māori patients appeared more likely than non-Māori to first access pain medicines within 2 weeks before their death and commensurately less likely to access them more than 24 weeks before death. CONCLUSION Given the plausibility that there are differences in first access to pain medicines (particularly opioid medicines) among Māori approaching end of life, further investigation of the factors contributing to this disparity is required.