bluuebunny/crossref_metadata_2025_split huggingface dataset:
Virological failure and antiretroviral resistance among HIV-infected children after five years follow-up in the ANRS 12225-PEDIACAM cohort in Cameroon
Authors: Tagnouokam-Ngoupo Paul Alain , Penda Ida Calixte , Tchatchueng Mbougua Jules Brice , Tetang Ndiang Suzie , Yuya Septoh Francis , Kenne Angeladine , Ngallè Jeannine Eboumbou , Jakpou Sorel , Ateba Ndongo Francis , Warszawski Josiane , Faye Albert , Tejiokem Mathurin Cyrille ,   The ANRS-Pediacam Study Group
Published: March 2021

Objective
In the present study, we aimed to evaluate the virological failure (VF) and drug resistance among treated HIV-infected children after five years follow-up in the ANRS-Pediacam cohort in Cameroon.

Methods
From November 2007 to October 2011, HIV-infected children born to HIV-infected mothers were included in the ANRS-PEDIACAM study and followed-up for more than 5 years. Plasma viral load (VL) was measured at each visit (every three months until month 24 and every 6 months thereafter). VF was the main outcome and HIV drug resistance test was performed using the ANRS procedures and algorithm.

Results
Data from 155 children were analyzed. The median age at combination antiretroviral therapy (cART) initiation was 4.2 months (interquartile range (IQR): 3.2–5.8), with 103 (66.5%) children taking LPV/r-containing regimen and 51 (32.9%) children taking NVP. After five years follow-up, 63 (40.6%; CI: 32.9–48.8) children experienced VF. The median duration between cART initiation and VF was 22.1 months (IQR: 11.9–37.1) with a median VL of 4.8 log10 (IQR: 4.0–5.5). Among the 57 children with HIV drug resistance results, 40 (70.2%) had at least one drug resistance mutation. The highest resistance rates (30.4–66.1%) were obtained with Lamivudine; Efavirenz; Nevirapine and Rilpivirine.

Conclusions
These results show high resistance to NNRTI and emphasize the need of VL and resistance tests for optimal follow-up of HIV-infected people especially children.
Perceptions of the parents of deceased children and of healthcare providers about end-of-life communication and breaking bad news at a tertiary care public hospital in India: A qualitative exploratory study
Authors: Das Manoja Kumar , Arora Narendra Kumar , Chellani Harish Kumar , Debata Pradeep Kumar , Meena K. R. , Rasaily Reeta , Kaur Gurkirat , Malik Prikanksha , Joshi Shipra , Kumari Manisha 
Published: March 2021

BackgroundParents of dying children face unique challenge and expect compassionate support from health care providers (HCPs). This study explored the experiences of the parents and HCPs about the end-of-life care and breaking bad news and related positive and negative factors in Indian context.MethodsThis qualitative exploratory study was conducted at paediatrics department of a tertiary care hospital in Delhi. In-depth interviews with the parents (n = 49) and family members (n = 21) of the children died at the hospital and HCPs (6 doctors, 6 nurses and 4 support staffs) were conducted. Also events and communication around death of eight children were observed. Data were inductively analysed using thematic content analysis method to identify emerging themes and codes.ResultsDoctors were the lead communicators. Majority of parents perceived the attitude, communication and language used as by resident doctors as brief, insensitive and sometimes inappropriate or negative. They perceived that the attitude and communication by senior doctor’s as empathetic, positive and complete. Parents recalled the death declaration by resident doctors as non-empathetic, blunt and cold. Most parents received no emotional support from HCPs during and after death of their child. All doctors expressed that death of their patients affected them and their emotions, which they coped through different activities. The overcrowded wards, high workload, infrastructural limitation and no formal communication training added to the emotional stress of the HCPs.ConclusionsMajority of the communication by the HCPs during the hospitalisation and end-of-life period were perceived as suboptimal by the parents. The HCPs were emotionally affected and faced end-of-life communication challenges. The study highlights the communication by HCPs and support for parents during the end-of-life communication and breaking bad news. It suggests adoption of context specific communication protocol and materials and training of HCPs in communication to improve the quality of care.
Mobile health technologies supporting colonoscopy preparation: A systematic review and meta-analysis of randomized controlled trials
Authors: El Bizri Maria , El Sheikh Mariam , Lee Ga Eun , Sewitch Maida J. 
Published: March 2021

Background
Mobile health (mHealth) technologies are innovative solutions for delivering instructions to patients preparing for colonoscopy.

Objective
To systematically review the literature evaluating the effectiveness of mHealth technologies supporting colonoscopy preparation on patient and clinical outcomes.

Methods
MEDLINE, EMBASE, CINAHL and CENTRAL were searched for randomized controlled trials (RCTs) that evaluated the effectiveness of mHealth technologies for colonoscopy preparation on patient and clinical outcomes. Two reviewers independently assessed study eligibility, extracted data, and appraised methodological quality using the Cochrane Risk-of-Bias tool. Data were pooled using random effects models and when heterogeneity, assessed using I2, was statistically significant, a qualitative synthesis of the data was performed. Publication bias was assessed using a funnel plot.

Results
Ten RCTs (3,383 participants) met inclusion criteria. MHealth interventions included smartphone apps, SMS text messages, videos, camera apps, and a social media app. Outcomes were bowel cleanliness quality, user satisfaction, colonoscopy quality indicators (cecal intubation time, withdrawal time, adenoma detection rate), adherence to diet, and cancellation/no-show rates. MHealth interventions were associated with better bowel cleanliness scores on the Boston Bowel Preparation Scale [standardized mean difference (SMD) 0.57, 95%CI 0.37–0.77, I2 = 60%, p = 0.08] and the Ottawa Bowel Preparation Scale [SMD -0.39, 95%CI -0.59–0.19, I2 = 45%, p = 0.16], but they were not associated with rates of willingness to repeat the colonoscopy using the same regimen [odds ratio (OR) 1.88, 95%CI 0.85–4.15, I2 = 48%, p = 0.12] or cancellations/no-shows [OR 0.96, 95%CI 0.68–1.35, I2 = 0%]. Most studies showed that adequate bowel preparation, user satisfaction and adherence to diet were better in the intervention groups compared to the control groups, while inconsistent findings were observed for the colonoscopy quality indicators. All trials were at high risk of bias for lack of participant blinding. Visual inspection of a funnel plot revealed publication bias.

Conclusions
MHealth technologies show promise as a way to improve bowel cleanliness, but trials to date were of low methodological quality. High-quality research is required to understand the effectiveness of mHealth technologies on colonoscopy outcomes.
Cost-effectiveness of financial incentives to improve glycemic control in adults with diabetes: A pilot randomized controlled trial
Authors: Egede Leonard E. , Walker Rebekah J. , Dismuke-Greer Clara E. , Pyzyk Sarah , Dawson Aprill Z. , Williams Joni S. , Campbell Jennifer A. 
Published: March 2021

Purpose
Determine the cost-effectiveness of three financial incentive structures in obtaining a 1% within group drop in HbA1c among adults with diabetes.

Methods
60 African Americans with type 2 diabetes were randomized to one of three financial incentive structures and followed for 3-months. Group 1 (low frequency) received a single incentive for absolute HbA1c reduction, Group 2 (moderate frequency) received a two-part incentive for home testing of glucose and absolute HbA1c reduction and Group 3 (high frequency) received a multiple component incentive for home testing, attendance of weekly telephone education classes and absolute HbA1c reduction. The primary clinical outcome was HbA1c reduction within each arm at 3-months. Cost for each arm was calculated based on the cost of the intervention, cost of health care visits during the 3-month time frame, and cost of workdays missed from illness. Incremental cost effectiveness ratios (ICER) were calculated based on achieving a 1% within group drop in HbA1c and were bootstrapped with 1,000 replications.

Results
The ICER to decrease HbA1c by 1% was $1,100 for all three arms, however, bootstrapped standard errors differed with Group 1 having twice the variation around the ICER coefficient as Groups 2 and 3. ICERs were statistically significant for Groups 2 and 3 (p<0.001) indicating they are cost effective interventions.

Conclusions
Given ICERs of prior diabetes interventions range from $1,000-$4,000, a cost of $1,100 per 1% within group decrease in HbA1c is a promising intervention. Multi-component incentive structures seem to have the least variation in cost-effectiveness.
Motivating for Reading through Transmedia Storytelling: A Case Study with Students from a Middle School in the Médio Tejo Region
Authors: Faria-Ferreira Ana Paula , Faria Ferreira Patrícia Alexandra , Marques Célio Gonçalo 
Published: March 2021

The evolution of information and communication technologies has changed the way we relate to each other and how we build our knowledge. This creates challenges for education systems, as school must provide all students with the educational experiences that will enable them to develop the skills reflected in the profile of the 21st-century student on com pletion of compulsory schooling. It is up to teachers to find new ways of teaching, making the most of the resources and digital tools made available by mobile technologies. Technology can make a significant contribution to increasing students' motivation because it is closer to what they like and use in their daily lives. And this introduction of technology into the classroom can promote student-oriented teaching, which contributes to the development of skills such as autonomy, critical thinking and self-esteem.
One of the areas that can contribute to this paradigm shift is the creation of experiences in immersive learning environments such as Transmedia Storytelling. Immersive learning environments can favour the creation and implementation of projects that promote reading skills in schools. This is the focus of this article.
The aim of this study is to evaluate the impact of transmedia storytelling on the level of motivation of students and on the improvement of pedagogical practices implemented by the teachers involved. This case study was carried out in the subject of Portuguese in three 7th-grade classes of a school from the Médio Tejo region.
The results obtained suggest a high level of motivation of students and teachers. The latter recognise that pedagogical routes using Transmedia Storytelling contribute to the motivation, autonomy and improvement of students' learning.
Influence of Sedation on the Detection Rate of Early Cancer and Precancerous Lesions During Diagnostic Upper Gastrointestinal Endoscopies: A Multicenter Retrospective Study
Authors: Zhou Jiawei , Li Zhen , Ji Rui , Wang Peizhu , Zhang Aijun , Wu Kangkang , Liu Chengxia , Niu Qiong , Chu Yanliu , Su Xiufeng , Zuo Xiuli , Li Yanqing 
Published: March 2021

INTRODUCTION:
The influence of sedation on the endoscopic detection rate of upper gastrointestinal (UGI) early cancer (EC) and precancerous lesions, including high-grade intraepithelial neoplasia (HGIN) and low-grade intraepithelial neoplasia, has not been assessed. The aim of this research is to assess whether the use of sedation can help improve the detection rate of UGI EC and precancerous lesions. The second objective is to evaluate its potential influencing factors.

METHODS:
The study includes 432,202 patients from a multicenter database from January 2012 to July 2019. Information on endoscopic findings and histology biopsies was obtained from endoscopy quality-control system. Associations of sedation with the detection rate of EC and precancerous lesions were assessed.

RESULTS:
The sedation group has a higher detection rate of UGI EC and HGIN compared with the no-sedation group, whereas the detection rate of low-grade intraepithelial neoplasia was similar between the 2 groups. There were more cases examined by using staining, image enhancement, or magnifying techniques in the sedation group (P < 0.001). And, the mean observation time was also longer in the sedation group (P < 0.001). The type 0-IIb esophageal HGIN and EC cases were significantly increased in the sedation group. No significant difference was detected on lesion subtypes for gastric HGIN and EC according to the Paris classification. More gastric HGIN and EC were detected at gastric body in the sedation group (P = 0.001).

JOURNAL/ajgast/04.03/00000434-202106000-00022/inline-graphic1/v/2023-07-18T070803Z/r/image-tiff

DISCUSSION:
Sedation may improve the endoscopic detection rate of EC and HGIN in the UGI tract probably through enhancing the use of accessary endoscopic techniques, prolonging observation time, and taking more biopsies in different locations (see Visual Abstract, Supplementary Digital Content 2, http://links.lww.com/AJG/B926).
Risk and Risk Score Performance of Hepatocellular Carcinoma Development in Patients With Hepatitis B Surface Antigen Seroclearance
Authors: Park Yewan , Lee Jeong-Hoon , Sinn Dong Hyun , Park Jun Yong , Kim Minseok Albert , Kim Yoon Jun , Yoon Jung-Hwan , Kim Do Young , Ahn Sang Hoon , Kang Wonseok , Gwak Geum-Youn , Paik Yong-Han , Choi Moon Seok , Lee Joon Hyeok , Koh Kwang Cheol , Paik Seung Woon 
Published: March 2021

INTRODUCTION:
Hepatocellular carcinoma (HCC) can develop among chronic hepatitis B patients after hepatitis B surface antigen (HBsAg) seroclearance. However, whether HCC risk after HBsAg seroclearance differs between antiviral therapy (AVT)-induced or spontaneous seroclearance cases and ways to identify at-risk populations remain unclear.

METHODS:
A retrospective cohort of 1,200 adult chronic hepatitis B patients who achieved HBsAg seroclearance (median age: 56 years; 824 men; 165 with cirrhosis; 216 AVT-induced cases) were analyzed. The risk of HCC after HBsAg seroclearance and the performance of 6 HCC prediction models were assessed.

RESULTS:
During a median of 4.8 years of follow-up (range: 0.5–17.8 years), HCC developed in 23 patients (1.9%). The HCC incidence rate was higher in the AVT-induced cases than that in the spontaneous cases (3.9% vs 0.9% at 5 years). AVT and cirrhosis were independent factors associated with HCC, with HCC incidence rates of 0.5%, 1.2%, 4.0%, and 10.5% at 5 years for spontaneous/no-cirrhosis, AVT-induced/no-cirrhosis, spontaneous/cirrhosis, and AVT-induced/cirrhosis patients, respectively. Among the 6 predictive HCC models tested, Chinese University-HCC score (0.82) showed the highest C-statistics, which was followed by guide with age, gender, HBV DNA, core promoter mutations and cirrhosis (0.81).

DISCUSSION:
AVT-induced HBsAg seroclearance was associated with higher HCC risk, especially for patients with cirrhosis, indicating that they need careful monitoring for HCC risk. The HCC risk models were able to stratify the HCC risk in patients with HBsAg seroclearance.
Metabolizer phenotype prediction in different Peruvian ethnic groups through CYP2C9 polymorphisms
Authors: Valencia Ayala Edward , Chevarría Arriaga Mylenka , Coelho Eduardo Barbosa , Sandoval José Sandoval , Granara Alberto Salazar 
Published: March 2021

Abstract

Objectives
The CYP2C9 gene have three common alleles, CYP2C9*1, CYP2C9*2 and CYP2C9*3, associated with different homozygous (*1/*1, *2/*2 and *3/*3) and heterozygous (*1/*2 and *1/*3) genotypes, which in turn are related to extensive (gEM), intermediate (gIM) and poor (gPM) metabolizers. Likewise, the inter-ethnic variability was intimately associated with different drug metabolism. Therefore, the aim of the present study was predict the metabolizer phenotypes in different Peruvian ethnic groups from lowland (<2,500 m) and highland (>2,500 m).

Methods
TaqMan genotyping assays were performed in a group of 174 healthy unrelated Peruvian individuals.

Results
In this study, the allelic comparison between the three eco-regions showed that the CYP2C9*1 was the most common in Andean (96.32%); the *2 was the most frequent in Coast (7.45%, p<0.05). Regarding the *3 was the most common in Amazonian (6.25%, p<0.05). In a corroborative manner, the gEM was the most common in Andean (94.74%), the gIM in Coast (17.02%) and gPM in Amazonian (6.25%) populations.

Conclusions
Our study provides a valuable source of information about to metabolizer phenotype drugs in different Peruvian ethnic groups. In this way, it could be established suitable genetic-dosage medicaments for various common diseases in these heterogenetic populations.
Association of genetic polymorphisms in vitamin D receptor (ApaI, TaqI and FokI) with vitamin D and glycemic status in type 2 diabetes patients from Southern India
Authors: Selvarajan Sandhiya , Srinivasan Akila , Surendran Deepanjali , Mathaiyan Jayanthi , Kamalanathan Sadishkumar 
Published: March 2021

Abstract

Objectives
To evaluate the association of VDR polymorphisms (FokI, TaqI and ApaI) with vitamin D levels and glycemic status in type 2 diabetes patients from Southern India.

Methods
In this observational study, genotype frequencies and vitamin D levels of 200 cases (type 2 diabetes patients) were compared with 300 controls (unrelated anonymised stored samples of healthy volunteers) from south India. Serum 25 (OH) D levels were measured by immunoassay technique, glycated hemoglobin (HbA1c) was measured using HPLC and genotyping of VDR polymorphisms were carried out using Real time Polymerase Chain Reaction (RT PCR).

Results
About 69.2% of type 2 diabetes patients were found to have vitamin D deficiency. FokI polymorphism showed variations in serum 25 (OH) D levels, with AA and AG genotypes having significantly lower serum 25 (OH) D levels as compared to GG [13.24 (8.4) ng/ml, 15.02 (7.07) ng/ml and 20.67 (13.64) ng/ml respectively]. There was no difference in HbA1c levels with respect to the vitamin D levels and VDR polymorphisms.

Conclusions
AA and AG genotypes of FokI polymorphisms are associated with low serum 25 (OH) D levels. However there was no association between VDR polymorphisms and glycemic status in south Indian type 2 diabetes patients.
Deformation mechanisms and plasticity of ultrafine-grained Al under complex stress state revealed by digital image correlation technique
Authors: Zhao Yonghao , Gu Yanglin 
Published: March 2021

Abstract
Conventional engineering stress–strain curve could not accurately describe the local deformability of the tensile necking part because the strain is calculated by assuming that the tensile specimen was deformed uniformly. In this study, we used 3D optical measuring digital image correlation to systematically measure the full strain field and actual flow stress in the necking region of ultrafine-grained (UFG) Al. The post-necking elongation and strain hardening exponent of the UFG Al were measured as 80% and 0.10, slightly smaller than those of the coarse-grained Al (117% and 0.28), suggesting the high plastic deformability of the UFG Al under complex stress state. Microstructural studies revealed the shear and ductile fracture, numerous micro-shear bands, and elongated UFG grains in the UFG Al, which are controlled by cooperative grain boundary sliding and multiple dislocation slips.
Evaluation and Development of Performance-Engineered Specifications for Monotonic Loading Cracking Performance Assessment Tests and Indicators
Authors: Alkuime Hamza , Kassem Emad , Bayomy Fouad M. S. , Nielsen Richard J. 
Published: March 2021

Abstract
This study investigated the validity of various monotonic cracking performance assessment testing standards and indicators to describe the expected cracking performance in the field. A total number of 17 field test sections with known field cracking performance were selected and evaluated. Field cores were extracted from these sections, and a comprehensive laboratory testing program was carried out. The authors conducted four monotonic testing standards and calculated 11 performance indicators. The study findings showed that there was no direct correlation between the laboratory testing results of monotonic tests and indicators and the observed field cracking performance. The variable air void content and thickness of the extracted field cores are believed to influence the laboratory testing results of monotonic tests and indicators. Therefore, this study proposed an alternative approach to develop performance specifications (thresholds) for monotonic tests and indicators. The thresholds were developed indirectly using a correlation between cyclic testing and both monotonic tests and the observed field cracking performance. The results demonstrated the effectiveness and success of the proposed approach in developing performance thresholds. Pass/fail cracking performance assessment thresholds were proposed for various monotonic indicators to distinguish between asphalt mixes with good, fair, and poor cracking resistance. Besides, the study recommends the Weibull cracking resistance index, determined from the indirect tension test, as a simple performance indicator to assess mixes resistance to cracking.