bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identifying asymptomatic Leishmania infections in non-endemic villages in Gedaref state, Sudan.
Authors: Mohamed Nouh Saad , Osman Hussam A. , Muneer Mohamed S. , Samy Abdallah M. , Ahmed Ayman , Mohammed Anwar O. , Siddig Emmanuel Edwar , Hamid Muzamil M. Abdel , Ali Mohamed Siralkhatim , Omer Rihab Ali , Elaagip Arwa H. 
Published: October 2019

Abstract
Objectives: Infection with the causative agent of visceral leishmaniasis (VL) may be either symptomatic or asymptomatic. In this study we aimed at investigating the prevalence of asymptomatic infections of leishmania in non-endemic villages in Gedaref state, Sudan. A descriptive cross-sectional study conducted during September and October 2014. Blood samples were collected for serological and molecular analysis. Sticky-traps, knockdown spray and CDC-miniature light traps were used for the collection of sandflies.
Results: Ninety-Five participants were included; 52 from Abukishma, 15 Algadamblia Tirfa, 25 Abualnaja and 3 were from Algadamblia Aljabal . Females constituted 56 (58.9%) of the study participants while males were 39 (41.1%). The most frequent age group was >40-years (54.7%). Balanites/Acacia trees were the most planted tree inside the houses; 78 (82.1%). Also, 85 (89.5%) of the participants breed animals inside the house. DAT test revealed 5 positive participants (5.2%). 4/5 DAT positive were past VL infection. PCR detected 35 (36.8%) positive participants. A total of 31/35 was considered asymptomatic infections based on PCR. Households planted Balanites/Acacia trees or breed domestic animals were found in high percentages with L. donovani PCR positive participants (60.1%, 91.4%). No statistically significant was found for VL associated risk factors and VL asymptomatic participants.
Blood donors’ knowledge and attitude towards blood donation at North Gondar district blood bank, Northwest Ethiopia: a cross-sectional study
Authors: Enawgaw Bamlaku , Yalew Aregawi , Shiferaw Elias 
Published: October 2019

Abstract
Objective: Blood transfusion saves millions of lives. In Ethiopia, the need and the actual number of donations are not balanced. The actual reason is not clearly assessed; however, level of knowledge and attitude may be the main contributing factors. Thus, the current study aimed to assess blood donors’ knowledge and attitude towards blood donation at North Gondar district blood bank.
Results: Of 401 blood donors, 142 (35.4%) and 379 (94.5%) of them had adequate knowledge and positive attitude, respectively. About 343 (85.5%) of study participants had no previous experience of blood donation. Perceptions of fear of pain, medically unfitness to donate and lack of information on when, where and how to donate blood were mentioned as reason for not donating blood. Educational status and residence were significantly associated with knowledge while participants with secondary and higher education were more likely to have good attitude towards blood donation. Thus, blood banks and others should design strategies for health education about blood donation and transfusion.
Keywords: Blood donation, Blood donors, Knowledge, Attitude, Gondar, Northwest Ethiopia
Diagnostic accuracy of clinical tools for assessment of acute stroke: a systematic review
Authors: Antipova Daria , Eadie Leila , Macaden Ashish , Wilson Philip 
Published: October 2019

Abstract
Introduction: Recanalisation therapy in acute ischaemic stroke is highly time-sensitive, and requires early identification of eligible patients to ensure better outcomes. Thus, a number of clinical assessment tools have been developed and this review examines their diagnostic capabilities.
Methods: Diagnostic performance of currently available clinical tools for identification of acute ischaemic and haemorrhagic strokes and stroke mimicking conditions was reviewed. A systematic search of the literature published in 2015-2018 was conducted using PubMed, EMBASE, Scopus and The Cochrane Library. Prehospital and in-hospital studies with a minimum sample size of 300 patients reporting diagnostic accuracy were selected.
Results: Twenty-five articles were included. Cortical signs (gaze deviation, aphasia and neglect) were shown to be significant indicators of large vessel occlusion (LVO). Sensitivity values for selecting subjects with LVO ranged from 23% to 99% whereas specificity was 24% to 97%. Clinical tools, such as FAST-ED, NIHSS, and RACE incorporating cortical signs as well as motor dysfunction demonstrated the best diagnostic accuracy. Tools for identification of stroke mimics showed sensitivity varying from 44% to 91%, and specificity of 27% to 98% with the best diagnostic performance demonstrated by FABS (90% sensitivity, 91% specificity). Hypertension and younger age predicted intracerebral haemorrhage whereas history of atrial fibrillation and diabetes were associated with ischaemia. There was a variation in approach used to establish the definitive diagnosis. Blinding of the index test assessment was not specified in about 50% of included studies.
Conclusions: A wide range of clinical assessment tools for selecting subjects with acute stroke has been developed in recent years. Assessment of both cortical and motor function using RACE, FAST-ED and NIHSS showed the best diagnostic accuracy values for selecting subjects with LVO. There were limited data on clinical tools that can be used to differentiate between acute ischaemia and haemorrhage. Diagnostic accuracy appeared to be modest for distinguishing between acute stroke and stroke mimics with optimal diagnostic performance demonstrated by the FABS tool. Further prehospital research is required to improve the diagnostic utility of clinical assessments with possible application of a two-step clinical assessment or involvement of simple brain imaging, such as transcranial ultrasonography.
Mild water stress-induced priming enhance tolerance to Rosellinia necatrix in susceptible avocado rootstocks
Authors: Martínez-Ferri Elsa , Moreno-Ortega Guillermo , Berg Noelani van den , Prieto Clara Pliego 
Published: October 2019

Abstract
Background: White root rot (WRR) disease caused by Rosellinia necatrix is one of the most important threats affecting avocado orchards in temperate regions. The eradication of WRR is a difficult task and environmentally friendly control methods are needed to lessen its impact. Priming plants with a stressor (biotic or abiotic) can be a strategy to enhance plant defense/tolerance against future stress episodes but, despite the known underlying common mechanisms, few studies use abiotic-priming for improving tolerance to forthcoming biotic-stress and vice versa (‘ cross-factor priming’ ). To assess whether cross-factor priming can be a potential method for enhancing avocado tolerance to WRR disease, ‘Dusa’ avocado rootstocks, susceptible to R. necatrix , were subjected to two levels of water stress (mild-WS and severe-WS) and, after drought-recovery, inoculated with R. necatrix . Physiological response and expression of plant defense related genes after drought-priming as well as the disease progression were evaluated.
Results: Water-stressed avocado plants showed lower water potential and stomatal limitations of photosynthesis compared to control plants. In addition, NPQ and q N values increased, indicating the activation of energy dissipating mechanisms closely related to the relief of oxidative stress. This response was proportional to the severity of the water stress and was accompanied by the deregulation of pathogen defense-related genes in the roots. After re-watering, leaf photosynthesis and plant water status recovered rapidly in both treatments, but roots of mild-WS primed plants showed a higher number of overexpressed genes related with plant defense than severe-WS primed plants. Disease progression after inoculating primed plants with R. necatrix was significantly delayed in mild-WS primed plants.
Conclusions: These findings demonstrate that mild-WS can induce a primed state in the WRR susceptible avocado rootstock ‘Dusa’ and reveal that ‘ cross-factor priming’ with water stress (abiotic stressor) is effective for increasing avocado tolerance against R. necatrix (biotic stressor), underpinning that plant responses against biotic and abiotic stress rely on common mechanisms. Potential applications of these results may involve an enhancement of WRR tolerance of current avocado groves and optimization of water use via low frequency deficit irrigation strategies.
Methodology for sampling women at high maternal risk in administrative data
Authors: Vanderlaan Jennifer , Dunlop Anne , Rochat Roger , Williams Bryan , Shapiro Susan E. 
Published: October 2019

Abstract
Background In population level studies, the conventional practice of categorizing women into low and high maternal risk samples relies upon ascertaining the presence of various comorbid conditions in administrative data. Two problems with the conventional method include variability in the recommended comorbidities to consider and inability to distinguish between maternal and fetal risks. High maternal risk sample selection may be improved by using the Obstetric Comorbidity Index (OCI), a system of risk scoring based on weighting comorbidities associated with maternal end organ damage. The purpose of this study was to compare the net benefit of using OCI risk scoring vs the conventional risk identification method to identify a sample of women at high maternal risk in administrative data. Methods This was a net benefit analysis using linked delivery hospitalization discharge and vital records data for women experiencing singleton births in Georgia from 2008-2012. We compared the value identifying a sample of women at high maternal risk using the OCI score to the conventional method of dichotomous identification of any comorbidities. Value was measured by the ability to select a sample of women designated as high maternal risk who experienced severe maternal morbidity or mortality. Results The high maternal risk sample created with the OCI had a small but positive net benefit (+ 0.6), while the conventionally derived sample had a negative net benefit indicating the sample selection performed worse than identifying no woman as high maternal risk. Conclusions The OCI can be used to select women at high maternal risk in administrative data. The OCI provides a consistent method of identification for women at risk of maternal morbidity and mortality and avoids confounding all obstetric risk factors with specific maternal risk factors. Using the OCI may help reduce misclassification as high maternal risk and improve the consistency in identifying women at high maternal risk in administrative data.
Weight Management Merits Attention in women with infertility: A Cross-Sectional Study on the Association of Anthropometric Indices with Hormonal Imbalance in a Ghanaian Population
Authors: Owiredu William K.B.A. , Ofori Peter Ntim , Turpin Cornelius Archer , Obirikorang Christian , Acheampong Emmanuel , Anto Enoch Odame , Owiredu Eddie-Williams , Adu Evans Asamoah 
Published: October 2019

Abstract
Objective: This study determined the association of anthropometric indices with hormonal imbalance among infertile women in a Ghanaian population.
Results: Follicle stimulating hormone (FSH) levels (18.47 vs 8.67, p-value =0.002), and luteinizing hormone (LH) (12.43 vs 8.01, p-value =0.044) were higher in women with primary infertility compared with women presenting with secondary infertility. Waist circumference (WC) and waist-to-height ratio (WHtR) showed significant negative partial correlation with prolactin in both primary and secondary infertile women. Also a significant negative partial correlation was observed between BMI and prolactin in secondary infertile women only. Waist-to-hip ratio (WHR) showed a positive association with LH in both primary and secondary infertility. WHR also showed significant positive correlation to LH/FSH ratio in secondary infertility whereas body adiposity index (BAI) showed a negative correlation to LH/FSH ratio. In a correlation analysis of anthropometric measures with hormonal profile and causes of infertility as a fixed factor, the association between anthropometric indices and fertility hormones was largely dependent on the underlying causes of infertility.
Supervised training in primary care units but not self-directed physical activity lowered cardiovascular risk in Brazilian low-income patients: a controlled trial
Authors: Lima Amana M. , Werneck André O. , Cyrino Edilson , Farinatti Paulo 
Published: October 2019

Abstract
Background: Public health strategies to increase physical activity in low-income communities may reduce cardiovascular risk in these populations. This controlled trial compared the cardiovascular risk estimated by the Framingham Risk Score (FRS) over 12 months in formally active (FA), declared active (DA), and physically inactive (PI) patients attended by the ‘Family Health Strategy’ in low-income communities at Rio de Janeiro City, Brazil (known as ‘favelas’). Methods: Patients were matched for age and assigned into three groups: a) FA (supervised training, n=53; 60.5±7.7 yrs); b) DA (self-reported, n=43; 57.0±11.2 yrs); c) PI (n=48; 57.0±10.7 yrs). FA performed twice a week a 50-min exercise circuit including strength and aerobic exercises, complemented with 30-min brisk walking on the third day, whereas DA declared to perform self-directed physical activity twice a week. Comparisons were adjusted by sex, chronological age, body mass index, and use of anti-hypertensive/statin medications. Results: At baseline, groups were similar in regards to body mass, body mass index, triglycerides, and LDL-C, as well to FRS and most of its components (age, blood pressure, hypertension prevalence, smoking, HDL-C, and total cholesterol; P>0.05). However, diabetes prevalence was 10-15% lower in DA vs. FA and PI (P<0.05). Intention-to-treat analysis showed significant reductions after intervention (P<0.05) in FA for total cholesterol (~10%), LDL-C (~15%), triglycerides (~10%), systolic blood pressure (~8%), and diastolic blood pressure (~9%). In DA, only LDL-C decreased (~10%, P < 0.05). Significant increases were found in PI (P<0.05) for total cholesterol (~15%), LDL-C (~12%), triglycerides (~15%), and systolic blood pressure (~5%). FRS lowered 35% in FA (intention-to-treat, P<0.05), remained stable in DA (P>0.05), and increased by 20% in PI (P<0.05). Conclusions: A supervised multi-modal exercise training developed at primary care health units reduced the cardiovascular risk in adults living in very low-income communities. The risk remained stable in patients practicing self-directed physical activity and increased among individuals who remained physically inactive. These promising results should be considered within public health strategies to prevent cardiovascular disease in communities with limited resources.
Towards Developing a Model for the Evaluation of Hospital Disaster Resilience: A Systematic Review
Authors: Aliabadi Saeed Fallah , Ostadtaghizadeh Abbas , Ardalan Ali , Fatemi Farin , Khazaei Bijan , Mirjalili Mohammad Reza 
Published: October 2019

Abstract
Background: Hospitals play a vital role in disaster stricken regions. The resilient hospitals will be able to provide essential services to affected people and it can mitigate the risk of injuries during and after disasters. The aim of this paper was to obtain the indicators required for the evaluation of hospital resilience.
Methods: This systematic review was conducted in 2018. Through this systematic review, the international electronic databases were investigated for the researches published in English. The exclusion and inclusion criteria were determined to extract the hospital resilience indicators. These indicators were used in order to develop a model to keep the system performance at an acceptable level during disasters.
Results: Out of 1794 researches that were published until September 2018, 89 articles and guidelines with full text were surveyed. Thirty-two articles and guidelines were then selected and analyzed to collect the indicators related to hospital disaster resilience (HDR). The domains and the indicators were extracted from these selected researches. We suggested a model including three domains and twenty seven subdomains. The three domains were constructive, infrastructural and administrative resilience. The relevant indicators were designed for each subdomain to measure the HDR.
Conclusion ; Since diverse indicators affect hospital resilience, therefore, other studies should be conducted to propose some models or tools to quantify the hospital resilience in different countries and scopes with an all hazard approach.
Key words : Disaster; Hospital; Resilience; Structural and non-structural systems; Indicators;
Perceptions and experiences with District Health Information System software to collect and utilize health data in Bangladesh: A qualitative exploratory study
Authors: Begum Tahmina , Khan Shaan Muberra , Adamou Bridgit , Ferdous Jannatul , Parvez Muhammad Masud , Islam Mohammad Saiful , Kumkum Feroza Akhter , Rahman Aminur , Anwar Iqbal 
Published: October 2019

Abstract
Background: Accurate and high-quality data are important for improving program effectiveness and informing policy. Bangladesh Health Management information System (HMIS) has adopted District Health Information software 2 (DHIS) in 2009 to capture real-time health service utilization data. However, routinely collected data are being underused because of poor data quality. We aim to understand the facilitators and barriers on implementing DHIS2 as a way to retrieve meaningful and accurate data for the Reproductive, Maternal and Child Health (RMCAH) services. Methods: This qualitative study was done among two districts of Bangladesh from September 2017 to 2018. Data collection method were key informant interview (n=11); in-depth interview (n=23); focus group discussion (n=2). Study participants were individuals involved with DHIS2 implementation from the community level to the national level. The data were analyzed thematically. Results: DHIS 2could improve the timeliness and completeness of data reporting over time. The reported facilitating factors were strong government commitment, extensive donor support and positive attitude of staffs. Quality checks and feedback loops at multiple levels of data gathering points was helpful to minimize data errors. Introducing dashboard makes the DHIS2 compatible to use as monitoring tool. However, the barriers to DHIS 2 implementation were lack of human resources, slow Internet connectivity, and frequent change of DHIS 2 versions, maintaining both manual and electronic system side by side. The collected data remains incomplete as private health facilities are not covered. The parallel presence of two MISs to report same RMNCAH indicators is a threat to achieve quality data and increases workload. Conclusion: The overall insights from this study are expected to contribute to the development of effective strategies for successful DHIS 2 implementation and building responsive HMIS. To sustain the achievements of digital data culture, focused strategic direction is needed. Periodic refresher trainings, incentives for increased performance, automated single reporting system for multiple stakeholders could make the system more user friendly. A national electronic health strategy and implementation framework can facilitate creating a culture of DHIS 2 use for planning, setting priorities, and decision making among stakeholder groups
A small dose of remifentanil pretreatment suppresses sufentanil-induced cough during general anesthesia induction: a randomized, double-blind, placebo-controlled trial
Authors: Lin Wendong , Sun Jiehao , Fu Shuying 
Published: October 2019

Abstract
Background: Intravenous use of sufentanil can elicit cough. This study aimed to evaluate the inhibitory effect of pre-injection of a mall dose of remifentanil on sufentanil-induced cough during the induction of general anesthesia.
Methods: This prospective, randomized, controlled trial was conducted from January 10, 2019 to March 01, 2019. A total of 100 patients undergoing elective surgery under general anesthesia were enrolled, and at last 84 patients were included and randomly allocated into two equal size groups (n=42): Patients in the Remifentanil group (R group) received an intravenous infusion of remifentanil 0.3 µg/kg (diluted to 2 ml) 1 minute before sufentanil injection; patients in the Control group (C group) received 2 ml of normal saline (NS) at the same time point. Injections of patients in both groups were completed within 5 seconds. Then, sufentanil 0.5 µg/kg was injected within 5 seconds and the number of coughs that occurred within 1 minute after sufentanil injection were recorded. One minute after sufentanil injection, etomidate 0.3 mg/kg and cisatracurium 0.15 mg/kg were given for general anesthesia induction irrespective of the presence or absence of cough. The mean arterial pressure (MAP) and heart rate (HR) at time points just before remifentanil pretreatment administration (T0), 3 minutes after administration (T1), 1 minute after intubation (T2), and 3 minutes after intubation (T3) were recorded.
Results: The incidence of cough in patients in the R group and C group was 4.8% and 31%, respectively. Compared with group C, the incidence and severity of cough in group R was significantly lower (P <0.01). No significant differences were observed in MAP and HR at the time of general anesthesia induction between the two groups (P> 0.05).
Conclusion: Pretreatment with a small dose of remifentanil effectively and safely reduced the incidence and severity of cough induced by sufentanil during anesthesia induction and can be used as an alternative treatment to inhibit coughing caused by sufentanil.
CD45dimCD34+CD38-CD133+ cells function as leukemic stem cells in acute myeloid leukemia
Authors: Heo Sook-Kyoung , Noh Eui-Kyu , Jeong Yoo Kyung , Cheon Jaekyung , Koh SuJin , Min Young Joo , Choi Yunsuk , Jo Jae-Cheol 
Published: October 2019

Abstract
Leukemia stem cells (LSCs) in acute myeloid leukemia (AML) played important roles in development of leukemia, chemotherapeutic drug resistance, and disease relapse and progression. The identification of LSCs and targeting therapies for them has been under investigation. We examined the CD45 dim CD34 + CD38 - CD133 + cells on bone marrow samples of hematologic malignancies and healthy controls using four-color flow cytometry experiments. Interestingly, the CD45 dim CD34 + CD38 - CD133 + cells were highly expressed in bone marrow of patients with AML compared to that of healthy controls (HC). Moreover, the proportions of CD45 dim CD34 + CD38 - CD133 + cells were also examined in diverse hematology malignancies including AML, CML, DLBCL, MM, MDS, HL, ALL and CLL. These cells were prominently detected in BMCs of AML and CML, but rarely in DLBCL, MM, MDS, ALL, CLL and HL. Additionally, the high levels of the CD45 dim CD34 + CD38 - CD133 + cells in AML patients were an independently significant poor risk factor for overall survival and event free survivals. Therefore, our results suggest that CD45 dim CD34 + CD38 - CD133 + cells in AML might have the potential of leukemia stem cells. In addition, this cell population might be a novel therapeutic target for AML.