bluuebunny/crossref_metadata_2025_split huggingface dataset:
Deaths From Surgical Conditions In Malawi A Randomised Cross-sectional Nationwide Household Survey
Authors: Varela Carlos Gomes , Young Sven , Groen Reinou , Banza Leonard Ngoe , Mkandawire Nyengo , Elisabeth Moen Bente , Viste Asgaut 
Published: October 2019

Abstract
Back ground The prevalence of untreated surgical conditions in Malawi has been estimated at 35% with 24% of the deaths associated with untreated surgical conditions. In SSA, the primary emphasis for health research has been on communicable diseases, and relatively little is known about deaths from surgical conditions in most middle- to low-, income African countries, including Malawi. This study aimed to address this knowledge gap by quantifying and describing the deaths from surgical conditions in Malawi. Methods To access the deaths associated with surgical conditions in Malawi, a randomised multi-stage cross-sectional national household survey was carried out using the Surgeons Overseas Assessment of Surgical Need (SOSAS) tool. Randomisation was done on 48 233 settlements, using 50 villages from each district as data collection sites. Two to four household were randomly selected from each village. Two members of each selected household were interviewed. 1487 households were involved in the survey. Data collection was done using an electronic questionnaire. Results The total number of reported deaths from all causes was 616 in the 1479 households, ranging from 0 to 9 dead household members. Further data related to the deaths were available for 558 persons, with 294 (52.7%) males and 259 (46.4%) females. A total of 13 women died during pregnancy (5% of deceased women). Non-surgical conditions accounted for 408 (73.5%) of all the total deaths. Symptoms such as body swelling, abdominal distension and injuries were among the common associations of deaths: (6.0%, 5.3% and 4.6%). Almost half of the deaths occurred at home (234 persons - 41.9%) while 288 (51.6%) died at a health facility. Thirty persons died on their way to a health facility. Seventy-two persons (12.9%) who died had sought care from a traditional herbalist prior to attending a health facility. Conclusion In Malawi, body swelling, abdominal distension and injuries were the main conditions reported to be related to surgical causes of death. These occurred while the patients were either waiting at home or at health centre. Some patients initially consult a traditional herbalist prior to seeking modern health care. This delayed the possibility of timely surgical intervention.
Risk factors associated with Hepatitis B virus infection among pregnant women attending antenatal clinic at Felegehiwot referral hospital, Northwest Ethiopia, 2018: An institution based cross sectional study
Authors: Gedefaw Getnet , Waltengus Fikadu , Akililu Almaz , Gelaye Kihinetu 
Published: October 2019

Abstract
Objective

This study aimed to determine the magnitude of serum HBsAg and the risk factors for Hepatitis B virus infection among pregnant women in Bahir Dar. An institution based cross sectional study was implemented from February 1 to May 1, 2018 among 338 pregnant women attending antenatal care clinic at Felegehiwot referral hospital, Bahir Dar, 2018. Systematic random sampling technique was implemented. Blood sample was taken from 338 study participants and serum was tested for Hepatitis B surface antigen (HBsAg) using Enzyme Linked ImmunoSorbent Assay.Results

The overall prevalence of hepatitis B virus infection among pregnant women were 16(4.7%) (95% CI= 2.7, 7.7). Having a history of blood transfusion (AOR=5.2; 95% CI=1.2-22.3), having a history of multiple sexual partners (AOR=4.6; 95% CI=1.1-19.6) and having a history tonsillectomy (traditional surgical procedure) AOR=3.4; 95% CI=1.1-10.1) were the significant risk factors for Hepatitis B virus infection.
MicroRNA Expression Profiles Analysis in Sperm Reveals hsa-mir-191 is an Auspicious Omen of in Vitro Fertilization
Authors: Xu Hua , Wang Xin , Wang Zhikai , Li Jianhui , Xu Zhiming , Miao Maohua , Chen Guowu , Lei Xiangdong , Wu Jun , Shi Huijuan , Wang Ke , Zhang Tiancheng , Sun Xiaoxi 
Published: October 2019

Abstract
Background : MicroRNAs (miRNAs) are a class of noncoding small RNAs that play important roles in many physiological processes by regulating gene expression. Previous studies have shown that the expression levels of total miRNAs increase during mouse embryonic development, and some miRNAs control the regulatory network in development progression. However, few studies have focused on the effects of miRNAs on early human embryonic development. The relationship between miRNAs and early human embryogenesis is still unknown.
Results: In this study, sperm samples from 102 patients with a normal sperm index but treated with assisted reproductive technology (ART) were collected for small RNA sequencing, and the relationships between differentially expressed small RNAs and the fertilization rate (FR), blastocyst rate and high-quality embryo rate (HQER) were analyzed. The sperm samples with high hsa-mir-191 expression had a higher FR, effective embryo rate (EER) and HQER. hsa-mir-191 was used as a single indicator to predict the HQER. The receiver operating characteristic (ROC) curve had an area under the ROC curve (AUC) of 0.686. We also found that hsa-mir-191 expression is correlated with an abnormal sperm rate (cor = 0.29, p < 0.01). We also evaluated the relationship between hsa-mir-34c and early human embryo development in these 102 sperm samples and obtained negative results.
Conclusions: These findings suggest that high hsa-mir-191-5p expression is associated with improved early human embryonic development and that hsa-mir-191-5p could be used as a potential marker to screen high-quality sperm to improve the success rates of in vitro fertilization (IVF).
“I wouldn’t have hit you, but you would have killed your baby:” Exploring Midwives’ Perspectives on Disrespect and Abusive Care in Ghana.
Authors: Author) Millicent Veronica Dzomeku(New Corresponding , Bemah Boamah Mensah Adwoa , Nakua Emmanuel Kweku , Author) Pascal Agbadi(Former Corresponding , Lori Jody R. , Donkor Peter 
Published: October 2019

Abstract
Background: Quality maternal health reduces maternal and neonatal mortality and morbidity. Healthcare professionals, including midwives, are significant agents for the promotion of quality maternal health. Frequents reports of disrespect and abuse of childbearing women by midwives during intrapartum care are becoming common, suggesting that many of these agents are engaging in care practices that compromise quality maternal health. Thus, understanding midwives’ descriptions and experiences of the phenomenon is critical to addressing the threat. on this common emerging public health issue of disrespect and abusive care (D&AC) have been explored, except for midwives. This paper, therefore, explored the understanding of midwives on D&AC and their occurrence in professional practice in a tertiary health facility in Kumasi, Ghana.
Method: An exploratory descriptive qualitative research design using an interpretative approach was employed in the study. Data were generated through individual in-depth interviews. Data saturation was reached with fifteen midwives. The interviews were audio-recorded and transcribed verbatim. Open Code 4.03 was used to manage and analyse the data.
Findings: The midwives understood D&AC. They also confirmed meting out or witnessing colleagues engage in D&AC in their professional practice. The midwives described D&AC as the provision of inadequate care and the overlooking of patient-centred care, and verbal, physical, and psychological abuse. The themes revealed that socio-economic inequalities, provider perception and victim blaming, and health system related factors facilitate D&AC. It emerged that the following marginalized groups were at high risk for D&AC: the non-compliant, mentally ill, HIV/AIDs+, teenagers, poor, and childbearing women on admission at the general labour ward.
Conclusion: The midwives understood D&AC and revealed that it frequently occurred in their professional practice. Frequent in-service training on respectful maternity care and monitoring of care provision in healthcare facilities are needed to eliminate the incidence of D&AC.
Assessing medical impoverishment and associated factors in health care in Ethiopia
Authors: Obse Amarech Guda , Ataguba John E. 
Published: October 2019

Abstract
Background

About 5% of the global population, predominantly in low- and middle-income countries, is forced into poverty because of out-of-pocket (OOP) health spending. In most countries in sub-Saharan Africa, the share of OOP health spending in current health expenditure exceeds 35%, increasing the likelihood of impoverishment. In Ethiopia, OOP payments remained high at 37% of current health expenditure in 2016. This study aims to assess impoverishment resulting from OOP health spending in Ethiopia and examine the factors associated with this impoverishment.Methods

This paper uses data from the Ethiopian Household Consumption Expenditure Survey (HCES) 2010/11. The HCES covered 10,368 rural and 17,664 urban households. OOP health spending includes spending on various outpatient and inpatient services. Impoverishing impact of OOP health spending was estimated by comparing poverty estimates before and after OOP health spending. A probit model was used to assess factors that are associated with impoverishment.Results

Using the Ethiopian national poverty line of Birr 3,781 per person per year (equivalent to US$2.10 per day), OOP health spending pushed about 1.19% of the population (i.e. over 957,169 individuals) into poverty. Living in rural areas (highland, moderate, or lowland) increased the likelihood of impoverishment compared to residing in an urban area. Households headed by males and adults with formal education are less likely to be impoverished by OOP health spending, compared to their counterparts.Conclusion

In Ethiopia, OOP health spending impoverishes a significant number of the population. Although the country had piloted and initiated many reforms, e.g. the fee waiver system and community-based health insurance, a significant proportion of the population still lacks financial protection. The estimates of impoverishment from out-of-pocket payments reported in this paper do not consider individuals that are already poor before paying out-of-pocket for health services. It is important to note that this population may either face deepening poverty or forgo healthcare services if a need arises. More is therefore required to provide financial protection to achieve universal health coverage in Ethiopia, where the informal sector is relatively large.
Effect of Continuation of Antiplatelet Therapy on Survival in Patients Receiving Physician Home Visits
Authors: Osugi Yasuhiro , Ino Teruo , Kobayashi Daiki , Iwata Mitzunaga , Asai Kanici 
Published: October 2019

Abstract
Background: Little is known about the effects of continued antiplatelet therapy in patients who receive physician home visits. This study aimed to evaluate the association of survival with the continuation of antiplatelet drugs in patients who received physician home visits.
Methods: A retrospective cohort study was conducted in a teaching hospital in Toyota, Japan, from April 2015 to October 2018. All patients who received home visits by physicians from the department of Family Medicine of the hospital were included. The primary outcome was the difference in all-cause mortality between patients who were taking antiplatelet drugs and those who were not. The Cox proportional hazards model was applied, adjusted for the patient’s demographic features, activities of daily living, comorbidities, and primary disease requiring home care.
Results: A total of 833 patients were included, of whom 61 received antiplatelet drugs (n = 42 for aspirin, n = 17 for clopidogrel, and n = 8 for cilostazol) and 772 received no antiplatelet drugs. The mean age of the patients was 78.3 years, 409 (49.1%) were male, and 314 (37.7%) had end-stage cancer. During a median follow-up period of 120 days (interquartile range, 29–364), 54.3% of the patients died. Compared with patients not taking antiplatelet drugs, patients taking antiplatelet drugs had a better outcome (p < 0.01, log-rank test) and a significantly lower hazard ratio (0.34; 95% confidence interval, 0.17–0.65; Cox proportional hazards regression).
Conclusions: The continuous prescription of antiplatelet drugs may have beneficial effects on mortality among patients who receive physician home visits.
Ultrasound Assessment of Tensile Stress in Carotid Arteries of Healthy Human Subjects with Varying Age
Authors: Luo Xianghong , Wu Rong , Du Lianfang , Li Zhaojun 
Published: October 2019

Abstract
Background: Arterial remodeling is thought to reflect the adaptation of the vessel wall to mechanical and hemodynamic stimuli and contributes to the progression of cardiovascular and cerebrovascular diseases. Tensile stress (TS) is one of the mechanical properties of the artery wall. The purpose of this study was to investigate the tensile stress change (TS) of carotid artery with varying viscoelasticity in healthy subjects within two groups of different ages. Methods: Forty-five subjects were recruited and randomly assigned into the group at the age above 50 years and below 50 years. The carotid arteries were examined by ultrasonography, using the techniques of shear wave elastography (SWE), shear wave dispersion (SWD) and radiofrequency (RF) -based ultrasound. The following values, including elastic modulus (SWER) and viscous index (SWDR), as well as the peak and mean TS of the left and right carotid arteries (L-PTS, R-PTS, L-MTS and R-MTS) were measured. The correlations between SWER, SWDR and tensile stress were evaluated by using what correlation method.Results: The SWER and SWDR of carotid arteries are lower in the subjects ≥50 years old than the subjects younger than 50 years (SWER, 10.29±9.57 kPa VS 17.24±14.07 kPa; SWDR, 11.99±3.51 (m/s)/kHz VS 13.97±3.71 (m/s)/kHz, P< 0.05). The R-PTS was lower in the group with younger age (P<0.05). Pearson correlation analysis showed that SWER of carotid artery was positively correlated with the parameters of tensile stress，R-PTS, R-MTS, L-PTS and L-MTS( r=0.218, r=0.359, r=0.209 and r=0.369, respectively, P<0.05). However, SWDR of carotid arteries was not significantly associated with TS.Conclusion: Ultrasonic shear wave imaging could be used to quantitatively assess carotid viscoelasticity. The carotid TS was related to its elasticity while little related to its viscosity, suggesting that mechanical properties of the arterial wall might be better revealed.
Comparison of three surgical approaches for thoracolumbar junction (T12-L1) tuberculosis: a multicentre, retrospective study
Authors: Zeng Yanping , Cheng Peng , Tan Jiulin , Li Zhilin , Chen Yuan , Li Li Tao , Zheng Yonghong , Wang Gaoju , Xu Jianzhong , Zhang Zehua 
Published: October 2019

Abstract
Background: The surgical approaches to thoracolumbar junction (T12-L1) tuberculosis were controversial. We aimed to compare the safety and efficacy of three different procedures through a multicentre retrospective study.
Methods: The medical records of thoracolumbar junction tuberculosis patients (n = 177) from January 2005 to January 2015 were collected and reviewed. 45 patients underwent anterior debridement and instrumented fusion (Group A), 52 underwent anterior combined with posterior debridement and instrumented fusion (Group B) and 80 underwent posterior-only debridement and instrumented fusion (Group C). Patients with neurological deficit were 10 in Group A, 23 in Group B, 36 in Group C. All patients had a standard preoperative and postoperative anti - tuberculous therapy regimen. Clinical outcomes, laboratory indexes and radiological evaluation of the three groups were compared. Operations at each centre were performed by the respective senior medical teams of the six different hospitals.
Results: All three surgical approaches achieved bone fusion and pain relief. Cases with neurological deficits had different degrees of improvement after surgery. The operative time was 330.2±45.4min, 408.0±54.3min, 227.9±58.5min, and the blood loss was 744.0±193.8ml, 1134.6±328.2ml, 349.8±289.4ml in groups A, B and C respectively.
The average loss of correction was 5.5±3.7° in group A, 1.6±1.9° in group B, 1.7±2.2° in group C, and the difference between groups except B vs C were of statistically significant (P < 0.05).
Conclusions: For patients with thoracolumbar junction (T12-L1) tuberculosis, the posterior-only procedure is the better than the anterior-only procedure in the correction of kyphosis and maintenance of spinal stability. The posterior-only procedure is recommended because it achieves the same efficacy as combined procedure with shorter operation time, less blood loss and trauma.
Hydro-alcoholic extract of Otostegia integrifolia Benth (Lamiacae) produces peripheral antinociception and central analgesia in mice models
Authors: Woldesenbete Abel Degu , Tesfaye Rediet 
Published: October 2019

Abstract
Objective Pain and inflammatory conditions are the commonest health problems reported to this date. The advent of numerous pharmacologic agents cannot still abated the demand due to the associated side effects, the search for satisfactory new molecule particularly from herbal sources is the main endeavor as experience shows. Thus, this study evaluated the analgesic activity of the 80% methanol leaf extract of Otostegia integrifolia in mice models of pain.Results Analgesic effect of various oral doses of the hydro-alcoholic extract (100, 200 and 400 mg/kg) was determined in hot plate and acetic acid induced writhing methods. In all models, the higher doses of the extract (400mg/kg) exhibited significant central and peripheral analgesic activities without significant difference compared to the standard drugs morphine and aspirin respectively. However, the lowest dose of the extract lacks central analgesic activity. The experimental finding from this study corroborates perhaps the presence of similar constituents within the genus Otostegia that might be responsible for the analgesic effects observed on other species. Thus, Otostegia integrifolia could be potential source for development of new analgesics.
Effects of Comprehensive Sexuality Education on the comprehensive knowledge and attitude to condom use among first-year students in Arba Minch University: a quasi-experimental study
Authors: Boti Negussie , Hussen Sultan , Shegaze Mulugeta , Shibru Simon , shibiru Tamiru , Zerihun Eshetu , Godana Wanzahun , Abebe Sintayehu , Gebretsadik Woyinshet , Desalegn Nathan , Temtime Zebene 
Published: October 2019

Abstract
ABSTRACT
Objective: To assess the effect of comprehensive sexuality education on the comprehensive knowledge and attitude to condom use among first-year students at Arba Minch University .
Results: A total of 832 students participated at a baseline, and 820 students participated at the posttest. This study found that there was a significant effect on changing students’ knowledge and attitude towards a condom. In the education group, the students’ average change of comprehensive condom knowledge score was 0.229 higher than the average score of students' in the control group (ATE=0.229, 95% CI, 0.132 to 0.328; p < 0.001). The average change of attitude toward condom score of students’ in the education group was 1.834 higher than the average change score of students’ in the control group (ATE=1.834, 95% CI, 1.195 to 2.772; p < 0.001).This study provides further evidence on the effectiveness of comprehensive sexuality education in terms of knowledge and attitude towards a condom. Therefore, the implementation of this education should be strengthened in order the prevent youths from STI/HIV and unintended pregnancies.
Prediction of Ebola Virus Disease (EVD) infestation trends across fruit bats migratory seasons
Authors: NAMAHORO Jean Pierre , Haijun Xiao 
Published: October 2019

Abstract
Background : The majority of the rural populace of West and Central Africa participate actively in bushmeat commodity trade. The peak of this trade usually occurs during the migration of massive flocks of fruit bats. Unfortunately, this commercial period happens to coincides with the most conducive time for the spread of Ebola Virus Disease (EVD) which is transmitted by these fruit bats. We, therefore, conducted this study to predict EVD infestation trend among individuals who might be vulnerable and/or infected (hunters, vendors, and consumers of bushmeat) as a result of this seasonal bats migration. Methods: A secondary data collected in Ghana and semi-structured questionnaires were administered to international students from 7 countries (Democratic Republic of Congo (DRC), Ghana, Liberia, Zambia, Gabon, Guinea, and Ivory-Coast) and responses collated were used in this study. Bivariate correlation, probabilistic transmission rate of EVD, and probabilistic model (P-SIR) were employed to predict susceptible and infected individuals. Results : In all affected countries, it was observed that; there was a yearly bats’ migration pattern. 80 % of all interviewees confirmed that hunting, trading and consuming of bats influenced the rapid spread of EVD. The bivariate correlation between fruit bats and people involved in the bushmeat commodity chain was significant (p < 0.05) and the probability of infected bats were equally significant across the sampled countries. The estimated probabilistic rate was between 0.0099 and 0.01120, while individuals susceptible to EVD were predicted to be approximately between 5 and 45 (hunters), 0-18 f(vendors), and 25-90 (consumers). Conclusion : The migratory season of fruit bats contributes to EVD transmission in the most affected countries. People should avoid bushmeat consumption or eradicate all activities leading to the interaction with fruit bats to reduce the spread of EVD (Ebola) especially during the migratory seasons. Policy-makers and government agencies should also put in mechanisms that will protect their citizens during the fruit bats season. Keywords : bushmeat commodity chain, Ebola, migration season, EVD, fruit bats