bluuebunny/crossref_metadata_2025_split huggingface dataset:
Determinants of First Line Antiretroviral Treatment Failure among Patients on Highly Active Antiretroviral Therapy in selected Public Hospitals Jimma, Southwest Ethiopia a Case Control Study
Authors: Asfaw Amrachu Bekele , Tekelehaimanot Aderajew Nigusie , Shewanew Tamirat , Gudina Esayas Kebede , Getnet Masrie , Amdisa Demuma , Lemma Tefera Belachew , Dadi Lelisa Sena 
Published: July 2019

Abstract
Background: Identifying determinant factors of antiretroviral therapy (ART) treatment failure are crucial to achieving 90-90-90 treatment target to help end AIDS epidemic by 2020. However, evidences on determinants of first line ART failure in Ethiopia are limited. Hence, the aim of this study was to assess determinants of first line ART failure among patients attending ART care in selected Public Hospitals Jimma, Southwest Ethiopia.

Methods: A case control study was conducted in March 2018 on sample of 384(288 controls and 96 cases) adult people living with HIV/AIDS (PLWHA). All available cases were enrolled in the study whereas controls were selected using simple random sampling. Cases were HIV patients aged 15 years or older who were on first line ART regimen with documented treatment failure (virologic, immunologic or clinical). Controls were HIV patients aged 15 years or older who were on first line ART regimen but without evidence of therapeutic failure. Data was extracted from electronic database and supplemented by data collected through interviewer administered questionnaire. Bivariate and Multivariate logistic regression analyses were used. Adjusted odds ratios and 95% confidence interval were used to report independently associated factors with the first line ART failure at P-value<0.05.

Results: Median ages of cases and controls were 28 (IQR 25-32) and 27 (IQR23-33), respectively. Being urban resident (AOR:2.2; 95%CI: 1.1, 3.6), smoking (AOR:5.9; 95%CI:3.2, 10.8), Khat use (AOR:2.2; 95%CI:1.3,3.7), poor treatment adherence (AOR: 2.2; 95% CI: 1.1,4.5), tuberculosis coinfection (AOR: 3.9; 95% CI:2.2, 6.8), prior exposure to ART (AOR: 3.8; 95% CI:1.7, 8.1), zidovudine based regimen (AOR: 4.8; 95% CI: 2.5,9.0) and median duration on treatment of more than 73 months (AOR:1.9; 95% CI:1.2, 3.3) were independently associated with first line treatment failure.

Conclusions: Multiple factors such as being urban resident, TB co-infection, poor treatment adherence, and zidovudine based regiment were independently associated with first line ART failure. Thus, strategies designed to curb the HIV pandemic should focus on these factors, among others, to achieve the ambitious target of ending AIDS pandemic by 2020 set by UNAIDS.
Key words: determinants, first line ART failure, HIV/AIDS, Jimma Zone, Public hospitals
Variation of malaria cases, parasite density and the multiplicity of Plasmodium falciparum infection throughout the year at three different health centers in Brazzaville, Republic of Congo
Authors: MAYENGUE - PEMBE ISSAMOU , Batsimba Dezi Kouhounina , Niama Roch Fabien , Ottia Reyna Ibara , Malonga-Massanga Alida , Fila-Fila Grâce Petula Urielle , Ahombo Gabriel , Kobawila Simon Charles , Parra Henri Joseph 
Published: July 2019

Abstract
Background: In the Republic of Congo, hot temperature and seasons distortions observed may impact seasonal variations of the development of malaria parasites. We investigate the variation of malaria cases, parasite density and the multiplicity of Plasmodium falciparum infection throughout the year in Brazzaville.

Methods: From May 2015 to May 2016, suspected patients with uncomplicated malaria were enrolled at the Hôpital de Mfilou, CSI « Maman Mboualé», and the Laboratoire National de Santé Publique. For each patient, thick blood was examined and parasite density was calculated. After DNA isolation, MSP1 and MSP2 genes were genotyped.

Results:
A total of 416, 259 and 131 patients with suspected malaria were enrolled at the CSI «Maman Mboualé», Hôpital de Mfilou and the Laboratoire National de Santé Publique respectively. Proportion of malaria cases and geometric mean parasite density were higher at the CSI «Maman Mboualé» compared to over sites (P-value ˂0.001). However the multiplicity of infection was higher at the Hôpital de Mfilou (P-value ˂0.001).
At the Laboratoire National de Santé Publique, malaria cases and multiplicity of infection were not influenced by different seasons. However, variation of the mean parasite density was statistically significant (P-value ˂0.01).
Higher proportions of malaria cases were found at the end of main rainy season including the beginning of the main dry season at the Hôpital de Mfilou and the CSI «Maman Mboualé»; while, lowest proportions were observed in September and January and in September and March respectively. Higher mean parasite densities were found at the end of rainy seasons with persistence at the beginning of dry seasons. The lowest mean parasite densities were found during dry seasons, with persistence at the beginning of rainy seasons. Fluctuation of the multiplicity of infection throughout the year was observed without any impact of different seasons.

Conclusion:
The current study suggests that malaria transmission is still variable between the north and south parts of Brazzaville. Seasonal fluctuations of malaria cases and mean parasite densities were observed with some extension to different seasons. Thus, both meteorological and entomological studies are needed to update the season’s periods as well as malaria transmission intensity in Brazzaville.
Accumulate evidence for IP-10 in diagnosing pulmonary tuberculosis
Authors: Qiu Xia , Xiong Tao , Su Xiaojuan , Qu Yi , Ge Long , Yue Yan , Zeng Yan , Li Wenxing , Hu Peng , Mu Dezhi 
Published: July 2019

Abstract
Backgrounds

Pulmonary tuberculosis (PTB) is a major health and economic burden. Accurate PTB detection is an important step to eliminating TB globally. Interferon gamma-induced protein 10 (IP-10) has been reported as a potential diagnostic marker for PTB since 2007. In this study, a meta-analysis approach was used to assess diagnostic value of IP-10 for PTB.

Methods

Web of Science, PubMed, the Cochrane Library, and Embase databases were searched for studies published in English up to February 2019. The pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and hierarchical summary receiver operating characteristic (HSROC) curve were estimated by a HSROC model.

Results

Eighteen studies including 2836 total participants met our inclusion criteria. The pooled sensitivity, specificity, PLR, and NLR of IP-10 for PTB detection were 86%, 88%, 7.00, and 0.16, respectively. The pooled DOR was 43.01, indicating a very powerful discriminatory ability of IP-10. Meta-regression showed that there was no heterogeneity with respect to TB burden, study design type, age, IP-10 assay method, IP-10 condition and HIV-infection status.

Conclusions

Our results showed that IP-10 is a promising marker for differentiating PTB from non-TB.
Adapting a nurse-led primary care initiative to cardiovascular disease control in Ghana: A qualitative study
Authors: Haykin Leah , Francke Jordan A. , Abapali Aurelia , Yakubu Elliasu , Dambayi Edith , Jackson Elizabeth , Aborigo Raymond , Awuni Denis , Nonterah Engelbert A. , Oduro Abraham , Bawah Ayaga , Phillips James F. , Heller David J 
Published: July 2019

Abstract
Background

CVD is the leading cause of morbidity and mortality worldwide, and its prevalence is rising in Ghana. The Community-Based Health Planning and Services (CHPS) initiative has used community-level clinics, home visits by nurses, and outreach services to decrease maternal and child mortality across Ghana. However, CHPS currently lacks capacity to screen for or treat CVD and its risk factors.

Methods

We conducted in-depth interviews (IDIs) with 21 nurse community health officers (CHOs) and 10 supervising sub-district leaders (SDLs) to identify factors that constrain or facilitate CHPS screening and treatment for CVD through the World Health Organization’s HEARTS protocol in the rural communities of the Kassena-Nankana East and West districts of Ghana. We transcribed audio recordings of the interviews, coded their content, and analyzed codes for key themes.

Results

Respondents spoke to CVD care barriers across three themes: community demand for CVD care; community access to CVD care; and provider capacity to render CVD care. CHOs and SDLs noted that community members were often unaware of CVD, despite high reported local prevalence of risk factors such as alcohol use and stress. Moreover, community members were unable to travel to or pay for treatment once diagnosed. CHOs lacked training on CVD and its risk factors, as well as medications and supplies to treat conditions such as high blood pressure. However, CHOs and SDLs recognized the importance of CVD care, expressed interest in acquiring further training, and emphasized the need to improve logistical support for primary care as a precondition for CVD care.

Conclusion

Nurses and supervisors associated with the CHPS program voiced multiple obstacles to CVD care, but also listed several feasible steps to address them. Initiatives such as CVD-focused training; provision of essential CVD equipment and pharmaceuticals; community education campaigns; and transportation to aid patients and providers could address these barriers. Future work will explore the feasibility and acceptability of these interventions among staff and community members, in preparation for a locally adapted pilot initiative drawing from the HEARTS initiative designed to control CVD risk factors such as hypertension, depression, and alcohol abuse.
Comparison of the therapy effect of aflibercept and ranibizumab in patients with neovascular retinal pigment epithelium detachment identified by fluorescence angiography and optical coherence tomography angiography
Authors: Ruebsam Anne , Dominika Pohlmann , Tina Dietrich-Ntoukas , Bert Müller , Joussen Antonia M , Winterhalter Sibylle 
Published: July 2019

Abstract
Background

To report on the current methods for choroidal neovascularization (CNV) detection and the clinical outcome of intravitreal therapies in patients with neovascular pigment epithelium detachment (PED).

Methods

Retrospective, interventional cohort study on 77 eyes of 59 patients. Inclusion criteria were a neovascular PED, identified by fluorescence angiography (FA) or/and optical coherence tomography angiography (OCTA) treated with aflibercept (16 eyes) or ranibizumab monotherapy (36 eyes) or with at least three injections of ranibizumab, with a therapy switch to aflibercept in case of persistent fluid (25 eyes). The therapy regimen was a pro re nata (PRN) scheme with an upload phase of three monthly injections.

Outcome measures were sensitivity of CNV detection and evaluation of CNV activity at baseline on FA compared to OCTA, the change in highest retinal prominence (HRP) and PED size, assessed by spectral - domain OCT (SD-OCT), and the change in best-corrected visual acuity (BCVA) three months after therapy initiation in the monotherapy groups or after the switch.

Results

Sensitivity of CNV detection was slightly superior for FA (0.786) compared to OCTA (0.706), whereas CNV activity evaluation was superior on OCTA. HRP significantly decreased after aflibercept (p<0.001) or ranibizumab monotherapy (p<0.001), and after therapy switch to aflibercept (p<0.001) in ranibizumab refractory patients. Corresponding BCVA improved in these groups, but without statistical significance (p=0.46; p = 0.11; p=0.19). PED size significantly decreased after aflibercept monotherapy (p=0.001) or after therapy switch to aflibercept (p<0.001), but not after ranibizumab.

Conclusions

The combination of FA and OCTA offers significantly improved visualisation, quantification, and predictability of CNV activity in neovascular PED. Aflibercept and ranibizumab are effective treatment options for neovascular AMD with PED, with a stronger effect of aflibercept on the PED itself. Furthermore, aflibercept appears to be a valuable tool for the management of patients unresponsive to ranibizumab.
Comparative perioperative outcomes associated with anesthetic technique for total hip arthroplasty: a retrospective cohort study
Authors: Fang Qing , Wang Yan-Lin , Zhang Zong-Ze , Wang Hong-Yu , Luo Huan , Song Xue-Min 
Published: July 2019

Abstract
Background

The influence of anesthetic technique on perioperative outcomes for total hip arthroplasty remains poorly elucidated. We studied a sample of total hip arthroplasty recipients, hypothesizing that spinal anesthesia has a superior impact on perioperative outcomes.

Methods

We conducted a retrospective cohort study of patients undergoing total hip arthroplasty between December 1, 2012 and October 31, 2018 in Zhongnan Hospital of Wuhan University. The primary outcome was cardiorespiratory complications. Secondary outcomes were intraoperative hypotension, packed red blood cells (pRBCs) transfusion, prolonged hospital length of stay, intensive care unit (ICU) use, life-threatening event, and mortality. Multivariable regression analyses were used to identify the impact of anesthetic technique on perioperative outcomes.

Results

Among the 1,233 patients, 561 had general anesthesia, and 672 had spinal anesthesia. Patients were averagely younger in general group than in spinal anesthesia group, (69.0 and 72.1 years, respectively; P < 0.001), with insignificant difference in comorbidity burden. When spinal anesthesia was used, the hospital length of stay, ICU times, and volume of pRBCs transfusion were significant decreased (P < 0.05). Life-threatening event and in-hospital mortality occurred frequently in general anesthesia, but with insignificant difference. After adjusting for covariates, spinal anesthesia was associated with 54.3% reduction in cardiorespiratory complications (adjusted odds ratio [OR]: 0.457, 95% confidence interval [CI]: 0.320–0.652; P < 0.001). Spinal anesthesia was favorably associated with decreased odds for intraoperative hypotension (OR: 0.653, 95% CI: 0.494–0.863; P = 0.003) and ICU use (OR: 0.371, 95% CI: 0.268–0.514; P < 0.001). The use of spinal anesthesia was not found to inﬂuence the risk of pRBCs transfusion (adjusted odds ratio [OR]: 0.823, 95% CI: 0.631–1.073; P = 0.149) and prolonged hospital length of stay (adjusted odds ratio [OR]: 0.886, 95% CI: 0.684–1.148; P = 0.360).

Conclusions

Compared with general anesthesia, spinal anesthesia for total hip arthroplasty was associated with decreased rates of cardiorespiratory complications, intraoperative hypotension, and ICU use.
Prevalence of undiagnosed mild cognitive impairment in elderly patients undergoing thoracic surgery and its relationship with postoperative outcome: a prospective cohort study
Authors: tong chaoyang , wu dehua , shen yaofeng , Xu meiying 
Published: July 2019

Abstract
Background

The prevalence of undiagnosed mild cognitive impairment (MCI) in elderly patients scheduled for thoracic surgery and its association with adverse clinical outcomes is still unproven.

Methods

We enrolled 170 patients 65 year of age or older who were scheduled for thoracic surgery. 82 males and 88 females with ASA grade II-III. All the elderly patients were tested with Chinese modified version of MoCA preoperatively. According to the test results, they were divided into two groups: group N (MoCA score>25) and group AN (MoCA score≤25). Outcomes included the hospital length of stay (primary outcome), the length of stay in patients with PPCs (LOS-PPCs), the pulmonary complications (atelectasis, pulmonary infection, respiratory failure) and other complications (blood transfusion, chylothorax, new arrhythmia, myocardial infarction and acute cerebral infarction) (secondary outcomes). Data were analyzed using univariate and multivariate analyses.

Results

Seventy-four of 154 (49%) patients screened positive for probable mild cognitive impairment (MoCA ≤ 25) in the final analyses. The hospital length of stay and LOS-PPCs in elderly patients with mild cognitive impairment preoperatively were significantly longer than those with group N (P<0.05). Multivariate stepwise regression showed that preoperative MCI was an independent risk factor for prolonging the hospital length of stay and LOS-PPCs. Patients with a MoCA score less than or equal to 25 were more likely to have a longer hospital length of stay (OR = 2.355, 95% CI =1.137 to 4.877, P=0.021) and LOS-PPCs (OR = 6.867, 95% CI =1.116 to 42.257, P=0.038), but not related to increase the incidence of postoperative pulmonary complications (OR = 0.955, 95% CI =0.280 to 3.254, P=0.941) and other complications (OR = 1.687, 95% CI =0.502 to 5.665, P=0.398) compared to those with a MoCA score greater than 25.

Conclusions

The prevalence of undiagnosed probably mild cognitive impairment among elderly patients scheduled for thoracic surgery is high (49%). Such impairment is associated with a longer hospital stay and LOS-PPCs, while it is not possible to conclude that it is related to the incidence of pulmonary complications and other complications after surgery.
Unilateral visual impairment in a patient undergoing chemotherapy: a case report and clinical findings
Authors: Yuan Xia , Feng Yuliang , Li Dan , Li Mei 
Published: July 2019

Abstract
Background: Visual impairment occurred as an infrequent form of chemotherapeutic toxicity and was often underestimated despite of several reports. We described a case of acute unilateral visual impairment after one cycle of intravenous chemotherapy of normal dose, aimed at raising attention to chemotherapy-induced ocular toxicity.
Case presentation: During chemotherapy, the patient developed progressive vision loss in the right eye. She had worse visual acuity of 0.4 in the right eye (VOD0.4) than before (VOD1.0) after one cycle of intravenous chemotherapy. No evidence of ocular infiltration was observed from the cerebral magnetic resonance imaging (MRI). During her follow-up period we documented the ophthalmologic examinations including visual acuity, visual field (VF), visual evoked potential (VEP), electroretinogram (ERG), fundus photograph (FP), fundus fluorescein angiography (FFA) and optical coherence tomography (OCT). Ophthalmoscope examination and fundus photograph showed optic disc edema, fuzzy boundary and linear hemorrhages in the right eye. Fundus fluorescein angiography (FFA) revealed capillary underdevelopment at the nasal and superior temporal area of optic disc in the early phase and capillary fluorescein leakage in the late phase. The result of VEP test suggested that the function of optic nerve was impaired. A diagnosis of nonarteritic anterior ischemic optic neuropathy (NAION) was made by an ophthalmologist and the patient received prednisone combined with neuroprotective drugs, which did not work. After cessation of chemotherapy, her impaired vision gradually improved.
Conclusions: This is the first reported case of acute visual impairment in a patient undergoing chemotherapy of normal dose. It is warranted that cancer patients benefiting from chemotherapy simultaneously suffer from the risk of vision loss.
Mečislovo Reinio pedagogikos idėjos ir jų reikšmė šiandienos dorinio ugdymo programose
Authors: Pipiras Nerijus 
Published: July 2019

Straipsnyje pristatomas Thomo Groome’o modelis, pagal kurį parengtos dorinio ugdymo (tikybos) programos Lietuvos bendrojo ugdymo pradinėse ir pagrindinėse mokyklose. Šiame modelyje krikščioniškosios vertybės atpažįstamos sprendžiant gyvenimiškas problemas. Galimybė apsispręsti ir būti atsakingam už savo sprendimus, mokymasis daryti argumentuotas išvadas matant dabarties problemas – pagrindinis dorinio ugdymo tikslas. Vertybės neturi būti atsietos nuo gyvenimo. Atvirkščiai, jos turi atsispindėti problemų sprendimuose. Tam reikalingas platus, visuminis požiūris.Dorinio ugdymo siekinys – visapusiškai ugdyti asmenybę, todėl pats procesas pasižymi interdiscipliniškumu. Visa tai akcentavo viena intelektualiausių tarpukario Lietuvos asmenybių – arkivyskupas Mečislovas Reinys.Antroje straipsnio dalyje apžvelgiama keletas arkivyskupo M. Reinio straipsnių, kuriuose gvildenama visapusiška asmenybės ugdymo svarba. Savo mintis apie ugdymo svarbą arkivyskupas publikavo tiek moksliniuose, tiek periodiniuose leidiniuose, pats iš karto grįžęs po studijų į Lietuvą, matė žmogaus, kaip asmenybės, ugdymo svarbą.
ÜNİVERSİTE MEZUNU UZUN SÜRELİ GENÇ İŞSİZLERİN EĞİTİM VE ÇALIŞMA YAŞAMI BEKLENTİSİ: ANKARA ÖRNEĞİ
Authors: ERİKLİ Suheyla , Bayat Bülent 
Published: July 2019

Uzun süreli işsizlik kavramı bireyin en az 1 yıl işsiz kalma durumunu ifade etmektedir. Eğitimli bireylerin uzun süreli işsiz olması ise içerisinde bir çelişki barındırmaktadır. Zira beşeri sermaye teorisine göre bireyin eğitim düzeyi arttıkça istihdam edilebilirliği de artacaktır. Diğer yandan yüksek düzeyde eğitime sahip bireylerin daha düşük düzeyde eğitime sahip bireylere göre işgücü piyasasında daha avantajlı olacağı varsayılmaktadır. Bu çalışmanın amacı amacı lisans veya lisansüstü eğitime sahip olup, uzun süreli işsiz olan gençlerin öncelikle eğitim ve çalışma yaşamı beklentilerini tespit etmektir. Araştırma Nicel araştırma yöntemlerinden biri olan “tarama (survey) modeline” göre tasarlanmıştır. Kartopu örnekleme yolu ile 420 katılımcıya anket uygulanmış; bazı anketlerin eksik bilgi içermesi nedeniyle veri analizi 375 anket üzerinden gerçekleştirilmiştir. Araştırma sonucunda Çalışma Yaşama Sonuç Beklentisi Ölçeği ile Üniversite Eğitimi Sonuç Beklentisi Ölçeği Pearson koreleasyon analizi ile test edilmiş; değişkenler arasında istatistiksel olarak doğrusal bir ilişki olduğu bulunarak, H1 hipotezi kabul edilmiştir.
The Application of Hydrogels Based on Natural Polymers for Tissue Engineering
Authors: Taghipour Yasamin Davatgaran , Hokmabad Vahideh Raeisdasteh , Del Bakhshayesh Azizeh Rahmani , Asadi Nahideh , Salehi Roya , Nasrabadi Hamid Tayefi 
Published: July 2019

:Hydrogels are known as polymer-based networks with the ability to absorb water and other body fluids. Because of this, the hydrogels are used to preserve drugs, proteins, nutrients or cells. Hydrogels possess great biocompatibility, and properties like soft tissue, and networks full of water, which allows oxygen, nutrients, and metabolites to pass. Therefore, hydrogels are extensively employed as scaffolds in tissue engineering. Specifically, hydrogels made of natural polymers are efficient structures for tissue regeneration, because they mimic natural environment which improves the expression of cellular behavior.:Producing natural polymer-based hydrogels from collagen, hyaluronic acid (HA), fibrin, alginate, and chitosan is a significant tactic for tissue engineering because it is useful to recognize the interaction between scaffold with a tissue or cell, their cellular reactions, and potential for tissue regeneration. The present review article is focused on injectable hydrogels scaffolds made of biocompatible natural polymers with particular features, the methods that can be employed to engineer injectable hydrogels and their latest applications in tissue regeneration.