bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementation of a new program of gestational diabetes screening and management in Morocco: A qualitative exploration of health workers’ perceptions
Authors: Utz Bettina , Assarag Bouchra , Lekhal Touria , Damme Wim Van , De Brouwere Vincent 
Published: August 2019

Abstract
Background

Gestational diabetes mellitus (GDM) is associated with an increased risk for a future diabetes mellitus in women and their children. As linkage between maternal health and non-communicable diseases, antenatal care plays a key role in the primary and secondary prevention of GDM associated adverse outcomes. While implementing a locally adapted GDM screening and management approach through antenatal care services at the primary level of care, we assessed its acceptability by the implementing health care providers.

Methods

As part of a larger implementation effectiveness study assessing a decentralized gestational diabetes screening and management approach in the prefecture of Marrakech and the rural district of Al Haouz in Morocco, we conducted four focus group discussions with 29 primary health care providers and seven in-depth interviews with national and regional key informants. Looking at the main themes screening, diagnosis, treatment and service organization, we thematically analyzed the data using a combined de- and inductive approach.

Results

The intervention of screening and managing women with gestational diabetes added value to existing antenatal care services but presented an additional workload for first line health care providers. Lack of knowledge about gestational diabetes in the community but also by private health care providers demanded more time for counseling. Nurses had to adapt recommendation on diet to the socio-economic context of patients. Despite the additional task, especially nurses and midwives felt motivated by their gained capacity to detect and manage gestational diabetes and the ability to take decisions on follow-up.

Conclusions

Detection and initial management of gestational diabetes is an acceptable strategy to extend the antenatal care service offer in Morocco and to facilitate service access for affected pregnant women. Despite its additional workload, gestational diabetes management can contribute to the professional motivation of primary level health care providers.
Low Proportion of Women who came knowing their HIV Status at First Antenatal Care Visit, Uganda, 2012-2016: A Descriptive Analysis of Surveillance Data
Authors: Nakanwagi Miriam , Bulage Lilian , Kwesiga Benon , Ario Alex Riolexus , Birungi Doreen Agasha , Lukabwe Ivan , Matovu John Bosco , Taasi Geoffrey , Nabitaka Linda , Mugerwa Shaban , Musinguzi Joshua 
Published: August 2019

Abstract
Background

HIV testing is the cornerstone for all HIV care and support services, including Prevention of Mother to Child Transmission of HIV (PMTCT). The earlier women of reproductive age know their HIV status, the better informed their reproductive decisions and their infants’ outcomes may be. We analyzed trends in known current HIV status among pregnant women attending their first antenatal care visit (ANC1) in Uganda, 2012-2016.

Methods

We conducted secondary data analysis using District Health Information Software2 data on all pregnant women who came for ANC1 during 2012-2016. Women who brought documentation with them to ANC1 of an HIV test within the previous four weeks or an HIV care card as evidence of being in HIV care were considered as knowing their HIV status in antenatal care clinics. We calculated proportions of women with known current HIV status at ANC1, and described the linear trends both nationally and regionally. We used improved Poisson regression with generalized linear models to test the statistical significance of the trend.

Results

There was no significant difference in the number of women that attended ANC1 visits over the years 2012 to 2016. The proportion of women that came with known HIV status was highest at 6.9% in 2016 and this was an increasing trend (p<0.001). Most of the regions had an increase in trend except the West Nile and Mid-Eastern (p<0.001). The proportion of women that came knowing their HIV positive status at ANC1 is slightly higher than that of women that were newly tested HIV positive at ANC1 in 2015 and 2016.

Conclusion

Although the gap in women that come at ANC1 without knowing their HIV positive status might be reducing, still a large proportion of women who were infected with HIV did not know their status before their ANC1 HIV test, indicating a major public health gap. Therefore, more efforts are still required to achieve full PMTCT. In light of the considerable number that comes not knowing their HIV positive status at ANC1, we recommend advocacy for early ANC attendance and hence HIV testing so that timely PMTCT interventions can be made.
Age-related anxiety and self-assessment of perinatal depression risk: A web-based study
Authors: shibata Ayako , Shigemi Daisuke , Maruo Nobuyuki 
Published: August 2019

Abstract
Purpose: To investigate the relationship between pre- and postpartum anxiety and self-assessment of perinatal depression (PD) risk in pregnant women.
Methods: We recruited volunteers for an anonymous questionnaire survey using an app service for pregnant and nursing mothers (Luna Luna Baby, MTI Co Ltd) from November 19 to 30, 2018. The questionnaire consists of 30 items on anxiety during and after pregnancy. Multivariate logistic regression analysis was performed with age, occupation, history of pregnancy, and self-assessment of PD risk as explanatory variables. All statistical analyses were performed using Stata software, Version 15.0. The study was approved by the ethics committee.
Results: A total of 1987 pregnant women responded. In both pregnancy and postpartum periods, women aged 19 years or younger felt the most anxious about their financial situation (17/25, 68%). Women in their 20's to 30's were the most worried about the baby’s safety (1162/1893,60.1%). Those with a higher self-estimated risk of PD tended not to list the baby’s safety as an anxiety item, but listed money, financial situation, and mother's own health as concerns. The percentage of those who worried about the baby’s safety was significantly lower in women with a self-assessed PD risk of 90% or higher.
Conclusions: The causes of the anxiety in the pregnancy and postpartum periods a may be correlated with age and risk of PD. Health care providers may need to consider the possibility of PD development in pregnant women with high anxiety regarding their financial conditions, health, or raising children.
Mortality rate and associated factors among preterm babies born in Moshi, north – Tanzania: A prospective cohort study
Authors: Chengo Rose , Mowo Frida , Tarimo Clifford Silver , Mahande Michael Johnson 
Published: August 2019

Abstract
Introduction

Globally, approximately 15 million babies are born before term each year. Of these, more than 1 million die within the first 28 days of their life. Understanding the mortality rate and its predictors during neonatal period among preterm babies is crucial to help designing interventions to avert the situation. This study aimed to determine the neonatal mortality rate and associated factors among preterm babies born in Moshi Municipality, Tanzania.

Methodology

A prospective cohort study was conducted in three hospitals in Moshi Municipality from December 2016 to May 2017. All live births at gestational age of <37 weeks and those of <24 hours were studied. Babies who died prior to gestation age assessment and those whose mother did not consent were excluded. Cox regression model was used to estimate maternal and fetal factors associated with neonatal mortality. A p-value of <0.05 was considered statistically significant.

Results

A total of 311 of preterm babies were recruited from 265 mothers and were followed for 28 days. The neonatal mortality rate was 6.5deaths per 1,000 preterm live births (95% CI: 4.83-8.61). It was higher among extremely preterm babies compared to very preterm ones (HR: 38.24; 95% CI: 16.62-87.96) versus (HR: 8.01; 95% CI: 3.96-16.20) respectively. Apgar score of <7 at 1st minute (HR: 14.03; 95% CI: 7.27-27.06), respiratory distress syndrome (HR: 8.14; 95% CI: 4.27-15.54) and antepartum hemorrhage (HR: 3.32; 95% CI: 1.49-7.39) were significantly associated with neonatal mortality.

Conclusion

Preterm birth complication is the major cause of neonatal death in the study setting. Interventions to address the identified risk factors may reduce neonatal mortality among preterm babies.
Burden of stillbirths and associated factors in Yirgalem Hospital, Southern Ethiopia: a facility based cross-sectional study
Authors: Mengesha Sintayehu , Dangisso Mesay Hailu 
Published: August 2019

Abstract
Abstract
Background
Stillbirth is an adverse pregnancy outcome of public health importance causing considerable psychosocial burden for parents and their family. Studies on stillbirth are scarce in southern Ethiopia. An assessment of stillbirths and associated factors in health care settings helps in devising strategies for tailored interventions. Therefore, we assessed the burden of stillbirths and associated factors in Yirgalem Hospital, southern Ethiopia
Methods: A facility based cross-sectional study was conducted between 1 August 2015 and 30 July 2016. We randomly selected medical records of women from a hospital delivery registry. The data were coded, entered, cleaned, and analysed by SPSS version 20. Bivariate analysis was employed to assess the association between independent and dependent variables. Multivariate logistic regression was used to identify independent risk factors for stillbirths and to control for confounding. The ethical clearance for the study was obtained from the Institutional Review Board of College of Medicine and Health Sciences, Hawassa University.
Results: Of 374 reviewed records of women, 370 were included for the study. The magnitude of stillbirths was 92 per 1000 births. Majority, 15 (44.1%) of fetal deaths occurred after admission to the hospital. In multivariate logistic regression, stillbirths were higher among low birth-weight babies (<2500grams) (AOR: 10.70, 95% CI 3.18-35.97) than normal birth-weight babies (2500-<4000). Women who experienced a prolonged labour for more than 48 hours were 12 times (AOR: 12.15, 95% CI 1.76-84.12) more likely to have stillbirths than women without a prolonged labour. Women with obstetric complications were 19.8 times more likely to have stillbirths than women without obstetric complications. Similarly, women with at least 2 pregnancies were more likely to have stillbirths than women with less than two pregnancies (AOR: 4.39, 95% CI 1.21-15.85).
Conclusion: We found a higher proportion of stillbirths than the National report and studies from other countries. Modifiable risk factors contributed to a higher risk of stillbirths in the study setting. Therefore, early identification and management of complications and reducing delays in getting care at each level of health system could avert preventable stillbirths.
Key words: stillbirths, pregnancy outcomes, maternal health, Sothern Ethiopia
Systematic review of the effectiveness of aromatherapy in labor
Authors: Suzuki Hitomi , Kato Mika , Shinozaki Katsuko , Lopes Katharina da Silva , Ota Erika 
Published: August 2019

Abstract
Background

Clinical practice with aromatherapy has become an expanding area for nursing, and is considered one of the most popularly used complementary treatments. However, there is insufficient evidence about the benefits of aromatherapy for pain management and other related discomforts in labor. We aimed to evaluate the effects of aromatherapy for women during delivery particularly for pain relief.

Methods

AMED, ClinicalTrials.Gov, CINAHL, Cochrane Library, EMBASE, MEDLINE, PubMed, and WHO ICTRP were searched in August 2017. For updates, these databases were searched from July 2017 to July 2018. This study included randomized controlled trials (RCTs) and quasi-RCTs for normal pregnancy women who were experiencing labor onset, and compared aromatherapy with standard care or control.

Results

Six RCTs from six reports, and four quasi-RCTs from five reports were included (1238 pregnant women). The trials found significant difference between groups for the primary outcomes of pain relief on the latent (MD -1.56, 95%CI: -2.45 to -0.67, low certainty of evidence) and early active phase (MD -1.69, 95%CI: -2.50 to -0.89, low certainty of evidence). However, there were no significant differences for the primary outcomes of pain relief on the late active phase, and anxiety relief on the early and late active phases.

Conclusions

This meta-analysis found evidence that the use of inhalation aromatherapy for term pregnancy women is associated with reduction of labor pain. However, there is insufficient evidence to confirm pain relief on the late active phase, anxiety relief, and other outcomes following aromatherapy.

Trial registration

We registered the study protocol with PROSPERO (CRD42017077617).
Perceptions of pregnant women on reasons for late initiation of antenatal care: A qualitative interview study
Authors: Warri Denis , George Asha 
Published: August 2019

Abstract
Background: Antenatal care serves as a key entry point for a pregnant woman to receive a broad range of services and should be initiated at the onset of pregnancy. The aim of the study was to understand the reasons for late initiation of antenatal by pregnant women in Nkwen Baptist Health Center, Cameroon.
Methods: The study applied purposive sampling to recruit eighteen pregnant women and three key informants for data collection through individual interviews. Pregnant women who initiated antenatal care after the first trimester were recruited during antenatal care clinics and interviewed in a room at the antenatal care unit. Key informants were midwives working at the antenatal care unit. Participation in the study was voluntary. Participants were explained the purpose of the study and signed a consent form if they were willing to participate in the research. Data was collected using an audio tape and analyzed using Thematic Coding Analysis.
Results: Pregnant women place low value on early antenatal care due to the fact that they perceive pregnancy as a normal health condition or not a serious issue that requires seeking health care. Furthermore previous pregnancy outcomes that were positive regardless of accessing care made them less motivated to initiate antenatal care early. The booking system is perceived as user-unfriendly with overcrowded conditions, long waiting times and rudeness of some service providers. Cost of services and distance to health facilities with uncomfortable transport and poor road network were identified as perceived barriers. The absence of effective community health programmes, perceived lack of support from parents and spouses, fear of bewitchment and stigma due to cultural beliefs about early initiation of antenatal care were also identified as variables influencing late initiation.
Conclusion: Pregnant women lack information on the purpose of early antenatal care. Health facility barriers as well as socio cultural beliefs also have significant influence on timing of antenatal care initiation. The government of Cameroon should strengthen the health system and implement activities that engage communities to improve timing of care seeking for antenatal care and thereby improve the maternal health status of women.
Genetic diversity and characteristics of gyrA gene in Neisseria spp
Authors: Zhao Pan , Zhang Aiyu , Zhu Bingqing , Xu Li , shao zhujun 
Published: August 2019

Abstract
Background

Neisseria meningitidis bacteria characterized by clonal complex (CC4821) showed a high resistance rate to quinolones. The aim of this study was to assess whether the DNA gyrase A gene from N.meningitidis CC4821 strains collected in China featured any specific characteristics compared to other Neisseria species. Two hundred fifty two gyrase gene sequences were analyzed, among them 77 generated in this study from N.meningitidis CC4821 strains collected in China between 1978 and 2016.

Results

The quinolone resistance-related gene, coding for the DNA gyrase subunit A (GyrA) protein, was highly divergent within the N.meningitidis strains whereas N. gonorrhoeae and N.lactamica counterparts appeared well conserved. Only one position, 91 (83 in E.coli gyrA gene), was linked to quinolone resistance, all resistant strains featuring the substitution T91I. The E.coli position 87, which was mutated in quinolone-resistant strains, was also divergent (position 95) in some Neisseria resistant strains. Moreover, twenty eight additional putative resistance markers were identified. Finally, putative recombination events between N.meningitidis and either N.subflava, or N.lactamica or N.cinerea as well as between N.meningitidis strains were reported.

Conclusions

Analyzing the evolution of gyrA gene within Neisseria spp. is critical to monitor the quinolone resistance phenotype and the acquisition of new resistance markers. Such studies are necessary for the control of the meningococcal disease and the development of new drugs targeting DNA gyrase.
Prevalence of mobile antimicrobial resistance genes carrying and toxin producing pathogens in retail beef and mutton
Authors: liu ying , Cui Yifang , Peng Wenjing , Huang Baoyong , Ma Lichao , Zheng Min , Ding Shuangyang , Zhu Kui 
Published: August 2019

Abstract
Background

Food safety has always been the global issue. In addition to food poisoning problems caused by toxin-producing strains, the arising of widely spread antimicrobial resistant bacteria have become a major issue that impacts food safety. The purpose of this study is to assess the safety of retail meat in the last link of sales.

Results

A total number of 134 samples were collected and 674 strains were isolated. There are different bacterial compositions distributed in meat, environmental and human-derived samples. The major pathogens in meat and environmental or human samples are Klebsiella spp. and Staphylococcus spp.. The resistance to amoxicillin + clavulanate (with the resistance rate of 46.78%), tetracycline (44.66%) and erythromycin (32.73%) are major resistant phenotypes of the isolates. According to the whole genome analysis, two K. pneumoniae strains harboring the extended spectrum beta-lactamase genes which are located on mobile elements and two Aeromonas hydrophila isolates carrying mcr-7.1 like genes have been detected. The major toxin genes of Bacillus cereus, and adhesion or invasion related virulence factors were also shared among the isolates.

Conclusion

There are different pathogens distributed in meat, environment and human source at the final stage of meat consumption. The mobile ARGs are prevalent in strains isolates from meat samples. And toxin-producing strains can be isolated from human source. These factors consist potential risk for public health and need attention.
Admission pattern, Clinical outcomes and associated factors among patients admitted in medical intensive care unit at University of Gondar Comprehensive and specialized hospital, Northwest Ethiopia, 2019. A retrospective cross-sectional study.
Authors: Tessema Hailemariam Getachew , Lema Girmay Fitiwi , Mesfin Nebiyu , Fentie Demeke Yilkal , Arefaynie Nurhussien Rizke 
Published: August 2019

Abstract
Background: Intensive care unit (ICU) is a multidisciplinary staffed and specially equipped area of a hospital dedicated to providea care for patient with life-threatening illness. Provision of intensive care services to critically ill patients is a global enterprise. The care is advancing but in resource-limited settings, it is lagging far behind and ICU mortality is still higher due to various reasons.
Objective: We aimed to determine the admission patterns, clinical outcomes and associated factors among patients admitted medical intensive care unit (MICU).
Results: A total of 738 patients were admitted to MICU during September 2015- April 2019. Two hundred thirty four patients had incomplete data on the registries and their charts could not be located. So that, 504 (68%) of all ICU admissions had complete data and were analyzed. Out of the 504 patients, 268 (53.2%) patients were females. Cardiovascular disease 182(36.1%) was the commonest categorical admission diagnosis. The overall mortality rate of the MICU was 38.7 %. In the multivariate analysis, mortality was associated with need for mechanical ventilation (AOR=5.87, 95% CI: 3.24 - 10.65) and abnormal mental status at admission (AOR = 2.8.8, 95% CI: 1.83-4.29). Patients who stayed less than four days in MICU are 5 times more likely to dies than who stayed(AOR= 5.58, 95% CI: 3.58- 8.69). Therefore, we recommend improving the acute critical care through the expansion of the care, supply emergency equipment’s and medications and implementation of admission criteria protocols and other local guidelines.
Key words: admission, intensive care unit, Length of stay, Mortality, Outcome
Targeting claudin-4 enhances chemosensitivity of triple negative breast cancer
Authors: Luo Yi , Kishi Shingo , Sasaki Takamitsu , Ohmori Hitoshi , Fujiwara-Tani Rina , Mori Shiori , Goto Kei , Nishiguchi Yukiko , Mori Takuya , Kondo Masuo , Kuniyasu Hiroki 
Published: August 2019

Abstract
Background

Triple negative breast cancer (TNBC) possesses highly aggressive phenotype, treatment with limited options, and a poor prognosis. In this study, we examined the therapeutic effect of anti-claudin (CLDN)-4 extracellular domain antibody, 4D3, on TNBC.

Methods

The expression of CLDN4 and CLDN1 in invasive ductal carcinoma (IDC) was examined in 78 IDCs (from 2004 to 2009 in a single center). CLDN expression and the effect of 4D3 on proliferation were examined in in human IDC cell lines MCF-7 (luminal subtype) and MDA-468 (TNBC).

Results

In IDC cases, CLDN1 had lower expression than CLDN4 and correlated with histological grade. In contrast, expression of CLDN4 correlated with histological grade, receptor subtype, and stage. CLDN4 expression in the two cells was at the same level. In both cells, paclitaxel (PTX)-induced growth suppression was enhanced by 4D3. Furthermore, 4D3 increased both intracellular PTX concentration (in both cells) and apoptosis. In the mouse model, 4D3 promoted the antitumor effect of PTX on subcutaneous tumors and reduced lung metastasis. The combination of PTX and 4D3 reduced M2 macrophages and mesenchymal stem cells in the tumor. 4D3 also reduced stemness of the tumors in association with increase in the intratumoral pH. Moreover, concurrent treatment of 4D3, PTX, or tamoxifen; or with PTX and tamoxifen in MDA-468 also showed the same level of antitumor activity and survival as MCF-7. Furthermore, in bone metastasis model, combination of PTX and bisphosphonate with 4D3 promoted tumor growth in both cells.

Conclusions

CLDN4 targeting of the antibody facilitated existing therapeutic effects.