bluuebunny/crossref_metadata_2025_split huggingface dataset:
Level of medication self-management capacity among patients on ambulatory care exiting hospital pharmacy at Muhimbili National hospital, Tanzania: a descriptive cross-sectional study
Authors: Mlyuka Hamu Joseph , Salehe Hija , Mikomangwa Wigilya P , Kilonzi Manase E , Marealle Alphonce I , Mutagonda Ritah F , Bwire George M. 
Published: August 2019

Abstract
Objectives

Medication management capacity of a patient on ambulatory care is direct related to adherence. To our knowledge data on medication management capacity for ambulatory care patients exiting outpatient pharmacy outlets in Tanzania are scarce. This study aimed to determine the level of medication management capacity among patients on ambulatory care exiting Muhimbili National Hospital outpatient pharmacy outlet.Results

Majority (62.3%) of the patients on ambulatory care had poor medication management capacity; 65.3% out of 387 patients were unable to correctly read the prescription and match the drugs they are carrying. More than half (57.4%) were unable to correctly take the dose, 57.4% were unable to correctly tell the dosing frequency and duration. Only 10.6% out 155 patients with prescription containing drugs with warning or precaution or contraindication or potential side effects were aware.
Polydrug use is associated with new HIV infections among men who have sex with men in China: a multicenter cross-sectional survey
Authors: Mao Xiang , Leuba Sequoia I. , Hu Qinghai , Yan Hongjing , Wang Zhe , Lu Lin , Zhuang Minghua , Chen Xi , Fu Jihua , Geng Wenqing , Jiang Yongjun , Shang Hong , Xu Junjie 
Published: August 2019

Abstract
Background: Recreational drug use is popular among men who have sex with men (MSM), while there is limited information about polydrug use and its consequent impact on sexual health and human immunodeficiency virus (HIV) acquisition.
Methods: MSM were recruited from a multicenter cross-sectional survey conducted in seven Chinese cities. Participants were divided into four subgroups based on the number of recreational drugs (RDs) used in the past 6 months. “Polydrug use” was defined as simultaneous use of ≥2 types of RDs. Information on demographics and HIV high-risk behaviors (HIV-HRBs) was collected, and blood samples were tested for recent HIV infection by the BED capture enzyme immunoassay.
Results: A total of 4,496 Chinese MSM participated, of which 28.4% used RDs, and 5% were polydrug users. Polydrug users commonly took poppers with one or more types of other RDs (e.g. methamphetamine). Polydrug users were likely to be aged 26–30 years, have low educational attainment, be internal migrants, have a high monthly income, use versatile positions during anal intercourse, and have inadequate knowledge about prevention of HIV infection ( P <0.05 for all). As the number of RDs used in the past 6 months increased, the prevalence of HIV-HRBs increased ( P <0.05 for all). The odds of recent HIV infection were higher among those who used one type (aOR = 2.2, 95%CI: 1.5–3.0) or two types of RDs (2.3, 1.0–5.2) in the past 6 months compared with those who did not use RDs. The population-attributable fractions of most HIV-HRBs for recent HIV infection were higher among polydrug users compared with those who used only one type of RD or used no RD in the past 6 months.
Conclusion: The level and pattern of polydrug use among Chinese MSM were different from developed countries. Polydrug use had a dose-effect relationship with HIV-HRBs. Polydrug users who have greater levels of RDs use are more likely to engage in various sexual risks, thus may associated with new HIV infections.
Understanding Barriers to Adoption of Facility Assisted Delivery in a Maasai Community in Ngorongoro District, Tanzania: A qualitative study to document psychosocial preferences, agency for decision-making, access barriers, and other factors that influence where a woman in Nainokanoka Ward will deliver
Authors: Mosley Paul D , Saruni Kisiaya , Lenga Bernadetha 
Published: August 2019

Abstract
BACKGROUND

Tanzania’s One Plan II health sector program aims to increase facility deliveries from 50% to 80% from 2015-2020. Success is uneven among certain Maasai pastoralist women in Northern Tanzania who resist going to a facility for birth even after completing 4+ ANC visits. EbOO is a program in Nainokanoka ward to promote facility-births through a care-group model using traditional birth attendants (TBAs) as facilitators. Results to date are promising but show a consistent gap between women completing ANC and those going to a facility for birth.

METHODS

A qualitative study was conducted in Nainokanoka ward to understand psychosocial preferences, agency for decision-making, and access barriers that influence where a woman in the ward will deliver. Interviews were conducted with twenty-three pregnant and/or parous women, along with 3 men’s and 2 TBA’s focus groups, and finally 3 key-informants from ward health facilities. Interviews were coded and analyzed thematically using a grounded theory approach.

RESULTS

Most women interviewed expressed preference for a home delivery with a TBA and even those who expressed agency and preference for a facility delivery usually had their last delivery at home attributed to unexpected labor. TBAs are engaged by husbands and play a significant influential role in deciding place of delivery as husbands defer to their judgment. TBAs claim to support facility deliveries but in practice use them as a last resort and reported a significant trust gap based on a bad experience at a facility where women in labor were turned away.

CONCLUSIONS

EbOO project data and study results show a slow but steady change in norms in Nainokanoka ward. Gaps between expressed intention and practice, especially around ‘unexpected labor’ present opportunities to accelerate this process by more intentionally promoting birth plans, and perhaps constructing a maternity waiting house near the ward health center. Rebuilding trust between facility midwives, TBAs, and the community on the availability of health facility services and assurance that women in labor will not be denied service, could also close the gap between the number of women who are currently using facilities for ANC and those returning for a facility delivery.
Protective and Therapeutic Effects of Nanoliposomal Quercetin on Acute Liver Injury in Rats
Authors: Liu Xiangyan , Zhang Yang , Liu Ling , Pan Yifeng , Hu Yu , Yang Pu , liao mingmei 
Published: August 2019

Abstract
Background

Quercetin, a pigment (flavonoid) found in many plants and foods, has good effects on protecting liver function but poor solubility and bioavailability in vivo. A drug delivery system can improve the accumulation and bioavailability of quercetin in liver.

Objective

In this study, we used liposomal nanoparticles to entrap quercetin and evaluated its protective and therapeutic effects on drug-induced liver injury in rats.

Design

The nanoliposomal quercetin was prepared by a thin film evaporation-high pressure homogenization method and characterized by morphology, particle size and drug content. Acute liver injury was induced in rats by composite factors, including carbon tetrachloride injection, high-fat corn powder intake and ethanol drinking. After pure quercetin or nanoliposomal quercetin treatment, liver function was evaluated by detecting serum levels of glutamic-pyruvic transaminase (GPT), glutamic-oxal acetic transaminase (GOT) and direct bilirubin (DBIL). Histology of injured liver tissues was evaluated by hematoxylin and eosin staining.

Results and discussion

On histology, liposomal nanoparticles loading quercetin were evenly distributed spherical particles. The nanoliposomal quercetin showed high bioactivity and bioavailability in rat liver and markedly attenuated the liver index and pathologic changes in injured liver tissue. With nanoliposomal quercetin treatment, the serum levels of GPT, GOT and DBIL were significantly better than treated with pure quercetin. Using liposomal nanoparticles to entrap quercetin might be an effective strategy to reduce hepatic injury and protect hepatocytes against damage.

Conclusions

Liposomal nanoparticles may improve the solubility and bioavailability of quercetin in liver. Furthermore, nanoliposomal quercetin could effectively protect rats against acute liver injury and may be a new hepatoprotective and therapeutic agent for patients with liver diseases.
The utility of a shortened palliative care screening tool to predict death within 12 months – a prospective observational study in two South African hospitals with a high HIV burden
Authors: Raubenheimer Peter , Day Cascia , Abdullah Faried , Manning Katherine , Cupido Clint , Peter Jonny 
Published: August 2019

Abstract
Background

Timely identification of people who are at risk of dying is an important first component of end-of-life care. Clinicians often fail to identify such patients, thus trigger tools have been developed to assist in this process.

Aim

To evaluate the performance of a screening tool (based on the Gold Standards Framework Prognostic Indicator Guidance) to predict death at 12 months in a population of hospitalised patients in South Africa

Design

Prospective cohort observational study using linkage analysis of hospitalised patients to death certification records.

Setting/participants

Patients admitted to the acute medical services in two public hospitals in Cape Town, South Africa

Results

822 patients (median age of 52 years), admitted with a variety of medical conditions were assessed during their admission. 22% of the cohort were HIV-infected. 218 patients were identified as meeting one of the specific indicators. Mortality in this group was 56% at 12 months, compared with 7% for those not meeting any criteria. The specific indicator component of the tool performed best in predicting death in both HIV-infected and HIV-uninfected patients, with a sensitivity of 74% (68-81%), specificity of 85% (83-88%), a positive predictive value of 56% (49-63%) and a negative predictive value of 93% (91-95%). The hazard ratio of 12-month mortality for those identified vs not was 11.52 (7.87 – 16.9; p < 0.001).

Conclusions

The identification tool is suitable for use in hospitals in low-middle income country setting that have both a high communicable and non-communicable disease burden amongst relatively young patients.
Genetic diversity of aflatoxin-producing Aspergillus flavus isolated from groundnuts in selected agro-ecological zones of Uganda
Authors: Acur Amos , Arias Renée S. , Odongo Steven , Tuhaise Samuel , Ssekandi Joseph , Muhanguzi Dennis , Adriko John , Buah Stephen , Kiggundu Andrew 
Published: August 2019

Abstract
Background

Aspergillus is the main fungal genus causing pre- and post-harvest contamination of groundnuts. Aspergillus flavus belongs to section Flavi, a group consisting of both the aflatoxigenic species (A. flavus, A. parasiticus and A. nomius) and non-aflatoxigenic species (A. oryzae, A. sojae and A. tamarii). Aflatoxins are food-borne toxic secondary metabolites produced by Aspergillus species, causing hepatic carcinoma and stunting in children and are the most toxic carcinogenic mycotoxins ever identified. Despite the well-known public health problems associated with aflatoxicosis in Uganda, information about the genetic diversity of the main aflatoxin causing fungus, Aspergillus flavus in this country is still limited.

Results

A cross-sectional survey was therefore carried out in three main groundnut-growing agro-ecological zones (AEZs) of Uganda; West Nile farming system, Lake Kyoga basin mixed farming system and Lake Victoria basin farming system. This was to assess the genetic diversity of A. flavus and to establish the contamination rates of groundnuts with Aspergillus species at pre- and post-harvest stages. Out of the 213 A. flavus isolates identified in this study, 96 representative isolates were fingerprinted using 16 insertion/deletion microsatellite markers. Data from fingerprinting were analyzed through Neighbor Joining while polymorphism was determined using Arlequin v 3.5. The pre- and post-harvest contamination rates were; 2.5% and 50.0% (West Nile farming system), 55.0% and 35.0% (Lake Kyoga basin mixed farming system) and 32.5% and 32.5% (Lake Victoria basin farming system) respectively. The Chi-square test showed no significant differences between pre- and post-harvest contamination rates among AEZs (p = 0.199). Only 67 out of 96 isolates produced suitable allele scores for genotypic analysis. Analysis of genetic diversity showed higher variation within populations than among populations. Two major clusters (aflatoxigenic and non-aflatoxigenic isolates) were identified as colonizing groundnuts at pre- and post-harvest stages.

Conclusions

These findings provide a first insight on the existence of non-aflatoxigenic strains of A. flavus in Uganda. These strains are potential candidates for developing local Aspergillus bio-control agent.
Evaluation of Bacterial Load and Antibiotic Resistance Pattern of Staphylococcus aureus from Ready-to-Eat Raw Beef in Bahir Dar City
Authors: Tsehayneh Bizuneh , Yayeh Taddesse , Agmas Birhan , Yilkal Semahegn 
Published: August 2019

Abstract
Background

Staphylococcus aureus is one of the most important causes of foodborne intoxication and most frequent antibiotic resistant pathogen in the world. Regular evaluation of the current safety status of food is a pro-active measure to minimize the possible danger of foodborne pathogens. Therefore, this study was conducted on to assess the bacterial load and antibiotic resistance profile of S. aureus from ready-to-eat raw beef in Bahir Dar city.

Methodology

This cross-sectional study was conducted from October 2018 to April 2019 by collecting a total 101 raw beef samples from butcher shops using simple random sampling method. Isolation and microbial load determination of S. aureus using was performed conventional culture method as well as antibiotic susceptibility test was conducted by using Kirby Bauer disk diffusion method on Mueller-Hinton agar. The data were analyzed by using STATA software version 12.0.

Result

Out of 101 raw beef samples, 55 (54.45%) were positive for S. aureus with mean bacterial count of 3.40±0.63(log10cfu/g). About 13% of butcher shops had unacceptable and potentially dangerous (above 104cfu/g) bacterial load. High S. aureus drug resistance were observed on penicillin (92.73%) followed by cefoxitin (74.5%), tetracycline (63.63%), clindamycin (50.9%). On the other hand there were highest susceptibility for ciprofloxacin (100%) followed by gentamycin (90.91%) and erythromycin (87.27%). Multi-drug resistance was also found in 54 (98%) of the isolates.

Conclusion

In this study highly drug resistant S. aureus was a major meat contaminant in butcheries of Bahir Dar city. Therefore, appropriate antimicrobial use and staphylococcal control methods should be employed to prevent S. aureus intoxications in foods.
Risk factors for Clostridium difficile infection and colonization among patients admitted to intensive care units in Shanghai, China
Authors: Cui Yingchao , Zhang Lihua , Dong Danfeng , Wang Daosheng , Jiang Cen , Ni Qi , Wang Chen , Mao Enqiang , Peng Yibing 
Published: August 2019

Abstract
Background : Clostridium difficile is considered to be the main pathogen responsible for hospital-acquired infections in western countries, but few studies on C. difficile have been carried out in China. This study performed a prospective study to describe the prevalence, molecular epidemiological characteristics and risk factors of Clostridium difficile infection (CDI) and Clostridium difficile colonization (CDC) among patients in intensive care units (ICUs), with the aim of providing strategies for efficient CD prevention and control.Methods: Stool samples were collected from adult patients on admission to an 18-bed ICU department, and were anaerobically cultured for C. difficile . The identified isolates were tested for toxin genes, followed by multilocus sequence typing to analyze the genotypes. Patients were divided into CDI, CDC and control groups according to clinical features. The medical records of these groups were collected and further analyzed using logistic regression to investigate the risk factors.Results: Of the 800 patients included in the study, 33 (4.12%) and 25 (3.12%) patients were identified with CDI and CDC, respectively. An association was found between CDI patients and having a fever (OR=13.993) or metabolic disorder (OR=7.972), and treatment with fluoroquinolone (OR=42.696) or a combination of antibiotics (OR=2.856). CDC patients were characterized by longer hospital stays (OR=1.137), an increased number of comorbidities (OR=36.509), respiratory diseases (OR=0.043) and treatment with vancomycin (OR=18.168). However, treatment with metronidazole was simultaneously found to be a protective factor in the two groups (OR=0.042; OR=0.013). Eighteen sequence types (STs) were identified. Among the CDI group, the isolates were predominantly toxin A- and toxin B-positive (A+B+) strains and genotype ST-2 was the epidemic clone. In the CDC group, the dominant strains were A+B+ and ST-81 was the epidemic clone.Conclusions: The prevalence of C. difficile colonization and infection in our ICU patients was relatively high, suggesting the importance of routine screening to detect the acquisition of this pathogen. Future prevention and treatment strategies for C. difficile -related disease should take into consideration the duration of hospital stays, enteral nutrition, underlying comorbidities, as well as the use of combined antibiotics. Moreover, metronidazole could be a protective factor for both CDI and CDC.
TIA and minor stroke: A qualitative study of long-term impact and experiences of follow-up care
Authors: Turner Grace M , McMullan Christel , Atkins Lou , Foy Robbie , Mant Jonathan , Calvert Melanie 
Published: August 2019

Abstract
Background

Transient ischaemic attack (TIA) and minor stroke are often considered transient events; however, many patients experience residual problems and reduced quality of life. Current follow-up healthcare focuses on stroke prevention and care for other long-term problems is not routinely provided.

We aimed to explore patient and healthcare provider (HCP) experiences of residual problems post-TIA/minor stroke, the impact of TIA/minor stroke on patients’ lives, and current follow-up care and sources of support.

Methods

This qualitative study recruited participants from three TIA clinics, seven general practices and one community care trust in the West Midlands, England. Semi-structured interviews were conducted with 12 TIA/minor stroke patients and 24 HCPs from primary, secondary and community care with framework analysis.

Results

A diverse range of residual problems were reported post-TIA/minor stroke, including psychological, cognitive and physical impairments. Consultants and general practitioners generally lacked awareness of these long-term problems; however, there was better recognition among nurses and allied HCPs. Residual problems significantly affected patients’ lives, including return to work, social activities, and relationships with family and friends. Follow-up care was variable and medically focused. While HCPs prioritised medical investigations and stroke prevention medication, patients emphasised the importance of understanding their diagnosis, individualised support regarding stroke risk, and addressing residual problems.

Conclusion

HCPs could better communicate lay information about TIA/minor stroke diagnosis and secondary stroke prevention, and improve their identification of and response to important residual impairments affecting patients.
Magnetic Resonance Enterography, Colonoscopy, and Fecal Calprotectin correlate in colonic Crohn’s Disease
Authors: Somwaru Alexander Stephen , Khanijow Vikesh , Katabathina Venkat 
Published: August 2019

Abstract
Background

Fecal calprotectin (FCP), magnetic resonance enterography (MRE), and colonoscopy are complementary biometric tests that are used to assess patients with Crohn’s Disease (CD). While prior studies have evaluated the association between combinations of two of these tests or surgical specimens, no study has established a correlation between all three: FCP, MRE, and colonoscopy. We investigated if the correlation between these three tests may result in improved clinical outcomes that can then be used to streamline patient monitoring and treatment modification.

Methods

156 patients with colonic CD were examined between March 2017 and December 2018. FCP levels, MRE, and colonoscopy were assessed in parallel on all 156 patients. Clinical CD activity was measured with the Crohn’s Disease Activity Index (CDAI). CD activity with FCP was measured with a quantitative immunoassay. CD activity on MRE was measured with the Magnetic Resonance Index of Activity (MaRIA). CD activity on colonoscopy was measured with the Crohn’s Disease Endoscopic Index of Severity (CDEIS).

Results

112 patients (72%) had active disease (Crohn’s Disease Activity Index > 150) and 44 patients (28%) were in clinical remission disease (Crohn’s Disease Activity Index < 150). FCP levels, MaRIA, and CDEIS are highly correlated with positive and significant Pearson and Spearman coefficients, respectively (P < 0.0001), in univariate analyses. Regression analysis (multivariate analyses) demonstrates significant, positive correlation between FCP and MaRIA (r = 1.07, P < 0.0001) and between FCP and CDEIS (r = 0.71, P = 0.03), and between

MaRIA and CDEIS (r = 0.63, P = 0.01).

Conclusions

FCP levels significantly correlate with the degree of active inflammation in patients with colonic Crohn’s Disease. Improved clinical results may be achieved by using a biometric strategy that incorporates FCP, colonoscopy, and MRE together. This strategy may in-turn be used in the future to streamline monitoring disease activity and adjustment of therapy to improve long term patient outcomes.