bluuebunny/crossref_metadata_2025_split huggingface dataset:
Women’s perspective of facility-based childbirth services in Ghana: A qualitative study
Authors: Avortri Gertrude S. , Modiba Lebitsi M. 
Published: July 2018

Background: Many policy makers at country level in both medium and low to middle-income countries still have great difficulty deciding which quality intervention would have the greatest impact on the health outcomes delivered by their health systems. Aim: To investigate women’s perceptions about the factors that hinders or facilitates the provision of quality childbirth services in Ghana’s health care services to guide improvement efforts. Setting: The study was conducted in the greater Accra region of Ghana in two primary level hospitals (district hospitals). Methods: A qualitative study design, which is exploratory, descriptive and contextual in nature, was used. Semi-structured interviews were used to examine the perspectives of 15 women on the factors that influence the quality of childbirth services and how services could be improved in Ghana. Data were analysed through data reduction, data display and generation of themes. Results: The findings in this study revealed two major themes, firstly, barriers to quality childbirth with five subthemes: high workload, shortage of health workers, non-availability of some services, as well as poor coordination, unacceptable staff behaviour and lack of cooperation from some clients, were identified by the participants as the major causes of poor quality. Secondly, ways to improve care reported, were encouraging health workers to be patient with clients, promoting open communication, friendliness and attentiveness. The need to reorganise service provision to make it more client centred, was also highlighted. Conclusion: The study findings highlight the importance of paying attention to factors such as service organisation and coordination, high workload, inadequate number of staff, as well as limitations in infrastructure and logistics for quality services delivery. Equally important are institutionalisation of systems to continuously assess and improve staff competence and attitudes and the creation of an environment that can foster good interpersonal relationship between health care providers and patients.
Assessing the efficacy of asynchronous telehealth-based hearing screening and diagnostic services using automated audiometry in a rural South African school
Authors: Govender Samantha M. , Mars Maurice 
Published: July 2018

Background: Asynchronous automated telehealth-based hearing screening and diagnostic testing can be used within the rural school context to identify and confirm hearing loss. Objective: The aims of the study were to evaluate the efficacy of an asynchronous telehealth-based service delivery model using automated technology for screening and diagnostic testing as well as to describe the prevalence, type and degree of hearing loss. Method: A comparative within-subject design was used. Frequency distributions, sensitivity, specificity scores as well as the positive and negative predictive values were calculated. Testing was conducted in a non-sound-treated classroom within a school environment on 73 participants (146 ears). The sensitivity and specificity rates were 65.2% and 100%, respectively. Diagnostic accuracy was 91.7% and the negative predictive values (NPV) and positive predictive values (PPV) were 93.8% and 100%, respectively. Results: Results revealed that 23 ears of 20 participants (16%) presented with hearing loss. Twelve per cent of ears presented with unilateral hearing impairment and 4% with bilateral hearing loss. Mild hearing loss was identified as most prevalent (8% of ears). Eight ears obtained false-negative results and presented with mild low- to mid-frequency hearing loss. The sensitivity rate for the study was low and was attributed to plausible reasons relating to test accuracy, child-related variables and mild low-frequency sensory-neural hearing loss. Conclusion: The study demonstrates that asynchronous telehealth-based automated hearing testing within the school context can be used to facilitate early identification of hearing loss; however, further research and development into protocol formulation, ongoing device monitoring and facilitator training is required to improve test sensitivity and ensure accuracy of results.
Evaluation of impact of occult hepatitis B infection in chronic HCV-infected patients: A retrospective cohort study
Authors: Bhatia Mohit , Gupta Ekta , Choudhary Manish C , Jindal Ankur , Sarin Shiv Kumar 
Published: July 2018

ABSTRACT
INTRODUCTION: Occult hepatitis B infection (OBI) may contribute to liver damage and variable therapeutic response in patients with chronic hepatitis C (CHC) infection.
AIMS: To study the prevalence of OBI and to evaluate its impact and/or that of anti-HBc total seropositivity on clinical outcomes and response to directly acting antiviral (DAA) therapy in CHC-infected patients.
SETTINGS AND DESIGN: A retrospective cohort study was conducted in a tertiary care liver hospital from January to May 2017.
SUBJECTS AND METHODS: Eighty HBsAg-negative CHC patients who were initiated on DAA therapy were retrospectively included. Archived pretreatment baseline plasma samples were retrieved and tested for quantitative HBV DNA, anti-HBs, and anti-HBc total antibodies. HCV RNA, genotype, clinical, biochemical and histopathological parameters & treatment response data were obtained from the hospital information system.
STATISTICAL ANALYSIS USED: Comparison of continuous variables was done by Mann–Whitney and Kruskal–Wallis tests and categorical variables by Fisher’s exact test or Pearson’s Chi-square test.
RESULTS: Prevalence of OBI was 1.25%. Anti-HBc total positivity was seen in 25% patients. Based on anti-HBc total status, patients were categorized into two groups namely Group 1 (anti-HBc positive) and Group 2 (anti-HBc negative). Group 1 patients were further categorized into three subgroups based on signal/cutoff (S/Co) of HBc total antibody semi-quantitative values. HBc total antibody levels did not influence the severity of CHC disease. Comparative evaluation of parameters such as median log10 baseline RNA (P = 0.929 and 0.464), median alanine aminotransferase (ALT 0) (P = 0.519 and 0.449), ALT at 12 weeks (P = 0.875 and 0.594), sustained virological response (SVR) at 12 weeks (P = 0.405 and 0.263) and SVR at 24 weeks (P = 0.265 and 0.625) between Groups 1 and 2 and among three categories within Group 1, respectively, were not found to be statistically significant.
Conclusions: Very low prevalence of OBI was seen in CHC patients. HBc total antibody levels did not influence clinical outcome and response to DAA therapy in this cohort.
Second-trimester fetal autopsy: A morphological study with prenatal USG correlations and clinical implications
Authors: Venkataswamy Chaitra , Gurusamy Umamaheswari , Lakshmi S. Vidhya 
Published: July 2018

ABSTRACT
OBJECTIVES: The objective of this study is to analyze the second-trimester fetal autopsies and to reemphasize the role of autopsy by comparing autopsy findings with prenatal ultrasound observations.
MATERIALS AND METHODS: Retrospective analysis of second-trimester fetal autopsies over a period of 7.5 years (January 2009–June 2016). A standard protocol of autopsy procedure was followed, which included external examination with photography, X-ray, internal examination, and histopathological examination. In fetuses with congenital malformations (CMs), the findings of prenatal ultrasonogram and autopsy examination were compared.
RESULTS: We analyzed a total of 66 fetuses, which includes 17 intrauterine fetal death, 49 terminations for CM, and increased risk for chromosomal abnormality. In fetuses with CM, multiple anomalies were more common than a single anomaly. The most common anomalies were seen involving central nervous system (neural tube defect) followed by the genitourinary system. Autopsy confirmed prenatal ultrasound findings in all cases except three. Complete agreement between USG findings and autopsy were seen in 17 cases (39.7%). Additional findings on autopsy were noted in 25 cases (62.2%). Among these, 15 cases had a significant change of recurrence risk due to altered initial ultrasound diagnosis.
CONCLUSION: Fetal autopsy plays an important role in arriving at the final diagnosis and detecting the cause of death. This information is very essential for the clinicians, in genetic counseling of the parents, and management of future pregnancies.
Rosuvastatin as forthcoming antibiotic or as adjuvant additive agent: In vitro novel antibacterial study
Authors: Al-Kuraishy Hayder M. , Al-Gareeb Ali I. , Al-Buhadily Ali K. 
Published: July 2018

ABSTRACT
INTRODUCTION: Rosuvastatin is a lipid-lowering agent that inhibits 3-hydroxy-3-methylglutaryl coenzyme A reductase leading to a reduction of cholesterol biosynthesis. Many studies have shown an association between statins use and the reduction of sepsis. The aim of the present study was to evaluate the in vitro combined antibacterial activity of rosuvastatin and cefixime.
MATERIALS AND METHODS: Five pathogenic bacteria isolates (Gram positive and Gram negative) were used for testing the antibacterial activity of rosuvastatin alone and in combination with cefixime.
Results: Rosuvastatin mainly inhibited Klebsiella pneumoniae and Escherichia coli where it caused zones of inhibition of (17.9 ± 0.6 mm) and (16.9 ± 0.3 mm), respectively; however, it moderately inhibited the growth of Staphylococcus epidermidis (12.9 ± 0.2 mm) and Staphylococcus aureus (12.76 ± 0.2) and produced less inhibition for Pseudomonas aeruginosa growth where it led to a zone of inhibition equal to (9.1 ± 0.5 mm). Minimal inhibitory concentration (μg/mL) of rosuvastatin was high compared to cefixime. Fractional inhibitory concentration (FIC) of rosuvastatin was low for E. coli and K. pneumoniae compared to the other types of bacterial strains. Rosuvastatin exhibited additive effects with cefixime against E. coli and K. pneumoniae. ΣFIC index was 0.536 and 0.734 for E. coli and K. pneumoniae, respectively.
Conclusions: Rosuvastatin has a significant antibacterial activity against both Gram-negative and Gram-positive bacteria with a potential additive effect when used in combination with cefixime.
Clinical and laboratory standards institute versus European committee for antimicrobial susceptibility testing guidelines for interpretation of carbapenem antimicrobial susceptibility results for Escherichia coli in urinary tract infection (UTI)
Authors: Sahu Chinmoy , Jain Vidhi , Mishra Prabhakar , Prasad Kashi Nath 
Published: July 2018

ABSTRACT
BACKGROUND: Carbapenems show excellent activity against resistant uropathogens, and they are the antibiotics of choice for urinary tract infections (UTIs). The choice of carbapenem prescription is strongly influenced by antimicrobial susceptibility testing (AST) report. With the publication of recent AST guidelines by the European Committee on AST (EUCAST), we were curious to evaluate the difference in results between Clinical and Laboratory Standards Institute (CLSI) and the EUCAST guidelines for the interpretation of carbapenems.
METHODS: During a period of 1 year, midstream urine specimens received in the laboratory were cultured by conventional techniques and 2932 of them grew significant colony counts of Escherichia coli. Out of them, 501 E. coli isolates which were resistant to at least six first-line antibiotics were further subjected to second-line antimicrobials imipenem and meropenem, reported by E-tests (bioMerieux, France). The E-test results were interpreted by both CLSI 2016 and EUCAST 6.0 (2016) guidelines. Weighted kappa was used to determine absolute agreement, and McNemar’s Chi-square test was used to test the difference in proportions of susceptibility between two methods, respectively.
RESULTS: Taking CLSI guidelines as a gold standard, there was 100% sensitivity in a susceptible category by the EUCAST guidelines for both the carbapenems. Weighted kappa showed good and moderate agreement between them for imipenem and meropenem, respectively. However, McNemar Chi-square test in the nonsusceptible category between the two tests was 9.38% and 33.03% for imipenem and meropenem, respectively, and they were highly significant (P < 0.001).
Conclusions: A laboratory can follow EUCAST guidelines as well and the guidelines are more useful in urinary concentrated antibiotics such as carbapenems. Further other antibiotics need to be evaluated by both these guidelines.
Primitive neuroectodermal tumor of the kidney: A rare case report
Authors: Talwar Amrita , Kishore Manjari , Bhardwaj Minakshi , Chauhan Devender Singh 
Published: July 2018

ABSTRACTRenal primitive neuroectodermal tumor (PNET) is a rare primary renal neoplasm. Morphologically, it may mimic small blue round-cell tumor. Hence, histopathology in conjunction with immunohistochemistry plays a significant role in correctly diagnosing this malignancy. We report a case of PNET of kidney in a 30-year-old female with an extension to inferior vena cava, who succumbed following an aggressive course of illness.
Seroprevalence of HSV-1 and 2 in HIV-infected males with and without GUD: Study from a tertiary care setting of India
Authors: Munawwar Arshi , Gupta Somesh , Sharma Surendra Kumar , Singh Sarman 
Published: July 2018

ABSTRACT
BACKGROUND: Herpes simplex virus (HSV) infection is associated with an increased risk of both human immune deficiency virus (HIV) transmission and acquisition. However, in India, literature on HSV infections in in HIV-infected males has been scarce. The present study was carried out to assess the seroprevalence of these viruses in HIV-infected males, so as to provide a baseline data from India and report on HSV associated GUD prevalence in HIV infected males.
OBJECTIVE: The aim of the study was to estimate the seroprevalence of herpes simplex type 1 and 2 viruses in HIV-infected males with and without genital ulcers disease (GUD).
MATERIAL AND METHODS: It was a prospective study. We included a total of 351 male participants in this study. Among these 233 were HIV-infected and 118 HIV-uninfected males who served as controls. The seroprevalence was estimated, using HSV-1 and 2 type specific IgG and IgM antibodies by ELISA.
RESULTS: HIV-infected patients had a median age of 32 ± 6.97 years (interquartile range: 28–36). Of the 351 males, 25.92% (91/351) were infected with HSV-1 and HSV-2 both. The overall seroprevalence of HSV-1 singly infected, HSV-2 singly infected, and dual infection in HIV-infected males was 39.92%, 25.58%, and 37.33% whereas in HIV-uninfected group the corresponding figures were 71.18%, 5.08%, and 3.38%, respectively. Seven of 233 (3%) HIV-infected males were having incident HSV infection. GUD was reported in both HSV-1 and HSV-2 seropositive individuals.
CONCLUSIONS: Both HSV-1 and HSV-2 infections were found to be associated with GUD in HIV-infected patients. The prevalence of HIV-HSV co-infection among GUD patients is high.
Discrimination and Class Oppression: An Example of Ifeoma Okoye’s The Fourth World
Authors: Odinye Ifeoma Ezinne 
Published: July 2018

Discrimination is a social problem which has eaten deep into the social circles of different African societies. It is seen in public or private sectors; religious or traditional groups as individuals in a given society engage in endless class struggles in order to control socio-economic and political powers. In essence, discrimination divides humanity into different classes and thus encourages marginalization and oppression in many forms; hence leading to violent protests or demonstrations. This paper examines discriminatory actions in Ifeoma Okoye’s The Fourth World in order to ascertain the causes of discrimination which divides the society into the ‘haves’ and ‘have-nots’. In order to critically explore the different levels of discrimination and oppression in the selected novel, this research employs Marxism as the theoretical framework. In exploring the novel, the findings show massive exploitation of the proletariats by the bourgeoisie (government and rich individuals) who neglect a poverty stricken section of the society called the ‘Fourth world’ and thus cause untold hardship. This research therefore recommends that the government should bridge a gap between the rich and poor by providing basic social amenities in different areas of the society in order to enhance the living conditions of the poor. Government should also monitor sectors that manage government owned establishments for efficiency and accountability in order to protect the rights of poor citizens who are daily exploited. Key words: Discrimination, Oppression, Marxism, Class struggle, Disillusionment
Hummingbird migration and flowering synchrony in the temperate forests of northwestern Mexico
Authors: López-Segoviano Gabriel , Arenas-Navarro Maribel , Vega Ernesto , Arizmendi Maria del Coro 
Published: July 2018

Background
Many species of birds are morphologically and physiologically adapted for migration. Migratory movements of birds can range from thousands of kilometers, such as when birds migrate from wintering to breeding sites in summer, to several kilometers, such as when birds migrate among habitats in a single mountain system. The main factor that influences bird migration is the seasonal fluctuation of food resources; climate, predation, competition for resources and endogenous programming are also important factors. Hummingbirds are highly dependent on nectar, so their migration is likely correlated with the blooming of plant species. The ecological implications of altitudinal migration in the mountains of North America as well as the latitudinal migration of Selasphorus rufus through Mexico are still poorly understood. To explore these issues, over three non-consecutive years, we evaluated interannual variation in the phenologies of a latitudinal migrant (S. rufus) and an altitudinal migrant (Amazilia beryllina) and their visited plants.

Methods
We assessed the relationship between two migratory hummingbirds and flower abundance in 20 fixed-radius plots (25 m radius). All available flowers were counted along transects (40 × 5 m) inside each fixed-radius plot. Sampling was performed every 10 days from November 12 through February 20 of 2010–2011, 2013–2014 and 2015–2016, resulting in a total of 11 samples of each plot per period. Phenological variation and the relationships among hummingbird abundance, flower abundance and vegetation type were evaluated using a generalized additive mixed model.

Results
S. rufus abundance was related to sampling time in the first and third periods; this relationship was not significant in the second period. A. beryllina abundance was related with the sampling time over all three periods. The abundance of S. rufus hummingbirds was significantly related to the number of Salvia iodantha flowers. The abundance of A. beryllina hummingbirds was related to the number of S. iodantha and Cestrum thyrsoideum flowers and the total number of flowers. We found a non-significant correlation between S. rufus and A. beryllina abundance and vegetation types.

Conclusion
Contrary to expectations, the long-distance migration of S. rufus was not consistent over the sampling periods. The migration of S. rufus through the study region may be altered by changes in climate, as has occurred with other species of migratory birds. In the present study, the migration of S. rufus was correlated with the blooming of S. iodantha. In comparison, the altitudinal migrant A. beryllina responded to the availability of floral resources but was not associated with a particular plant. The migration of this latter species in the area probably depends on multiple factors, including climatic and demographic factors, but is particularly dependent on the supply of floral resources and competition for these resources.
4D Biofabrication: Materials, Methods, and Applications
Authors: Ionov Leonid 
Published: July 2018

AbstractThe mission of regenerative medicine is the development of methods to regrow, repair, or replace damaged or diseased cells, organs, or tissues. 3D bioprinting techniques are one of the most promising approaches for engineering the design of artificial tissues. Current 3D bioprinting technologies possess, however, several intrinsic limitations. 4D biofabrication, a recently developed technology with the embedded ability of shape transformation upon response to intrinsic and/or external stimuli, may solve challenges of 3D bioprinting as well as more accurately mimic the dynamics of the native tissues. This article covers recent advances in 4D biofabrication. It gives a detailed picture of used materials and technologies, provides critical comparisons of methods, discusses possibilities and limitations of different 4D biofabrication technologies, and gives examples of applications.
Electrical Breakdown‐Induced Tunable Piezoresistivity in Graphene/Polyimide Nanocomposites for Flexible Force Sensor Applications
Authors: Jiang Yonggang , Liu Mengyang , Yan Xing , Ono Takahito , Feng Lin , Cai Jun , Zhang Deyuan 
Published: July 2018

AbstractFlexible force sensors based on graphene/polymer nanocomposites have attracted tremendous attention owing to their remarkable sensitivity and ease of fabrication. In the present study, nanocomposites consisting of graphene as conducting fillers in a polyimide matrix are prepared, and an electrical breakdown method is used to endow the nanocomposite with a high piezoresistivity. Electromechanical tests and theoretical models confirm that the piezoresistivity of the nanocomposite originates from the cracks in the carbonized polymers induced by electrical breakdown. The fabricated force sensor exhibits a broad working range of 0–495 kPa, ultrafast response (2.12 ms), and excellent stability (>2000 compression–release cycles). In addition, the sensitivities of the force sensor can be tuned by varying the applied current in the electrical breakdown process. Thus, the electrical breakdown method allows highly facile fabrication of piezoresistive force sensors with tunable sensitivities.
Catalytic O‐ to N‐Alkyl Migratory Rearrangement: Transition Metal‐Free Direct and Tandem Routes to N‐Alkylated Pyridones and Benzothiazolones
Authors: Mishra Abhishek Kumar , Morgon Nelson Henrique , Sanyal Suparna , Robinson de Souza Aguinaldo , Biswas Srijit 
Published: July 2018

AbstractThe present study reports the synthesis of N‐alkylated pyridones and benzothiazolones via O‐ to N‐alkyl group migration under transition metal‐free TfOH‐catalyzed reaction conditions for the first time, to the best of our knowledge. Primary as well as secondary alkyl groups smoothly migrate under the present reaction conditions. Moreover, a minor modification of the protocol used in this study is found to be applicable for an entirely new tandem synthesis of 2‐alkoxy‐N‐heterocycles from the simplest starting materials in a solvent‐free reaction conditions. Density Functional Theory (DFT) calculation identifies the energy species associated with the rearrangement, whereas, mechanistic experiments explore the role of the catalyst as the alkyl group transfer mediator.magnified image
Palladium‐Catalyzed Regioselective Cyclocarbonylation of N‐(3‐Phenylprop‐2‐ynyl)anilines with Carbon Monoxide and Alcohols for the Synthesis of Quinoline‐3‐carboxylic Esters
Authors: Zhang Wei , Zhao Mi‐Na , Chen Ming , Ren Zhi‐Hui , Guan Zhenghui 
Published: July 2018

AbstractA convenient palladium‐catalyzed regioselective cyclocarbonylation of N‐(3‐phenylprop‐2‐ynyl)anilines with carbon monoxide and alcohols has been developed. This methodology provides a simple and practical approach to various quinoline‐3‐carboxylic esters in good yields with high atom efficiency.