bluuebunny/crossref_metadata_2025_split huggingface dataset:
The cost‐effectiveness of 10 antenatal syphilis screening and treatment approaches in Peru, Tanzania, and Zambia
Authors: Terris‐Prestholt Fern , Vickerman Peter , Torres‐Rueda Sergio , Santesso Nancy , Sweeney Sedona , Mallma Patricia , Shelley Katharine D. , Garcia Patricia J. , Bronzan Rachel , Gill Michelle M. , Broutet Nathalie , Wi Teodora , Watts Charlotte , Mabey David , Peeling Rosanna W. , Newman Lori 
Published: May 2015

AbstractObjectiveRapid plasma reagin (RPR) is frequently used to test women for maternal syphilis. Rapid syphilis immunochromatographic strip tests detecting only Treponema pallidum antibodies (single RSTs) or both treponemal and non‐treponemal antibodies (dual RSTs) are now available. This study assessed the cost‐effectiveness of algorithms using these tests to screen pregnant women.MethodsObserved costs of maternal syphilis screening and treatment using clinic‐based RPR and single RSTs in 20 clinics across Peru, Tanzania, and Zambia were used to model the cost‐effectiveness of algorithms using combinations of RPR, single, and dual RSTs, and no and mass treatment. Sensitivity analyses determined drivers of key results.ResultsAlthough this analysis found screening using RPR to be relatively cheap, most (> 70%) true cases went untreated. Algorithms using single RSTs were the most cost‐effective in all observed settings, followed by dual RSTs, which became the most cost‐effective if dual RST costs were halved. Single test algorithms dominated most sequential testing algorithms, although sequential algorithms reduced overtreatment. Mass treatment was relatively cheap and effective in the absence of screening supplies, though treated many uninfected women.ConclusionThis analysis highlights the advantages of introducing RSTs in three diverse settings. The results should be applicable to other similar settings.
Introduction of rapid syphilis testing in antenatal care: A systematic review of the impact on HIV and syphilis testing uptake and coverage
Authors: Swartzendruber Andrea , Steiner Riley J. , Adler Michelle R. , Kamb Mary L. , Newman Lori M. 
Published: May 2015

AbstractBackgroundGlobal guidelines recommend universal syphilis and HIV screening for pregnant women. Rapid syphilis testing (RST) may contribute toward achievement of universal screening.ObjectivesTo examine the impact of RST on syphilis and HIV screening among pregnant women.Search strategyWe searched MEDLINE for English‐ and non‐English language articles published through November, 2014.Selection criteriaWe included studies that used a comparative design and reported on syphilis and HIV test uptake among pregnant women in low‐ and middle‐income countries (LMICs) following introduction of RST.Data collection and analysisData were extracted from six eligible articles presenting findings from Asia, Africa, and Latin America.Main resultsAll studies reported substantial increases in antenatal syphilis testing following introduction of RST; the latter did not appear to adversely impact antenatal HIV screening levels at sites already offering rapid HIV testing and may increase HIV screening among pregnant women in some settings. Qualitative data revealed that women were highly satisfied with RST. Nevertheless, ensuring adequate training for healthcare workers and supplies of commodities were cited as key implementation barriers.ConclusionsRST may increase antenatal syphilis and HIV screening and contribute to the improvement of antenatal care in LMICs.
Lessons learned from integrating simultaneous triple point‐of‐care screening for syphilis, hepatitis B, and HIV in prenatal services through rural outreach teams in Guatemala
Authors: Smith Adriana , Sabidó Meritxell , Camey Elsy , Batres Anabelle , Casabona Jordi 
Published: May 2015

AbstractMother‐to‐child‐transmission of HIV, syphilis, and hepatitis B virus (HBV) remains a challenge in Guatemala, especially in rural regions. A triple antenatal screening program for these infections using point‐of‐care (POC) testing offered through outreach teams was implemented in the municipality of Puerto de San José. One year following program implementation, antenatal care coverage increased to 99.6% (32.5% increase, P < 0.001), testing uptake increased to 50.3% for HIV and syphilis (143.9% (P < 0.001) and 1.3% (P = 0.89) increase, respectively), and HBV testing increased from 0 to 42.2%. Lessons learned showed that, despite the expansion of triple antenatal POC screening in rural Guatemala, a shortage of healthcare workers and poor supply chain management limited screening uptake. Moreover, training is essential to help health workers overcome their fear of communicating positive results and improve partner notification. Engagement of community health workers was essential to build local capacity and facilitate community acceptance.
Elimination of mother‐to‐child transmission of HIV and syphilis: A dual approach in the African Region to improve quality of antenatal care and integrated disease control
Authors: Newman Owiredu Morkor , Newman Lori , Nzomo Theresa , Conombo Kafando Ghislaine , Sanni Saliyou , Shaffer Nathan , Bucagu Maurice , Peeling Rosanna , Mark Jennifer , Diop Toure Isseu 
Published: May 2015

AbstractThe World Health Organization's (WHO) Strategic Framework for the Elimination of New HIV Infections among Children in Africa by 2015 identifies important synergies for the elimination of mother‐to‐child transmission of HIV and syphilis in terms of prevention interventions, implementation logistics and service delivery, monitoring and evaluation systems, and need for sustained political commitment. The WHO advocates the use of an integrated, rights‐based dual approach with partnerships and collaboration to make the best use of available resources. Through a consultative approach, six countries in the African Region committed to dual elimination and developed and implemented action plans for this purpose. Where interest and commitment are high, this may also be possible and effective in other African countries.
Estimating the uptake of maternal syphilis screening and other antenatal interventions before and after national rollout of syphilis point‐of‐care testing in Ghana
Authors: Dassah Edward T. , Adu‐Sarkodie Yaw , Mayaud Philippe 
Published: May 2015

AbstractObjectiveTo compare the uptake of maternal syphilis and HIV screening, intermittent preventive treatment for malaria, and tetanus toxoid administration in three regions of Ghana, before and after the rollout of syphilis point‐of‐care tests (POCTs).MethodsAntenatal register records were reviewed in 15 selected health facilities over an eight‐month period, 16 months apart. Register records had been evaluated using the maternal record booklets as a gold standard in a separate prior survey.ResultsIn the evaluation study, the sensitivity of register data was low, ranging from 33.3% for tetanus toxoid administration to 53.8% for syphilis serology. In total, 8282 antenatal client records (4141 in each period) were reviewed. Less than a third of pregnant women received any single intervention at either period (ranging from 17.8% for tetanus toxoid to 29.8% for HIV testing). Overall, HIV screening had a marginal absolute increase of about 2% while the remaining interventions experienced non‐significant absolute decreases of 4.1 to11.1%. When adjusting for under‐recording, syphilis screening uptake was 50% before and 33.6% after the introduction of POCTs.ConclusionUse of POCTs for syphilis did not result in increased uptake. Routine monitoring of antenatal interventions using the antenatal register may result in underestimation of their uptake.
The need for further integration of services to prevent mother‐to‐child transmission of HIV and syphilis in Mwanza City, Tanzania
Authors: Balira Rebecca , Mabey David , Weiss Helen , Ross David Anthony , Changalucha John , Watson‐Jones Deborah 
Published: May 2015

AbstractObjectiveTo assess the operational integration of maternal HIV testing and syphilis screening in Mwanza, Tanzania.MethodsInterviews were conducted with 76 health workers (HW) from three antenatal clinics (ANC) and three maternity wards in 2008–2009 and 1137 consecutive women admitted for delivery. Nine ANC health education sessions and client flow observations were observed.ResultsOnly 25.0% of HWs reported they had received training in both prevention of mother‐to‐child transmission (PMTCT) and syphilis screening. HIV and syphilis tests were sometimes performed in different rooms and results recorded in separate registers with different formats and the results were not always given by the same person. At delivery, most women had been tested for both HIV (79.4%) and syphilis (88.1%) during pregnancy. Of those not tested antenatally for each infection, 70.1% were tested for HIV at delivery but none for syphilis.ConclusionIntegration of maternal HIV and syphilis screening was limited. Integrated care guidelines and related health worker training should address this gap.
Bottlenecks in the implementation of essential screening tests in antenatal care: Syphilis, HIV, and anemia testing in rural Tanzania and Uganda
Authors: Baker Ulrika , Okuga Monica , Waiswa Peter , Manzi Fatuma , Peterson Stefan , Hanson Claudia 
Published: May 2015

AbstractObjectiveTo identify and compare implementation bottlenecks for effective coverage of screening for syphilis, HIV, and anemia in antenatal care in rural Tanzania and Uganda; and explore the underlying determinants and perceived solutions to overcome these bottlenecks.MethodsIn this multiple case study, we analyzed data collected as part of the Expanded Quality Management Using Information Power (EQUIP) project between November 2011 and April 2014. Indicators from household interviews (n = 4415 mothers) and health facility surveys (n = 122) were linked to estimate coverage in stages of implementation between which bottlenecks can be identified. Key informant interviews (n = 15) were conducted to explore underlying determinants and analyzed using a framework approach.ResultsLarge differences in implementation were found within and between countries. Availability and effective coverage was significantly lower for all tests in Uganda compared with Tanzania. Syphilis screening had the lowest availability and effective coverage in both countries. The main implementation bottleneck was poor availability of tests and equipment. Key informant interviews validated these findings and perceived solutions included the need for improved procurement at the central level.ConclusionOur findings reinforce essential screening as a missed opportunity, caused by a lack of integration of funding and support for comprehensive antenatal care programs.
Cortical microinfarcts on 3T MRI: Clinical correlates in memory‐clinic patients
Authors: van Veluw Susanne J. , Hilal Saima , Kuijf Hugo J. , Ikram Mohammad Kamran , Xin Xu , Yeow Tan Boon , Venketasubramanian Narayanaswamy , Biessels Geert Jan , Chen Christopher 
Published: May 2015

AbstractIntroductionThis is the first study to assess cerebral microinfarcts (CMIs) on 3 tesla (3T) magnetic resonance imaging (MRI) in a memory clinic population.MethodsWe included 238 consecutive patients (aged 72.5 ± 9.1 years) from a memory clinic in Singapore. All patients underwent extensive neurological and neuropsychological testing and 3T MRI on the same day. Cortical CMI rating criteria were adapted from a previous study on 7T MRI. We analyzed the frequency and association of cortical CMIs with demographic, clinical, cognition, and other MRI findings.ResultsSeventy‐five patients (32%) had cortical CMIs (median 1, range 1–43). Patients with CMIs showed worse cognitive functioning on MMSE, and in the domains of language and visuoconstruction. The presence of CMIs was related to other markers of small vessel disease, but most strongly larger cortical infarcts. Patients with CMIs were more often diagnosed with vascular dementia.DiscussionCortical CMIs on 3T MRI are a novel marker of cerebrovascular disease in dementia.
Evaluation of the anti-inflammatory and antioxidant effects of the sucralfate in diversion colitis
Authors: Martinez Carlos Augusto Real , Rodrigues Murilo Rocha , Sato Daniela Tiemi , da Silva Camila Morais Gonçalves , Kanno Danilo Toshio , Mendonça Roberta Laís dos Santos , Pereira José Aires 
Published: May 2015

AbstractSucralfate enemas present good results in the treatment of colitis, however the mechanism of action of the drug is not yet fully clarified.
Objective To evaluate the anti-inflammatory and antioxidant effects of sucralfate enemas in diversion colitis model.
Method Thirty-six Wistar rats underwent intestinal bypass by end colostomy in the descending colon and distal mucous fistula. The animals were divided into 3 experimental groups according to the daily dose of enemas received containing 0.9% SF, sucralfate enemas or sucralfate enemas 1 g/kg/day or 2 g/kg/day. Each group was divided into two subgroups according to euthanasia to be performed 2–4 weeks after derivation. The tissue grade of inflammation was assessed histologically, and neutrophil infiltration by the tissue expression of myeloperoxidase (MPO) identified by immunohistochemistry and quantified by computerized morphometry. Oxidative stress was measured by tissue levels of malondialdehyde (MDA). To compare the results the Student's t test variance was used, and also the variance by ANOVA test, establishing a level of significance of 5% (p < 0.05) for both.
Results The intervention with sucralfate enemas showed improvement in the intensity of tissue inflammation related to the concentration used and the duration of the intervention. Intervention with sucralfate enemas reduced the tissue levels of MPO, independent of concentration or time of intervention (p < 0.01). There was a reduction of MDA levels in animals irrigated with sucralfate enemas, independent of concentration or duration of the intervention (p < 0.01).
Conclusion Enemas with sucralfate enemas reduce inflammation, neutrophil infiltration and oxidative stress in the excluded colon suggesting topical application of the substance to be a valid therapeutic option for the treatment of diversion colitis.
Thymosin‐β4 is a determinant of drug sensitivity for Fenretinide and Vorinostat combination therapy in neuroblastoma
Authors: Cheung Belamy B. , Tan Owen , Koach Jessica , Liu Bing , Shum Michael S.Y. , Carter Daniel R. , Sutton Selina , Po'uha Sela T. , Chesler Louis , Haber Michelle , Norris Murray D. , Kavallaris Maria , Liu Tao , O'Neill Geraldine M. , Marshall Glenn M. 
Published: May 2015

AbstractRetinoids are an important component of neuroblastoma therapy at the stage of minimal residual disease, yet 40–50% of patients treated with 13‐cis‐retinoic acid (13‐cis‐RA) still relapse, indicating the need for more effective retinoid therapy. Vorinostat, or Suberoylanilide hydroxamic acid (SAHA), is a potent inhibitor of histone deacetylase (HDAC) classes I & II and has antitumor activity in vitro and in vivo. Fenretinide (4‐HPR) is a synthetic retinoid which acts on cancer cells through both nuclear retinoid receptor and non‐receptor mechanisms. In this study, we found that the combination of 4‐HPR + SAHA exhibited potent cytotoxic effects on neuroblastoma cells, much more effective than 13‐cis‐RA + SAHA. The 4‐HPR + SAHA combination induced caspase‐dependent apoptosis through activation of caspase 3, reduced colony formation and cell migration in vitro, and tumorigenicity in vivo. The 4‐HPR and SAHA combination significantly increased mRNA expression of thymosin‐beta‐4 (Tβ4) and decreased mRNA expression of retinoic acid receptor α (RARα). Importantly, the up‐regulation of Tβ4 and down‐regulation of RARα were both necessary for the 4‐HPR + SAHA cytotoxic effect on neuroblastoma cells. Moreover, Tβ4 knockdown in neuroblastoma cells increased cell migration and blocked the effect of 4‐HPR + SAHA on cell migration and focal adhesion formation. In primary human neuroblastoma tumor tissues, low expression of Tβ4 was associated with metastatic disease and predicted poor patient prognosis. Our findings demonstrate that Tβ4 is a novel therapeutic target in neuroblastoma, and that 4‐HPR + SAHA is a potential therapy for the disease.
Maximum Power During Vertical Jump and Isometric Knee Extension Torque Alter Mobility Performance: A Cross‐Sectional Study of Healthy Individuals
Authors: Tsubaki Atsuhiro , Kubo Masayoshi , Kobayashi Ryosaku , Jigami Hirofumi , Sugawara Kazuhiro , Takahashi Hideaki E. 
Published: May 2015

AbstractObjectiveTo provide reference values of muscle function (MF) and mobility performance (MP) and to clarify the effects of MF on MP.DesignA normative cross‐sectional study.SettingAn urban area of Niigata, Japan.ParticipantsA total of 401 individuals (210 men and 191 women) with a mean age of 41.8 years (range, 7‐79 years) who lived in the community and did not have impairments in activities of daily living.MethodsGrip strength, isometric knee extension torque (IKET), and maximum ground reaction force (Fmax) and maximum power (Pmax) during a vertical jump were used as measurements of MF. The chair‐rise test (CRT) and the timed “Up and Go” test (TUG) were used to assess MP.Main Outcome MeasurementsMean values of GS, IKET, CRT, TUG, Fmax, and Pmax were calculated according to age and gender. A stepwise multiple regression analysis was used to identify MF factors with an effect on CRT and TUG in participants ≥20 years of age.ResultsOur results showed that all MF parameters were decreased in individuals ≥20 years of age compared to those <20 years old. Moreover, all of the MP parameters increasingly deteriorated with increasing age. CRT and TUG were affected by Pmax and IKET in men and by IKET in women according to logistic regression analysis.ConclusionThe study findings suggest that muscle power affects MP more than the muscle strength in persons aged ≥20 years.
Effect of Hypertonic Saline in Intra‐Articular Hydraulic Distension for Adhesive Capsulitis
Authors: Lee Jong Hwa , Kim Sang Beom , Lee Kyeong Woo , Lee Sook Joung , Lee Jae Uk 
Published: May 2015

AbstractBackgroundMaintaining the integrity of the capsule along with infusing a sufficient amount of fluid is 1 of the therapeutic concepts in intra‐articular hydraulic distension (IHD) for adhesive capsulitis. It has been known that hypertonic saline solution decreases tissue edema and increases the fluid volume within the epidural space, causing microdissection, in epidural adhesiolysis.ObjectiveTo investigate the effect of hypertonic saline solution in capsule‐preserving intra‐articular hydraulic distension (CPIHD) for adhesive capsulitis.DesignProspective randomized controlled trial.SettingUniversity outpatient clinic of physical medicine and rehabilitation.ParticipantsA total of 64 patients who were diagnosed as adhesive capsulitis of shoulder were randomly assigned to 1 of 2 treatment groups. The hypertonic saline group was treated by CPIHD with hypertonic saline (3% NaCl), and the normal saline group with normal saline solution (0.9% NaCl).MethodsBoth groups were treated with CPIHD, a method that preserves the capsule with maximal distension without inducing capsule rupture. The volume of saline solution necessary to adequately distend the capsule was recorded. Injection materials contained 4 mL of 1% lidocaine, 1 mL of triamcinolone (10 mg), and saline solution (hypertonic or normal saline). The intra‐articular injection was monitored with ultrasound to maximize the infused volume while preserving the capsule.Main Outcome MeasurementsThe Shoulder Pain and Disability Index (SPADI) and shoulder passive range of motion (PROM) was measured before the procedure and 2 weeks after CPIHD.ResultsThe mean CPIHD volume was 20.2 ± 5.2 mL for the hypertonic saline group and 19.5 ± 5.9 mL for the normal saline group. The hypertonic saline group showed statistically significant improvement in shoulder PROM and SPADI score compared with the normal saline group. Side effects such as soreness or complications related to injection were not reported.ConclusionsOur results suggest that CPIHD with hypertonic saline solution is more effective than that using normal saline solution in patients with adhesive capsulitis.
Structure and stability of steady porous medium convection at large Rayleigh number
Authors: Wen Baole , Corson Lindsey T. , Chini Gregory P. 
Published: May 2015

A systematic investigation of unstable steady-state solutions of the Darcy–Oberbeck–Boussinesq equations at large values of the Rayleigh number $\mathit{Ra}$ is performed to gain insight into two-dimensional porous medium convection in domains of varying aspect ratio $L$. The steady convective states are shown to transport less heat than the statistically steady ‘turbulent’ flow realised at the same parameter values: the Nusselt number $\mathit{Nu}\sim \mathit{Ra}$ for turbulent porous medium convection, while $\mathit{Nu}\sim \mathit{Ra}^{0.6}$ for the maximum heat-transporting steady solutions. A key finding is that the lateral scale of the heat-flux-maximising solutions shrinks roughly as $L\sim \mathit{Ra}^{-0.5}$, reminiscent of the decrease of the mean inter-plume spacing observed in turbulent porous medium convection as the thermal forcing is increased. A spatial Floquet analysis is performed to investigate the linear stability of the fully nonlinear steady convective states, extending a recent study by Hewitt et al. (J. Fluid Mech., vol. 737, 2013, pp. 205–231) by treating a base convective state, and secondary stability modes, that satisfy appropriate boundary conditions along plane parallel walls. As in that study, a bulk instability mode is found for sufficiently small-aspect-ratio base states. However, the growth rate of this bulk mode is shown to be significantly reduced by the presence of the walls. Beyond a certain critical $\mathit{Ra}$-dependent aspect ratio, the base state is most strongly unstable to a secondary mode that is localised near the heated and cooled walls. Direct numerical simulations, strategically initialised to investigate the fully nonlinear evolution of the most dangerous secondary instability modes, suggest that the (long time) mean inter-plume spacing in statistically steady porous medium convection results from a balance between the competing effects of these two types of instability.
HECKE ALGEBRAS FOR INNER FORMS OF -ADIC SPECIAL LINEAR GROUPS
Authors: Aubert Anne-Marie , Baum Paul , Plymen Roger , Solleveld Maarten 
Published: May 2015

Let$F$be a non-Archimedean local field, and let$G^{\sharp }$be the group of$F$-rational points of an inner form of$\text{SL}_{n}$. We study Hecke algebras for all Bernstein components of$G^{\sharp }$, via restriction from an inner form$G$of$\text{GL}_{n}(F)$.For any packet of L-indistinguishable Bernstein components, we exhibit an explicit algebra whose module category is equivalent to the associated category of complex smooth$G^{\sharp }$-representations. This algebra comes from an idempotent in the full Hecke algebra of$G^{\sharp }$, and the idempotent is derived from a type for$G$. We show that the Hecke algebras for Bernstein components of$G^{\sharp }$are similar to affine Hecke algebras of type$A$, yet in many cases are not Morita equivalent to any crossed product of an affine Hecke algebra with a finite group.