bluuebunny/crossref_metadata_2025_split huggingface dataset:
The burden of disease in Zimbabwe in 1997 as measured by disability‐adjusted life years lost
Authors: Chapman Glyn , Hansen Kristian S. , Jelsma Jennifer , Ndhlovu Chiratidzo , Piotti Bruno , Byskov Jens , Vos Theo 
Published: April 2006

SummaryObjective  To rank health problems contributing most to the burden of disease in Zimbabwe using disability‐adjusted life years as the population health measure.Methods  Epidemiological information was derived from multiple sources. Population size and total number of deaths by age and sex for the year 1997 were taken from a nationwide census. The cause of death pattern was determined based on data from the Vital Registration System, which was adjusted for under‐reporting of human immunodeficiency virus (HIV) and reallocation of ill‐defined causes. Non‐fatal disease figures were estimated based on local disease registers, surveys and routine health service data supplemented by estimates from epidemiological studies from other settings if no Zimbabwean sources were available. Disease and public health experts were consulted about the identification of the best possible sources of information, the quality of these sources and data adjustments made.Results  From the information collected, HIV infection emerged as the single most serious public health problem in Zimbabwe responsible for 49% of the total disease burden. A quarter of the total burden of disease was attributed to morbidity rather than premature mortality. The share of the disease burden was similar in females and males.Conclusion  Using local sources of information to a large extent, it was possible to develop plausible estimates of the size and the relative significance of the major health problems in Zimbabwe. The disease pattern of Zimbabwe differed substantially from regional estimates for sub‐Saharan Africa justifying the need for countries to develop their own burden of disease estimates.
The economic impact of visceral leishmaniasis on households in Bangladesh
Authors: Anoopa Sharma D. , Bern Caryn , Varghese Beena , Chowdhury Rajib , Haque Rashidul , Ali Mustakim , Amann Josef , Ahluwalia Indu B. , Wagatsuma Yukiko , Breiman Robert F. , Maguire James H. , McFarland Deborah A. 
Published: April 2006

SummaryObjectives  To explore current patterns of diagnosis and treatment, quantify household economic impact and identify household strategies to cover the costs of visceral leishmaniasis (VL) care in rural Bangladesh.Method  Structured interviews with 113 VL patients from 87 households documenting all provider visits and expenditures for health care for VL, and the ways in which the expenditures were covered.Results  Patients paid a median of 7 visits to six different providers before beginning VL treatment. All visited the subdistrict government hospital at least once. While health care, including antileishmanial drug therapy, is officially available free of charge at government facilities, 79% of patients reported making informal payments for provider access, diagnostics and drug administration; only 14% of patients received their full drug course from this source. For the 58% of patients who purchased the full treatment course, drug cost constituted 34% of direct expenditure. Median direct expenditure for one VL patient was US$87 and median income lost was $40; median total expenditure was 1.2 times annual per capita income of our study population. Households employed multiple coping strategies to cover expenditures, most commonly sale or rental of assets (62%) and taking out loans (64%).Conclusions  Visceral leishmaniasis treatment causes a major economic burden in affected families. Control strategies for VL should facilitate timely, affordable diagnosis and treatment of patients to decrease the infection reservoir and to alleviate the economic burden of VL on households.
The indoor use of plastic sheeting pre‐impregnated with insecticide for control of malaria vectors
Authors: Diabate A. , Chandre F. , Rowland M. , N'guessan R. , Duchon S. , Dabire K. R. , Hougard J.‐M. 
Published: April 2006

SummaryObjective  To evaluate the efficacy of permethrin‐treated plastic sheeting (ITPS) applied as a lining to the ceiling or walls of rooms against pyrethroid‐susceptible and pyrethroid‐resistant Anopheles gambiae.Method  Overnight tests were carried out in veranda‐trap experimental huts in Vallée du Kou, where two molecular forms of A. gambiae, S and M, occur. The S form is mostly pyrethroid resistant due to the kdr mechanism, and the M form is mostly kdr susceptible. A variety of ITPS covered surfaces were tested, ranging from ceiling only to all walls plus ceiling covered.Results  ITPS had a major effect on the mortality of mosquitoes, the proportion killed being dependent upon the surface area covered. Homozygotes for kdr resistance showed lower rates of mortality than did heterozygotes or homozygotes for susceptibility. Deterred entry of mosquitoes and inhibition of blood feeding were also correlated with surface area covered. The mode of action and efficacy of ITPS seems to bear closer resemblance to that induced by indoor residual spraying (IRS) than to that induced by insecticide‐treated nets.Conclusions  ITPS might be conceived as being equivalent to long‐lasting or permanent IRS but without some of the operational constraints normally associated with spraying. High coverage of ITPS could potentially have a mass population effect on mosquitoes and give rise to long‐term community protection against malaria. A phase III trial is justified to assess the acceptability of ITPS and its efficacy against malaria.
Post‐abortion care and voluntary HIV counselling and testing – an example of integrating HIV prevention into reproductive health services
Authors: Rasch Vibeke , Yambesi Fortunata , Massawe Siriel 
Published: April 2006

SummaryObjective  To assess the acceptance and outcome of voluntary HIV counselling and testing (VCT) among women who had an unsafe abortion.Method  706 women were provided with post‐abortion contraceptive service and offered VCT. We collected data on socioeconomic characteristics and contraceptive use and determined the HIV status of those who accepted VCT. Using a nested case–control design, we compared women who accepted HIV testing with women who did not. To study the association between socioeconomic factors, HIV testing acceptance and condom use in more detail, we did stratified analyses based on age and marital status.Results  58% of the women who had an unsafe abortion accepted HIV testing. Women who earned an income were more likely to accept testing than housewives. Women who accepted testing were more likely to accept using a condom. The HIV prevalence rate was 19% among single women aged 20–24 years and 25% among single women aged 25–45 years.Conclusion  HIV testing and condoms were accepted by most women who had an unsafe abortion. The poor reproductive health of these women could be improved by good post‐abortion care that includes contraceptive counselling, VCT and condom promotion.
Platelet gel and fibrin sealant reduce allogeneic blood transfusions in total knee arthroplasty
Authors: Everts P. A. M. , Devilee R. J. J. , Brown Mahoney C. , Eeftinck‐Schattenkerk M. , Box H. A. M. , Knape J. T. A. , Van Zundert A. 
Published: April 2006

Background:  Total knee arthroplasty (TKA) is often associated with a considerable amount of post‐operative blood loss, necessitating the transfusion of allogeneic blood, which can add to the complications. Optimization of strategies to reduce the need for blood transfusion is desired. This study was designed to evaluate the efficacy of autologous platelet gel and fibrin sealant in unilateral TKA.Methods:  Consecutive patients were operated on and assigned to the study and control groups. Study group patients (n = 85) were operated on according to our standard TKA protocol, with the application of autologous platelet gel and fibrin sealant on the wound tissues at the end of surgery. Eighty patients were operated on according to the same protocol, but without the use of platelet gel and fibrin sealant, and served as the control group. All blood transfusions, occurrence of wound leakage, wound healing disturbances and incidences of post‐operative infections were recorded.Results:  Patients in the treatment group had a significantly higher post‐operative haemoglobin level (11.3 vs. 8.9 g/dl, respectively) and a decreased need for allogeneic blood products (0.17 vs. 0.52 units, respectively) than those in the control group (P < 0.001). The incidences of wound leakage and wound healing disturbance were significantly less (P < 0.001) in patients managed with platelet gel and fibrin sealant. Four patients in the control group, who received blood products, developed wound infection. The hospital stay was decreased by 1.4 ± 1.5 days for patients in the treatment group (P < 0.001).Conclusion:  Peri‐operatively applied platelet gel and fibrin sealant may reduce the incidence of allogeneic blood transfusions and complications associated with TKA.
To eject or to abandon? Life history traits of hosts and parasites interact to influence the fitness payoffs of alternative anti-parasite strategies
Authors: Servedio M. R. , Hauber M. E. 
Published: April 2006

Abstract
Hosts either tolerate avian brood parasitism or reject it by ejecting parasitic eggs, as seen in most rejecter hosts of common cuckoos, Cuculus canorus, or by abandoning parasitized clutches, as seen in most rejecter hosts of brown-headed cowbirds, Molothrus ater. What explains consistent variation between alternative rejection behaviours of hosts within the same species and across species when exposed to different types of parasites? Life history theory predicts that when parasites decrease the fitness of host offspring, but not the future reproductive success of host adults, optimal clutch size should decrease. Consistent with this prediction, evolutionarily old cowbird hosts, but not cuckoo hosts, have lower clutch sizes than related rarely- or newly parasitized species. We constructed a mathematical model to calculate the fitness payoffs of egg ejector vs. nest abandoner hosts to determine if various aspects of host life history traits and brood parasites’ virulence on adult and young host fitness differentially influence the payoffs of alternative host defences. These calculations showed that in general egg ejection was a superior anti-parasite strategy to nest abandonment. Yet, increasing parasitism rates and increasing fitness values of hosts’ eggs in both currently parasitized and future replacement nests led to switch points in fitness payoffs in favour of nest abandonment. Nonetheless, nest abandonment became selectively more favourable only at lower clutch sizes and only when hosts faced parasitism by a cowbird- rather than a cuckoo-type brood parasite. We suggest that, in addition to evolutionary lag and gape-size limitation, our estimated fitness differences based on life history trait variation provide new insights for the consistent differences observed in the anti-parasite rejection strategies between many cuckoo- and cowbird-hosts.
Successful caspofungin treatment of multidrug resistant Candida parapsilosis septicaemia in an extremely low birth weight neonate
Authors: Yalaz Mehmet , Akisu Mete , Hilmioglu Suleyha , Calkavur Sebnem , Cakmak Bilin , Kultursay Nilgun 
Published: April 2006

SummaryCandida septicaemia with multidrug resistance is an uncommon event in preterm neonates. We present an extremely low birth weight infant (gestational age of 27 weeks, birth weight of 980 g) who developed congenital Candida parapsilosis septicaemia. Because the fungus was resistant both to amphotericin B and fluconazole, caspofungin was chosen for therapy. The fungus was successfully eradicated without any clinical or laboratory adverse effects.
Onychomycosis in Lebanon: a mycological survey of 772 patients
Authors: El Sayed Fouad , Ammoury Alfred , Haybe Rita Feghaly , Dhaybi Rola 
Published: April 2006

SummaryAccurate diagnosis of onychomycosis is based on clinical findings, direct microscopic investigation and mycological culture. If the diagnosis is not confirmed by culture and improvement does not occur, it is impossible to tell whether this represents treatment failure or an initial incorrect diagnosis. The aim of this study was to identify the major organisms involved in onychomycosis with emphasis on the importance of culture in treating onychomycosis. The study was performed at the Lebanese University, Beirut, Lebanon over a 5‐year period (2000–2004). Clinically suspected patients were referred to our mycology laboratory for KOH test and culture. The study included 772 patients (520 women, 252 men). Cultures were positive in 54.3% of cases (predominantly male). The ratio of onychomycosis in toenails/fingernails was 1.9. In toenails, dermatophytes were found in 77.1% of cases, Candida in 18.9% and moulds in 4%. In fingernails, Candida was found in 81% of cases, dermatophytes in 18.1% and moulds in 0.9%. The most commonly isolated dermatophytes were Trichophyton mentagrophytes (36%), T. rubrum (27.5%) and T. tonsurans (26%). Pathogens involved in onychomycosis change according to each geographical area. Therefore, treatments should be based on studies carried out in the same region.
Characterisation of the anticryptococcal effect of the FC‐1 toxin produced by Filobasidium capsuligenum
Authors: Keszthelyi A. , Ohkusu M. , Takeo K. , Pfeiffer I. , Litter J. , Kucsera J. 
Published: April 2006

SummaryThe basidiomycetous yeast Filobasidium capsuligenum produces a killer toxin (FC‐1) which is highly effective against the opportunistic fungal pathogen Cryptococcus neoformans. The aim of this work was to study the effect of the toxin on C. neoformans cells. The sensitivities of strains representing eight molecular subtypes (VNI–IV and VGI–IV) of the C. neoformans species complex, and of an additional 50 clinical and environmental isolates were determined. Analysis of cellular DNA by laser scanning cytometry and fluorescein isothiocyanate (FITC) staining of the toxin‐treated cells revealed that the killing mechanism of FC‐1 is neither cell cycle‐ nor cell wall biosynthesis‐dependent; rather it may act as an ionophoric protein that disrupts the cytoplasmic membrane function. The competition assay results suggest that β‐1,6‐glucan in the cell wall may provide the binding site for the killer protein. This anticryptococcal toxin has the potential to be applied as a therapeutic agent for the treatment of cryptococcosis.
Multiple viral hepatitis in injection drug users and associated risk factors
Authors: Reimer Jens , Lorenzen Juergen , Baetz Bernhard , Fischer Benedikt , Rehm Juergen , Haasen Christian , Backmund Markus 
Published: April 2006

AbstractBackground:  While infections due to hepatitis B virus (HBV) and hepatitis C virus (HCV) have been well‐studied in injection drug users (IDUs), hepatitis A virus (HAV) infection and coinfection with multiple hepatitis viruses have received less attention.Methods:  Hepatitis serology as well as sociodemographic and drug‐related parameters were explored in patients (n = 1512) admitted for opiate detoxification.Results:  Antibodies to HAV were positive in 57.7%, to HBV in 53.0%, and to HCV in 75.0% of the sample. Lack of any hepatic marker was reported in 11.2%; one marker was positive in 24.7%; two markers were positive in 31.2%; and all markers were positive in 32.9%. In patients with one positive marker, 58.8% had had exposure to HCV, and 27% had exposure to HAV. In patients with two positive markers, 46.7% were HAV/HCV and 41.8% HBV/HCV antibody positive. Presence of HBV and HCV antibodies was associated with older age, longer duration of (i.v.) heroin use, and a higher number of rehabilitation treatment episodes (anova), current coconsumption of cocaine was associated with presence of antibodies to either HAV, HBV, and HCV.Conclusions:  Coinfection with hepatic viruses is highly relevant in IDUs, although HAV does not necessarily share the same risk factors relevant for HBV or HCV transmission. The need for outreach vaccination programs is emphasized for HAV and HBV in the target population. Primary prevention should be implemented before initiation or at early stages of a drug career. Epidemiology and transmission of HAV in IDUs requires further research.
Overexpressed cyclo‐oxygenase‐2 in the background liver is associated with the clinical course of hepatitis C virus‐related cirrhosis patients after curative surgery for hepatocellular carcinoma
Authors: Morinaga Soichiro , Tarao Kazuo , Yamamoto Yuji , Nakamura Yoshiyasu , Rino Yasushi , Miyakawa Kaoru , Ohkawa Shinichi , Akaike Makoto , Sugimasa Yukio , Takemiya Shoji 
Published: April 2006

AbstractBackground: The probable role of cyclo‐oxygenase‐2 (COX‐2) in the development of hepatocellular carcinoma (HCC) in patients with chronic liver diseases has been accepted to be relevant. The purpose of the present study was to determine whether overexpressed COX‐2 in the background liver affects the clinical course of hepatitis C virus (HCV)‐related cirrhosis patients after curative surgery for HCC.Methods: Twenty‐nine clinical stage I HCC patients with HCV‐related cirrhosis, who underwent curative surgery, were enrolled in the present study (22 men and seven women, age range 53–73 years; follow‐up period; range 22–159 months, median 61 months). The COX‐2 expression in the cirrhotic liver was examined by immunohistochemistry using the avidin–biotin–peroxidase complex technique on paraffin‐embedded formalin‐fixed tissue. The COX‐2 expression was scored, then correlated with monitored alanine aminotransferase (ALT) levels during the follow‐up period after surgery, response to alternative therapy aiming to improve elevated ALT levels, and recurrence/survival after surgery.Results: The COX‐2 expression scores were significantly higher in the high‐ALT group than in the low‐ALT group (Mann–Whitney,P = 0.010), and were significantly higher in non‐responders to the alternative therapy than in responders (Mann–Whitney,P = 0.028). The higher COX‐2 expression in the cirrhotic liver was the significant independent risk factor for residual liver recurrence (Cox multivariate analysis,P = 0.014), but not for survival.Conclusions: Overexpressed COX‐2 in the background liver may play an important role in prolonged acceleration of necroinflammation, resistance to the alternative therapy, and recurrence/new development of HCC in HCV‐related cirrhosis patients.
Modified technique of high‐resolution ultrasonography of the normal cervical esophagus
Authors: Mateen Mohammed A , Kaffes Arthur John , Sriram Parupudi VJ , Rao Guduru V , Reddy D Nageshwar 
Published: April 2006

AbstractBackground and Aim:  To study a modified technique of neck ultrasound for the visualization of cervical esophagus using a high‐resolution and high frequency linear transducer in normal subjects.Methods:  Consecutive control subjects were patients who underwent abdominal sonography for other diseases and had no past or current history of dysphagia or esophageal disorders. The thyroid gland was used as a transducer window to obtain images. We used a slightly flexed neck position with the head turned 45 degrees to the opposite side while scanning the neck on either side.Results:  One‐hundred subjects were scanned and their age range was 10–74 years (male : female ratio 1:1). In 36% of cases it was difficult to visualize the right lateral 2/3rd in the traditional scanning position of the neck. This improved to 2% with the modified neck position. All patients had the left window visualized with both neck positions. The transverse diameter, anterior‐posterior diameter and wall thickness measures were all significantly greater with the modified technique. All patients tolerated the procedure with no reported discomfort.Conclusions:  This modified technique provides superior views of the cervical esophagus, particularly from the right window, in almost all patients. Normal parameters using ultrasound have now been established.
Threshold elemental ratios of carbon and phosphorus in aquatic consumers
Authors: Frost Paul C. , Benstead Jonathan P. , Cross Wyatt F. , Hillebrand Helmut , Larson James H. , Xenopoulos Marguerite A. , Yoshida Takehito 
Published: April 2006

AbstractInadequate supply of one or more mineral elements can slow the growth of animal consumers and alter their physiology, life history and behaviour. A key concept for understanding nutrient deficiency in animals is the threshold elemental ratio (TER), at which growth limitation switches from one element to another. We used a stoichiometric model that coupled animal bioenergetics and body elemental composition to estimate TER of carbon and phosphorus (TERC:P) for 41 aquatic consumer taxa. We found a wide range in TERC:P (77–3086, ratio by atoms), which was generated by interspecific differences in body C : P ratios and gross growth efficiencies of C. TERC:P also varied among aquatic invertebrates having different feeding strategies, such that detritivores had significantly higher threshold ratios than grazers and predators. The higher TERC:P in detritivores resulted not only from lower gross growth efficiencies of carbon but also reflected lower body P content in these consumers. Supporting previous stoichiometric theory, we found TERC:P to be negatively correlated with the maximum growth rate of invertebrate consumers. By coupling bioenergetics and stoichiometry, this analysis revealed strong linkages among the physiology, ecology and evolution of nutritional demands for animal growth.
Predator biodiversity strengthens herbivore suppression
Authors: Snyder William E. , Snyder Gretchen B. , Finke Deborah L. , Straub Cory S. 
Published: April 2006

AbstractSpecies diversity at lower trophic levels generally improves ecosystem functioning. However, the impact of greater predator diversity on herbivore regulation is uncertain because predator species both compete with and prey on each other. In a large‐scale field experiment we examined the relationship between predator species diversity and the suppression of two herbivores, green peach and cabbage aphids, on collard plants. We show that, for both aphid species, the strength of herbivore suppression increased with higher predator biodiversity. Greater resource exploitation by predators in diverse communities generally led to improved predator survivorship and reproduction. Herbivore population size was negatively correlated with plant biomass, providing evidence that greater aphid suppression leads to improved plant growth. Our study suggests a harmonious relationship between predator conservation and herbivore control, and a relatively weak role for predator interference, within this community.
Working on educational research methods with masters students in an international online learning community
Authors: Hudson Brian , Owen David , Veen Klaas van 
Published: April 2006

AbstractIn this paper we discuss the background to this study in the development of the international MSc e‐Learning Multimedia and Consultancy. The aims of the study focus on the conditions for achieving communication, interaction and collaboration in open and flexible e‐learning environments. We present our theoretical framework that has informed the design of programme as a whole which is based on a socio‐constructivist perspective on learning. Our research is placed within an action research framework and we outline our position within the critical or emancipatory tradition and also our standpoint on the use of ICT in education. We discuss the design of the programme and also our pedagogical approach and describe in detail the particular context for this study. We report on the student experience of being learners on this module, their perceptions of what they have gained most from learning from and with each other and their responses to the various ways in which ‘scaffolding’ has been designed and implemented by the tutors. Finally we offer some reflections on the conditions for achieving well‐orchestrated interdependence in open and flexible e‐learning environments.