bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring wealth-related inequalities in maternal and child health coverage in Latin America and the Caribbean
Authors: Colomé-Hidalgo Manuel , Campos Juan Donado , De Miguel Ángel Gil 
Published: September 2020

Abstract
Background. Maternal and child health have shown important advances in the world in recent years. However, national averages indicators hide large inequalities in access and quality of care in population subgroups. We explore socioeconomic inequalities affecting health coverage and interventions in reproductive, maternal, newborn, and child health in Latin America and the Caribbean. Methods. We analyzed representative national surveys from 15 countries conducted between 2001 and 2016. We estimated maternal-child health coverage gaps using the Composite Coverage Index – a weighted average of interventions that include family planning, maternal and newborn care, immunizations, and treatment of sick children. We measured absolute and relative inequality to assess gaps by wealth quintile. Pearson’s correlation coefficient was used to test the association between the coverage gap and population attributable risk. Results. The Composite Coverage Index showed patterns of inequality favoring the wealthiest subgroups. In eight countries the national coverage was higher than the global median (78.4%; 95% CI: 73.1-83.6) and increased significantly as inequality decreased (Pearson r = 0.9; p <0.01). Conclusions. There are substantial inequalities between socioeconomic groups. Reducing inequalities will improve coverage indicators for women and children. Additional health policies, programs, and practices are required to promote equity.
Pooling for SARS-CoV-2 Control in Care Institutions
Authors: Alvargonzalez Jorge J. Cabrera , Cao Sonia Rey , Castro Sonia Pérez , Lamas Lucía Martínez , Calvo Olaia Cores , Piñon Julio Torres , Fresco Jacobo Porteiro , Comesaña Julio Garcia , Garcia Benito Regueiro 
Published: September 2020

Abstract
BackgroundWorkers and residents in Care Homes are considered at special risk for the acquisition of SARS-CoV-2 infection, due to the infectivity and high mortality rate in the case of residents, compared to other containment areas. The role of presymptomatic people in transmission has been shown to be important and the early detection of these people is critical for the control of new outbreaks. Pooling strategies have proven to preserve SARS-CoV-2 testing resources.The aims of the present study, based in our local experience, were (a) to describe SARS-CoV-2 prevalence in institutionalized people in Galicia (Spain) during the Coronavirus pandemic and (b) to evaluate the expected performance of a pooling strategy using RT-PCR for the next rounds of screening of institutionalized people.MethodsA total of 25,386 Nasopharyngeal swab samples from the total of the residents and workers at Care Homes in Galicia (March to May 2020) were individually tested using RT-PCR. Prevalence and quantification cycle (Cq) value distribution of positives was calculated. Besides, 26 pools of 20 samples and 14 pools of 5 samples were tested using RT-PCR as well (1 positive/pool). Pooling proof of concept was performed in two populations with 1.7% and 2% prevalence.ResultsDistribution of SARS-CoV-2 infection at Care Homes was uneven (0-60%). As the virus circulation global rate was low in our area (3.32%), the number of people at risk of acquiring the infection continues to be very high. In this work, we have successfully demonstrated that pooling of different groups of samples at low prevalence clusters, can be done with a small average delay on Cq values (5 and 2.85 cycles for pools of 20 and 5 samples, respectively). ConclusionsA new screening system with guaranteed protection is required for small clusters, previously covered with individual testing. Our proposal for Care Homes, once prevalence zero is achieved, would include successive rounds of testing using a pooling solution for transmission control preserving testing resources. Scale-up of this method may be of utility to confront larger clusters to avoid the viral circulation and keeping them operative.
Clinical features of patients with hepatic portal venous gas
Authors: Fujii Manato , Yamashita Suguru , Tanaka Mayuko , Tashiro Jo , Takenaka Yoshiharu , Yamasaki Kazuki , Masaki Yukiyoshi 
Published: September 2020

Abstract
Background: Hepatic portal venous gas (HPVG) is a rare clinical condition that is caused by a variety of underlying diseases. However, the factors that would permit accurate identification of bowel ischemia, requiring surgery, in patients with HPVG have not been fully investigated.Methods: Thirty patients that had been diagnosed with HPVG using computed tomography between 2010 and 2019 were allocated to two groups on the basis of clinical and intraoperative findings: those with (Group 1; n=12 [40%]) and without (Group 2; n=18 [60%]) bowel ischemia. Eleven patients underwent emergency surgery, and bowel ischemia was identified in eight of these (73%). Four patients in Group 1 were diagnosed with bowel ischemia, but treated palliatively because of their general condition. We compared the characteristics and outcomes of Groups 1 and 2 and identified possible prognostic factors for bowel ischemia.Results: At admission, patients in Group 1 more commonly showed the peritoneal irritation sign, had lower base excess, higher lactate, and higher C-reactive protein, and more frequently had comorbid intestinal pneumatosis. Of the eight bowel ischemia surgery patients, four (50%) died, mainly because of anastomotic leak following bowel resection and primary anastomosis (3/4, 75%). All except one patient in Group 2, who presented with aspiration pneumonia, responded better to treatment.Conclusions: Earlier identification and grading of bowel ischemia according to the findings at admission should benefit patients with HPVG by reducing the incidence of unnecessary surgery and increasing the use of safer procedures, such as prophylactic stoma placement.
Personal Social Capital and Self-Rated Health among Middle-Aged and Older Adults: A Cross-sectional Study Exploring the Roles of Leisure-Time Physical Activity and Socioeconomic Status
Authors: Kim Youngdeok , Schneider Tim , Faß Eric , Lochbaum Marc 
Published: September 2020

Abstract
Background: Personal social capital, which refers to the scope and quality of an individual’s social networks within a community, has received increasing attention as a potential sociological factor associated with better individual health; yet, the mechanism relating social capital to health is still not fully understood. This study examined the associations between social capital and self-rated health while exploring the roles of leisure-time physical activity (LTPA) and socioeconomic status (SES) among middle-aged and older adults.Methods: Cross-sectional data were collected from 662 middle-aged and older adults (Mean age: 58.11±10.59 years old) using the Qualtrics survey panel. Personal Social Capital Scale was used to measure bonding and bridging social capital and the International Physical Activity Questionnaire was used to assess LTPA levels. SES was assessed by education and household income levels. Self-rated health was assessed using a single item, by which the participants were categorized into the two groups, having ‘good’ vs. ‘not good’ self-rated health. A series of univariate and multivariate logistic regression models were established to examine the independent and adjusted associations of social capital with self-rated health and to test mediating and moderating roles of LTPA and SES, respectively.Results: Bonding and bridging social capital were positively associated with self-rated health (Odds ratios = 1.11 and 1.09; P’s <.05, respectively), independent of LTPA that was also significantly associated with greater self-rated health (P-for-linear trends = .007). After adjusting SES, the associations of social capital were significantly attenuated and there was a significant interaction effect by household income (P-for-interaction = .012). Follow-up analyses stratified by household income showed that beneficial associations of social capital with self-rated health were more apparent among the people with low and high levels of household income; yet, LTPA was the stronger predictor of self-rated health among those in the middle class of household income.Conclusions: Findings suggest that both social capital and LTPA are associated with better self-rated health; yet, these associations vary by SES. The health policymakers should address both social capital and PA for enhancing perceived health among aging populations but may need to consider varying SES backgrounds.
Low Rates of All-Cause Revision in Displaced Subcapital Femoral Neck Fractures Treated with Hip Hemiarthroplasty - A Retrospective Review of 4516 Patients from a Single Institute
Authors: Yeung Chi-Yung , Tsai Shang-Wen , Wu Po-Kuei , Chen Cheng-Fong , Chang Ming-Chau , Chen Wei-Ming 
Published: September 2020

Abstract
Background: Femoral neck fracture (FNF) is among the commonest fractures affecting the geriatric population. Hemiarthroplasty (HA) is a standard treatment procedure and has been performed by hip surgeons for decades. Recently, primary total hip replacement has proved advantageous for the treatment of such fractures. The aim of this study is to retrospectively review all causes of failure of all patients who underwent HA in our institute and reevaluated whether HA remains a favourable choice of treatment for patients with displaced FNFs.Methods: A total of 4516 patients underwent HA at our centre from 1998 to 2017. The HA implants included unipolar and bipolar prostheses. Patients diagnosed with displaced FNF, underwent primary HA initially, required second revision procedures, and followed up for a minimum of 36 months were included in this study. Data were collected and comprehensively analysed.Results: In 4516 cases, 99 patients underwent second surgeries. The revision rate was 2.19%. Reasons for failure were acetabular wear (n = 30, 30.3%), femoral stem subsidence (n = 24, 24.2%), periprosthetic fracture (n = 22, 22.2%), infection (n = 16, 16.2%), and recurrent dislocation (n = 7, 7.1%). The mean follow-up period was 78.1 months. The interval between failed HA and revision surgery was 22.8 months.Conclusion: HA has a low revision rate and remains a favourable choice of treatment for patients with displaced FNFs.Levels of Evidence: Level III, Retrospective Cohort Study, Therapeutic Study
Adverse events of video capsule endoscopy over the past two decades: a systematic review and proportion meta-analysis
Authors: Wang Yuan-Chen , Pan Jun , Liu Ya-Wei , Sun Feng-Yuan , Qian Yang-Yang , Jiang Xi , Zou Wen-Bin , Xia Ji , Jiang Bin , Ru Nan , Zhu Jia-Hui , Linghu En-Qiang , Li Zhao-Shen , Liao Zhuan 
Published: September 2020

Abstract
Background: A full spectrum of video capsule endoscopy (VCE) adverse events over the past two decades has not been evaluated. We aimed to determine pooled rates, predictors and temporal-trend of VCE adverse events over the past two decades. Methods: Systematic search of PubMed and EMBASE for English-language publications reporting VCE adverse events (January 1, 2000 to March 31, 2019). Data were extracted independently by two investigators. Pooled VCE adverse event rates were calculated using the random or fixed model as appropriate. Predictors and temporal-trend of each adverse event were performed by meta-regression analyses. Results: In total, 402 studies were identified, including 108,079 VCE procedures. Rate of retention, swallow disorder, aspiration, technical failure, and procedural adverse events were 0.73% (95% confidence interval [CI], 0.59%-0.89%), 0.75% (95% CI, 0.43%-1.13%), 0.00% (95% CI, 0.00%-0.00%), 0.94% (95% CI, 0.65%-1.28%), 0.67% (95% CI, 0.32%-1.10%), respectively; incomplete examination rate of esophagus, stomach, small bowel, and colon were 9.05%, 7.69%, 12.08%, 19.19%, respectively. Patency capsule reduced retention rate by 5.04%, whereas known inflammatory bowel disease increased retention rate by 4.29%. Elder was the risk and protective factor for small bowel incomplete examination (0.30%) and swallow disorder (-0.72%), respectively. Rates of retention and small bowel incomplete examination significantly declined over time (P = .0006 and P < .0001).Conclusions: VCE adverse event rates were generally low, and retention and small bowel incomplete examination rates declined over the past two decades. Patients with known inflammatory bowel disease or elder should be alerted to high risk of retention or small bowel incomplete examination (PROSPERO: CRD42019139595).
Development and Psychometric Testing of a Questionnaire to Assess Nurse’s Perception of Risks during Enteral Nutrition
Authors: Feng Ping , Yang Huili , Xu Lan , Omorogieva Ojo , Lu Xiao-yan , Zhang Hai-ying , Wang Xiao-hua 
Published: September 2020

Abstract
Background: Enteral nutrition (EN) therapy is widely used in clinical practice to provide artificial nutrition to patients, while the incidence of adverse events are relatively highly. In the clinical setting, the occurrence of adverse events is associated with the nurse’s risk perception. Thus, using tool to evaluate nurse’s risk perception of enteral nutrition is necessary. Methods: The draft questionnaire with 37-items was formed by comprehensive literature reviews and semi-structured in-depth interviews with eleven nurses. Two iterations of expert consultations were used to evaluate the content validity, and 4 items were deleted in this phrase. A 33-items questionnaire was used to survey 352 nurses from five tertiary hospitals in China from May to July 2019 with convenience sampling. Content validity, construct validity and known-groups validity were evaluated by content validity index (CVI), exploratory factor analysis, and the comparisons of the different EN risk perception levels of nurses at different working departments and different educational backgrounds, respectively. Reliability was tested by internal consistency, test-retest reliability, and split-half reliability.Results: After the exploratory factor analysis, four items were excluded. Finally, the newly developed questionnaire included 29 items explaining 71.356% of the total variance. It consisted of three factors: Risks of operation (15 items); Risks of EN-related adverse events (11 items), and Risks of EN solution selection (3 items). The CVI of the questionnaire was 0.95 and the CVI of items ranged from 0.875-1.0. The results of known-groups validity showed that the nurses with different educational backgrounds had a statistically significant difference of EN risk perception (z = -3.024, p = 0.002), whereas there was not significantly different between EN risk perception of nurses working in different departments (z = -1.644, p = 0.100). The Cronbach’s α, test-retest reliability, and split-half reliability of the questionnaire were 0.967, 0.818, and 0.815, respectively. Conclusions: The newly developed questionnaire for assessing nurse’s EN risk perception showed good reliability and validity. It can be used as a tool for nursing managers to assess Chinese nurses’ EN risk perception ability, so as to help to reduce the occurrence of adverse events during EN implementation.
The technique of 3D reconstruction combining with biochemistry to build an equivalent formula of indocyanine green (ICG) clearance test to assess the liver reserve function
Authors: Zheng JinLi , Xie Wei , Huang Yang , Zhu Yunfeng , Jiang Li 
Published: September 2020

Abstract
Background: The indocyanine green(ICG) clearance test is the main method of evaluating the liver reserve function before hepatectomy. However, some patients may be allergic to ICG or the equipment of ICG clearance test was lack, leading to be difficult to evaluate liver reserve function. We aim to find an alternative tool to assist the clinicians to evaluate the liver reserve function for those who were allergic to the ICG or lack of equipment before hepatectomy.Methods: We retrospected 300 patients to investigate the risk factors affecting the liver reserve function and to build an equivalent formula to predict ICG 15 minutes retention rate (ICG-R15) value. Results: We found that the independent risk factors affecting ICG clearance test were total bilirubin, albumin, and spleen-to-non-neoplastic liver volume ratio (SNLR). The equivalent formula of the serological index combining with SNLR was: ICG-R15=0.36×TB (umol/L)- 0.78 × ALB(g/L) + 7.783×SNLR + 0.794×PT (s) - 0.016×PLT(/109) - 0.039× ALT (IU/L) + 0.043 × AST (IU/L) + 23.846. The equivalent formula of serum index was: ICG-R152=24.6650.382×TB (umol/L) - 0.799 × ALB(g/L) - 0.025 × PLT(/109) + 0.048 × AST(IU/L) - 0.045 × ALT(IU/L). And the area under the ROC curve (AUC) of predicting ICG-R15≥10% was 0.861 and 0.857, respectively. Conclusion: We found that SNLR was an independent risk factor affecting liver reserve function. Combining with SNLR to evaluate the liver reserve function was better than just basing on serology.
The effect of screening and treatment of Ureaplasma urealyticum infection on semen parameters in asymptomatic leukocytospermia: a case control study
Authors: Zhang Qi-Feng , Zhang Yu-Ji , Wang Sheng , Wei Yu , Li Feng , Feng Ke-Jian 
Published: September 2020

Abstract
Background: Ureaplasma urealyticum (UU) infection, as well as asymptomatic leukocytospermia, whether it has effect on semen parameters and whether it needs screening and treatment is still a confusing and controversial topic for clinicians.Methods: Among 1,530 adult males who visited Guilin People's Hospital due to infertility, 295 were diagnosed with asymptomatic leukocytospermia, and 95 were further screened for UU-positive. 81 UU-positive asymptomatic leukocytospermia patients received 7-day or 14-day treatment plan with doxycycline, and 70 cases were cured. The semen parameters of non-leukocytospermia, leukocytospermia, UU-positive leukocytospermia and UU-negative leukocytospermia groups were compared, and the differences between the two treatment plans and the semen parameters before UU treatment and 1 month after UU-cured were compared.Results: Compared with non-leukocytospermia patients, the sperm concentration, progressive motility (PR), and normal morphology of patients with leukocytospermia decreased, while those with UU-positive leukocytospermia performed more significantly. The PR, total motility, and normal morphology of UU-positive leukocytospermia patients were significantly lower than those of UU-negative leukocytospermia patients (all p<0.001). The UU cure rates of the 7-day and 14-day treatment plan with doxycycline was 84.62% and 89.66% (p=0.738), respectively, and the sperm concentration, PR, total motility, and normal morphology of the cured UU-positive leukocytospermia patients were all increased after 1 month (p=0.001, p=0.022, p=0.004 and p=0.008, respectively).Conclusions: It is significant to screen and treat UU infection in asymptomatic leukocytospermia for improving sperm quality. Where appropriate, the 7-day treatment plan with doxycycline may be a good choice.
EQ-5D-3L health state utility values in transfusion-dependent thalassemia patients in Malaysia : A cross-sectional assessment
Authors: Shafie Asrul Akmal , Chhabra Irwinder Kaur , Wong Jacqueline Hui Yi , Mohammed Noor Syahireen 
Published: September 2020

Abstract
Purpose: There is a gap of information describing the health state utility values (HSUVs) of Transfusion-dependent Thalassemia (TDT) patients in Malaysia. These values are useful in the assessment of health-related quality of life (HRQoL), economic evaluations and provide guidance to disease management decisions. The objective of this study was to estimate and derive HSUVs associated with the treatment and complications of TDT patients in Malaysia using the EQ-5D-3L instrument.Methods: A cross-sectional survey using the EQ-5D-3L instrument was conducted between May to September 2018 across various public hospitals in Malaysia. Using a multi-stage sampling, patients diagnosed with TDT and receiving iron chelating therapy were sampled. The findings on the EQ-5D-3L survey were converted into utility values using local tariff values. A two-part model was used to examine and derive the HSUVs associated with the treatment and complications of iron overload in TDT.Results: A total of 585 patients were surveyed. The unadjusted mean (SD) EQ-5D-3L utility value for TDT patients were 0.893 (0.167) while mean (SD) EQ VAS score was 81.22 (16.92). Patients who had more than two iron overload complications had a significant decline in HRQoL. Patients who were on oral monotherapy had a higher utility value of 0.9180 compared to other regimen combinations.Conclusion: Lower EQ-5D-3L utility values were associated with patients who developed iron overload complications and were on multiple iron chelating agents. Emphasizing compliance to iron chelating therapy to prevent the development of complications is crucial in the effort to preserve the HRQoL of TDT patients.
The Immediate Effect of COVID-19 Pandemic on Children and Adolescents with Obsessive Compulsive Disorder
Authors: Nissen Judith Becker , Højgaard David , Thomsen Per Hove 
Published: September 2020

Abstract
Background Obsessive compulsive disorder (OCD) is a distressing psychiatric disorder. Traumas may trigger or aggravate OCD symptoms. COVID-19 pandemic has coursed a global crisis and has been associated with onset of psychiatric disorders in adults. Little is known about children/adolescents with OCD. The present study aimed to examine how children/adolescents with OCD react towards COVID-19 crisis. Methods A questionnaire was distributed to two separate groups of children/adolescents. One group was a clinical group newly diagnosed at a specialized OCD clinic. All the children/adolescents had a current close contact to a therapist or doctor. The other group was a survey group identified through the Danish OCD Association. Most of these children/adolescents were diagnosed years ago, and their primary treatment was completed. For the clinical group, data from patient files was available. Results In both groups, but most pronounced in the survey group, participants experienced a worsening of their OCD, anxiety, and depressive symptoms. The aggravation of OCD correlated with the worsening of anxiety, depressive symptoms, and the extent of avoidance behavior. For both groups, OCD aggressive symptoms predicted a significant worsening. Poor baseline insight showed a trend to predict a symptom worsening. The worsening was most pronounced in children with early age of onset and a family history of attention deficit hyperactivity disorder.Conclusions To our knowledge, this is one of the first studies examining the effect of COVID-19 in children/adolescents with OCD. The effect was examined in two separate populations strengthening the findings. The study points towards an influence of the OCD phenotype, baseline insight suggesting a continued vulnerability, and a family history of psychiatric disorders. Trial registration The study is approved by the Danish Data Protection Agency (1-16-02-147-20) registered 1st of April 2020. Oral and written information was given to parents and patients and written consent from patients over 15 years and parents were received.